THE PLACE OF PSYCHOTHERAPY
THE PLACE OF PSYCHOTHERAPY
PSYCHOTHERAPY AND THE CHURCH
The belief in supernatural energies has cured diseases at all times and among all peoples. Everywhere the patient sought help through the agents of higher forces and everywhere these agents themselves utilized their therapeutic success for strengthening the belief in their over-natural power. The psychologist would say that it was always the same story, the influence of suggestion on the imagination of those who suffer. Yet the variety of forms is abundant. Not only the special symbols but the whole attitude may take most varied character, and every special appearance is intimately related to the whole mystical background and to the religious, scientific, and social ideas of the time. If nevertheless, even at the same time in the same country, very different forms of religious suggestion are at work, it must not be forgotten that those who live together in any nation and are united in many common purposes represent, after all, different stages in the development of civilization. It has always been true that those whose minds are saturated with the real culture of their time are working together with those whose culture belongs to earlier centuries and with others whose minds are essentially of the type of the primitive peoples.
Let us glance at the life of the savages. In darkest Africa, we find a special caste with its professional secrets which accepts new members only after long tests. They are evidently persons with over-sensitive nervous systems and liable to hallucinations. As soon as they have their attacks of abnormal excitement, they are conceived to be agents of superhuman powers, and on account of this they are able to prescribe the cure of any diseases. In Australia, therapeutic power belongs to the koonkie, a man who as a child had a vision of a demonic god. From him he received the power to heal the sick. He goes to the patient, touches the painful parts and rubs them and after a few minutes, he shows a little piece of wood which he had hidden in his hand and which he claims to have extracted from the body of the sufferer. The native feels actually cured after such manipulation of the koonkie, who evidently believes himself in his power. In Siberia, we find shamanism. The shaman stands between man and the gods. These shamans are excitable persons with epileptic tendencies, or at least over-suggestible men or women who by autosuggestion and imitation can bring themselves into ecstatic convulsions. They alone know from the gods the means to treat diseases and their personal influence overcomes the ailment. In early America, before the European discovery, the cure of disease belonged in the same way to the middleman between the gods and human beings. In the Antilles, for instance, the bohuti heals the diseases which are regarded as punishments of the gods for human neglect. The priest by inhaling a certain powder brings himself into an ecstatic condition, then presses the painful organs of the patient, sucks at various parts of his body until he finally produces some little bone or piece of meat which until then he kept hidden in his mouth. The disease disappears, and the extracted bone is used as an amulet which secures good harvests. Other Indians had their piachas. They were selected from among the boys of about ten years old and were then sent to lonely forests where they had to live for years upon plants and water without any friends, seeing only at night the older priests from whom they learned the ceremonies for curing the sick. Here too their art consisted mostly in touching the painful parts of the body with the lips and sucking them to bring the evil saps out of the body by their supernatural power. In short, at the most primitive stages in Africa and Asia, in America and Australia, therapy was acknowledged to be a special power of men who had superhuman forces derived from good or evil gods.
All this repeats itself in the so-called half-civilizations. Among the masses of China, mental and bodily diseases were ascribed to the fox, which plays such a large part in the superstitions of eastern Asia. The priest has the power to banish the fox by mystical writings which he pastes on the wall of the sick-room, and the patient recovers, as the fox has to leave his body. In old Japan the mountain monks, who inherited their superhuman powers from a martyr of the fifth century, can remove the diseases which have magical origin or which are induced by the devil. They also supply the magical papers covered with writings and pictures of birds, to prevent the appearance of smallpox and pestilence and to cure a number of diseases. India, the classical land of suggestion and hypnosis, shows the most extensive connection between religious and magical powers among which the cure of diseases is only one feature. Such cure may be with medicaments or without, but the essential part always belongs to the prayers which make the good and evil spirits obedient to the healer. These prayers were often spoken in Sanscrit, which the people did not understand and which thus added to the mystic solemnity of the procedure. This suggestive influence of the use of older languages for religious solemnities, known only to the priests, repeats itself also at all times and among all nations. In Assyria and Babylonia, too, medicine was exclusively a branch of mysticism and essentially in the hands of the priests, who by words and magical beverages annihilated the influence of the malevolent demons. It is well known how the Old Testament reports the same traits of belief among the Jewish nation. We hear there that Miriam became leprous, white as snow, and Moses cried unto the Lord, saying: "Heal her now, oh God, I beseech thee." And after seven days Miriam was cured in consequence of Moses’ prayer. And again, "The Lord sent fiery serpents among the people and they bit the people and much people of Israel died.—And Moses prayed for the people.—And Moses made a serpent of brass and put it upon a pole and it came to pass that if a serpent had bitten any man, when he beheld the serpent of brass, he lived."
