Captain Newman
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162 PSYCHOSOMATICS MARCil-APRIL influencing the basic pacemaker pattern by cen- tripetal autonomic and sensory centripetal im- pulses from the muscles and glands, which is reminiscent of the autonomic nervous system's control of the sino-auricular node of the heart. At the time this book was written there was less interest in understanding psychic energy than there is now with the widespread use of the MAO inhibitors and other anti-depressives. Any- one who is interested in neuro-anatomy and phys- ics will flnd Dr. Colby's book very interesting-, but may also flnd the book difficult, perhaps be- cause of Dr. Colby's own thorough grasp of the basic sciences. As a psychiatrist, Dr. Colby has temporarily departed from the id-ego-superego tripartite sys- tem of Freud in proposing this operational con- cept that embodies a new hypothesis of the mean- ing of psychic energy. Freud himself had once attempted to translate the meaning of psychic energy into a diagram that would also have R. neuro-anatomical meaning, but he was never able to do this to his own satisfaction. Dr. Col- by's attempt does seem to be more meaningful than Freud's earlier attempts, but it must be taken as an hypothesis only, since no one can quite grasp exactly what psychic energy is, just as the mathematician uses the term infinity with- out being able to conceive of it. In the frame- work of this book, psychic energy is conceived of as never varying, either in depression or elation, which is somewhat analogous to the first law of thermodynamics which holds that the total amount of energy in the universe is always con· stant without ever any loss or gain. It would seem that Dr. Colby has cautioned us not to as- sume that there is any relationship between psychic energy and either physical activity or the ability to concentrate. The text presents a rather complex diagram, shOWing the hypothetical pulse pattern rising from the pacemaker and then passing through an unconscious "storage center," where all memory is stored from birth forward. Those pulse pat- terns that have proved useful to the individual in the past are augmented and coordinated, the reverse occurring if the pulse pattern drive has not proved useful. These electrical pulses then are cycled through the only two conscious areas, perception and thought, and then must re-enter the storage centers to record the emotion just experienced. If the pulse pattern emerges coor- dinated and augmented, it enters the motor out- flow tracts and useful activity is begun. As long as the pulses remain uncoordinated, they must cycle again and again through the two con· scious areas, and this is felt as depression even though there may be a normal amount of psy- chic activity. It is hypothesized that this reo peated "spinning of the wheels" in the thought and perception areas eventually weaves the pulse pattern into a coordinated one that may enter the motor areas resulting in a gradual return of normal muscular activity during recovery, even though there may have been no increased psychic energy. In this context depression might be com- pared to a car stuck in the snow where the wheels are spinning. When the wheels have worn the snow away down to firm ground, the car moves off without there being any change in the engine's energy output. In our ignorance about the very nature of psychic energy it is suggested by this reader that we avoid the term itself. To many patients (often those with a psychosomatic illness), a psychic energizer is seen as a "jaZZing up" drug, or if it is labeled as haVing an effect on mood or depression, a certain personal taboo may also be encountered. Such a drug is apt to be rejected or taken irregularly as a result of this psycho- logic rejection. Most people are willing to ascribe an illness to over-work, but not to depression, and it may be wisest not to tamper with this face-saving device. An appeal to the strong, realistic side of the personality is basic in psy- chotherapy, and this principle may well apply to the terminology of psychotropic drugs. A medi- cation given a patient with the implication that he is "strong but overworked" may be more ef- fective than if he is made to feel "weak and de- pressed," and the latter is implied by the pre- scription of a psychic energizer. The use of such terms as psychic energizers and tranquilizers does seem to promote the attitude that the per- sonality is "weak." These drugs might be much more effectively employed if their nomenclature were designed to appeal to the stronger and more realistic part of the personality. Walter EraWl, M.D. CAPTAIN NEWMAN, M.D. Leo Rosten, Harper & Bro••, N. Y. 331 page •• $4.95. The author, a leading social scientist and most versatile writer, has produced a stimulating story of a psychiatrist at an Air Corps base during the war. The doctor, analytically trained, is a "ge- nius at therapy" but a genuine thorn in the hide of his military superiors. Although the book is labeled as fiction, many readers of Psychosomat- ics will qUickly find themselves in their Army Camps. Captain Newman is brilliant and intuitive as a psychiatrist, but shines even brighter as a hu- man being. He constantly reserves the right to have feelings of his own, a role often denied to healers of the psyche. Although accused by non- believers of giving "every feather-merchant and
Transcript of Captain Newman
162 PSYCHOSOMATICS MARCil-APRIL
influencing the basic pacemaker pattern by centripetal autonomic and sensory centripetal impulses from the muscles and glands, which isreminiscent of the autonomic nervous system'scontrol of the sino-auricular node of the heart.
