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WORKS BY BORIS SIDIS


NERVOUS ILLS, THEIR CAUSE AND CURE.

THE FOUNDATIONS OF NORMAL AND ABNORMAL PSYCHOLOGY.

SYMPTOMATOLOGY, PSYCHOGNOSIS, AND DIAGNOSIS OF PSYCHOPATHIC DISEASES.

THE CAUSATION AND TREATMENT OF PSYCHOPATHIC DISEASES.

HUMAN PROGRESS.

THE PSYCHOLOGY OF SUGGESTION.

MULTIPLE PERSONALITY.

PSYCHOPATHOLOGICAL RESEARCHES.

AN EXPERIMENTAL STUDY OF SLEEP.

PHILISTINE AND GENIUS.

THE PSYCHOLOGY OF SUGGESTION.

A STUDY OF GALVANOMETRIC DEFLECTIONS.

THE NATURE AND CAUSATION OF THE GALVANIC PHENOMENON.




  NERVOUS ILLS

  _THEIR CAUSE AND CURE_

  BY

  BORIS SIDIS, M.A., PH.D., M.D.

  MEDICAL DIRECTOR, THE SIDIS PSYCHOTHERAPEUTIC
  INSTITUTE, PORTSMOUTH, NEW HAMPSHIRE

  Author of “The Foundations of Normal and Abnormal
  Psychology,” “The Causation and Treatment of Psychopathic
  Diseases,” “Symptomatology, Psychognosis
  and Diagnosis of Psychopathic Diseases,” etc., etc.

  [Illustration: (Publisher’s colophon)]

  BOSTON

  RICHARD G. BADGER

  THE GORHAM PRESS




  COPYRIGHT, 1922, BY RICHARD G. BADGER

  All Rights Reserved


  Made in the United States of America

  Press of J. J. Little & Ives Company, New York, U. S. A.




  “_The thing in the world I am most afraid of is fear._”

                                        MONTAIGNE.




INTRODUCTION


In this volume I give a brief, popular account of some of my work
in Psychopathology, or Abnormal Psychology for the last quarter
of a century. I do not refer to my work on psychopathic reflexes,
moment-consciousness, moment-thresholds, multiple personality and
other subjects. The reader will find all these subjects in my other
works. In this volume I make an attempt to simplify matters. I lay
stress on the main factors and principles of that part of Abnormal
Psychology that deals with the subject of nervous ills.

It is to be regretted that some physicians, and among them many
neurologists of excellent standing, hesitate to accept the work
accomplished in the domain of Psychopathology, confusing the latter
with what parades at present under the name of psychoanalysis. Thus
a well known physician writes to me:

“I think that the majority of men in general work (medical) do not
separate Psychopathology from Psychoanalysis. Freud’s theories and
the whole trend of psychoanalysis have been so turned into channels
of distorted and perverted sexual life that it has blinded people
to the fact that there are many dominant phases in mental life
which are not sexual. The ordinary, healthy minded, and vigorous
practitioner sees a lot of motives in life that are not sexual,
and where everything is twisted and turned to one side, to one
‘complex,’ he becomes indignant and disgusted, and condemns the
whole broad subject of Psychopathology.” I think that the physician
is right in his attitude.

As a matter of fact psychoanalysis, by which Freud and his
adherents have baptized their sexual theories and metaphysical
wish-speculations, should be regarded as savage and barbaric.
Psychoanalysis is a sort of Astrology, full of superstitious
symbolizations, dream vagaries, and idle interpretations, foisted
on the credulous, on those obsessed by sexual inclinations, and on
those suffering from sexual perversions. It is idle and credulous
to search in adults for “unconscious” memories of babies a few
months old. Many take up psychoanalysis as a sort of mental
masturbation which in the long run is sure to play havoc with their
nerve and mind.

Psychoanalysis excites the curiosity of the vulgar just as for
thousands of years Astrology held the interest of semi-civilized
nations to the detriment of the science of Astronomy.
Psychoanalysis belongs to the class of dangerous superstitions,
harmful to health, both social and individual. Psychoanalysis, like
Palmistry or Oneiroscopy, that is, “interpretation of dreams,”
imposes on the uncritical sense of the credulous public. Freudian
psychoanalysis should be openly declared as a fraud.

Lecky points out that superstitions are not destroyed by
discussion. To start a discussion in an earnest way a common
ground is required. What common ground is there between science
and superstition? Superstition should be left alone to die of
inanition. There is no common ground between psychoanalysis and
psychopathology. That is why it is just as impossible to argue
with a psychoanalyst as with a Mormon or a Mohammedan. Anyone who
does not accept the dogmas and superstitions of psychoanalysis
is accused of “resistance of hidden complexes,” just as pious
believers accuse sceptics of evil thoughts.

A famous professor of a well known eastern college asked me to
continue my “good work” against psychoanalysis. But criticism
of psychoanalysis is a thankless task. It is futile to discuss
psychological and medical matters with psychoanalysts. For
psychoanalysts care for nothing else but the fulfillment of sexual
wishes. It is useless to argue with psychoanalysts, who as a rule
possess no more critical sense than Mormon saints. Psychoanalysis
is a sort of Mormonism. In the far West psychoanalysis is preached
from the pulpits in churches. Psychoanalysis is a sex religion. One
should combat it with ridicule and scorn. Psychoanalysis needs a
Voltaire, a Molière, or a Swift.

The so-called present civilized humanity, and especially our
populace, lives in an age of vulgarity. Success _per se_ is the
sole aim in life. Books by the thousands tell how to achieve
“success,” how to fool the nerves, or how to deceive the mind.
“Efficiency” and “success” fill home and school with all sorts of
lucubrations and advertisements. Mental tests are supposed to help
to success. Business success is the slogan. And success is only to
the mediocre and the vulgar. Mediocrity writes for mediocrity, and
is applauded by mobs of mediocrity. To teach the truth is a great
privilege, but to deceive the ignorant and to debauch the young and
inexperienced is a serious offence.

When science, literature, and art sink to the movie stage, why
wonder at their triviality? When Government experts take seriously
Freudian “Sublimation,” why blame the credulity of the layman? When
the Bureau of Education spreads far and wide pamphlets on mental
tests, why wonder at the gullibility of the populace?

The tendency towards the rule of mediocrity in the twentieth
century was observed by Tolstoy:

“About twenty years ago Matthew Arnold wrote a beautiful article
on the purpose of criticism. According to his opinion, it is the
purpose of criticism to find what is most important and good in any
book whatever, wherever, and whenever written, and to direct the
reader’s attention to what is important and good in them.

“Such a criticism seems to me indispensable in our time of
newspapers, periodicals, books, and advertisements. Such a
criticism is requisite for the future of the cultured world.

“_Printing has for some time served as the chief instrument for the
diffusion of ignorance among the well-to-do_ (the middle classes,
especially the so-called new women).

“Books, periodicals, especially the newspapers, have in our time
become great financial undertakings for the success of which the
largest possible number of purchasers is needed. The interests and
tastes, however, of the largest possible number of purchasers are
always low and vulgar. For the success of the press it is necessary
that the productions should respond to the demands of the great
majority of the purchasers, that is, that they should touch upon
the low interests and correspond to the vulgar tastes. The press
fully satisfies these demands, which it is quite able to do, since
among the number of workers for the press there are many more
people with the same low interests and vulgar tastes as the public
than men with high interests and refined taste.

“The worst thing about it is that the reading of poor works
corrupts the understanding and taste. Good works can no longer be
appreciated.

“In proportion as newspapers, periodicals, and books become more
and more disseminated, the value of what is printed falls lower
and lower, and the class of the so-called cultured public sinks
more and more into a most hopeless, self-contented, incorrigible
ignorance....

“A striking example is that of the English prose writers. From
the great Dickens we descend at first to George Eliot, then to
Thackeray, to Trollope; and then begins the indifferent manufacture
of a Rider Haggard, Kipling, Hall Caine, and so forth.

“Still more striking is this fall noticed in American literature.
After the great galaxy, Emerson, Thoreau, Lowell, Whittier, and
others, everything breaks off suddenly, and there appear beautiful
editions with beautiful illustrations and with beautiful stories
and novels which are impossible to read on account of absence of
all meaning.

“The ignorance of the cultured crowd of our times has reached such
a pass that great thinkers and writers of former times no longer
satisfy the highly refined demands of new men (and new women).

“The last word of philosophy is the immoral, coarse, inflated,
disconnected babbling of Nietzsche. Senseless, artificial
conglomeration of words of decadent poems is regarded as poetry of
the highest rank. The theatres give dramas, the meaning of which is
not known to any one, not even to the author.”

What would Tolstoy have said had he witnessed the full blown art of
our movies?

What the movies and literature accomplish in the world of art and
letters, that is what psychoanalysis and mental tests achieve in
normal and abnormal psychology.

The mediocrity of the modern man is akin to the vulgarity of the
ancient freedman, so well described by Petronius in his type of
Trimalchio. Both, the greedy freedman and the “efficient” freeman,
have the same deleterious influence on the course of civilization.

Our age is not the age of Democracy, but of Mediocrity. It is in
such an age that sensationalism, movies, and psychoanalysis are apt
to flourish like green bay trees.

The reader will find that I often turn to Social Psychology. This
is requisite. As I carry on my work on nervous ills I become
more and more convinced that a knowledge of Social Psychology is
essential to a clear comprehension of nervous ills.

The number of cases given in the volume will, I am sure, be of
great help to the reader. For the concrete cases, carefully studied
by me, bring out distinctly the mechanism, the factors, and the
main principles of nervous ills.

I address this volume to the reader who wishes to learn the truth,
not to those who are in search for ever new amusements, or for the
“best seller” of the year. I hope that this work will prove of
value to the thoughtful physician and of interest to the cultured
layman.

I further hope that my reader will not be offended by my statements
about superstitions. _I address myself to the liberal-minded reader
who does not care to follow the herd._

                                             BORIS SIDIS

  Maplewood Farms,
  Portsmouth, New Hampshire.




CONTENTS


                  PAGE

          INTRODUCTION                                         7

  CHAPTER

       I  SELF-PRESERVATION AND FEAR                          19

      II  STAGES OF FEAR                                      27

     III  THE PRIMACY OF FEAR                                 32

      IV  FEAR AND SUPERSTITION                               38

       V  THE POWER OF FEAR                                   45

      VI  FEAR AND DISEASE                                    56

     VII  FORMS OF NEUROSIS                                   61

    VIII  FEAR AND THE HYPNOIDAL STATE                        66

      IX  HEALTH AND MORBIDITY                                73

       X  THE SUBCONSCIOUS                                    77

      XI  THE CONDITIONS AND LAWS OF SUGGESTION               81

     XII  IS THE SUBCONSCIOUS A PERSONALITY?                  86

    XIII  THE CHARACTER OF THE HYPNOIDAL STATE                91

     XIV  HYPNOIDAL PSYCHOTHERAPY                            101

      XV  EGOTISM AND FEAR                                   115

     XVI  NEUROTIC PARASITISM                                131

    XVII  FUNDAMENTAL PRINCIPLES                             137

   XVIII  ILLUSTRATIONS, NEUROTIC HISTORIES                  149

     XIX  HYPNOIDAL TREATMENT                                164

      XX  FEAR CONFESSIONS                                   183

     XXI  TRANCE APPARITIONS                                 211

    XXII  RECURRENT FEAR STATES--PSYCHOLEPSY                 216

   XXIII  APHONIA, STAMMERING, AND CATALEPSY                 234

    XXIV  SUGGESTED HALLUCINATIONS                           250

     XXV  TRANCE SERVILITY                                   258

    XXVI  THE HYPNOIDAL STATE AND SUPERSTITIONS              264

   XXVII  NEUROSIS AND HEREDITY                              271

  XXVIII  NEUROSIS AND EUGENICS                              276

    XXIX  PRIMITIVE FEARS                                    287

     XXX  THE HERD AND THE SUBCONSCIOUS                      303

    XXXI  MYSTICISM, PRAYER, CONVERSION, AND METAPHYSICS     312

   XXXII  FEAR SUGGESTIONS                                   324

  XXXIII  LIFE ENERGY AND THE NEUROTIC                       332

   XXXIV  DYNAMIC ENERGY                                     339

    XXXV  FEAR VARIETIES                                     347

   XXXVI  CONTROL OF THE NEUROTIC                            358

  XXXVII  REGAINED ENERGY AND MENTAL HEALTH                  369

          INDEX                                              377




NERVOUS ILLS

THEIR CAUSE AND CURE




NERVOUS ILLS




CHAPTER I

SELF-PRESERVATION AND FEAR


The impulse of self-preservation is at the basis of all animal
life. From the simplest lump of protoplasm constituting a microbe
to the highest form of life, such as man, one meets with the
same primitive life tendency,--the impulse of self-preservation.
Throughout all animal creation one important purpose runs, and that
is the preservation of life.

When a creature is launched into the world, it is animated with one
central, innate mission,--to live; and to fight for its living. For
this purpose,--if purpose it really be, the creature, however small
and insignificant, is provided with a rich arsenal of armour for
defense and attack. When a biologist demonstrated the anatomical
structure of a caterpillar, a bystander exclaimed in surprise:
“Why, I always thought that a caterpillar was nothing but skin and
squash!”

The simple living creatures, swarming in the waters of stagnant
ponds and murky pools, the bits of living matter, inhabiting by the
million the little world of a hanging drop of water, are supplied
with the most complicated reactions, mechanical and more especially
chemical, for the maintenance of their life existence. Simple as a
cell, a minute particle of protoplasm, may appear, it is none the
less a most wonderful laboratory where toxins, anti-toxins, and an
infinite variety of secretions, highly poisonous and protective,
are being produced, for the keeping in existence of that
insignificant, microscopic bit of living matter. _Self-preservation
is the central aim of all life-activities._

The tendency of all organic processes is the maintenance of the
life of each particular individual organism. It is this aspect that
I wish to impress on the minds of my readers. Self-preservation
is the nucleus of organic life. It is the mainspring of organic
activities and functions. _The tendency of life is not the
preservation of the species, but solely the preservation of each
individual organism, as long as it is in existence at all, and is
able to carry on its life processes._

Every living thing, from the ultra-microscopic to the highest
and most complex multicellular organism, man included, has only
one fundamental tendency, the maintenance and defense of its
_individual_ existence. The claim that the individual counts for
little or nothing, and that the species is everything, is not
true to facts. “Nature cares not for the individual, but for the
species” is a glittering generality of a metaphysical character.

It is the maintenance of its individual existence and the _struggle
for this individuality_ and its preservation, whether in defense or
aggression, that form the main object of organic life in all its
aspects. _The aim of life activities is the individual, the species
is a secondary matter._ It is only when we keep this fundamental
truth in mind that we begin to understand life in general, and
human life in particular.

The struggle for existence of which so much is heard in modern
science, theoretical or applied, means really the preservation of
the individual organism, or the self-preservation of individuality.
We may say that the _struggle for existence in the biological
and social worlds means nothing else but the Struggle for
Individuality_.

Wherever the organism forms a whole as to its vitality, whether it
be an amoeba or a man, the struggle is for the maintenance of that
whole or of that particular individual organism. All the structures
and functions go to the preservation of that individuality,
or of that individual organic self, constituting the impulse
of self-preservation in the total activity of the particular
individual organism. The great number of physico-chemical and
mechanical processes, adaptations and adjustments of inner
structures and functions, as well as the different reactions
to the stimuli of external environment, even in the lowest of
micro-organisms, are for the _whole_ of the individuality.

When organisms take to forms of social life the fundamental aim
is still the protection or self-preservation of the individual.
The community is an additional defense of the individual against
a hostile environment. Thus the herds of Damara cattle, or of
social aggregates of other animals, offer greater protection to
each individual animal. The individual wolf running in packs has
more power for attack and defense. The individual man has more
forces for aggression and for protection by living in a social
medium which provides the individual with more sensory organs for
observation of danger and with more organs for defense and attack,
than in isolated states. The herd, the pack, the horde, the society
are for the self-preservation of the individual.

It has been shown on good grounds that the very sense of external
reality has become intensified in the individual by his capacity
of living in a social aggregate. The social aggregate strengthens
each individual member of the group. The individual is not for the
group, but the group is for self-preservation of the individual.
Should the individual lose his self-protection, or even have his
impulse of self-preservation lowered, the whole aggregate faces
ultimate destruction. That is why when in a social aggregate
the impulse of self-preservation becomes limited, inhibited,
and lowered by tyranny of social commandments, society is sure
to decline, degenerate, and finally dissolve; or fall a victim
to an external invader,--the fate of tribes, communities, and
nations in the past and the present. _The moving power of life is
self-preservation of the individual._

A close study of life in general and of animal life in particular
brings one to the inevitable conclusion that life in all its
forms has self-preservation as its fundamental principle.
_Self-preservation is the main impulse, the prime mover of life._
The prime mover of life is not the impulse of species preservation,
or of sex, but the impulse of self-preservation of the individual
organism.

Self-preservation has two aspects, the positive and the negative.
In the positive form the primitive impulse is to keep the
individual alive, to keep the functions and structure in normal
condition, to conduce to the full development and harmonious
activity of the individual. The negative form of the preservative
impulse is the preservation from injury, degeneration, destruction,
and death. This negative aspect of the impulse of self-preservation
expresses itself in the higher animals in the form of fear.

The fear instinct is an essential constituent of the impulse of
life. We may call the fear instinct the guardian of all sentient
being. Wherever there is the least scent or even the least
suggestion of danger, there the instinct of fear is aroused. Fear
is the companion following close on the heels of the impulse of
self-preservation.

Since every animal is always surrounded by enemies, and since every
strange thing or strange occurrence is a menace or possible signal
of danger, the fear instinct is aroused on all strange occasions.
The fear instinct requires the slightest stimulus to start into
function.

While most of the instincts require special conditions, and are
usually _periodic_, the fear instinct is _ever present_ and can be
awakened on all occasions, and under any circumstances. Anything
unfamiliar,--darkness, a state of exhaustion, weakness, fatigue,
arouses the fear instinct, startling the animal into running,
hiding, crouching, and preparation for attack or defense.

The fear instinct stays with us, and watches over us day and night.
It follows us closely in our active, waking life, attends us in
our resting hours, and watches over us in our sleeping periods.
The fear instinct is the last to fall asleep, and the first to
awake. The fear instinct follows us like our shadow, with the
only difference that it constantly affects our actions, hardly
ever leaves us alone, and keeps steady vigilance over our life
activities. The reason for this apparently strange companionship
is the fact that the fear instinct is the primitive instinct of the
life impulse, the impulse for self-preservation.

The overwhelming intensity of the fundamental impulse of
self-preservation is well described by the great writer Dostoevsky,
whose insight into the psychology of human life and especially into
abnormal mental life transcends that of any other writer: “Where is
it I have read that someone condemned to death says or thinks, an
hour before his death, that if he had to live on some high rock, on
such a narrow ledge that he had only room to stand, and the ocean,
everlasting darkness, everlasting solitude, everlasting tempest
around him, if he had to remain standing on a square yard of space
all his life, a thousand years, eternity, it were better to live so
than to die at once! Only to live, to live, and live! Life whatever
it may be!”

Just as the touch and pain nerves enmesh closely our body, warning
us against hurtful stimulations, so we may say that fear, through
our distant receptors of sight, hearing and smell, surrounds us,
warning us against enemies, or inimical, suspicious objects, and
forces. Were it not for the fear instinct, directly awakened, the
animal threatened with danger would not have the time and the
strong impulse to get ready for defense or for escape, by running
or by hiding.

The fear instinct is of the utmost importance in animal life.
Looked at from this standpoint the fear instinct is as important
in animal economy as the skin which covers our body, which,
by pain and hurts, warns of external injurious objects, and
has an important function of warding off incessant invasion of
disease-bearing organisms. In nervous ills we find the same
fundamental factors:--_self-preservation and the fear instinct_.




CHAPTER II

STAGES OF FEAR


The fear instinct in its course of development passes through three
stages:

    I. The Stimulating Stage
   II. The Arrestive, or Inhibitory Stage
  III. The Paralyzing Stage.

In its milder forms when the fear instinct is but nascent, it
serves as a sort of trigger to the activities of the organism.
The animal may for a moment stop whatever activities and pursuits
in which it happens to be engaged, and have its interest turn in
the direction of the particular new stimulus, whether it be of an
auditory, visual, or olfactory character. The fear instinct is
just strong enough to suspend present interests, and direct its
activities to the new source of the unknown stimulus.

When the source is unfamiliar, the animal becomes prepared for
action. The energies are aroused for attack, or for hiding,
freezing, or running, according to the mode of defense to which the
animal has been adapted in its adjustments to the stimulations of
its environment. The lion, the tiger, the skunk, the snake, the
bird, the rabbit, the squirrel will act differently, according
to their natural disposition in response to external objects and
stimuli.

While the motor system may react differently in various animals,
the fear instinct is alike in all of them. This stage of the fear
instinct should be regarded as the healthy physiological reaction
to strange and new stimuli, and is essentially protective, inasmuch
as it serves for the arousal of energy and proper reactions of
self-defense, characteristic of the particular individual.

In its milder forms the fear instinct is _normal_, _physiological_,
and healthy in its reactions. In fact, the absence of it is rather
pathological. It is quite natural that under the influence of some
danger, the organism may feel the urging of this vital instinct,
the consequent of the fundamental life impulse, and feel it as a
stimulus rather than as a deterrent experience, feel fear as the
key for the unlocking of energies in defense or attack. Such a
reaction is healthy and strictly requisite in the total economy of
life.

When I advanced the theory that the fear instinct is at the bottom
of functional psychosis, or of psychopathic maladies, some jumped
to the conclusion that I regarded the fear instinct as abnormal,
giving rise to pathological states under all conditions and
circumstances. This is not correct. _The fear instinct in its
initial stages is perfectly normal, and is as indispensable to life
as hunger and thirst._ It is only in the more advanced and extreme
stages that the fear instinct becomes pathological, and is apt to
give rise to psychopathic states.

In the arrestive or inhibitory state, the innervation of the
voluntary and the involuntary muscular systems is arrested, or
weakened. There is tremor and even convulsive contractions,
the voluntary reactions are affected, and are carried out with
some difficulty; there is cardiac arrhythmia, the respiration
is irregular; there may be chattering of the teeth; the various
bodily secretions are interfered with, and the vaso-motor nerves
as well as the general vascular structures are thrown into
disorder. Peristalsis, intestinal secretions, and the innervation
of the sympathetic nervous system may become affected, first
by inhibition, and then by irregular functioning. Associative
mental or cerebral activity becomes arrested, confused; memory is
disturbed, and the whole personality or individuality appears in a
state of dissociation, accompanied by a lack of precision and lack
of exactness of neuromuscular adaptations. The delicate reactions
and adaptations are specially affected.

If this stage of fear instinct does not become intensified, the
organism recovers its control,--many of the disturbances pass
away, and the following reaction may come with a greater release
of energy, developing a greater output of activity than under
normal conditions. In short, the fear instinct may still serve as
a stimulation to greater effort, but the chances of such a result
are far smaller than in the first stage, which is essentially of a
stimulating, useful, and healthful character.

The second stage of the fear instinct is the possibility of a
pathological state, and, if persistent, leads directly to the third
stage with consequent paralysis and danger of destruction. The
first stage of fear is fully normal, helpful, and self-defensive.
The second stage is harmful, but with the possibility of recovery
and restitution of normal function. The third stage leads to
destruction and death.

In the third stage there is paralysis of function of most of the
muscular, secretory, excretory, circulatory, intestinal, and
nervous systems. The animal is petrified with fear, and falls
into a state of paralysis, rigidity, cataplexy, or in a state
simulating death. This last stage of the effects of the fear
instinct is pathological, and instead of conducing to the good of
the individual, really leads to his destruction and death. The fear
instinct in its extreme cases is not a help to the organism, but is
distinctly a hindrance, and is felt as such by the organism which
experiences it.

The fear instinct, which originally is a stimulating agent for
self-defense, when in excess becomes a danger hastening the
dissolution of the animal organism into its constituent parts.
The intensity of the fear instinct is the expression of the fact
that the organism is in imminent danger of destruction. The fear
instinct in its extreme state is decidedly to the disadvantage of
the animal.

Of course, it may be claimed that the paralysis and inhibition
stages might have been of service or of protective value in the
lower forms of life, when mimicking death or freezing prevented
the animal from being noticed. This may possibly hold true in the
cases of lower forms, but in the higher forms the fear instinct in
its third stage, by bringing about inhibitions and paralysis of the
vital functions, is decidedly of disservice to the organism, and
leads to its destruction and death.




CHAPTER III

THE PRIMACY OF FEAR


The fear instinct is intimately related to the innermost
principle, characteristic of all life, namely the impulse of
self-preservation. When, however, the fear instinct becomes
deranged by being too intense, and especially when reaching
the extreme stage, the instinct becomes pathological, and its
functioning leads to degeneration, destruction, and death. Even
in its initiatory stages the fear instinct may become abnormal,
when associated with objects, situations, and sensori-motor
reactions which are otherwise normal and beneficial, or actually
requisite in the total economy of life activity of the particular
organism. Under such conditions the fear instinct is decidedly
pathological.[1]

In fact we may say that the fear instinct is the main source
of functional, psychopathic diseases. This also holds true of
the individual in his aggregate capacity. If the impulse of
self-preservation is at the basis of life, the fear instinct is its
intimate companion. We may unhesitatingly assert that the fear
instinct is one of the most primitive instincts of animal life. We
are sometimes apt to overlook the power of fear, because our life
is so well guarded by the protective agencies of civilization that
we can hardly realize the full extent, depth, and overwhelming
effects of the fear instinct. Fear is rooted deep in the nature of
animal life, in the impulse of self-preservation.

The fear instinct is the earliest instinct to appear in child
life. Preyer observed definite manifestations of the fear instinct
on the twenty-third day after birth. Perez and Darwin put its
appearance somewhat later. In my observations of child life I found
the manifestation of the fear instinct during the first couple of
weeks, Ribot and other psychologists regard the fear instinct as
“the first in chronological order of appearance.”

“The progress from brute to man,” says James, “is characterized
by nothing so much as the decrease in the frequency of the proper
occasion for fear. In civilization in particular it has at last
become possible for large numbers of people to pass from the cradle
to the grave without ever having had a pang of genuine fear. Many
of us need an attack of mental disease to teach us the meaning
of the word. Hence the possibility of so much blindly optimistic
philosophy and religion. (James refers here to the blind optimism
and cheerful metaphysical mysticism handed out to the uncultured
classes.) Fear is a genuine instinct, and one of the earliest shown
by the human child.”

The fear of the unknown, of the unfamiliar, of the mysterious,
is of the utmost consequence in the life history of children,
savages, and barbaric tribes, and even in the social life of
civilized nations. The fear of coming mysterious, unknown evil
is a source of great anxiety to the young, or to the untrained,
uncultivated minds. All taboos of primitive societies, of savages,
of barbarians, and also of civilized people take their origin,
according to anthropological research, in the perils and salvation
of the soul, or in the fear of impending evil. As an anthropologist
puts it: “Men are undoubtedly more influenced by what they fear
than by what they love.”

The civilized nations of antiquity used to be terrorized by
omens, by occurrences of an unfamiliar character, such as
storms, thunders, lightnings, comets, meteors, meteorites, and
eclipses. Affairs of states and wars were guided by superstitions
of fear. Whole armies used to throw away their weapons and run
panic-stricken at the appearance of meteorites, meteors, and
especially of comets. Even the ancient Athenians were influenced
by strange, meteorological phenomena. On the appearance of a solar
eclipse Pericles saved his ship by throwing his mantle round the
helmsman, telling him that that was all that an eclipse was, and
that there was no reason to be scared by the veiling of the sun
from us. The father of pragmatic history, the great Thucydides,
in his history of the Peloponnesian wars, puts the appearance of
comets among national disasters.

The fear of the mysterious, the unknown, and the unfamiliar is a
source of anxiety and distress in the young, or in the untrained
and uncultured minds. Fear may become fixed and morbid when taking
place in early childhood, when not inhibited by the course of
further development, and, all the more so, when kept up by further
events of life.

In most people the instinct of fear is controlled, regulated by
education, and inhibited by the relatively secure life led in the
herd, pack, group, and society generally. The instinct of fear,
however, is but dormant and requires the opportune moment such as
a social, mental epidemic, a “group-panic,” to become manifested
in its full intensity, giving rise to a morbid state of the
“group-mind,” or “herd-mind.”

There are again cases when even under ordinary conditions fear
becomes developed in the individual from early childhood either
by lack of inhibitory training or by accidents in early child
life. In all such cases the fear instinct becomes morbid, giving
rise in later life to various forms of mental disease known as
psychopathies, or recurrent morbid states.

We can, therefore, realize the full significance of the principle
laid down by one of the greatest thinkers of humanity, Plato,
that to learn “What to fear and what not to fear” is of the utmost
consequence to the individual, both in his private and social
activities.

Throughout the whole domain of the animal kingdom anything strange
and unfamiliar is an occasion for the awakening of the fear
instinct. The strange, the unfamiliar may be detrimental to the
organism, and the animal recoils from meeting it directly. There
must be exploration made before the reaction of approach can be
effected. We find the same tendency in children and savages who run
in terror of anything unusual.

On the whole escape is probably the safest course, since the
unfamiliar may prove of great danger. The well known saying
“Familiarity breeds contempt” has its significance in that the
familiar does not arouse the fear instinct, and can be approached
without risk. Reactions to a familiar object or known situation run
in well established, habitual grooves.

In man the sense of familiarity may be acquired by the use of
intelligence, by observations of various forms of unfamiliar
situations and strange objects. Reason, leading to the
understanding of the causes of things, turns the strange and
unfamiliar into the familiar and the known, and thus dispels the
terrors and horrors of the fear instinct.

The function of the intellect is to conquer the world by making
man at home and familiar in this “wild universe.” This is the
course of human progress. “The aim of knowledge,” says Hegel, “is
to divest the objective world of its strangeness, and to make us
more at home in it.” In the words of the ancient poet:

      _Felix qui potuit rerum cognoscere causas,_
      _Atque metus omnes, et inexorabile fatum,_
      _Subject pedibus, strepitumque Acherontis avari._[2]


FOOTNOTES:

[1] See Chapter “Psychopathic Reflexes” in my volume “The Causation
and Treatment of Psychopathic Diseases.”

[2] Happy is he who knows the causes of things, who can trample on
fear, inexorable fate, and the horrors of death.




CHAPTER IV

FEAR AND SUPERSTITION


An individual limited in intelligence, leading a narrow life, is
specially subject to fear suggestions which can be easily aroused.
Inhibitions of the personal self are produced by stimulation of
the fear instinct with consequent easy access, by means of fear
suggestions, to man’s subconscious fear instinct, thus inducing
various forms of morbid mental life.

When a person is limited in his interests, when he is ignorant
and full of prejudices and superstitions, his critical, personal
sense is embryonic, and the predisposition to fear suggestions is
specially pronounced. He easily falls a victim to all kinds of
bizarre beliefs and absurd superstitions, such as the mysticism
which obsesses uncultured classes of all ages.

The optimistic, “metaphysical” beliefs, rampant in this country,
are all due to the beggarly intelligence subconsciously obsessed
by innumerable fear suggestions. Neurotic adherents cling to their
irrational optimism in order to assuage the pangs, caused by the
fear instinct, from which they are unable to free themselves.

In the embryonic personality of the child, as well as in the
undeveloped or narrowed individuality of the adult, the sense of
the strange, of the unknown, and of the mysterious, is apt to
arouse the fear instinct. In fact, the unfamiliar arouses the fear
instinct even in the more highly organized mind.

“Any new uncertainty,” says Bain, “is especially the cause of
terror. Such are the terrors caused by epidemics, the apprehensions
from an unexperienced illness, the feeling of a recruit under fire.
The mental system in infancy is highly susceptible, not merely
to pain, but to shocks and surprises. Any great excitement has a
perturbing effect allied to fear. After the child has contracted
a familiarity with the persons and things around it, it manifests
unequivocal fear on the occurrence of anything strange. The grasp
of an unknown person often gives a fright. This early experience
resembles the manifestations habitual to the inferior animals.”

In another place Bain rightly says, “Our position in the world
contains the sources of fear. The vast powers of nature dispose of
our lives and happiness with irresistible might and awful aspect.
Ages had elapsed ere the knowledge of law and uniformity prevailing
among those powers was arrived at by the human intellect. The
profound ignorance of the primitive man was the soil wherein his
early conceptions and theories sprang up; and the fear inseparable
from ignorance gave them their character. The essence of
susperstition is expressed by the definition of fear.”

Compayré, in speaking of the fear of the child, says, “In his
limited experience of evil, by a natural generalization, he
suspects danger everywhere like a sick person whose aching body
dreads in advance every motion and every contact. He feels that
there is a danger everywhere, behind the things that he cannot
understand, because they do not fit in with his experience.

“The observations collected by Romanes in his interesting studies
on the intelligence of animals throw much light on this question;
they prove that dogs, for instance, do not fear this or that,
except as they are ignorant of the cause. A dog was very much
terrified one day when he heard a rumbling like thunder produced by
throwing apples on the floor of the garret; he seemed to understand
the cause of the noise as soon as he was taken to the garret, and
became as quiet and happy as ever.

“Another dog had a habit of playing with dry bones. One day Romanes
attached a fine thread which could hardly be seen, to one of the
bones, and while the dog was playing with it, drew it slowly
towards him; the dog recoiled in terror from the bone, which seemed
to be moving of its own accord. So skittish horses show fright as
long as the cause of the noise that frightens them remains unknown
and invisible to them.

“It is the same with the child. When in the presence of all the
things around him, of which he has no idea, these sounding objects,
these forms, these movements, whose cause he does not divine, he is
naturally a prey to vague fears. He is just what we should be, if
chance should cast us suddenly into an unexplored country before
strange objects and strange beings--suspicious, always on the _qui
vive_, disposed to see imaginary enemies behind every bush, fearing
a new danger at every turn in the road.”

Similarly, Sully says, “The timidity of childhood is seen in the
readiness with which experience invests objects and places with
a fear-exciting aspect, in its tendency to look at all that is
unknown as terrifying, and in the difficulty of the educator in
controlling these tendencies.”

Sully is right in thinking that education tends greatly to reduce
the early intensity of fear. “This it does by substituting
knowledge for ignorance, and so undermining that vague terror
before the unknown to which the child and the superstitious
savage are a prey, an effect aided by the growth of will power
and the attitude of self-confidence which this brings with it.”
An uncultivated personality with a limited mental horizon, with a
narrow range of interests, a personality trained in the fear of
mysterious agencies, is a fit subject for obsessions.

In certain types of functional psychosis and neurosis the patient
has an inkling of the fear instinct in his dread of objects, or of
states of mind, lack of confidence, blushing, expectations of some
coming misfortune and some mysterious evil, but he is not aware of
the fear instinct as developed in him by the events and training of
early childhood. _The fears of early childhood are subconscious._
At any rate, the patient does not connect them with his present
mental affection.

In other types of psychopathic affections the patient is entirely
unaware of the whole situation, he is engrossed by the symptoms
which he regards as the sum and substance of his trouble;
the fear is entirely subconscious. Frights, scares, dread of
sickness, instructions associated with fear of the mysterious and
unseen, injunctions with fear of punishment or failure in moral
standards, enforcement of social customs with dread of failure
and degradation,--all go to the cultivation of the fear instinct
which in later life becomes manifested as _functional psychosis_ or
_neurosis_.

_Functional psychosis or neurosis is an obsession, conscious and
subconscious, of the fear instinct._ Thus one of my patients
became obsessed with fear of tuberculosis, manifesting most of the
symptoms of “consumption,” after a visit to a tubercular friend.
Another patient was obsessed by the fear of death after visiting a
sick relative of his in one of the city hospitals. Another became
obsessed with the fear of syphilis after having been in contact
with a friend who had been under antiluetic treatment. Still
another of my patients, in addition to the fear of darkness, became
obsessed with the fear of stars, and also with a fear of comets,
regarded by some people as poisoning the air with noxious gases.

In all such cases anxiety and dread were present, but in none of
the patients have I found an insight into the real state of the
mind. In all of them the fear was traced to early childhood, to
early experiences of the fear instinct, fostered and fortified by
unfavorable conditions. In all of those fears there was a long
history of a well-developed _subconscious fear instinct_.

I may assert without hesitation that in all my cases of functional
psychosis, I find the presence of the fear instinct to be the sole
cause of the malady. _Take away the fear and the psychosis or
neurosis disappears._

The fear instinct arises from the impulse of self-preservation
without which animal life cannot exist. The fear instinct is one of
the most primitive and most fundamental of all instincts. Neither
hunger, nor sex, nor maternal instinct, nor social instinct can
compare with the potency of the fear instinct, rooted as it is in
self-preservation,--the condition of life primordial.

When the instinct of fear is at its height, it sweeps before it
all other instincts. Nothing can withstand a panic. Functional
psychosis in its full development is essentially a panic,--it
is the emergence of the most powerful of all instincts, the fear
instinct.

Functional psychosis or neurosis is a veiled form of the fear of
death, of destruction, of loss of what is deemed as essential to
life, of fear of some unknown, impending evil. How many times has
it fallen to my share to soothe and counteract the fear instinct of
panic-stricken psychopathic patients! A psychogenetic examination
of every case of functional psychosis brings one invariably to the
fundamental fear instinct.

Conflicts, repressions, imperfections, sex-complexes,
sex-aberrations, and others do not produce psychopathic symptoms or
neurotic states. It is only when mental states become associated
with an exaggerated impulse of self-preservation and an intensified
fear instinct that neurosis arises.

A close study of every neurotic case clearly discloses the
_primary_ action of those two important factors of life
activity,--self-preservation and fear instinct.




CHAPTER V

THE POWER OF FEAR


The function of fear is quite clear. Fear is the guardian instinct
of life. The intensity of the struggle for existence and the
preservation of life of the animal are expressed in the instinct of
fear. The fear instinct in its mild form, when connected with what
is strange and unfamiliar, or with what is really dangerous to the
animal, is of the utmost consequence to the life existence of the
animal. What is strange and unfamiliar may be a menace to life, and
it is a protection, if under such conditions the fear instinct is
aroused.

Again, it is of the utmost importance in weak animals, such as
hares or rabbits, to have the fear instinct easily aroused by the
slightest, strange stimulus: the animal is defenseless, and its
refuge, its safety, is in running. The unfamiliar stimulus may be a
signal of danger, and it is safer to get away from it; the animal
cannot take chances.

On the other hand, animals that are too timid, so that even the
familiar becomes too suspicious, cannot get their food, and cannot
leave a progeny,--they become eliminated by the process of natural
selection. There is a certain amount of trust that nature demands
even of its most defenseless and timid children.

Animals in whom the fear instinct can be aroused to a high degree
become paralyzed and perish. Under such conditions the fear
instinct not only ceases to be of protective value, but is the very
one that brings about the destruction of the animal possessed by
it. Intense fear paralyzes the animal.

“One of the most terrible effects of fear,” says Mosso, “is the
paralysis which allows neither of escape nor defense. Not all
the phenomena of fear can be explained on the theory of natural
selection. In their extreme degree they are morbid phenomena,
indicating imperfection of the organism. One might almost say that
nature had not been able to find a substance for brain and spinal
cord which should be extremely sensitive, and yet should never,
under the influence of exceptional or unusual stimuli, exceed in
its reactions those physiological limits which are best adapted to
the preservation of the animal.” Mosso quotes Haller to the effect
that “phenomena of fear common to animals are not aimed at the
preservation of the timid, but at their destruction.”

The fear instinct is no doubt one of the most fundamental and one
of the most vital of animal instincts, but when it rises to an
extreme degree, or when associated with familiar instead of strange
and unfamiliar objects, then we may agree with Haller that the
phenomena are not aimed at the preservation of the animal, but at
its destruction; or, as Darwin puts it, are of “disservice to the
animal.” This is just what is found in the case of psychopathic
or neurotic affections. The fear instinct, when aroused and
cultivated in early childhood, becomes associated in later life
with particular events, objects, and special states.

When the instinct of fear is aroused in connection with some future
impending misfortune, the feeling of apprehension with all its
physiological changes, muscular, respiratory, cardiac, epigastric,
and intestinal, goes to form that complex feeling of anxiety so
highly characteristic of the acute varieties of psychopathic
maladies. When fear reaches its acme, the heart is specially
affected; circulatory and respiratory changes become prominent,
giving rise to that form of oppression which weighs like an incubus
on the patient,--the feeling known as “precordial anxiety.”

The fear instinct is the ultimate cause of functional
psychosis,--it is the soil on which grow luxuriantly the infinite
varieties of psychopathic disturbances. The body, sense, intellect,
and will are all profoundly affected by the irresistible sweep of
the fear instinct, as manifested in the overwhelming feeling of
anxiety. The fear instinct and its offsprings--hesitation, anxiety,
conflicts and repressions--weaken, dissociate, and paralyze the
functions of the body and mind, producing the various symptoms of
psychopathic diseases. The fear instinct keeps on gnawing at the
very vitals of the psychopathic patient.

Even at his best the psychopathic patient is not free from the
workings of the fear instinct, from the feeling of anxiety which,
as the patients themselves put it, “hangs like a cloud on the
margin or fringe of consciousness.” From time to time he can hear
the distant, threatening rumbling of the fear instinct. Even when
the latter is apparently stilled, the pangs of anxiety torment the
patient like a dull toothache.

Montaigne, writing of fear, says, “I am not so good a naturalist
(as they call it) as to discern by what secret springs fear has
its motion in us; but be this as it may, it is a strange passion,
and such a one as the physicians say there is no other whatever
that sooner dethrones our judgment from its proper seat; which is
so true, that I myself have seen very many become frantic through
fear; and even in those of the best settled temper, it is most
certain that it begets a terrible confusion during the fit. Even
among soldiers, a sort of men over whom, of all others, it ought to
have the least power, how often has it converted flocks of sheep
into armed squadrons, reeds and bullrushes into pikes and lances,
and friends into enemies....

“The thing in the world I am most afraid of is fear. That passion
alone, in the trouble of it, exceeding all other accidents. Such
as have been well banged in some skirmish, may yet, all wounded and
bloody as they are, be brought on again the next day to the charge;
but such as have once conceived a good sound fear of the enemy
will never be made so much as to look the enemy in the face. Such
as are in immediate fear of losing their estates, of banishment
or of slavery, live in perpetual anguish, and lose all appetite
and repose. And the many people who, impatient of perpetual alarms
of fear, have hanged or drowned themselves, or dashed themselves
to pieces, give us sufficiently to understand that fear is more
importunate and insupportable than death itself.”

