Balint: The doctor, Hidden people in the archives, recovery of the past, research into treatment of neuroses in General practice., The importance of archives, the paitent and the illness
‘ … you may be interested to hear something of your book, ‘The Doctor, The Patient and the Illness’… ( Chapman to Balint 19 July 1958).
One of the delights for researchers trawling through archives is the discovery of people who have done their bit for the cause! It may be little more than a brief a letter, or an article: the outcome of years of their own research. Sadly they have faded away, their memories lost in a plethora of documents constituting our archives. It all adds texture and depth to the understanding of past sensibilities. What people thought was important in the past may look very different from the present. Their thoughts and ideas framed within the social unconscious of the period, are also formative of our own. It is one of the reasons why archive retention and preservation is so important. It holds the present accountable. And we need to know how we got to here from there.
I first found the General Practitioner, Dr Herbert Owen Chapman, in the Balint Papers at the British Psychoanalytical Society. He had written a letter introducing himself to Michael Balint in 1958. Balint’s book, The Doctor, the Patient and the Illness had come to Chapman’s attention. He wanted to congratulate Balint and tell him about his own research into the incidence of neurotic illness in Medical Practice. It led me to Chapman’s article, a piece of research into presentations of people with neurotic conditions – emotional distress- in General Practice published in 1953. Based on three years research the article is, I think, one of the first pieces of research into this arena.
Chapman also opens a new doorway for research when, in his introduction, he speaks of his return from Missionary Hospital Work in Central China in 1945 after twenty-five years. It serves to contextualize the life and career of this remarkable man. Owen Chapman joined the Christian Medical Mission and, in 1940 was the Superintendent of the Hankou Mission Hospital. In China, he says, he had developed an interest in neurotic illness and its treatment. He was witness to the 1926 -27 revolution in China, and published a book about China’s history and the influence of the Russian Community Part in 1929. A smaller work examining Church history in China was published in 1968. His article, Neurosis in General Practice, the outcome of three years Locum Tenems work following his return to Australia in 1946, was published in the Medical Journal of Australia dated 12 September 1952.
Born in New South Wales in on 6 February 1884, Chapman qualified in Medicine and, from 1910 took locum tenems work around Western Australia Newspaper articles show he was deeply involved in the Wesleyan church. His brother, Burgoyne Chapman and father, Benjamin Chapman were also significant figures in the Methodist Church. Owen joined the Army as a Medical Officer during the Great War and was discharged after an admission to hospital for ‘Sinusitis’. He departed for China in 1920.
Chapman’s research into the treatment of neurosis in Australian General Practice extended over three years from 1947 to 1949. It included 23 different locum assignments in thirteen new practices. Ten other terms were re engagements. Some practices were large and wealthy, he wrote. Others varied in size and financial stability. He covered inner city practices, rural and coastal practices as well as mining and industrial towns. The duration of the appointment ranged from seven days to thirty one days. A total of 213 cases were considered.
Chapman observed the difficulty of finding time in a busy practice to put patients at their ease so as to engage their trust sufficiently to explore underlying issues. However most of the active cases ‘were not buried so deeply’, nor was the resistance strong, although cases of where the condition had a sexual origin were difficult to reach. ‘But the most startling difference [lay] in the duration of the cases’. Where classical psychoanalysis determined treatment to be over several years, this was impracticable for medical practices. Chapman found that many people had a positive response to treatment based on Carl Rogers six to fifteen weekly contacts. Longer cases, usually treated by psychoanalysis, were often more severe.
Chapman was critical of medical training which offered little on the theory and practice of psychotherapy. In part this was due to a generalized fear of psychiatry in the community. DF Buckle had also noted that as a result the burden of treatment had fallen upon psychologists, teachers, social workers and the patient’s families. Neurotic illness was, Chapman, continued, ‘the greatest therapeutic problem confronting us today, whose final solution must remain for future years and a new generation of medical practitioners and statesmen’. There could be a beginning, now. He urged the development of psychiatric training, and for non specialists, experience in psychiatry. Such practitioners needed to be ‘introverts’, sensitive to and keenly interested in the human aspect of their practice. He recommended reading such as Freud’s Interpretation of Dreams, Ross’s Çommon Neuroses‘ and Rogers’s “Counselling and Psychotherapy“, as well as for more advanced practitioners, Alexander and French’s “Psychoanalytic Therapy”.
This is a thoroughly researched piece Chapman sought to show the importance of this field of medical practice, concluding, hat it was but a beginning. He hoped there would be others who would take up the ideas and thoughts he was expressing. Balint’s book, The doctor, the patient and the illness clearly resonated for him.
H Owen Chapman to Michael Balint, 19 July 1958, Balint Papers, Archives of the British Psychoanalytical Society.
H. Owen Chapman, The Chinese Revolution, 1926–27: A Record of the Period Under the Communist Control as Seen from the Nationalist Capital, Hankow. London: Constable & Co., Ltd. 1928.
H Owen Chapman, Neuroses in General Practice. Medical Journal of Australia, 12 September 1953, pp. 407-415.
H Owen Chapman, The second Reformation; a historical study: With a foreword by C. P. FitzGerald and a postscript by Keith Buchanan, Sydney, Times Press, 1968.
AMONG THE NEW BOOKS (1929, January 26). The Methodist (Sydney, NSW : 1892 – 1954), p. 4. Retrieved June 20, 2021, from http://nla.gov.au/nla.news-article155297565