Among the old Egyptians, it was especially Isis who discovered many remedies and had been much experienced in medicine, and after having become immortal, it was her greatest pleasure to cure the sick and to announce the right remedies in dreams to those who came to sleep in her temples. Many who could not be cured by any physician, and who had lost their sight and hearing or could not move their limbs, became well again when they took refuge in her temples. The same holds true for the Serapis temple; even the best known men go there to sleep to get from the goddess cures for themselves or for their friends. It is well known again that in other ways the old Greeks attached medical influence to temples and sacred springs and rivers and tombs. There were sacred springs which cured everybody who drank from them, there were statues which removed every disease when offerings were brought to them. Here again the most frequent is the cure of paralytic symptoms and of obsessions. The Orphic priests of old Greece most nearly resembled the shamans of the savages.
Those who are inclined to give to the life of Christ a rationalistic interpretation have often pointed out that the therapeutic effects described in the Gospels might also be understood as effects of suggestion by word and tactual impressions, produced especially on hysterics, epileptics, paralytics, and psychasthenics. Such rationalistic interpretations could also explain in the same way through the suggestive influence in the minds of the sick, those cures which Christ effected through others without being present himself. Here belongs perhaps the cure of the servant of the centurion in Capernaum or the cure of the daughter of the woman of Canaan. "And when he had called unto him his twelve disciples, he gave them power against unclean spirits to cast them out and to heal all manner of sickness and all manner of disease." The Acts give us the full details of how Peter and Paul cured the lame and how special miracles were performed by their hands. No doubt this belief in the curative effect of the disciples and their successors fills the first centuries after Christ. Eusebius tells us how they healed the sick by laying on of hands. The forms were frequently changing through the history of Christianity but the essence remains the same. Sometimes more emphasis is laid on the personal factor of the priest, sometimes more on the sacred origin of the symbol as in the case of the relics, sometimes more on prayer and godly works, but it is always the religious belief which cures. Typical are the therapeutic wonders of Francis de Assisi. He banishes devils, cures gout, lameness, and blindness. The traditional means of suggestion, prayer and the laying on of hands, had in the meantime been supplemented by the sign of the cross which the church had added. Moreover whatever he had only touched became a remedy for the sick. Protestantism brought no change in this respect. Martin Luther writes: "The physicians consider in the diseases only the natural causes from which a disease results and want to remove them by their medicines, and they are quite right in it. But they do not see that the devil often sends to one a disease which has no natural causes. Therefore there must exist a higher medicine, namely, the religious belief and the prayer through which the spiritual medicine can be found in the word of God."