A well known writer, who is a psychopathic sufferer, writes:
“Carlyle laid his finger upon the truth, when he said that the
reason why the pictures of the past were always so golden in tone,
so delicate in outline, was because the quality of fear was taken
from them. It is the fear of what may be and what must be that
overshadows present happiness; and if fear is taken from us, we
are happy. The strange thing is that we can not learn not to be
afraid, even though all the darkest and saddest of our experiences
have left us unscathed; and if we could but find a reason for the
mingling of fear with our lives, we should have gone towards the
solving of the riddle of the world.”

Anxiety states of neuroses and psychoses are essentially clue
to the awakening of the fear instinct, normally present in every
living being. The fear instinct is a fundamental one; it is only
inhibited by the whole course of civilization and by the training
and education of life. Like the jinn of the “Arabian Nights,” it
slumbers in the breast of every normal individual, and comes fully
to life in the various neuroses and psychoses.

Kraepelin and his school lay special stress on the fact that
“Fear is by far the most important persistent emotion in morbid
conditions.... Fear is manifested by anxious excitement and by
anxious tension.” “Experience,” says Kraepelin, “shows an intimate
relationship between insistent psychosis and the so-called
‘phobias,’ the _anxiety states_ which in such patients become
associated with definite impressions, actions, and views.” The
states are associated with the thought of some unknown danger.
Violent heart action, pallor, a feeling of anxiety, tremor, cold
sweat, meteorisms, diarrhœa, polyuria, weakness in the legs,
fainting spells, attack the patient, who may lose control of his
limbs and occasionally suffer complete collapse.

“These states,” says Kraepelin, with his usual insight into
abnormal mental life, “remind one of the feeling of anxiety which
in the case of healthy people may, in view of a painful situation
or of a serious danger, deprive one of the calmness of judgment and
confidence in his movements.”

Thus, we find from different standpoints that the feeling of
anxiety with its accompanying phenomena is one of the most potent
manifestations of animal instincts, the fear instinct, which is at
the basis of all psychopathic, neurotic maladies.

The fear instinct, as the subtle and basic instinct of life, is
well described by Kipling:--

      Very softly down the glade runs a waiting, watching shade,
        And the whisper spreads and widens far and near;
      And the sweat is on thy brow, for he passes even now--
        He is Fear, O Little Hunter, he is Fear!

      Ere the moon has climbed the mountain, ere the rocks are ribbed
              with light,
        When the downward dipping trails are dank and drear,
      Comes a breathing hard behind thee--_snuffle_--_snuffle_ through
              the night--
        It is Fear, O Little Hunter, it is Fear!

      On thy knees and draw the bow; bid the shrilling arrow go:
        In the empty, mocking thicket plunge the spear;
      But thy hands are loosed and weak, and the blood has left thy
              cheek--
        It is Fear, O Little Hunter, it is Fear!

      When the heat-cloud sucks the tempest, when the slivered pine
              trees fall,
        When the blinding, blaring rain-squalls lash and veer;
      Through the war gongs of the thunder rings a voice more loud
              than all--
        It is Fear, O Little Hunter, it is Fear!

      Now the spates are banked and deep; now the footless boulders
              leap--
        Now the lightning shows each littlest leaf-rib clear;
      But thy throat is shut and dried, and thy heart against thy side
        Hammers: Fear, O Little Hunter,--This is Fear!

It is interesting to learn what a practical and thoughtful surgeon,
such as George Crile, has to say on the matter of fear. Dr. Crile
lays stress on the facts that in his researches he finds evidence
that the phenomena of fear have a physical basis similar to those
morphological changes in the brain cells observed in certain stages
of surgical shock and in fatigue.... That the brain is definitely
damaged by fear may be proved by experiments.

“According to Sherrington the nervous system responds in action as
a whole, and to but one stimulus at a time.... Under the influence
of fear or (fear of) injury the integration of the common path is
most nearly absolute.... Hence fear and injury (or fear of injury)
drain the cup of energy to the dregs....

“We can understand why it is a patient consumed by fear suffers
so many bodily impairments, (so many functional disturbances)
and diseases even. We can understand the grave digestive and
metabolic disturbances under strain of fear.... We can understand
the variations in the gastric analyses in a timid patient alarmed
over his condition and afraid of the hospital. The patient is
integrated by fear, and since fear takes precedence over all other
impulses, no organ can function normally (under the influence of
fear)” ... Dr. Crile arrives at the conclusion that “Fear dominates
the various organs and parts of the body....”

Dr. Crile lays special stress on the pathological character of the
fear instinct: “That the brain is definitely influenced, damaged
even, by fear has been proved by the following experiments: Rabbits
were frightened by a dog, but were neither injured nor chased.
After various periods of time the animals were killed and their
brain cells compared with the brain cells of normal animals,
wide-spread changes were seen (in the brain cells of the animals
affected by fear). The principal clinical phenomena expressed by
the rabbits were rapid heart, accelerated respiration, prostration,
tremors, and a rise in temperature. The dog showed similar
phenomena, excepting that, instead of such muscular relaxation as
was shown by the rabbit, it exhibited aggressive muscular action.”

Animals in which the fear instinct can be aroused to a high degree
become paralyzed and perish. The animal mechanism is by no means
perfect. A stab in the heart, a rip in the abdomen, a cut of the
carotids, a prick in the medulla, a scratch of a needle infected
with anthrax, or tetanus bacilli, a drop of hydrocyanic acid, an
arrow tipped with curare, extinguish every spark of life. Organic
material may be delicate and complex, but for that reason it is
highly imperfect and vulnerable.

Living matter is the feeblest material in nature, and is as fragile
as a delicate crystal vase. Protoplasm, or living matter, may be
wonderful material, but it can be crushed with a pebble. The most
beautiful colors may be displayed by a thin, delicate bubble, but
it bursts at the least touch. Living matter is like a bubble, like
foam on the ocean. Perhaps no better material is available for the
functions of life.

Meanwhile it remains true that the flimsiness of living material
makes it easily subject to decay and destruction. It is a profound
error, having its root in prejudice, that nature always helps, and
that the processes going on in the organism are always of benefit
to the individual. Nature is as ready to destroy life as to protect
it.

Preservation or destruction of a particular individual depends
on the fact as to whether or no normal or pathological processes
predominate in the total economy of the organism. This holds true
of the fear instinct. The fear instinct is a delicate mechanism,
and when its action is slightly intensified, the animal is on the
way to destruction. For the cosmic forces are careless of the
creatures which keep on pouring forth in generous profusion from
the lap of nature.

Living matter, or protoplasm can only exist under special,
restricted conditions,--the least variation means death. The more
complicated, and more organized protoplasm is, the more restricted
are the conditions of its existence. A rise of a couple of degrees
of temperature or a fall means disease and death. The same holds
true of the rise and fall of quantity and quality of bodily
secretion of glands and of other organs. Protoplasm can only exist
in an _optimum_ environment. Any change spells disease and death.

The fear instinct, being at the heart of highly organized life
activities, is delicately responsive to any changes and variations
from the _optimum_, requisite for the proper functioning of the
organism. Any deviation from the _optimum_ environment, external or
internal, produces corresponding changes in the fear instinct with
consequent pathological changes in the organism.

The fear instinct like a delicate indicator is the first to get
deranged, with harmful results to the organism as a whole. We can
thus realize the importance of keeping the fear instinct in good
condition. We can understand the significance of Plato’s doctrine
of rational guidance of the fear instinct. “What to fear and what
not to fear” is at the basis of all organized life, individual and
social.[3]


FOOTNOTE:

[3] See my work “The Source and Aim of Human Progress.”




CHAPTER VI

FEAR AND DISEASE


If we examine closely the symptoms of fear, we invariably find
the symptoms of functional psychosis or neurosis. Fear affects
the muscular and sensory systems, the vasomotor system, the
respiratory system, the sudorific glands, the viscera, the heart,
the intestines, all organs and functions of the organism.

Bain, in describing the emotions of fear or terror, says, “Terror
on the physical side shows both a loss and a transfer of nervous
energy. The appearances may be distributed between the effects
of relaxation and effects of tension. The relaxation is seen, as
regards the muscles, in the dropping of the jaw, in the collapse
overtaking all organs not specially excited, in trembling of the
lips and other parts, and in the loosening of the sphincters. Next,
as regards the organic processes and viscera. The digestion is
everywhere weakened; the flow of saliva is checked, the gastric
secretion arrested (appetite failing), the bowels deranged; the
respiration is enfeebled. The heart and circulation are disturbed;
there is either a flushing of the face or a deadly pallor. The
skin shows symptoms--the cold sweat, the altered odor of the
perspiration, the creeping action that lifts the hair. The kidneys
are directly or indirectly affected. The sexual organs feel the
depressing influence. The secretion of milk in the mother’s breast
is vitiated.”

Darwin gives the following description of fear:--

“The frightened man at first stands like a statue, motionless and
breathless, or crouches down as if to escape observation. The heart
beats quickly and violently, but it is very doubtful if it then
works more efficiently than usual so as to send a greater supply
of blood to the body; for the skin instantly becomes pale, as
during incipient faintness. The paleness of the surface, however,
is probably in large part or is exclusively due to the vasomotor
center being affected in such a manner as to cause the contraction
of the small arteries of the skin. That the skin is much affected
under the sense of great fear we see in the marvelous manner in
which the perspiration immediately exudes from it. This exudation
is all the more remarkable as the surface is then cold, and hence
the term, a cold sweat; whereas the sudorofic glands are properly
excited into action when the surface is heated. The hairs also
on the skin stand erect, and the superficial muscles shiver. In
connection with the disturbed action of the heart the breathing is
hurried. The salivary glands act imperfectly; the mouth becomes
dry and is often opened and shut. I have also noticed that under
slight fear there is a slight tendency to yawn. One of the best
symptoms is the trembling of all the muscles of the body. From this
cause and from the dryness of the mouth, the voice becomes husky or
indistinct, or may altogether fail.”

If we turn now to the manifestations of psychopathic maladies, we
meet with the same fear symptoms:--

(a) The attacks may be muscular, involving symptoms such as
trembling, shaking, paresis, paralysis, or rigidity; there may be
affection of locomotion or of muscular co-ordination.

(b) There may be sensory disturbances,--anesthesia, paresthesia,
analgesia, or hyperalgesia as well as affection of muscular sense
and kinesthesia.

(c) There may be skin disturbances, such as arrest of perspiration
or profuse perspiration, especially under the influence of
emotions, worry, and fatigue; such perspiration may also occur at
night, and in some cases the fear of tuberculosis may be associated
with such conditions.

(d) The lungs may become affected functionally, and there may occur
respiratory disturbances; coughing, hawking, apnea, dyspnea, and
asthmatic troubles.

(e) The heart becomes affected, bringing about precordial pain;
palpitation of the heart, bradycardia, tachycardia, and cardiac
arrhythmia.

(f) The stomach and intestines become affected, indigestion and
vague fugitive soreness and pain may be experienced all over or in
special regions of the abdomen; constipation or diarrhea may ensue.

(g) The renal apparatus may become affected and its activity
arrested, or, as is more often the case in the milder forms of
psychopathic troubles, there may be present an alteration in
the amount or frequency of micturition, such as is found in the
conditions of anuria and polyuria.

(h) Menstruation becomes disturbed, and we may meet with conditions
of dysmenorrhea, amenorrhea, menorrhagia, and other disturbances of
the tubes, ovaries, and uterus.

(i) There are disturbances of the nervous system, such as headache
and a general dull sensation of fatigue and paresis of all mental
functions, with dizziness and vertigo.

On the mental side we find in the psychopathies the following
disturbances:--

(a) Affections of perceptual activity,--illusions and
hallucinations.

(b) Affections of intellectual activity,--argumentativeness in
regard to insignificant things.

(c) Affections of the moral sense,--scrupulousness,
over-conscientiousness, not living up to ideal states.

(d) Affections of religious life,--fear of commission of sins and
terror of punishment.

(e) Affections of social life,--timidity, blushing, etc.

(f) Affections in regard to objects, such as astrophobia,
acmephobia, agoraphobia, claustrophobia, etc.

(g) Affections of conceptual life,--insistent ideas.

(h) Affections of the attention,--aprosexia.

(i) Affections of the will,--states of aboulia, indecision,
discord, conflicts, and uncontrollable impulses.

(j) Affections of the memory,--amnesic and paramnesic states.

(k) General mental fatigue.

(l) Affections of sexual life,--impotence, perversion, and
inversion.

(m) Affections in regard to marital relations.

(n) Affections in regard to personal life,--diffidence,
self-condemnation, self-depreciation.

(o) Affections of apparent loss of personality,--feeling of self
gone.

(p) Formation of new personalities,--dual and multiple personality.

In connection with all such neurotic affections we find invariably
present a feeling of unrest, hesitation, doubt, conflict, discord,
uneasiness, a feeling of anxiety, _conscious or subconscious_,
feeling of some impending evil. In all such affections we find the
brooding spirit of the most powerful of all animal instincts,--the
fear instinct. _Neurosis is a disease of self-preservation and
fear._




CHAPTER VII

FORMS OF NEUROSIS


A brief outline of a classification of nervous and mental diseases,
made by me in my various works, may be of help towards a clear
understanding of neurotic disturbances.

The different forms of nervous and mental diseases may be
classified into _Organic_ and _Functional_.

By _organic_ affections I mean to indicate pathological
modifications of the neuron and its processes taking place in the
very structure (probably the cytoreticulum) of the nerve cell.
Under this category come such maladies as general paresis, dementia
praecox, all mental and nervous affections of a degenerative
and involutionary character. Such diseases are termed by me
_Organopathies_, or _Necropathies_.

By _functional_ affections I mean to indicate all neuron changes
in which the functions of the neuron and its reactions to external
and internal stimulations are involved in the pathological process
without, however, affecting the anatomical structure of the nerve
cell. The pathological changes are not permanent,--recovery of
normal function is possible with the restitution of favorable
conditions of nutrition and elimination.

Functional nervous and mental diseases are in turn subdivided into
_Neuropathies_ and _Psychopathies_.

Neuropathic diseases are disturbances of functioning activity,
due to defective neuron matabolism, brought about by external
stimuli, and more specially by harmful internal stimuli--glandular
secretions, hormones, toxic and autotoxic agencies. The
pathological, neuropathic process produces few, if any anatomical,
changes in the structure of the neuron. The pathology of
neuropathic diseases, (probably of the cytoplasm) is essentially
_chemico-physiological_ in nature.

Neuropathic diseases include maladies in which the neuron undergoes
degenerative changes. At first there is an apparent increase,
then an inhibition, and finally a complete suspension of neuron
function, not terminating in the destruction of the neuron. Neuron
restitution is possible.

Such affections are produced by mild poisons, organic,
or inorganic, by autotoxic products, by hyposecretion or
hypersecretion, or by absence of hormones in the economy of the
organism. Here belong all the temporary, or recurrent maniacal,
melancholic, delusional states, puerperal mania, epileptic
insanity, the mental aberrations of adolescent and climacteric
periods, periodic insanity, alternating insanities, and in
general all the mental affections known under the description of
manic-depressive insanity.

Where the disease depends on the _interrelation_ of neurons in
a complex group, on _association of systems_ of neurons, the
condition is _psychopathic_ in nature.

In psychopathic troubles the neuron itself may remain unaffected,
may be perfectly normal and healthy. The disorder is due to
association with systems of neurons which are usually not called
into action by the function of that particular neuron system.

By _Organopathies_ or _Necropathies_ I indicate a group of
psychophysiological symptoms, accompanied by structural, necrotic
changes of the neuron, terminating in the ultimate death of the
neuron systems, involved in the pathological process.

By _Neuropathies_ I indicate a group of psychophysiological
manifestations due to pathological functional neuron modifications,
capable of restitution through normal metabolism.

By _Psychopathies_ I designate pathological phenomena of
psychophysiological dissociation and disaggregation of neuron
systems and their functions in clusters, the neuron itself and its
special function remaining undamaged.

The psychopathies are further subdivided into _Somatopsychoses_
and _Psychoneuroses_ or _Neuropsychoses_.

The _Somatopsychoses are characterized by somatic symptoms_, by
disturbances of bodily functions, such as paralysis, contractures,
convulsions, anesthesia, analgesia, hyperalgesia, and other sensory
disturbances, as well as by intestinal, cardiac, respiratory, and
genito-urinary troubles.

The _psychoneuroses or Neuropsychoses are characterized by mental
symptoms_. The patient’s whole mind is occupied with mental
troubles.

Such conditions are found in obsessions, fixed ideas, imperative
impulses, emotional compulsions, and other allied mental and
nervous maladies.

Somatopsychoses simulate physical and organic nervous troubles.
Thus, many “hysterical” forms simulate tabes, or paralysis
agitans, hemiplegia, paraplegia, or epilepsy, while many of the
neurasthenic, hypochondriacal, and their allied states may simulate
tumor, cancer, intestinal and glandular derangements, cardiac,
laryngeal, pneumonic, hepatic, splanchnic ovarian, tubal, uterine,
renal, and other bodily afflictions.

The neuropsychoses or psychoneuroses simulate all forms of mental
disease, beginning with melancholia and mania, and ending with
general paresis and dementia.

_Psychoneurosis_ and _somatopsychosis_ are diseases of the
subconscious; in the former mental, in the latter physical symptoms
predominate.

_Psychopathic states should be rigidly differentiated from
other disturbances, such as neuropathies and organopathies, or
necropathies._ The following diagram may be of help:

[Illustration: _Nervous and Mental Diseases_

DIAGRAM I]




CHAPTER VIII

FEAR AND THE HYPNOIDAL STATE


In my work on “Sleep” I report a series of interesting experiments
carried out by me on guinea pigs, rabbits, cats, dogs, children,
and adults.[4] I discovered one of the most important states of
animal life, a state which I termed _hypnoidal_.

The study shows that in almost every animal, from the lowest to
the highest, from frog to man, a somewhat sudden change of the
usual environment deprives that animal of its activities and its
functions. If the change is not too intense and prolonged, the
animal merges into the hypnoidal state in which the lost functions
are restored. During this hypnoidal state the functions are
weakened, the animal may be regarded in a state of invalidism, its
reactions being enfeebled, practically speaking, paretic.

Perhaps it is advisable to approach the phenomena from their
more striking aspect. In seizing a triton, salamander, or frog,
and stretching it on the table, one will observe with surprise
that the animal remains in the same position given it. The most
uncomfortable and bizarre position may be given to the limbs, and
still the animal will not move. Testing the extremities one finds
them rigid and resisting. Something similar we find in the hypnotic
condition, when under the suggestion that the extremities are
rigid, and they cannot be moved by the subject. The same can be
done with a lobster and other animals of the same type.

Everyone has heard of the _experimentum mirabile_ made by Kirchner
in the seventeenth century. A rooster or hen is seized, the legs
are tied with a string and the bird is put on the ground. A piece
of chalk is passed over the beak,--the chalk tracing a line
from beak to some distant point on the ground. When the bird is
released, it remains in the same position. Some explain that the
animal is kept prisoner, because it “imagines” that it is bound by
the line of chalk. The chalk, however, is unnecessary. The animal
may be seized, shouted in its ear, or kept down forcibly, and the
same result will happen. This state has been termed by Preyer
“cataplexy.” The phenomenon can also be produced in insects, in
mollusca.

Many investigators have been interested in this phenomenon. I have
devoted a good deal of work to this condition which is also found
in mammals in which it is induced by the fear instinct. In mammals,
however, the state of cataplexy is not necessarily accompanied
by rigidity, although it may be present, but there is a complete
loss of voluntary activity. Horses tremble violently and become
paralyzed at the sight of a beast of prey, such as a tiger or a
lion. At the sight of a serpent, monkeys are known to be in such an
intense state of fear that they are unable to move, and thus fall
easy victims to the reptile.

Under similar conditions birds are so paralyzed by fear that they
are unable to fly away from the source of danger, and fall a prey
to the threatening serpent. The birds resemble very much the
hypnotized subject in a state of catalepsy. Although the gibbons
are the most agile of all the simians, they are easily taken by
surprise, and captured without any resistance,--they are paralyzed
by fear. Seals when pursued on land become so frightened that they
are unable to offer any opposition to their pursuers, and let
themselves easily be captured and killed.

In large cities one can often witness nervous people affected
suddenly by the presence of danger; they remain immobile, in the
middle of the street, becoming exposed to fatal accidents. The fear
instinct paralyzes their activities, they are petrified with terror.

I was told by people who have experienced the effects of
earthquakes, that during the time of the earthquakes they were
unable to move, and the same condition was observed in animals,
especially in young dogs. It is hard to move cattle and horses from
a burning stable, on account of the fear of fire which obsesses
the animals, so that they become paralyzed, suffocated and burnt
to death. So vital is the fear instinct that the least deviation
from the normal state is apt to play havoc with the safety of the
individual.

The fear instinct is the most primitive, the most fundamental,
and the most powerful of all instincts. When the fear instinct is
let loose, the animal succumbs. We should not wonder, therefore,
that with the aberration of the fear instinct, the life guardian
of the individual, all orientation is lost, the animal becomes
demoralized, and the organism goes to destruction. No other
instinct can surpass the fear instinct in its fatal effects.

The more one studies the facts, the more one examines various
psychopathic, functional maladies, without going into any
speculations and without being blinded by foregone conclusions
and pseudo-scientific hypotheses, the more one is driven to the
conclusion that the fear instinct is at the bottom of all those
nervous and mental aberrations, conscious and subconscious.

The infinite varieties of functional psychopathic diseases are the
consequences of some abnormal association with the fear instinct
which alone gives rise to the infirmities characteristic of
functional mental maladies.

President Stanley Hall accepts my view of the subject. In a recent
paper he writes: “If there be a vital principle, fear must be one
of its close allies as one of the chief springs of the mind”....
In spite of his former psychoanalytic inclinations President Hall
asserts now that “Freud is wrong in interpreting this most generic
form of fear as rooted in sex. _Sex anxieties themselves are
rooted in the larger fundamental impulse of self-preservation with
its concomitant instinct of fear._” This is precisely the factor
and the teaching which I have been expounding in all my works on
Psychopathology.

So deeply convinced is Professor Stanley Hall of the primitive
and fundamental character of the fear instinct, that he refers to
the facts that “if the cerebrum is removed, animals, as Goltz and
Bechterev have proved, manifest very intense symptoms of fear, and
so do human monsters born without brains, of hemicephalic children,
as Sternberg and Lotzko have demonstrated.”

The fear instinct is of such vital importance that it is found
in animals after decerebration, and persists in animals after
spino-vago-sympathetic section. Sherrington found the fear instinct
present in dogs after section of the spinal cord and also after
complete section of the vago-sympathetic nerves, thus removing
all sensations coming from the viscera, muscles, and skin, below
the shoulder, leaving only the sensations from the front paws,
head and cerebral activity. The dog was a sort of cerebral animal.
The whole body below the shoulder, skin, muscle, viscera, were all
anaesthetic, and yet the fear instinct remained intact.

On the other hand, after complete ablation of the cerebral
hemispheres of the dog, so that the animal became spinal, all
cerebral functions being totally wiped out, Goltz invariably found
that the fear instinct remained unimpaired. _The fear instinct is
inherent in animal life--existence. As long as there is life, there
is fear._

So potent, all embracing, and all pervading is the fear instinct,
that the physician must reckon with it in his private office, in
the hospital, and in the surgical operating room. In a number of
my cases psychognosis, the study and examination of mental states,
clearly reveals the fact that even where the neurosis has not
originated in a surgical trauma, surgical operations reinforced,
developed, and fixed psychopathic conditions.

The fear instinct is one of the most primitive and most fundamental
of all instincts. Neither hunger, nor sex, nor maternal instinct,
nor social instinct can compare with the potency of the fear
instinct, rooted as it is in the conditions of life primordial.

When the instinct of fear is at its height it sweeps before it
all other instincts. Nothing can withstand a panic. Functional
psychosis in its full development is essentially a panic. A
psychogenetic examination of every case of functional psychosis
brings one invariably to the basic instinct of life, self
preservation and the fear instinct.

As Whittier puts it:

      Still behind the tread I hear
      Of my life companion, Fear,
      Still a shadow, deep and vast
      From my westering feet is cast;
      Wavering, doubtful, undefined,
      Never shapen, nor outlined.
      From myself the Fear has grown,
      And the shadow is my own.


FOOTNOTE:

[4] The experimental work was carried on by me at the physiological
laboratory, Harvard Medical School, and in my private laboratory,
and published in my work on “Sleep.”




CHAPTER IX

HEALTH AND MORBIDITY


While health cannot be separated from disease by a sharp line, the
two are relative and fluctuating. Still, on the whole, the two can
be differentiated by the criterion of hurt and dissolution. Any
process or state conducive to hurt, and tending to dissolution of
the organism may be regarded as pathological or abnormal. The same
criterion should be applied, when differentiating the healthy,
normal states of instincts and emotions from abnormal and morbid
states of instinctive and emotional activities. Those states that
further life activities are healthy, normal; those that hinder life
are morbid.

The same holds true of the fear instinct. Every form of fear
which, instead of helping or furthering vigor of life, instead of
stimulating living energy, instead of being a protection, becomes a
hindrance, a menace to the organism, is accompanied with suffering
and distress, and ultimately leads to destruction, should be
regarded as essentially morbid.

The following are the chief characteristics of morbid instinctive
and emotional states:

I. When they are _disproportionate_ to the cause.

II. When they are chronic.

III. When their feeling-tone is _painful_, _distressing_.

IV. When they are _non-adaptive_ to the stimulations.

V. When the reactions are _not adjusted_ to the external
environment.

VI. When they are _uncontrollable_.

VII. When coming in _recurrent_ or _periodic attacks_.

VIII. When the physical and mental reactions are of _great
intensity_.

IX. When they are _dissociative_.

X. When they lead to _dissolution_.

Fear is not a matter of belief. To regard fear as a form of belief,
is fallacious, dangerous, and suicidal. It is as dangerous as to
consider smallpox and cholera the result of faith. We must never
forget that fear is one of the most fundamental of animal instincts
having its roots deep down in animal life existence. To ignore this
fact is suicidal.

According to the great anthropologist, Galton: “Every antelope in
South Africa has to run for its life every one or two days, and
the antelope starts and gallops under the influence of a false
alarm many times a day. Fear is a fundamental condition of animal
existence.”

The fear instinct in its healthy normal state is a protection
and defense. As Ribot puts it: “The basis of fear exists in the
organism, forms part of the constitution of animals and man, and
helps them to live by a defensive adaptation:” In fact, we may even
go to the point of affirming that the fear instinct, like all other
healthy, normal instincts, is absolutely requisite in the total
economy of animal and human life.

In man, however, fear should not be at the mercy of blind animal
instincts and reflexes, but should be guided and controlled
by reason, by reflection, by scientific, medical measures, by
scientific sanitation, by physical and mental hygiene, and by the
rational cultivation and development of all human functions and
faculties.

One of the greatest Greek thinkers well puts it: “Imbeciles, fools,
and the mad alone have no understanding of fear. True education,
true reason, and true courage consist in the knowledge of what to
fear and what not to fear.”

Mysticism, occultism, and credulity act like virulent germs,
fatal to man. “Metaphysical” cults anesthetize the intellect, put
judgment into lethargic sleep from which there is no awaking.
Mysticism kills the most precious essence of man’s life,--the
critical sense of human personality.

Occultism, mysticism, _et id genus omne_ declare that “fear is
a false belief, an error of the mortal mind.” Mystics claim the
“unreality” of the material fear instinct of which they are in
“reality” in “mortal” terror. This zealous negation of fear is its
strongest affirmation.

As a matter of fact, fear is one of the most stern realities of
life. The neurotic in denying disease, evil, and fear is like the
proverbial ostrich which on perceiving danger hides its head in the
sand. _The “Love” of mysticism is the Fear of death._




CHAPTER X

THE SUBCONSCIOUS[5]


Man’s nerve cell organization may be classified into two main
systems:

(I) The inferior, the reflex, the instinctive, the automatic
centers.

(II) The superior, the controlling, selective, and inhibitory
brain-centers of the cortex.

The double systems of nerve-centers have correspondingly a double
mental activity, or double-consciousness as it is sometimes called,
the inferior, the organic, the instinctive, the automatic, the
reflex consciousness, or briefly termed the _subconsciousness_,
consciousness below the threshold of self-consciousness; and
the superior, the choosing, the willing, the critical, the
_will-consciousness_. This controlling will-consciousness may also
be characterized as the guardian-consciousness of the individual.

From an evolutionary standpoint, we can well realize the biological
function or importance of this guardian-consciousness. The external
world bombards the living organism with innumerable stimuli. From
all sides thousands of impressions come crowding upon the senses of
the individual. Each neuron system with its appropriate receptors
has its corresponding system of reactions which, if not modified or
counteracted, may end in some harmful or fatal result.

It is not of advantage to an individual of a complex organization
to respond with reaction to all impressions coming from the
external environment. Hence, that organism will succeed best in the
struggle for existence that possesses some selective, critical,
inhibitory “choice and will” centers. The more organized and the
more sensitive and delicate those centers are, the better will the
organism succeed in its life existence.

The guardian-consciousness wards off, so far as it is possible, the
harmful blows given by the stimuli of the external environment. In
man, this same guardian consciousness keeps on constructing, by a
series of elimination and selection, a new environment, individual
and social, which leads to an ever higher and more perfect
development and realization of the inner powers of individuality
and personality.

Under normal conditions man’s superior and inferior centers with
their corresponding upper, critical, controlling consciousness
together with the inferior automatic, reflex centers and their
concomitant subconscious consciousness, keep on functioning in
full harmony. The upper and lower consciousness form one organic
unity,--one conscious, active personality.

Under certain abnormal conditions, however, the two systems of
nerve-centers with their corresponding mental activities may become
dissociated. The superior nerve-centers with their critical,
controlling consciousness may become inhibited, split off from the
rest of the nervous system. The reflex, automatic, instinctive,
subconscious centers with their mental functions are laid bare,
thus becoming directly accessible to the stimuli of the outside
world; they fall a prey to the influences of external surroundings,
influences termed _suggestions_.

The critical, controlling, guardian-consciousness, being cut off
and absent, the reduced individuality lacks the rational guidance
and orientation given by the upper choice- and will-centers,
and becomes the helpless plaything of all sorts of suggestions,
sinking into the _trance states of the subconscious. It is this
subconscious that forms the highway of suggestions._ Suggestibility
is the essential characteristic of the subconscious.

The subconscious rises to the surface of consciousness, so to
say, whenever there is a weakening, paralysis, or inhibition of
the upper, controlling will and choice-centers. In other words,
whenever there is a disaggregation of the superior from the
inferior nerve-centers, there follows an increase of ideo-sensory,
ideo-motor, sensori-secretory, reflex excitability; and
ideationally, or rationally there is present an abnormal intensity
of suggestibility.[6]


FOOTNOTES:

[5] The theory of the subconscious was first developed by me in my
volume “The Psychology of Suggestion,” 1898.

[6] I object to the term “Subliminal,” because it is understood
in a cosmic, or metaphysical sense. The term “co-conscious” is
limited and refers to independently functioning, contemporaneous
personalities, or mental systems. The term “Unconscious” is
_misleading_, because it may refer to the metaphysics of Hartmann.
At best it simply means nervous processes which, as such, belong to
neurology, physiology, but not to the domain of abnormal psychology.

The term “subconscious,” used by me in “The Psychology of
Suggestion,” means _tracts of mental states which may or may not
function in the total mental reaction of the individual_.




CHAPTER XI

THE CONDITIONS AND LAWS OF SUGGESTION


In order to bring to the fore subconscious activities with their
reflex, automatic psycho-motor reactions by removal of the upper
consciousness I have found requisite, in my investigations, the
following conditions:

_Normal Suggestibility,--Suggestibility in the Normal, Waking
State._

(1) Fixation of the Attention.

(2) Distraction of the Attention.

(3) Monotony.

(4) Limitation of Voluntary Activity.

(5) Limitation of the Field of Consciousness.

(6) Inhibition.

(7) Immediate Execution of the Suggestion.

_Abnormal Suggestibility,--Suggestibility in Hypnotic and Trance
States_:

(1) Fixation of the Attention.

(2) Monotony.

(3) Limitation of Voluntary Activity.

(4) Limitation of the Field of Consciousness.

(5) Inhibition.

The nature of abnormal suggestibility, the result of my
investigations, is a disaggregation of consciousness, a cleavage
of the mind, a cleft that may become ever deeper and wider,
ending in a total disjunction of the waking, guiding, controlling
guardian-consciousness from the automatic, reflex, subconscious
consciousness....

Normal suggestibility is of like nature,--it is a cleft in the
mind. Only here the cleft is not so deep, not so lasting as in
hypnosis or in the other subconscious trance states. The split is
but momentary. The mental cleavage, or the psycho-physiological
disaggregation of the superior from the inferior centers with their
concomitant psychic activities is evanescent, fleeting, often
disappearing at the moment of its appearance.

The following laws of suggestibility were formulated by me:

I. _Normal suggestibility varies as indirect suggestion and
inversely as direct suggestion._

II. _Abnormal suggestibility varies as direct suggestion and
inversely as indirect suggestion._

A comparison of the conditions of normal and abnormal
suggestibility is valuable, since it reveals the nature of
suggestibility, and discloses its fundamental law. An examination
of the two sets of conditions shows that in abnormal suggestibility
two conditions, distraction of attention and immediate execution
are absent, otherwise the conditions are the same. This sameness
of conditions clearly indicates the fact that both normal and
abnormal suggestibility flow from some one common source, that they
are of like nature, and due to similar causes.

Now a previous study led us to the conclusion that the nature of
abnormal suggestibility is a disaggregation of consciousness,
a slit produced in the mind, a crack that may become wider and
deeper, ending in a total disjunction of the waking, guiding,
controlling consciousness from the reflex consciousness. Normal
suggestibility is of a like nature. It is a cleft in the mind. The
cleft is not so deep, not so lasting as it is in hypnosis, or in
the state of abnormal suggestibility. The split is but momentary,
disappearing almost at the very moment of its appearance.

This fleeting, evanescent character of the split explains why
suggestion in the normal state, why normal suggestibility requires
immediate execution as one of its indispensable conditions. We
must take the opportunity of the momentary ebb of the controlling
consciousness and hastily plant our suggestion in the soil of
reflex consciousness. We must watch for this favorable moment, not
let it slip by, otherwise the suggestion is a failure. Furthermore,
we must be careful to keep in abeyance, for the moment, the ever
active waves of the controlling consciousness. We must find for
them work in some other direction, we must divert, we must distract
them. That is why normal suggestibility requires the additional
conditions of distraction and immediate execution. For in the
waking state the waking, controlling consciousness is always on its
guard, and when enticed away, leaves its ground only for a moment.

In normal suggestibility the psychic split is but faint; the
lesion, effected in the body consciousness, is superficial,
transitory, fleeting. In abnormal suggestibility, on the contrary,
the slit is deep and lasting,--it is a severe gash. In both cases,
however, we have a removal, a dissociation of the waking from the
subwaking, reflex consciousness, suggestion becoming effected only
through the latter. For suggestibility is the attribute of the
subwaking, reflex consciousness.

A comparison of the two laws discloses the same relation. The two
laws are the reverse of each other, thus clearly indicating the
presence of a controlling, inhibiting, conscious element in one
case, and its absence in the other. In the normal state we must
guard against the inhibitory, waking consciousness, and we have to
make our suggestion as indirect as possible. In the abnormal state,
on the contrary, no circumspection is needed; the controlling,
inhibitory, waking consciousness is more or less absent. The
subwaking, reflex consciousness is exposed to external stimuli, and
our suggestions are therefore the more effective, the more direct
we make them.

Suggestibility is a function of disaggregation of consciousness, a
disaggregation in which the subwaking, reflex consciousness enters
into direct communication with the external world. The general law
of suggestibility is:

_Suggestibility varies as the amount of disaggregation, and
inversely as the unification of consciousness._




CHAPTER XII

IS THE SUBCONSCIOUS A PERSONALITY?


The problem that interested me most was to come into close contact
with the subwaking self. What is its fundamental nature? What are
the main traits of its character? Since in hypnosis the subwaking
self is freed from its chains, is untrammeled by the shackles of
the upper, controlling self, since in hypnosis the underground
self is more or less exposed to our view, it is plain that
experimentation on the hypnotic self will introduce us into the
secret life of the subwaking self. For, as we pointed out, the two
are identical.

I have made all kinds of experiments, bringing subjects into
catalepsy, somnambulism, giving illusions, hallucinations,
post-hypnotic suggestions, etc. As a result of my work one central
truth stands out clear, and that is the _extraordinary plasticity
of the subwaking self_.

If you can only in some way or other succeed in separating the
primary controlling consciousness from the lower one, the waking
from the subwaking self, so that they should no longer keep
company, you can do anything you please with the subwaking self.
You can make its legs, its hands, any limb you like perfectly
rigid; you can make it eat pepper for sugar; you can make it drink
water for wine; feel cold or warm; hear delightful stories in the
absence of all sounds; feel pain or pleasure, see oranges where
there is nothing; you can make it eat them and enjoy their taste.
In short, you can do with the subwaking self anything you like. The
subwaking consciousness is in your power, like clay in the hands of
the potter. The plasticity of the subconscious is revealed by its
extreme suggestibility.

I wanted to get an insight into the very nature of the subwaking
self; I wished to make a personal acquaintance with it. “What is
its _personal_ character?” I asked. How surprised I was when, after
a close interrogation, the answer came to me that there cannot
possibly be any personal acquaintance with it,--for _the subwaking
self lacks personality_.

Under certain conditions a cleavage may occur between the two
selves, and then the subwaking self may rapidly grow, develop,
and attain, apparently, the plane of self-consciousness, get
crystallized into a person, and give itself a name, imaginary,
or borrowed from history. This accounts for the spiritualistic
phenomena of personality, guides, controls, and communications by
dead personalities, or spirits coming from another world, such as
have been observed in the case of Mrs. Piper and other mediums
of like types; it accounts for all the phenomena of multiple
personality, simulating the dead or the living, or formed anew out
of the matrix of the subconscious.

All such personality metamorphoses can be easily developed,
under favorable conditions in any psychopathological laboratory.
They can be easily formed, by suggestion in trance, hypnotic,
and waking states. The newly crystallized personality is, as a
rule, extremely unstable, ephemeral, shadowy in its outlines,
spirit-like, ghost-like, tends to become amorphous, being formed
again and again under the influence of favorable conditions and
suggestions, rising to the surface of consciousness, then sinking
into the subconsciousness, and disappearing, only to give rise to
new personality-metamorphoses, bursting like so many bubbles on the
surface of the upper stream of consciousness.

There are cases when the personality of the individual is changed,
or more personalities are formed. This metamorphosis may be brought
about _artificially_, by suggestion, either direct or indirect.
This is often brought about in a state of hypnosis when any number
of personalities may be formed at the will of the hypnotizer
who may create them deliberately; or they may become formed by
subtle indirect suggestion, coming from the hypnotizer, of which
he himself is not fully conscious; or the personalities may be
formed by auto-suggestions. Such phenomena may be regarded as the
_artefacts of Psychopathology_.

There are again cases which are no play-personalities depending on
hypnotic suggestion, or suggestion in waking life, but which are
really due to pathological agencies. The former, due to suggestion,
are _suggestion-personalities_, the latter, due to pathological
agencies, are _pathological personalities_. The formation of
multiple personality by means of suggestion does not belong to our
present subject.

I have discussed these facts of suggestion personalities in my
volume, “The Psychology of Suggestion,” and other works. The
pathological multiple personalities are of immense interest from
many standpoints which we need not go into just at present, since
our object is rather the causation, not the nature and character of
the personalities themselves.[7]

The subwaking self is extremely credulous; it lacks all sense of
the true and rational. “Two and two make five.” “Yes.” Anything
is accepted, if sufficiently emphasized by the hypnotizer. The
suggestibility and imitativeness of the subwaking self were
discussed by me at great length. What I should like to point out
here is the extreme _servility_ and _cowardliness_ of that self.
Show hesitation, and it will show fight; command authoritatively,
and it will obey slavishly.

_The subwaking self is devoid of all morality._ It will steal
without the least scruple; it will poison; it will stab; it will
assassinate its best friends unhesitatingly. When completely cut
off from the waking person, it is precluded from conscience.


FOOTNOTE:

[7] The subject of pathological multiple personalities is discussed
in my work, “Multiple Personality.”




CHAPTER XIII

THE CHARACTER OF THE HYPNOIDAL STATE


In “The Psychology of Suggestion,” I pointed out the conditions
of normal and abnormal suggestibility. Among these conditions,
monotony and the limitation of voluntary movements play an
important rôle. Any arrangement of external circumstances, tending
to produce monotony and limitation of voluntary movements, brings
about a subconscious state of suggestibility in which the patient’s
mental life can be influenced with ease.

I find that in the subconscious hypnoidal state consciousness
is vague and memory is diffused, so that experiences apparently
forgotten come in bits and scraps to the foreground of
consciousness. Emotional excitement is calmed, voluntary activity
is somewhat passive, and suggestions meet with little resistance.

The induced subconscious hypnoidal state is a rest state, a
state of physical and mental relaxation. It is a state of rest
and relaxation that is specially amenable to psychotherapeutic
influences. The important results obtained by me led to a closer
study of what I then thought was a peculiar mental state
designated by me as the _subwaking_, or the _hypnoidal_ state.

The subwaking, or the hypnoidal state is essentially an
intermediary state belonging apparently to the borderland of mental
life. On the one hand, the hypnoidal state touches on the waking
condition; on the other it merges into sleep and hypnosis. _A
close study of the hypnoidal state shows that it differs from the
hypnotic state proper and that it can by no means be identified
with light hypnosis._

In my years of work on patients and subjects, I have observed the
presence of the hypnoidal state before the development of hypnosis
and also before the onset of sleep. When again the hypnotic or
sleep state passes into waking, the hypnoidal state reappears.
The hypnoidal state then may be regarded as an intermediate and
transitional state.

A somewhat related state has been long known in psychological
literature as the hypnagogic state which precedes the oncome
of sleep and is rich in hallucinations known under the term of
_hypnagogic_ hallucinations. In coming out of sleep, a closely
related state may be observed, a state which I have termed
_hypnapagogic_. In both states, hypnagogic and hypnapagogic,
dream-hallucinations hold sway.

The hypnagogic and hypnapagogic states do not belong to light
hypnosis, as it can hardly be claimed that men fall into light
hypnosis twice, or possibly more than that, every day of their
life. We do not go into light hypnosis with every nap we take. We
do, however, go into the hypnoidal state when we pass into sleep or
come out of sleep. Every drowsy state has the hypnoidal state as
one of its constituents; every sleep state is preceded and followed
by the hypnoidal state.

Hypnosis may be regarded as belonging to the abnormal mental
states, while the hypnoidal state is more closely allied to waking
and sleep, and belongs to the normal, physiological, mental states.
At first, I regarded the hypnoidal state as peculiar, but as I
proceeded with my observations and experiments I could not help
coming to the conclusion that the hypnoidal state is found in all
the representatives of animal life and is as normal as waking and
sleep.

