SAMPLES OF SOCIAL THERAPEUTICS
1. _Order in social treatment_
The principles of linkage embodied in the work of the home visitor, in
her cooperation with doctors and other social workers, and in good
history-taking which avoids the fallacies of the catastrophic point of
view, take on a little more impressiveness when we consider what a
widely general law that "linking-up" law is. It is the essence of
science; indeed, it is the essence of things still wider, for it is the
essence of order.
There is an old phrase that "order is heaven's first law." It certainly
is an impressively universal principle. How universal this linking-up
process is, and how it applies to all possible situations medical and
social, can be made to stick in our memories by the phrase, "_In view of
this, what next?_" This is a prosaic and unimpressive-sounding dictum;
but with some trivial and some important illustrations I can show that
it is really useful.
1. A terrier dog is watching a rat-hole: in view of this, what next?--a
question full of importance for the dog and for the rat.
2. A cobbler is working on his shoe: in view of what he has already done
upon that shoe, what shall he do next? The value of the shoe, the value
of the cobbler's working time, depend upon his seeing truly, and then,
in view of that vision, doing whatever is next called for by the
conditions of the shoe which he is dealing with.
3. As we go down the bill of fare of a restaurant, we say, "In view of
what I have eaten, what next?" Presumably there is a method, an order in
our madness.
4. We may have known, in the course of our lives, a few people who, when
we ask them a question, think before they answer. These are the people
who habitually say to themselves, "In view of this question and of the
truth which I should speak, what words should issue from my lips?"
5. The whole science of logic is the science of seeing truly: in view of
certain premises, what is next? What follows and must follow, if we are
to be logical.
6. Anybody who has got to a certain point in his profession says, "In
view of my successes and my failures thus far, what is the next thing
for me to do?" One can say the same, and I imagine that most people have
often said it to themselves, in relation to friendships: in view of my
present affection or dislike for that person, what next? We have come
through the world's most gigantic war: in view of this, what next?
7. I tried to exemplify this principle also in our medical and social
history-taking. Our histories should be orderly. There is a thing that
rightly comes first and a thing that, in view of this, should come next.
8. When the musician composes or plays, he is guided in the writing-out
or in the instrumental expression of his musical idea by his
consciousness of the whole piece--what is done and still to be done. "In
view of this whole," he asks himself, "what notes come next?"
9. When a man prays he says to himself, "In view of my sins and of God,
what next?"
It appears, then, that the most trivial and the highest things that go
through the human mind, if they go right, follow that formula, because
it is simply a way of putting truth in order, and because order is as
fundamental to a human mind that is working right and not wrong, as
anything can be. The catastrophic point of view, on the other hand, is
the point of view of disorder, the belief that things happen "as the
result of accident," come upon us without order, were never in view
beforehand, occurred for no known reason.
The _principle of order_ is also closely knit to the principle of
independence or integrity, which we want to achieve in social work when
we give. Physically we want the person to be independent, not depending
upon a drug, not needing to be jacked up by a stimulant, not dependent
as a sick man is dependent, on nursing, special diets, and long rests.
In the economic field we try to avoid making a person depend on a
crutch, a support, a pension, which atrophies his economic powers
instead of developing them. At least we desire not to weaken them. We
want to give and build, to give something that will go on by itself to
make him independent of us.
But independence is not altogether a good phrase. No human being, linked
up in a world-order as we all are, is ever independent. What we mean by
that not altogether satisfactory phrase is that we want to be dependent
only upon something that we can rely upon, only upon permanent, central,
orderly powers of the universe. Physical independence does not mean
independence of food or of rest; one soon comes to the end of his tether
if one attempts such independence. Dependence means hanging. We must all
hang. But we want to hang upon something that will not let us down, upon
food, air, warmth, exercise, rest, such as are always available in an
orderly life, or should be.
