PROCESSES OF "SPONTANEOUS" RECOVERY FROM THE PSYCHONEUROSES
IAN STEVENSON M.D.1
1 Department of Neurology and Psychiatry, University of Virginia School of Medicine, Charlottesville, Va.
1. Several independent studies of untreated psychoneurotic patients have shown that between 40 and 60% of such patients recover within a few years of the first observations of their conditions. Treated and untreated patients probably recover through the same processes which include and require the learning of new behavioral responses. We have some evidence that treatment which emphasizes the practice by the patient of new behavioral responses in periods between his therapeutic sessions will shorten the number of interviews required and possibly the total duration of the illness.
2. Examples are given from some 20 cases of spontaneous improvements or recoveries derived from observations or reports of patients, experiences of other persons, or published accounts of such recoveries.
3. The following circumstances or processes seem to facilitate recovery from psychoneuroses: (a) desensitization through recall, verbalization and assimilation of past painful experiences; (b) desensitization through association of painful experiences with new pleasurable experiences; (c) increased supplies of respect, reassurance, and affection; (d) entry into the patient's life of new models of behavior; (e) occurrence in the patient's life of new situations requiring different behavioral responses; (f) shifts in motivation brought about by fear, shame, or desperation.
4. Further study of so-called spontaneous recoveries from mental illnesses may teach us much more about experiences which prove valuable to patients. From this we may learn more about what we need to do to assist patients to recover more rapidly than they would without psychotherapy.