The hypnoidal state may be said to partake not only of the nature
of waking and sleep, but also to possess some characteristics of
hypnosis, namely, _suggestibility_. It is clear that, from the very
nature of its mixed symptomatology, the hypnoidal state is variable
and highly unstable. The hypnoidal state may be regarded in the
light of an equivalent of sleep. Like sleep, the hypnoidal state
has many levels of depth. It differs, however, from sleep in the
rapidity of oscillation from level to level.

In the experiments of various investigators, the depth of sleep
is found to be represented by a rapidly rising curve during
the first couple of hours, and by a gradually descending curve
during the rest of the hours of sleep. No such regularity of curve
can be found in the hypnoidal state. The depth of the hypnoidal
state changes very rapidly, and with it the passive condition and
suggestibility of the patient.

For many years investigations of the hypnoidal state were carried
out by me on subjects and patients, adults, and children. The work
was entirely limited to the study of such states as found in man.
Having found that during the hypnoidal state the condition of
suggestibility is quite pronounced for therapeutic purposes, and
having effected many cures of severe psychopathic maladies ranging
throughout the whole domain of hysterical affections, neurasthenia,
obsessions, drug habits, especially alcoholic ones, the hypnoidal
state has become, in my practice, quite an important therapeutic
agent. Other investigators have obtained some excellent results
with the hypnoidal state in their treatment of various functional,
psychopathic maladies.

Thus far, the work with the hypnoidal state has been confined
entirely to observations and experiments on human subjects
and patients, and also to the treatment of man’s psychopathic
ailments. I undertook a series of experiments on sleep, both
from a phylogenetic and ontogenetic standpoint, following up the
conditions and manifestations of sleep in the ascending scale of
animal life, from the frog and the guinea pig, through the cat, the
dog, to the infant and the adult.

My experiments clearly prove that the hypnoidal state is by no
means confined to man, but is also present in animals. This
is important since it indubitably shows how widely spread the
hypnoidal state is throughout the domain of animal life. Moreover,
the experiments clearly prove that the further down we descend in
the scale of animal organization, the more prominent, the more
essential, does the hypnoidal state become.

The conclusion is forced upon me that _the hypnoidal state is the
primitive rest-state out of which sleep has arisen in the later
stages of evolution. We may say that sleep and hypnosis take their
origin in the hypnoidal state_.[8] Sleep and hypnosis are highly
differentiated states; they have evolved out of the primitive,
undifferentiated, hypnoidal state which is essentially a subwaking
rest-state characteristic of early and lowly-organized animal life.
_The hypnoidal state is the primordial sleep state._

The development of the hypnoidal state into sleep has proven itself
useful in the struggle for existence of the higher animals; it
has, therefore, become fixed as the rest-state, characteristic of
the higher representatives of animal life. Hypnosis and other
trance-states, variations of the primitive hypnoidal rest-state,
have become eliminated as useless and possibly harmful to the
normal life adjustments of the higher animals and can only be
induced under artificial conditions in but a fraction of the human
race.

The hypnoidal state is the normal rest-state of the lower
vertebrates and invertebrates. The rest or sleep state of the lower
animals is a sort of passive waking state,--a subwaking state which
has survived in man as the hypnoidal state. Of course, the state
has been largely modified in man by the course of evolution, but
it can still be clearly detected, just as the tail of the simian
can be discerned in the human coccyx, or as the structure of the
prehensile hand of the quadrumana can be still clearly traced in
the foot of man. Waking, hypnoidal, and sleep-states may be termed
_normal_ states, while _hypnosis_ and various other trance-states
may be termed _sub-normal_ states.

The relation of the hypnoidal state to waking, sleep, hypnosis,
and other subconscious states may be represented by the diagram on
following page.

The hypnoidal state is normal, it is present in all representatives
of animal life.

Sleep, hypnosis, and trance-states are variations of the
fundamental hypnoidal state. The sleep-state has proven useful and
has become normal in the higher animals, while hypnosis like animal
“cataplexy” and the various forms of trance-states, likewise
variations of the fundamental hypnoidal state, characteristic
of man, have not proven of vital value, and have fallen below
the normal stream of consciousness with its concomitant adaptive
reactions.

[Illustration: DIAGRAM II]

The hypnoidal state is brief, variable, and unstable. They who
have observed the rest-states of the lower metazoa can form a
clear idea of the nature as well as of the biological significance
of the hypnoidal state in the life of the lower animals. The
animal is at rest for a brief period of time as long as it remains
undisturbed by external conditions of its environment, or by
internal conditions, such as hunger, sexual impulses, or other
internal disturbances. Soon the animal begins to move, sluggishly
at first, and then more quickly, and if there are no disturbing
stimulations, comes to rest, to be again disturbed from its
rest-equilibrium by the varying conditions of its environment.

The resting state is brief, irregular, differing from the waking
state in but slight relaxation, in comparatively slow reactions to
stimulations, and in a passive condition of the muscular system.
Respiration is regular, and diminished in rate. The heart beat is
slightly decreased, and general katabolic activity is somewhat
reduced.

The animal, however, is quite alive to what is going on. _The
animal rests, watching for danger._

Resting and active states alternate periodically, if possible, but
usually are irregular. The resting state is but a passive condition
in which the animal may be considered to hover between waking and
what we describe in the case of the higher animals as sleep. Sleep,
in its proper sense, does not exist among the lower representatives
of animal life.

This state of hovering between waking and sleeping, the
characteristic of the hypnoidal state, is no doubt of paramount
importance in the life-existence of the lower animals, considering
the numerous dangers to which they are continually exposed. The
animal must always be on the watch, either for food or for foe. It
can only rest or “sleep” with its eyes wide open. The hypnoidal
“sleep” can be best characterized as a _subwaking_, “twilight”
rest-state.

I demonstrated in my experiments that the animal, while in the
hypnoidal, subwaking rest-state, is apt to fall into a cataleptic
state, especially when the movements are suddenly and forcibly
inhibited. This cataleptic state, which reminds one of the hypnotic
state, may be observed in the lower animals, such as the frog,
the snake, the lobster, the bird, and, to a slighter degree, even
in the higher animals, such as the guinea pig, the cat, the dog,
especially in the young ones, such as the kitten, the puppy, and
the infant.

There is little doubt that the cataleptic state into which animals
fall during the hypnoidal rest-state is of some protective value
in their life. The animal “freezes,” “feigns death,” and is thus
either enabled to remain undetected by the animal on which it feeds
or, what is still more important, is enabled to remain unnoticed by
its enemy and thus escape certain death. The subwaking, hypnoidal
state may be regarded as the fundamental rest-state of lower
animals, and is characterized by a mixed symptomatology of waking,
sleep, and hypnosis.

The hypnoidal state is a powerful instrument in the tracing of
the past history of the growth and development of the symptoms of
psychopathic or neurotic cases; and practically is of far greater
value, inasmuch as the hypnoidal state has proven to be an easy
agency in effecting a cure, and bringing about beneficial results
in otherwise uncontrollable cases.

For the present, we can only say that the hypnoidal state is
found in man but in a rudimentary condition. It is a vestige of
man’s primitive, animal ancestors. The hypnoidal state is brief,
variable, forming the entrance and exit of repose,--the portals
of sleep. The primordial rest-state has shrunk to a transitory,
momentary stage in the alternation of waking and sleep. _The
subwaking, hypnoidal rest-state shrinks with the increase of
security of life._


FOOTNOTE:

[8] Prof. Ed. Claperèdé of Geneva University, Switzerland, and
Anastay seem to favor some similar view.




CHAPTER XIV

HYPNOIDAL PSYCHOTHERAPY


Once the hypnoidal state is induced by any of the various methods
of hypnoidization, we can either attempt to follow up the history
of the development of the malady, or we may chiefly work for
therapeutic effects. It is, however, advisable, from a purely
practical, therapeutic purpose to combine the two procedures; the
cure is then effective and far more stable. When the history of the
origin and development of the disease can not be traced, on account
of the age or unintelligence of the patient, the therapeutic
effects alone of the hypnoidal states have been utilized.

The getting access to subconscious experiences, lost to the
patient’s personal consciousness, makes the hypnoidal state a
valuable instrument in the tracing of the origin and development of
the symptoms of the psychopathic malady.

From a practical standpoint, however, the therapeutic value of the
hypnoidal state is most important. Our experiments have revealed to
us the significant fact that the hypnoidal state is the primordial
rest-state; sleep is but a derivative form. In many conditions of
disease it is advisable to have the patient revert to a simple
and primitive mode of life. Similarly, in _psychopathic diseases
a reversion to a simple, primitive state proves to be of material
help to the patient_.

In plunging the patient into the hypnoidal state, we have him
revert to a primitive rest-state with its consequent beneficial
results. The suggestibility of the state, if skillfully handled,
is apt to increase the therapeutic efficacy. Relaxation of nervous
strain, rest from worry, abatement of emotional excitement are
known to be of great help in the treatment of nervous troubles of
the neurasthenic, or of the so-called “psychoasthenic” variety.
That is what we precisely observe in the treatment of psychopathic
or neurotic diseases by means of the agency of the hypnoidal state,
the efficacy of which is all the greater on account of the presence
of the important trait of suggestibility.

The most important fact, however, is _the access gained through the
hypnoidal state to the patient’s stores of subconscious reserve
neuron energy, thus helping to bring about an association of
disintegrated, dissociated mental-systems_.

Dr. John Donley in his article, “The Clinical Use of
Hypnoidization” (_Journal of Abnormal Psychology for
August-September, 1908_), gives the following account of the method
of hypnoidization:

  “The treatment of that large group of disorders, forgotten
  memories, and emotions is operative in the production of mental
  disaggregation, but also in those numerous instances where the
  experience causing the obsessive idea or emotion is well known to
  the upper consciousness.

  “In hypnoidal states they were made to reproduce their obsessive
  thoughts and images and then to describe them in words. When this
  had been accomplished and they had received further assurance
  and persuasion from the experimenter, although the purely
  intellectual content of their obsessions remained known to them,
  the insistent automatic character and disturbing emotional
  factors had disappeared. In this metamorphosis of emotional
  reaction we may observe one of the most interesting and useful
  attributes of the hypnoidal state.”

Dr. Donley gives a series of cases which he treated successfully
from psychognostic and psychotherapeutic standpoints. The reader is
referred to the original article.

“The value of hypnoidization,” says Dr. T. W. Mitchell, “in the
resurrection of dissociated memories is that which is perhaps best
established. And this applies not only to the restoration of the
forgotten experiences of ordinary amnesia, but to the recovery
of dissociated memories that are of pathogenic significance....
Sidis himself has insistently taught that the reassociation of
dissociated complexes effects a cure of psychopathic disease.... My
own experience, so far as it goes, tends to corroborate in every
respect the claims put forward by Sidis....”

While in the hypnoidal state the patient hovers between the
conscious and the subconscious, somewhat in the same way as in
the half-drowsy condition one hovers between wakefulness and
sleep. The patient keeps on fluctuating from moment to moment, now
falling more deeply into a subconscious condition in which outlived
experiences are easily aroused, and again rising to the level of
the waking state. Experiences long submerged and forgotten rise
to the full light of consciousness. They come in bits, in chips,
in fragments, which may gradually coalesce and form a connected
series of interrelated systems of experiences apparently long dead
and buried. The resurrected experiences then stand out clear and
distinct in the patient’s mind. The recognition is fresh, vivid,
and instinct with life, as if the experiences had occurred the day
before.

It cannot be insisted too much that the hypnoidal state is not
a slight hypnosis. _The hypnoidal state is a light sleep state,
a twilight state._ The hypnoidal state is the anabolic state of
repose, characteristic of primitive life.

The hypnoidal state is an intermediary state between waking and
sleep. _Subwaking_ is an appropriate descriptive term of the
character of the hypnoidal state.

The subwaking hypnoidal state, like sleep and hypnosis, may be of
various depth and duration; it may range from the fully waking
consciousness and again may closely approach and even merge into
sleep or hypnosis. The same patient may at various times reach
different levels, and hence subconscious experiences which are
inaccessible at one time may become revealed at some subsequent
time, when the patient happens to go into a deeper hypnoidal state.

On account of the instability of the hypnoidal state, and because
of the continuous fluctuation and variation of its depth, the
subconscious dissociated experiences come up in bits and scraps,
and often may lack the sense of familiarity and recognition. The
patient often loses the train of subconscious association. There
is a constant struggle to maintain this highly unstable hypnoidal
state.

One has again and again to return to the same subconscious train
started into activity for a brief interval of time. One must
pick his way among streams of disturbing associations before the
dissociated subconscious experiences can be synthesized into a
whole, reproducing the original experience that has given rise to
the whole train of symptoms.

The hypnoidal state may sometimes reproduce the original experience
which, at first struggling up in a broken, distorted form, and
finally becoming synthesized, produces a full attack. The
symptoms of the malady turn out to be portions, bits and chips of
past experiences which have become dissociated, giving rise to a
disaggregated subconsciousness.

The method of hypnoidization, and the hypnoidal states induced by
it, enable us to trace the history and etiology of the symptoms,
and also to effect a synthesis and a cure. The hypnoidal state may
not be striking and sensational in its manifestations, but it is a
powerful instrument in psychopathology and psychotherapeutics.

For many years my investigations of the hypnoidal state were
carried out on subjects and patients, adults and children. Having
found that during the hypnoidal state the condition of mental
plasticity is quite pronounced for therapeutic purposes, and having
effected many cures of severe psychopathic maladies, ranging
throughout the whole domain of so-called hysterical affections,
neurasthenia, obsessions, drug habits, especially alcoholic ones,
the hypnoidal state has become in my practice quite an important
therapeutic agent. Lately, others have obtained excellent results
with the hypnoidal state in their treatment of various functional,
psychopathic or neurotic maladies.

Perhaps it may be opportune here for the sake of further
elucidation to give a few extracts from the Presidential address on
“The Hypnoidal State of Sidis,” given by Dr. T. W. Mitchell before
the Psycho-Medical Society of Great Britain, January 26, 1911.

“The history of science,” says Dr. Mitchell in his address,
“affords us many instances in which the neglect of residual
phenomena in experimental research has led to the overlooking
of important facts, and prevented investigators from making
discoveries which, had they paid attention to their residues, they
could hardly have missed. The great chemist, Cavendish, probably
missed the discovery of argon, because in his estimate of nitrogen
of the air he neglected a residue which his experiments showed him
could not be more than 1/120 part of the whole. More than a hundred
years afterwards this residue was accounted for by the discovery of
argon.

“Now in the history of Psychotherapeutics, from its earliest
beginning down to our own time, we find many cases where the
circumstances under which curative results have been obtained
render it difficult for us to range these results under the
category of the therapeutics of suggestion.

“Such cases as these may be regarded as the residual phenomena
of the therapeutics of suggestion, and just as Cavendish and his
successors too readily assumed that all the so-called nitrogen of
the air was the same as the nitrogen of nitre, so we may be missing
some important truth, if we too readily assume that all these
therapeutic results are due solely to suggestion. The value of
suggestion during hypnosis is well attested, and the possibility of
effecting physiological and psychological changes by its means is
supported by a large amount of experimental evidence. But evidence
of this kind is lacking in regard to suggestion without hypnosis,
and until it is forthcoming, we are justified in receiving
with some suspicion the account of the therapeutic efficacy of
suggestion in the waking state. We seem bound to consider whether
some state of consciousness intermediate between waking and
hypnosis may not be artificially induced and utilized for the
purpose of giving therapeutic suggestion.

“The scientific investigation of states of consciousness
intermediate between waking and hypnosis is a contribution to
psychology and psychotherapy which we owe practically to one
man--Dr. Sidis. A research into the nature of suggestibility led
him to formulate certain laws and conditions of normal and abnormal
suggestibility....

“By keeping the patient for a short time under the conditions of
normal suggestibility we induce a peculiar mental state which Sidis
named _Hypnoidal state_. The process by which it is induced is what
Sidis calls, _hypnoidization_.

“By the use of various methods a state of consciousness is induced
which differs from full waking, but is not hypnosis or ordinary
sleep.

“The hypnoidal state is an intermediary territory, on the
borderland of waking, sleep and hypnosis. In the course of a
valuable experimental investigation of sleep in man and the lower
animals, Sidis discovered that the hypnoidal state is a phase of
consciousness which is passed through in every transition from one
of these states to another. In passing from the waking state to
ordinary sleep or hypnosis, there is always a longer or shorter
hypnoidal stage. In the practice of hypnoidization the patient
sometimes drops into hypnosis, or he may fall asleep without
touching on hypnosis. And so also in awaking from sleep or from
hypnosis, the hypnoidal state has to be passed through. Sidis found
that the further we descend in the scale of animal life, the more
important does the hypnoidal state become in relation to bodily
rest and recuperation, and he concludes that it is the primitive
rest-state out of which both sleep and hypnosis have been evolved.

“The relation to each other of waking, sleep, hypnosis and the
hypnoidal state, may be represented in a diagram in which the
primitive hypnoidal state is represented as a nucleus from which
the segments of the larger circle, waking, sleep and hypnosis, have
arisen. The transition from one of these segments to another can
take place through the central territory with which they each have
relations. (See diagram on page 110.)

“The spontaneous occurrence of the hypnoidal state in man is as a
rule merely a transitory stage in the alternation of waking and
sleep. From the point of view of evolution it is a vestige derived
from a long race of ancestors, a rudimentary function which has
been superseded by the more highly specialized rest-state, sleep.
But it can be artificially induced and maintained by the methods
which have been described, and it can be utilized with effect in
the treatment of psychopathic disorders.

[Illustration: DIAGRAM III]

“The therapeutic use of the hypnoidal state is a somewhat complex
subject, for hypnoidization may be employed as an adjunct to other
methods or as a curative measure in itself.

“The full record of hypnoidization is in the account of the well
known Hanna case, given in his ‘Multiple Personality.’ This was a
case of total amnesia, following a severe injury to the head. The
patient, a cultured clergyman, was reduced to the mental condition
of a new-born child. All his former acquisitions and memories had
entirely disappeared, and he had to start learning everything
again from the beginning. When he (the patient) was put into the
hypnoidal state various fragmentary experiences of his past life
emerged into consciousness, demonstrating to his observers that his
lost memories were merely dissociated and not destroyed. This same
method (hypnoidization) was made use of in other cases of amnesia,
and it was found to be of great assistance in effecting the
resurrection of dissociated mental material and its reintegration
in consciousness.

“With the progress of his studies in Psychopathology, the
reintegration of consciousness became, for Sidis, the aim of
all therapeutic endeavor in connection with maladies that are
associated with, or produced by, mental dissociation. The
recurrent psycho-motor states of functional psychosis, insistent
ideas, imperative concepts, persistent, or periodically appearing
emotional states, so-called psychic epilepsy, and other states of
dissociation all lent themselves to treatment by hypnoidization.
By its means the dissociated complexes could be recovered, the
psychogenesis of the malady could be traced, a synthesis of
consciousness effected, and the patient thereby cured. As his
confidence in his method increased, Sidis gradually extended its
employment, until at the present time he seems to use it in every
kind of disorder in which psychotherapy is indicated.

“I have no doubt that Dr. Bramwell induces in his patients a state
of consciousness which is identical with the hypnoidal state of
Sidis.

“My own experience, so far as it goes, tends to corroborate in
every respect the therapeutic claims put forward by Sidis. I have
observed the good effects of the hypnoidal state apart from any
other measure.

“In his later writings Sidis insistently maintains that the use
of hypnoidization alone is sufficient to cure certain morbid
conditions. He bases this claim on the fact that he has found the
hypnoidal state effective towards this end, and he interprets his
results as being due to a release of reserve energy which has been
locked up in the inhibited and dissociated systems or complexes.

“The _principle of reserve energy_ is based upon a wide
generalization of facts, namely, that far less energy is utilized
by the individual than is actually at his disposal. In the struggle
for existence, those forms of life which have accumulated a store
of reserve energy that can be drawn upon in emergencies have the
best chance for survival.”

According to my experimental and clinical work the waking state,
sleep, hypnosis, and the hypnoidal state, may be differentiated as
follows:

(I) In the waking state the upper, controlling consciousness
_predominates_ over the subconscious. In other words, in the waking
state the conscious is more responsive and more active than the
subconscious which as a rule under such conditions may be regarded
as partially dormant.

(II) In sleep _both_ the conscious and the subconscious are
_reduced_ in activity, often even _inhibited_ in function. Motor
consciousness is _arrested_; motor control is paralyzed. The
personality is _disintegrated_.

(III) In hypnosis the upper, controlling consciousness is
_diminished_ in activity, while the subconscious activities
are _increased_ in extensity and intensity. In hypnosis
the relationship of the conscious and subconscious is
interchanged,--the conscious becomes subconscious, and _vice
versa_. The habitual type of character may become changed by
suggestion, giving rise to double and multiple personality,
according to the crystallization of various association systems,
while the habitual, critical attitude is reduced in intensity.

(IV) In the hypnoidal state both conscious and subconscious
functions are _lowered_ in activity with no decrease in the
intensity of critical attitude, and with _no change_ of personality.

The hypnoidal state is therefore not a light hypnosis, but rather a
_light sleeping state, a twilight state_. The hypnoidal state is a
primitive rest-state out of which sleep and hypnosis have arisen in
the course of animal evolution.




CHAPTER XV

EGOTISM AND FEAR


As we have pointed out, the fear instinct is the arousal of
the impulse of self-preservation. Psychopathic conditions are
at bottom fear states interrelated with hypnoidal states and
with an abnormal, pathological condition of the impulse of
self-preservation. This is manifested in the fundamental trait of
extreme selfishness characteristic of psychopathic patients. The
patient is entirely absorbed in himself, and is ready to sacrifice
every one to his terrors.

For many years, day after day and night after night, I lived with
patients who were under my care, observation, and treatment. One
trait always revealed to me the predominant characteristic under
the constantly changing psychopathic symptom-complex and that is
_the extreme selfishness of the patients_. There is no greater
egotism to be found than in the typical cases of psychopathic
disorders. This egotism runs parallel to the condition of the
psychopathic state. This does not mean that every egotist is
necessarily psychopathic, but _every psychopathic case is
essentially egotistic_.

The psychopathic patient does not hesitate a moment to sacrifice
to his “affection” father, mother, brother, sister, husband, wife,
lover, friend, and children. In severe cases the patient stops at
nothing and only fear of suffering, sickness, evil consequences,
and punishments can restrain the patient. In some extreme cases the
patient is almost diabolical in his selfishness.

The constant sympathy which the patients crave from others, and
which they demand, if it is not given to them immediately, is
but an expression of their extreme obsession by the impulse of
self-preservation. In their struggle for self-preservation they
forget everything else, nothing is remembered but themselves. This
condition becomes the ground character which is often expressed
in a frank, brutal way. Even in the best of patients one can find
glimpses into the depths of the psychopathic soul which is nothing
but the immense egotism of the beast, worsted in the struggle for
existence, tortured by the agonizing pangs of the fear instinct.

In the vanity, conceit, arrogance, and overbearing attitude towards
others, friend or stranger, as well as in the total indifference
to the suffering of his intimate friends and acquaintances, we
once more find the expression of that terrible selfishness which
obsesses the psychopathic patient. In order to get rid of some
small inconvenience, or to obtain some slight pleasure, the patient
will put others as well as his “near and dear ones” not only to
inconvenience, but to permanent pain, and even torture.

The patient lacks confidence, at least that is what he complains
of, but he does not hesitate to demand of his best friends and even
of total strangers all the services possible, if they are given
to him, thinking that he is fully entitled to them. The patient
has the conceit and vanity of his great worth in comparison with
other people. The world and especially his family, physicians,
attendants, friends, acquaintances, lovers, should offer their
happiness and life for his comfort.

Even when the psychopathic patient does some altruistic act,
it is only in so far as he himself can benefit by that deed.
He is ready to drop it as soon as the work does not answer his
selfish purposes. Himself first and last, that is the essence of
psychopathic life.

The patient is convinced of his goodness and kindness, and of his
human affections which are far superior to those of the common
run. He adores himself and he is always ready to dwell in the
glory of his delicacy and extraordinary sensitivity. This trait
he is specially anxious to impress on his friends, on his family,
and even on those whom he apparently loves. “I am the delicate
being of whom you all, unappreciative, gross, insensible people
should take care.” That is the principle on which the psychopathic
patient lives. The patient will do anything to attract attention
to this side of his personality. He will emphasize his sickness,
exaggerate his symptoms, and even manufacture them for the benefit
of those who dare to ignore him or who pay little attention to
his condition, to his wants, needs, caprices, passing whims, and
especially his fears, which underlie all his wishes and desires.
_There is nothing so tyrannical and merciless as the autocratic,
fear-obsessed “weak” will of a psychopathic or neurotic patient._

The patient’s whole attention is concentrated on himself, or more
specially on the symptoms of his psychopathic malady, symptoms
which obsess him for the time being. Whatever the symptoms be,
permanent or changing, the patient’s demand is to have others
sympathize with the illness from which he suffers, to have them
realize the “fearful” agonies which he undergoes. The selfishness
of the patient is exacting and knows no bounds. The whole world is
to serve him, and be at his command. The psychopathic patient is
driven by the impulse of self-preservation and by the furies of the
fear instinct.

Many of my psychopathic patients tell me that they feel sensitive
as long as they witness the sufferings of other people, otherwise
they do not care to know anything about them. They are anxious
to have such things away from them as a nuisance. They insist on
being surrounded only with pleasant things or with persons and
objects that contribute to their health and happiness. Everything
is absorbed by the worship of Moloch Health to whom the patients
sacrifice everything. Pain, suffering, and distress of other people
are looked at only from the standpoint of the possible effect they
may have on the patient’s “precarious health.” Like Nero, who
was probably a psychopathic character, the psychopathic patient
is ready to burn others for his health; if necessary, to torture
“health and happiness” out of his best friends.

One of my patients, who is highly intelligent, tells me frankly
that he uses others to squeeze out of them strength for himself.
As soon as he can no longer get it, or has obtained all he can,
he is anxious to part with them, gets tired of them, and even
begins to be resentful because they are in the way of his health.
Another of my patients was ready to burn parks, stables, and
destroy everything, if he knew that it was good for his health.
Other patients of mine do not hesitate to wake up the whole house
to help them in insomnia or indigestion. Many of my patients take
pleasure in forming acquaintances and even friendship with people,
ask for their sympathy, require their help and assistance, come to
them early in the morning and late at night, disturb their sleep
in the small hours of the morning, display all their symptoms
of indigestion, nausea, eructation, and vomiting. The patients
then turn round, abuse the person who helps them, telling him
disagreeable things, because he is no longer useful. A few hours
later the patients may turn again for help to the same person,
because they find that they could still make use of him.

Psychopathic patients do not hesitate, for the alleviation of their
pains, of depression, of insomnia, to take a bath in the early
morning and wake up all the other patients. They are entirely
absorbed in themselves. Self is the only object of their regard.
A clever lawyer, aptly characterized one of my most severe and
typical psychopathic cases as “egomaniac.” “When you talk of
gravity, ‘I am gravity,’ she claims. Talk of the Trinity: ‘I am the
Trinity.’” As a matter of fact every psychopathic patient is an
egomaniac.

Bacon’s aphorisms about self-lovers may well apply to psychopathic
patients: “And certainly it is in the nature of extreme
self-lovers, as they will set a house on fire, and it were but
to roast their eggs.... That which is specially to be noted is,
that those which are _sui amantes sine rivali_, are many times
unfortunate.”

Driven by the impulse of self-preservation and by the anguish of
extreme fear, the psychopathic patient may be pitied as a most
unfortunate, miserable wretch.

In the psychognosis of the particular condition, mental or nervous,
be it object, idea, or action from which the patient suffers, the
impulse of self-preservation with its instinctive emotion of fear
can always be found in the background of consciousness or in the
subconsciousness.

An insight into a series of cases will help best to understand the
fundamental psychopathological processes that give rise to the
different forms of psychoneuroses and somatopsychoses.

The inhibition of the patient’s activities, produced by the most
primitive impulse of self-preservation with its instinct of fear,
limits the patient’s life to such an extent that the interests and
the activities are reduced to automatic repetition of reactions of
a stereotyped character. The stimuli must be the same, otherwise
the patient does not care to respond. He loses interest in his
business, in reading, in his work, and games. The attention keeps
on wandering. Games, pleasures, and hobbies in which he formerly
used to take an interest lose their attraction for him. The life
he is disposed to lead is of a vegetative existence. He is afraid
of anything new. Things are done in an automatic way. _Routine and
automatisms are characteristic of his activities._

The psychopathic or neurotic patient talks about his humanitarian
ideals, about his great abilities superior to the common run of
humanity, and how with his talents he is willing and has been
willing to confer benefits on poor suffering humanity in spite of
the fact that he has to struggle with his poor health, physical,
nervous and mental. In spite of the overwhelming fatigue due to
ill health, and in spite of the fearful ideas and impulses that
have beset him day and night he still has succeeded in fighting his
way through.

The patient hankers for notoriety, for praise, for appreciation by
other people. He is apt to complain that the family, neighbors,
acquaintances, friends cannot appreciate his good points, his good
will, and his high ideals to which he conforms his life, tortured
as it is with pains and suffering of poor health. The _egocentric_
character of the psychopathic patient is bound up in his abnormally
developed impulse of self-preservation and in his pathological
state of the fear instinct.

Thus one patient opens his account with the phrase: “From boyhood I
had a sensitive conscience.”

Another patient writes: “As a child I had a keener instinct as to
the real unexpressed attitude of those about me toward each other
than the average child.”

One of my patients, a puny being of mediocre intelligence, writes:
“I have always, from the earliest childhood, felt that I was
different from those about me; and I must acknowledge that it was
not alone a feeling of inferiority on account of poor control, but
a feeling that I understood more than they. I was, however, of a
delicate constitution and suffered from ill health.”

Psychopathic patients subscribe to the “cheerful” effusions of
“New Thought,” and plaster the walls of their rooms with elevating
“Rules for Health and Happiness.” Psychoanalysis and Christian
Science are the rage. The victims hide behind the veil of sickly,
psychopathic “Love.”

The writings and accounts of the patients are full of introspection
about health, and about the minutiae of their feelings in the
various parts of their body. Some of the patients with a literary
turn keep on writing volumes about the most minute symptoms of
their troubles to which they happen at any moment to be subject.
I have numbers of manuscripts, biographies, autobiographies, all
telling the same old story of “blighted lives” due to ill health,
drugs, and treatment, all describing with the over-scrupulous
exactness of microscopic anatomy the different symptoms that plague
them by night and by day. The patients tell of their talents and
remarkable abilities, superior to the average run, of their ill
luck and failures, due to their unfortunate state of ill health.

In quoting from some of the accounts given to me by the patients
themselves I wish to attract attention to this side of the
patient’s mental condition, the expression of the impulse of
self-preservation, manifested in the general panic of health, or
fear of disease, whether nervous or physical.

A patient of mine, a clerk of mediocre intelligence, with hardly
any ability, but with plenty of selfishness, introspection, and
immeasurable conceit, writes about his ideals in life:

“I would ask that this manuscript be considered in connection with
my other two writings. I have already partially covered this ground
in my autobiography. I should be glad to have my general outlook on
life considered, and to receive suggestions relative to vocations
and avocations, since my anxieties regarding these are inseparably
intermingled with my thoughts of physical and mental health.

“Of course since childhood my ideals have undergone a gradual
modification. First, there was the religious motive of life: I
wanted to be a soldier of the cross and assist in the regeneration
of souls and their preparation for the life beyond.... I began
to meditate upon ethical theories.... It appears that in doing
the world’s work the tendency is to specialize.... In the matter
of choosing my employment my own interest is identical with the
interest of society. At different times of my life I have fancied
I had a liking for one calling or another.... My lines of thought
have gradually drifted into the philosophical (patient means the
various occult scribblings about ‘health metaphysics’). I now
ask myself why I should be a lawyer, a physician, a minister,
a philanthropist or any other special thing? I conceive that a
man’s life is largely what circumstances make it, and it may be,
therefore, that I shall always be a clerk in an office, trying to
be useful in a small way; but now we are talking of influencing
such matters as far as we can by choice. I imagine that perhaps
my field is in the line of ethics, philosophy, or whatever words
may be used to signify the _general principles_ governing human
affairs. My reasons for thinking so are as follows: First, I feel a
strong interest in those principles comparing to no other interest
in my life. Second, I find very few people who seem to feel any
such interest in such matters. Third, I believe such principles
to be of supreme importance. The question is,--Is my position
in regard to general truths so peculiar that I should regard it
my mission to give those subjects more attention in study and
expression than do other men?

“The question I want to settle is,--Do other men feel this
same philosophical interest, realize the broad field of human
obligation, and come down to special occupations, not because
they are more interesting to them than the general field, but
because they realize they must specialize in order to properly
assist in carrying on the world’s work? If this be so then I am
mistaken in thinking I should give particular attention to general
principles. But my observations have gone to show that the average
physician, lawyer, merchant or politician is not interested in the
broad questions of life, but only in medicine, law, business,
or politics, caring little for the relation of his vocation to
other vocations except as he makes his bread by it. Why then if
the various departments of human activity must be correlated, and
if the individuals making up those respective departments have no
disposition to do the correlating,--should it not be done by those
who are interested in the general field?”

It means that such work could be and should be done by the patient,
by the philosophical clerk, interested in the general “metaphysics”
of health.

Such confessions can be easily elicited from psychopathic patients
even in their best states of apparent diffidence, humility.
_This paranoidal aspect of self-aggrandizement is present in
all psychopathic cases._ In some this trait stands out more
clearly and distinctly than in others. It is, however, present
in all psychopathic patients, if one observes them closely and
attentively. It is the expression of an intensified state of the
impulse of self-preservation and fear instinct. In other words, it
is a state of an exaggerated, hypertrophied egotism.

“We must appeal to a law higher than the material law,” a patient
writes in his account. “I worried much over it. Since that time
the relation of mind and matter greatly interested me.... My
health at this time failed, I lost appetite and strength, had
hysterical symptoms. I was treated for general neurasthenia.” ...
Psychopathic, philosophical and ethical speculations and interests
have their sole source in fear of sickness and self-preservation.

“One of my anxieties,” another patient writes, “of my present life
is connected with my business and my relationship to my partners.
I am naturally conscientious and inclined to be not only earnest
and sincere, but serious. My nature, instincts, and desires are
not superficial. Yet my relation to the business is a superficial
one. I am neither fitted by natural tastes nor by training for the
indoor, rather mechanical, conventional, and routine processes upon
which business and commercial success depends....

“Without the common motives of an ordinary merchant (greed) I am
placed in the position of the one who lives not by the usual and
conventional standards of right and wrong, but rather by a more
exalted and more rigid one of his own making which, unsupported
by habit, and institutions, requires a greater loyalty, a higher
resolve, and a firmer will than is required of the conventional
and conforming citizen. Emerson says it demands something Godlike
in one who would essay such a task, not placing the same values
on money, trade, commerce, and profits as the natural money
maker and money lover, and not the opportunity to substitute and
supplement the usual motives by and with the larger, and to me
more compelling, of community betterment and employee welfare....”
This man had abandoned his wife and three children.

Another patient writes of himself, “The hypersensitive nervous
system with the initial shock has inhibited the development of my
highest potentialities and my highest endeavors.” He summarizes
his symptoms: “Dread and anxiety about being away from home and
friends, self-consciousness, mental sluggishness, quick fatigue,
inability for deep thought, general state of irritability.”

A neurotic patient tells me that he suffers from fatigue, insomnia,
dullness, inability of concentration of attention, failure in
studies, slowness of comprehension, and so on; and yet he gives
his opinion with papal infallibility on every conceivable subject,
and hints at being an undeveloped, unappreciated genius. The
psychopathic, neurotic patient rarely, if ever, suffers from a
complaint of inferiority. His real fear is that his superiority may
be humbled.

Obsessed by the impulse of self-preservation and fear instinct, and
with utter disregard of others, the patients are convinced of their
extraordinary kindness, gentleness, sympathy, martyrdom, and even
saintliness. It is from this class that neurotic philanthropists
are recruited. Psychopathic patients are always ready “to sacrifice
themselves for the good of humanity.” They talk endlessly about
goodness, and may even devote themselves to charity and instruction
of the “poor and degraded.” A patient of mine worked for three
years for the “good of the poor,” had “high ideals and a sensitive
conscience,” according to his accounts, but abandoned readily his
wife and children.

Another young woman, a typical psychopathic, full of high ideals,
ran away with a married man, had a child that died of exposure.
This patient was interested in modern education and improvement of
humanity. In reality she never cared to do anything for anybody,
and without any hesitation took advantage of others in order to
satisfy the least whim that might have crossed her mind, especially
those whims that relate to health. She had all kinds of directions,
prescriptions, exercises, requisite for the strength and health of
the body and the nerves.

One of my patients used to be anxious about my going and coming.
Was it love or devotion? I found out that he was afraid that I
might be killed. This fear was developed in him by an actual
accident in which his brother had died, but the same fear
associated with me was due to the fact that the patient was sure
that my treatment was requisite for his health and welfare. He
was in fear lest I might be killed, he would be unable to get his
treatments, and thus lose time in getting back his health.

For the sake of his “health” the patient will not stop at anything.
Neurotics may well name their troubles “Health and Science.” _The
psychopathic, neurotic patient makes of health his science and
religion, because self-preservation and fear are at the bottom of
the psychopathic, neurotic constitution._




CHAPTER XVI

NEUROTIC PARASITISM


The psychopathic patient may be regarded as a case of parasitism.
The parasite, living on his host, gradually loses all active
functions, a condition followed by atrophy of organs no longer
necessary to the life existence of the organism.

According to Demoor, “Atrophy begins with function when an organ
has become useless. This uselessness may arise from two causes:
the function may be no longer useful to the individual or to the
species, or it may be assumed by another organ.” When an organism
turns parasite it is an economy of nutrition and energy to save as
much as possible. The tendency of parasitism is to dispense with
unnecessary functions in the struggle for existence.

The loss of function is from the less useful, to the more
useful, to the functions absolutely indispensable to survival;
from the less essential, to the more essential, to functions
absolutely essential to the life existence of the individual. The
life activity of the parasite becomes more and more narrowed,
circumscribed, and dwindles down to a few functions requisite
to its life existence, namely self-preservation, nutrition, and
reproduction.

With the further increase of parasitism even the digestive and
reproductive functions become simplified, the parasitic individual
becomes reduced to the most fundamental of all impulses, the
impulse of self-preservation and reproduction.

The penalty of parasitic life is the _simplification_ of organic
activities, the atrophy of all higher and complex life processes.
This is what takes place in the case of the psychopathic
individual. All higher activities, all higher interests cease.

In many neurotic cases of the severe type even _the sexual instinct
becomes gradually atrophied. The patient’s life is narrowed down
to the impulse which is absolutely requisite for individual life
existence, namely the impulse of self-preservation with its
concomitant fear instinct._

The growth of the impulse of self-preservation with its fear
instinct brings about their hypertrophy which in turn hastens the
degenerative processes or atrophy of all higher and more complex
activities. The psychopathic patient in the process of degeneration
and atrophy falls so low that not only moral, social, intellectual,
but simpler psychomotor reactions become gradually diminished and
atrophied. _In severe cases even the instinct of sex, requisite
for the preservation of the species, is made subservient to the
impulse of self-preservation and the fear instinct._

In psychopathic life all activities are narrowed down to the
pettiness of individual existence. It is not sex, it is not
species-interests, nor conflicts, nor self-repressions that trouble
the neurotic patient. An abnormal impulse of self-preservation and
fear instinct are at the bottom of all psychopathic miseries. _All
psychopathic, neurotic interests are reduced to the sorry life of
self and fear._

Lacking interest in anything but himself, terrorized by the fear of
existence, the psychopathic patient lives a dreary, monotonous life
out of which he seeks to escape. Monotony, _ennui_, indifference
form the curse of his life. The patient is in a frantic condition,
constantly in quest of interests which he cannot enjoy. Nothing can
interest him, because he has no other interest but himself, and
that is so narrow, that it can hardly fill existence.

As a matter of fact he is afraid to meet his fears, he is afraid
of himself. He is afraid to come to a decision, never at peace,
ever at war with himself. He is bored with himself, wearied with
everything and with everybody. He is constantly eager to find
new pastures and new excitements, so as to fill with some living
interest his poor, narrow, mean, short existence obsessed by fear,
misery, wretchedness, and brutish selfishness.

The patient is afraid to work, because it may “fatigue and
exhaust” him, and may bring about a state of disease, while he
looks for health. He has no interest, because he only thinks of his
little self, reduced to digestion, evacuation, and sleeping. The
psychopathic patient leads an inactive existence of a sluggard, a
lazy, idle existence of a parasite, and still he is driven to life
and activity which, from the very nature of his narrow, parasitic
individuality, he can no longer enjoy. He has the ideals of a hero
and lives the life of a coward. This puts the patient in a state
of dissatisfaction, discontent, and ceaseless contest with himself
and others. Fear and self never leave him at peace. He is ever in a
state of agitation, restlessness, and anxiety.

Obsessed with the anxious fears of self-impulse, the patient avoids
the terrors of life, and drags the grey, monotonous existence of
a worm. Hence there is a tendency in the psychopathic patient to
be on the lookout for ever new energetic personalities, lean on
them, suck out all the energies he possibly can, then reject his
new friends unhesitatingly and brutally, and be again in search for
new personalities who can disperse, for ever so brief a time, the
fearful monotony and dread of his miserable, psychopathic, neurotic
existence.

The neurotic patient may be characterized as a psychopathic leech,
or truer still, a psychopathic vampire. For it is on the life and
blood of other people that the psychopathic ogre is enabled to
carry on his bewitched, accursed, narrow, selfish existence, full
of terror and anguish of life.

“When the attack is on,” exclaimed a psychopathic patient, affected
with cardiac palpitation and intense fear, “I am too d----d scared
about myself to think about her!” referring to the woman with whom
he was in love. The psychopathic patient is a parasitic ogre with
an hypertrophied ego.

Patients who claim to love children when the latter are well and
healthy, avoid them, like a pest, when the children happen to fall
sick, for fear of disease and for fear that the sick children may
produce an evil influence on the patient’s “sensitive” nerves.
The patient is afraid to come near sickness, or even afraid to
hear of evil things, such as description of misfortunes, ailments,
accidents, and sufferings, because they may upset him and arouse
his fears of himself.

All the patient wants is to be surrounded with cheer, joy,
merriment, excitement, and happiness which he is unable to enjoy.
The psychopathic patient is in constant search after happiness. Not
that he is interested in the problem of happiness from a moral,
philosophical, or even purely religious standpoint. His interest is
of the crudest, the meanest, the most selfish kind. It is happiness
for self,--for a low, mean, short, and brutish self. Psychopathic
search for happiness is the anguish of the beast, cornered by
terror. The patient is tortured by an unsuccessful search for
happiness, ever tantalized by self and fear. Egotism, fear, ennui,
restlessness, anxiety, discord are the harpies of psychopathic,
neurotic life.

