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while the most ignorant, careless, and improvident will continue to behave as they always have behaved" (p. 194).
Now it is of course true that in the past birth-control has tended to work dysgenically for the reasons indicated. But the champions of birth-control may legitimately reply that this method has seldom, if ever, been given a fair chance to act eugenically. This is indeed realized by McDougall himself—as when he very truly says that "in this all-important matter of birth-control the position of America is remarkably and uniquely disastrous. The educated classes seem to cultivate and practise the principles of birth-control more assiduously than any other class of persons of the civilized world, while, mirabile dictu, they maintain laws which forbid the extension of the knowledge of such principles to the mass of the people" (p. 163). It would seem that if this deplorable attitude (upon the psychological foundations of which the present writer has endeavoured to throw some light in the article in this Journal already referred to) could be altered, birth-control might well become the most powerful and at the same time the most simple, humane and inexpensive weapon in the whole eugenic armoury. If only our population could be induced to adopt the principle that no individual should bring into the world more children than he can reasonably hope to bring up healthily and happily, this would create a vast eugenic factor operating throughout the greater part of the social and economic scale. Assisted by sterilization or segregation of refractory individuals at the bottom of the scale and perhaps also by some such measure of positive eugenics as that advocated by McDougall at the top end of the scale (or perhaps only by an alleviation of the burdens imposed by socialistically-tending legislation), such a factor should soon bring about a tolerably near approach to the eugenic ideal, with the minimum of trouble, expense or interference with individual liberty.
That the outlook for the rational adoption of birth-control methods along these lines by the poorer and less intellectual members of society is by no means hopeless is indicated by the results of the propaganda meetings recently held by the Malthusian League in one of the poorer parts of London, where (as the writer can testify) great interest was shown as soon as the mists of ignorance and prejudice-largely the result of the selfishness and hypocrisy of the wealthier classes, combined (one must regretfully add) with the obstinacy and monoideism of the socialists-began to be removed. Some important evidence, moreover, that a change of attitude on this question would really bring about the results here claimed is provided by the example of Holland, the only country where Neo-Malthusianism has met with some degree of official approval a country where the death-rate and infantile mortality has fallen more rapidly than with any other nation, where the physique of the population, as indicated by the examinations for military service, has amazingly improved (Dr Soren Hansen at the Eugenics Congress of 1912 actually asserted that the average stature of the Dutch people had increased by four inches within 50 years) and where there appears to be a marked absence of many of the disturbing social features at present to be found in most other parts of Europe. Under these circumstances it seems a pity that McDougall should not have accorded a more important place to rationally directed birth-control in his suggestions for eugenic reform.
This leads us to the last comment that we have to make before taking leave of this interesting book. In his apparent advocacy of positive eugenic measures unaccompanied by any simultaneous measures on the negative side, McDougall
seems to have overlooked the fact that the adoption of his scheme on a large scale would almost certainly give rise to an intensification of the struggle for existence. At the present moment most countries of the world are overpopulated in the sense that more children are being born than can be adequately fed (with the result that the death-rate in these countries is higher than would otherwise be the case). If there were brought about an increase in the birth-rate of the higher classes without a corresponding decline in that of the lower classes, there would be a still larger surplus of mouths over available food, so that the death-rate-already higher than it should be would inevitably rise. It is true that this rise of the death-rate would be confined almost entirely to the poor, so that McDougall's eugenic scheme would be but little interfered with. But the eugenic improvement would be obtained at the cost of much additional human misery; a result which the most ardent enthusiast for positive eugenics would surely seek to avoid, if any means for such avoidance were available. Such a means is to be found, the reviewer would like to suggest, in the spread of birth-control among the poorer classes (and probably in nothing else).
There are many further interesting lines of thought that will occur to the reader on closing McDougall's little volume. We will only mention three of them without following them up:
(1) The relative infertility of the more cultured classes is, as McDougall himself points out (p. 195), largely the result of the desire for the good things of life that money can procure good things, some of which would, under ordinary circumstances, have to be sacrificed in the event of more extensive parentage. How best can this anti-eugenic tendency be combated (apart from an increase of income for each child, such as McDougall suggests)? Possibly by a clearer realization of the 'decreasing returns' of pleasure so frequently obtained by each additional outlay upon luxuries and by a more thorough understanding of such truths as those brought forward not very long ago by Professor Urwick in his Luxury and Waste of Life.
(2) Does not the increasing difficulty of civilized life, as postulated by McDougall (supposing this to be at all generally true), itself militate against a more extensive parentage on the part of the intellectual members of the community? If the higher professions are such as can only be entered after a long and arduous period of study and apprenticeship, will this not necessarily tend to delay marriage and parenthood? If so, are there any means available for combating this tendency?
(3) Is not this difficulty specially grave in the case of women, with whom the physiological strain of frequent childbirth and the cares of motherhood on a large scale will in most cases be incompatible with the devotion to study, of sufficient time and energy, to enable them to enter the higher walks of life? If so, should we discourage women from entering the higher professions and sacrifice such social advantages as may accrue therefrom-as the positive eugenists would rather seem to imply (in McDougall's Eugenia it is thought desirable that each couple should have from five to ten children)? Or should we be content with a relatively small number of children from such women and rely more upon negative eugenics for our racial improvement (which seems to be the only eugenic alternative)?
It must be mentioned in conclusion that the book contains several appendices in addition to that to which we have specifically referred. Appendix I contains three interesting portraits intended as a commentary on the proJ. of Psych. (Med. Sect.) II
position that all men are born with equal capacities for moral and intellectual development." Appendix II is on "Birth-Rate and the Social Strata" (this we have dealt with incidentally in the course of our review), and Appendix III expounds "The New Plan," as already indicated. Appendix IV is a plea for the registration of family histories and (perhaps as an encouragement to this end), Appendix V a pretty picture of the author's own children. Appendix VI gives a short list of books upon Eugenics-all those mentioned being published in America.
