As we return anew to the concept of the patient as a total entity, we realize that all facets of himself must be taken into account. These include not only physical factors or complications, but also psychologic ones. These latter have been at times sadly ignored, both because of their relative intangibility and lack of availability to quantitative measurement, and because they have lain in the shadow of suspicion and opprobium which for long blanketed the entire field of psychology and psychiatry. On the other hand, the patient's psychologic constellation, which varies from individual to individual, is not only frequently the chief etiologic factor in his illness itself; it is also a constantly acting factor in determining his attitude toward treatment and his response to it. This is particularly true in treatment by Physical Medicine, where the procedures themselves are fraught with psychologic implications.We have presented a brief summary of the way in which congenital and environmental factors interact to produce the particular psychologic structure of the patient presenting himself for treatment. We have reviewed some of the ways in which the procedures of Physical Medicine are likely to impinge on this structure. We have considered some of the specific problems which arise as complicating factors on these bases, and have discussed some of the fundamental principles of their proper management. We have stressed the necessity for careful thoughtful observation, flexibility, and adaptability in technique, and the utilization of psychiatric consultation in cases presenting complicated or profound psychiatric syndromes.Subconscious drives in the patient must be looked out for and taken into account. Those which can be utilized therapeutically should be taken advantage of; those which would complicate or interfere with treatment should be avoided. There is often a strong temptation to buck these drives in others: sometimes in order to minister to one's own desires for mastery; sometimes from sheer lack of understanding that thereareany other than rational forces which influence behavior; sometimes from a mistaken idea that psychologic drives can be extinguished by brute force. The physiologic requirements of treatment must not be compromised, but up to that point there is no advantage to be gained from denying or refusing to adapt to any factor in the total situation, whether it be psychologic or otherwise. For if these same psychologic drives of which we have been speaking can, as in the case of the neurotic,makea person ill, they may well be strong enough tokeephim ill, and hardly to be conquered by mere refusal to “give in” to them.