General Introduction to the Psychotherapy of Pierre Janet

KARL-ERNST BUHLER, M.D., Ph.D*

GERHARD HEIM, Ph.D.**

This article deals with Pierre Janet's concept of "Psychological Analysis"

(analyse psychologique). It brings out Janet's criticism of Sigmund Freud's
ideas, and delineates the difference between psychological analysis (Janet) a
psychoanalysis (Freud). Further it points out that Janet's theories on th
pathogenesis of neurotic disorders rely on the concept of psychic trauma an
associated fixed ideas. Mental force and mental tension, described in greate
detail, are essential for the pathogenesis of mental disorders. According t
Janet, a significant characteristic of the neurotically disturbed person is
feature that Von Gebsattel calls "Werdenshemmung" ("inhibition of beco
ing"), a state which impairs the life development of the ill person.
INTRODUCTION
Pierre Janet (1859-1947) began his scientific career as philosopher, psycholo-
gist, and psychotherapist before Sigmund Freud and practiced it for longer.
Yet his work has been to a large extent unjustly forgotten as, like many
scientific theories, it did not provide the starting point for a whole new
(social) movement. His work is more matter-of-fact and less speculative
than that of Freud and is well suited as the starting point for the new
formulation of a scientific depth psychology, as is essential for the explana-
tion and treatment of dissociative disorders and conversion disorders.
Janet was a patient and tireless observer. "Psychological Analysis,"
("analyse psychologique"), as he termed his method, aimed at an exact
exploration of both current and past conditions of life and life events, as
well as exhaustive observation and description of behavior.
Janet thus pursued not only nomothetic research, i.e., looking for
scientific laws or regular patterns, but also idiographic research based on
the individual case. He justified this with a psychology for the individual
necessarily arising from practical psychology, which itself proceeds from
generalizations, in order to best serve the individual. This idiographic
approach was pursued by Janet using his method, i.e., psychological

^Lecturer, Medical School of Julius-Maximilians-University, Wurzburg. Matting address: Haafstr.

12; D-97082 Wurzburg, Germany.
**Lecturer, Humboldt-University, Berlin.

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 General Introduction to the Psychotherapy of Pierre Janet

analysis. He regarded this as the essential method for a psychology of the

individual that concerns itself with those characteristics that differentiate
one individual from another. According to Janet, this individualized ap-
proach to psychological analysis makes it impossible to give a definitive and
generally applicable set of rules for the method, as unprecedented changes
and circumstances may always arise. Janet expressed this in the following
words: "Psychological analysis is the essential method for a psychology of
the individual that aims to seek out those characteristic behavioral patterns
that distinguish one individual from another. If this is so, then it is
impossible to describe in a generalized way the rules and methods of a
psychological analysis" (1, p. 369).

BIOGRAPHICAL SKETCH OF PIERRE JANET

Pierre Janet was born in Paris on May 30,1859, and died there on February
24, 1947. After finishing high school, he went to the Ecole Normale
Supérieure, one of the élite schools of France. After completing his studies
there, he first taught philosophy at a grammar school in Chateauroux and
then at one in Le Havre. There he also did voluntary work in a hospital and
engaged in psychiatric research. This research was the basis for his thesis in
philosophy entitled "L'Automatisme Psychologique" in the year 1889.
After a time, he returned to Paris and began, concurrendy with his pro-
fessional and research activities, the study of medicine, which he completed
in 1893 with a thesis entitled "L'État Mental des Hystériques."
This was followed by work in the psychological laboratory at the
Salpêtrière. Janet can be regarded as the founder of medical or clinical
psychology in France. In addition, Janet continued to teach, first in Paris
grammar schools, later at the Sorbonne and, starting in 1902, at the Collège
de France. After completing his medical studies he opened his own practice
and also treated patients at a private sanatorium in Vanves. In this way Janet
acquired great clinical experience.
According to a bibliography of the "Société Pierre Janet" in Paris his
publications comprise 148 monographs and articles in journals (2). In
contrast to Freud's works, very few of Janet's books are translated or
available today (3-7). Nevertheless, in the USA Janet was highly acclaimed
in the first quarter of the 20th century (8, 9). After his death Elton Mayo
published a commemorative book entitled Some Notes on the Psychology of
Pierre ]anet (10). Yet before the publication of Henri F. Ellenberger's The
Discovery of the Unconscious in 1970 (8), Janet seemed practically forgot-
ten. In recent years, a renewed interest in his ideas can be observed,
particularly with regard to his work on posttraumatic and dissociative
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disorders (11, 12), his stance concerning psychoanalysis (13-15) as well as