Finally, we can only recommend all those who are interested in the future of the human race to study this eminently suggestive and readable book and to ponder over for themselves the vastly important problems to which it so strikingly and eloquently draws attention.
J. C. FLÜGEL.
The Technique of Psycho-Analysis. By DAVID FORSYTH, M.D., D.Sc., F.R.C.P. London: Kegan, Paul, Ltd., 1922. Pp. 133. Price 5s.
This excellently written small book comes as a refreshing surprise to anyone who has had to handle the type of manual on psycho-analysis which has become so common. The pernicious nonsense contained in some of them on the subject of technique is perhaps the most distressing thing about them; for theory or disbelief hurts no one, but the technique of any curative treatment is a serious matter. Dr Forsyth's small volume, however, is a great contrast to these and will consequently be of real value to the many who are seriously endeavouring to fit themselves to practise this method. Their number and the absence of any adequate means of instruction would alone deservedly ensure it great success; those who know little or nothing about the matter will find in it broad general outlines and many details that will no doubt set them on the right path. It must be said, however, that when they have won their own experience by other paths by being analysed, analysing others, and becoming imbued with the theory and principles laid down by the initiator of this work— we think they will regard some of the views it expresses with surprise.
There is one striking omission which gives a somewhat false perspective to the book as a whole, and this is the absence of any specific mention in it of the 'fundamental rule' of the method. It is in fact alluded to once incidentally, as the rule that "the patient is to speak everything that comes to his mind." But it is not honoured with a bare statement in plain terms on its own account. 'Free association' too is only mentioned in passing in connection with dreamanalysis, where "it is assumed that the reader is familiar with what is meant by it." He may be familiar with the meaning of the phrase; but it would be ascribing advanced experience to the beginner to assume that he is familiar with the importance of it in the work. In analytic treatment the rule is the one and only, but an absolutely necessary, prescription to be given to the patient. Upon the degree to which he adheres to it and upon nothing else depends the success of the treatment; the whole problem of resistance (and therefore, of analysis) is bound up with it. But from reading this book one would not imagine that this rule was anything of fundamental importance. This attitude of the author's is most plainly seen in regard to the opening of the treatment and is in the sharpest contrast with Freud's own view in this matter. In Freud's paper dealing with this1 we find an example of the kind of opening words the analyst should address to the patient before he begins to speak. They deal entirely with this rule and occupy a full page of a large book. A comparison of this with Dr Forsyth's suggestion for the same occasion will illustrate the point. We can only conclude that this is one of Freud's 'discoveries and theoretical conceptions' which have been found 'difficult of acceptance' by the author; it is perhaps the reason why he advises the beginner "to keep an open mind and test the validity of Freud's work." If, however, the beginner does indeed adhere to 'practical observations on patients,' as 1 Sammlung Kl. Schriften, IVte Folge, S. 428.
Dr Forsyth recommends, we believe that the result will only be an everdeepening realisation in him of the supreme importance of this rule; he will discover that it contains the essence and whole secret of analytic treatment and that all other prescriptions are merely accessory to it-indeed, it may be said that the depth of this appreciation is a mark distinguishing the expert from the inexpert analyst.
It is not surprising that we find a corresponding absence in the book of any mention of the 'rule for the analyst' the counterpart to the rule for the patient. In a most important passage1 Freud expounds the way in which the analyst is to employ his instrument-his mind, memory and knowledge—in the work by making use of his own unconscious. But although nearly every other paragraph in this one essay is quoted by the author of this book, he has ignored this essential point which, as Freud says, represents the aim of all the minor prescriptions, gives the key to the analyst's attitude, and explains the necessity for his being himself free from inhibitions.
The absence of any reference to the underlying basis on which the technique is constructed affects the whole book and makes much that the author has to say appear didactic and not clearly worked out. This applies particularly to the section on the analyst, in which great insistence is laid on the important part played by the 'personality' of the analyst, though it is by no means clear what this means. We are told that "the analyst's first duty is to be passive," that "it is for the analyst never to allow his feelings to be played on," that "his own feelings must not become involved," and that "the personality of the analyst is to be kept altogether apart from the treatment"; there even seems to be a contradiction here, for we read that some personal traits are of help and others stand in the way," while the analyst must learn "how to employ his personality with each case that comes before him." We are told most explicitly too that no social relations between physician and patient are permissible during the treatment; but no reason is given for these injunctions. One passage plainly shows the want of clearness in the author's mind on this point; for he says "the fact that the analyst keeps his personality in the background is only likely to provoke the patient's curiosity...to lead him to seize upon every casual remark or action"...and "these side-winds...impede rather than expedite the analysis." There is no explanation of why the analyst must take up an attitude which has this effect. The fact is that it does not actually have this effect, if the function of the transference and resistances is properly understood.
Again, although a passive attitude is laid down as correct early in the book there is much in it which controverts the statement. Numerous passages are written on the assumption that the analyst can actively control the course of the treatment. For instance, we are told that the beginner cannot "go very deep" into his cases and that he should "carry on superficially with two or three cases," while "working hard" at another. We think that any beginner proceeding on such an assumption will not merely learn very little, but will have a great deal to unlearn if he should ever hope to go deep into a case. We are expressly told that an analysis can be conducted "by short cuts and abridgements" (although this is advised against except after long experience); also that "deeper analysis is work for more experienced hands." A treatment conducted by 'short cuts' is not analysis: it implies an active management
1 Idem, S. 405.