So in the economic field, no man is economically independent or ever
will be. But we want his powers knit into an orderly system that is not
dependent upon a protective tariff, on somebody's whim who pays his
salary, or on political "pull." We want people to be independent in the
sense that they get their living by connection with a well-ordered
economic system. Even then, of course, we are not independent. A planet
may run into us and we shall then be wrecked in spite of the fact that
we are not dependent upon charity or a protective tariff.
Obviously literal independence is also impossible in moral and personal
relations. We are never independent of society, never capable of going
it alone. The only question is, On what do we depend? Do we depend on
one person, or one particular kind of entertainment or stimulation? Or
can we find our food in any of a vast number of places and persons which
in the natural order are fairly sure to be available? Or in the absence
of all finite persons can we find our food in God? That is the
fundamental question in relation to personal independence. Its answer
states the degree in which our personal history is orderly and not
catastrophic.
If one is habitually trying to order his own life in this way, the
principles by which he lives will guide his attempts at social treatment
and give him continuity and steadiness.
2. _Presence of mind in social treatment_
All our diagnostic duties, whether as doctor or social worker, are part
of our search for truth, physical, economic, mental, and moral, as the
basis for medical-social treatment. I have used again and again the
figure of chains, each of them starting with the individual's present
misfortune, need, or sorrow, as a central link, and radiating in
different directions as we trace out the relevant physical and economic
facts, the chain of the patient's relationships to family and friends,
some of whom he is apt to forget, and finally the chain of mental and
moral causes which lead up to the present moment. I believe in that
method with all my heart. I also believe it can be employed so
one-sidedly, so exclusively, as to spoil social work. The criticism of
social work which recurs most often and most justly, I think, is that we
are not human enough, not big enough people to do social work, that we
have not vision, that we get into mechanical and routine methods which
spoil the whole adventure. I know that this is true. We fail because it
is difficult for us to drive in span two strongly contrasted ideals only
one of which I have yet laid great stress on. Truth and the following
out of the links of truth, physical, economic, etc., is a process which
we might call looking for the _background_ of the fact that presents
itself close to you. We need to see that background. We must not get our
perspective distorted. It is the doctor's commonest fault, that he sees
only the disease that is just now before him, and nothing of its
"background," economic, mental, or moral. Hence he does not make a
fundamental diagnosis or prescribe fundamental treatment.
We need in our dispensary work to _find truth_. Yes; but we need to
_find joy_ also in our work; we need to see the _foreground_. We do not
want to have attached to us the stigma and the weakness which we think
of in professional work. We are accustomed to believe that professional
philanthropists find no joy in their work, which they do as a matter of
routine, for pay, without vision and without a sense of the unexpected
and momentary values which are precious.
The process of tracing chains, of looking off and away from the
patient's present pain, sorrow or poverty for its causes and relations,
tends to make us look over the head of the present fact. We all know
people who always look over our heads when they talk, and we know how
little they get into touch with us. We must not stare into the physical,
economic, or mental background so constantly or so fixedly that we
cannot see the present fact before us. That is preoccupation. I have
often accused myself and my assistants of going about their work with a
care-worn air, because we are thinking so much of the fine, helpful
plans which we are making and the truths which we are going to discover,
or of bothersome details which we have not got round to finishing up.
But we shall do no good in the long run unless we enjoy our work. There
may be some professions where a man or a woman can be of use who does
not draw joy from work, but certainly social work is not such a
profession. We have with Stevenson the duty of happiness:
"If I have faltered more or less
In my great task of happiness,"
--What are we to do? We must wake up--
"Lord, Thy most pointed pleasure take
And stab my spirit broad awake."
We are not awake. We are half asleep, dreaming over our plans, our
worries, our visions. That is why we are preoccupied; looking over the
head of the immediate fact, we miss the amazing beauty of face, word,
and character tempered and enhanced by suffering.