_The love of the psychopathic patient is at bottom self-love_; it
is like the love of the wolf for the lamb. Lover, husband, child,
friend, father, mother, brother, sister, are all victims to the
patient’s greedy self.

The fear instinct has a positive and negative aspect. There is
the fear of life, fear of putting forth energy in meeting the
exigencies of life. The patient is afraid to participate in the
struggle of life. Struggle spells to him danger, peril,--fear of
the external world. Struggle means to him fear, suffering, and
misery. The patient avoids society, avoids not only strangers, but
even his acquaintances, friends, and sometimes his own family.

While he constantly craves for ever new stimulations to his
depleted nerves, he is at the same time in terror of everything
that is _new_. The patient is afraid of life, he shirks duties,
responsibilities, efforts, and joys of life struggle. Hence his
love of automatism, routine, and fear-fatigue.

The fear manifests itself more often in the form of the negative
side of life, such as fear of sickness, weakness, incapacity,
degradation, loss of vitality, and generally the fear of death.
_Neurotic states are due to fear of life and fear of death._




CHAPTER XVII

FUNDAMENTAL PRINCIPLES


The following principles may be regarded as fundamental in the
development of psychopathic or nervous ills:


I. _The Principle of Embryonic Psychogenesis_

The mental states of psychopathic or nervous ills are of an
infantile, child type. In this respect the mental states simulate
cancerous and other malignant growths of an embryonic character.
The psychopathic mental states are not only of a childish
character, but they are often associated with child experiences
of early life. The psychopathic condition points to some early
fear-producing experience, or fear awakening shock.


II. _The Principle of Recurrence_

Fear experiences tend to repeat themselves in consciousness,
and especially in the subconscious states of the child. This
repetition or recurrence keeps alive the psychopathic fear nucleus,
and _fixes_ it in the mind. Fixed fear systems become further
developed by the subsequent experiences of life. The aroused
fear instinct may either become weakened or strengthened. When
the conditions of life are unfavorable and adverse, tending to
further cultivation of the impulse of self-preservation and the
fear instinct, the outcome is a psychopathic disposition, ending
in a nervous state with typical symptoms of some definite nervous
trouble, formed by the _latest_ or _ultimate_ fear experiences.


III. _The Principle of Proliferation and Complication_

With the growth of the child the fear experiences increase and
multiply. These experiences become associated with the original
child nucleus of fear and thus a complexity of fear systems is
built up. Worries, depressions, and anxieties help to increase and
develop the psychopathic system of groups of fear experiences. The
morbid state grows like an avalanche in its progress downwards.


IV. _The Principle of Fusion or of Synthesis_

All the fear experiences become associated and grouped gradually
around the original child fear experience which is often of a
subconscious character. The long series of fear experiences becomes
fused and synthesized by the central fear instinct and impulse
of self-preservation, which are fundamental in every being, but
which have been specially cultivated by the course of events and
experiences in the neurotic patient. The experiences become fused,
synthesized, and systematized, forming one complex network of
closely interrelated fear obsessions with the fear instinct and
impulse of self preservation in the background.


V. _The Principle of Contrast_

Feelings and emotions follow by contrast. Excitement is followed by
depression, enjoyment by disgust, exhilaration by disappointment.
This is well brought out in the changes observed in the
psychopathic self and fear states.

Fear may be followed by _anger_, especially against those who
are sure to show no opposition, or may even manifest fear. The
excitement of fear in others is a way which diminishes fear in the
patient and helps him to have confidence in himself, strengthening
his impulse of self preservation.

The fear of the psychopathic may even resort to love so as to gain
safety and protection from the tantalizing agonies of the fear
instinct. _That is why some physicians are deceived, and ascribe
psychopathic troubles to love instead of to the real fundamental
cause of all psychopathic disorders, namely self-preservation and
the fear instinct._

Similarly mysticism, a psychopathic malady of a social character,
has its origin in the impulse of self-preservation and the fear
instinct, and takes refuge in “love” or in “union” with the
Infinite which serves as a rock of protection, security, and
salvation from all terrors of life. _Psychopathic love is a
neurotic fear delusion._ There is nothing more deceptive and
delusive than psychopathic love,--for it takes its origin in self
and fear.


VI. _The Principle of Recession_

Experiences are blotted out from memory in the course of time. A
very small percentage of impressions is registered by the brain,
a still smaller percentage can be reproduced, and out of them a
very small percentage carries _recognition_ as memory, that is,
of impressions experienced before. _Forgetfulness is therefore a
normal physiological function characteristic of the brain and mind._

Forgetfulness depends on at least three conditions, lack of
registration, lack of reproduction, and lack of recognition.

There will correspondingly be at least three forms of amnesia or
forgetfulness, _amnesia of registration, amnesia of reproduction,
and amnesia of recognition_. The real problem of Psychology is not
so much the lapses of memory, but the _why_ and _how_ of memory,
and especially of recognitive memory.

This, however, we may establish as a law that when memory in
regard to definite experiences weakens in the course of time, the
lapse follows _from recognition to reproduction, and finally to
registration_. Recognition fails first, then comes the failure of
memory reproduction, and finally memory registration of the special
experience becomes blurred and wiped out. This may be termed
_the law of memory decay, or of memory regression_. This is the
principle of memory recession.

Some, though by no means all, child memories or infantile
experiences follow this law of regression or recession. Child
experiences, like all old experiences, tend to recede in
their course of decay or of regression below the threshold of
consciousness. The experiences are not recognized on reproduction,
or are reproduced with great difficulty, or have even lost the
function of being reproduced. When under such conditions, the
experiences are said to have become subconscious, or have receded
into the subconscious.

On the other hand some of those subconscious experiences, or
subconscious memories may, under favorable conditions, once more
regain their functions of reproduction and recognition, and
become fully conscious. This may occur in various trance states,
subconscious states, and in various psychopathic conditions.

Such states, however, rarely fix the experiences in memory, because
the states are instable, temporary, and the memories lapse with the
disappearance of the states. This principle of recession may be
regarded as one of the fundamental facts of the Psychopathology of
the Subconscious. In fact, _subconscious states may also be termed
Recessive States_.


VII. _The Principle of Dissociation_

Recessive states, becoming marginal and subconscious, lapse
from voluntary control, they cannot be recalled deliberately
and consciously by the activities of voluntary, recognitive,
associative memories, constituting the mental life of personality,
and hence may be regarded as mental systems in a state of
_dissociation_. The lapsed states are present subconsciously when
not completely blurred and obliterated by the process of decay or
regression.

Dissociated, subconscious states, when affected by the impulse of
self-preservation and the fear instinct, tend to become parasitic,
and like malignant growths may suck the life energy of the
affected individual. Under such conditions we have psychopathic,
subconscious, dissociated states.


VIII. _The Principle of Irradiation and Diffusion_

In the dormant, subconscious states the fear instinct gradually
extends to other subconscious states. The fear instinct acts like a
malignant growth, like a fermenting enzyme. The subconscious fear
instinct gradually infiltrates, diffuses, irradiates its affective
state throughout the subconscious life of the patient, finally
giving rise to a psychopathic disposition with its selfishness,
apparent repressions, apprehension, anxiety, anguish, terror,
and panic. This may also give rise to the general psychopathic
character of doubt, indecision, and _conflicting_ states, all being
determined by the underlying fear instinct.


IX. _The Principle of Differentiation_

With the growth of the impulse of self preservation and with the
development of an exaggerated fear instinct, the individual becomes
more and more neurotic and psychopathic. This general, neurotic,
mental state attaches itself to various events in the life of the
individual. The psychopathic disposition keeps on progressing from
one event to another. Each one may be regarded as a separate fear
state, or phobia. Finally the disposition may settle on the last
event in the patient’s life experience. This last event may often
become the nucleus, or rather the apparent nucleus of the neurosis.

The last experience appears to be central. _As a matter of fact
there is a great number of fear states or of phobias in the
neurotic patient._ A few only appear to predominate in the network
of fear events. The network of fears is woven into an incongruous
whole by the impulse of self-preservation and the fear instinct.
This network becomes differentiated into a tangle of numerous fear
states.


X. _The Principle of Dominance_

The last fear states or _Ultimate Fear States_ which stand out
clearly and distinctly in the patient’s mind become the leading,
the dominant abnormal, pathological states. The patient thinks
that they are the real source of all his troubles, and if they
were removed he would be cured. As a matter of fact the ultimate
states are not _causes_, but _occasions. The real causes of
the psychopathic constitution are the exaggerated impulse of
self-preservation and the intensified fear instinct._


XI. _The Principle of Dynamogenesis_

Recessive, and especially dissociated systems, being dormant
subconsciously, may become envigorated, may accumulate emotion,
and when the opportunity comes, may react to external stimuli
with vigor and energy. The attacks may occur like epileptic fits.
They often so well simulate epileptic maladies that even good
clinicians have classed such attacks under the term of larval
epilepsy, psychic epilepsy, hystero-epilepsy, or psychic equivalent
of epilepsy. This subconscious energy manifestation may be termed
_Dynamogenesis_.


XII. _The Principle of Inhibition_

Self-preservation and the fear instinct inhibit associated mental
systems, producing morbid states. _Morbid mental states, however,
are not produced by inhibitions, or repressions._ It is only
when the inhibitive factors are self and fear that a true morbid
mental state, or neurosis arises. To regard self repression as
a bad condition and leading to diseases is to misapprehend the
nature of man, to falsify psychology, and to misrepresent the
development of humanity. The self should not become hypertrophied.
Self-preservation should not become overgrown. The self must be
kept within limits. The self impulse should be kept under control
by the individual. For true happiness is to be a law unto oneself.
As the great Greek thinkers put it: Happiness is in self rule. The
unruly are miserable. In fact, self-control is absolutely requisite
to mental health, to sanity. _Self-repression is requisite for
happiness. Self-repression never leads to disease._ It is only when
self-repression is produced and dominated by selfishness and fear
that morbid states of a psychopathic, neurotic character are sure
to arise. It is not inhibitions that produce fear, but _it is fear
that produces inhibitions_. To ascribe neurosis to self-repression
and to conflict is like attributing malaria or tuberculosis to air
and light.


XIII. _The Principle of Mental Contest and Discord_

Mental states associated with intense emotions tend to take a
dominant lead in consciousness. This, however, may be totally
opposed by the general character of the individual. In such
cases the whole mental set, being in opposition to the total
individuality, is in contest with the character of the person who
is then in state of discord. A mental set in contest with the
make-up of the person is usually inhibited, becomes subconscious,
and as a rule fades away from the mind, often leaving no trace
even in memory, conscious or subconscious. In some cases where a
compromise is possible, a reconciliation is effected. The mental
set is assimilated, and disappears from consciousness as an
independent, functioning state.

When, however, the opposing or contesting mental set is based on a
fundamental impulse and accompanying instinct, such as the impulse
of self-preservation and the fear instinct, a total inhibition
is not always possible, even a compromise may not be successful,
because the mental set is in association with the core of the
individual,--namely self-preservation. The contesting mental set
remains, in what Galton terms, “the antechamber of consciousness.”
The mind is in a state of tension, in a state of anxiety, in
restless, uneasy discord, due to the fear instinct, the companion
of the impulse of self-preservation. The contesting mental set,
charged with intense fear emotion, presses into the foreground of
consciousness, and a contest, a discord, ensues in the mind of the
individual, a contest, a discord, a conflict which keeps the person
in a state of indecision and lack of will power.

The partly inhibited, contesting mental set, when not fading away,
may thus remain in the mind, and act like a splinter in the flesh,
giving rise to a state of discomfort. This is just what happens
when the individual has not been trained to assimilate fear states,
and is unable to adjust fear reactions to the welfare of total
psycho-physiological life activity.

In cases where the impulse of self-preservation and the fear
instinct have become aroused, the contesting fear set of mental
states presses again and again to the foreground of consciousness.
When no compromise of the contesting states can be brought about,
when the fear set cannot be assimilated, the mind is in a state of
restless discord. _It is not, however, the discord that produces
the neurosis, it is the impulse of self-preservation and the fear
instinct that constitute the cause of the psychopathic, neurotic
condition._


XIV. _The Principle of Diminishing Resistance_

In proportion as the neurotic attacks keep on recurring the
formed pathological system is gaining in energy and in ease of
manifestation. The psychopathic attacks with their symptoms emerge
at an ever diminishing intensity of stimulation. The resistance of
healthy normal associations is ever on the decrease until a point
is reached when all power of resistance is lost. The conscious
and subconscious groups which enter into the psychopathic system,
forming the neurosis, get control over the patient’s life, and
become an uncontrollable, psychopathic obsession.


XV. _The Principle of Modification_

The patient attempts to control or alleviate his fear state
by a totally different fear state. In the long run this is a
losing game. For the general fear disposition becomes ultimately
reinforced. Finally he may land in the mystic regions of love or of
an Infinite Love in which he expects to find safety, protection,
and salvation from the miseries of exaggerated self impulse and
intensified fear instinct. Such a course, however, leads to a
swamp in which the patient’s individuality becomes engulfed and
obliterated. The end is mental suicide.

These fundamental principles of neurosis-development should be
kept in mind in the examination and study of psychopathic cases.
The cases adduced in this volume will help one to understand the
mechanism of the main factors and principles of neurosis.




CHAPTER XVIII

ILLUSTRATIONS, NEUROTIC HISTORIES


The psychopathic character appears to be full of contradictions,
“a house divided against itself.” Neurotics are like “the troubled
ocean which never rests.” Some of my patients complain of fatigue,
physical and especially intellectual, inability of concentration of
attention, and yet they hint at being undeveloped, unappreciated
geniuses. The patient may be said to suffer from a paradoxical
state of “humble superiority.”

A few of my cases may help one to form some faint idea of the
intensity of the impulse of self-preservation and fear instinct
which obsess the psychopathic sufferer.

M. A. Age 43, female, married; sister and brother died of
tuberculosis. When young, she herself had an attack of tuberculosis
from which, however, she entirely recovered. This made her, from
her very childhood, think of herself and of the fear of death. She
suffers from headaches, backaches, indigestion, and intestinal
pains. Her mind is entirely engrossed with herself. The whole
world is for her sake, and she does not scruple to utilize anyone
who is willing to serve her. She takes advantage of everybody and
does not care what the feeling of others might be about her extreme
selfishness. If she were sure that no fine or punishment would
follow, she would not hesitate to take anything that belongs to
others, no matter whether it be a friend or enemy, provided it does
her good, drives away some of her discomforts, fear of disease,
or gives pleasure to her, even at the expense of other people’s
agonies. If there were a prize for selfishness, she would be sure
to get it. She is sure to take advantage of people who do not
know her and who practice the ordinary activities and amenities
of life in regard to her. She does not get offended when people
refuse her demands. She goes to look for other victims who have as
yet no knowledge of her temperament and “sickness.” Everything is
legitimate to her in order to get well and healthy.

The patient talks of high ideals and of service to humanity,
and yet she has not hesitated to lure away a man who had a wife
and three children. She made him divorce his wife who was her
bosom friend, and marry herself. She spends all his money on her
“artistic dresses,” while his former wife and his little family
are allowed just enough to keep them from starvation. The patient
goes around travelling, visits physicians, cures herself, keeps on
being sick in various health resorts, learning all kinds of fads,
modes of “healthy living.”

The patient is in terror of disease and of old age. She fears even
to think of such things. She carries around with her all kinds of
prescriptions and directions as to how to preserve youth. I was
especially instructed by her husband not to inquire for her age.
Everything must be subservient to her impulse of self-preservation
and instinct of fear. She has dwindled to a parasitic existence,
obsessed with the lowest instincts of life. She avoids all
responsibilities. She wants to get as much as she can in order to
obtain for herself the highest possible benefit. When she meets
people who do not know her, she is quick in taking advantage of
them. Life to her has no duties but rights. Patient is a typical
Nero, a Caligula. She would cheerfully sacrifice a nation to get
out a mite of pleasure, comfort, and health.

V. S. Age 49, female. Married; no children. She has three sisters
and two brothers who are all well. As a child she lived in great
poverty. She was neglected and met with accidents and scares;
suffered from sickness until her little body was emaciated from
privation. She managed, however, to go through school and become
a clerk in a small store; she was very careful of her appearance
which meant to her a good marriage, comfortable life. She also
took care of her health which was rather precarious, on account
of the many colds accompanied by severe headaches. At the same
time on account of the poor life led, she also suffered from some
obscure troubles. After years of precarious health and quests for
happiness, for marriage, she succeeded in capturing a well-to-do
merchant in whose store she had worked as a clerk. Immediately
after marriage she rigged up a beautiful home with “rich mahogany
furniture” which the husband regarded with a gasp, settled down to
a life of leisure, to complete idleness, and began to attend to her
health....

The patient began to find more and more troubles with her organs,
from the top of her head to the pelvis and intestines. Nothing
was quite right. Things could be improved. The impulse of
self-preservation gained more and more control over her. Along with
this impulse the fear instinct gained in strength, became more and
more extensive.

The patient became full of fear which, by the principle of
proliferation and diffusion, kept on growing and diffusing in
ever new directions, and spreading to ever new associations and
systems. The central fear was poverty. The patient was afraid
she might become poor. This was naturally a fear from her early
childhood,--the fear of suffering in poverty, a fear which
persisted throughout her life. The fear became accentuated and
developed with time. She was afraid to spend money, especially
sums above a five dollar bill. No matter how much she tried to
reason with herself this fear persisted. She was afraid to buy new
things which she regarded more or less expensive. She was afraid
to put on new dresses, to buy new furniture, to spend money in any
way. In fact, quite often the fear was so uncontrollable that even
when she had no thought of threatening poverty she was in a panic
of being confronted with expensive purchases.

The fears then began to spread to other things,--such as giving
away small articles or loaning books, or presenting any things or
objects that might be regarded as expensive and valuable. The fears
spread to other objects of importance and value.

Along with it she had fears of indigestion and nutrition, nausea,
vomiting, intestinal pains, discomfort, and especially an
inordinate amount of distress when in a state of nervous excitement.

The patient was as obstinate as a mule, though claiming that
she was doing her best and trying everything in her power to
co-operate. She was doing everything in her power to frustrate the
physician’s directions, claiming at the same time that she was
doing her best to follow scrupulously the doctor’s orders. She
claimed she was nice to people when she was nasty and offensive to
everybody who in any way happened not to fall in with her whims
and caprices. In fact, even those who went out of their way to
please her and did everything in attending to her, and helping
her in every way day and night, even those she treated with lack
of consideration, even positive disdain and contempt. She was the
incarnation of demoniacal obsession of psychopathic meanness and
egotism.

She abused and dominated her husband by her sickness, trouble,
fainting and crying spells, headaches, moans and weeping. She made
him do everything she pleased. In fact, she tyrannized over her
husband, and kept on claiming she loved him. She could not for
a moment be without him, and complained that on account of her
extreme devotion to him, “her will was broken.”

She was a regular termagant, a demon incarnate. She knew how to
make a scene and put the blame on her “dear ones.” It was enough
for her to suspect what her friends wanted her to do, she was sure
out of sheer malice, to act the contrary. She was distrustful,
spying on others, sneaky and lying without any scruples; and
yet “no one was so mild, so ideal, so kind, so affectionate, so
considerate, so calm as she was.” She went around reciting poetry
about ideals, health, and happiness. She persuaded herself that
she was highly educated, that she was the best business woman,
the best critic, appreciative of poetry and of art in general.
She was a veritable Nero, an “egomaniac” devoid of all love and
human sympathy. She suffered so much, because she was so unusually
altruistic. A coyote in her fear, a tigress in her rage, she
claimed the gentleness of the dove and the innocence of the babe.

Not for a moment could she fix her attention on anything but
herself, eating, drinking, sleeping, and feeling. Nothing
interested her but herself. She avoided work, however short and
easy. She could, however, talk of herself, of her achievements, of
her moral, intellectual qualities by the hour and by the day. Even
games did not interest her, nothing but herself, and self. This was
so evident that one of the attendants noticed this characteristic
psychopathic trait, and described her as “egomaniac.” She was the
“Great I am.” “The Ego-person is the reflection of the Ego-god.” ...

Whenever one spoke of a great man, she was sure to have her opinion
of him. She was at any rate superior to him. She could give her
opinion on any conceivable subject in literature, economics, and
politics.

She was as cunning as a savage, and as treacherous as a wild
brute, and yet she was to all appearances a veritable saint, full
of suffering for the sins of humanity, and for the faults of her
husband who was “boyish and foolish, whom she had to manage,” and
whom she did control and handle with an iron rod.

There is no doubt, however, that she herself was driven by her
intense, uncontrollable impulse of self-preservation and by the
instinct of fear. What especially terrorized her was the slow but
sure _extension of the fear instinct to more and more objects and
acts_. The fear instinct kept on creeping on her, slowly choking
the life sources of her being. To call the patient “egocentric” is
a mild descriptive term,--“tigress,” “satan,” “fiend,” would be
more appropriate appellations. In her terror of self-preservation
she tormented herself and others. She was a firebrand from hell, a
firebrand fanned by the furies of self and fear.

F. W. Age 47; female, married; has no children. The patient claims
to have been an invalid from childhood; that she was of extremely
delicate health; she always had to take care of her health, and had
to go through all kinds of diseases, especially gastro-intestinal
troubles. At the age of eighteen she got married and then her
family felicity began. She began to complain of all kinds of
infirmities. The gynecologist humored her with operations and
treatments. The fear disease became strengthened, and finally she
cultivated a typical pathophobia; she was in terror of some fearful
malady that might possibly take possession of her.

The patient always wanted to have someone near her. This fear of
remaining alone dated from childhood, when at the least discomfort,
she asked and screamed in terror for help. A companion, or nurse
had to be with her day and night, so as to protect her from any
impending evil.

Occasionally, to relieve her feelings, in the middle of a
conversation, whether for the sake of impressing her family, her
husband or her physicians with the gravity of her disease, or as
a vent for the rising instinct of fear, she emitted a scream,
wild and weird, reminding one of the howling of a timber wolf, or
of a wild whoop of an Indian. This was a habit she kept up from
childhood. It was a reaction of her fears, and a protection, it was
a call for help which was sure to attract attention. The family
could not refuse help at hearing such an unearthly call. Later on,
it was consciously and unconsciously utilized by the patient as a
rod to rule the family and especially her husband, when the latter
happened to become refractory. The fear reaction was thus used as a
protection and as a weapon of defense.

Things had to run according to her pleasure, or else she was put in
a state of nervous excitement and fear with its awful yell of which
the family and the husband were in perfect terror; they yielded
unconditionally. The patient literally subjugated her husband by
her spells of fear, especially by the fearful acoustic performance,
the aura, the harbinger of a psychopathic attack.

The patient was always discontented and grumpy. Nothing could
satisfy her, nothing was good enough for her. Everybody was
criticized. No matter how one tried to please her, she always found
fault with the person. In fact, the fault-finding was in proportion
to the eagerness one tried to serve and oblige her. The nurses are
not good, the servants intolerable, and people in general are bad,
mean, stupid, and vulgar. She claims she comes from an “old New
England family, from good stock.” Her grandfather was a fisherman,
and her father a petty tradesman. The patient makes pretensions to
education, poetry, art, and drawing. In reality, she is quite dull
and ignorant.

G. A. Female, age 63; the patient was obsessed with pathophobia for
over thirty-five years. She has been to a number of physicians, and
to many sanitariums, looking for health everywhere, not finding it
anywhere. The fears date to her early childhood. She was regarded
as a delicate child, the fear of disease was strongly impressed on
her. She went through a number of children’s diseases. Although she
had several sisters and brothers, the child’s supposed delicate
constitution was the fear and worry of the parents. This fear was
communicated to the child, who for the rest of her life became a
psychopathic patient with the characteristic developed impulse of
self-preservation and intense fear of disease. She could not think
of anybody but herself, everything had to be arranged for her,--for
her food, for her sleep, and for her rest. She kept on complaining
at the slightest change either in herself, in others, about the
arrangements of the house, or about the weather. Everything had to
be arranged just as she demanded, otherwise she was sick, or was
going to become dangerously ill.

When about the age of thirty, she married a widower with two
children. She trained the children to obey her commands implicitly,
otherwise she resorted to the rod of sickness. The pathophobia,
consciously or unconsciously, became a power which she wielded
in the most tyrannical way. The children had to sacrifice
themselves for the pleasure of the sick step-mother. They had to
stay with her, and minister to all her whims and fears. The very
individuality of the children became almost obliterated by the
persistent, egotistic tyranny of the sick, old step-mother. She was
like a regular vampire, sucking the life blood of her family.

It goes without saying that the same fear of disease tamed her
husband over whom she ruled with an iron hand. The least opposition
to her whims, or to her fears of possible disease made her so sick
with all kinds of pains that the family and the husband were driven
into submission.

The woman was obese as a hippopotamus, well nourished, with
a florid complexion, and with an appetite that would shame a
Gargantua. The rarest, the best, and the most appetizing dainties
had to be on her table. She made of her meals a form of worship,
requisite to propitiate the goddess of maladies. She did not
hesitate to take the best morsels from the plates of her daughter
and son in order to satisfy her appetite which was supposed to be
“delicate and small.”

The patient was conscious of every square inch in her body; she was
afraid that some form of malady may lurk there. She was a typical
case of pathophobia. Fear of disease and quest of health were ever
in her mind. She could not talk, or think of anything else, but
herself and her symptoms. She made of her step-daughter a poor,
colorless being, a day and night nurse, tyrannized over by pitiful,
neurotic whimpering.

When the patient happened to wake during the night for ever
so short a period of time, she did not hesitate to wake her
step-daughter, tired as the latter was by constant attendance on
this psychopathic shrew. The daughter had to wake up everybody
who could in any way bring comfort to that “poor, old, suffering
invalid.” After much groaning, moaning, and bewailing her bitter
lot the invalid took some medicine to appease the fear of disease,
partook of some nourishing food to keep up her strength and health,
and went to sleep for the rest of the night.

Years ago, the patient was under the care of Weir Mitchell who sent
her to me as a last resort. Dr. Weir Mitchell characterized the
patient as an “American humbug.” As a matter of fact, the patient
herself was convinced that she was on the verge of death, and
was in terrible agony of her fears of disease, fears which made
her quest for health a matter of life and death. The patient was
obsessed by _parasitic egotism_, the _quintessence of psychopathic
affections_.

Many times during the day she paced the room reciting elevating
passages from the Bible, from “great poets,”--Emerson being her
favorite writer.

I have heard neurotics with their “Mortal Mind,” “Sin and Error,”
“Disease and Nothing,” recite edifying phrases such as: “The
decaying flower, the blighted bud, the gnarled oak, the ferocious
beast, like the discords of disease, sin, and death are unnatural”
... “Fear is inflammation, error” ... “_Adam, a-dam, a-dam, dam,
dam_”....

A man, thirty-eight years old, married, highly sensitive, suffers
from migraine; he is irritable and restless. When about eight
years old, he wandered in the woods near his house. An Italian ran
after him, flourishing a big knife. The boy ran away in terror.
When he reached home he dropped from exhaustion and fear. Once or
twice, on account of the fear of sharp objects, he actually hurt
himself while handling knives. This increased his terror and fixed
his fear. The instinct of fear was still further developed and
stimulated by a series of events, such as falling into a river,
from which he was saved. He does not like to take baths, he is
afraid to enter a river, and he is in terror of sharp objects, such
as knives and razors.

The patient is extremely selfish. He insists on playing games which
he likes much, irrespective of the pleasure of his friends and
acquaintances. All he cares for is to have a good time, to neglect
his duties to his family. In his business he is exacting of others,
although he himself is rather slovenly in his work, and slow in the
performance of his obligations. He always insists on having his own
way. Other people’s rights do not trouble him, provided his rights
are carefully and scrupulously observed. He always demands services
from others, especially from his friends.

The patient’s mind is occupied with his health, his fears, and his
ailments. The interest he takes in his friends and acquaintances
is how far they may serve his purposes of pleasure, game, health,
and avoidance of fear of disease. His wife and child are regarded
from a personal standpoint of his own good, otherwise they are
totally ignored. When they interfere with him, or arouse his fears,
he becomes impatient, angry, and furious. He claims to be the most
considerate and kindest of men, brimful of humanitarian ideals.
He thinks that he can accomplish more than anyone else in his
circumstances. Nothing is too good for him, nobody is superior
to him. As a rule things are badly conducted, he finds fault
with everybody and with everything. He is driven by psychopathic
furies,--discord, fear, and maddening egotism.




CHAPTER XIX

HYPNOIDAL TREATMENT


_Psychopathic or neurotic maladies do not depend on the abnormal
action of some one organ or function, but on a general condition
common to all bodily and mental functions,--the fundamental
primitive fear instinct which relates to life in general._

The deranged functions, cardiac, respiratory, or sexual,--fatigue,
conflict, shock, repression and others are only the _occasions_.
To regard any of these occasions as the sources of psychopathic
maladies is like regarding the weather-cock as the cause of the
wind. _Self-preservation and the fear instinct alone form the
source of all psychopathic maladies._

I adduce here a few cases which may be taken as typical:

Mrs. M. C., aged thirty-two years. Family history good; well
developed physically and mentally. A year before the present
trouble set in, patient suffered from a severe attack of
grippe. Menstruation, which was before painless and normal in
amount, became painful and scanty, accompanied by headaches,
indisposition, irritability, crying spells and backache which
lasted long after the menstrual period was over. The family
physician ascribed the symptoms to endometritis, mainly cervical
and treated her with absolute rest, fomentations, injections,
scarification and dilatation of the cervix, and finally curetted
the uterus. As the patient grew worse under the treatment, she was
taken to a gynecologist, who after an examination suggested an
operation. The operation was duly performed, with the result that
the nervous symptoms became intensified, and the attacks increased
in violence and duration. The turn of the nerve specialist
came next. Hysteria, neurasthenia, and the more fashionable
“psychasthenia” have been diagnosed by various neurologists. A
year of psychoanalysis made of the patient a complete wreck, with
depression, introspection and morbid self-analysis. Patient was put
by neurologist under Weir Mitchell’s treatment.

When the patient came under my care, she was in mental agonies, a
complete wreck. I gave up the Weir Mitchell rest treatment, sent
away the nurse, released the patient from solitary bed confinement,
told her to leave the sick room, to give up dieting and medicines,
and to return to a normal, active life. I kept on treating her by
the hypnoidal state. The patient began to improve rapidly, and
finally all her physical and mental symptoms disappeared; she has
continued for over six years in excellent condition of health.

A study of the case traced the fear instinct to experiences of
early childhood, fears accentuated and developed into morbid states
by the deleterious tendencies of the treatment, giving rise to a
_somatopsychosis_, the physical symptoms mainly predominating.

A lady, aged fifty-nine years, suffered from kynophobia. When about
the age of twenty-nine years she was bitten by a dog; since then
she was afraid of hydrophobia. She kept on reading in the papers
about cases of hydrophobia until the fear became developed to an
extraordinary degree and became fixed and uncontrollable. According
to the principles of evolution of psychopathic states, the fear
kept on extending. The fear psychosis included all objects that
might possibly carry the germ of hydrophobia. The neurosis became a
mysophobia.

As in all other cases of psychopathic states the psychosis was
traced to the fear instinct, the germ of which was laid in the
patient’s early history. The patient was a timid child, and was
afraid of strange animals. In the village where she lived there
were a few cases of hydrophobia which impressed her when a child.
This germ was in later life developed by thirty years’ cultivation.

Psychopathic or neurotic symptom complexes I observed in children
whose early training was favorable to the awakening and
development of the fear instinct. In children affected with fear of
animals I traced the fear psychosis to the parents who were afraid
of animals, on account of actual traumas in their life history,
_the child being influenced by imitation, by suggestion, often
subconscious, by the behavior of the parents in the presence of
animals_. Such children are predisposed to recurrent psychopathic
states.

In all such cases the etiology is easy to find, if the patient
is carefully examined. In many cases the fear instinct with its
symptom complex is associated with external objects, giving rise
to the so-called phobias. Instead, however, of being associated
with external objects, the fear instinct is frequently associated
with somatic functions (pathophobia), or with mental activities
(phrenophobia).

Man, aged forty-seven years; actor; family neurotic. Patient
suffered from anorexia, indigestion, choking, vomiting, gagging,
eructation, gastralgia, and occasional pains in the limbs. He led
a rather gay and irregular life up to the age of thirty-two years,
when he had syphilis, for which he was under treatment for two
years. This scared him because he had the opportunity to see the
consequences of syphilis in many of his friends. He had been under
continual fear of the possibility of development of parasyphilitic
diseases.

Seven years ago, at the age of forty years, he had to watch at the
bedside of an intimate friend, who had been suffering from severe
gastric crises of tabes dorsalis. After one specially exhausting
night of vigil, worry and fear, he went to bed for a short nap and
woke up with the idea of general paresis and intense fear. From
that time he began to suffer from symptoms of tabes with fear of
general paresis.

The patient had been an imaginative child; he had his fear instinct
cultivated from early childhood by stories of frights, scares,
and horrible accidents. When ten years old, his grandfather gave
_Faust_ to him to read. Since then the patient was troubled with
the fear of selling his soul to Satan. The patient was religious
in his childhood, prayed much, and was possessed by the fear of
committing sins. “It has now all come back,” he complained. A great
number of fears could be traced to his early childhood. The somatic
symptoms were the manifestations of association of experiences of
parasyphilitic diseases, based on the pathological state of the
fear instinct, a case of pathophobia, a somatopsychosis.

A few hypnoidal treatments effected a cure. The patient returned to
his occupation, free from any distressing symptoms.

H. M. aged twenty-seven years, male, Canadian. Family history
good; looked pale, anemic, and frail; very intelligent, sensitive,
restless, and had a tendency to worry. About a year ago, he began
to feel depressed, to worry about his health; thought he suffered
from tuberculosis. His physician assured him that nothing was the
matter, but he had an uncontrollable fear of consumption; and the
idea kept on recurring. Up to the age of nineteen years he was
perfectly well. He was then laid up with a sore knee for a few
weeks. He had time enough to brood over the knee, and read some
literature on the subject. He thought it was tuberculosis and
worried much. The knee, however, got well, and gradually he forgot
all about it, although the idea of tuberculosis often made him feel
uncomfortable, and the idea of “water in the knee” used to flash
through his mind, to pass away the next moment.

A year ago, however, he happened to lose his work, became
despondent, began to worry and to brood over his financial
troubles, slept restlessly, suffered from anorexia, and began to
lose flesh. The idea of the knee and the fear of tuberculosis
got possession of him. He could not rid himself of the idea of
tuberculosis. If in the clinic the physician assured him that he
was all right, he felt better for a couple of hours; but often it
did not last even as long as that. The least pain, cough, heart
beat, a feeling of chill or heat, and the like, brought the idea
and fear of tuberculosis back to his mind with renewed energy. He
was obsessed by the fear of tuberculosis and felt he was doomed to
certain death, a psychosomatic pathophobia.

Hypnoidal states did good service. The patient’s mental condition
began to improve rapidly. He was no longer troubled with
depression, insomnia, and fears; began to gain in weight, appetite
improved, felt energy flowing in; began to look for work in real
earnest, finally found it, and kept at it.

Man, aged forty-three years, suffered from palpitation of the
heart, fainted easily, especially on physical examination by
physician, or at the beginning of medical treatment. He suffered
from indigestion for which he had been under treatment for a number
of years by physicians who gave him medicine for his bowels and
also from time to time kept on washing his stomach. He had a great
fear of becoming a victim of cardiac troubles, especially of some
unknown, terrible, valvular affection. When under my care he kept
on asking to be taken to heart and stomach specialists, to be
examined, and have some radical operation performed. Frequently
under the influence of the fear states and obsession of heart and
stomach trouble, especially the heart, he would collapse suddenly,
be unable to walk, and be afraid that he suffered from some
paralysis.

On examination the patient revealed a history full of various
traumas which, from his very childhood until he came under my care,
helped to bring about his psychopathic condition, and developed the
fear instinct to an extraordinary degree.

Physicians had the lion’s share in this special case by their
rearing of the fear instinct, and by their favoring the patient’s
phobias by their examinations, by their prescriptions, and by the
diet and treatment. The patient was in such a panic that he kept
on taking his pulse on the least occasion, was feeling his heart,
stomach, and intestines at every opportunity. The hypertrophied
growth of his morbid self and fear instinct had invaded and
dominated the patient’s whole personality, developed a typical
psychosomatic pathophobia with its recurrent states. The patient
was cured by hypnoidal states.

In the _Trudi_ for 1913 of the University of Moscow, Russia,
Doctor Ribakov made an extensive study of a series of cases of
psychopathic or psychoneurotic asthma, and arrived at a conclusion
similar to my own, although he was no doubt unaware of my work and
publications on the same subject. He came to the same conclusion
as I that the etiology of _neurosis is to be found in fear, which
alone forms the basis of psychopathic neurosis. All other factors,
social, professional, sexual, religious, repressions, conflicts are
only occasions of the disease. It is fear, and fear alone that
forms the pathology of the psychopathic neurotic symptom complex._

A young lady was afflicted with ornithophobia, fear of birds, fear
of chickens. The sight of a chicken set her into a panic. The
patient is very timid, and this timidity can be traced to her early
childhood. When at the age of six, a play-mate threw a live chicken
at her in the dark. The child was terribly frightened, screamed,
and fainted. The mother used to tell her fairy stories full of
adventure, of ghosts, of dragons, and of monsters. This prepared
the patient to react so violently to the sudden attack made by the
flight, struggling, and feel of the chicken in the dark. Since that
time, patient has formed an uncontrollable fear of live birds.

Another patient of mine, a lady of forty-nine years, single,
suffered from potamophobia, a fear of going into rivers, or into
the ocean. When about seven years old she was thrown into water by
one of her elder sisters. She was nearly drowned and was half dead
with fear when rescued. Since then she has been in terror of water,
or rather of rivers and oceans. Several times she made conscious
efforts to get rid of the fear, but the attempts were unsuccessful.
In fact, the more she was forced or forced herself consciously to
get into the water, the greater was the fear. This fear became
all the more intensified, when some of her intimate friends were
drowned in a boat. This fixed the fear which became uncontrollable.

A patient of mine, a man of thirty-five years, was afraid of going
out in the dark. This was traced to early associations of fears of
the dark, to superstitious beliefs in ghosts and spirits cultivated
in the patient’s early childhood. He was afraid to remain alone
in the dark or to go down at night into cellars or other secluded
places. This fear was unfortunately still more intensified by an
accident. At the age of twenty-seven, one night when returning
late from a visit, he was assaulted from behind by foot-pads. This
accident fixed the fear of darkness.

A lady of sixty-seven years, with pronounced arteriosclerosis, had
an attack of hemiplegia of the left side. She suffered from motor
aphasia, but did not lose consciousness. The paralysis cleared up
in a few days, but the sudden attack demoralized her. Since that
time she is in terror of another attack. She watches for symptoms,
and the least sensation of faintness throws her into a panic. The
patient is the wife of a general and was in China during the Boxer
riots, in the Spanish American war, in the Philippines, and other
military engagements. The fear instinct was cultivated in her by
all such conditions.

In her early childhood there were fears and frights of child
character, enough to arouse the fear instinct, which was gradually
developed and cultivated by the circumstances of life and by
worries in the course of the various wars, of which she was a
witness. Finally the fear culminated by the stroke of paralysis.

Similarly, I had patients who suffered from tuberculosis, from
asthma, from heart trouble, and from all kinds of intestinal
affections which specially abound in psychopathic cases. All
such cases can be clearly traced to various somatic symptoms
based on the fear instinct. The etiology is fear, the arousal and
development of the fear instinct in respect to the special symptom
complex.

A patient, aged twenty-six years, suffered from agoraphobia at
various intervals. As a child of nine years, he was attacked by
rough boys. He freed himself and ran in great terror. The boys
threatened him with another “licking” when he appeared again
on the street. He was afraid to go out for several weeks. The
parents forced him to go and buy some things. Living in a rough
neighborhood, on account of his father’s circumstances, he had been
many times subjected to knocks, blows, and assaults by rough boys,
until the fear of the open street became fixed into the well known
form of agoraphobia.

Another case, that of a lady of thirty-eight years, married,
suffers from ailurophobia, or fear of cats. This can be traced to
the patient’s early childhood. When she was a child her brothers
and sisters went through attacks of diphtheria, which was ascribed
to infection caused or transmitted by cats. The patient was
specially impressed with the danger from cats. Under such training
and suggestion given in early childhood, the patient gradually
formed a fear of cats. This fear was still more intensified and
became a panic when she was put into a dark room and a cat was let
loose on the poor victim by her mischievous companions, who knew
of the patient’s fear. When the patient had children of her own,
she was still more affected by the fear of cats, on account of the
subconscious and conscious fear of the possibility of infection
transmitted by cats to her children.

All those cases were investigated and cured by hypnoidal states.

Mr. D., a young man of twenty-five years, was born in Poland. As
far as can be ascertained, the parents as well as the brothers and
sisters are well. A physical examination of the patient reveals
nothing abnormal. There are no sensory, no motor disturbances.
He complains of severe headaches, preceded by a feeling of
indisposition, depression, vertigo and distress. During the attack
there is hyperesthesia to touch, pressure, temperature, and to
visual and auditory stimulations. _The patient shivers and looks
pale._ The cold experienced during the attack is so intense that
the patient has to wrap himself in many blankets, as if suffering
from a malarial paroxysm.

Fears have strong possession of the patient’s mind. He is afraid to
remain in a closed place in the daytime and especially at night.
When he has to remain alone at night, he is in an agony of fear,
and cannot go to sleep. Every passer-by is regarded as a robber or
murderer, and he quakes at the least noise. When walking in the
house in the dark, he has the feeling as if someone were after him,
and occasionally even experiences the hallucination of some one
tugging at his coat. He is mortally afraid of the dead and shuns
a funeral. The patient has also a fear of dogs, a kynophobia. The
fear is irresistible, and is as involuntary as a reflex.

An investigation, by means of the hypnoidal states, brought out
of the patient’s subconscious life the following data: When a
child of three years, the patient lived with his family in a
small village near a large forest infested with wolves. In one of
the intermediary states a faint memory, rather to say a vision,
struggled up, a vision of wolves and dogs. Some one cried out:
“Run, wolves are coming!” Crazed with fear, he ran into the hut and
fell fainting on the floor. It turned out to be dogs instead of
a pack of wolves. It is that fright in early childhood which has
persisted in the subconscious mind, and, having become associated
with subsequent experiences of attacks of dogs, has found
expression in the patient’s consciousness as an instinctive fear of
dogs.

