A Broad Perspective on Mental Healing

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vii                        THE SCOPE OF PSYCHOTHERAPY                     287
that it is wrong even to contemplate such feelings as hatred or jealousy, the conflict becomes very much more difficult, for here a complicating factor is introduced, namely, guilt at the very presence of these feelings. In the first example anxiety was seen to be caused by the strength of the impulse. Passionate individuals may be quite consciously afraid of losing control of themselves, and doing something they know they will later regret. In the second example, where there was a tendency to try and shelve the conflict there is a double cause for anxiety. Not only does it result from the strength of the impulse, but it also arises from fear of admitting the presence of tendencies, the very existence of which the individual finds hard to tolerate on account of his upbringing. Finally, some people cannot face their primitive impulses at all, and they become entirely repressed from consciousness. Anxiety in these cases is partly a fear of these impulses returning to consciousness.
Cases of phobia, whether of closed space, of travelling by train, or fear of going into an open space, all yield to psychotherapy. Such patients are suddenly seized with violent terror ; they have violent palpitations, sweating and trembling. There is very often pain over the heart, which the patient attributes to disease of that organ. There is also commonly a fear of death during an attack.
People suffering from phobias are sometimes classified into obsessional and hysterical types. The former are the over-conscientious, meticulous, methodical ; while the latter are exactly the opposite. Cases of anxiety depressions respond well to treatment, especially of analytical kind.
Another group of anxiety states occurs chiefly in the middle-aged, where worry, tiredness, aches and pains,