rpart in
the abnormal lack of energy and lack of attention. The patient--and it
is especially the neurasthenic patient--has lost his usual strength, he
shrinks from every undertaking, he cannot decide upon any action, he
needs a disproportionate effort for the smallest task, and cannot
concentrate his attention in spite of his best will. The varieties of
this lack of power and inertia are familiar to every physician. They
certainly often need much more than merely psychotherapeutic treatment,
although on the physical side no schematic method is admissible. The
laziness of the anaemic needs a different treatment from the laziness of
the exhausted but in every case psychological factors can be of decisive
influence, whatever the physical and chemical treatment besides them may
be. A few letters may again illustrate the varieties. Here again there
is no sharp demarcation line between the normal and the abnormal.
Letters like the two following, for instance, are hardly letters of
patients. They show a variation which is still entirely within normal
limits and yet a source of suffering; it is a disturbance which usually
can be removed by psychotherapeutic means.

"I do almost everything with effort, nothing spontaneously. I have
been writing for five years but am a mood writer of the worst type.
The mood comes at such uncertain times that I seem to be absolutely
at the mercy of caprice. This might not in itself be a misfortune
but writing is my only calling and I suffer the proverbial torments
of lost spirits when I am idle. The necessity of driving myself to
every piece of work, aggravated by the fact that my parents allowed
my constitutional inertness to have full play, has hitherto
prevented me from forming any regular habit of labor. I am now
thirty-eight. Would you suppose that if I kept my nose to the
grindstone for one, two or three years, I might yet hope to work
with some ease and regularity? That is, if I compelled myself to
write a certain number of hours every day as a discipline,
regardless of the quality of matter I produce, is there any
probability that I might ultimately overcome the fearful paralysis
that so often grips my faculties? Can constitutional indolence be
overcome by determination? I put in a little time on a couch every
day. When worried I get neurasthenia and all kinds of phobias. Just
now I am afraid t