The therapeutic personality, as illustrated by Paul Federn and August Aichhorn.

Abstract

This paper is the result of a casual remark made at a presentation of Paul Federn's ego psychology to the s:taff of Philadelphia State Hospital in .September :[956. The writer said then that Federn's personality may have contributed to his success in treating psychotic patients, while Freud's different personal approach to these patients might explain his pessimism about their treatability. I t is a fact that not a few of Freud's followers were surprised at how little Freud cared about treating people with severe mental illness and how very doubtful he was that they could be treated at all. He "did not exclude ''1 the po.ssibility that eventually a modified method would be fo.u~d f~or treating psychotics; yet when Federn and others, notably Hollos, asked for his active support of their efforts, he shielded himself behind old age and illness--for Freud, hardly real reasons. So.me of those close to him felt that he was always more interested in the research aspects of his work than in healing and helping. This attitude is also apparent in his writings. If one further considers that the result of mental illness is impairment of abstract thinkiag and flattening of individual qualities, it can easily be understood that psychotic patients hardly present the intellectual challenge of neurotics. Similarly, the dissocial person appears to be untrustworthy and a liar. Freud had no use for weak characters, anyway. Neither the delinquent nor the psychotic was the intellectually interesting patient whom Freud alone considered the o.nly worthwhile .candidate for analysis. But delinquency and psychoses are, .at least in Federn's opinion, diseases of want; those who suffer from them must receive mental nourishment before one can reason with them. One must compare Freud's attitude with Federn's unending devotion and even sacrifices for the treatment of psychotics--insignificant as their individual per,sonalities may have been--to give full weight to, the difference between Federn's a~d Freud;s views .on treatment of the psychoses. This, in short~ was the essential idea be-