Much as I hate the fault of never going beyond the fact that we see
before us, I hate just as much the opposite error of not getting the
full vision of the foreground. We ought always to be able to feel, at
the end of any single home visit, that we have done something,
accomplished something. Well: one of the things that we must make every
effort to accomplish, and to feel ourselves a failure if we have not
accomplished, is to find and to give pleasure, to enjoy ourselves, and
if possible to give a little courage. The little embellishments of our
work, the smile, the tone of voice, the jokes and courtesies of our
fleeting contacts with individual patients, should be just as precious
to us as any of our far-reaching plans and deep-plunging attempts to
study into cases. How poignantly, how intensely Christ put this to us in
saying that inasmuch as we did any good thing unto the least of his
brethren we did it unto Him! I believe that He meant this not only of
human beings, but of days, of moments. The least of these opportunities
is infinitely precious and we are making a grievous mistake if we do not
take it so.
I have known a few social assistants who make each little deed and each
little moment a perfect work of art in itself. Art at its best this work
is. It was my greatest single experience in 1917-18 to admire the French
art for finding joy in little things, and of making beauty in little
things. I asked recently a group of Americans what they had found the
most admirable in their contact with the French people. Everybody
present had had the experience of finding in his own hotel or _pension_,
a _femme de chambre_ or some other domestic who, though starting to work
at five o'clock in the morning and working until late at night,
nevertheless always kept joy or the appearance of joy in her work. On
the first night that I was in Paris I went with a friend to dine at a
restaurant very late. There was but one waitress, who had nearly
finished serving an enormous number of people. She ought to have been
near the end of her day's work, which our arrival prolonged still more.
But I never can forget the welcoming look and tone with which she said
to us, "Now I shall have the pleasure of serving _you_."
We need the artistic spirit, the spirit of beauty in social work. It is
not opposed to, but surely very different from, the spirit of science
which I have been emphasizing in the earlier chapters of this book. I
must confess my impression that, on the whole, thus far, social work has
been ugly. Social workers have not kept beauty and the sense of beauty
in the foreground of their work. Beauty and joy always tend to drop out
in social work, but this must not be. There is an old story of an
inspired social assistant in Boston who had been working for a long time
with a needy family who were at that time much discouraged. One day she
had an idea: "What that woman needs is a blue dress. She is
extraordinarily fond of that color. She has not had a new dress for a
long time." And it was true. She was given a blue dress, and the
history of that family afterwards began to show signs of the sort of
change and upward constructive effort which had long been lacking. We
cannot neglect that sort of thing, slight or sentimental though it may
seem.
I remember another family in which flowers, and money spent on giving
the children a chance to grow flowers, played a beneficent rôle; and
still another discouraged family in which a canary bird seemed an
essential element in the social work done.
There is something certainly very divine about the present moment. We
shall never have it again. We are apt to think that next year we shall
do something great. Then, we think, at last we shall gather up all the
forces of our soul and do something worthy. But I do not believe we can
tell ourselves too often in social work that _now is the time_, and that
the opportunity of the present moment is priceless.
Hence, after trying to exemplify the backgrounds which we ought to seek
out when a fellow being comes to us in trouble, I must now correct that
overemphasis by paying homage to that state of mind which sees
foregrounds. What we want is _presence of mind_--a very familiar and
hackneyed phrase, but one which may grow precious to us after analysis.
My complaint against the preoccupied, solemn look in the social worker's
face is that the person's mind is not there with his fellow beings; it
is aloof with his own troubles. He is not "in it," not all there on the
spot. The necessity of joy in one's work, and the necessity of seeing
the momentary and infinitely precious opportunities, come to the same
thing. If you are "in it," you get _your chance_. To have sufficient
presence of mind to seize one's chance is surely the crucial act in
social work or anywhere else, for that chance does not recur.