The broad undercurrent of religious cures, especially in the Catholic Church and in the Greek Church, but with fewer symbols also outside of them, has up to the present time never ceased to flow. But independent of it the therapeutic belief has again and again been focused on certain individuals or certain sects or certain schools, in the midst of the steady progress of scientific medicine and sometimes synthesizing the religious claims with new-fashioned scholarly ideas. In the seventeenth century, for instance, the Irish nobleman Greatrakes became a famous center of attraction. He felt himself to be the bearer of a divine mission and healed the sick, appealing to their belief by laying on of hands and by movements which we nowadays call passes. Much more influential in the eighteenth century was Pastor Gassner in Germany. Gassner succeeded in producing with his religious psychotherapy such a tremendous stir that many thousands who needed cure from functional diseases, and thousands of curious people, too, streamed to his church in Ellwangen, and his methods of cure spread almost contagiously among the ministers of the country: an Emmanuel Church Movement of the eighteenth century. Gassner, too, discriminated between the diseases which have natural causes, that is the organic diseases, which he did not treat, and the functional ones, which were obsessions of the devil. To determine to which group the disease belonged, he ordered the devil to produce the symptoms of the sickness. When in this way the obsessional character of the disease was recognized, the minister began with his suggestive influences to banish the devil. He demanded firm confidence in the name of Christ, reënforced his effectiveness by narration of the cures he had perfected, used further certain manipulations such as the rubbing of the skin and passes on the head, and finally gave his suggestions with authoritative firmness. Many ministers who became his pupils treated like him with skillful combination of religion and hypnoid influences the spasms, catalepsies, neurasthenias, paralysis, and deafness, of neurotic patients.
There is no need to follow in detail the frequent similar occurrences between Gassner’s time and our own. We all know where we are to-day. The medical profession and the medical science with its bacteriology and serum therapy, its Roentgen rays and its organic chemistry is far away from the church and without concession to religious aspects. On the other hand there are the yearly processions of thousands and thousands who make their pilgrimage to the sacred waters of Lourdes, guided by the Catholic priests, half-hypnotized by the hope that the Virgin will cure them. In every niche of the Catholic churches in all Europe, there are kneeling before the burning candles those who pray for nothing but their health; and their belief will sometimes yield almost miraculous cures. In England the Society of Emmanuel was founded by men and women to whom it seemed necessary to bring back to the minds of Christians the undoubted fact that Christ taught and worked for physical heath and to revive this sense of power over disease. Thousands were treated and the results have been "most encouraging." Among the cases successfully treated may be mentioned "one of cancer in which case the specialist called in had given the sufferer only three months to live while by means of the laying on of hands in prayer, a complete cure was effected."
Not dissimilar in its proceedings, though much more elaborate in its metaphysics than this movement in the midst of the Church of England, we find in America the Christian Science movement started by Mrs. Eddy. It was new as a therapeutic system, however old its philosophic elements. Mrs. Mary Baker Eddy writes: "In the year 1866 I discovered the Christ science or divine laws of life and named them Christian Science. God had been graciously fitting me during many years for the reception of a final revelation of the absolute divine principle of scientific being and healing." The disease is cured for the Christian Scientist by the belief in God because a true belief in God includes the insight that God is all reality and that reality therefore cannot include the ungodlike, that is, error and sin and disease. Disease is thus recognized as unreal and if it has become unreal, of course it has disappeared as part of our real life. Thousands and thousands have been cured under this symbol. And as the latest chapter of this history of five thousand years, we find the movement which Dr. Worcester has started in Boston and which, too, spreads rapidly over the continent and awakens the ambition of many a minister in every denomination in the land. The aim is to cure the patient by reënforcing in him through religious persuasion, through the contact with the symbols of the church and with godly men and through religious suggestion, a confident belief which gives new unity and through it new strength to the mind of the sufferer until it overcomes the functional disease of the body. The physician at first examines whether or not an irreparable organic disease has attacked the body, but if he does not find such organic destruction, then the patient is to be handed over to the minister, who will take care that through his religious belief and inspiration the mind will triumph over the weakness of the body.
