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PSYCHOLOGY AND PSYCHIATRY



BY SHEPHERD IVORY FRANZ




4P.












UNIVBBSITY of CALIFORNIA

AT

LOS ANGELES
LIBRARY



[Reprinted from THE PSYCHOLOGICAL REVIEW, Vol. 29, No. 4, July, 1922.]



PSYCHOLOGY AND PSYCHIATRY 1

BY SHEPHERD IVORY FRANZ
St. Elizabeths Hospital, Washington

In the past a number of papers have dealt with the
topic assigned to me. With their special views and argu-
ments I shall not concern myself beyond pointing out some
of the difficulties that have arisen either because of them
or as provoking them. Psychiatrically, some of the writers,
not all in the distant past, have identified psychology with
one or more psychologists with whom they have come in
contact, sometimes in person but usually through their
writings. With the psychological views expressed there was
no sympathy, since they were considered to be one-sided,
or they were thought to show evidence of gross ignorance,
or the wording produced anger and was supercilious or
overbearing. The psychologist, on the other hand, has
sometimes tried to make the term psychiatry synonymous
with the ideas and the behavior of one psychiatrist whose
superficiality was recognized by his professional confreres,
but whose 'holier than thou' attitude or whose expressions
of superiority have incited the psychologist to sarcasm, abuse,
denunciation, or pity. In some cases, it is apparent that
the physician, jealous or fearing lest some of his licensed
prerogatives, or lest some of his assumed functions might
be encroached upon, or that others might develop a clientele
of potential financial value, has set himself upon a pedestal
of supposed knowledge of the whole mental and physical

1 Paper read before the American Psychological Association, December 29, 1921,
as part of a Symposium on Psychology in its Social Relations.

241

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242 SHEPHERD IVORY FRANZ

life and character of the individual. He has charged the
psychologist with incompetency in dealing with people,
because the latter has not taken the trouble to graduate
from a medical college, and because he is not willing to
accept uncritically all that the particular psychiatrist be-
lieves. The criticizing psychologist, on the other hand,
wonders how the physician acquired his supposed superior
knowledge of mental phenomena when his medical training
of about 4,000 hours comprised instruction in psychology
and psychiatry amounting to about 60 hours or less.

Similar personal verbal encounters will doubtless recur
and with the same result as in the past. Each of the com-
batants will have shot at the other without making a hit,
and the only difference between such a discussion and a
French duel is that after the duel the combatants fall upon
each other's neck and kiss. Up to the present time, so
far as my knowledge goes, most psychiatrists as such will
not kiss a psychologist, nor will most psychologists kiss a
psychiatrist as such.

The criticism of individual psychiatrists or of individual
psychologists may be a necessary and often a commendable
performance to prevent an undue exhibition of what the
Freudians call a homo-sexual trend, viz., egotism. Such
criticisms, unless the individual recognizes and accepts his
temporary position as a patient who is being psychoanalyzed,
may be amusing for the spectators, but in the words of
the comic supplement "it don't mean anything." Further-
more, the generalization from one case is a recognized method
of unscientific procedure which should have no place in
either medical or psychological literature.

This is the first point of importance. Let us recognize
and remember that there are all degrees of psychiatrists
and all degrees of psychologists, that there are differences
in specialization as well as in amount of knowledge a man
may have, that some of each group are positively ignorant
and that others are negatively learned, and that blatancy,
obstinacy, intolerance, puerility, and quibbling are neither



PSYCHOLOGY AND PSYCHIATRY 243

characteristic nor absent because of the occupation or title
or self-advertisement of the individual. Let us, therefore,
confine ourselves to the subjects psychology and psychiatry,
and to the psychologist and the psychiatrist in general, and
exclude the individual.

Psychiatry is much more easily defined at the present
time than is psychology. The facts or conditions that con-
stitute the field of psychiatry are more generally accepted
than those of psychology. The psychiatrist is by etymo-
logical derivation a mental healer, he is concerned with
the cure of those who exhibit 'variations from their usual
or normal way of thinking, feeling, and acting.' In practice
he also usually deals with feeblemindedness, which is not
a deviation from the individual's normal or usual, but a
continued or a continuing state. Psychiatry, like other
specialized divisions of the practice of medicine or surgery,
is an application of facts and principles to certain practical
problems dealing with the diagnosis, with the treatment or
care of patients, and with the prevention of pathological
conditions.

It would be presumptuous for me to try to harmonize
the conflicting views of the professional psychologists at
this time respecting the definition, the scope, and the methods
of psychology. It would not be bravery, but unthinking rash-
ness, to attempt to decide between the obviously opposing
views, to decide which is pure and virtuous and which is
improper and evil and corruption. I respect the introspec-
tionist's severe individual in the nun's drab habit, I look
with pleasure on the ballet dancer of Miss Calkins's 'True
Behaviorism,' I see beauty in the Miss Psychology clothed
by Warren in the fig-leaf costume, but I also approve what
others may call the brazen nakedness of Watson's 'Physio-
logical Behaviorism.' I can see, however, that while the
garb is of some importance, more to others than to me,
the fundamental is the same. Regardless of the outward
coverings, psychology is and her beauty or ugliness is de-
pendent upon the eye of the beholder. She may be described



2 44 SHEPHERD IVORY FRANZ

in terms of brass instruments, or measurements of time and
space and energy, as mental science, as behavior, as the
study of psychical processes, or as the science of the facts
or content of experience, but in every case there is meant
what historically and popularly has been known as mind.