his ideas on the psychology of action, memory, and personality (16, 17).
Of great significance for Janet's psychology is his conception about
"fixed ideas" or rather the formation of cognitive-emotional complexes.
These can lead to an impairment of the biological basis of mental processes,
causing not only a constricted field of consciousness, but a diminishing
mental synthesis formation as well. In this way, fixed ideas can become
subconscious and, like posthypnotic suggestion, greatly influence con-
scious mental activity.
For Janet, the deliberate auto- or hetero-suggestively induced hypnoid
is a model for dissociative and conversion disorders, that means, the basic
processes are the same in both altered states of consciousness. Presupposi-
tions for the auto- or hetero-suggestively induced hypnoid and for the
dissociative and conversion disorders as well are the stigmata, as Janet calls
them, namely, basic neuropsychological disturbances. Stigmata are, for
example, the disposition for psychic dissociation, neurophysiologically
caused contraction of the field of consciousness, suggestibility, absentmind-
edness, impairment of attentiveness, and conversion, that is, an enhanced
tendency of bodily functions to be influenced by psychic causes. These
stigmata are based on hereditary dispositions and on acquired vulnerability,
but are less operative in persons not reacting to auto- or hetero-suggestively
induced hypnoid. The hypnoid can therefore nowadays, when dissociative
and conversion disturbances are infrequent, be helpful in further research
into these disorders.
Research into hysteria—in modern terminology dissociative, somato-
form, and conversion disorders—plays a large role in Janets works.
According to Janet, all hysterical illnesses arise from fixed ideas, i . e.,
cognitive-emotional complexes that make themselve felt in the form of a
mental automatism.
However, Janet was also concerned with a wide spectrum of mental and
psychosomatic disorders. Even before Freud, he developed psychological
analysis for their treatment, but only as one element of his treatment
approach. Janet can therefore not be described as a psychoanalyst in the
ordinary sense, but rather as an early cognitive therapist who recognized a
deep psychological dimension.
His later work is characterized by a behavioral approach, but less
restrictive than American behaviorism or Russian reflexology of his time.
Instead Janet's concept of "behavior" in his "psychologie de la conduite"
(psychology of conduct) was broader, i.e., included attention, cognition,
emotion, action, and a sociogenetic approach. He developed his concep-
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 General Introduction to the Psychotherapy of Pierre Janet

tion of mental tendencies that form a basis for behavior. These mental
tendencies are ordered hierarchically with reflex actions as the lowest
grade, followed in ascending order by perceptive, social, elementary intel-
lectual, verbal, assenting (actes assertifs), reflective, rational, experimental,
and creative actions (actes progressifs).
As the conception of tendencies demonstrates, Janet had a highly
differentiated behavioral approach. He is also a precursor of life-event
research and can be regarded as a founder of the diathesis-stress model, in
which acute and chronic mental stresses were taken into account.
Unfortunately, Janet, unlike Freud, did not incorporate the rich fund of
psychological knowledge of the French moralists into his nosology. The
reason for this is probably that he did not consider this knowledge to be
sufficiently scientific. Although the moralists were not empirical scientists,
they still based their work on everyday experience, which, though not
scientifically validated, lends it a certain plausibility.
Another argument against Janet is that he paid too little attention to the
individual motivational state of the patients. While generalized motivations
were incorporated into his conception of tendencies, individual wishes and
needs were not sufficiently included.

COMPARISON OF JANET'S PSYCHOLOGICAL ANALYSIS

WITH FREUD'S PSYCHOANALYSIS
Janet continually commented critically on the work of Freud. He accused
him, for example, of using concepts that he himself had introduced without
quoting the source: "they [i.e., the Freudians] used the term 'psychoanaly-
sis' for what I had called 'psychological analysis', they described as a
'complex' what I had termed a 'psychological system'. . . , they regarded as
'displacement' what I had associated with 'constriction of consciousness',
they gave the term 'catharsis' to what I had described as 'psychological
dissociation' or 'mental disinfection' " (transl. by authors; 4, vol.2, p.216).
Barraud, moreover, quotes the following critical comment from Janet:
"The characteristic of this method [i.e. Freud's] is symbolism. Any mental
event can always, when it serves the theory, be regarded as a symbol for
another one . . . from which it follows that any fact at all can be made to
mean anything that one wants" (transl. by authors; 18, p.23).
In Janet's opinion, psychoanalysis is a method of arbitrary and symbolic
construction that appears to be valid if a sexual source of the neurosis has
already been established. As long as this is not the case, it has no scientific
justification, but is based only on an assumption or a philosophical
speculation (4, p.240).
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Janet considered psychoanalysis to be a philosophic system that could

