The patient’s reaction to psychological approaches will help the physician differentiate between a mental disease that stems from a somatic disease and one that stems from bad practices, etc.
If the mental disease is not yet fully developed and if there is still some doubt as to whether it arose from somatic suffering or whether it stemmed from faulty upbringing, bad habits, perverted morality, neglect of the spirit, superstitions or ignorance, the way to decide the point is as follows:
1. If it stems from the latter [faulty upbringing, bad habits, etc.], then the mental disease will subside and improve with understanding, well-intentioned exhortations, consolation, or with earnest and rational expostulations.
2. If it is a mental or emotional disease that is really based upon a somatic disease, it will rapidly worsen with such treatment. The melancholic patient will become still more downcast, plaintive, disconsolate and withdrawn; someone who is maliciously insane will become still more embittered; and senseless talk will become obviously more nonsensical. 192
192 In such cases where understanding and exhortations, etc. aggravate the mental or emotional disease, it appears as if the soul of the patient feels, with exasperation and sadness, the truth of these rational expostulations and acts directly upon the body as if it wanted to restore the harmony that has been lost; but it appears as if the body, by means of its disease, reacts too strongly back upon the mental and emotional organs, throwing them into an even greater uproar through a renewed transference of its sufferings upon them.