But why was the patient in such abject terror of dead people? This
found its answer in the experiences and training of his early life.
When a young child, the patient heard all kinds of ghost stories,
and tales of wandering lost souls and of spirits of dead people
hovering about the churchyard and burial grounds; he heard tales
of ghouls and of evil spirits inhabiting deserted places, dwelling
in the graves of sinners and the wicked. He listened to stories of
haunted houses and of apparitions stalking about in the dark. His
social and religious environment has been saturated with the belief
in the supernatural, as is usually the case among the superstitious
populations of Eastern Europe. We cannot wonder, then, that an
impressionable child brought up under such conditions should stand
in mortal fear of the supernatural, especially of the dead.

When the patient was about nine years old, his parents noticed
some prominences on his right chest. It was suggested to them that
the hand of a dead person possessed the property of blighting life
and arresting all growth, and would, therefore, prove a “powerful
medicine” for undesirable growths. It happened that an old woman
in the neighborhood died. The little boy was taken into the room
where the dead body was lying, and the cold hand of the corpse was
put on the child’s naked chest. The little fellow fainted away in
terror. The fear of dead people became subconsciously fixed, and
manifested itself as an insistent fear of the dead, and, in fact,
of anything connected with the dead and the world of spirits.

The patient had hardly recovered from the shock of the “dead hand,”
when he had to pass through a still more severe experience. A party
of drunken soldiers, stationed in the little town, invaded his
house and beat his father unmercifully, almost crippled him: they
knocked down his mother, killed a little brother of his, and he
himself, in the very depth of a winter night, dressed in a little
shirt and coat, made his escape to a deserted barn, where he passed
the whole night. He was nearly frozen when found in the morning,
crouching in a corner of the barn, shivering with fear and cold.

From that time on the headaches manifested themselves in full
severity, with hyperesthesia and death-like paleness and intense
cold of the body. The early cultivation of the fear instinct
resulted in a _neurosis_ with its recurrent states.

Another patient is a man of thirty years; his family history is
good. He is physically well developed, a well known professor
of physics in one of the foremost institutions in this country.
He suffers from attacks of loss of personality. The attack is
of a periodical character, coming on at intervals of two weeks,
occasionally disappearing for a few months, then reasserting
itself with renewed energy and vigor. During the attack the
patient experiences a void, a panic, which is sudden in its onset,
like _petit mal_. The trouble was diagnosed as larval or psychic
epilepsy; the man was referred to me by Dr. Morton Prince as an
extremely interesting, but puzzling neurological case.

Patient feels that his “self” is gone. He can carry on a
conversation or a lecture during the attack, so that no outsider
can notice any change in him, but his self is gone, and all that he
does and says, even the demonstration of a highly complex problem
in integral calculus is gone through in an automatic way. The
fury of the attack lasts a few moments, but to him it appears of
long duration. He is “beside himself,” as he puts it. He seems to
stand beside himself and watch his body, “the other fellow,” as
he describes it, carry on the conversation or the lecture. He is
“knocked out of his body, which carries on all those complicated
mental processes.” For days after he must keep on thinking of
the attack, feels scared and miserable, thinking insistently, in
great agony, over his awful attack, _a recurrent psychoneurotic
phrenophobia_.

At first the patient could trace this attack only as far back as
his seventh year. Later on, earlier experiences of childhood came
to light, and then it became clear that the _attack developed out
of the primitive instinctive fear of early childhood_, fear of the
unfamiliar, fear of the dark, of the unknown, of the mysterious,
fears to which he had been subjected in his tender years.

This state was further reinforced by the early death of his
parents, it was hammered in and fixed by hard conditions of life,
full of apprehension and anxiety. Life became to the child one
big mysterious fear of the unknown. The fear instinct formed the
pathological focus of the attack. As the patient puts it: “It is
the mystical fear of the attacks which overpowers me.”

With the disintegration of the focus the symptom complex of the
attacks disappeared. The patient is in excellent condition, he is
doing brilliant work in physics and chemistry and is professor in
one of the largest universities in Canada.

I present another case apparently “paranoidal,” a case interesting
from our standpoint. The patient is a man of twenty-seven years;
his parents are neurotic, religious revivalists. As far back as
the age of eight he suffered from agonizing fears of perdition and
scares of tortures in hell, impressed on his sensitive, young mind
during the revivals. He is very religious, obsessed with the fear
of having committed an unpardonable sin. He thinks he is damned to
suffer tortures in hell for all eternity. He keeps on testing any
chance combinations, and if his guesses turn out correct, he is
wrought up to a pitch of excitement and panic. For to him it means
a communication coming from an unseen world of unknown mysterious
powers. With his condition diagnosed as “paranoidal dementia
praecox,” the patient was committed to an insane asylum, from which
he was subsequently released.

The attack comes in pulses of brief duration, followed by long
periods of brooding, depression, and worry. The primitive fear
of pain, of danger and death, and the sense of the mysterious
cultivated by his religious training, reached here an extraordinary
degree of development. Among the earliest memories that have
come up in the hypnoidal state was the memory of a Sunday school
teacher, who cultivated in the patient, then but five years of age,
those virulent germs which, grown on the soil of the primitive
instinctive fear and the highly developed sense of the unknown
and the mysterious, have brought forth poisonous fruits which now
form the curse of his life. The case is a typical _psychoneurotic
phrenophobia_ with its characteristic recurrent states.

“It is difficult,” the patient writes, “to place the beginning
of my abnormal fear. It certainly originated from doctrines of
hell which I heard in early childhood, particularly from a rather
ignorant teacher who taught Sunday school. My early religious
thought was chiefly concerned with the direful eternity of torture
that might be awaiting me, if I was not good enough to be saved.”

After a couple of years of persistent treatment by means of the
hypnoidal state and by methods of association and disintegration of
the active subconscious systems, the patient recovered. He entered
a well known medical school and took the foremost rank among the
medical students.[9]

_In the investigation or psychognosis of psychopathic cases I
invariably find the psychopathology to be a morbid condition
of the fear instinct, rooted in the primordial impulse of
self-preservation._ The psychognosis of this underlying
pathological state and disintegration of the latter are of
the utmost consequence in the domain of psychopathology and
psychotherapeutics.


FOOTNOTE:

[9] A full account of the cases is published in my volume “The
Causation and Treatment of Psychopathic Diseases.”




CHAPTER XX

FEAR CONFESSIONS


A few “Confessions” made by psychopathic sufferers will help us
best to understand the character, the mechanism, the factors, and
principles of neurosis:


I

“As you are desirous of knowing more about my life and environment,
I state concerning them as follows:

“You will remember that I told you that my step-father was a liquor
dealer. Throughout all the time that he was in business we either
lived over the bar-room or else right in the place where the liquor
was sold. My step-father was a very heavy drinker, a man of violent
nature, and decidedly pugnacious. As a child I have been scared to
death by drunken brawls, and many nights have been dragged out of
bed by my mother who would flee with me to the house of a neighbor
for safety.

“I might say that until I was seventeen years old, I lived in
continual terror of something going to happen. If he was arrested
by the police, as often happened, our home would be a scene of
turmoil until the case was settled.

“I remember one incident very plainly, when he came home one night
completely covered with blood as the result of being held up by
thugs, and another time when he left the house to subdue some
quarreling drunks with a pistol and returned after an exchange of
shots with his hand shot through.

“As a child, I was inclined to study, and associated very little
with other children. My mother tells me that I talked early,
but when about three years old I began to stammer. This trouble
bothered me a great deal, and I used to worry about it all the
time, especially in school when I would try to recite. I might add
that even now, when excited, I am troubled in the same way.

“My step-father has been subject to nightmares nearly all his life;
when asleep he would cry and moan and would be unable to move
until some one would shake him out of it. He was terribly afraid
of them, and I remember he used to say that he expected to die in
one of them. I used to be left alone with him quite frequently, and
I stood in constant fear of his dying; and if he fell asleep, as
he frequently did in the day time, I would wake him or watch his
respiration to see if he was alive.

“At other times I have been awakened in the night by his cries
and would assist my mother in bringing him to consciousness. It
was during one of these times that I became aware of my heart
palpitating, and whenever he had such a spell, I would be in a
state of fear and excitement for some time after. He would have
these nightmares nearly every night and some times four or five
times in one night, and I might add that he has them even now.

“I began to have attacks of dizziness in the streets, and finally
one day, I had one, and all symptoms and fears of the attack came
on in school, and from that time on I have watched my respiration
and suffered from dizziness, mental depression, and sadness.

“You have asked me to tell you more in detail about the attacks or
nightmares to which my step-father was subject, and which always
frightened me greatly, especially when a child.

“My step-father had the habit of falling asleep quite often, even
in the day time, and I have never known him to go to sleep without
having an attack in some form. If one watched him asleep, as I
often did, one could tell by his respiration when an attack was
coming. His breathing would become slower and hardly perceptible,
and finally he would begin to moan, and cry out; then, when shaken
vigorously and spoken to, he would awaken in great fear and
apparent suffering. If he had an attack, and we did not respond
soon enough, he would be very angry and say that we cared not if he
should die. We were so afraid of these attacks that we had trained
ourselves to be ever on the look-out for his cries, even at night.

“It really seemed as if his life rested in our hands. I might say
that sometimes these attacks lasted several minutes, before he
could be awakened. He used to say that at such times he always
dreamed someone was choking, beating, or otherwise torturing him.
He had been told by some physician that he would ultimately die in
such an attack.

“These attacks were sufficient to precipitate a small panic in the
house. I know not a single hour of the day or night, but that I
have either been called or awakened by my mother in her efforts
to awaken him. With the attack over, I would be trembling all
over, and my heart would be beating madly. I can remember these
attacks from my earliest childhood, and it seems to me that on one
occasion, at your office, I was startled just as these attacks used
to make me.”

While in the hypnoidal state, patient exclaimed: “I am afraid. All
my life I lived under terror.... This is just my disease,--fear.”


II

“I lived from infancy in a state of apprehension and fear. In my
home there seemed to be always a tension. I don’t know that I
ever relaxed there during my waking hours. I was never at peace
mentally. This was largely brought about by my mother’s chronic
condition of fear. I should not have had such a large development
of the fear habit had there been any neutralizing influence. But
my father was a weak character, living under fear, being afraid of
responsibility, so that my character was closely molded on his. He
gave me no moral fiber to resist fears of mother, and so did not
help me to build any character of my own. I still carry with me the
state of apprehension and fear that I contracted in my early life.
I had only one serious illness in my life outside of my nervous
troubles. Had an attack of bowel trouble somewhere near the age of
six. I was once struck in the face by a dog’s teeth. I have had
various cancer experiences.

“My father, when I was very young, had some irritation of the
throat. A physician told him he was in danger of cancer. I can
recall him anxiously looking at his throat. Later a neighbor went
to a ‘plaster specialist’ to have a supposed cancer of the tongue
removed. His wife was often at our home talking of his sufferings.

“While attending dental school I contracted some trouble. I went to
a physician near where I lived. He talked to me of a possibility of
syphilis. I became much frightened, and read all I could find on
syphilis. The books scared me still more. At last on the advice of
friends, I went to another physician who reassured me, and I lost
part of my fear.

“After this I returned home for a summer vacation. This was in
1904. That summer my tongue felt sore, I looked at it, and found
it peculiar. This aroused my fears of syphilis. Upon returning to
Chicago in the fall (1904) I asked my physician to recommend a
specialist. He sent me to a syphilographer, who told me I had no
syphilis, but that the condition of my tongue was caused by gall
bladder trouble. He wished me to have the gall bladder operated
which I refused to do. I thought no more about my tongue until I
studied cancer in oral surgery. I would then occasionally worry
over my condition. About this time an actor whom I knew died of
cancer of the tongue. I worried over my tongue, being afraid of
cancer, for several days after this. I then went along for seven or
eight years without much thought of my tongue.

“One day in February 1913, after some pain in my side which brought
the thoughts of gall bladder and then of the tongue, I asked
advice of a physician. He looked at my tongue and said: ‘I don’t
wish to frighten you, but you should have that tongue attended to.
You might some day have a cancer there.’ He sent me to a throat
specialist who said the condition of my tongue was due to a back
tooth. I had the tooth removed. I afterwards consulted Dr. L.,
a surgeon at Eau Claire, Wis., with the idea of having the gall
bladder operated upon. He laughed at the gall bladder trouble, but
sent me to Battle Creek Sanitarium with the idea, I think, that
the change would relieve me of my fears. At Battle Creek I was told
I had a mild case of colitis, and was put under treatment for it.

“While at Battle Creek my fears grew less. I remained at Battle
Creek about two months. Shortly before leaving there I was given a
Wasserman test. This they told me was faintly positive. I was then
given three injections of Neo-Salvarsan. I then left Battle Creek
and stopped at Chicago to see Dr. P. Dr. P. said any Wasserman
would be positive, taken with no more care than mine had been. That
there was no reason to think there was any syphilis anyway. He then
sent me to Dr. W., an internist, who said I had hyperacidity of the
stomach.

“I did not feel very badly at this time, although my fears of
cancer persisted. I was carrying on the work in my office. Later in
the summer I went to the Mayo Clinic at Rochester, Minn., where I
was given a local application for my tongue. In the fall of 1913,
while in Milwaukee I consulted an oral surgeon, Dr. B. He said
‘I will send you to Dr. F., a dermatologist who knows more about
diseases of the tongue than any man I know.’ I consulted Dr. F. who
said: ‘Geographical tongue, do not worry about it.’ My fears were
instantly relieved. I seldom thought of my tongue in the next two
years.

“In the fall of 1916 I had some trouble with my stomach. This
seemed to bring my fears to mind and one day my fear of cancer
returned. There was a connection between my fears and the stomach
and gall bladder trouble diagnosed in regard to my tongue. At least
the stomach trouble would bring thoughts of the tongue condition.

“I tried to help myself out of my mental condition by reading
articles on cancer. This made me worse. I went to Chicago where
I was told by Dr. S., a dermatologist, that radium might remedy
the condition of my tongue. I had several applications of radium.
After this I still worried a great deal. I went through the spring
and summer under a nervous strain, but still able to carry on my
work. That fall (1917) I had such intense fear that I was attacked
by acute insomnia. I was unable to sleep without Veronal. The day
after my insomnia began I found myself very weak. I was pale, and
my heart would pound on the least exertion. I had also a great
deal of pain in my bowels. I went to Chicago and consulted Dr. E.,
Dean of Northwestern University Medical School. He told me such
conditions usually traveled in a circle, that my nervous condition
might leave me in a few months. I went through the winter in this
condition.

“I began to have a great fear of the fact that it was necessary to
use hypnotics. This fear of drugs was strong, and overshadowed my
other fears. I read an article on hypnotics as a habit; this added
to my fear of them.

“Before using hypnotics I noticed my sexual power was less, or
rather there was no pleasure in it. This did not trouble me as I
thought it a part of my nervous condition.

“In April, 1918, I went again to Battle Creek. I did very well
there for a week, but then got into a deep depression, became weak,
and was frightened to think I was no better. I remained in Battle
Creek for three weeks, and then went home. A month later I went to
St. Paul and consulted a neurologist. He did not know what to do
for me.

“I went to Milwaukee and consulted another neurologist. I was
becoming more despondent all the time. I decided to go to a
sanitarium to see if I could not get rid of my drug habit. I went
to Wauwatosa, Wis., and remained there three weeks, but I could see
they did not know what to do for me.

“In August I entered the Rest Hospital at Minneapolis and remained
there for a while under the care of Dr. J. I managed to drag along,
terrorized by my condition and by the fact that I could get no
relief.

“The drug habit was my greatest obsession at this time. I used
bromides and chloral hydrate,--changed hypnotics frequently.

“In January, 1919, I saw Dr. P. of Chicago, who sent me to
a sanitarium where I received no help. I then hunted through
magazines for articles on nervous diseases. I read of Dr. S. and
his work and came under his care at Portsmouth in May, 1919. While
there I learned to control my fears. I left Portsmouth in August
feeling sure of myself. I would occasionally have a depression
which would not frighten me and did not remain with me long. I was
looking forward to a happy future.

“During the summer of 1921 I felt tired most of the time. However,
I was still sure of being able to handle myself. One day after
feeling very tired my fear of cancer returned. I got into a panic
and started East to see Dr. S. On arriving in Boston I found he was
in the West. I went to Dr. P.’s office; was sent to Dr. W. and by
him to a psycho-analyst. The psycho-analyst said I had a ‘mother
complex, without usual sexual features.’ Psycho-analysis proved a
failure, and I abandoned the treatment with disgust, as useless and
silly.”

The patient was under my care for five months. He is now back to
his dental work. He writes to me that he is gaining rapidly in
weight, and is in excellent condition.


III

“I am a married woman of fifty-two. All my life I have been
imprisoned in the dungeon keep of fear. Fear paralyzes me in every
effort. If I could once overcome my enemy, I would rejoice forever
more.

“In childhood everything cowered me. I was bred in fear. At five
or six my mother died, and I feared and distrusted a God who would
so intimidate me and bereave me. I heard tales of burglars being
discovered hiding under beds, and a terrified child retired nightly
for years. I was in agony of fears. My fears I never told. Later
I heard of the doctrines of God’s foreknowledge, and, as a little
rebel, I would place dishes on the pantry shelves, changing from
place to place, and then giving up in despair, knowing that if
foreknowledge were true, God knew that I would go through with all
that performance.

“Through childhood I feared suicide. It was a world of escape that
appealed to me and yet appalled me. I also heard of somnambulism,
and I never saw a keen bladed knife, but I dreaded that in my
sleep I might do damage to myself or to my friends in a state of
unconsciousness.

“In my twenties I did attempt suicide a number of times, but
somehow they proved unsuccessful. I always aimed to have it appear
an accident. I dreaded to have my death appear as a stain and
disgrace to my family which I loved.

“I always fear to walk at any height, on a trestle over running
walls, or even to walk on a bridge without side railings.

“As a child I was afraid of the dark, I was afraid of going out
on the street in a dark night. In fact, even a moonlight night
terrified me when I remained alone. I was afraid to go into dark
places, such as cellars, or into lonely places even in the daytime.

“As a child I was always shy, fearful, timid, and self-conscious to
a painful degree. Even as a grown-up woman I am often a sufferer
from the same cause, although I have sufficient self-control to
conceal it.

“I have to be careful of my state of health, as the latter is
very delicate. I am a chronic sufferer from indigestion and
constipation, although I somehow manage to regulate these troubles.

“When I need my nerves in good control so frequently, they are in
a state of utter collapse. My brain is in a state of confusion, in
a state of whirl just when I need to think the clearest. My poor
brain feels as if a tight band encircled and contracted it. It
seems to me as if the brain has shrunken from the temples.

“My memory is unreliable. Often I read quite carefully, but I am
unable to recall what I have read. Especially is this so, if called
upon without previous warning. My brain goes into a panic of an
extremely alarming kind.

“I was told that I was a woman of a good brain and of great talent,
that all I needed was to exercise my will and determination, and
that I would succeed. I lack concentration and I lack confidence.

“In my childhood hell fire was preached. Fore-ordination and an
arbitrary God were held up to my childish comprehension. I was bred
in fear, and self destruction resulted.”


IV

The following valuable account given by an eminent physician brings
out well the factors and principles of neurosis expounded in this
volume:

“You ask me to write about my fears. I give you a brief account.

“As a child, as far as memory carries, I had a fear of ghosts, of
giants, of monsters, and of all kinds of mysterious and diabolical
agencies and witchcraft of which I had heard a number of tales and
stories in my early childhood. I was afraid of thieves, of robbers,
and of all forms of evil agencies. The fears were stronger at
daytime, but more so at night. Strange noises, unexpected voices
and sounds made a cold shiver run down my back.

“I was afraid to remain alone in a closed room, or in the dark, or
in a strange place. It seemed to me as if I was left and abandoned
by everybody, and that something awful was going to happen to me.
When I happened to be left alone under such conditions I was often
in a state of helplessness, paralyzing terror. Such states of
fear sweep occasionally over me even at present. I find, however,
that they are far more complicated with associations of a more
developed personal life. I know that in some form or other the
fears are present, but are inhibited by counteracting impulses and
associations. I still feel a cold shiver running down my back, when
I happen to go into a dark cellar in the dead of night, or happen
to remain alone in a dark, empty house. Such fears date back to my
fourth year, and possibly to an earlier time of my childhood.

“As a matter of contrast-inhibitions of such fears I may either
brace myself and put myself in a state of courage and exaltation,
or when this does not succeed, I let my mind dwell on other fears
and troubles. I find that the last method is often far more
effective in the inhibition of fear states which at the moment are
present with me. All I need is to press the button, so to say, and
awaken some other fears, the present fears diminish in intensity,
and fade away for the time being. I actually favor, and welcome,
and even look for disagreeable and painful experiences so as to
overcome some of my present fears. The new fears are then treated
in the same way.

“As I became older, about the age of eight, I began to fear disease
and death. This may be due to the infectious diseases that attacked
many members of our family, about this time. In fact, I have been
present at the death bed of some of them, and the impression was
one of terror, mysterious horror. I was afraid I might get diseases
from which I might die. After my witnessing the last agonizing
moment of death, my elders thought of removing me to a safer place;
their fears and precautions still more impressed the fear of danger
of disease and death. I may say that I really never freed myself
from the fear of disease and death. The latter fear is always
present with me in a vague form, always ready to crop up at any
favorable opportunity. This fear, in so far as it is extending its
tentacles in various directions, is often the bane of my life. Even
at my best there is always a kind of vague fear of possible danger,
lurking in various objects which may be infected or possibly
poisonous.

“This fear has been spreading and has become quite extensive,
involving my family, my children, my friends, my acquaintances, and
my patients. Usually I ignore these fears, or get control over them
by an effort of will. When, however, I happen to be fatigued, or
worried over small things in the course of my work, or happen to be
in low spirits by petty reversals of life, these fears may become
aroused. Under such conditions I may become afraid, for instance,
of drinking milk, because it may be tuberculous.

“This fear may spread and involve fear for my children and my
patients; or again I may be afraid of eating oysters and other
shell fish, because they may be infected with typhoid fever
germs. I may refuse to eat mushrooms, because they may be
poisonous. The other day I was actually taken sick with nausea
and with disposition to vomiting after eating of otherwise good
mushrooms. The fear seized on me that they all might be poisonous
‘toadstools.’ Such fears may extend to ever new reactions and to
ever new associations, and are possibly the worst feature of the
trouble.

“I have a fear of coming in contact with strangers, lest I get
infected by them, giving me tuberculosis, influenza, scarlet fever,
and so on. This mysophobia involves my children and my friends,
inasmuch that I am afraid that strangers may communicate some
contagious diseases. A similar fear I have in regard to animals,
that they may possibly be infected with rabies, or with glanders,
or with some other deadly, pathogenic micro-organism. I am afraid
of mosquito bites, lest they give me malaria, or yellow fever.
The fears, in the course of their extension, may become ever more
intense and more insidious than the original states.

“As a child I had some bad experiences with dogs; I was attacked
by dogs and badly bitten. Although this fear is no longer so
intense as it was in my childhood, still I know it is present. My
heart sometimes comes to a sudden standstill, when I happen to
come on a strange dog. When the strange dog growls and barks, all
my courage is lost, and I beat an inglorious retreat. It is only
in the presence of other people that I can rise to the effort of
walking along and apparently paying no attention to the dog. This
is because I fear the opinion of others more even than I fear the
growls of dogs. My social and moral fears are far greater than my
purely physical fears.

“When I became older, about the age of eighteen to twenty, a new
form of fear appeared, like a new sprout added to the main trunk,
or possibly growing out of the main fear of disease and death,
that is the fear of some vague, impending evil. The fear of some
terrible accident to myself and more so to my family, or to any of
the people of whom I happen to take care, is constantly present
in the margin of my consciousness, or as you would put it, in
my subconsciousness. Sometimes the fears leave me for a while,
sometimes they are very mild, and sometimes again they flare up
with an intensity that is truly alarming and uncontrollable. The
energy with which those fears become insistent in consciousness,
and the motor excitement to which they give rise are really
extraordinary. The fear comes like a sudden flood. The energy with
which those fears rise into consciousness is often overwhelming.

“Fear gets possession of me under circumstances in which my
suspicions are, for some reason or other, aroused to activity,
all the more so if the suspicions of possible impending evil
are awakened suddenly. In other words, the fears arise with
stimulations of associations of threatening danger to myself
and to my family. I am afraid that something may happen to my
children; I fear that they may fall sick suddenly; I fear that
some terrible accident may happen to them; I fear that they may
fall down from some place, and be maimed or be killed. I fear that
my children and other members of my family may be poisoned by
people who are not well disposed towards them. I am afraid that
they may pick up some food that was infected, or that they may
be infected in school by children who happen to suffer from some
infectious maladies. I am afraid that my children may be overrun
by some vehicles, by automobiles, or that they may be killed in an
accident, that they may be killed by a street car, or even that
the house may collapse. This latter event has actually taken place
when I was a child. In fact, many, if not all of those fears have
actually their origin in my experience.

“As I write you these lines, memories of such events come crowding
upon my mind. Are they the noxious seeds that have been planted
on the soil of fear? I am afraid sometimes that even the food I
and my children as well as other people eat may give rise to toxic
products and thus produce disease. Often in the dead of night, I
may come to see my children in order to convince myself that they
have no fever, and that they are not threatened by any terrible
disease. The very words ‘sickness,’ ‘disease,’ ‘not feeling well,’
‘death,’ arouse my feeling and sometimes throw me into a panic. I
am afraid to use such words in connection with any of my children.
I am afraid that the evil mentioned may actually happen.

“When a child I learned about testing and omens. If a test comes
through in a certain way, it is an omen of good luck, otherwise it
means bad luck. This superstitious testing and omens have remained
with me, and that in spite of my liberal training and knowledge
of the absurdity of such superstitions. I may test by opening the
Bible at any page, or I may test by anything that might occur,
according to my guesses. All of these fears I know have no meaning
for me, they are senseless and absurd, but they are so rooted in
my early childhood, they have been so often repeated, they have
accumulated round them so much emotion of fear that they come to my
mind with a force which is truly irresistible. Many of the fears
have multiplied to such an extent that I cannot touch anything
without rousing some slumbering fear.

“To continue with my fears; I am often afraid that the doors are
not well locked, and I must try them over and over again; I go away
and come back again, and try and try again, and once more. It is
tiresome, but as the fear is constantly with me, and is born again
and again, I cannot be satisfied, and must repeat the whole process
over and over until I get tired, and give up the whole affair in
sheer despair. In such cases a contrary and different fear comes
in handy. One devil banishes another. I am afraid that the gas jet
is left open, and I must try it over and over, and test the jets
with matches. This process of testing may go on endlessly. The
fear remains and the process must begin again until it is stopped
by sheer effort of will as something meaningless, automatic,
and absurd. The performance must be stopped and substituted by
something else.

“Colds, or attacks of influenza of the mildest character have
given rise to fears of pneumonia. Pain in the abdomen, or a little
intestinal distress has awakened fears of possible appendicitis, or
of tumor, or intestinal obstruction. The least suspicion of blood
in the stools awakens the fear of possible cancer. Vomiting or even
nausea brings fears of cancer of the stomach. There is no disease
from which I have not suffered.

“The same fears have naturally been extended to my children, and to
all those who are under my care. The least symptom is sufficient to
arouse in me fears of possible terror and horrible consequences.

“I am afraid that suits may be brought against me, or that some of
my own people, patients and even employees whom I discharged, may
bring legal action against me in court, or blackmail me. When I
leave home, I am afraid that something terrible has happened. The
fear of impending evil is always with me. The fears have invaded
every part of my being. It seems as if there is no resistance in
my mind to those terrible fear states.

“Perhaps it may interest you to know that, although I am quite
liberal, and even regarded as irreligious, still I am afraid to
express any word against God, Christ, saints, martyrs of any church
and denomination, be they Christian, Mohammedan, Buddhist, or
pagan. I am afraid lest they may hear me and do me harm; I fear to
say a word even against the devil or Satan. I am obsessed by fears.
Fears pursue me as long as I am awake, and do not leave me alone in
my sleep and dreams. Fears are the curse of my life, and yet I have
control of them, none but you has any suspicion of them. I go about
my work in a seemingly cheerful and happy way. The fears, however,
are the bane of my life, and torture me by their continued presence.

“I tried to find whether or not those fears had any relation to my
wishes or to my sexual experiences. I must say that I find they
bear no relation whatever to wish or sex. My mental states grow on
fear, take their origin in fear, and feed on fear. Fear is the seed
and the soil of all those infinite individual phobias that keep on
torturing me unless opposed by a supreme effort of my will.

“Truly the Biblical curse well applies to my life.

“‘The Lord will make thy plagues wonderful, and the plagues of
thy seed, even great plagues, and of long continuance, and sore
sickness, and of long continuance. Moreover, he will bring upon
thee all the diseases of Egypt, which thou wast afraid of, and
they shall cleave unto thee. And every sickness and every plague,
which is not written in the book of this law, them will the law
bring upon thee, until thou be destroyed. Thou shalt find no ease,
neither shall the sole of thy foot have rest; but the Lord shall
give thee a trembling heart, and failing of eyes, and sorrow of
mind. And thy life shall hang in doubt before thee, and thou shalt
fear day and night and shall have none assurance of thy life. In
the morning thou shalt say, Would God it were even! and at even
thou shalt say, Would God it were morning! for the fear of thine
heart wherewith thou shalt fear....’

“I laid bare my soul before you. I permit you to do with this
document whatever you may think fit.”


V

“I was born of healthy parents; grand-parents were also healthy.
All lived to a ripe old age, and died of natural causes. Father is
still living; I was a healthy normal child with little sickness
up to the age of 16. A few years prior I belonged to a gymnasium
and enjoyed superb physical strength and health, though I was from
childhood somewhat of a coward. I then became associated with some
youngsters who liked night life. This association influenced me to
join them in their nightly escapades.

“Between overtaxing myself in my work and trying to keep up with
the boys socially my system was drained. This was kept up for about
five years. I was working for a dry cleaning establishment the
owner of which did not appreciate my hard work. I gave ten hours a
day service, but he required even more, so that I spent as many as
fifteen and eighteen hours a day, and kept that up for about five
years.

“It was in January, 1911, at the age of twenty while sitting in
a restaurant eating my lunch, I felt a strange sensation coming
over me, such as blood rushing to my head, followed by weakness,
trembling, and fainting spells. I summoned up what will power I had
left, shook my head in effort to brace up, and tried to finish my
meal, but without success. I left the restaurant and coming outside
felt the same sensation. I leaned against a building, and my knees
gave way from under me until I was compelled to lie down. I made
an attempt to get up, boarded a street car, and started for my
father’s store which was about a mile down the street. As I stepped
on the platform I felt the same spell coming over me. Some of the
men standing on the back platform saw my condition, and helped me.
I arrived at the store where I collapsed.

“An ambulance was called, and I was taken to the city hospital.
The interne diagnosed the case as acute indigestion. He prescribed
some soda tablets, and told me to be careful with my diet. I
felt relieved at what he told me, because I thought it was not
so serious as I had expected. For I thought the end was near. My
brother who accompanied me spoke kind and encouraging words which
soothed my nerves.

“On the street car my thoughts started to go over the whole of what
had occurred. I could not control myself and gave way again. When I
got home I could not eat. I lay down and tried to get some sleep,
but sleep was out of the question. My thoughts always wandered back
to these spells, and that would bring back another spell. I took
the tablets prescribed by the physician, but they did not help me
any.

“The next day I tried to go to work, but could not on account of
these spells. I then decided to call our family physician. He told
me it was a nervous breakdown, and prescribed bromides. I kept on
having these spells in spite of the bromides. I was at a loss what
to do. From then on I became afraid to venture anywhere, to go to
any place, for fear of these spells. My real trouble began. I was
afraid to live, and afraid to die, afraid to go out, afraid to lie
down, always afraid of these spells.

“I remained at home for a couple of weeks, but the spells
continued. I then decided to try another doctor. This time a
stomach specialist, and as might be expected he claimed my stomach
was the cause of my disturbances. The news was gratifying to me. I
knew that stomach troubles could be cured, and the thought helped
to quiet some of the fears. I went back to work after a few weeks.
The belief in the efficacy of the drug enabled me to get down town
to work, but I kept on having spells, losing weight, and feeling
miserable.

“I decided to try another physician. This time a nerve specialist.
After examination he diagnosed the case as nervous prostration. He
gave me what he called a good nerve tonic. In addition to it he
used to stripe my back with red hot instruments. I was under this
doctor’s care for about a year. I kept on going to work whenever I
could, but the spells continued right along, at home in the night,
or at work in the daytime. After a year of treatment I felt no
better.

“I decided to try another nerve specialist,--his diagnosis was
depletion of the nerves. He advised me to come in a couple of times
a week for electric treatment. I followed instructions for a couple
of months, but the spells continued just the same.

“One April day there was an electric storm. The lightning caused in
me a great dread and fear. The wind broke some of the windows in
our house. I had then the worst spell. I lost consciousness. When
I awoke I was worse than ever. I was just choked up with tear of
everything and everybody.

“I found I could no longer live in C., for the last bit of life was
ebbing right out of me. I started on the train for Los Angeles. No
one can realize the suffering I had to endure on my trip out West.

“Everybody on the train talked about accidents, wrecks, and
robberies. After arriving in Los Angeles I felt somewhat relieved,
but the spells kept on just the same. I consulted a great nerve
specialist in Los Angeles. He claimed I had neurasthenia, and that
I was much run down. His method of therapy was different from the
rest. He suggested renting a cottage along the ocean front, and he
would furnish a trainer whose wife was to take care of the cottage.
The trainer was supposed to have some knowledge of physical culture
and massage. After being in this camp for three months I saw no
improvement in my condition.

“I went to another doctor who employed a different method. He would
inject pig serum into my arm three times a week. After a thorough
trial I found no relief.

“I then decided to try Christian Science for a while, but I had
no relief from all my woe and misery. (When asked why he went to
Christian Science while he was of Jewish faith, he replied that
he was in such a state of fear that had he been ordered to be a
cockroach he would have tried to become one).

“I tried another nerve doctor. After a while it was the same old
story. I then tried chiropractice. After three months’ trial
I found out that I had to give it up, because the manipulator
aggravated my condition. Towards the end I felt such pains in my
back and spine that I was compelled to lie in bed for a week before
I could recover enough strength to sit up. I then tried Osteopathy.
I felt no better, so I had to abandon that.

“In search for health I could not stop here, so I went to another
nerve specialist who after examination claimed to have discovered
something different from any other physician. He discovered I had
a pair of tonsils in my mouth which did not look well to him. He
ordered them removed; that meant an operation under an anesthetic.
Can you imagine my feeling when he told me the news? I had a
terrible time in making up my mind what to do. Bad as I felt I
made up my mind that I might as well die under ether as in any
other way. I consented to the operation. It is needless to go into
details here of what took place after the operation. Words cannot
express it. All the tortures of hell would have been paradise
towards what I went through after this operation.

“I have been going since from physician to physician, each one
claiming that I haven’t been to the right one, and that he was the
proper physician who understood my case and could cure me. No one
has been able to effect a cure.”

As an example of the patient’s state of extreme fear the following
instance may be given. One day he came to me, a picture of
misery and depression. He told me he had suffered agonies for
the last couple of days, on account of an “ingrowing hair.” It
turned out that the patient overheard a conversation among his
gossips, that some one died of an “ingrowing hair.” This news
strongly impressed him, and aroused his fear instinct, since he
discovered an “ingrowing hair” on his throat. I found his throat
was wrapped around with cotton, and covered with adhesive plaster.
On unwrapping the mess I found just an ordinary little pimple. I
threw away the wrappings, and gave the patient a scolding, and
ridiculed him for his silliness. He felt as he said in “paradise.”
A competent observer will find this trait of trivial fears,
characteristic, in various degrees, of every psychopathic patient.

By a series of trance states the patient was freed from his
psycholeptic fear attacks; he is now in good health, and attending
successfully to his business.




CHAPTER XXI

FEAR TRANCE APPARITIONS


The following study of a psychopathic case brings out the character
of the fear trance dream.

Mrs. A. is twenty-two years old; Russian; married. She suffers
periodically from attacks of violent headaches, lasting several
days. Family history is good. The patient was brought up in the
fear of ghosts, evil spirits, magical influences, and diabolical
agencies. Mrs. A. is easily frightened, and has suffered from
headaches and pressure on the head for quite a long time, but the
pain became exacerbated some five years ago. The attack is sudden,
without any premonitory feelings, and lasts from eight hours to two
days. The headache often sets in at night, when she is asleep, and
she wakes up with frightful pain.

At the time of the first attack she was much run down. Otherwise
the patient is in good condition, but complains that her memory is
getting bad. Patellar reflex is exaggerated. Field of vision is
normal. The eyes show slight strabismus and astigmatism, corrected
by glasses which did not in the least diminish the intensity as
well as the frequency of the headaches.

Mrs. A. suffers from bad dreams and distressing nightmares, the
content of which she cannot recall in her waking state. She also
often has hallucinations, visions of two women wrapped in white,
pointing their fingers at her and running after her. She never had
any fall, nor any special worry or anxiety, never suffered from any
infectious diseases.

After a persistent inquiry, however, she gave an account of an
accident she met with when a child of eight. Opposite her house
there lived an insane woman of whom she was mortally afraid. Once
when the parents happened to be away, the insane woman entered
the house, caught the child, and greatly frightened her. Another
time she was sent out by her parents to buy something in a grocery
store. It was night and very dark. She bought the things and on
the way back she saw two women in white with hands stretched out
running after her. She screamed from great fright and ran home.

Mrs. A. is afraid to remain alone, and especially in the dark. She
is not so much afraid in the street as in the house. The two women
appear to her now and then, and she is mortally afraid of them.

The patient was put into hypnotic state. There was marked
catalepsy; the eyes were firmly closed, and she could not open them
when challenged. Suggestion of general well-being was given and she
was awakened. On awakening, she could not remember what had taken
place in the hypnotic state.

Next day she was again put into hypnosis and went into a deeper
state than the day before. She was asked whether she thought of the
crazy woman occasionally, she replied in the negative. The patient
spoke in a low, suppressed voice, the words coming out slowly, as
if with effort and with fear. It was then insisted that she should
tell one of her recent dreams. After some pause, she said: “Last
night I had a bad dream; I dreamt that I stood near a window and a
cat came up to the same window. I saw it was crazy. I ran away, the
cat ran after me and scratched me. Then I knew that I was crazy. My
friends said there was no help for me.

“I dropped the baby, ran, and jumped down stairs. I remember now
that when I fell asleep I saw a woman, maybe the crazy woman. I
covered myself; I knew I was only afraid, and that she was not
real. Six weeks ago I saw the same woman, when falling asleep or
when asleep. I ran away, and she ran after me.”

Mrs. A. in relating these dreams, shivered all over and was afraid,
as if actually living the dream experience over again. “It was this
woman who caught me in her arms, kissed me, and embraced me, and
did not let me go, until my screams brought friends and my father;
they took me away from her by force.”

Gradually some more dreams emerged. “I dreamt some time ago that
the woman came to me and spilled hot water on me. Another time I
dreamed that I was in the insane asylum; she came out, told me she
was well; I was greatly frightened and ran away.”

Mrs. A. then became quiet. After a while she began to relate a
series of dreams. Some time ago she dreamed that the woman entered
the room where her father was and ran up to him, evidently with the
intention of hurting him. Her father ran away, and she hid herself
in a closet in the next room. “I also dreamt that the woman was
shadowing me in an alley. She wanted to get hold of me, while I was
trying to get away from her. I turned round, and she gave me such
a fierce look. I ran and she could not catch me. I should die, if
she catches me. In one of my dreams about her, I saw people putting
cold water on her, and I could hear her scream. It was awful. I
dreamt I went upstairs, opened the door and met her. I was badly
frightened. I jumped out of the window.”

This is an extract from a letter sent to me by the patient’s
husband: “ ... She had another attack. It did not last long, and
it was not severe. She dreamt several times a week. I shall try to
relate them as accurately as possible. She dreamt that I left the
room for a while. Our baby was asleep in the next room. All of a
sudden she heard baby cry out: ‘Mamma, I am afraid.’ She told the
baby to come to her as she herself was afraid to leave the bed.
Baby came to her. The child looked frightened, her face pale with
fear, exclaiming ‘Mamma, a devil.’ As the child cried out, my wife
heard a noise in the room, something moved close by. She became
scared. It seemed to her that something terrible and unknown was
after her. She wanted to scream for help, but could not. A hand was
stretched out after her to catch her. She woke up in great terror.
Another time she dreamt that she was in a hall way. She saw a woman
and became frightened. It was the same crazy woman. My wife is
exceedingly nervous, and is in fear that something awful is going
to happen to her or to the family.”

A rich, subconscious dream-life of agonizing fears was thus
revealed, a life of terrors of which the patient was unaware in
her waking state. The dreams referred to the same central nucleus,
the shock and fears of her early childhood. Worries about self and
family kept up and intensified the present fear states.

Her selfishness has no bounds, her fears have no limits. The
symptoms of the “fear set,” as in all other psychopathic cases,
took their origin in the impulse of self-preservation with its
accompanying fundamental fear instinct.

This patient was cured after a long course of hypnotic treatment.




CHAPTER XXII

RECURRENT FEAR STATES,--PSYCHOLEPSY


There are cases in which the nature of the psychopathic states
stands out more clearly and distinctly than in others. They occur
periodically, appearing like epileptic states, in a sort of an
explosive form, so that some authorities have mistaken them for
epilepsy, and termed them psychic epilepsy. My researches have
shown them to be recurrent explosions of subconscious states,
which I termed _psycholepsy_. They really do not differ from
general psychopathic states, but they may be regarded as classic
_pseudo-epileptic_, or _psycholeptic_ states; they are classic
_fear-states_--_states of panic_.

M. L. is nineteen years of age, of a rather limited intelligence.
He works as a shopboy amidst surroundings of poverty, and leads
a hard life, full of privations. He is undersized and underfed,
and looks as if he has never had enough to eat. Born in New York,
of parents belonging to the lowest social stratum, he was treated
with severity and even brutality. The patient has never been to any
elementary school and can neither read nor write. His mathematical
knowledge did not extend beyond hundreds; he can hardly accomplish
a simple addition and subtraction, and has no idea of the
multiplication table. The names of the President and a few Tammany
politicians constitute all his knowledge of the history of the
United States.

Family history is not known; his parents died when the patient was
very young, and he was left without kith and kin, so that no data
could be obtained.

Physical examination is negative. Field of vision is normal. There
are no sensory disturbances. The process of perception is normal,
and so also is recognition. Memory for past and present events is
good. His power of reasoning is quite limited, and the whole of his
mental life is undeveloped, embryonic. His sleep is sound; dreams
little. Digestion is excellent; he can digest anything in the way
of eatables. He is of an easy-going, gay disposition, a New York
“street-Arab.”