only possibly be of interest to philosophers. However, it claims to be a
medical science with diagnostic and therapeutic consequences. Janet saw
this mixture of scientific disciplines as the reason for misunderstanding
between the followers of psychological analysis (Janet) on the one hand,
and psychoanalysis (Freud) on the other (4, p.251). Elsewhere he remarked
about this problem: "Above all, he [i.e., Freud] transforms clinical observa-
tion and therapeutic method with limited and exact indications into a vast
system of medical philosophy" (transl by authors; 5, p.41).
Janet also differentiated between psychological analysis and psychoanaly-
sis through their different evaluations of sexuality and its significance for
mental disorders. Psychological analysis indeed ascribes great significance
to sexuality in the formation of neuroses, but, in contrast to psychoanalysis,
it avoids pansexualism. Here again is a quotation from Janet: "Instead of
establishing, as all previous researchers have done, that in the case of some
mentally ill patients traumatic memories based on sexual occurences are
present, it [i.e., psychoanalysis; the authors] asserts that such memories are
present in all mentally ill patients without exception" (transl by authors; 4,
p.227).
Janet disputes the view that all mentally ill persons are impaired by
sexual trauma. On the contrary, in his opinion, this applies to only a limited
number of them. Limitation of the ability to experience sexual pleasure was
also for him the expression of overriding mental disorders. But it would be
a great mistake to regard sexual disorders as being fundamental and to see
their origin in earlier sexual traumatization as they are usually only the
expression of, for example, a depression. On the contrary, impartial
observation and empirically inductive experience indicate, according to
Janet, that apparently grave sexual disturbances and the traumatic memo-
ries connected with them result from the disorder itself and cannot explain
it.
Another difference between psychological analysis and psychoanalysis
is seen by Janet in the significance given to dreams in treatment. Dream
analysis as an approach to investigating mental states is not the crux of
Janet's therapeutic efforts, even though dreams provide a window into the
mental state existing parallel to the consciousness of the waking state.
Dream experiences are in a certain way similar to subconscious processes,
in that they are massively distorted with respect to the predominant theme
of the dream as well as to the subconscious processes themselves, since the
theme of the dream has become isolated and independent of other

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thoughts. Janet explains this as follows: "It is simply the dreams that
present us with numerous pictures following one another, without our
being able to steer their course, and which sometimes reveal to us things we
did not think we knew (for example, a latent illness, a particular worry
etc.)" (transl. by authors; 19, p.419).
The concept of the role of the subconscious in dreams is one that poses
many questions, however. One can, for example, ask whether dream
experiences are accompanied by a particular form of consciousness that
differs from that of the conscious waking state.
Janet ascribes no other meaning to dreams than that given by the
manifest dream content and does not take any symbolic content into
account. However, he continually stresses the importance of dreams for
therapy and emphasizes the necessity of taking dreams into consideration
as they contain clues to traumatic experiences that can be directly con-
nected to the illness. Janet considers that traumatic memories are con-
nected to latent tendencies. When these tendencies are aroused they give
rise to dreams in which they are relived and later partly remembered.
Traumatic experiences in dreams appear undisguised in the form of
subconscious memories. Distortions, according to Janet, arise due to a
particular state of mind and functional characteristic of dream conscious-
ness, which differs from the waking conscious state (20, p.31). For Freud,
on the contrary, the dream is nothing else than the realization of a wish that,
for censorship reasons, has been more or less concealed in the waking state,
and even in the dream only appears in a distorted form.
An additional difference to Freud and his school was seen by Janet in
connection with mental trauma. Psychological analysis and psychoanalysis
both take the exposing of traumatic memories as the starting point in the
treatment of neuroses. In Janet's opinion, traumatic memories are con-
nected to other mental states and so occasion certain symptoms of illness.
Psycholanalysis elevates this partial hypothesis to a general principle.
Freud, in a very original way, as Janet conceded, changed Janet's theories
about traumatic memories and subconcious conceptions by generalizing
them in exaggerated form. In acknowledgment of this Janet wrote: "The
systematic generalisation of the unconscious traumatic memory lends this
doctrine [i.e., psychoanalysis] an undeniable originality" (21, p.225).
For Janet, however, these generalizations and exaggerations are not
acceptable. Freud is forced, because of the overrating of psychic trauma, to
assume a primeval suppression in all those patients for whom no actual
adequate trauma can be established.

