The Value of Neurosis

The Neurologist’s Point of View: Essays on Psychiatric and other Subjects.
by I.S. Wechsler, M.D.
New York, L.B. Fischer,1945. 251 pp. $3.00.

This collection of papers of the last twenty years, by the clinical professor of neurology at Columbia University, breathes a humor, tolerance, and irony that come from respect for the eons of natural evolution and millennia of history and wariness of the cultural conceits of a few decades. The main themes that recur through the book are the potentialities of neurosis in the historical nature and situation of the Jew; scorn for the pretension and mediocrity of the attempts to flatten out mankind into a dull “normalcy”; and evaluation, mainly laudatory, of the work of Sigmund Freud.

Technically, by “the neurologist’s point of view” Dr. Wechsler means the following: as a scientist strictly of the structure and function of nervous and brain tissue, a neurologist must believe that all mental and emotional disturbance has to show physical traces; at the same time, with regard to most patients, in the present state of knowledge it is often impossible to demonstrate such disturbances and almost always impossible to treat the íllness on a physical basis. Therefore the neurologist, or at least Dr. Wechsler, employs the best means at his disposal, especially the verbal techniques of psychoanalysis, but with the mental reservation that this is not strictly scientific and that some day much of the analytic theory will seem like gibberish. (That tissue-traces will progressively become demonstrable is certain; but whether or not they must necessarily become the central feature in the treatment of mental and social disorders seems to me to depend on a philosophical assumption that the doctor does not go into.) What a curious and subtle attitude this is: a pragmatic realism, a skepticism of all words and symbols and anything but observable facts—tolerance, and yet the single-minded aim to reduce everything to what can be seen!

In a certain sense this picture of the neurologist is Dr. Wechsler’s picture of the Jew. The Jew, he says, has lofty ideals as have many other peoples; but only the Jew is at the same time an intransigent realist and will not rest until he has turned the ideal into the historical fact—even when it cannot be done. To this stress of the equal claims of the ideal ego and the realist ego, Dr. Wechsler primarily attributes Jewish nervousness. (The Jews, he says, show a more than proportionate incidence of neurosis but a less than proportionate incidence of psychosis.) The Jew is not satisfied with symbolic satisfactions. But once he is set apart by this trait, he suffers all the mental dangers of the alien: excessive fears, suspicion, sensitiveness, migrations, too quick adjustment to new cultures, clash between the first and second generations, etc., etc.

But lest anyone imagine that the doctor pities the Jew or condemns his earnest conscience, he at once hastens to explain that the neurotic character and even neurosis are the absolute prerequisites for all cultural progress. In this he is explicitly locking horns with the “mental hygienists” who would make everyone perfectly adjusted—the school of Adler and more recently Horney and Fromm. On the “normalcy” of adjustment he pours all his scorn. He says truly that the concept of normalcy must be broadened to include all those who manage to be effective in the social environment—it must include the “sports,” the genius, the artist.

He contrasts Zionism with the Russian experiments in colonizing the Jews. In Russia, he feels, the result is to reduce the Jew to the dull level of a contented peasant; in Palestine he observed, combined with hard agricultural work, the old combative argumentativeness and the book in hand:

Up to now, this mad people had the whole world for their lunatic asylum, and now they are trying to build a little asylum of their own. I sometimes feel that the Jew must remain a little abnormal if he is to survive at all. In the Ukraine there is grave danger that the men of the soil will revert to type and become normal, well-balanced, smug individuals. Fortunately, there is no danger, at least not yet, that the Palestine Jew will cease to be restless and become dull-normal.

It is on this very point of need for individual sports, differences, and conflicts that Dr. Wechsler does not sufficiently understand the message of Sigmund Freud (concerning whom, however, he says some fine things both in appreciation and criticism). Freud would say that, for the emergence of real human values, we must not look so much to individuals and society and their conflict, but we must place more reliance on the resources of original nature, before society has either warped or stereotyped the instincts of children and made them into “individuals” or “dull-normals.” We must try harder to set this original nature free.