At the time this book was written there wasless interest in understanding psychic energythan there is now with the widespread use of theMAO inhibitors and other anti-depressives. Anyone who is interested in neuro-anatomy and physics will flnd Dr. Colby's book very interesting-,but may also flnd the book difficult, perhaps because of Dr. Colby's own thorough grasp of thebasic sciences.
As a psychiatrist, Dr. Colby has temporarilydeparted from the id-ego-superego tripartite system of Freud in proposing this operational concept that embodies a new hypothesis of the meaning of psychic energy. Freud himself had onceattempted to translate the meaning of psychicenergy into a diagram that would also have R.
neuro-anatomical meaning, but he was neverable to do this to his own satisfaction. Dr. Colby's attempt does seem to be more meaningfulthan Freud's earlier attempts, but it must betaken as an hypothesis only, since no one canquite grasp exactly what psychic energy is, justas the mathematician uses the term infinity without being able to conceive of it. In the framework of this book, psychic energy is conceived ofas never varying, either in depression or elation,which is somewhat analogous to the first law ofthermodynamics which holds that the totalamount of energy in the universe is always con·stant without ever any loss or gain. It wouldseem that Dr. Colby has cautioned us not to assume that there is any relationship betweenpsychic energy and either physical activity orthe ability to concentrate.
The text presents a rather complex diagram,shOWing the hypothetical pulse pattern risingfrom the pacemaker and then passing through anunconscious "storage center," where all memoryis stored from birth forward. Those pulse patterns that have proved useful to the individualin the past are augmented and coordinated, thereverse occurring if the pulse pattern drive hasnot proved useful. These electrical pulses thenare cycled through the only two conscious areas,perception and thought, and then must re-enterthe storage centers to record the emotion justexperienced. If the pulse pattern emerges coordinated and augmented, it enters the motor outflow tracts and useful activity is begun. As longas the pulses remain uncoordinated, they mustcycle again and again through the two con·scious areas, and this is felt as depression eventhough there may be a normal amount of psychic activity. It is hypothesized that this reo
peated "spinning of the wheels" in the thoughtand perception areas eventually weaves the pulsepattern into a coordinated one that may enterthe motor areas resulting in a gradual return ofnormal muscular activity during recovery, eventhough there may have been no increased psychicenergy. In this context depression might be compared to a car stuck in the snow where thewheels are spinning. When the wheels haveworn the snow away down to firm ground, thecar moves off without there being any changein the engine's energy output.
In our ignorance about the very nature ofpsychic energy it is suggested by this readerthat we avoid the term itself. To many patients(often those with a psychosomatic illness), apsychic energizer is seen as a "jaZZing up" drug,or if it is labeled as haVing an effect on mood ordepression, a certain personal taboo may also beencountered. Such a drug is apt to be rejectedor taken irregularly as a result of this psychologic rejection. Most people are willing to ascribean illness to over-work, but not to depression,and it may be wisest not to tamper with thisface-saving device. An appeal to the strong,realistic side of the personality is basic in psychotherapy, and this principle may well apply tothe terminology of psychotropic drugs. A medication given a patient with the implication thathe is "strong but overworked" may be more effective than if he is made to feel "weak and depressed," and the latter is implied by the prescription of a psychic energizer. The use of suchterms as psychic energizers and tranquilizersdoes seem to promote the attitude that the personality is "weak." These drugs might be muchmore effectively employed if their nomenclaturewere designed to appeal to the stronger and morerealistic part of the personality.
Walter EraWl, M.D.
CAPTAIN NEWMAN, M.D. Leo Rosten, Harper &Bro••, N. Y. 331 page•• $4.95.
The author, a leading social scientist and mostversatile writer, has produced a stimulating storyof a psychiatrist at an Air Corps base during thewar. The doctor, analytically trained, is a "genius at therapy" but a genuine thorn in the hideof his military superiors. Although the book islabeled as fiction, many readers of Psychosomatics will qUickly find themselves in their ArmyCamps.
Captain Newman is brilliant and intuitive asa psychiatrist, but shines even brighter as a human being. He constantly reserves the right tohave feelings of his own, a role often denied tohealers of the psyche. Although accused by nonbelievers of giving "every feather-merchant and
1962 PSYCHOSOMATICS 163
malingerer a year's therapy," he proves himselfto be a competent officer rather than a wet nurse.Although gentle, he can be firm; even whenangry he cannot be hostile.