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MENTAL TRAUMA AND EMOTION

It had been clear for a long time to the early experts in psychiatry that
mental disorders can be caused by intensive emotion, worry or grief arising
from a specific event. Moreau de Tour (1844), Baillager (1809) and Briquet
(1796) were convinced of the pathological influence of worry and emotion.
Janet was also convinced that mental disorders depend to a large extent on
the patients' lifestyle as well as their actual circumstances.
It is necessary to take into account that "émotion" in Janet s sense means
the abnormal "émotion-choc" (shock) as opposed to normal "sentiment"
(feeling). This distinction is important also regarding his later-developed
theory of sentiments (22, p. 329 ff). Throughout this section we refer
exclusively to "émotion-choc."
In addition to predisposing causes of organic or hereditary nature, both
Charcot and later Janet took into consideration mental trauma as a
causative factor for mental disorders. In his lectures of 1884 and 1885
about certain forms of hysterical attack, Charcot succeeded in clearly
demonstrating the influence of emotionally impressive events. For some
cases of hysterical paralysis in which the disorder had developed following
an accident, he was able to show that the emotions immediately evoked by
the accident were not the sole and immediate cause of the illness, but that
one had to recognize that the memory of the accident and the resulting
worries and notional concepts that the patient had also influenced the
course of the illness. The following quotation from Janet clearly shows the
connection between traumatic memory and the course of illness:
As the uncovering of such [i.e., traumatic] memories is of significance for the
understanding and treatment of certain neuroses, one must do everything
possible to uncover them if they are present. However, as it is obvious that such
memories are often missing in other cases of neurosis, which must therefore be
assessed and treated differently, one must be equally careful not to discover
such traumatic memories where they do not actually exist (transi, by authors;
23,p.208).
Janet was a cautious researcher in respect to the diagnosis of illnesses
caused by traumas. In his view the symptoms of the illness are better seen as
the regular pattern of the course of the illness, even in their origin, than as
the result of coincidental painful memories (4, p.263). The symptoms may
only be given an interpretation based on the life history of the patient when
clinical observation makes this seem essential. It must be carefully investi-
gated whether the disorder arose at the same time as the remembered
event, whether there is a parallel development between the disorder and
the memory, and whether in the case in question both components are knit
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together in such a manner that one can change the one by influencing the
other.
Janet warns the therapist against speculative thinking. It is not sufficient
that an event previously had a significant influence in the past, but rather
that this influence still makes itself felt in the actual case, and that the
therapist must, therefore, then take its effect into consideration. These
precautions did not hinder Janet from seeking the cause of the illness in the
past of the patient where no explanation could be found in the present
circumstances. However, a traumatic memory should only be taken into
account when it often recurs in the present and when it causes easily
recognizable long-term exertions that in their turn lead to exhaustion.
In the authors' opinion, childhood traumas have distinctive features
compared to those of adult life. A traumatic event in childhood is of much
greater significance because of the physical and mental weakness of the
child compared to adults, and so remains a more harmful memory in adult
life than it would for an adult who experienced the same traumatic event
when grown up. This hypothesis finds confirmation in optical perception.
Because children see from a different perspective they remember objects as
being larger than they appear when viewed again in adult life. The
constancy of impressions of objects from the past is considerable.
Trauma is regarded as a life event that has produced an emotion of
shock:
A memory only becomes traumatic when the reaction to the event is inappro-
priate; the person concerned was unable or only partially able to assimilate the
event properly because of the inner adjustment of the person to the event,
whether because of a depression already present for other reasons, or whether
because of a depression triggered at that moment by the emotion itself (transi,
by authors; 23, p.289).
An emotion, according to Janet, is inseparable from the causative
mental trauma. What exists, is a chronic emotion, i.e., one that keeps on
reproducing itself unchanged.
Janet developed a complex theory about emotions and distanced
himself from James-Lange 's theory of emotions that regards bodily, above
all vascular, changes as playing a central role in the course of an emotional
reaction. According to Janet, these bodily changes only play one role in the
consciousness a person has of this emotion. Bodily changes themselves the
results of someone's emotions, influence, however, the total impression that
that person receives of this emotion. Janet posits: "A strong emotion has a
destructive effect on the spirit, it reduces the mental synthesis {synthèse)
and produces a feeling of affliction" (transi, by authors; 23, p.457).
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Emotions, according to Janet, cause mental trauma insofar as they must