The patient complains of “shaking spells.” The attack sets in
with tremor of all the extremities, and then spreads to the whole
body. The tremor becomes general, and the patient is seized by
a convulsion of shivering, trembling, and chattering of teeth.
Sometimes he falls down, shivering, trembling, and shaking all
over, in an intense state of fear, a state of panic. The seizure
seems to be epileptiform, only it lasts sometimes for more than
three hours. The attack may come any time during the day, but is
more frequent at night.

During the attack the patient does not lose consciousness; he knows
everything that is taking place around him, can feel everything
pretty well; his teeth chatter violently, he trembles and shivers
all over, and is unable to do anything.

The fear instinct has complete possession of him. He is in agony
of terror. There is also a feeling of chilliness, as if he is
possessed by an attack of “fear ague.” The seizure does not start
with any numbness of the extremities, nor is there any anaesthesia
or paraesthesia during the whole course of the attack. With the
exception of the shivers and chills the patient claims he feels
“all right.”

The patient was put into a condition close to the hypnotic
state. There was some catalepsy of a transient character, but no
suggestibility of the hypnotic type. In this state it came to light
that the patient “many years ago” was forced to sleep in a dark,
damp cellar where it was bitter cold. The few nights passed in that
dark, cold cellar he had to leave his bed, and shaking, trembling,
and shivering with cold and fear he had to go about his work in
expectation of a severe punishment in case of non-performance of
his duties.

While in the intermediary, subwaking, hypnoidal state, the patient
was told to think of that dark, damp, cold cellar. Suddenly the
attack set in,--the patient began to shake, shiver, and tremble
all over, his teeth chattering as if suffering from intense fear.
The attack was thus reproduced in the hypnoidal state. “This is
the way I have been,” he said. During this attack no numbness, no
sensory disturbance, was present. The patient was quieted, and
after a little while the attack of shivering and fear disappeared.

The room in which the patient was put into the subconscious
state was quite dark, and accidentally the remark was dropped
that the room was too dark to see anything; immediately the
attack reappeared in all its violence. It was found later that it
was sufficient to mention the words, “dark, damp, and cold” to
bring on an attack even in the fully waking state. We could thus
reproduce the attacks at will,--those magic words had the power
to release the pent-up subconscious forces and throw the patient
into convulsions of shakings and shiverings, with chattering of the
teeth and intense fear.

Thus the apparent epileptiform seizures, the insistent psychomotor
states of seemingly unaccountable origin, were traced to
subconscious fear obsessions.

The following case is of similar nature. The study clearly shows
the subconscious nature of such psycholeptic attacks:[10]

Mr. M., aged twenty-one years, was born in Russia, and came to this
country four years previously. His family history, as far as can be
ascertained, is good. There is no nervous trouble of any sort in
the immediate or remote members of his family.

The patient himself has always enjoyed good health. He is a young
man of good habits.

He was referred to me for epileptiform attacks and anaesthesia
of the right half of his body. The attack is preceded by an aura
consisting of headache and a general feeling of malaise. The aura
lasts a few days and terminates in the attack which sets in about
midnight, _when the patient is fully awake_. The attack consists of
a series of spasms, rhythmic in character, and lasting about one or
two minutes. After an interval of not more than thirty seconds the
spasms set in again.

This condition continues uninterruptedly for a period of five or
six days (a sort of status epilepticus), persisting during the time
the patient is awake, and ceasing only during the short intervals,
or rather moments, of sleep. Throughout the whole period of the
attacks the patient is troubled with insomnia. He sleeps restlessly
for only ten or fifteen minutes at a time. On one occasion he was
observed to be in a state of delirium as found in post-epileptic
insanity and the so-called Dämmerzustände of epilepsy. This
delirium was observed but once in the course of five years.

The regular attack is not accompanied by any delirious states or
Dämmerzustände. On the contrary, during the whole course of the
attack the patient’s _mind remains perfectly clear_.

During the period of the attack the whole right side becomes
anaesthetic to all forms of sensations, kinaesthesis included, so
that he is not even aware of the spasms unless he actually observes
the affected limbs.

The affected limbs, previously normal, also become paretic. After
the attack has subsided, the paresis and anaesthesia persist (as
sometimes happens in true idiopathic epilepsy) for a few days,
after which the patient’s condition remains normal until the next
attack. After his last attack, however, the anaesthesia and paresis
continued for about three weeks.

He has had every year one attack which, curiously, sets in about
the same time, namely, about the month of January or February.
The attacks have of late increased in frequency, so that the
patient has had four, at intervals of about three or four months.
On different occasions he was in the Boston City Hospital for the
attacks.

There was a profound right hemianaesthesia including the right half
of the tongue, with a marked hypoaesthesia of the right side of the
pharynx. All the senses of the right side were involved. The field
of vision of the right eye was much limited. The ticking of a watch
could not be heard more than three inches away from the right
ear. Taste and smell were likewise involved on the right side. The
muscular and kinaesthetic sensations on the right side were much
impaired.

The patient’s mental condition was good. He states that he has few
dreams and these are insignificant, concerned as they are with the
ordinary matters of daily life. Occasionally he dreams that he is
falling, but there is no definite content to the dream.

These findings were indicative of functional rather than organic
disease. The _previous history_ of the case was significant. The
first attack came on after peculiar circumstances, when the patient
was sixteen years of age and living in Russia. After returning from
a ball one night, he was sent back to look for a ring which the
lady, whom he escorted, had lost on the way. It was after midnight,
and his way lay on a lonely road which led by a cemetery. When near
the cemetery he was suddenly overcome by a great fright, thinking
that somebody was running after him. He fell, _struck his right
side_, and lost consciousness. The patient did not remember this
last event. It was told by him when in a hypnotic state.

The patient was a Polish Jew, densely ignorant, terrorized by
superstitious fears of evil powers working in the dead of night.

By the time he was brought home he regained consciousness, but
there existed a spasmodic shaking of the right side, involving the
arm, leg, and head. The spasm persisted for one week. During this
time he could not voluntarily move his right arm or leg, and the
right half of his body felt numb. There was also apparently a loss
of muscular sense, for he stated that he was unaware of the shaking
of his arm or leg, unless he looked and saw the movements. In other
words, there was right hemiplegia, anaesthesia, and spasms.

For one week after the cessation of the spasms his right arm and
leg remained weak, but he was soon able to resume his work, and he
felt as well as ever. Since then every year, as already stated,
about the same month the patient has an attack similar in every
respect to the original attack, with the only exception that there
is no loss of consciousness. Otherwise the subsequent yearly
attacks are _photographic pictures, close repetitions, recurrences
of the original attack_.

A series of experiments accordingly was undertaken. First,
as to the anaesthesia. If the anaesthesia were functional,
sensory impressions ought to be felt, even though the patient
was unconscious of them, and we ought to be able to get sensory
reactions.

Experiments made to determine the nature of the anaesthesia
produced interesting results. These experiments show that the
anaesthesia is not a true one, but that impressions from the
anaesthetic parts which seem not to be felt are really perceived
subconsciously.

Different tests showed that the subconscious reactions to
impressions from the anaesthetic hand were more delicately plastic
and responsive than the conscious reactions to impressions from
the normal hand. We have the so-called “psychopathic paradox” that
_functional anaesthesia is a subconscious hyperaesthesia_.

It is evident then that there could be no inhibition of the sensory
centres, or suppression of their activity, or whatever else it
may be called. In spite of the apparent, profound anaesthesia,
the pin pricks were felt and perceived. Stimulations gave rise to
perception, cognition, to a sort of pseudo-hallucinations that
showed the pin pricks were counted and localized in the hand. The
results of these tests demonstrate that in psychopathic patients
all sensory impressions received from anaesthetic parts, while
they do not reach the _personal_ consciousness are perceived
_subconsciously_.

Inasmuch as the sensations are perceived, the failure of the
subject to be conscious of them must be due to a _failure in
association_. The perception of the sensation is dissociated from
the personal consciousness. More than this, these _dissociated_
sensations are capable of a certain amount of independent
functioning; hence the pseudo-hallucinations, and hence the
failure of psychopathic patients to be incommoded by their
anaesthesia. This condition of dissociation underlies psychopathic
states.

For the purpose of studying the attacks, the patient was
hypnotized. He went into a deep somnambulic condition, in which,
however, the _anaesthesia still persisted_. This showed that the
dissociation of the sensory impressions was unchanged.

In hypnosis he related again the history of the onset of the
trouble. His memory became broader, and he was able to give the
additional information, which he could not do in his waking state,
that at the time he was badly frightened, he fell on his right
side. Moreover, he recalled what he did not remember when awake,
that throughout the period of his attacks when he fell asleep,
he had vivid dreams of an intense hallucinatory character, all
relating to terror and fall.

In these dreams he lived over and over again the experience which
was the beginning of his trouble. He again finds himself in his
little native town, on a lonely road; he thinks some one is running
after him; he becomes frightened, calls for help, falls, and then
wakes up with a start, and the whole dream is forgotten. After he
wakes he knows nothing of all this; there is no more fear or any
emotional disturbance; he is then simply distressed by the spasms.

While testing the anaesthesia during hypnosis, an attack
developed, his right arm and leg began to shake, first mildly
and then with increasing intensity and frequency. His head also
spasmodically turned to the right side. The movements soon became
rhythmic. Arm and leg were abducted and adducted in a slow rhythmic
way at the rate of about thirty-six times per minute. With the
same rate and rhythm, the head turned to the right side, with
chin pointing upward. The right side of the face was distorted
by spasm, as if in great pain. The left side of the face was
unaffected. Pressure over his right side (where he struck when
he fell) elicited evidences of great pain. Respiration became
deep and labored, and was synchronous with each spasm. The whole
symptom-complex simulated Jacksonian epilepsy.

Consciousness persisted unimpaired, but showed a curious and
unexpected alteration. When asked what was the matter, he replied
in his native dialect, “I do not understand what you say.” It was
found that he had lost all understanding of English, so that it was
necessary to speak to him in his native dialect. His answers to
our questions made it apparent that during the attack, as in his
dreams, he was living through the experience which had originally
excited his trouble.

The attack was _hypnoidic, a fear attack_, hallucinatory in
character. He said that he was sixteen years old, that he was
in Rovno (Russia), that he had just fallen, because he was
_frightened_, that he was lying on the roadside near the cemetery,
which in the popular superstitious fear is inhabited by ghosts. At
that hour of the night the dead arise from their graves and attack
the living who happen to be near.

The hypnoidic state developed further, the patient living through,
as in a dream, the whole experience that had taken place at that
period. He was in a carriage, though he did not know who put him
there. Then in a few moments he was again home, in his house,
with his parents attending on him as in the onset of his first
epileptiform seizures.

The attack terminated at this point, and thereupon he became
perfectly passive, and when spoken to answered again in English.
Now he was again twenty-one years old, was conscious of where he
was, and was in absolute ignorance of what had just taken place.

It was found that an attack could regularly and artificially be
induced, if the patient in hypnosis was taken back by suggestion to
the period when the accident happened.

The experiment was now tried of taking him back to a period
antedating the first attack. He was told that he was fifteen years
old, that is, a year before the accident occurred. He could no
longer speak or understand English, he was again in Rovno, engaged
as a salesman in a little store, had never been in America, and
did not know who we were. Testing sensation, it was found that it
had spontaneously returned to the hand. _There was not a trace of
the anaesthesia left._ The hands which did not feel deep pin pricks
before now reacted to the slightest stimulation. _Spontaneous
synthesis of the dissociated sensory impressions had occurred._
Just as formerly before the accident, sensation was in normal
association with the rest of his mental processes, so now this
association was re-established with the memories of that period to
which the patient was artificially reduced.

The patient was now (while still believing himself to be fifteen
years old) taken a year forward to the day on which the accident
occurred. He says he is going to the ball tonight. He is now at the
ball; he returned home; he is sent back to look for a ring. Like
a magic formula, it calls forth an attack in which again he lives
through the accident,--the terror and the spasms.

It was thus possible to reproduce an attack at any time with
clock-like precision by taking him back to the period of the
accident, and reproducing all its details in a hypnoidic state.
Each time the fear and the physical manifestations of the attack
(spasms, paresis, and anaesthesia) developed. These induced attacks
were identical with the spontaneous attacks, one of which we had
occasion to observe later.

At periodic intervals, as under the stress of fear, the
dormant activity is awakened and, though still unknown to the
patient, gives rise to the same sensori-motor disturbances
which characterized the original experience. These subconscious
dissociated states are so much more intense in their manifestations
by the very fact of their dissociaton from the inhibitory
influences of the normal mental life.

The psychognosis of such cases reveals on the one hand a
dissociation of mental processes, and on the other hand an
independent and automatic activity of subconscious psychic states,
under the disaggregating, paralyzing influence of the fear instinct.

A patient under my treatment for four months during the year of
1922 presents interesting traits. I regard the case as classic as
far as the fundamental factors of neurosis are concerned.

Patient, male, age 32, married, has two children. He lives in an
atmosphere of fear and apprehension about himself. He comes from
a large, but healthy family. The patient is of a rather cowardly
disposition especially in regard to his health. He worked hard in a
store during the day, and led a life of dissipation at night. One
day, after a night of unusual dissipation, or orgy, when on his
way to his work, he felt weak, he was dizzy, he became frightened
about himself; he thought he had an attack of apoplexy, and that
he was going to die. His heart was affected, it began to beat
violently, and he trembled and shivered in an “ague” of intense
fear. The palpitation of the heart was so great, the trembling was
so violent, and the terror was so overwhelming that he collapsed in
a heap. He was taken to his father’s store in a state of “fainting
spell.” A physician was called in who treated the patient for an
attack of acute indigestion.

For a short time he felt better, but the attacks of terror,
trembling, shivering, weakness, pallor, fainting, palpitation of
the heart and general collapse kept on recurring. He then began
to suffer from insomnia, from fatigue, and is specially obsessed
by fear fatigue. He is in terror over the fact that his energy
is exhausted; physical, mental, nervous, sexual impotence. This
was largely developed by physicians who treated him for epilepsy,
putting him on a bromide treatment; others treated and diagnosed
the case as cardiac affection, kidney trouble, dementia praecox,
and one physician operated on the poor fellow for tonsillitis.
The patient was terrorized. He was on a diet for toxaemia, he was
starved. He took all sorts of medicine for his insomnia.

The patient became a chronic invalid for ten years. He was in
terror, scared with the horrors of sleepless nights. He has
been to neurologists, to psychoanalysts, and he tried Christian
Science, New Thought, Naturopathy, and Osteopathy, but of no avail.
The condition persisted. The attacks came on from time to time
like thunder storms. There were trembling, shivering, chattering
of teeth, palpitation of the heart, weakness, fainting, and
overwhelming, uncontrollable terror.

The first time I tried to put the patient into a hypnoidal state
was nine at night. I put out the electric light, lighted a candle,
and proceeded to put him into a hypnoidal condition. The patient
began to shiver, to tremble, to breathe fast and heavily, the pulse
rose to over 125, while the heart began to thump violently, as if
it were going to jump out. He was like one paralyzed, the muscles
of the chest labored hard, and under my pressure the muscle fibers
hardened, crackled, became rigid, and he could not reply when
spoken to. It took me some time to quieten him. He was clearly in a
state of great panic. I opened his eyelids and found the eye ball
turned up. The whole body was easily put in a state of catalepsy.
Clearly the patient was not in a hypnoidal state, he was in a state
of hypnosis. Night after night he fell into states of hypnosis
with all the symptoms of intense fear attacks. When the fear
attacks subsided the depths of the hypnotic state proportionately
diminished.

In my various clinical and laboratory experimental work, covering
a period of a quarter of a century, I have gradually come to the
conclusion that fear and hypnosis are interrelated. In fact I am
disposed to think that the hypnotic state is an ancient state,
a state of fear cataplexy, or rather trance obedience. While the
hypnoidal state is a primitive sleep state, the hypnotic condition
is a primitive, fear condition, still present in lowly formed
organisms.

After some time the general fear instinct becomes alleviated.
The patient goes by habit into a trance hypnotic state under the
influence of the hypnotizer in whom he gains more confidence. The
patient gets into a state of trance obedience to the hypnotizer of
whom he is in awe, and who can control the patient’s fear instinct.

Man obeys the commands, “the suggestions” of the hypnotizer, of the
master whom he subconsciously fears, and who inspires him with awe,
with “confidence-fear”. The crowd, the community, “public opinion,”
the mob, the leader, the priest, the magician, the medicine man,
are just such forces, such authorities to procure the slavish
obedience of the subconscious described as hypnosis. Soldiers and
slaves fall most easily into such states.

Man has been trained in fear for milleniums, in fear of society,
custom, fashion, belief, and the authority of crowd and mob. He
fears to stand alone, he must go with the crowd.

Man is a social being, a hypnotized, somnambulic creature. He walks
and acts like a hypnotized slave. Man is a social somnambulist
who believes, dreams, and acts at the order of the mob or of its
leader. Man belongs to those somnambulists who become artificial,
suggested, automatic personalities with their eyes fully open,
seeing and observing nothing but what is suggested to them.

The hypnoidic states, observed and described by me in the classical
Hanna case, belong to the same category. The hypnoidic states are
essentially fear cataleptic states of a vivid character, closely
related to hypnotic conditions of primitive life.[11]


FOOTNOTES:

[10] Dr. Morton Prince and Dr. H. Linenthal coöperated with me in
the study of the case published in full in the “Boston Medical and
Surgical Journal.”

[11] See my works, “The Psychology of Suggestion,” “Multiple
Personality,” and others.




CHAPTER XXIII

APHONIA, STAMMERING, AND CATALEPSY


S. R. Age 25. Russian Jewess; married; has four children. Patient
was brought to me in a state of helplessness. She could not walk,
and was unable to utter a word. When spoken to she replied in
gestures. When challenged to walk, she made unsuccessful attempts.
The step was awkward, the gait reeling, the body finally collapsing
in a heap on the floor. When I shut her eyelids, the eyeballs began
to roll upwards, the lids soon became cataleptic, and the patient
was unable to open them. When I insisted that she should open the
lids, she strained hard,--the muscles of the upper part of the
body became painfully tense,--wrinkled her forehead, and contorted
violently her face. After long insistence on her replying to my
questions, and after long vain efforts to comply with my request,
she at last succeeded in replying in a barely audible voice. When
whispering she kept on making incoordinate movements with jaws and
lips, began to shut her eyelids, rolled up the eye-balls, forced
the tongue against the teeth, stammered badly on consonants,
uttering them with great difficulty after long hesitation, the
sound finally coming out with explosive force.

I insisted that she must stand up, she raised herself slowly and
with effort, took a couple of steps, and sat down at once on the
chair. During the period of effort there was marked tremor in her
left arm. When she sat down, she threw her head backward, rolled
up her eyeballs, and began gradually to close her eyelids. She
remained in this position for a couple of minutes, and then began
spasmodically to open and shut the eyelids. When taken to her room,
the patient walked up, though with some difficulty, three flights
of stairs without the nurse’s support.

The patient was greatly emaciated,--she lived in extreme poverty.
She was married five years, and had given birth to four children.
Patient was suffering from severe headaches which set in soon
after the birth of the second child. At first the headaches came
at intervals of a few weeks, and lasted about a day, then with the
birth of the other children the headaches grew more severe and more
frequent, and finally became continuous. From time to time the
attacks were specially exacerbated in violence, she then complained
of violent pains in the head, excruciating agony toward the vertex.
The face was deadly pale, the hands and feet were ice-cold, the
pulse weak and sluggish. During the attack the head had to be
raised, since in any other position the pain was unbearable. The
pain was originally unilateral, starting on the left side of the
head. Of late the pain spread from left to right. The whole head
felt sore, like a boil, the scalp was highly sensitive. The intense
attacks, sweeping over the patient unawares, were accompanied by
twitchings of the eyelids, rolling of the eyeballs, dizziness,
sparks before the eyes, pains in the left side of the chest, and by
numbness and hypoaesthesia of the face, arms and legs. The patellar
reflex was markedly exaggerated, no clonus was present; the pupils
reacted well to light and accommodation.

The patient was admitted to a local hospital, and was allowed to
nurse her one year old baby. Three days after admission, while
nursing her baby, she was seized with a violent attack of headache
and pain in the left side. The arms felt numb and “gone.” The
patient was seized with a panic that the child might fall; hugging
the baby to her left breast she screamed for help in agony and
terror. Immediately following this seizure the patient lost her
voice, speech, and power of walking.

After staying in the hospital for two weeks, the patient was put
under my care.

The patient was an extremely timid creature. She lived in Russia
in a small town where the religious persecutions of the neighbors
were persistent and unremittent. To this were joined the petty
annoyances by the village police, the representatives of which
acted with all the cruel tyranny characteristic of the old Russian
regime. The patient’s family was in constant terror. In childhood
the patient has undergone all the horrors of the _pogromi_ with
all the terrors of inquisitorial tortures. A highly sensitized
impulse of self-preservation and intense easily stimulated fear
instinct were the essence of the patient’s life. She was afraid
of everything, of her very shadow, of anything strange, more so
in the dark, and at night. With this morbid self-preservation and
intensified fear instinct there were associated superstitions to
which her mind was exposed in early childhood, and in her later
life. The patient lived at home in the fear of the most savage
superstitions and prejudices, characteristic of the poor ignorant
classes of Eastern European countries, and outside the house she
was in fear of her life. The patient was brought up on fear and
nourished on fear. No wonder when she was run down, and met with a
fear shock, that the fear instinct seized on her and gave rise to
the symptoms of physical and mental paralysis.

To this life of terror we may add the extreme poverty in which the
patient lived in Russia and afterwards in this country. The hard
work in a sweat-shop and the ill nutrition ran down the patient
and further predisposed her to disability and disease. Patient
lived in constant dread of actual starvation, with fear of having
no shelter, with fear of no roof over her head. She was so timid
that she was scared by any sudden movement, or by a severe, harsh,
threatening voice. She was extreme suggestible, imitative, and
credulous. She was like a haunted animal, like a scared bird in the
claws of a cat. Fear often threw her into a state of rigidity.

The patient suffered from a fear of fatigue, from fear of
exhaustion, from fear of disability, from fear of paralysis,
pain, sickness, and death, fear of the negative aspect of the
most primitive, and most fundamental of all impulses, the impulse
of self-preservation. The fear psychosis, based on an abnormally
developed fear instinct which formed the main structure of her
symptom complex, had a real foundation in the psycho-physiological
condition of her organism. The patient actually suffered from
fatigue due to exhaustion, underfeeding, and overworking.

Married at the age of twenty, she bore four children in succession.
This was a drain on the poor woman, and further weakened her
feeble constitution. Her husband was a poor tailor working in
a sweat-shop, making but a few dollars a week. The family was
practically kept in a state of chronic starvation. The wolf was
hardly kept away from the door. The family was in constant dread of
“slack time” with its loss of employment and consequent privations
and suffering.

The husband was a hard worker, did not drink, but the long hours of
work, the low wages, the poor nutrition, the vicious air, and the
no less vicious environment, cheerless and monotonous, sometimes
gave rise to moods, discontent, anger, and quarrels, of which the
patient with her timidity stood in utter terror.

The patient’s dream life was strongly colored by a general
underlying mood of apprehension. The fear instinct of
self-preservation formed the soil of the whole emotional tone
of the psychosis, waking, sub-waking, dreaming, conscious, and
subconscious. Again and again did the nurses and attendants report
to me that, although the patient was aphonic and it was hard to
elicit from her a sound, in her sleep she quite often cried out,
sometimes using phrases and words which were hard to comprehend,
because they were indistinct, and because they were sometimes in
her native language. When awakened immediately, it was sometimes
possible to elicit from her shreds of dreams in regard to scares
and frights about herself, about her children, about her husband,
relatives, and friends. When she came under my care the patient
often used to wake up in the morning in a state of depression due
to some horrible hallucinatory dreams in which she lived over
again in a distorted form, due to incoordination of content and to
lack of active, guiding attention, dreams in which the dreadful
experience of her miserable life kept on recurring under various
forms of fragmentary association and vague synthesis, brought
about by accidental, external and internal stimulations.

The patient was taken to her room in the evening, and put to bed.
During the night she was somewhat restless, kept on waking up,
but on the whole, according to the nurse’s account, she slept
quite well. In the morning the patient had a hearty breakfast,
and felt better than the day before when she was brought to me.
The voice improved somewhat in strength and volume. During the
day she rested, felt well, and enjoyed her meals. Speech was
still in a whisper barely audible, but there was no stammering,
no muscular incoordination, no twitchings of the face. About four
in the afternoon patient sat up in bed, her voice became somewhat
stronger, though speech was still in a whisper. This improvement
lasted but a few minutes. When her arms were raised, the left hand
manifested considerable tremor and weakness as compared with the
right arm. After having made a few remarks which apparently cost
her considerable effort, she had a relapse, she again lost her
voice, and was unable to whisper. I insisted that she should reply
to my questions; she had to make a great effort, straining her
muscles and bringing them into a state of convulsive incoordination
before she could bring out a few sounds in reply. A little later,
about ten or fifteen minutes after I left the room, the nurse came
in and quietly asked her a question, the patient answered in a
whisper, with little strain and difficulty. An hour later the
patient regained her speech for a short period of a few minutes.
These changes went on during the patient’s waking period. Once
towards evening the patient regained her voice and speech to
such an extent that she could talk with no difficulty and little
impediment; the voice was so resonant and strong that it could be
heard in the hall adjoining the room. This however lasted but a few
moments.

After having had a good night’s sleep the patient woke up in good
condition; appetite was good. Voice was clear, though low. She was
in a state of lassitude and relaxation. I attempted to examine her
and kept testing her condition, physical and mental. I was anxious
to make a psychognosis of the patient’s case. The tests and the
questions strained her nervous system by requiring to hold her
attention, and by keeping her in a state of nervous and mental
agitation. She looked scared, anxious,--the scared, haunted look in
her face reappeared. The patient was no more than about twenty to
twenty-five minutes under experimentation when a severe headache of
the vertex and of the left side of the head set in. The eyeballs
began to roll up, eyelids were half closed; lids and eyeballs
were quivering and twitching. The hands were relaxed and looked
paralyzed. When raised they fell down by her side in an almost
lifeless condition. There was marked hypoaesthesia to pain and heat
sensations. The anaesthesia was more marked on the left than on the
right side. The left arm when raised and kept for a few seconds
showed marked tremor as compared with the right arm. This is to be
explained by the fact that the exacerbations of the headache, of
pain, and the general cataleptic seizures set in usually during or
after the nursing periods. The infant while nursing was kept by the
mother on the left arm, the left side thus bearing the pressure,
weight, and strain,--it was with the left side that fear became
mainly associated.

During the height of the attack the patient was quietened, her
fears allayed, and a five-grain tablet of phenacetine was given her
with the authoritative remark that the drug was sure to help her.
As soon as she swallowed the tablet the patient opened her eyes,
and said she felt better. About an hour later, when another attempt
at an examination was made, patient had an attack of headache,
cried, said she was afraid, but she answered in a whisper when
spoken to. She talked slowly, in a sort of staccato way. I insisted
that she should talk a little faster and pronounce the words
distinctly. She made violent attempts to carry out my command, but
got scared, began to hesitate, and stammer, her voice and speech
rapidly deteriorating with her efforts, ending in complete mutism.

During the day I tried from time to time to keep up the experiment
of insisting that the patient should speak, and every time with
the same result of bringing about an attack.[12] The patient began
to stammer and stutter, becoming more and more frightened the
more the nurse and myself insisted that she should make an effort
and reply to our questions. Still, when the patient’s attention
became distracted, when she was handled gently, when her fears were
allayed, the speech and sound improved in quality and in loudness,
and at times her sentences were quite fluent, her enunciation quite
distinct.

This state of instability lasted for several days until the patient
became somewhat familiar with the surroundings. In one of her
better moments the patient told me that she thought her stammering
began with a definite event. One evening when she was fatigued with
the labors of the day for her family, a stammerer came in to see
her. The stammering made a strong impression on her. She felt the
strain of the stammerer; she could not control the sympathy and the
strain, and involuntarily began to imitate stammering. She began to
fear that she might continue to stammer and be unable to enunciate
sounds and words. The more she feared the harder it was for her to
speak or even to use her voice.

A few days later the patient began to improve, she began to adapt
herself to her surroundings, and did not get so easily scared.

About eight days after the first examination the patient woke up
one morning in a state of depression; she cried a good deal. She
did not sleep well the night before, dreamt and worried on account
of her children. She was afraid that something might have happened
to them in her absence, perhaps they were sick, perhaps the
husband could not take good care of them. She talked in a whisper,
her eyes were shut. When I insisted on opening the eyelids, she
opened them, but did it with difficulty. I put her into a hypnotic
state. In about a minute her eyes rolled up, and the eyelids shut
spasmodically. There was present a slight degree of catalepsy.
Mutism was strongly marked. Upon sudden and unexpected application
of an electric current, the patient opened her eyes, cried out,
but soon relapsed into a state of lethargy. Gradually patient was
brought out of the lethargic state.

A couple of hours later, after she had a good rest a few more
experiments as to her sensori-motor life were attempted. I
asked her to raise objects, tested her sensitivity to various
stimulations, her concentration of attention, asked her questions
about her life, about her family, took again her field of vision.
All that was a great effort to her. While I was taking her field of
vision the patient’s eyes began to close, and it took about twenty
seconds before she could open them. She opened them with effort,
but shut them again. This time it took her about 45 seconds before
she could open the lids. Fatigue, or rather fear fatigue, set in
sooner with each repetition of experiment and test, and lasted a
longer time.

For several days the patient kept on improving slowly. She then had
another relapse. She slept well the night before, but woke up early
about six in the morning; she began to worry about her family, and
complained of headache. About half past eight the headache became
severe, there was again pain in the left side, the left hand began
to tremble, and felt anaesthetic, the eyelids closed, and could not
open, aphonia returned, in fact she fell into a state of mutism.
About ten o’clock patient opened her eyes, but she was unable to
talk. After long insistence on her reply to my question as to how
she was, she finally replied in a whisper: “Well,” then added “I
have a bad headache.” She had great difficulty in replying to my
questions, moved her jaws impotently before she was able to emit
a sound, her muscles were strained, the face was set, tense, and
drawn, the brow was corrugated, the eyeballs rolled up, and the
eyelids shut tightly. The patient was unable to raise her hands,
they lay powerless at her side. When raised the arms were found
to be lethargic, fell to her side, only the left hand manifested
light, fibrillary twitchings and a gross tremor. When insisted upon
that she must raise her arms, she became agitated, scared, began
to moan and cry. Claimed severe pain in head, in chest, in heart.
“Pain in heart, in head, I am afraid,” she moaned in a whisper.
There was loss of kinaesthetic sensibility, patient complained that
she did not feel her arms, “they are not mine.” She had to look
at the arm in order to find it. There was also present anaesthsia
to other sensations such as pain, touch, heat, and cold. After a
couple of hours’ rest the sensibility returned. The sensibility was
affected more on the left side than on the right, and also returned
earlier on the right side.

When the fatigue and the scare subsided the patient was tested
again. This time the reactions to sensory stimulations were normal.
The patient was touched, pinched, and pricked, she reacted to
each stimulus separately, and was able to synthesize them and
give a full account of their number. Kinaesthetic sensibility was
good,--she was fully able to appreciate the various movements and
positions in which her limbs and fingers were put.

The patient was left to rest, quietened, treated carefully,
avoiding sudden stimulations, allaying her fears and suspiciousness
of danger, lurking in the background of her mind. After a few
hours she sat up, made an attempt to raise herself from bed, got
up with some effort, and sat down in an easy rocking chair next to
her. Her eyes were wide open. Asked how she was, she replied in a
whisper that she felt quite well. The effort however fatigued her,
her head began to drop, eyelids began to close, and the eyeballs
began to roll up. Twitchings were observed in the eyelids, and
tremors in the left arm. She was again put to bed and given a rest
of a few hours. She opened her eyes, and told me that she was weak.
This statement she herself volunteered. I found that she could move
her hands easily, and that the numbness was completely gone.

For a whole week the patient kept on growing in health and in
strength, her sensori-motor reactions improved, she walked round
the room for a few minutes, talked in a low voice for a quarter
of an hour at a time without manifesting her symptoms of fatigue;
her appetite and sleep improved accordingly. At the end of the
week there was again a relapse,--she did not sleep well the night
before, dreamt of being hunted and tortured, woke up depressed, had
no appetite for breakfast, complained of headache, pains, worries,
and fears. The headaches have abated in their virulence during last
week, but now they seemed to have reappeared in their former vigor.
When I began to examine her she looked frightened, her eyeballs
rolled up, her eyelids closed. The aphonia was severe, patient lost
speech and voice. When spoken to she could not answer. Asked if
she heard me, she nodded her head affirmatively. There were slight
twitchings of her left hand and also of the muscles of her face.
When attention was attracted to the arm the twitchings increased in
violence and rapidity. With the distraction of the attention the
twitchings disappeared. When the left hand was put in the patient’s
field of vision, thus making her attention concentrate on that
limb, the tremors increased again, becoming finally convulsive in
character.

I insisted she should try to open her mouth, and say
something,--she made fruitless efforts, moving incoordinately the
muscles of the face and of the forehead, but she could not utter a
sound. She could not move her arms on command, could hardly wriggle
the fingers of her hand. She appeared like a little bird paralyzed
by fear. When the arm was raised passively it fell down slowly
being in a cataleptic state.

I allayed the patient’s fear. I strongly impressed her with the
groundlessness of her fears, and also with the fact that everything
was well with the children, and that her husband will be good and
gentle with her. The patient was permitted to see her family.
The husband was made to realize that he must treat her with more
consideration. He came often to visit her, and learned to treat
her well. He soon found a better position, was advised to remove to
a healthy locality and to more cheerful surroundings. The children
were well cared for. The patient found deep satisfaction in the
midst of this family happiness. The fear state abated,--the patient
became more confident, more hopeful for the future, and began
to improve. The infant was weaned so that the strain of nursing
was removed. The patient’s appetite began to improve; she gained
several pounds in a few days. Long periods of examination and
investigation of her nervous and mental state no longer exhausted
or terrified her. Her concentration of attention could be kept up
from a quarter to half an hour at a stretch without giving rise to
fatigue, headache, or to a seizure with its consequent psychomotor
effects. The haunted look of fear disappeared, and along with
it were also gone the fatigue and dread of physical and mental
exercise or work. She could work and walk with ease the whole
length of the room and of the hall. She began to take more and more
interest in her appearance and in dress. For many minutes at a time
she looked out on the street taking an interest in all that was
done and what was going on.

The case was discharged, and was sent home. She continued to stay
well.


FOOTNOTE:

[12] In fact from my long experience with cases of stammering,
stuttering and mutism I may say that where no organic lesion may be
suspected, the disturbance is one of self and fear.




CHAPTER XXIV

SUGGESTED HALLUCINATIONS


The servility, the state of fear of the subconscious, the source of
neurosis, in its relation to the master hypnotizer is well brought
out in the mechanism of hypnotic and post-hypnotic hallucinations.

Before we proceed with our discussion it may be well to give an
analysis, however brief, of the normal percept, of the abnormal
percept or hallucination, and then compare them with hypnotic and
post-hypnotic hallucinations. The understanding of perception,
normal and abnormal, is, in fact, at the basis of normal and
abnormal psychology.

We may begin with the percept and its elements. In looking at
the vase before me I see its beautiful tints, its rounded shape,
its heavy pedestal with its rough curves, its solidity, weight,
brittleness, and other experiences which go to make up the
perception of the vase. The visual elements are given directly by
the visual perceptive experience; but whence come the seemingly
direct experiences of weight, heaviness, roughness, smoothness, and
others of the like kind? They are evidently derived from other
senses. The whole perceptive experience is of a visual character.
We take in the whole with our eye. In the organic structure of
the percept then, besides the experiences directly given by the
stimulated sense-organ, there are other experiences, sensory in
character, indirectly given, and coming from other sense organs
which are not directly stimulated.

The percept is a complicated dynamic product, and its elementary
processes are never derived from one isolated domain of sensory
experience. The activities of all the sensory domains co-operate
in the total result of an apparently simple percept. Along with
sensory processes directly stimulated, a mass of other sensory
processes becomes organized and helps to contribute to the total
result. The direct sensory elements are termed by me _primary
sensory elements_; the indirectly given experiences are termed
_secondary sensory elements_. The secondary sensory elements may be
figuratively said to cluster round the primary sensory elements as
their nucleus.

The whole perceptual experience is tinged by the character of
the primary elements which constitute the guiding nucleus, so to
say. Thus, where the primary sensory elements are visual, the
whole mass, no matter from what domain the sensory experiences
are derived, appears under the form of the visual sense, and the
percept is a visual percept. While the primary sensory elements
form, so to say, the dynamic center of the total perceptual
experience, the secondary sensory elements mainly constitute its
content. Both primary and secondary elements are sensory and
are induced peripherally; the primary directly, the secondary
indirectly. The percept then is sensory and is constituted by
primary sensory elements, or primary sensations, and by secondary
sensory elements, or secondary sensations.

The character of the secondary sensory elements stands out clear
and independent in the phenomena of synaesthesia, of secondary
sensations. In the phenomena of synaesthesia we have a sensation
of one sense organ followed, without an intermediary direct
stimulation, by a sensation coming from another sense organ. Thus,
when a sensation of light instead of giving rise to a subsequent
idea gives rise to a sensation of sound, for instance, we have the
phenomenon of secondary sensation. Here the secondary sensations
stand out free and distinct, but they are really always present in
our ordinary perceptive experiences as bound up secondary sensory
elements, as secondary sensations grouped round primary sensations.

When the phenomena of synaesthesia were first brought to the
notice of the scientific world, they were regarded as abnormal
and exceptional, and only present in special pathological cases.
Soon, however, their field became widened, and they were found not
only in the insane and degenerate, but in many persons otherwise
perfectly normal. We find now that we must further widen the field
of secondary sensory elements, and instead of regarding them as a
freak of nature existing under highly artificial conditions, we
must put them at the very foundation of the process of perception.

Secondary sensations are at the basis of perception. We have become
so accustomed to them that we simply disregard them. When, however,
the conditions change, when the secondary sensations stand out
by themselves, isolated from the primary nuclear elements with
which they are usually organically synthesized into a whole, into
a percept, when they become dissociated, it is only then that we
become conscious of them directly and declare them as abnormal.

Secondary sensations are always present in every act of perception;
in fact, they form the main content of our perceptual activity,
only we are not conscious of them, and it requires a special
analysis to reveal them. Secondary sensations _per se_ are not
something abnormal--just as hydrogen present in the water we drink
or the oxygen present in the air we breathe are not newly created
elements,--it only requires an analysis to discover them. If there
be any abnormality about secondary sensations, it is not in the
elements themselves, but rather in the fact of their dissociation
from the primary nuclear elements.

When the secondary sensory elements come to the foreground and
stand out clearly in consciousness, a full-fledged hallucination
arises. In the phenomena of synaesthesia we have hallucinations
in the simplest form, inasmuch as only isolated secondary
sensory elements dissociated from their active primary central
elements stand out in the foreground of consciousness. This
very simplification, however, of hallucinations reveals their
inner character. The most complex hallucinations are only
complex compounds, so to say, of secondary sensory elements.
Hallucinations are not anything mysterious, different from what
we find in the normal ordinary processes of perception; they
are of the same character and have the same elements in their
constitution as those of perception. Both hallucinations and
percepts have the same secondary as well as primary elements. The
difference between hallucinations and percepts is only one of
relationship, of rearrangement of elements, primary and secondary.
When _secondary sensory elements become under conditions of
dissociation dynamically active in the focus of consciousness we
have hallucinations_.

From this standpoint we can well understand why a hallucination,
like a percept, has all the attributes of external reality. A
hallucination is not any more mysterious and wonderful than a
percept is. We do not recognize the humdrum percept, when it
appears in the guise of a hallucination, and we regard it as some
strange visitant coming from a central, or from some supersensory
universe. Hallucinations, like percepts, are constituted of primary
and especially of secondary sensory elements, and like percepts,
hallucinations too are induced peripherally.

How is it with suggested[13] or hypnotic hallucinations? Do we
find in hypnotic or suggested hallucinations, as in the case of
hallucinations in general, the requisite primary and secondary
sensory elements directly and indirectly induced? Binet makes an
attempt to establish a peripheral stimulus in the case of hypnotic
hallucinations, claiming that there is a _point de repére_, a
kind of a peg, on which the hypnotic hallucination is hung. It
is questionable whether Binet himself continued to maintain this
position. However the case may be, this position is hardly tenable
when confronted with facts. Hypnotic hallucinations may develop
without any peg and prop.

Furthermore, granted even that now and then such a peg could be
discovered, and that the alleged hypnotic hallucination develops
more easily when such a peg is furnished, still the fact remains
that even in such cases the peg is altogether insignificant, that
it is altogether out of proportion and relation to the suggested
hallucination, and that on the same peg all kinds of hallucinations
can be hung, and that finally it can be fully dispensed with. All
this would go to show that the peg, as such, is of no consequence,
and is really more of the nature of an emphatic suggestion for the
development of the alleged hypnotic or post-hypnotic hallucinations.

The arbitrariness of the hypnotic hallucinations, showing that the
whole thing is simply a matter of representations, or of what the
patient happens to think at that particular moment, is well brought
out in the following experiments: Mr. F. is put into a hypnotic
state, and a post-hypnotic suggestion is given to him that he shall
see a watch. The eyeball is then displaced, the watch is also
displaced; now when the eyeball returns to its normal condition
we should expect that the hallucinatory watch would return to its
former place; but no, the watch is not perceived in its previous
place,--it appears in a displaced position. The hallucinatory watch
could thus be displaced any distance from its original position.
The patient evidently did not see anything, but simply supplied
from his stock of knowledge as to how a seen watch would appear
under such conditions, and he omitted to observe the fact that with
the normal position of the eye the watch should once more return
to its former position. Such inconsistencies are often found in
hypnosis.

More intelligent and better informed patients would reason out
the matter differently, and would give different results. If the
subject knows of contrast colors and if a color is suggested to him
he will without fail see such contrast colors. If his eyes have
been fixed on some hallucinatory color, such as red, for instance,
he will even give you a detailed account of the green he sees, but
if he does not know anything of the effects of contrast colors no
amount of fixation on hallucinatory colors will bring out the least
contrast effects. The reason is the patient does not know anything
about it and cannot think of it.

We tried to mix by suggestion different hallucinatory colors, and
as long as he knew nothing of the real results his replies were
uniformly wrong; no sooner did he find out what the right mixture
_should_ be than he gave correct results. The hypnotic subject
really does not perceive anything; he tells what he believes
the master wants him to see under the given conditions. The
subconscious fear instinct makes the hypnotized subject obey and
please the hypnotizer, as the dog obeys his master.