With two of the parts or divisions of psychology we must
concern ourselves. These are abnormal psychology and
pathological psychology or psychopathology. It is these
two fields, their relations and dependencies, which give the
clue to so many of the disputes of the past, and which if
properly understood should bring about a much better under-
standing between psychiatrists and psychologists.

The field of abnormal psychology can best be understood
in terms of the distribution curve. We define the normal
as that which is near the average or the medium, and con-
versely we define the abnormal as that which deviates greatly
from the average or the median. Such a definition can be
applied to the individual's sense endowment, to his mental
processes, to his behavior in relation to his environment, or
to social activities. It carries no teleological meaning. It
does not say that the things we speak of should have a cer-
tain extensity, or intensity, or speed, or number. It does
not define the thing in terms of 'should be/ or 'might be,'
or 'ought,' but solely in terms of 'is.' Abnormal psychology,
therefore, deals with the extremes, with the hypernormal
traits and individuals, as well as with subnormal activities
and combinations of function. The distinction has been
drawn that pathological psychology and patho-psychology
stress the psychological .aspects of the thing under consid-
eration, while psycho-pathology stresses the pathological
character. All three terms, however they be otherwise
differentiated, involve the concept of disease or disorganiza-
tion which prevents proper (not the usual or average or
the median) function. Normal in contradistinction to patho-
logical means the desirable or the necessary. An individual
who shows an intelligence quotient of 20 is abnormal, and
he may also be pathological. One who passes the Army



PSYCHOLOGY AND PSYCHIATRY 245

Alpha with a perfect score of 212 is also abnormal,, but not
probably pathological. The man of 80 who retains the
intellectual vigor which he showed at 40 is abnormal, but
decidedly not pathological. He who at 80 exhibits mental
deterioration shows only what more than 90 per cent of
individuals of that age show, but he is certainly pathological.

Psychiatry, as an art or an application of science looking
towards the cure of those who are mentally diseased, bears
the same relation to the underlying science of psychology
as any other technical application bears to its fundamental
science. Psychiatry has relations, however, to many funda-
mental sciences and not alone to psychology. It must take
from pathology, from physiology, from chemistry, from
bacteriology, and from a host of other sciences what it
needs to bring about the desired ends, in treatment or cure,
and in prevention. It does need the fundamental facts of
psychology, those of sensation and perception, those of
action and the will, those of feeling and emotion, those
of character and personality, and those of the mental life
of the child and of the adult. Regardless of the attitude
one may take with respect to the value of dissection as
giving facts of functional or use value, it is true that one
must know the names, colors, and textures of the parts
of which a complex machine is composed before one is able
to speak of the spatial, temporal, and forceful relations of
the parts.

And it is in just this direction that psychiatry has taken
a peculiar slant. Anatomy, physiology, chemistry, bacteriol-
ogy, pathology, are thought to be necessary preliminaries
to the understanding of certain bodily functions with which
the psychiatrist must deal, but the psychiatrist usually denies
the necessity of understanding the methods and the results
of psychology in relation to mental things. Because in a
technical psychological journal an article appears which
his previous education, or rather lack of education, has not
fitted him to read with understanding, he considers the
modern laboratory psychology to be futile and entirely
unpractical. For him and his work it has no meaning.



246 SHEPHERD IFORY FRANZ

But, why should it convey a meaning to him? Is it
possible to get for one's work the meaning of chemistry
or of physics without special training and study? Is it
necessary to assume that psychology and its methods should
be simplified to the extent that the reading of an intro-
ductory text is all sufficient for the understanding of the
details of research? To the last question psychiatry has
answered vociferously "Yes," but to the former question
psychiatrists are forced to answer meekly "No."

The difference in attitude is understandable when one
knows something of the history of medicine. We need
consider only one analogy, that of chemistry. The value
of chemistry in medical practice has long been recognized,
but the advances in chemistry since the time when it was
an almost exclusive medical discipline have been numerous
and varied. These advances have been due to the develop-
ment of a group of chemical specialists whose interests have
not centered on the diagnosis and treatment of the sick,
but solely in the discovery of new facts of a chemical order.
There have also developed a group of specialized medical
chemists the physiological or biological chemists with
divided medical and chemical interests, who are the go-
betweens or the mediators. They cull from the researches
of the silica chemist, from those of the organic chemist,
from those of the physical chemist, and from those of other
specialized chemists what appears to be applicable to the
work and welfare of the body, and they apply this knowledge
in their own specialized laboratories. After the intermediary
steps have been taken, the results are given to the physician
to further apply. A similar division of labor and the steps
towards partial application exist between most of the other
fundamental medical sciences and the practice of medicine,
with the notable exception of psychology.