be viewed as a maladjustment of behavior to a situation. An emotionally
moving event is, in his opinion, an event that a badly prepared individual
cannot completely adjust to, meaning that he cannot overcome the shock
and the subsequent disorder produced by the event. A memory only
becomes traumatic when the reaction to an event is inappropriate. Because
no appropriate reaction pattern had been established beforehand, the
person in question can only resort to older, more elementary, reaction
patterns. Before higher tendencies are formed these older, elementary
patterns normally come into play. These elementary tendencies are charac-
terized by the fact that they are of subordinate importance in the hierarchy
of mental tension, even if they are able to mobilize great mental force.
Because of an inappropriate reaction pattern the individual is unable to
master a difficult situation and has to make great efforts in the attempt to
surmount it. This continual effort produces fatigue or even exhaustion.
According to Janet, this fatigue and exhaustion plays a great role in
neuroses.
Janet regards emotion as a pathogenic state. He sees emotion as a
particular form of exhaustive depression. It expresses a weakness of the
organism that results in the appearance of manifold disorders. Janet
assumes a susceptibility or disposition for emotions. The mental trauma
allows this susceptibility to come to the fore and so favors a progressive
diminishment of mental force.
Symptoms occur in many different forms, for example, as an already
existing depression with other causes, or an immediately arising depression
that can contribute to the patient s inability to adjust wholly or partially to
the event, i.e., a maladjustment of the person to the event.
This energetic view of the etiology of mental illnesses also allows the
possibility that the summation effect of similar or even different mental
trauma can be considered a cause of mental disorder. Mental trauma
usually impacts on an already weakened mental state, adds to this weakness
and favors the appearance of further emotions that again damage the
mental state. The result is a vicious circle of emotions and mental disorders.
Janet describes this vicious circle very vividly: "It is the impending depres-
sion that paves the way for emotional susceptibility and that is without
question strengthened through a new emotion that overcomes the nervous
and mental disquiet of the depression in an avalanche" (transl. by authors;
24,p.221).
The emotions cause the patient to arrive at a state of distraction. They
loosen the mental synthesis and bring it into disorder. The emotions at the
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same time work destructively, in contrast to the will and the concentration
that produce mental synthesis (19, p 143). The destructive influence of
emotions is particularly clearly seen in the case of memory. Janet writes:
"While I was investigating memory changes I was able to establish . . . that
this amnesia . . . often spread over certain of events of everyday life, where
these events were accompanied by vehement passions" (transl. by authors;
5,p.38).
Of particular importance are the changes caused by feelings, such as
fear, fury, and grief, by feelings of insufficiency and by disturbances of
mental functions, that are manifested in the development of "fixed ideas"
whereby the imagination presents the traumatic event in an exaggerated
form. The excessive appearance of unassimilated thoughts upsets the
mental equilibrium. This can additionally lead to a constriction of the field
of consciousness, which in its turn results in an increased suggestibility.
This development reaches its climax in the clinical picture of what used to
be called "hysteria."
The mechanism of a mental trauma can be described in the following
way: the trauma hits a weakened mental state and calls up emotions that
then develop into two different syndromes:
1. In the case of insufficient mental force, the ideas do not become part
of the subconscious and the syndromes do not impair the personal-
ity. For Janet, these syndromes belonged to the group of "psychasthe-
nia."
2. In the case of insufficient mental tension, the illnesses that result
strongly impair the personality and cause the appearance of subcon-
scious concepts that Janet placed in the group of "hysteria."
Janet, as opposed to Freud, relativized the influence of traumatic
memory on the actual course of the illness. His opinion is made clear in the
following citation:
It is often a great mistake to attribute to this or that memory of the patient, even
though it be an emotional one, such considerable influence on present
disorders. Present exhaustion does not always bear any relation to the more or
less conscious persistence of certain memories of the sort. In many cases, the
emotional event and its memory have at the start played an important role for a
certain period. The disorder to which they have led, the bad thought habits,
and the memory do not act upon them.... To insist upon pursuing indefinitely
an analysis of memories is to misunderstand many other elements which play an
important part in mental disorder. (1, p. 370ff)
Janet compares mental illnesses in this respect with infectious diseases,
the disorders of which can continue after the infectious agent has disap-
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peared. A subsequent disinfection can no longer influence the course of the

illness itself or its healing.