Whoever looks in this way over the history of mankind can no longer doubt that belief in supernatural powers is really an agency for the overcoming of disease. We may be interested in it from the standpoint of religion or from the standpoint of psychology or from the standpoint of ethnology. In every case we have to acknowledge that he who believes may be cured. If we abstract first from the religious point of view and consider the problem as a scientific one, we have to interpret all those curative effects of belief as results of suggestion. The attitude of the one who gives the suggestion has gone in the history of mankind through all possible variations. He may have been filled with fervent belief, rejecting any interpretation except the religious one, or he may have produced the suggestion of belief almost with the intentions of a physician who simply relies on the physiological effects of any suggestion; and between these two extremes any number of steps is possible. Moreover the suggestion may have been detached from any personality and may have belonged to any symbol of religious energies, like the relics of the Catholic Church. Even the most skeptical of ethnologists ought to acknowledge that very little in this history of religious psychotherapy points to a conscious fraud. Those shamans of the savages from Siberia to South Africa, from Australia to Mexico, are in ecstasies which make them really believe in the mysterious power of their manipulations. The ethnologist finds indeed as most common characteristics of all those primitive movements that those who cure are chosen from among neurotics who by epileptic attacks or hallucinations and obsessions are predisposed to feel themselves as bearers of a higher mission.
Yet whether the attitude of the transmitter is religious or half-scientific, is inspired or insincere, the receiver of the suggestion is always in the same condition: he is believing in his cure through religious influence and through his belief he is helped, if he is helped at all. This uniformity does not exclude the fact that the patients too may show a manifoldness of mental states. They may remain in a completely waking state with reënforced suggestibility, or they may go over into a drowsy or hypnoid state or deeply into a hypnotic state, or may receive the suggestions as we saw even in sleep. Further their minds may be entirely filled with fine religious emotions and the therapeutic effect be only an appendix or, on the other hand, this confident expectation of the relief from pain may be their central content of consciousness and may control the whole mental interplay. The practical problem of the scientist is to consider how far these religious energies ought to be used today in the interests of the cure of diseases.
From a scientific standpoint such a discussion can hardly be fruitful with those who consistently take the religious point of view only. A view of the world which demands the faith that religious belief moves an almighty power to cure a diseased organ, or that the disease has no reality for one who lives in God, is invulnerable to merely scientific arguments.
The sick woman who kneels between the candles before the picture of the Virgin, praying that her heart, which the physicians declare incurable on account of a valvular disease, be cured, moves in a sphere of thought which lies entirely outside of the medical study of causes and effects. The same holds true, for instance, of Christian Science. This statement is in itself no criticism and no argument; it only acknowledges that any possible exchange of opinions has to be carried over from the scientific psychological ground to that of metaphysics and philosophy. It is quite different with modern movements of the type of the Emmanuel Church Movement, where the religious thought is intertwined with the psychological theory and where an actual coöperation of physician and minister is sought. Here church and science really meet on common ground, and it is important to examine objectively whether it is wise and beneficial to encourage the spreading of this tempting enterprise. The movement has reached the large cities between the Atlantic and the Pacific and is beginning to captivate the ministers of the small towns and villages. It seems as if an epoch has come for the church—the church which too long has ministered only to the spiritual needs of the community will at last remember again that Christ healed the sick, that mind and body are one, that the personality must be understood in its unity, and that endless fields of blessed influence may again be opened to the church when the minister becomes the physician of his congregation. Whoever knows the suggestive power of such a social movement, and considers the ease with which triumphant successes may be reached in this field and the disappointing and discouraging reduction of power which the church shows everywhere in its purely spiritual hold on the community, can foresee that all the conditions are favorable for a rapid spread and that the church clinics will become the American fashion of the near future.
It cannot be denied that the Christian church takes in hand there once more a work which belonged to it through centuries. But they were centuries in which the priest was in a certain degree the physician, just as he was the educator and teacher, simply because in the church there was centered all cultural influences which the community knew. The complexity of modern times has for centuries demanded the opposite system. Centralization is allowed only to the purely administrative influence of the state, while all the active functions are divided among specialists. We rely on the expert in education, we demand the expert in medicine: is more gained or lost if the religious leader now again suddenly undertakes a part of the functions which belong to the physician? It is true that the ministers of this school do not propose to undertake the physician’s work to its full extent. They leave to him the first and in some respects most important step, the diagnosis, and abstain from the treatment of such cases as the physician declares inaccessible to psychical influences. They do not heal cancer and phthisis like the Emmanuel Movement in England or like the mental healers in America.