CHAPTER XXV

TRANCE SERVILITY


Dr. C., a known psychoanalyst, on whom I carried on a series of
experiments, goes into a deep somnambulistic state. He is an
excellent visualizer and takes readily visual hallucinations. Being
a physician and psychiatrist the subject’s account is all the
more valuable. Now Dr. C. describes his hypnotic hallucinations
as “mental pictures,” as “auditory memories,” which “lack
exteriority, are not located in space.” He aptly characterizes his
hallucinations, visual, auditory, and others, as “_fixed ideas_.”

Mr. M. goes into deep hypnosis. When in one of the deep
trance-states a suggestion is given to him that on awakening he
shall see a watch. When awake he claims he sees a watch. He was
asked: “Do you really see it?” He replied, “Yes.” The interesting
point here was the fact that the subject did not even look in the
direction where the suggested hallucinatory watch was supposed to
be placed and where he himself claimed that the watch was located.
When tested by automatic writing the hand wrote: “Yes, I see the
watch.” The subconscious then was also under the influence of the
suggested hallucination. It is well to bear in mind this point.

Re-hypnotized, and suggested that on awakening he would see _two_
watches. One was a real silver watch and the other was suggested
hallucinatory. The subject claimed he saw both, but he only handled
the hallucinatory one, and when asked which of the two he would
prefer he pointed to the hallucinatory watch. When asked why,
he replied that the suggested watch was bigger. He was really
indifferent to the chosen watch and paid no further attention to
it, as if it did not exist for him. He tried to please the master
hypnotizer of whom he was subconsciously in awe.

He was again put into the hypnotic state and was suggested to see
a flower. On awakening he claimed he saw a flower and smelled it
in an indifferent, perfunctory fashion. The subconscious was then
tested by automatic writing and the writing was to the effect that
he saw it. “I see a flower.” The subconscious then had also the
same hallucination. A series of similar experiments was carried
out with the same results. _The subconscious claimed in automatic
writing that the suggested hallucination was real._

The subject was again put into hypnosis and was given the
suggestion that he would see a watch on awakening, but here I made
some modification. “When you wake up you will be sure to see a
watch,” I said, emphatically. “Look here; I want you to write what
you really see and not what you do not see.” When awake he saw a
watch, but he immediately wrote: “I do not see anything.” _Here the
subconscious disclaimed the suggested hallucinations which it had
claimed and insisted on before._

Re-hypnotized, and was given the suggestion that on awakening he
would see three watches. He was awakened and a real silver watch
was put before him; the other two were suggested hallucinatory. He
claimed he saw all three. Meanwhile, in automatic writing he wrote:
“One silver watch, real, the others golden, not real; nothing
there.” A series of similar experiments was made and with the same
results. _The automatic writing disclaimed the hallucinations,
although before, under the same conditions, it most emphatically
insisted on their reality._

The subject was put into hypnosis and a post-hypnotic suggestion
was given to him that he would see his wife and child. When awake,
he began to smile. When asked why he smiled he said: “I see my wife
and child”; but he wrote “I see nobody.” When put again in hypnosis
he still continued to smile and said: “I see my wife and child”;
but he wrote (in hypnotic state): “I really do not see them; I see
nothing; I see my child, but I really see nothing.” That was when
the psychopathic patient got the inkling that I wished to know the
truth rather than to be misled by his slavish obedience and fears
by complying with my orders. “What do you mean,” I asked, “by ‘I
see my child, but I really see nothing?’” To which he replied in
automatic writing: “I mean that I see my child in my mind only, but
I don’t see anything.”

I then gave him a post-hypnotic suggestion to see a snake. He
claimed on awaking that he saw a snake. He manifested little
fear. He certainly did not behave as if he really saw a snake
and instead wrote “I see a snake. I see it in my mind.” A great
number of similar experiments were carried out by me, varying the
suggestions, and all with the same results. I shall not burden the
reader with a detailed account, as they all gave identical results.

At first the automatic writing claimed emphatically the presence
of the hallucinatory object and when the truth of the automatic
writing was insisted on, the writing disclaimed fully the
perception of the hallucinatory object. Finally we came on the real
character of the suggested hallucination; “I see my child, but
_honestly_, I do not see anything; I see my child in my mind only,
I don’t see anything.” In other words, if we take the facts plainly
and do not play hide and seek with the subconscious, we come to the
conclusion that in the suggested hallucinations the subject does
not perceive anything as is the case in an actual hallucination.
He does not _perceive_, but he simply _thinks_ of the suggested
hallucination.

As long then as the automatic writing was regarded by the subject
as independent, for which he was not responsible, as long as the
suggestion of the hallucination was not taken as directly addressed
to it, the subject himself frankly acknowledged the fact that he
did not see anything. When this truth of automatic writing was
brought home to the subject he was bound by suggestion to claim
that he actually saw the suggested hallucination, although he
really did not see anything at all.

This clearly shows that the hypnotic consciousness, from the very
nature of its heightened suggestibility, clings most anxiously
to the given suggestion, and insists on the reality of its
fulfillment. We must, therefore, be on our guard and not trust
the subject’s introspective account, unless it is well sifted by
good circumstantial evidence. It is because such precautions have
not been taken in the close interrogation of the subject’s actual
state of mind, and because of the deep-rooted psychological fallacy
as to the relation of ideational and perceptual activities, that
the prevalent belief in the validity of suggested hallucinations
has passed unchallenged. If not for those factors, it would have
been quite evident that the _hypnotic and post-hypnotic suggested
hallucinations are not genuine, but are essentially spurious.
Hypnotic hallucinations, unlike actual hallucinations, are not
really experienced. Hypnotically suggested hallucinations are only
forms of delusions_, attempts to appease the master hypnotizer of
whom the subconscious stands in awe and fear.

The state of hypnotic subconsciousness is a state based on the
will to conform to the master hypnotizer’s commands. At bottom
the subconscious trance-will is one of slavish obedience to the
authoritative, fear-inspiring will of the master hypnotizer, whom
the hypnotic subconscious attempts to please and obey slavishly.
The hypnotic state is a fear state of a primitive type. It is the
fear state of the Damara ox obeying the herd, or the leader of the
herd.

Man is hypnotizable, because he is gregarious, because he is
easily controlled by _self-fear_, because he easily falls into a
_self-less_ state of complacent servility. Man, subconscious man,
is servile, in fear of his Lord. The independent, free man is yet
to come.


FOOTNOTE:

[13] I use the term “suggested hallucination” to indicate the
character and origin of the latter. The term seems to me convenient
and may prove acceptable.




CHAPTER XXVI

THE HYPNOIDAL STATE AND SUPERSTITIONS


The hypnoidal state into which man is apt to fall so easily, is
well adapted to fear suggestions, since the fear instinct and the
impulse of self-preservation are present in the subconsciousness,
exposed during trance states to all sorts of fear suggestions
and superstitions. It is during these brief periods of primitive
hypnoidal states that the animal is exposed to attacks of enemies
whose senses become sharpened to detect the weak spots in the armor
of their victims, immersed in the momentary rest of the hypnoidal
state.

During these periods of repose and passivity or of sleep stage, the
animal can only protect itself by all kinds of subterfuges, such as
hiding in various inaccessible places, or taking its rest-periods
in shady nooks and corners, or in the darkness of the night. Each
hypnoidal period closely corresponds to the larval stage of the
insect, reposing in its cocoon,--the most critical time of the
insect organism, most exposed to the depredations of its enemies.
And still the hypnoidal state is requisite to the animal in
order to restitute its living matter and energy which have been
wasted during the active moments of its life activities. Hence the
weakness of the animal depends on the very constitution of its
organism.

The hypnoidal state, although absolutely necessary in the process
of metabolism, is also the moment of its greatest danger, and the
fear instinct is specially intense at the onset of that hypnoidal
moment, the lowest point of the weakness of the organism. The
animal, after taking all precautions, is finally paralyzed into
temporary immobility at the risk of its own existence.

The fear instinct determines the nature and character of rest and
sleep. The lower the animal, the scantier are its means of defense
in the ceaseless struggle for its preservation. The simpler the
animal, the greater and more numerous are the dangers menacing it
with total extinction,--hence it must be constantly on its guard.
A state of sleep such as found in the higher animals is rendered
impossible. The sleep must be light, and in snatches, rapidly
passing from rest into waking,--the characteristic of the hypnoidal
state. The fear instinct is the controlling factor of sleep and
rest. When we are in danger the sleep is light and in snatches, and
we thus once more revert to an ancient form of rest and sleep.

_The insomnia found in cases of neurosis is a reversion to
primitive rest-states, found in the lower animals._ The insomnia
is due to the fear instinct which keeps dominating the conscious
and subconscious mental activities, a state which has prevailed in
the early stages of animal life. That is why the sleep of neurotics
is unrefreshing and full of dreams of dangers and accidents, and
peopled with visions of a terrorizing nature. Hence the neurotic
fear of insomnia which is itself the consequence of the obsession,
conscious and subconscious, of the fear instinct.

In my work on sleep I was greatly impressed with the place fear
holds in animal life existence. From the lowest representative,
such as the insect to the highest, such as man, fear rules with an
iron hand. Every animal is subject to cataplexy of fear and to the
hypnoidal state itself, the consequence of fear-adaptations to the
external conditions of a hostile environment. Cataplexy and the
consequent hypnoidal state which paralyze the animal, depriving
it of all defense, are grounded in the imperfections of living
protoplasm.

Man is subject to the hypnoidal periods of primitive life. It is
during those periods that the shafts of suggestion are most apt
to strike his subconsciousness, divorced as it is during those
moments from the nodding self consciousness. During these nodding
moments of his life he is exposed to harmful suggestions, since
they are apt to arouse the fear instinct, the most sensitive
of all human instincts. It seems as if the fear instinct is
never fully asleep, and is the easiest to arouse. It seems to be
watchful or semi-watchful during the most critical moments of man’s
helplessness.

Fear of darkness and fear of invisible foes are specially strong in
man, because of the deeply rooted fear instinct, but also because
of his memories of accidents and dangers that have befallen him,
and which may befall him. Man’s fears hang round dark places,
gloomy corners and nooks, caves and forests, and more especially
during the darkness and shades of night, appearing as treacherous
visions and specters of lurking dangers. And still from the very
nature of his being man must rest and sleep, hence the association
of terrors with night time. He can only overcome his night terrors
by living and sleeping in more or less secure corners, in the
neighborhood of his fellow-beings who by the mere fact of numbers
multiply not only the means of defense, but actually increase
susceptibility for the scent of danger and possible speedy defense.
In the society of his fellows the sense organs of the individual
are increased by the presence of others who are in various stages
of vigilance, and hence there is greater protection against dangers
and invisible foes that lurk in the darkness of night, foes of
which primitive man is in terror of his life.

The fear of the unknown, the mysterious, and the dark, peoples the
mind of primitive man with all sorts of terrible spectres, ghosts,
spirits, goblins, ghouls, shades, witches, and evil powers, all
bent on mischief, destruction and death. _Primitive man suffers
from chronic demonophobia._ Fear states are specially emphasized
at night when the “demons” have the full power for evil, and man
is helpless on account of darkness and sleep which paralyze him.
Hence the terrors of the night, especially when man is alone, and
defenseless.

The fear of solitude comes out strongly in the intense fear that
obsesses man in the gloomy darkness of the night horrors. Fire
and fellow-beings can alone relieve his night terrors. The fear
of foes, of demons, of evil powers does not abate in the day,
only it is relieved by reason of light, of association, and of
wakefulness. Man, more than any other animal, is the victim of the
fear instinct. Many tribes, many races of men perished, due to
superstitions and fear obsessions.

The _Homo sapiens_ is rare. We may agree with Tarde that _Homo
somnambulis_ would be a proper definition of the true mental
condition of most specimens of the human race. For the human race
is still actuated by the principle of “_Credo, quia absurdum
est_.” I need not go far to substantiate the fact that this
principle still guides the life of the average specimen of
civilized humanity. Spiritualism, theosophy, telepathy, ghost
hunting, astrology, oneiromancy, cheiromancy, Christian Science,
psychoanalytic oneiroscopy employed in events and situations of
individual and social life, and many other magical practices
whose name is legion, based on the mysteries of communication
with ghosts, spirits, demons, and unknown fearsome powers, still
haunt the credulous mind, obsessed with conscious and subconscious
horrors of the terrible, invisible spirit world.

Against the fears of diseases, the scares of the day and terrors
of night, civilized man still uses the magic arts and mysterious,
miraculous powers of the magician, the wizard, the witch, the
mental healer, the shaman, the medicine man, the miracle man, and
the psychoanalyst. Just at present under my own eyes I witness
the pitiful credulity of man, driven by the terrors and horrors
of the fear instinct. In San Jose, San Diego, in Los Angeles, and
in many other Western “culture” centers mystic cults hold high
carnival, swaying the minds of fear-crazed, deluded humanity. As
typical specimens of superstitious fears and absurd beliefs, due
to the fear instinct, we may take as illustrations the following
occurrences in the centers of the far West, obsessed by the
aberrations of the fear instinct (I quote from Los Angeles papers):

“Faith Healer at Los Angeles, Venice, California, after several
wonder cures, orders sun’s rays to be darkened. ‘Brother Isaiah,’
called by thousands the ‘Miracle Man,’ claimed to have repeated the
marvel of dimming the sun at Venice yesterday evening.

“At 6 o’clock the disciple of healing by faith raised his hands
and announced that as evidence of his power he would blot out the
brilliant solar rays. He gazed at the dazzling red ball above the
waters of the Pacific, and his lips moved in low murmurs.

“‘It is done,’ he said. ‘I have clouded the sun. All those who have
seen this miracle raise your hands.’ Hundreds of hands waved in the
air.

“The first time ‘Brother Isaiah’ claimed to have dimmed the sun’s
rays was at Miracle Hill, when he had been in Los Angeles but a few
days.

“Brother Isaiah stepped to one side of his wooden platform on the
Venice Beach yesterday. He placed a silver police whistle to his
lips and blew. The piercing crescendo sent a shiver through the
tense mass of humanity which stretched from the sand back to the
ocean walk.” Similar miracles and cures were carried on by Mrs. Amy
McPherson in San Diego, San Jose, and all along the Pacific coast.

The self-impulse and the fear instinct, in their intensified forms,
are the bane of deluded, neurotic humanity.




CHAPTER XXVII

NEUROSIS AND HEREDITY


The following discussion in the form of questions and answers may
prove of interest to the physician and to the intelligent layman.
The discussion occurred in the course of correspondence. A friend
of mine thought the subject of sufficient importance to have it
brought to the attention of the cultured public.

The questions are as follows:

“Are not all neuropathic conditions the results of a morbid,
unstable nervous organism, the basis of which lies in a faulty
heredity?

“Are not weak nerves the cause of hysterical, neurasthenic and
neuropathic affections in general?

“Is not all neurosis due to defective parent stock?

“If the occasions for fear, as some psychopathologists claim, were
more frequent in primitive times than now, then the cave men must
have had more psychopathic affections than civilized man.”

To these questions the following answers are given:

Psychopathic diseases are not hereditary--they are _acquired_
characteristics, having their origin in the abnormal, hypertrophied
growth of the fear instinct which is at the root of the primal
impulse of self-preservation. This is proved by psychopathological
studies of clinical cases; and it can be further demonstrated by
experimental work in the laboratory even in the case of animals.
“Weak nerves,” “a run down, exhausted nervous system,” whatever
the terms may mean, may overlap psychopathic conditions, but the
two are by no means equivalent, much less identical. Psychopathic,
psychoneurotic states are not “weak nerves” or “fatigued nerves.”
Above all, there is no need to obscure the matter and resort to the
much abused, mystical and mystifying factor of heredity. It is easy
to shift all blame on former generations, when, in most cases, the
fault is close at hand, namely, a debased environment, a defective
training, and a vicious education.

There is good reason to believe that primitive man had a far
greater tendency to dissociation, to subconscious psychopathic
states than modern man. Even the Middle Ages teem with psychopathic
mental epidemics of the most puerile type. In the course of
evolution, social and individual, this neurotic, psychopathic
tendency has gradually diminished, but has never been completely
eliminated. Increase of knowledge, better education, the increase
of social safeguards, sanitary and hygienic conditions with
consequent increase of safety from dangers, have all helped
materially in decreasing the occasions for the cultivation of the
fear instinct.

Under the rigorous conditions of primitive life individuals who
have been unfortunate and have become affected with mental troubles
and emotional afflictions of the fear instinct are mercilessly
exterminated by the process of tribal and social selection. Each
generation weeds out the individuals who have been unfortunate
enough to fall under unfavorable circumstances and have become
mentally sick, suffering from acquired psychopathic disturbances.
In primitive life the crippled, the maimed, the wounded, the sick
fall by the way, and are left to perish a miserable death. In fact,
the less fortunate, the wounded and the stricken in the battle of
life, are attacked by their own companions,--they are destroyed by
the ruthless, social brute. The gregarious brute has no sympathy
with the pains and sufferings of the injured and the wounded. The
faint and the ailing are destroyed by the herd.

Civilization, on the other hand, tends more and more towards the
preservation of psychopathic individuals. We no longer kill our
sick and our weak, nor do we abandon them to a miserable, painful
death,--we take care of them, and cure them. Moreover, we prevent
pathogenic factors from exercising a harmful, malign social
selection of the “fit.” We do our best to free ourselves from the
blind, merciless, purposeless selection, produced by pathogenic
micro-organisms and by other noxious agencies. We learn to improve
the external environment.

We do not condemn people to death because they are infected with
smallpox, typhus, typhoid bacilli, or because of an infected
appendix. We no longer regard them as sinful, unclean, accursed,
and tabooed. We vaccinate, inoculate, operate, and attempt to cure
them. By sanitary and prophylactic measures we attempt to prevent
the very occurrence of epidemics. Our valuation of individuals is
along lines widely different from those of the stone age and cave
man. We value a Pascal, a Galileo, a Newton, a Darwin, a Pasteur,
and a Helmholtz far above a Milo of Croton or an African Johnson.

Civilization is in need of refined, delicate and sensitive
organizations, just as it is in need of galvanometers,
chronometers, telephones, wireless apparatuses, and various
chemical reagents of a highly delicate character. We are beginning
to appreciate delicate mechanisms and sensitive organizations.
We shall also learn to train and guard our sensitive natures
until they are strong and resistant to the incident forces of an
unfavorable environment. The recognition, the diagnosis, and the
preservation of psychopathic individuals account for the apparent
increase of neurotics in civilized communities.

It may be well to add that, although occasions for sudden, intense,
overwhelming fears are not so prevalent in civilized societies
as they are in primitive savage communities, the worries, the
anxieties, the various forms of slow grinding fears of a vague,
marginal, subconscious character present in commercial and
industrial nations, are even more effective in the production of
psychopathic states than are the isolated occasions of intense
frights in the primitive man of the paleolithic or neolithic
periods.




CHAPTER XXVIII

NEUROSIS AND EUGENICS


In my work on Psychopathology I lay special stress on the fact that
the psychopathic individual has a predisposition to dissociative
states. Early experiences and training in childhood enter largely
into the formation of such a predisposition. Still, there is
no doubt that a sensitive nervous system is required--a brain
susceptible to special stimuli of the external environment. This,
of course, does not mean that the individual must suffer from
stigmata of degeneration. On the contrary, it is quite possible,
and in many patients we actually find it to be so, that the
psychopathic individual may be even of a superior organization. _It
is the sensitivity and the delicacy of nervous organization that
make the system susceptible to injurious stimulations, to which a
lower form of organization could be subjected with impunity._

An ordinary clock can be handled roughly without disturbance of
its internal workings, but the delicate and complicated mechanism
of a chronometer requires careful handling and special, favorable
conditions for its normal functioning. Unfavorable conditions are
more apt to affect a highly complex mechanism than a roughly made
instrument. It is quite probable that it is the superior minds
and more highly complex mental and nervous organizations that
are subject to psychopathic states or states of dissociation. Of
course, unstable minds are also subject to dissociative states,
but we must never forget the fact that highly organized brains, on
account of their very complexity, are apt to become unstable under
unfavorable conditions. A predisposition to dissociation may occur
either in degenerative minds or in minds superior to the average.
_Functional psychosis requires a long history of dissociated,
subconscious shocks, suffered by a highly or lowly organized
nervous system, a long history dating back to early childhood._

As Mosso puts it: “The vivid impression of a strong emotion may
produce the same effect as a blow on the head or some physical
shock.” We may, however, say that no functional psychosis, whether
somatopsychosis or psychoneurosis, can ever be produced simply
by physical shocks. _In all functional psychoses there must
be a mental background, and it is the mental background alone
that produces the psychosis and determines the character of the
psychopathic state._

_Fear is an important factor in the etiology of psychopathic
affections which include somatopsychoses and psychoneuroses._

To regard fear as “error,” as do some sectarians, is absurd, and
is certainly unscientific. Abnormal fear which is the basis of
all functional nervous or psychopathic maladies, is essentially
a pathological process affecting the organs in general and the
nervous system in particular in as definite a way as the invasion
and infection of the organism by various species of bacteria,
bacilli, and other micro-organisms which attack the individual
during his lifetime.

Like infectious diseases, the deviations, abnormalities, and
excesses of the fear instinct are _acquired_ by the individual in
the course of his relations with the external environment, and are
as real and substantial as are syphilis, smallpox, diphtheria,
cholera, and the bubonic plague. To regard them as imaginary or
to relegate them to the action of Providence or to heredity is
theoretically a misconception, and practically a great danger to
humanity.

There is nowadays a veritable craze for heredity and eugenics.
Biology is misconceived, misinterpreted, and misapplied to social
problems, and to individual needs and ailments. Everything is
ascribed to heredity, from folly and crime to scratches and
sneezes. The goddess Heredity is invoked at each flea-bite--_in
morsu pulicis Deum invocare_.

Even war is supposed to be due to the omnipotent deity of Heredity.
Superior races by their patriotism and loyalty destroy the weak
and the helpless, and relentlessly exterminate all peaceful tribes.
Such warlike stock comes of superior clay. The dominant races have
some miraculous germ-plasm, special “unit characters,” wonderful
dominant “units” which, like a precious heritage, these races
transmit unsullied and untarnished to their descendants.

Wars, carnage, butcheries make for progress, culture, and
evolution. Our boasted civilization with its “scientific” business
thoroughness and its ideal of “efficiency” attempts to carry into
effect this quasi-evolutionary doctrine--this apotheosis of brute
force under the aegis of science. The eugenic belief is really
a recrudescence of the ancient savage superstition of the magic
virtues of noble blood and of divine king stock.

All nervous, mental, neuropathic, and psychopathic maladies are
supposed to be a matter of heredity. If people are poor, ignorant,
superstitious, stupid, degraded, brutal, and sick, the eugenists
unhesitatingly put it all down to poor stock.

The eugenic remedy is as simple as it is believed to be
efficacious: Introduce by legislation “efficient” laws favoring
“eugenic” marriage, and teach the masses control of births. The
select and chosen stock alone should multiply--the millennium is
then bound to come. Such is the doctrine of our medico-biological
sages.

“Scientific” farmers and breeders of vegetables, fruits, and
cattle are regarded as competent judges of human “breeders.”
Agriculturists and horticulturists set themselves up as advisers
in “the business of raising good crops of efficient children.”
Bachelors, spinsters, and the childless generally, are specially
versed in eugenic wisdom and pedagogics.

All social ills and individual complaints are referred to one main
source--heredity. With the introduction of eugenic legislation,
with the sterilization of the socially unfit, among whom the
greatest men and women may be included, with the breeding of good
“orthodox, common stock,” and with eugenic Malthusian control
of births, all evil and diseases on earth will cease, while the
Philistine “superman” will reign supreme forevermore.

In the Middle Ages all diseases and epidemics, all wars, all social
and private misfortunes were considered as visitations of Divine
wrath. The fear instinct held sway, terrorizing poor, deluded
humanity. In modern times our would-be eugenic science refers all
ills of the flesh and woes of the mind to an outraged Heredity.
The dark ages had resort to prayers, fasts, and penitence, while
our age childishly pins its faith to the miraculous virtues and
rejuvenating, regenerative powers of legislative eugenic measures,
and to the eugenic Malthusian control of births.

Our scientists in eugenics gather hosts of facts, showing by
elaborate statistical figures that the family history of neurotics
reveals stigmata of degeneration in the various members of the
family. The eugenic inquirers do not stop for a moment to think
over the fact that the same sort of evidence can be easily brought
in the case of most people. In fact, the eugenists themselves,
when inquiring into the pedigree of talent and genius, invariably
find somewhere in the family some form of disease or degeneration.
This sort of “scientific” evidence leads some eugenic speculators,
without their noticing the _reductio ad absurdum_, to the curious
conclusion or generalization that degeneration is present in the
family history of the best and the worst representatives of the
human race.

The so-called scientific method of the eugenists is faulty, in
spite of the rich display of colored plates, stained tablets,
glittering biological speculations, brilliant mathematical
formulae, and complicated statistical calculations. The eugenists
pile Ossa on Pelion of facts by the simple method of enumeration
which Bacon and the thinkers coming after him have long ago
condemned as puerile and futile. From the savage’s belief in
sympathetic, imitative magic with its consequent superstitions,
omens, and taboos down to the articles of faith and dogmas of the
eugenists, we find the same faulty, primitive thought, guided by
the puerile, imbecile method of simple enumeration, and controlled
by the wisdom of the logical _post hoc, ergo propter hoc_.

What would we say of the medical man who should claim that measles,
mumps, cholera, typhoid fever, yellow fever, malaria, tetanus,
and various other infectious diseases are hereditary by quoting
learnedly long tables of statistics to the effect that for several
generations members of the same family suffered from the same
infectious diseases? What would we say of the medical advice
forbidding marriage to individuals whose family history reveals
the presence of exanthemata? We stamp out epidemics not by eugenic
measures, but by the cleansing of infectious filth, and by the
extermination of pathogenic micro-organisms.

Every human being has a predisposition to smallpox, cholera,
tetanus, bubonic plague, typhus fever, malaria, and to like
infectious diseases, but there is no inherent necessity for
everyone to fall a victim to the action of pathogenic organisms,
if the preventive and sanitary conditions are good and proper. No
one is immune against the action of bullets, cannon balls, shells,
and torpedoes, or to the action of various poisons, organic and
inorganic, but one is not doomed by fate to be killed by them, if
one does not expose himself to their deadly action.

Every living organism is, by the very nature of its cellular
tissues, predisposed to wounding by sharp instruments, or to the
burning action of fire, but this does not mean an inherent organic
weakness to which the organism must necessarily submit and perish.
We are all of us predisposed to get injured and possibly killed,
when we fall down from a high place, or when we are run over by an
automobile or by a locomotive, but there is no fatalistic necessity
about such accidents, if care is taken that they should not occur.

We may be predisposed to neurosis by the very nature of complexity,
delicacy, and sensitivity inherent in the structure of a highly
organized nervous system, and still we may remain healthy and
strong all our life long, provided we know how to keep away from
noxious agencies. The creed of the inevitable fatality of neurosis
is as much of a superstition as the Oriental belief in the fatalism
of infectious diseases, plagues, and accidents of all kinds.
Such fatalistic superstitions are dangerous, fatal, because they
distract the attention from the actual cause and from the requisite
prophylactic measures.

We go far afield in search for the remote source of our troubles,
when the cause is close at hand. We need only open our eyes to see
the filth of our towns, the foul, loathsome slums of our cities,
the miserable training, the wretched education given to our
children, in order to realize at a glance the source of our ills
and ailments. We should lay the guilt at the door of our social
order. We starve our young. We starve our children physically and
mentally. We piously sacrifice our tender children and the flower
of our youth to the greedy, industrial Moloch of a military,
despotic, rapacious plutocracy.

Witness semi-civilized Europe with its lauded culture brutally
shedding the blood of its youth and manhood on the altar of
commercial patriotism! It is not heredity, it is the vicious
conditions of life that stunt the physical, nervous, and mental
growth of our young generation. When we are confronted with the
miserable, degraded, crippled forms of our life, we fall back
cheerfully on some remote grandparent, and credulously take refuge
in the magic panacea of eugenics.

The practical aspect is clear. Psychopathic neurosis in its two
varieties, somatopsychosis and psychoneurosis, is not hereditary,
but _acquired_. We should not shift the blame on former generations
and have resort to eugenics, but we must look to the improvement of
mental hygienic conditions of early childhood, and to the proper
education of the individual.

It is easy to put the blame on grandparents,--they are dead and
cannot defend themselves. Could they arise from their graves,
they could tell some bitter truths to their descendants who are
ready to shift responsibility to other people’s shoulders. It is
about time to face the truth fairly and squarely, a truth which
is brought out by recent investigations in psychopathology, that
no matter where the _fons et origo_ of neurosis be, whether in
self-preservation and its accompanying fear instinct, the condition
of life primordial, or in the other forms of self-preservation,
_the formation of psychopathic neurosis with all its characteristic
protean symptoms is not hereditary, but acquired. Neurosis arises
within the life cycle of the individual; it is due to faulty
training and harmful experience of early child life._

Future medicine will be largely prophylactic, preventive, sanitary,
hygienic, dietetic. What holds true of medicine in general holds
true of that particular branch of it that deals with neurosis.
The treatment will become largely prophylactic, preventive,
educational, or pedagogic. It is time that the _medical and
teaching profession should realize that functional neurosis is not
congenital, not inborn, not hereditary, but is the result of a
defective, fear-inspiring education in early child life_.

The psychopathic diathesis can be overcome by dispelling the
darkness of ignorance and credulity with their false fears
and deceptive hopes, above all, by fortifying the critical,
controlling, guiding consciousness. Let in sun and air into the
obscure cobwebbed regions of the child and man. The gloom and the
ghosts of the fear instinct are dispersed by the light of reason.

As the great Roman poet, Lucretius, well puts it:

      “Hunc igitur terrorem animi tenebrasque necessest
       Non radii solis neque lucida tela diei
       Discutiant, sed naturæ species ratioque.”[14]


FOOTNOTE:

[14] Darkness and terror of the soul are not dispelled by the rays
of the sun and glittering shafts of the day, but by the rational
aspect of nature.




CHAPTER XXIX

PRIMITIVE FEARS


Various authorities in Ethnology and Anthropology concur in their
description and testimony as to the superstitious fears that obsess
primitive man.

Professor Baldwin Spencer, the anthropologist, writes of the
Australian aborigines that they have “an intense belief in evil
magic. The natives have no idea of disease or pain as being due to
anything but evil magic, except that which is caused by an actual
accident which they can see.... Anything they do not understand
they associate with evil magic.... You have only to tell a native
that he is the victim of evil magic, and he succumbs at once, and
can only be cured by the exercise of counter magic.

“The number of supernatural beings feared by aborigines of
Australia is exceedingly great. For not only are the heavens
peopled with such, but the whole face of the country swarms with
them; every thicket, most watering places abound with evil spirits.
In like manner, every natural phenomenon is believed to be the work
of demons, none of which seem to be of a benign nature, one and
all apparently striving to do all imaginable mischief to the poor
black fellow.”

The same is true of the negro. “The negro is wont to regard the
whole world around him as peopled with envious beings, to whom
he imputes every misfortune that happens to him, and from whose
harmful influence he seeks to protect himself by all kinds of magic
means.” “The religion of the Bolok (of the Upper Congo River),”
writes an observer, “has its basis in their fear of those numerous
invisible spirits which surround them on every side, and are
constantly trying to compass them in their sickness, misfortune and
death; and the Boloki’s sole object in practising their religion
is to cajole, or appease, cheat or conquer or kill those spirits
that trouble them, by their Nganga (medicine men), their rites,
their ceremonies, and their charms. If there were no evil spirits
to circumvent there would be no need of medicine men and their
charms.... The Boloki folk believe that they are surrounded by
spirits which try to thwart them at every twist and turn, and to
harm them every hour of day and night.... I never met among them a
man daring enough to go at night through the forest that divided
Monsembe from the upper villages even though a large reward was
offered. Their invariable reply was: ‘There are too many spirits in
the bush and forest.’ The spirits whom the people dread so much
are the mingoli, or disembodied souls of the dead; the life of the
Boloki is described as ‘one long drawn out fear of what the mingoli
may next do to them.’ Those dangerous beings dwell everywhere, land
and water are full of them; they are ever ready to pounce on the
living and carry them away, or to smite them with disease, and kill
them.... The belief in witchcraft affects their lives in a vast
number of ways. It regulates their actions, modifies their mode
of thought and speech, controls their conduct towards each other,
causes cruelty and callousness in a people not naturally cruel,
and sets the various members of a family against each other....
Belief in witches is interwoven into the very fiber of every Bantu
speaking man and woman; and the person who does not believe in them
is a monster, a witch to be killed.”

The fear of evil spirits, the fear of witchcraft, and the fear of
malicious spiritual agencies have been the pests of credulous,
fear-obsessed humanity in all the ages of its existence. The
crusades, and religious wars have shown us the blight suffered by
humanity, obsessed by the impulse of self-preservation and the fear
instinct. _Fear_ or _pretended Love_ of the great spirit, under
whatever name, is used for the avoidance of fears and evils.

Sir E. F. im Thurn describes the Indian of Guiana as haunted by
the omnipresence of malicious ghosts and spirits. “The whole world
of the Indian swarms with these beings. If by a mental effort,
we could for a moment revert to a similar mental position, we
should find ourselves surrounded everywhere by a host of harmful
beings.... It is not therefore, wonderful that the Indian fears to
move beyond the light of his camp-fire after dark ... nor is it
wonderful that occasionally the air round the settlement seems to
the Indian to grow so full of beings, that a sorcerer is employed.”

The Indians of Paraguay “live in constant dread of supernatural
beings and if nothing else contributed to make their life
miserable, this ever present dread would be in itself quite
sufficient to rob it of most of its joys.”

Professor Powell writes of the Indians: “The Indians believed that
diseases were caused by unseen evil beings and by witchcraft,
and every cough, every toothache, every headache, every fever,
every boil and every wound, in fact all their ailments were
attributed to such a cause. Their so-called medical practice was a
horrible system of sorcery and to such superstition human life was
sacrificed on an enormous scale....”

Similarly, the malignant spirits of the Maori are “so numerous as
to surround the living in crowds.” The Maori claims: “the spirits
throng like mosquitoes, ever watching to inflict harm.” The
Melanesian “sees himself surrounded at every step by evil spirits
and their influences.” The Papuans “people land and sea with
mysterious, malignant powers which take up their abode in stones
and trees or in men, and cause all kinds of misfortunes, especially
sickness and death.” The Bakua of New Guinea are in constant fear
of spirits.... “Of forest spirits the number is infinite; for it
is above all in the mysterious darkness, the tangled wilderness of
the virgin forests that the spirits love to dwell.... The spirits
are never bent on good, they live in evil places. At night-fall
the native hears the voices of the spirits, they make inroads into
human habitations, and drive man crazy.”

In Java, the people are firmly convinced that “the number of
spirits is innumerable, they are a source of fear and anxiety.” The
natives of Sumatra are possessed of “fear of unknown powers....
Every misfortune bespeaks the ill-will of hostile spirits. The
whole world is a meeting place of demons.” The Batakas “live in
perpetual fear of evil spirits.”

Professor M. Williams writes of the Hindoos: “The great majority
of the inhabitants of India are, from the cradle to the burning
ground, victims of a form of mental disease which is best explained
by the term _demonophobia_. They are haunted and oppressed by a
perpetual dread of demons. They are firmly convinced that evil
spirits of all kinds, from malignant fiends to mischievous imps
and elves, are ever on the watch to harm, harass and torment them,
to cause plague, sickness, famine, and disaster, to impede,
injure and mar every good work. The worship of at least ninety per
cent of the people of India in the present day is a worship of
fear. The simple truth is that evil of all kinds, difficulties,
dangers and disasters, famines, diseases, pestilences and death,
are thought by an ordinary Hindoo to proceed from demons, or more
properly speaking, from devils, and from devils alone.” “The
underlying principle (of the religion of the Kacharis of Assam) is
characteristically one of fear or dread.”

“The Thibetans,” writes an observer, “are thorough-going demon
worshippers. In every nook, path, big tree, rock, spring, waterfall
and lake there lurks a devil,--for which reason few individuals
will venture out alone after dark. The sky, the ground, the house,
the field, the country, have each their special demons; and
sickness is always attributed to malign demoniacal influence.”

The Burmese, the Laosians of Siam, the Thay of Indo-China are in
all their activities controlled by the fear instinct which is at
the bottom of all their beliefs. “The Thay cannot take a single
step without meeting a demon on the path.... Spirits watch him,
ready to punish negligence, and he is afraid. _Fear is not only for
him, the beginning of wisdom, it is the whole of his wisdom._”

The Koreans may be regarded as the most superstitious people among
the Orientals. Before me lies a Korean book full of superstitions
which can only be matched in their absurdities with those of
Australian aborigines who, in their savage culture, belong to
the paleolithic period. The whole course of the Korean’s life is
controlled to the very minutiae by the terrors and horrors of
demoniacal, invisible, deadly, malignant powers of demons, spirits,
ghosts, hobgoblins, specters, and witches. According to the Korean
belief the earth is a pandemonium in which witches and evil spirits
hold high carnival.

J. M. de Groot writes “In Korean belief, earth, air, and sea are
peopled by demons. They haunt every umbrageous tree, shady ravine,
spring and mountain crest.... They make a sport of human destinies.
They are on every roof, ceiling, oven and beam. They fill the
chimney, shed, the living room, the kitchen, they are on every
shelf and jar. In thousands they waylay the traveler as he leaves
his home, beside him, behind him, dancing in front of him, whirring
over his head, crying out upon him from air, earth, and water. They
are numbered by thousands of billions, and it has been well said
that their ubiquity is an unholy travesty of Divine Omnipresence.
This belief, and it seems to be the only one he possesses, keeps
the Korean in a perpetual state of nervous apprehension, it
surrounds him with indefinite terrors, and it may be truly said of
him that he passes the time of his sojourning here in fear.... The
spirits keep the Korean in bondage from birth to death.”

Im Bang, a Korean writer on Korean beliefs, has a characteristic
story of a poor relative of some Korean dignitary. This poor
relative of the high official once a year gathered hundreds of
thousands of spirits whom he checked off, so as to keep their
malignant disposition under control. And this gentleman was but
one of the many clerks; he was but one census man of the vast
bureaucratic spiritistic machinery for the regulation and control
of evil demons.

The same holds true of the other tribes in Asia. Thus the Gyliaks
think that all the places on earth are filled with malicious
demoniacal agencies. Similarly, the Koryaks on the Amoor are
terrorized by the malignancy of evil spirits that dog their steps.
W. Jochelson tells of the Koryaks that “when visiting the houses
to cause diseases and to kill people, they (the spirits or demons)
enter from under the ground.... They are invisible to human
beings, they are sometimes so numerous in houses that they sit
on the people, and fill up all corners.... With hammers and axes
they knock people over their heads and cause headache. They bite,
and cause swellings. They shoot invisible arrows which stick in
the body causing death. The demons tear out pieces of flesh from
people, thus causing sores and wounds to form on the body.” The
same spirit of fear of the invisible and of the mysterious, fear of
evil powers, controlling the fate of man, constitutes the central
belief of almost every primitive tribe, semi-civilized, ancient, as
well as modern nation. They are all controlled by the fundamental
instinct of life--the fear instinct.

The Semitic scholar, R. H. Harper, writes of the Assyrians and
Babylonians as follows: “There is no place in the universe where
evil spirits can not penetrate. Every manner of evil and disaster
is ascribed to them, from pestilence, fever, and the scorching wind
of the desert, down to the trifles of life,--a quarrel, a headache,
a broken dish, or a bad dream. They walk the street, slip into
the door, get into the food, in short, are everywhere, and the
danger from their presence is always imminent.... Corresponding to
a widespread belief in demons was a similar belief in witchcraft.
It was not at all strange that the demons, who worked in every
possible corner of the universe, should take possession of human
beings....”

The tablets excavated in the imperial library of Ashurbanipal show
the spirit of the people even of the highest classes debased with
delusions and religious hallucinations due to self-preservation
and fear instinct, so dominant in man who, when common-sense
departs from him, may be regarded as the _irrational animal par
excellence_.

We may give the following illustration taken from one of the many
tablets of the Shurpu series:

“The evil spirits like grass have covered the earth. To the four
winds they spread brilliancy like fire, they send forth flames. The
people living in dwellings they torment, their bodies they afflict.
In city and country they bring moaning, small and great they make
to lament. Man and woman they put in bonds, and fill with cries of
woe. Man they fall upon and cover him like a garment. In heaven and
earth like a tempest they rain; they rush on in pursuit. They fill
him with poison, his hands they bind, his sides they crush.”

According to the ancient rabbis, a man should not drink water by
night, for thus he exposes himself to the Shavriri, demons of
blindness. What then should he do if he is thirsty? If there be
another man with him, let him rouse him up and say: “I am thirsty,”
but if he be alone, let him tap upon the lid of the jug (to make
the demon fancy there is some one with him), and addressing him
by his own name, let him say: “Thy mother bid thee beware of the
Shavriri, vriri, riri, ri.” Rashi, a mediaeval commentator, says
that by this incantation the demon gradually contracts and vanishes
as the sound of the word Shavriri decreases.

The ancient rabbis instruct that “no one should venture out at
night time on Wednesday or Saturday, for Agrath, the daughter of
the demon Machloth, roams about accompanied by eighteen myriads of
evil demons, each one of which has power to destroy.” The rabbis
claim that the air, land and sea are full of demons, all bent on
evil and destruction of man. In this respect the learned rabbis
differ but little from the superstitious Koreans and Australian
savages. The rabbis warn the pious Jew that “should he forget to
fold his prayer cover, he is to shake it thoroughly next morning,
in order to get rid of the evil spirits that have harbored there
during the night.” The evil spirits are infinite in number. Thus
the Talmudic authorities are in full accord with the ancient
Babylonians, Assyrians, and with the lowest savages, ancient and
modern, obsessed by the fear of spirits, by Demonophobia.

One cannot help agreeing with the English anthropologist, Frazer,
who after his study of the subject, arrives at the following
conclusion: “In India from the earliest times down to the present
day the real religion of the common folk appears always to have
been a belief in a vast multitude of spirits of whom many, if
not most, are mischievous and harmful. As in Europe beneath a
superficial layer of Christianity a faith in magic and witchcraft,
in ghosts and goblins has always survived and even flourished among
the weak and the ignorant (and apparently cultivated) so it has
been and so it is in the East (and we may say also in the West).
Brahmanism, Buddhism, Islam may come and go, but the belief in
magic and demons remains unshaken through them all, and, if we may
judge of the future from the past, it is likely to survive the
rise and fall of other historical religions. For the great faiths
of the world, just in so far as they are the outcome of superior
intelligence, of extraordinary fervor of aspiration after the
ideal, fail to touch and move the common man. They make claims
upon his intellect and his heart, to which neither the one nor the
other is capable of responding. With the common herd who compose
the great bulk of every people, the new religion is accepted only
in outward show.... They yield a dull assent to it with their lips,
but in their heart they never abandon their old superstitions
(and fears of evil and mysterious miraculous agencies); in these
they cherish a faith such as they can never repose in the creed
which they nominally profess; and to these, in the trials and
emergencies of life, they have recourse as to infallible remedies.”
And he quotes Maxwell to the effect that “The Buddhists in Ceylon,
in times of sickness and danger ... turn to demons, feared and
reverenced in the same way as do ‘the Burmese, Talaings, and
Malays.’”