But presence of mind connects itself with an interesting fact in our
grammar about the _present tense_. The present tense, in contrast with
past and future tenses, expresses presence of mind, attention to the
wonder of the moment, the opportunity of the moment. But it also
expresses a wholly different thing, namely, the _eternal_. Some
languages have an eternal tense and use it about facts that are not
present or past or future. We use the present tense for the eternal. Two
and two make four. When? Well, not of course at ten minutes before
twelve on the 11th of November, 1918, more than at any other time. We
might just as well use the future tense. Two and two always will make
four. But by a peculiar accident we have hitched on to one tense the
whole body of eternal truth. _Why did we hitch the eternal to the
present rather than to the past or to the future?_ Because anything that
we really grasp now, as truth or as joy or as beauty, anything that we
really comprehend, can be eternally ours. In the physical sense it is
so. The electric light that I am now looking at and which might be
turned off at any moment, is eternal, for its vibrations are travelling
off through space and always will be. The fact that those vibrations
are going off through the ether is ever the same.
Any present fact, then, so far as we realize its truth or its wonder, is
eternally ours. Hence presence of mind is the quality needed in social
work to balance the scientific habit which looks for past and future,
for what is not present. Investigation and history-taking must always be
completed by _appreciation_, the other half of our mental life, which is
acutely conscious of the present and therefore can be conscious of
eternity.
I hope I have not put the contrast of science and art in social work so
sharply that it seems as if one must take one extreme or the other. I do
not feel any such contradiction. I believe that we can get courage for
the long, discouraging search for causes out of the present joy which we
find in speaking and listening to a person now. On the other hand, these
momentary contacts are thin, capricious, and insufficient if we are not
also planning some solid progress which will give us something to show
for it at the end of a day or a year. One of the dreary things in human
beings' work is that sometimes, after a month or a year, they cannot see
that they have accomplished anything. It is all a mass of details. I
remember a very marvellous social worker saying to me, "I do not want to
die thinking that I have never done anything but case work." Case work
seems to me as great a thing as any one can do. One might as well say,
"I have never done anything but miracles." But I know what she meant.
She meant that through case work she wanted to feel that there was a
thread of continuity which ought to be science or character or
friendship, a thread whereon something accumulates. We ought each year
to be able to say and to _write_ what we have learned, or given.
3. _How to give in social treatment_
_Social treatment is giving and constructing._ We want to give
Pleasure
Beauty
Money
Information
Education
Courage
and to help build the power to get more of each.
1. _Pleasure._ As we want to _find_ pleasure in our work, we surely want
to try, so far as our human capacities allow us, to _give_ pleasure, to
make people feel comfortable, to be always so polite to them and finally
so fond of them, that they will enjoy the momentary contact no matter
what it is about. As I look back over medical work of twenty-five years,
I should say that in most of my cases I have failed from the medical
point of view. Yet in a great many of those failures I can see some
redeeming feature because of the friendships that the patient and I
built while I was failing in my medical job.
Such a blending of success and failure is the rule, not the exception.
We make elaborate social plans, but we know that many of them are going
to fail. It is humanly impossible that they should not fail. But they
will not be _flat_ failures if along the way we have tried to treat
people, not as they deserve, but a great deal better.[4]
But when we give pleasure we must try to provide that the stock shall go
on. We want to try to build in and with the person some capacity to get
that pleasure for himself after we have gone out of his life. This is
just as true of course of _Beauty_ which we surely want to try to bring
into our patients' lives, and which is one of the things that redeems
our failures on the other side of social work. Even people who are dying
sometimes can get great enjoyment of beauty.
2. _Money_ is, I suppose, on the whole, the thing we are asked for
directly or indirectly most often in social work. If we are not doing
direct medical work, if we are not giving a direct medical relief or
trying to, we are more than likely to be asked for help in the way of
money, clothes, food, or rent. Surely no one works long in social work
who does not find the right place to give money. But I have to go back
to the figure already used, the parallelism of money and morphine. A
person comes to us with pain and begs for money or its
equivalent--direct, immediate relief. What makes us hesitate in the one
case is the same that makes us hesitate in the other. We may relieve,
yes; but have we constructed? In the long run we must both construct and
give, else our giving may be useless or harmful.
When can we give money without doing harm?