But is not perhaps just this compromise dangerous in another direction, inasmuch as it awakens a feeling of safety in those who feel in sympathy with scientific medicine? They have passed the hand of the physician and believe accordingly that because their illness is recognized as functional, the minister can really perform all that ought to be done. Is this belief justified? At the threshold, it occurs to every one that such a diagnosis by physicians may be erroneous and that the chances for such error are under the conditions of the church clinic much greater than under the conditions of a regular medical treatment. The diagnostician who treats the patient himself has ever new chances to remodel his diagnosis and to correct it under the influence of therapeutic effects. The danger is great that under the proposed conditions, the activity of the physician will be superficial, because he is deprived of his chief means, the constant observation. But we may abstract from this possibility of error. Does the fact that the disease is one the symptoms of which may yield to psychical treatment really make it advisable that the further treatment be handed over to the clergyman? To begin at the beginning, the usefulness of psychical treatment does not at all exclude the strong desirability of physical treatment at the same time. The emphasis which is laid on religious persuasion and inspiration, on prayer and spiritual uplift practically excludes the use of baths and douches, of massage and electricity, of tonics and sedatives. And yet it is not caprice or sham when every well-schooled medical specialist applies such means in the treatment of these so-called functional diseases of the nervous system. The minister applies and can apply only one of many possible methods for cure and yet, if we really want to make use of the resources of modern knowledge, we have to adapt most carefully all possible means to the individual case. If we take the strictly religious standpoint the situation is of course different, but if we speak of psychophysiological effects, we may acknowledge the healing influence of prayer and yet rely in the special case still more on bromide or strychnine. Yet the religious psychotherapists not only neglect the physical help but usually emphasize the antagonism. Some of the strongest supporters proclaim it as a non-drug healing, thus deciding adversely about a medical method regarding which they have no means at all to judge.
Parallel to this neglect of physical theory goes, of course, the neglect of the physical factors in the disease. The physician may have justly diagnosed that the case is "merely" neurasthenia or hysteria and not a brain tumor or paralysis of the brain. Yet that does not mean in the least that a real treatment which remains in harmony with the progress of modern medicine ought to ignore the hundred physical elements which enter daily into the disease. There are the most complex digestive problems involved which demand a thorough understanding of chemical metabolism, there are still more complex problems of the sexual organs which the minister certainly ought not to discuss with his female parishioners, there are bacteriological questions, there are questions of the peripheral nervous system and sense organs; in short, questions which belong to a world into which the minister as minister has never looked. Even if he believes he might gather in an amateurish way some information as to those questions which lie so far from his experience as student of divinity, how can his half-baked knowledge compare with the experienced study of the regular physician? Such physical questions cannot be settled by the preparatory examination of the physician; they come up every day during the treatment and what the spiritual diet which the minister offers may help, may at the same time be ruined by the physical diet about which the minister without chemistry cannot judge.
But let us abstract from the bodily aspect. Is the situation really very different for the mental one? The appeal to the religious emotion, the reënforcement of religious faith is from the religious point of view certainly the one central effort from which everything has to irradiate. The unity of this controlling thought is the glory of such inspiration. But as soon as we handle this thought as a psychotherapeutic remedy, destined to restitute the disturbed psychological equilibrium, it becomes evident that the very uniformity of it makes it a clumsy, inadjustable pattern. If there is anything which impresses the careful student of psychology, it is the over-rich manifoldness, the complexity of mental life. Even the simplest content of consciousness is a tissue woven from millions of threads and any stereotyped influence means crudeness and destruction. The minister’s attitude towards inner life is there directly opposite to that of the psychologist. He cannot enter into those endless interplays of associations and memories, or inhibitions and sensations and impulses, he cannot examine from which remote psychological sources those ideas have arisen, how the feelings become disturbed and the judgments sidetracked. He should not analyze even if he could, because his whole aim is to synthesize. He asks for the meaning and not for the structure, for the aims and not for the elements. His therapeutic effort is therefore not even directed towards a careful rebuilding of the injured parts of the mind, but it is nothing more than a general stimulation to the mind to help itself. By touching on one of the deepest emotional layers of the mind, the layer of religious ideas, the minister gives to the soul an intense shock and expects that in the resulting perturbation, everything will be shaken and may then settle itself by its own energies in a healthful way. It is a fact that that can sometimes happen and under certain conditions the chances for it are even favorable. Under many other conditions the chances are unfavorable and the result does not happen at all.