PATHOGENESIS OF MENTAL ILLNESSES

Trauma theory assumes paramount importance in Janet's nosology. Accord-
ing to this, the patient does not manage, in response to a difficult and
painful experience, to completely relativate the event in its significance for
his present life and thus making it part of his life story. The efforts to
assimilate are constantly continued because the problem in question has
not been solved. The more or less conscious memory of the event then leads
to exhaustion and results in symptoms of illness caused by the constant
continued drain on mental force through the repetition of the particular
event. The traumatic memories stand in connection with the diminishment,
or lack, of the feeling of success that occurs when difficulties are sur-
mounted. According to Janet, "Traumatic memory is nothing other than a
disturbed feeling of success and of having accomplished something. Pa-
tients suffering from such traumatic memories have gone through none of
the characteristic stages of success; they are constantly trying to gain the
satisfaction of having completed this stage and to finish something that
escapes them" (transl. by authors; 4, p.280).
One should only regard those memories as traumatic that are often
repeated in the present, when they result in easily ascertainable long-term
efforts and when they are of a kind that can lead to exhaustion.
The patient with a fixed idea about a past event does not have an actual
memory of this event in the normal sense, but, according to Janet, a
particular form of memory, "traumatic memory," of nonassimilated events.
The patient is, therefore, often incapable of taking part in a normal
conversation about the event, as is the case with normal memories.
Janet calls mental illnesses, such as neuroses, "functional disorders"
because of their genesis. He noted: "As well as so-called organic illnesses in
which tendencies are completely destroyed in their material foundations
there are functional illnesses in which tendencies continue to exist without
far-reaching changes but where the mental tension needed to make use of
them has undergone grave changes" (transl. by authors; 25, p.950).
The functions build a hierarchy of levels lying over one another. In the
case of neurotic disorders the "higher" functions in question are never
totally and finally destroyed. These higher functions of the brain are subject
to a recurrent autopoetic process. They repeatedly renew themselves in the
same way. Janet also calls neuroses developmental illnesses (26, p 136). The
autopoetic process of development does not, or not sufficiently, take place
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in the case of neuroses. Neuroses can also be traced back to functional

disorders or to an arrest in patients development.
From Janet s point of view, mental disorders are fundamentally "func-
tional," in opposition to "organic" and "genetic" in the sense of genesis as
origin. Lower tendencies escape control through higher tendencies due to
the diminished ability of the brain to synthesize, which means that the
mental tension is not strong enough to integrate them into meaningful
actions. Janet calls this constellation hypotonia. When at the same time
mental force is not impaired, positive symptoms, i.e., automatisms, can
occur under the influence of dissociated tendencies. Behavior becomes,
from the psychogenetic point of view, "more primitive". It then develops
the symptoms of hysteria. Once the mental force is reduced or fluctuates
"negative" symptoms appear: an attempt is made to regulate the mental
tension, but the force available is insufficient for effective action, producing
"asthenia."
A disorder is not necessarily permanently resolved when the psychotrau-
matically induced fixed idea has been dispersed. A vulnerability or suscep-
tibility remains which repeatedly leads to relapses. This higher vulnerability
also has the effect that a new fixed idea can gain strength and reinforce
itself. In this way a new illness begins.
On this basis Janet developed a diathesis-stress model. When the
original experience was very stressing it aroused very strong emotions. In
such a case the emotional fixed idea plays a decisive role. In other cases only
an unimportant emotional reaction can be noted at the start of the illness.
Mental weakness is here of decisive importance, since it leads to labile
mental balance, a diminished mental ability to synthesize, a numbing
("engourdissement") of the associative centers and disturbed functioning
of the sensory centers (19, pp.155,180; 27).
Janet's view of the genesis of mental disorders can be ascribed to the
"disijnhibition theories" already held by writers on neurology of the time,
such as Jackson, von Monakow, Head and Sherrington. However, Janet
confines himself to a psychological version of these disinhibition theories.
With this concept, developed mainly in the twenties, Janet had outlined
a comprehensive framework for psychotherapy, a visionary accomplish-
ment that can, perhaps, be more easily acknowledged today after the
breakthrough of behavioral therapy with its "cognitive" and "affective"
turning point, especially as his functional and genetic psychopathology
makes possible a typology and differentiated indication for therapeutic
intervention.
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MENTAL FORCE AND MENTAL TENSION