There is humor in this book as well as pathos.Excellent clinical descriptions of psychiatric illness and clear examples of psychotherapeuticskill prOVide an educational experience in themidst of hilarious comedy.
W.D.
THE PRACTICAL APPLICATION OF MEDICALAND DENTAL HYPNOSIS. Milton H. Erickson, M.D., Seymour Hershman, M.D., and IrvingI. Sector, D.D.S. New York: The Julian Press,1961. $12.50.
This textbook is compiled from material presented at the Seminars on Hypnosis conductedaround the country for the past several years.They have been transcribed from tape recordings,revised and edited. These seminars, conductedat the post-doctoral level for physicians, dentists,and psychologists, go into some detail about theinductions and other technics used in hypnotherapy. The authors state that "the full fiow ofconversation has been preserved as transcribedfrom tapes, so that the reader may capture theentire sequence and interplay of events." Fortunately, the authors further state that "seminars and texts can only serve as beginnings inthe training of individuals for the employmentof hypnosis in their specialties. Beyond thatpoint, it is essential for each student to practice,analyze, discuss with others, and gain as extensive and intensive experience as possible. Clearly,no seminar or single text can provide basic training for the internist, obstetrician, gynecologist,anesthesiologist, dentist, oral surgeon, psychologist, or psychiatrist. It is necessary to assumethat each specialist has his basic training andthen to demonstrate methodb and approaches bywhich he can apply his special training to theareas benefited by the employment of hypnosis.Inevitably, the various discussions of problems inany given specialty have overtones that also apply to others. Each specialist who seeks to employ hypnosis is dealing with people and withthe problems of human nature."
This textbook is unique, is well presented, andthe detailed instructions are clearly brought out.Dr. Erickson has been in the field of hypnosisfor many years and has had much opportunity touse it in its many ramifications. The co-authors,Drs. Hershman and Secter, are cognizant of theproblems of practice, and their case records arewell presented.
The eleven chapters: "Outline of History andTheory of Hypnotism," "Suggestion and Hypnotizability," "The Phenomena of Hypnosis," "In-
duction Techniques," "Clinical Applications ofSurgical Anesthesia," "Hypnosis in Obstetrics,""Hypnosis in Children," "Clinical Applications ofHypnosis to General Medicine," "Clinical Applications of Hypnosis to Psychiatry," "Hypnosis inDentistry," and "Hypnosis in Psychology:' showthe scope of this book. One hundred thirty-fourreferences are given.
The volume is well indexed and will be a readyreference to anyone interested in the use of hypnosis.
James L. McCartney, M.D.
TEXTBOOK OF NEUROLOGY. H. Houston Merritt, M.D. Lea and Febiger, Philadelphia, 1959(Second Edition), pp. 765.
The preface to the first edition (1955) pointedup the author's conviction that neurology had"returned to the fold of internal medicine" because biochemical studies offered some promiseto the solution of many degenerative or heredodegenerative diseases. The rapid recent advances in the etiology and treatment of diseasesof the nervous system, especially in metabolicconcepts and correlations, are featured in thissecond edition of a classic in neurology. Mentalsymptoms accompanying organic disease of thenervous system are discussed with the appropriate diseases, but purely functional disease is notconsidered.
The book is divided into ten chapters dealingwith infectious disease, vascular lesions, tumors,trauma, developmental defects, degenerative andheredo-degenerative diseases, diseases due to toxins, metabolic disease, demyelinating diseases andparoxysmal disorders.
Each chapter is complete and considers etiology, pathogenesis, pathology, symptomatology,signs, laboratory data, complications and sequelae, differential diagnosis, prognosis and treatment. The book is profusely illustrated; eachchapter has an excellent bibliography.
This reviewer recommends the book to all whoseek the very latest in neurological advances. Itshould meet the needs of generalists as well asneurologists in search of a comprehensive, detailed review of diseases of the nervous system.
W.D.
CLINICAL ELECTROENCEPHALOGRAPHY. ByL. G. Kiloh, M.D., and J. W. OSMlton. Butterworths, London, 1961. 135 pages. $10.00.
This is a short book of eight chapters produced mainly for the clinician. It is well written,clear and comprehensive. The very numerousillustrations are excellent, and easily understood.
The recording techniques are adequately de-