But whether or not a cure results, in any case it is certainly not an effort which can be said to be in harmony with modern science. The idea of science is always to understand the complex from its elements and to restore the disturbed complex object by recognizing the disturbances in the elements and by bringing those disturbed elements into right shape again. Certainly the psychologist, too, in examining carefully the injured mental mechanism may discover emotional injuries which might be cured by the introduction of religious ideas, but he will not give to them a value different from the introduction of any other ideas and emotions, for instance, those of art and music and poetry, those of social company or civic interest, of travel or sport or politics. Each may have its particular value and to cure every mind with religious emotion would be from a psychological point of view as one-sided as it would be to cure every disturbed stomach by milk alone. Moreover in very frequent cases, for instance, of neurasthenia or hysteria or psychasthenia, such wholesale remedies can form only the background of the treatment, but all the details have to be furnished with reference to a most subtle analysis of the special symptoms, and a particular organic symptom or a particular memory idea or a special inhibition by a well-selected counter-idea will do much more than any great emotional revival.
Stereotyped religious appeal is not only insufficient in an abundance of cases—it must never be forgotten that those who nowadays go to the minister for their health are already selected cases more open to religious suggestion than the average—but can easily be decidedly harmful. Of course that holds true for every physical remedy too, and the judgment of the exact limit is one of the chief duties of the physician. It holds also for the other mental factors like sympathy. A certain amount of sympathy may save a neurasthenic from despair, and only a little more may make his disease much worse and may develop in him a consciousness of misery which makes him a complete invalid. Still more is it true for the religious emotion, from the standpoint of nervous physiology the strongest next to the sexual emotion, that it can be the healing drug or the destructive poison. Everything depends upon the degree of the intrusion and upon the resistance of the psychophysical system. From a purposive point of view there cannot be faith enough, from a causal point of view there can easily be too much of the faith emotion. Religious fervor has at all times helped to create hysteria and to develop psychasthenias. It cannot be otherwise. A group of ideas which has such tremendous power over man must easily be able to produce inhibitions and exertions which become dangerous to a nervous system the constitution of which is pathological. To leave such a dangerous and powerful remedy entirely in the hands of men who by their profession must aim towards a maximum dose of religious influence can certainly not be in the interests of the patients or of the community.
Even the whole technique of this movement awakens the fear of possible harmful consequences. On the one hand we have the movement itself as a popular suggestion for the suggestible masses. The patient who seeks the help of a scientific neurologist hardly becomes a center of psychical contagion, but the church services for the sick offer favorable conditions for an epidemic development of hysterical symptoms. But more important are the influences on the individual patient. The whole purpose of the treatment demands the highest possible degree of suggestibility brought about by the ministerial persuasion. But it is evident that this degree of suggestibility means at the same time the most fertile soil for every chance suggestion and for influences which are perhaps entirely unintended. The physician and the psychologist, considering the mental state with reference to its elements, will make most careful use of those accessory influences. The minister, who necessarily has his spiritual aim in mind, cannot even become aware of all the involuntary influences which reach the mind in its most suggestible state. There can be no doubt that it would often need psychological art to avoid the creation of new pathological symptoms in such half-hypnotized patients. Yet the minister even goes so far as to make use of the sleeping mind without any consideration of the possible damage which may be done to his subject. He goes to the bedside of a sleeping girl and whispers his suggestions and is satisfied when they show their effects the next day. It does not lie in his horizon to consider the grave consequences which such suggestions during sleep may produce during future years in the brain the sleep of which has been transformed into such half-somnambulic relations. Hysterias may be created by such methods. No one can blame the minister for his remoteness from such doubts and problems, but the physician is to be blamed if he encourages the belief that all this still belongs to the proper sphere of the ministerial worker in abnormal psychology.