Janet assumes an activity through which the tendencies necessary for an
action are organized. To characterize this synthetic activity Janet uses the
term "tension." Tension describes the relation of specific situations and the
behavior called for by them. The quantitive complement of this construct
"tension" is, according to Janet, "force." It can be seen as the relationship
between requirement and available resources, i.e., as motivational strength
at the beginning, at the carrying-out stage, and at the ending of the
behavioral action. In respect to the level of an action, the amount of force is
the necessary condition, the extent of tension the sufficient condition. The
tension of an action is, therefore, a function of force and the level of
development. Their varying relationship to one another or the "balance"
between motivation and action potential is the starting point of Janet s
nosology of disorders.
These terms were first developed in Les Obsessions et la psychasthenic
(28); (a synopsis of this book is available in English, cf. Pitman, 29). His
conception of obsessive-compulsive disorders and their "spectrum," not
the subject of our introductory paper, would deserve an article by itself.
Two factors are important for mental dynamic; mental force and mental
tension. Janet describes mental tension as follows:
Mental tension, to be precise, is the ability to respond to stimuli with reactions
of higher level. There are illnesses that essentially consist in the diminishment
of this tension and the disappearance of higher forms of activity, while baser,
simpler and, above all, older forms of this activity continue to exist or are
strengthened, (transl. by authors; 30, p.32)
High tension occurs when high-level mental functions are carried out
easily and often, a lower tension for functions appears in the lower level of
the hierarchy. Disorders of mental tension occur most clearly in a group of
phenomena described by Janet as "constriction of consciousness." This
reduction of mental tension and mental force reduces the ability for mental
synthesis and causes the disappearance of higher mental abilities, whereby
lower levels and older mental abilities gain greater influence and often
survive in unbalanced and exaggerated form. The different degrees of
intensity of mental tension correspond to the different forms of activation
of tendencies. The activation of a tendency after due consideration is, for
example, one of the highest stages of mental functioning, while the
activation after immediate agreement without reflection is of lower degree.
The reduction of mental force and mental tension are for Janet two causes
for a diminished ability to synthesize and for the outbreak of mental
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dissociation. The causes of this can be found in chronic stress factors, such
as uncertain social status or large debts, but can also be organic factors,
such as insufficient brain functioning, especially of the cortex. Congenital
malformations, growth disorders or illnesses are also seen by Janet as causes
of diminished mental tension. Heredity also plays a role in the form of
family predispositions. All these factors result in a diminishment of the
ability to synthesize. This is the ability that is first disturbed when mental
force and mental tension decrease. This reduction in the ability to synthe-
size encourages mental dissociation, which is the central symptom of
subconscious actions and conceptions.
The diminished ability to synthesize results in the patient no longer
being sufficiently able to adapt to new and unexpected situations, as mental
abilities lower in the hierarchy are resorted to, resulting in inappropriate
behavior. In this connection, Janet talks of a disintegration of mental
connection ("désagrégation de l'esprit") as the result of the diminished
ability to synthesize.
Mental tension and mental force have, according to Janet, a great
influence on the hierarchy of tendencies and their realization. Tendencies
are mental dispositions. Janet writes: "There are modes of behavior with
little mental tension, in which only subsidiary tendencies come into play,
and modes of behaviour with high mental tension, which require tenden-
cies higher in the hierarchy and their complete activation" (transi, by
authors; 31, p. 14).
Latent tendencies require the lowest degree of mental tension. In this
latent state they are not, however, completely inactive. An act of volition, by
contrast, calls for the highest degree of mental tension. The forming of
character depends on different tendencies, on their degree of mental
tension and mental force (32, p.37f).
Emotions exert an influence on those tendencies that were active at the
time of the traumatic experience and lead to their exhaustion. The ex-
hausted tendency is no longer able to develop into the hierarchy of higher
mental phenomena, particularly not in those associated with personal
consciousness. The subconscious fixed idea is the consequence of the
exhaustion, as described above, of a particular tendency. The extent of the
diminishment of mental force and mental tension can be seen in the greater
or lesser number of higher mental functions that are changed or annulled,
as well as their position in the hierarchy of the remaining and the
exaggerated functions.
The chance of recovery is particularly unfavorable in the case of chronic
stress. The repetition of the emotional stress, which alone requires a high
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degree of mental force, greatly increases the loss of energy and causes
ever-increasing exhaustion. Under the influence of mental exhaustion the
attempt to master the situation, which from the beginning was insufficient,
becomes inappropriate and abnormal. This mastering of the situation is
carried out on a low level in the hierarchy of mental functions. It loses the
characteristics of higher activity, is no longer in accord with other reactions,
is no longer a part of the life story that we continually call to memory, and is
no longer an integral part of our personality. The attempt at mastering the
situation gradually becomes an automatic or subconscious action. One can
observe all the intermediary steps from the simple emotional act that
repeats itself over and over again to a genuine subconscious act that
constantly occurs without consciousness or memory.
Changes in mental force and mental tension are the unmistakable
characteristic of mental disorders, e.g., depression (24, p.213). The greater
the depression, the greater the number of reduced tendencies and the
further the disorder sinks to the elementary tendencies. Janet compares
depression to an exaggerated emotion. He sees its cause analogue to
emotion in a stimulus that is followed by insufficient and inappropriate
reactions (23, p.28).
When mental force is too large in comparison to mental tension a
disorder arises that Janet describes as a "paradox of agitation" (33,
pp.49-68). The agitation comprises partly a complete activation of certain
tendencies very low in the hierarchy, partly an incomplete activation of
certain higher tendencies, which, however, still lie under the level of that
which the person could manage. Agitation seems to replace the suppressed
or incompletely formed functions. It consists of a myriad of subordinate
mental functions of low mental tension that replace those of higher
functions that can no longer be realized.
Janet also explains mental derivations as the dynamic between mental
force and mental tension. This occurs when the mental force originally
determined for a higher mental function remains unused. The higher
mental function can no longer be carried out as a result of diminished
mental tension. This unused mental force results in mental derivations on a
lower level of the hierarchy of mental functions (25, p.938).