In a general way, when it is not going to lead to the repetition of the
same demand. When are we perfectly sure that we may safely give
morphine? In gall-stone colic. For it may be weeks, months, years,
perhaps, before there will be another such attack of colic. We give
morphine once only. The person gets over the attack, and does not want
morphine again for months or years. But if the patient's pain is chronic
or likely to recur soon and frequently, it is cruel to give morphine,
because soon the patient will have all that pain again, and more--_the
pain which is produced by morphine_ after it has been taken a little
while. We never can tell that the pain suffered is not wholly due to
morphine. So the person's trouble after we have given money may be due
to the money itself, ill used. We should be able to say, after a
careful, though not care-worn study of the case, that we know the
patient's pecuniary need is not going to recur, because we are not
dealing with a chronic difficulty like extravagance or alcoholism, which
will recur and cannot be checked by money.
3. On the whole, the safest form of giving that I know, that which is
surest to perpetuate itself, to be planted like a seed and go on
without our having to stand by it, is giving _information_--a
cold-sounding thing, but sometimes very useful. One difference between
the social worker and the person for whom she works ought to be that the
social worker has had more education, more freedom, more friends, more
opportunity to look around the world and see resources. Hence, when, for
instance, she comes to find a job for a man, the social worker, because
of the perfectly undeserved blessings that she happens to have, ought to
be in a position to give information that is of value.
One of the most precious kinds of information is information how to
secure more information. The difference between uneducated people and
those whom we call educated, is not that the latter know very much, but
that if they do not know something they know how to go to one who does.
The uneducated person is helpless to improve his education. He does not
know and cannot find out how to look up a subject.
I have distinguished information from education. Information as such
never changes character in my opinion. This subject has been discussed
in recent years in connection with what some call quite falsely _sex
hygiene_. Information biological, pathological, physiological, talks
about health and disease, never kept any man or woman straight morally.
It never changes character. So our public school education sometimes
represents only information, only the facts, not the meaning, the
interpretation, the use of those facts. Hence the public school is
justly open to the criticism brought upon it by those who say that it
does a child no lasting good to know facts. It may make him clever and
so able (like German science in war) to do more harm than if he knew
less.
But when we give education--for example, hygienic or economic
education--we give something else than information. Education is that
which, by reason of practice, by doing something again and again, and
doing it if possible in the presence of a good model (living or dead,
book or person), changes our character and our habits, as the use of a
muscle changes the muscle. A person learns to write. That is not merely
information--he has learned to do something. Learning to swim is not
information. We learn it by practice, by doing it, and by the imitation
of good models. How does one learn to think? By doing the thing, and if
there is any model in sight, by trying to imitate that model.
4. _Education_ is what social workers try to give most often, most
consciously, over the longest time, and sometimes with the greatest
results. We try to give people hygienic education. We try to give, not
merely hygienic information, but motives fit to bring about a change in
habits, a wholly different thing, and one which may be of signal value.
We try to teach self-control, the control of sleep, the control of
emotion, the control of appetite. It is hard, but it can be done by
prolonged effort, under such influences as give us courage to work at
it. We try to give economic education, the power of foreseeing what is
going to happen by reason of what has happened before. People are
extraordinarily prone to forget things which they do not want to
remember. We may help people by economic education, to economic
foresight, to economic organization of their resources by practice, and
by going over with them the cases of other people who have won out in
similar difficulties.
5. Anybody who does much talking is asked a good many times, "Won't you
please come round this evening and just give us a little inspiration?"
There is no request that I look on more sadly, more wistfully, than I do
on that. I know how little good such "inspiration" usually is because it
can be given the same way as money or morphine can be given. Inspiration
or courage means emotion of some kind. Nobody believes in emotion more
than I do. I believe the greatest life is the life that feels the most,
enjoys the most, suffers the most. But emotion is one of the most
transient and unreliable of states. One may be in a most exalted and
courageous state of mind at the end of a lecture, and a few hours later
be as weak as an invalid, because, though courage has come, it is
courage which does not provide for its reënforcement, for a new supply.