Those engaged in such work were not long in finding out that the mere emotional inspiration is often no sufficient remedy, and the development went along the same lines in which it has gone everywhere for some thousands of years. Not to disappoint the sufferers, the religion had to become in very many cases simply an inactive side issue and the real cure was performed by the same methods with which any worldly neuropathologist would go to work. If the woman who cannot sleep is cured from her insomnia by being made to listen to the beats of a metronome, it may sometimes be effective, however crude, but it is certainly no longer religion, even though the metronome stands in a minister’s room. The more the movement spreads to those who have no psychological training and knowledge, the more it must be necessary for them to import the whole claptrap of the quack hypnotist and soon the minister may discover that in certain cases physical means and drugs help still better. Thus he simply enters into competition with the regular physician, only with the difference that he has never studied medicine. The chances are great that in his hands even such remedies and drugs may do harm and finally, even if they were effective, is not the question justified: will not religion suffer?
Indeed we have so far considered the question from one side only. We have confined ourselves to the question of how far such a movement is sound for the interests of the patient; but can we be blind to the other side and overlook the not less important problem of whether it lies in the interests of religion and of the church to amalgamate its spiritual work with a medical one? We are not thinking of those widespread, unfair arguments to the effect that this whole movement is undignified because it is instituted by the desire to fill the empty pews or to make competition with the success of Christian Science. That is utterly unjust. But there are intrinsic factors in the movement which interfere with the true aims of religion. First of all it cheapens religion by putting the accent in the meaning of life on personal comfort and absence of pain. The originators of the Emmanuel Movement stand well above such error, but their national congregations do not. Certainly the longing for pleasure and a well feeling and the abhorrence of pain and illness pervades our practical life and keeps in motion all our utilitarian efforts. But if there is one power in our life which ought to develop in us a conviction that pleasure is not the highest goal and that pain is not the worst evil, then it ought to be philosophy and religion. It is only the surface appearance if it seems as if the religious therapeutics minimizes the importance of pain; in truth it does the opposite. It tries to abolish pain, but not because it thinks little of pain; on the contrary, because it thinks so much of pain that it is willing even to put the whole of religion into the service of this strife for bodily comfort. The longing for freedom from pain becomes the one aim for which we are to be religious. In a time which denies all absolute ideals, which seeks the meaning of truth only in a pragmatic usefulness, it may be quite consistent to seek the meaning of religion in its service for removal of pain, and personal enjoyment. But in that case the ideal of both religion and truth is lost. It is finally not less undignified for religion to seek support for the religious belief in effects which it shares and knows that it shares with any superstitious belief on earth. Granted that the church can cure: the shaman of Siberia can cure too, and the amulets of Thibet not less. The psychologizing church knows, therefore, that it is not the value of the religion which restores the unbalanced nervous system; and yet it wants to provide for the spreading of true belief by the miraculous cures which it exhibits.
This situation naturally produces the desire of the church to substitute a religious explanation for a psychological one. It is claimed that after all it is not the mental effect of the prayer, but the prayer itself, not the psychophysical emotion of religion, but the value of religion which determines the cure. Yet in that moment the whole movement in its modern shape comes into a still more precarious position. If the cure results from the inner value of the religion how can we confine it to the so-called functional diseases and abstain from any hope in organic diseases?
