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healers. Many accepted their fate, others went for advice and comfort to
their religious leaders. Only a small number, mostly from the higher
and more educated strata of society, went to a psychiatrist or psychoan–
alyst, and only when they suffered from severe, incapacitating neurotic
symptoms. Even today the great majority of people who look for some
kind of help do not seek psychoanalysis, but rather some kind of
therapy, and for most of these people, psychoanalysis would never have
been considered the right choice of treatment for their needs.
There is, of course, a close relationship between neurosis and
society. The changes in our society have transformed the pictures of
neurosis. One of the fundamental ideas of psychoanalysis has been the
inevitable conflict between man's instinctu al drives and the demands of
civilization. This concept is basic for an understanding of mental
health: the conflict has to be tolerated to such a degree that a reasonable
level of adaptation is achieved-one is considered healthy if one is able
to adjust to the environment without impairment of personality,
without suffering too much from the unavoidable daily frustrations of
civilization, and if one is able to make use of the possibilities of the
surrounding culture for instinctual satisfactions and sublimations and
for the development of one's individual character. The evolution of
civilization shows ever-changing attempts to find a balance between
human drives and the restrictions necessary for social cohesion. Cultur–
al periods differ great ly in the help they offer the individual in
reconciling his conflicts with society, in aiding him to find drive
satisfaction, mechanisms of defense, and channels for sublimation.
The chances of developing a tolerable balance of inner conflicts and at
the same time adapting to society's demands are obviously not the same
in differen t epochs .
In 1923, Freud gave us a picture of the interrelationship between
neurosis and culture in his paper "A Neurosis of Demoniacal Posses–
sion in the Seventeenth Century." The content of this man's neurosis
was rooted in the cu ltural and religious background of his time, the
universal belief in God and Satan; religion helped him eventuall y to
overcome his affliction.
Today we know that cultural changes can occur within a very
short period. Most conspicuous in the field of psychiatry is the
disappearance of certain hysterical cases, those patients whom Charcot
demonstrated when Freud visited the Salpetriere and who are not seen
any more (or only very rarely in patients brought up in unusual
circumstances).
It
is seldom pointed out that these very changes in
hysteria have confirmed strikingly Breuer's and Freud's idea that the
symptoms resulted from repressed sexual desires and experiences. The
