Bell C C
J Natl Med Assoc. 1979 Apr;71(4):361-8.
While the author recognizes the positive impact community psychiatry has had on postpsychotic patients by the uses of medical management and environmental manipulation, he demonstrates that there is a deficiency in the treatment of lower socioeconomic patients with neurotic illnesses. Specifically, neurotic patients tend to be given supportive therapy and psychopharmacotherapy when a form of psychoanalytic psychotherapy would be more appropriate. The author supports these contentions by presenting three cases which have a diagnosis of hysterical neurosis and which clearly demonstrate the economic, topographical, structural, dynamic, and genetic components of the psychoanalytic theory. Finally, as psychoanalytic psychotherapy is too time-consuming, the author suggests that Freud's early psychoanalytic technique of symptom removal by memory recovery be used when appropriate.
虽然作者认识到社区精神病学通过医疗管理和环境控制对精神病后患者产生了积极影响，但他表明，在治疗社会经济地位较低的神经症患者方面存在不足。具体而言，当采用某种形式的精神分析心理治疗更为合适时，神经症患者往往接受支持性治疗和心理药物治疗。作者通过呈现三个被诊断为癔症性神经症的病例来支持这些观点，这些病例清楚地展示了精神分析理论的经济、地形学、结构、动力学和遗传学成分。最后，由于精神分析心理治疗耗时过长，作者建议在适当的时候采用弗洛伊德早期通过记忆恢复来消除症状的精神分析技术。
