But it is certain that in the majority of cases more than this may be accomplished.  It is often a great surprise and relief to a woman to realize that her overconscientiousness, her fussiness, her rebellion, and discontent, her reaction to something or other is back of her symptoms.  She has feared disease of the brain, tumor, insanity, or has blamed her trouble on some other definite physical basis.

If one deals with intelligence, explanation helps a great deal.  The intelligent usually want to be convinced; they do not ask for miracles, they seek counsel as well as treatment.

It is my firm belief that the function of intelligence is to control instinct and emotion, and that temperament, if inborn, is not unchangeable, even at maturity.  Once you convince a person that his or her symptoms are due to fear, worry, doubt, and rebellion you enlist the personal efforts to change.

A new philosophy of life must be presented.  Less fussiness, less fear, more endurance, less reaction to the trifles of their life are necessary.  The aimless drifter must be given a central purpose or taught to seek one; the dissatisfied and impatient must be asked, “Why should life give you all you want?” “What cannot be remedied must be endured!” What a wealth of wisdom in the proverb!  One seeks to establish an ideal of fortitude, of patience, of fidelity to duty,—­old-fashioned words, but serenity of spirit is their meaning.  Suddenly to come face to face with one’s self, to strip away the self-imposed disguise, to see clearly that jealousy, impatience, luxurious, and never satisfied tastes, a selfish and restless spirit, are back of ennui and fatigue, pains and aches of body and mind, is to step into a true self-understanding.

If a situation demands action, even drastic action, “surgical” action, then that action must be forthcoming, even though it hurts.  To end doubt, perplexity, to cease being buffeted between hither and yon, is to end an intolerable life situation.  I have in mind certain domestic situations, such as the effort to keep up in appearance and activity with those of more means and ability.

Sexual difficulties, so important and so common, demand the cooeperation of the husband for remedy.  He should be seen (for usually the wife consults the physician alone) and the situation gone over with him.  Men are usually willing to help, willing to seek a way out.  A neurasthenic wife is a sore trial to the patience and endurance of her husband and he is anxious enough to help cure her.

Where there is conflict of other kinds the situation is complicated by the intricacy of the factors.  Financial difficulties especially wear down the patience and endurance of the partners, and the physician cannot prescribe a golden cure.  In prosperous times there is less neurasthenia than in the unprosperous, just as there is less suicide.

Sometimes it is just one thing, one difficulty, over which the conflict rages.  I have in mind two such cases, where one habit of the husband deenergized his wife by outraging her pride and love.  When he was induced to yield on this point the wife came back to herself,—­a highly strung, very efficient self.