and need to be recognized by the first responsible person to whose
notice they are brought. Unless she knows, for instance, what
constitutes excess in sex relations, a worker may misunderstand the
situation described to her and condemn a man for being a selfish brute,
when the trouble is really sexual anæsthesia in the wife. It is well
known that this single cause operates disastrously to disrupt many
marriages or else to render them insupportable. The warning should be
added, however--and it cannot be added too emphatically--that the social
worker must scrupulously refrain from making diagnoses in these cases,
even tentatively; she must refer such data as come to her either to the
general practitioner or to the psychiatrist, selecting one or the other
as the symptoms presented may indicate.

Less well understood by the lay worker are actual maladjustments, both
physical and mental (or spiritual), which prevent the complete
satisfaction of one or both. Some of these are curable by medical care,
others by instruction and education. This instruction should be given,
needless to say, by the physician and not by the case worker. If
uncorrected such maladjustments are apt to result in marital shipwreck.

No attempt can be made here to discuss actual sex perversions in their
relation to desertion. Their effect is obvious; and the social worker
should be sufficiently well informed, not only from a few standard books
on the subject,[13] but from a knowledge of the phrases which are used
in the tenements, to understand them, so that significant symptoms are
not overlooked. So intimately are sex difficulties connected with the
neuroses that the lay social worker should consult the psychiatrist
freely wherever one is available, before attempting to deal with them.