We never give people help that has any permanence except when we give
them reality. We try at first to help people in their woes through our
own personalities. But we are not strong enough to keep anybody else
afloat. We have to transmit something greater than ourselves, if
possible to bring people in touch with a life-preserver that will be
there after we are gone.
I suppose that when we can teach people to work and give them something
they can practise all their lives and get joy out of, when we teach
people to play, to deal rightly with their affections, and to worship,
we have given realities permanently buoyant.
Our social history cards at the Red Cross Refugees' Dispensary in Paris
had a great many blanks on them, which represented the blanks in our
knowledge of the patients and the defects of our social work. We rarely
entered deeply into our patients' lives in relation to their education,
family life, recreation, religion. In our work at that Dispensary we
dealt chiefly with medical facts and economic facts. To go thus far and
no farther cannot satisfy many nor remake lives. That Dispensary was
open but a few months and within that time, of course, nobody could
expect us to enter into intimate relations with a human being's life.
But if we were to work in any Dispensary for years and still not one of
those cards had any note about the patient's education, recreation,
family relationships, and religion, I should feel that we had failed. I
should feel not only that we had done superficial work (that is often
inevitable), but that we had done nothing but superficial work, which is
not satisfactory.
It is because we want to give people the best, not that we have but
that the world contains, that we should have spaces on our social
history card for notes about those things which we believe are
fundamental in our own lives and which we want therefore to see
constructed or increased in somebody else.
Social treatment, then, is chiefly, the giving and building of health,
pleasure, money, beauty, information, education, courage. It is not
because we have such a tremendous stock of those goods to give away, but
because we know that we must somehow help a person to self-help in those
directions or else be superficial, that I have phrased social treatment
in those terms.
4. _Creative listening in social treatment_
One of the simple and yet honestly useful things that we can do in
social work is to give a man a hearing. Often he will solve his own
problems with the aid of a little information from one whom he trusts
and has talked things out with. But this implies unusual powers of
listening on the social worker's part. It implies what Mr. R. H.
Schauffler calls _creative listening_. Some of the most delightful
friendships are those one makes through a magazine. In the "Atlantic
Monthly" some years ago I saw an article on playing string quartets by a
man whom I had never heard of, Mr. Robert H. Schauffler. Mr.
Schauffler's writings, which I came to know through this article,
contain many interesting points, but nothing so valuable to me as the
essay on "The Creative Listener."[5] It was founded upon an
autobiographical incident. As a musical amateur he used to attend
orchestral concerts in what was then his home city, Chicago. He used to
go with a certain group of friends, his brother and others, who liked to
sit together because they found that in this way they enjoyed the music
more. Ordinarily they were very regular in their attendance. But one
evening for some reason they had to miss the concert, and then it came
to their knowledge that the orchestra had felt their absence very much,
and really could not play their best without them. This is true. There
are people whose attention makes us play or speak or act better than we
could otherwise. We have known it in friendship We all know that some
people when we talk with them, make us feel as if we really were worth
something, had some ideas. Others are destructive listeners who make us
feel as if we had no ideas; our personality seems destroyed.
I think it is perfectly within the province of any of us to make himself
more of a creative listener than he has been before. For creative
listening is due in part to the intensity of our sympathy, the
whole-heartedness with which for the time being we give ourselves to the
person we are with.
Under favorable conditions the power of the creative listener to enlarge
and to remake a personality is not capable of limit. The people whom I
most often help are the people for whom I do nothing. They tell their
tale, spread it all out before me; then they see the solution
themselves. Just to state our difficulties clearly to another person who
will listen not merely sympathetically but creatively, and with
resistance as well as furtherance, is of value. With certain people we
run against a stone wall every now and then, even though they are only
listening silently. This is right and helpful. The right kind of
listening is sympathetic when it ought to be and dissenting when it
ought to be.