Theoretically, and to a certain extent practically, abnor-
mal psychology and psychopathology intervene between
psychology and psychiatry, but as intermediate kinds of
technology with groups of workers they do not exist. A



PSYCHOLOGY AND PSYCHIATRY 247

few are engaged in the fields bordering upon both psychology
and psychiatry. Without laboratory training some psychia-
trists consider themselves psychopathologists, and there are
few psychologists who have adequate training in first-hand
acquaintance with the different kinds of abnormalities in the
mental diseases.

A psychiatric criticism of psychology that has had vogue
is that the psychologist as an analyst has dissected the mind,
and metaphorically cut, mounted, and examined it through
the microscope, but that he has devoted little or no attention
to the interrelations and importances of the things the
psychiatrist has seen and described. Because of this psy-
chology is said to have no value in psychiatry. I am quite
willing to grant the validity of the conclusion, but I object
to the argument. I am quite willing to admit at the same
time and in the same sense that anatomy, histology, physi-
ology, chemistry, physics, and bacteriology have no value
in psychiatry. The analyses made in these scientific pur-
suits have only indirect values. The workers have not, and
are not expected to have, direct interest in the advancement
of psychiatry. It is the right of the psychiatrist to take
what he will, or to have it adapted to his own use by an-
other. But even though all of the facts may not be of
equal value, and even though we may admit that the ana-
tomical facts of a psychological kind are not equally valuable
in the care of the mentally diseased, it is true that some
of them must be known and understood. While the analogy
is not to be followed out completely it may be said that
the psychiatric attitude towards analytic psychology is much
the same as that of many drivers of automobiles towards
their machines. A few obvious gross details are all they
are willing to admit to be necessary for the running of a
machine. The places where the feet must be placed, the
hands and water and gas, are apparently all that are needed
for the operation of the machine in health. It is when the
car will not work that its behavior is then described in
terms of depression, dissociation, repression, egocentric reac-



248 SHEPHERD IVORY FRANZ

tions, regression, and the like. So far, so good, but more
anatomical knowledge is needed before the car can be placed
in running order. Its anatomy, as well as its physiology,
must be partly understood. The reason for some of the
common disabilities, such as flat tires and the like, may
be learned from a casual anatomical examination, but in
those cases in which the driver does not know the difference
between the vacuum tank and the magneto, his ability to care
for the machine is greatly reduced. When the engine coughs,
spits, and stops, the symptoms point to inadequate food
supply. But they may also be due to other physiological
dissociations. If the psychiatric driver does not know more
than that the machine has a kind of catatonic reaction he
may spend hours on a lonely road trying to locate and remedy
the trouble.

Conversely, the psychologist who knows the weights,
the sizes, the shapes, the colors, and the intimate composi-
tions of the parts of a machine will not infrequently find,
after the pieces have been laid out and measured, that
putting them together again is a task of a different order.
He may discover many apparently superfluous parts.

Psychology is, however, becoming more and more dy-
namic, even in the psychiatric sense. More effort is being
made to understand interrelations and dependencies, just as
in present-day anatomy it is no longer deemed sufficient
to describe and classify but to use the facts to illustrate
functional relations. But even though psychology become
entirely functional or dynamic, there is no reason to assume
that the facts or explanations can be carried over bodily
into psychiatry. There must be, in the same way as between
anatomy and medical practice, close connecting links. It
is here that, in different senses, abnormal psychology and
psychopathology belong. They are psychological-psychia-
tric intermediaries.

In psychology the deviations are of interest because
exaggerations and diminutions frequently point out relations
that are not obvious in the normal. From the standpoint



PSYCHOLOGY AND PSYCHIATRY 249

of psychology it makes no difference whether or not the
abnormality be associated with a pathology. In psychiatry
the important thing is the combination of phenomena point-
ing to disease types, or giving indications of prognosis or
treatment. Because in both psychology and psychiatry a
knowledge of abnormalities and of pathological conditions
are of value, more and more investigations must be made
if advances are to be expected. It is here that abnormal
psychology and psychopathology find their work. They will
serve to benefit both psychology and psychiatry.

Extreme enthusiasm for a cause and an excessive damna-
tion of what is believed to be opposing that cause are charac-
teristic of the fanatic and the reformer. During the past
few years there has been an exaggeration of one aspect of
psychopathology psychoanalysis which in certain quar-
ters of psychiatry has produced a reaction against psychology
and which in certain psychological quarters has produced a
reaction against psychiatry. But this is the history of many
scientific advances. To counteract the many forces advo-
cating cults it is important that both psychologists and
psychiatrists study and keep in mind the mental epidemics,
and recognizing their virulence and their usually short .dura-
tion, take scientific hygienic measures to preserve their own
mental health and stability. This will best be accomplished
when there are more psychological psychiatrists and more
psychiatric psychologists, as well as more real abnormal
psychologists and more real psychopathologists.



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Online LibraryShepherd Ivory FranzPsychology and psychiatry → online text (page 1 of 1)