Luther, from his religious point of view, still had the right to separate the two groups because only those functional diseases were effects of the devil, obsessions which could be banished by the minister and by prayer, while the other diseases did not result from the devil, but merely from natural causes. Such a definition does not fit into the modern system. To-day from a really religious point of view, both groups of diseases must be acknowledged to be natural or with Mrs. Eddy, as the work of the unholy spirit. Christian Science is indeed by far more consistent. If the cure results through the meaning and value of religion, there is no reason whatever why cancer and diphtheria and paralysis should not be cured as well as psychasthenia. And if, on the other hand, organic diseases cannot be cured because the psychophysical process of the religious emotion has no influence over diphtheria bacilli, then the whole process is removed to the causal sphere and it is acknowledged that the purposive meaning of religion is not in question at all. The whole system of such religious psychotherapeutics is therefore in its inner structure contradictory. It contains causal and purposive elements without any possibility of unifying them. They are loosely mixed, and the power of prayer means on one page something entirely different from what it means on another. In these respects Christian Science is by far more unified and in harmony with itself; its therapeutics is really anchored in a system.
From a scientific point of view, its dangerousness is of course much greater inasmuch as it extends its methods over every organic disease and thus applies merely psychical treatment where from a standpoint of scientific medicine, physical treatment would be absolutely necessary. Moreover its philosophy is after all only a pseudophilosophy; its tempting equations of disease and error and sin and unreality are ultimately a mere playing with conceptions. If we were to point to the root of the misunderstanding in Christian Science, we should say that everything depends on the philosophical commonplace that the objects with which we deal in our life are ideas and that our whole experience is mind. "Christian Science reveals incontrovertibly that Mind is All-in-All, that the only realities are the divine mind and idea." But now silently this mental character of the real world is identified with the mental experience which stands in contrast to the physical experience. There results the impression that physical experience therefore, does not belong to the world of reality. It is evident, however, that mental in contrast to physical means something entirely different from mental in the philosophical sense. In the latter meaning of the word, we all agree that the world is mental; the word mental indicates there that the world has reality not in itself but only as experience of subjects. In the second sense, mental or psychical means that it is experience for one particular subject only and not for every possible subject. The physical thing, for instance this table, is indeed different from my mental memory idea of a table, inasmuch as every possible subject can experience this table while my mental memory image belongs to me alone. The physical table and the mental memory image of it are both equally mental in the philosophical sense, inasmuch as the physical which is object for every possible subject and in this sense not mental is therefore not less given to subjects. Every physical body with its disease is thus in one sense taken as something not mental while in another sense as mental; if we use the same word in two entirely different meanings, it indeed cannot be difficult to demonstrate any metaphysical consequences.
But we do not have to deal here with the metaphysics of "Science and Health." If it is brought down to the concrete application, we stand before the same confusion which characterizes all compromises. Causal effects are sought in a sphere which belongs to purposive values. The psychological effects of the emotion of faith are sought and are misinterpreted as the emanations of religious powers. Religious psychotherapeutics in all its forms seeks to demonstrate to us the triumph of the soul over the body, while in reality it deals only with the mental mechanism which as such belongs to the chain of causal events in the same natural way as the organism. The soul, as spiritual agency in its sphere of purposes and ideals, does not enter the machinery of psychotherapy, and the psychological material on which psychotherapy is applied is not freer and not better and does not stand higher than the material of the bodily cells and tissues. The Emmanuel Movement deserves the highest credit for bringing about a systematic contact between religious faith cure and scientific medicine, but the time in which the minister himself undertook the medical treatment had to be a time of transition. It had to lead to a new relation in which the ministerial function is confined to the spiritual task of upbuilding a mind while the therapeutic function remains entirely in the hands of the physician. Where the physician believes that the psychomedical treatment demands a new equilibrium of the patient to be secured by religion, there the minister should be called for assistance. Psychotherapeutic hospitals would offer the most favorable conditions for such coöperation. But the minister ought to enter even such a hospital with a strictly spiritual aim, and he should never forget that the task of the church stands much higher than the utilitarian task of removing pain from the sick room. But if those psychotherapeutic hospitals will flourish and the physicians will at last make use of psychical factors in their regular practice, they ought not to forget on their part that the important step forward was taken under the pressure of popular religious movements. The ministers first saw what the physicians ought to have seen before, but the physicians will see it more fully and more correctly.