(4) The language of the psychiatrist is unique and formidable.  The names he has applied to motives and impulses, to symptoms and syndromes, are foreign to the tongue of the general practitioner who is so awed by them that he withdraws from them and remains humbly reticent in a state of enomatophobia; or, if he be more tough-minded, he may be amused by, or contemptuous of, what he refers to as “psychiatric jargon” or “pseudoscientific gibberish.”  There is, furthermore, a dearth of concise, authoritative, well-written text-books on psychiatry, and the general medical journals rarely print psychiatric papers designed to interest the average practitioner.  The most widely diffused psychiatric reports of our time are the sensational news items of the daily press.

(5) The overemphasis of psychogenetic factors to the apparent neglect of important somatogenic factors by some psychiatrists has tended to arouse suspicion regarding the soundness of the opinions and methods of psychiatric workers in the minds of men thoroughly imbued with mechanistic conceptions and impressed with the results of medical researches based upon them.  The ardor of the psychoanalysts, also, though in part doubtless justified by experience, has, it is to be feared, excited a certain amount of antipathy among the uninitiated.

(6) The fears of insanity prevalent among the laity and the repugnance of patients to any idea that they may be “psychotic” or “psychoneurotic” (words that, in their opinion, refer to “imaginary symptoms,” or to symptoms that they could abolish if they would but “buck up” and exert their “wills”) undoubtedly exert a reflex influence upon practitioners who put the “soft pedal” on the psychobiological reactions and “pull out the stop” that amplifies the significance of any abnormal physical findings.

(7) Psychotherapy, to the mind of the average medical practitioner, is (or has been) something mysterious or occult.  He uses much psychotherapy himself but it is nearly always applied unconsciously and indirectly through some form of physical or chemical therapy that he believes will cure.  He is usually quite devoid of insight into the effect of his own expressed beliefs and bodily attitudes upon the adjusting mechanisms of his patients.  Conscious and direct psychotherapy is left by the average practitioner to New Thoughters, Christian Scientists, quacks, and charlatans.  If he were to use psychotherapy consciously and were to receive a professional fee for it he would feel that he was being paid for a value that the patient had not received.  A highly respected colleague once privately criticised a paper of mine (read before the Association of American Physicians) on the importance of psychotherapy.  “What you said is true,” he remarked; “we all use psychotherapy but we are a little ashamed of it; and it is better not to talk about it.”  Even he did not realize that every psychotherapy is also a physical therapy.