We help people out of trouble in other ways also; often by bringing new
facts. A person tells us about his difficulties at work. He sees it
perhaps more clearly after he has talked about it. But he may not know
some facts that we know, and therefore we may be able to help in some
ways that go beyond creative listening. But in the end a person has to
make his own decision, to find his own solution; and in many cases he
will find it without any more active or physical help than this.
5. _The case-worker's pyramid in social treatment_
It might well be objected by any thoughtful reader that if a person
carried out the physical, economic, mental, moral, spiritual
investigations that I have suggested in this book, he could take care of
no more than one patient at a time, and would need years to finish up
the tasks suggested by the history of that one person. That is an
objection that certainly deserves an answer. I will begin my answer by a
comparison with medical work. A trained physician is supposed to know
something of all the organs in the body. Even a dentist or an oculist
has had some training on all the bodily organs and not merely on the
special ones he treats. Among the organs of the body, the medical
profession is supposed to include the brain and all the functions of the
brain. This implies that he is supposed to have at his finger-ends the
ability to make an examination so complete that a whole day would be
needed to finish it. Obviously if he attempted anything like that he
would soon be overwhelmed. But on the other hand if he limits himself to
the professional examination of a single organ, the one perhaps which
the patient complains of, he does so at his peril. He is in danger of
making a wholly wrong diagnosis. But that can be diminished only in
proportion to his knowledge of all the other organs that he does not
examine. A well-trained physician must and can safely do some
superficial work. So a very well-trained social worker can and must do
some superficial social work. In the practice of any doctor who counts
up a month's patients we will say to one hundred, there will be about
fifty that he has examined and treated very slightly. Then there may be
twenty-five whom he knows a little more about, fifteen perhaps that he
could give a full account of, and possibly ten whom he has had to study
from all the points of view that his medical education has made
possible for him. His professional life then is not wholly superficial
yet does not attempt to deal exhaustively with every case.
As I see it, therefore, our work in the social or medical field ought to
be something like a pyramid.
. Thoroughly studied cases.
. . .
. . . . .
. . . . . . .
. . . . . . . . .
. . . . . . . . . . . Superficially studied cases.
We should study and treat many cases superficially, a smaller number
more intensively, and at the top of the pyramid which represents our
case-work will come a few to which days or weeks of time are devoted.
Such a distribution of time is not unsatisfactory or slipshod because
not all the needs that come to our attention call for thorough study.
Such a pyramidal distribution of our energies is familiar and
satisfactory in other fields of life, for instance in the field of
friendship. Nobody wants only intimate personal relations. Everybody
needs as a basis a host of acquaintances. Out of them all he makes a few
friends whom he hopes to know as well as he can know any human being.
Almost no one is satisfied to possess only acquaintances or only
intimate friends. The properly balanced life has both.
Both among those for whom we attempt only slight study or slight
service, and among those to whom we devote ourselves intensively, doctor
and social assistant alike must count failures as well as successes. We
do not try to balance failures and successes if we are wise. The Lord
only knows which of our seeming failures are really successes and which
of our successes are failures. Some of the people with whom we seem to
have made total failures, a more complete knowledge might show to have
been actually helped. All this we must face from the start. Then we
shall not be disappointed because we have to touch a great many people
superficially and to fail a great many times. That is all right so long
as we are not always superficial and do not always fail.
Such a philosophy is my defence for so elaborate and extensive a scheme
of social investigation and social treatment as I have tried to explain
in this book. The experienced physician and the well-trained social
assistant can judge with some accuracy which cases to select for
thorough study and continued devotion. But such a judgment is impossible
unless one keeps always ready in the background of one's mind the whole
apparatus of social diagnosis and treatment as it might be applied _in
toto_, if time and strength were unlimited.
FOOTNOTES:
[4] _Polonius_ (_showing out the wandering actors_):--My Lord, I will
use them according to their desert.
_Hamlet_: Odd's bodikin, man, much better! Use every man after his
desert and who shall 'scape whipping.
[5] In the volume called _The Musical Amateur_. (Houghton Mifflin Co.,
Boston.)