MENTAL ILLNESS AND PERSONALITY

In addition to mental trauma arising with emotions, Janet considers
personality another influence in the formation of mental disorders. Here
we have a forerunner of the neuroticism concept, which is recognizable in
outline.
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Janet (5, p.l64f) gives a comprehensive description of the personality of

the neurotic patient. We can here only give an overview of the most
important aspects. According to this, mental tension is reduced in spite of
the agitation caused by mental force and stubbornness ("entetement").
Patients cannot carry out any task calling for patience and effort. They do
not know where to begin or where to end. They also do not know how to
deal with the new situation, nor how to make decisions, nor can they take
responsibility for the task. These patients talk the whole time about their
affections and often have an obsession to love someone. One should,
however, not be deceived as they are in reality incapable of real love. What
they call "being loved" is, above all, never to be attacked or in any way hurt.
Those people who appear to love them are those who are at their service.
These patients often take precautionary measures to avoid action and to
avoid being involved in large-scale activities. They restrict their wishes and
avoid acquiring any particular tastes. Almost all of them cultivate a kind of
asceticism that is actually a form of laziness. They like to hide their
personality and to keep their feelings secret.
Janet sees a fundamental characteristic of neurotic patients in a trait that
was very accurately described by Gebsattel (34) "Werdenshemmung" (i.e.,
"inhibition of becoming"). All these patients seem to be impaired in their
life development. They stick fast, as it were, to some obstacle they are
unable to surmount, which can, for example, be the expression of a mental
conflict. The traumatic event puts the patients in a position to which they
must react, i.e., to which they must adapt by a change in their surroundings
or by adjusting themselves. In Janet's words: "What characterizes all these
'frozen' patients is the fact that they cannot surmount the difficult situa-
tion" (transl. by authors; 23, p.271).
Elsewhere he writes: "The patient is stuck at some little difficulty that
life has thrown in his way; he is continually stuck with the same behavioral
pattern that he is not only incapable of carrying out; he exhausts himself in
the attempt. He is constantly running into a wall" (transl. by authors; 23,
p.405).
Lack of adaptibility is a symptom for all these patients without excep-
tion and it results in the majority of their difficulties as well as in mental
exhaustion.
"Inhibition of Becoming" is partly a stable character trait of the
neurotically ill, but also the result of psychotraumatic influences. The latter
cause a reduction of mental force and mental tension through the exhaus-
tion to which they lead, whereby those tendencies and dispositions stand-
ing higher in the hierarchy are disconnected, so that only those lower in the
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hierarchy are available for use. These lower tendencies are characterized by
automatism in their realization. In the case of neuroses, the autopoetic
process of development of the higher functions no longer takes place at all
or else insufficiently. Neuroses can be traced back to functional disorders
or to a standstill in their development. Thus closes the vicious circle of
mental trauma, mental exhaustion, and the personality of neurotic patients.

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