The Jews firmly believed in demoniacal agencies. “When the even
was become, they brought unto Him many that were possessed with
devils; and He cast out the spirits with His word, and healed
all that were sick.” “And in the synagogue there was a man which
had a spirit of an unclean devil; and he cried out with a loud
voice.” “And devils also came out of many ..., and He rebuking them
suffered them not to speak.” “And there was a herd of many swine
feeding on the mountains.... Then went the devils out of the man,
and entered into the swine, and the herd ran violently down a steep
place, and were choked.” “Casting out devils” was a sure proof of
divine mission.

Perhaps a quotation from the Talmud will make clear the fear of
demons which obsesses the Jew: Abba Benjamin says, “if the eye were
permitted to see the malignant spirits that beset us, we could not
rest on account of them.” Abai, another sage, says: “They outnumber
us, they surround us as the heaped up soil in our garden plots.”
Rav Hunna says: “Every one has a thousand on his left side and ten
thousand on his right.” Rava claims: “The crowding at the schools
is caused by their (demons) pushing in; they cause the weariness
which the rabbis experience in their knees, and even tear their
clothes by hustling against them. If one would discover traces
of their presence, let him sift some ashes upon the floor at his
bedside, and next morning he will see their footmarks as of fowls
on the surface. But if one would see the demons themselves, he must
burn to ashes the after-birth of a first born black kitten, the
offspring of a first-born black cat, and then put a little of the
ashes into his eyes, and he will not fail to see the demons.”

In the words of Lord Avebury, the archeologist, “the savage is a
prey to constant fears.... Savages never know but what they may
be placing themselves in the power of these terrible enemies (the
demons); and it is not too much to say that the horrible dread
of unknown evil hangs like a thick cloud over savage life and
embitters every pleasure.”

In our modern times the preachers, the revivalists, the pulpit,
appeal to fear and to hell in order to keep their flock in the
fold. Fear of eternal damnation for infidels is the war cry of
religion.

Professor Dreslar elicited from 875 California normal school
students four-fifths of whom were young women, 3225 confessions of
belief in superstitions.... “How thin is the veneer of culture over
that great mass of irrational predisposition which in the hour of
fear and excitement resumes control of the popular mind, and leads
on to folly and ruin!” (Ross).

Buckle is right in pointing out the significant fact that
superstition is found in any walk of life in which risk or danger
predominates. Sailors are more superstitious than landsmen, while
farmers and business people, especially gamblers and speculators,
are more superstitious than industrial workers. Similarly Cumont is
right in ascribing the superstitions of soldiers as due to risks
and dangers of war.

After the great world war one notices the rise of all sorts of
superstitions. Superstitions and fear are close companions. A
modern historian does not hesitate to declare that “Europe is held
in hate, because the nations fear each other.... What sentiment
has dug the ditch separating Russia from the rest of the world? It
is fear. The states of Western Europe, which the Soviets regard as
their persecutors, think themselves menaced in their turn by the
Soviet republic.” The Great War was produced by self-preservation
and fear. The world is still in the grip of the fear instinct.

The Bible claims: Fear of the Lord is the beginning of wisdom.
The Latin poet declares: _Primus in orbe deos fecit timor_. The
real state of things is: _Self and fear are the Lords of life_,
individual and social.

Bacon in his essay “On the Wisdom of the Ancients,” with his
clear insight has stated the matter succinctly: “In the Panic
terrors there is set forth a very wise doctrine; for by the nature
of things _all living creatures are endued with a certain fear
and dread_, the office of which is to preserve their life and
existence, and to avoid or repel approaching mischief. But the
same nature knows not how to keep just measure,--but together with
salutary fears ever mingles vain and empty ones; insomuch that _all
things (if one could see into the heart of them) are quite full of
Panic terrors; human things most of all_; so infinitely tossed and
troubled as they are with superstition (which is in truth nothing
but a Panic terror), especially in seasons of hardship, anxiety,
and adversity.”




CHAPTER XXX

THE HERD AND THE SUBCONSCIOUS


Superstitious terrors are by no means confined to race; they are
common to all races. For example, among the aborigines of Australia
a native will die after the infliction of even the most superficial
wound, if he is scared by the suggestion that the weapon which
inflicted the wound has been sung over, and thus endowed with
magical virtue. He simply lies down, refuses food, and pines away.

Similarly among some of the Indian tribes of Brazil, if the
medicine-man predicted the death of anyone who had offended him,
“the wretch took to his hammock instantly in such full expectation
of dying, that he would neither eat nor drink, and the prediction
was effectually executed.”

Speaking of certain African races Major Leonard observes: “I have
seen more than one hardened old Haussa soldier dying steadily and
by inches, because he believed himself to be bewitched; so that no
nourishment or medicines that were given to him had the slightest
effect either to check the mischief or to improve his condition in
any way, and nothing was able to divert him from a fate which he
considered inevitable.

“In the same way, and under very similar conditions, I have seen
Kru-men and others die, in spite of every effort that was made to
save them, simply because they had made up their minds, not (as
we thought at the time) to die, but that being in the clutch of
malignant demons they were bound to die.”

The gregarious individual must obey the master leader on pain of
death. In gregarious life the whole pack attacks the disobedient
individual for challenging the chief, king, priest, the god-man,
the lord of the horde. Obedience is a virtue, disobedience
is a mortal sin, affecting the whole horde, hence a horrible
death of the sinner is the sole punishment. The independent
personality is inhibited, the individual falls into a state of
social somnambulism, and the will-less, self-less subconscious, a
semblance of personality, charged with self-preservation and fear
instinct, obeys the commands of the master leader who is often a
brutal type, a Nero, a Domitian, a Caracalla, a Caligula, a John
the Terrible.

In a society where the socio-static press is always at work,
where political pressure is far stronger than even in the ancient
despotic monarchies, where a class government is in possession of
all modern improvements, where gray uniformity and drowsy monotony
reign supreme, obedience must be the rule. Blind, stupid obedience,
that slavish obedience which is peculiar to somnambulic subjects,
characterizes such societies.

Servility is well illustrated by the following historical incident:
Prince Sougorsky, ambassador to Germany in 1576, fell sick _en
route_ in Courland. The duke of the province often inquired as
to his health. The reply was always the same: “My health matters
nothing, provided the sovereign’s prospers.” The duke, surprised,
said, “How can you serve a tyrant with so much zeal?” He replied,
“We Russians are always devoted to our Czars, good or cruel. My
master (Ivan the Terrible) impaled a man of mark for a slight
fault, who for twenty-four hours, in his dying agonies, talked with
his family, and without ceasing kept repeating, ‘Great God, protect
the Czar!’”

The same is true of modern class societies where the Demos is the
despot. God preserve the Demos! When the business demon of the
Demos requires sacrifice, self immolation, anticipate his order.
Pray for the Demos; Great God, protect the greedy Demos! The Demos
is my Lord, to him is due my servile loyalty.

It is interesting to observe that the superstitious, the
savage, the negro, and the soldier are excellent subjects for
hypnotic purposes. Soldiers as experiments show, have a strong
predisposition to hypnotic states. I was told by Professor
Münsterberg that the hypnotic predisposition was strongly
developed in the German soldier. M. Liebault experimented on ten
hundred and twelve persons, and found only twenty-seven refractory.
Berenheim remarks on this that “It is necessary to take into
account the fact that M. Liebault operates chiefly upon the common
people.”

The great pressure exerted on the lower social strata, and
especially on soldiers, the dull monotony of their life, the
habit of strict obedience to command, predisposes them to social
subconscious automatisms,--to the formation of mobs, clubs, unions,
lodges, associations, parties, clans, sects, mobocracies. In all
such organizations there is present the same servile spirit--the
impersonal self and the gregarious fear instinct--the basis of
subconscious, social somnambulism.

Man is a social somnambulist, he lives, dreams, and obeys with his
eyes open. Whenever the impulse of self-preservation gets a special
grip on the gregarious individual, when he becomes wild with terror
in the bosom of the herd, then he may be regarded as a psychopathic
victim.

The historian of the future will represent our age as dark,
barbaric, savage, an age of the cruel Napoleonic wars, of
commercial crises, financial panics, religious revivals, vicious,
brutal, savage world wars,--mobs, crazes, plagues, social pests of
all sorts and description....

A herd of sheep stand packed close together, looking stupidly into
space.... Frighten them,--and if one begins to run, frantic with
terror, the rest are sure to follow,--a stampede ensues, each sheep
scrupulously reproduces the identical movements of the one in front
of it. This susceptibility to imitation is but what we, in relation
to man, term suggestibility, which consists in the impressing
on the person of an idea, image, movement, however absurd and
senseless, which the person in his hypnotized state reproduces
like an automaton,--although he or she thinks it is done quite
voluntarily. Suggestibility is natural to man as a social animal.
Under specially favorable conditions this suggestibility which is
always present in human beings may increase to an extraordinary
degree, and the result is a stampede, a mob, an epidemic.

It is sometimes claimed that somnambulic persons are asleep.
Sleep and somnambulism have been identified. This is a misuse of
words since there are a whole series of subconscious states in
which not one symptom of sleep appears. _Extreme susceptibility
to suggestions and mental automatisms are the chief traits of the
subconscious._

Gregarious men and women carry within themselves the germs of the
possible mob, or of mental epidemics. As social creatures men and
women are naturally suggestible. When this susceptibility or
sensitivity to suggestions becomes abnormally intense, we may say
that they are thrown into a social subconscious, somnambulic state.

We know by psychological and psychopathological experiments
that limitation of voluntary movements and inhibition of free
activities induce a subconscious state. This subconscious state
is characterized by inhibition of the will power,--memory remains
unaffected; consciousness appears intact; the subject is aware of
all that goes on.

Keeping this in mind, we can understand social life, and especially
morbid, social movements, mob life of all ages.

A subconscious state is induced in the organized individual by
the great limitation of his voluntary activities and by the
inhibition of his free critical thought. Bound fast by the strings
of tradition and authority, social men and women are reduced to
subconscious automata. The subconscious rises with the growth of
organized civilization, while the critical, independent powers of
the individual correspondingly fall. Hence the apparent social
paradox that the growth of society tends to destroy the mental
forces which helped to build up civilization.

In such societies the individual staggers under the burden of laws
and taboos. Individuality is stifled under the endless massive
excretions of legislators. Recently even the lawgivers or law
manufacturers began to object to the labor involved in the work
on the ever growing mass of bills introduced into the legislature
of one state alone. Thus a senator of a Western state complained
that in _one_ year over 1700 bills passed through the mill of his
Legislature. Multiply that figure by the number of states, add the
municipal edicts, and the endless laws turned out by the Federal
Government, and one can form some faint idea of the vast burden
laid on the shoulders of the individual citizen.

The Los Angeles Times, which no one will accuse of radicalism,
pointedly remarks: “The State has just issued a reference index to
the laws of California since 1850--it is of itself a bulky volume
of more than 1300 pages. When it takes a book of that size merely
as an _index_ it would seem that the lawmakers had about done their
worst.”

Over-production of laws is one of the great evils of modern
civilization. Civilized society is apt to be obsessed by a state of
law-mania which is a danger and a menace to the free development of
the individual citizen.

The Roman legal thinkers left us two significant sayings: _Ex
Senatus consultis et plebiscitis, crimina execrentur_,--(Senatorial
decisions and popular decrees give rise to crimes) and: _Ut olim
vitiis, sic nunc legibus laboramus_,--(As we formerly suffered
from vices and crimes so we suffer at present from laws and
legislation)....

In describing the gregariousness of the Damara oxen Francis Galton
writes: “Although the ox has so little affection for, or interest
in, his fellows, he cannot endure even a momentary severance from
his herd. If he be separated from it by stratagem or force, he
exhibits every sign of mental agony; he strives with all his might
to get back again, and when he succeeds, he plunges into the middle
to bathe his whole body with the comfort of closest companionship.
This passionate terror is a convenience to the herdsman.” ... When
an animal accustomed to a gregarious life is isolated from the
herd, it is agitated with extreme terror. The same holds true of
man who is a social animal. Man must go with the herd or with the
pack, and he is terrified to stand alone, away from the crowd,--and
still more terrorized when the crowd disapproves of him. Man is
gregarious, and as such he must go with the mass, with the crowd.
He is in mortal fear of social taboo. As a gregarious animal man
lives in fear of external danger, and is in terror of social
authority.

As Galton writes: “The vast majority of persons of our race have
a natural tendency to shrink from the responsibility of standing
and acting alone: they exalt the _vox populi_, even when they know
it to be the utterance of a mob of nobodies, into the _vox Dei_;
they are willing slaves to tradition, authority and custom. The
intellectual deficiencies corresponding to these moral flaws are
shown by the rareness of free and original thought as compared
with the frequency and readiness with which men accept the opinions
of those in authority as binding on their judgment.” This slavish
obedience is intimately bound up with one of the most fundamental
of all instincts,--the fear instinct.

The individual is so effectively trained by the pressure of taboo
based on self and fear, that he comes to love the yoke that weighs
him down to earth. Chained to his bench like a criminal galley
slave, he comes to love his gyves and manacles. The iron collar put
around his neck becomes a mark of respectability, an ornament of
civilization. Tarde finds that society is based on respect, a sort
of an alloy of fear and love, fear that is loved. A respectable
citizen is he who is fond of his bonds, stocks, and shekels, and
comes to love his bonds, stocks, and shackles of _fears and taboos_.

Human institutions depend for their existence and stability on the
impulse of self-preservation and its close associate,--the fear
instinct.




CHAPTER XXXI

MYSTICISM, PRAYER, CONVERSION, AND METAPHYSICS


The psychology of mysticism and conversion is a fascinating
subject. This is not the place to go into detail or even adequately
cover the subject which is as extensive as it is important. I can
only touch the matter in a superficial way--enough to answer the
present purpose.

The state of mysticism is essentially a hypnoidal trance state, and
its traits are the characteristics of the hypnoidal consciousness.
Like the hypnoidal state, that of the mystic state may pass into
waking, sleep, or into the hypnotic condition.

James marks off mystic states, by the traits of Ineffability,
Transciency, Passivity, and Noetic Quality. These traits are just
the ones found in the deeper states of the hypnoidal consciousness,
especially the ones which approximate and pass into the hypnotic
condition. In the mystical state, as in the hypnoidal state, there
is a delicious languor, a lack of tension to the stimulation of
the external environment which retreats in the distance; there is
the instability of the hypnoidal consciousness which soon passes
into the other forms such as sleep, hypnosis, or waking. There is
also present the refreshing, invigorating condition of the whole
individuality on emerging from those peculiar subconscious states.
The lethargic and cataleptic states often present in states of
ecstasy, in which the mystics fall, depend entirely on states of
the hypnoido-hypnotic trance.

The mystic consciousness and the hypnoidal one are not identical.
The mystic consciousness is a species of the hypnoidal
consciousness. What are then its special features? In the first
place, the mystic consciousness has a negative and a positive
aspect, depression and exaltation. In the second place, mysticism
expresses a definite reaction of the individual to the conditions
of his external environment. This reaction is one of retraction
from the miseries and fears of life.

If we examine closely the type of consciousness characteristic of
the state preceding the onset of the mystic condition, we find that
it is essentially that of suffering, of misery, of disappointment,
of despair, of inability to meet fairly, squarely, and courageously
the experiences of life. There is a strong feeling of insecurity,
a feeling of anxiety as to self and the world. A feeling of
intense anguish seizes on the individual that he and the world are
going to perdition, that on such terms life is not worth living.
The instinct of fear penetrates every pore of his being, and
inspires the individual with dread, horror, and terror. Terrorized
by the wild evils of life, the personality becomes benumbed and
paralyzed, and ready to succumb. This state of intense depression
is not simply related to fear, _it is fear_. It is the _status
melancholicus_ often preceding states of exaltation. The individual
reaches a critical condition where life becomes impossible. The
whole universe holds for him nothing but terrors and horrors.

Carlyle expresses this attitude when he makes Teufeldroeckh say:
“I live in a continual, indefinite, pining fear; tremulous,
pusillanimous, apprehensive of I know not what: it seems as if
things, all things in the heavens above and the earth beneath would
hurt me; as if the heavens and the earth were but boundless jaws
of a devouring monster, wherein I, palpitating, lie waiting to be
devoured.”

In this state of agony of fear, the individual looks for salvation
in fleeing from the terrors of the world to the arms of the
divinity.

In his terror the individual passes through a second stage, he
becomes “converted,” he turns with prayers to the divine power to
which he looks for shelter from the dangers of life. He appeals
to the divinity for protection from the evils of the day and from
the terrors of the night. This second stage is often preceded by
a period of subconscious incubation which sometimes gives rise to
sudden conscious explosions, conscious conversions, or sudden
onset of mystic state of ecstasy.

In the library of Ashburbanipal, king of Assyria, there are found
“penitential psalms” much alike to our own, but some millenniums
older than the Biblical psalms. These Assyro-Babylonian penitential
psalms, inscribed in cuneiform script on clay tablets, clearly
express the attitude of the worshipper or suppliant:

     “O Goddess, in the anguish of my heart have I raised cries of
           anguish to thee; declare forgiveness.
      May thy heart be at rest.
      May thy liver be pacified.
      The sin which I have committed I know not.
      The Lord in the anger of his heart hath looked upon me.
      The goddess hath become angry and hath stricken me grievously.
      I sought for help, but no one taketh my hand.
      I wept, but no one cometh to my side.
      I utter cries, but no one harkens to me.
      I am afflicted, I am overcome.
      Unto my merciful god I turn.
      I kiss the feet of my goddess.
      How long, known and unknown god, until the anger of thy heart
            be pacified?
      How long, known and unknown goddess, until thy unfriendly heart
            be pacified?
      Mankind is perverted, and has no judgment,
      Of all men who are alive, who knows anything?
      They do not know whether they do good or evil.
      O Lord, do not cast aside thy servant!
      He is cast into the mire; take his hand.
      The sin which I have sinned turn to mercy!
      Known and unknown goddess, my sins are seven times seven;
      Forgive my sins!
      Forgive my sins, and I will humble myself before thee.
      May thy heart, as the heart of a mother who hath borne children,
            be glad!
      As a father who hath begotten them, may it be glad!”

In this respect we agree with Ribot. “Depression,” says Ribot, “is
related to fear.... Does not the worshipper entering a venerated
sanctuary show all the symptoms of pallor, trembling, cold sweat,
inability to speak--all that the ancients so justly called _sacer_
horror? The self abasement, the humility of the worshipper before
the deity supposed to be possessed of magic power, is essentially
one of fear.” With the anthropologist we may refer this awe or
fear to the terror which the savage mind feels in the presence of
the magician, the witch, the medicine man, the man-god, and the
woman-deity.

The Mithraic religion, which for some time has been the great
rival of Christianity for the salvation of the individual from the
terrors of the world, played a great rôle in the mystic ceremonies
of the cult. In fact, the dying and the resurrection of a god-man
for the salvation of the worshippers constituted a cardinal
principle in the actual practices or rites of barbarous nations and
savage tribes. The man-god or woman-deity had to die, had to be
sacrificed by the community. The sins of the savages were redeemed
by the divine flesh and blood of “the man-god.”

In describing the life and theological doctrines of St. Paul,
Professor Pfleiderer says: “Perhaps Paul was influenced by the
popular idea of the god who dies and returns to life, dominant
at that time in the Adonis, Attis, and Osiris cults of Hither
Asia (with various names and customs, everywhere much alike). At
Antioch, the Syrian capital, in which Paul had been active for a
considerable period, the main celebration of the Adonis feast took
place in the spring time. On the first day, the death of ‘Adonis,’
the Lord, was celebrated, while on the following day, amid the wild
songs of lamentations sung by the women, the burial of his corpse
(represented by an image) was enacted. On the next day (in the
Osiris celebration it was the third day after death, while in the
Attis celebration it was the fourth day) proclamation was made that
the god lived and he (his image) was made to rise in the air. It is
noteworthy that the Greek Church has preserved a similar ceremony
in its Easter celebration down to our own day.

“During the joyous feast of the resurrection of the god in the
closely related Attis celebration, the priest anointed the mouths
of the mourners with oil, and repeated the formula:

      ‘Good cheer, ye pious! As our god is saved,
       So shall we, too, be saved in our distress.’

“The rescue of the god from death is the guarantee of a like rescue
for the adherents of his cult. In the mysteries of Attis, Isis, and
Mithra, the fact that the worshippers partook of the god’s life by
the mystical participation in his death, was visualized by such
rites, which employed symbols showing the death of the initiate,
his descent into Hades, and his return. Hence, this ceremony
was called the ‘re-birth to a career of new salvation,’ a ‘holy
birthday.’ In one Mithra liturgy, the newly initiated pray: ‘Lord,
reborn, I depart; in that I am lifted up, I die; born by that birth
which produces life, I will be saved in death, and go the way which
thou hast established, according to thy law and the sacrament which
thou hast created.’”

In all those mysteries the central note is the salvation of the
worshipper from the “perils of the soul.”

In some cases the terrorized individual is driven to the mystic
state. He falls into a sort of trance. The world of fears becomes
veiled from him, and recedes in a mist, and even completely
disappears from his view. He finds repose in his god. This is the
positive stage of mental exaltation, of ecstasy; it figures as
“the union” of the worshipper with his god or goddess. It is this
oblivion in the depths of the hypnoidal and the hypnotic states,
it is this relapse into the regions of the subconscious that brings
about relief from all fears of life. The bliss felt in these dim
regions of mental life refreshes and invigorates the wearied soul.
The coming in contact with new vast stores of subconscious reserve
energy may once more vitalize and supply with new energy the fear
stricken personality. This is the inspiration of those who have
experienced the mystical power of “conversion.”

In a later chapter I take up the subject of subconscious reserve
energy advanced by James and myself, independently. Meanwhile, we
may say that the phenomena of prayer, conversion, and especially
of mysticism belong fundamentally to the manifestations of
self-preservation and the fear instinct on the one side and to
subconscious reserve energy on the other.

Of course, we must add the fact that certain historical and social
conditions are apt to give rise to phenomena of mysticism, the
conditions of social unrest being especially favorable. When social
life begins to decay, when the protection of society is weakened,
and the individual is set loose, and left to stand alone, something
that especially terrorizes the social brute, then nothing is left
to the individual bereft of his social stays and social stimulants,
but to turn _inward_ and _upward_, that is to turn mystic. In his
states of desolation and fear-obsession the individual is inclined
to turn to the stimulating, narcotizing influence of the deity
which puts the soul in a state of transcendental bliss, thus hiding
the terrorized soul in a misty and mystic cloud, so that he no
longer sees the terrors and horrors of life.

Such mystic states are found in periods of social and moral decay.
Instance the decaying Roman empire, the Hellenistic period, the
Middle Ages, and in fact, any period in which security, safety, and
social stability are on the ebb, while fears and perils are on the
increase. Mysticism, Salvation of the soul, under all their guises,
are interrelated with the primordial fear instinct which dominates
the hunted beast and the terror-stricken neurotic patient.

If we turn to philosophical and metaphysical speculations, we
find, on examination from a pragmatic point of view, that their
essential differences revolve on the _security and safety of the
world scheme_. From Plato and Aristotle to Seneca, Epictetus,
Marcus Aurelius, down to Schopenhauer, Hegel, and our American
thinkers Royce and James, as well as from the Bible to Brahmanism
and Buddhism, we find the same valuation of world safety, based on
the vital impulse of self-preservation and its fundamental fear
instinct. The _Salvation_ of the World and the Individual is the
fundamental keynote of theological metaphysics and metaphysical
religion.

Professor Royce, the representative of transcendental, monistic
idealism in America, thus summarizes his philosophical and
religious attitude: “It is God’s true and eternal triumph that
speaks to us ‘In this world ye shall have tribulations. But fear
not; I have overcome the world.’” This reminds one of the ancient
Assyrian cuneiform oracles addressed to the Assyrian kings: “To
Esarhaddon, king of countries, Fear not! I am Ishtar of Arbela.
Thine enemies I will cut off, fear not!” “Fear not, Esarhaddon, I,
Bel, am speaking with thee. The beams of thy heart I will support.”
“Fear not, you are saved by Faith. Fear thy Lord only, He is your
Rock and Salvation,” says the Bible. “Fear not!” teaches the
Buddhist, “Nirvana, the Absolute, is your refuge.”

Professor James in his inimitable way summarizes the difference
between his pluralism and idealistic monism: “What do believers in
the Absolute mean by saying that their belief affords them comfort?
They mean that since in the Absolute finite evil is ‘overruled’
already, we may, therefore, whenever we wish, treat the temporal as
if it were potentially the eternal, be sure that we can trust its
outcome, and, without sin, dismiss our fear and drop the worry of
our finite responsibility.... The universe is a system of which the
individual members may relax their anxieties....” James contrasts
his empirical, pragmatic pluralism with the idealistic monism.

In another place James says: “Suppose that the world’s author put
the case before you before creating, saying: ‘I am going to make a
world not certain to be saved, a world, the perfections of which
shall be conditioned merely, the condition being that each several
agent “does his level best.” I offer you the chance of taking part
in such a world. Its safety, you see, is unwarranted. It is a real
adventure, with real danger, yet it may win through.... Will you
join the procession? Will you trust yourself and trust the other
agents enough to face the risk?’ Should you in all seriousness, if
participation in such a world were proposed to you, feel bound to
reject it as not safe enough? Would you say that rather than be
part and parcel of so fundamentally pluralistic and irrational a
universe, you preferred to relapse into the slumber of nonentity
from which you had been aroused by the tempter’s voice?

“Of course, if you are normally constituted, you would do nothing
of the sort. There is a healthy-minded buoyancy in most of us which
such a universe would exactly fit.... The world proposed would seem
‘rational’ to us in the most living way.

“Most of us, I say, would, therefore, welcome the proposition,
and add our _fiat_ to the _fiat_ of the creator. Yet perhaps some
would not; for there are morbid minds in every human collection,
and to them the prospect of a universe with only a fighting
chance of safety would probably not appeal. There are moments of
discouragement in us all, when we are sick of self, and tired of
vainly striving. Our own life breaks down, and we fall into the
attitude of the prodigal son. We mistrust the chance of things. We
want a universe where we can just give up, fall on our father’s
neck, and be absorbed into the absolute life as a drop of water
melts into the river or the sea.

“The peace and rest, the security desiderated at such moments
is security against the bewildering accidents of so much finite
experience.

“Nirvana means safety from this everlasting round of adventure of
which the world of sense consists. The Hindoo and the Buddhist, for
this is essentially their attitude, are simply _afraid, afraid_ (my
italics) of more experience, afraid of life....

“Pluralistic moralism simply makes their teeth chatter, it
refrigerates the very heart within their breast.”

Thus we find that at the bottom of philosophical, metaphysical, and
religious speculations there are present the same primitive impulse
of self-preservation and fear instinct.

While there are some other important factors in that theological
and metaphysical problem which has agitated humanity for ages,
a problem which I expect to discuss some other time in another
place, there is no doubt that James with his great psychological
genius has laid his finger on fundamental factors of human
life,--self-preservation and the fear instinct.




CHAPTER XXXII

FEAR SUGGESTIONS


In my psychopathological and clinical work of the various
manifestations and symptoms of psychopathic and functional diseases
I come to the conclusion that the principal cause of all those
morbid affections is the fear instinct, rooted in the very impulse
of life, the impulse of self preservation. Fears are not secondary
effects, they are due to one of the most fundamental of all
instincts, the instinct of fear which is primary and elemental.

Anything which arouses the fear instinct in the inhibitory or
paralyzing stages will necessarily give rise to psychopathic
functional psychosis or neurosis. The fear instinct and the impulse
of self-preservation, inherent in all life, are the alpha and omega
of psychopathic maladies.

The fear instinct is usually cultivated by a long history of events
of a fearsome character so that fear instinct and the impulse
of self-preservation become easily aroused on various occasions
of external stimulation, producing general fear, mental or
emotional, and often accompanied by sensory, motor, and intestinal
derangements of various organs with their secretions and hormones,
as well as with general morbid, functional changes of the central
nervous system, sympathetic and parasympathetic systems. This
in its turn gradually cultivates a disposition to formation of
hypnoidal states, that is, the brief momentary formation of trance
states, in which the subconscious becomes through dissociation
exposed to fear suggestions or fear stimulations, which arouse in
the morbidly cultivated subconscious morbid fear symptoms, motor,
sensory, intestinal, emotional in their various combinations and
associations.

_The cultivated predisposition to lapses into hypnoidal states is a
prerequisite of psychopathic disturbances. We may, therefore, say
that the three factors, namely, Self-preservation, Fear instinct,
Hypnoidal states form the triumvirate of psychopathic, functional
neurosis._

Charcot with his sharp eye for observation as well as his long
clinical experience observed, in what he termed hystericals, a
brooding period which precedes the manifestations of the hysterical
attacks and symptom complex of the hysterical manifestations. These
brooding periods are of the utmost consequence, although Charcot
and his disciples as well as the psychopathologists generally,
hardly paid any attention to this important phenomenon.

These brooding periods preceding the onset of the malady
afterwards recur regularly before each attack of the malady, only
the period is brief, and is hardly noticeable except by the one who
looks searchingly. Psychopathologists pass this important stage
without noticing its full significance. _The period appears as a
sort of a psychic aura, a sort of_ momentary attack of epileptic
_petit mal_. This brooding state is a modification of the hypnoidal
state.

It is during such hypnoidal states, when the conditions which
I have shown to be requisite for the induction of trance or
subconscious states, happen to be specially strong and the
hypnoidal state is prolonged, that the unprotected subconscious
becomes subject to fear suggestions or to stimuli arousing the fear
instinct and the impulse of self-preservation.

“Many patients,” says the famous physiologist and physician, Mosso,
“die in the hospital from fear and depression who would probably
have recovered had they been tended in their own homes.... In their
morning round the physicians find that the serious cases have grown
worse, while those who are better beg to be dismissed.... The
physician, who has the night watch must walk up and down the whole
night, and is kept busy preventing convulsive attacks, or fainting
fits.

“Fear attacks nullify every effort of the will.... Even Alexander
of Macedon had to count with fear in his courageous army of select
Macedonians. In order to insure victory he offered sacrifices to
Fear before he joined battle.”

Physical maladies become worse during the night, and especially
during the early morning hours when the energy of the body is at
its lowest level,--conscious and subconscious fears reaching their
highest intensity. This holds specially true of nervous cases, and
particularly of psychopathic patients, who are dominated by the
impulse of self-preservation and the fear instinct. The fears and
worries keep the patient awake, and the subconscious fears become
emphasized by concentration of attention, monotony, limitation
of field of consciousness, limitation of voluntary movements,
and other factors favorable to dissociation and the induction of
the hypnoidal state, in which the patient becomes sensitive to
the awakening of the fear instinct, with all its horrible fear
suggestions.

The symptoms of the disease which are more or less under his
control during the day become often so intensified in the dark,
that the patients become demoralized with fear, suffering as they
do the anxiety and anguish induced by the terrors of the night.
Even medical men, professors of medical colleges, who have come
under my care, have confessed to me that, when in a state of
insomnia, the terrors of the night are so intense that they had to
resort to morphine to still the anguish of the fear instinct.

For years I lived in close relation with neurotic, psychopathic
patients. I watched them day and night. I have been called by
patients for medical aid in the late hours of the night, and more
so during the vigil hours of the darkness of the night. I had to
relieve and soothe the fears, the terrors of the night. It is in
the night, when in a low state of neuron energy that patients
feel the grip of horrors oppressing them with nightmares of the
relentless and merciless instinct, the fear instinct. To be
relieved of the night terrors many patients are willing to risk
anything, even the consequence of deadly narcotics, the plagues of
mental healers, and the sexual phantasms of Psychoanalysis.

The hypnoidal state is induced artificially, often brought about
by intoxication, as in the case of holy Soma drink among the
Hindoos, or by fasting, as among the American Indians during the
initiation periods, or by dancing, such as the corrobboree among
the aborigines of Australia, or by singing, or by praying. All the
conditions of disjunction of consciousness with the manifestations
of subconscious activities are brought into play, in order to come
in contact with demons, spirits, totems, and find among them guides
and protectors.

In prolonged hypnoidal states, the fear instinct and the impulse
of self-preservation are calmed under appropriate conditions.
Illusions and hallucinations which easily appeared in the twilight
states of hypnoidal subconscious states became manifested as
beneficent spirits, as agents favorable to the life existence of
the individual, the spirit appearing as the totem, the guardian of
the individual. Prayer and singing, which are the most successful
of all the methods of inducing subconscious subwaking, twilight
states, have survived to our present day.

Of all the methods of utilization of subconscious subwaking,
twilight states the most effective is prayer, especially,
the individual form of prayer. Prayer admirably fulfills the
conditions requisite for the induction of the hypnoidal state
and for the getting access to the subconscious activities, the
formation of subconscious personalities, subconscious illusions
and hallucinations. Such subconscious states have been shown, on
experimental evidence, to be not of a sensory, but of a purely
delusional character, strong enough to affect the individual with
an intense belief in its external reality.

The deluded human mind in its craven fear of the unseen and
the mysterious spirit-forces helps itself to any soporific or
anaesthetic, narcotic stimulant, to bring about a scission of the
conscious self from the subconscious activities. The induction of
the hypnoidal state is brought about by all kinds of intoxicants,
narcotics, fasting, dancing, self-mortification, sex excesses which
exhaust the devotee, and leave him in a state of trance. All such
practices and rites seek blindly for some trance-state to still the
morbid fear instinct.

The psychoanalysis of Freud, Jung, Adler, Stoekel, with their
sexual love, belongs to this category of _narcotic sexual
religions_ which inhibit the critical self.[15]


FOOTNOTE:

[15] The popular novelists try to disclose “the secrets of the
heart” by means of Freudian sex phantasies, psychoanalytic mother
complexes, and Jungian mystic sex libido. It is only in an era
of philistinism and vulgarity with a literature of decadence and
commonplace mediocrity that psychoanalysis can take root and
flourish.

“Die Theorie behauptet mit ausschliessender Sicherheit (?),
das es nur sexuelle Wünschregungen aus dem Infantilen sein
können, welche in den Entwicklungsperioden der Kindheit die
Verdrängung (Affectverwandlung) erfahren haben, in späteren
Entwicklungsperioden dann einer Erneuerung fähig sind, sei es in
folge der sexuelle Konstitution, die sich ja aus der ursprünglichen
Bisexualität herausbildet, sei es in folge ungünstiger Einflüsse
des sexuellen Lebens, und die somit die Triebkräfte für alle
psychoneurotische Symptombildung ab geben.” (S. Freud, “Die
Traumdeutung,” p. 376, zweite Auflage 1909.) In other words,
slippery and mutable as Freud’s statements are, he clearly declares
in his _magnum opus_ the far-reaching generalization that neurosis
is based on infantile sexual wishes, either due to bisexuality or
to unfavorable influences of sexual life. Suppression of sexual
experiences can be easily observed (by competent observers, of
course), in infants a few months old. If you miss the process
of suppression in the baby, you can easily trace it by means of
psychoanalysis to the early recollections of tender infancy. It
is certainly lack of comprehension that induces Ziehen to dub
Freud’s speculations as Unsinn (nonsense). Freud’s admirers with
a metaphysical proclivity delight over the theory of suppressed
wishes. The wish is fundamental and prior to all mental states.
This piece of metaphysical psychologism is supposed to be based on
clinical experience. If wishes were horses, beggars would ride. The
Freudist manages to ride such horses.

The following speculation of Jung’s well represents the
metaphysico-religious character of psychoanalysis: “By entering
again into the mother’s womb he (Christ) redeems in death the sin
of life of the primitive man, Adam, in order symbolically through
his deed to procure for the innermost and most hidden meaning of
the religious libido its highest satisfaction and most pronounced
expression.... In the Christian mysteries the resurrected one
becomes a supermundane spirit, and the invisible kingdom of God,
with its mysterious gifts are obtained by his believers through
the sacrifice of himself on his mother. In psychoanalysis the
infantile personality is deprived of its libido fixations in a
rational manner. The libido which is thus set free serves for the
building up of a personality matured and adapted to reality, a
personality that does willingly and without complaint everything
required by necessity. (It is, so to speak, the chief endeavor of
the infantile personality to struggle against all necessities,
and to create coercions for itself where none exist in reality.)”
Such metaphysico-religious lucubrations parade under the term
psychoanalysis.

“Man,” says James, “believes as much as he can,” but the
credulity of the psychoanalyst is limitless. The psychoanalyst
with his allegories, symbolism, sublimation, incest phantasies,
bi-sexuality, sexual suppression, mother complexes, Oedipus and
Electra phantasms, and all the other complex psychoanalytic
instrumentalities is an excellent example of sex obsessed,
delusional dementia praecox. Psychoanalysis is a sort of sexual
mysticism. All mental life is reduced by psychoanalysis to
“creation” or “procreation.”




CHAPTER XXXIII

LIFE ENERGY AND THE NEUROTIC


The subject of fear may be considered from a somewhat different
point of view, namely from a purely physiological and biological
aspect. The cell in general, the nerve cell, or neuron, is a
reservoir of energy. In fact the great biologist Sachs proposed to
term the cell, _energid_.

For we must look at the organism as a store of energy which is
used up in the course of the adjustments of the individual to his
environment. The organism stores up energy and uses the energy
during the course of its life activity.

Life energy is physiological, bio-chemical, electrical, mechanical,
etc. The mental and emotional activities are intimately related
with the expenditure of energy accumulated by the cells of the
organism, which discharge that energy in response to the various
stimulations of the external world. In its activities the organism
keeps on taking in energy, and once more discharging energy in its
life reactions. The storing up of energy falls under the anabolic
or building up processes, while the discharging or liberating
processes of the amount of the stored up energy are classed under
the katabolic processes.

The total cycle of energy from the start of storage to the end
of liberation of energy, starting once more with the storing
of energy, may be regarded as the cycles of organic functional
activity which is classified under metabolism. We deal here with a
reservoir of vital energy whose life activities or reactions depend
on the amount of energy contained in the cell or the neuron, and
whose functioning and reactions vary with the level of energy in
the reservoir.

The neuron is but a highly differentiated cell or reservoir for
the intake and outgo of energy. In this respect the nerve cell
is entirely like other cells of humbler function. Every cell is
a storage cell, accumulating energy and then liberating it at an
appropriate occasion of a given stimulus, all cells working for
the preservation of the organism as a whole. The rise and fall
of the level of energy in the reservoir regulate the various
manifestations, sensory, motor, emotional, mental which the
individual displays to the various stimulations coming from his
environment.

Within certain limits the fall of energy is normal,--when it
reaches a certain level the organism once more replenishes the
store and once more the level of energy rises. This energy is
_Dynamic_ under certain conditions. However, the discharge of
energy must go on, and the organism must draw further on its store
of energy, on the accumulated store of energy put away for safety
and emergency. This stored up energy is _Reserve Energy_.[16]

The late Charles S. Minot, the American histologist, points out
this reserve energy present in the organism, a reserve energy of
growth called forth under special emergencies of life.

By a striking series of instructive facts, Dr. Meltzer points
out that “all organs of the body are built on the plan of
superabundance of structure and energy.” Like Minot, Meltzer refers
to the significant fact that most of our active organs possess a
great surplus of functioning cells. This surplus is requisite for
the safety of the individual.

If, however, the drain of energy still goes on without replenishing
the total store, the energy drawn on the region of the danger zone
is entered. _This energy is Static._ The concomitant symptoms
are various psychomotor and psycho-secretory disturbances of a
psychopathic or psycho-neurotic character. This energy is drawn
from the upper levels of energy. Under such conditions restitution
of the total amount of energy to its normal level is still possible.

Should the process of liberation of energy go on further without
restitution, the energy drawn is taken from the lower levels of
static energy, and the symptoms are _functional_, _neuropathic_.
The lower-most levels of static energy are the last the cell can
dispense with to save itself from total destruction. With further
increase of discharge of energy the cell must give its very life
activity, the energy is drawn from the breaking up of cell tissue;
this energy is organic or necrotic.

Thus the total energy of the nerve cell or the neuron may be
divided into normal dynamic energy, reserve energy, static energy,
and organic or necrotic energy. The various nervous and mental
diseases may thus be correlated with the flow and ebb of neuron
energy, with the physiological and pathological processes that take
place in the neuron in the course of its activity and reactions to
the stimuli of the external and internal environment.

The various levels of neuron energy may be represented by the
diagram on page 336.

Static energy is indicated by the diagram NWFI. By _organic energy_
is meant that energy contained in the very structure of the
tissues of the neuron, not as yet decomposed into their inorganic
constituents. This is indicated by diagram IFGH.

These phases of neuron energy are not different kinds of energy,
in the sense of being distinct entities; they merely represent
progressive phases or stages of the same process of neuron
activity.

_Liberation_ of neuron energy is correlative with active psychic
and physical manifestations. Hence states of the nervous system
corresponding to liberations of energy are designated as _waking
states_. _Restitution_ of expended energy or arrest of liberation
of neuron energy goes hand in hand with _passive_ conditions of the
nervous system; hence states of restitution or arrest of energy are
termed collectively _sleeping states_.

[Illustration: DIAGRAM IV]

The ascending arrow, indicating the process of restitution of
energy, corresponds to the ascending arrow on the right, indicating
the parallel psychomotor sleeping states. The descending arrows
indicate physiological and pathological processes of liberation of
energy, and also their concomitant psychomotor waking states.

“Ascending” and “descending” mean the rise and fall of the amount
of neuron energy, taking the upper level of dynamic energy as the
starting point. Briefly stated, _descent_ means _liberation_ of
energy with its concomitant, psychomotor, waking states. _Ascent_
means _restitution_ of energy with its parallel sleeping states.

The cycles in dynamic energy correspond to the physiological
manifestations of the nervous system in the activity and rest
of the individual in normal daily life. Concomitant with the
expenditure of dynamic energy of the neurons, the individual passes
through the active normal waking state, and hand in hand with the
restitution of this expended energy, he passes through the sleeping
states of normal daily life.

When, however, in the expenditure of energy, the border line or
margin is crossed, dynamic and reserve energies are used up. In
crossing KA the ordinary normal energies of everyday life are
exhausted, and reserve energy has to be drawn upon. If this reserve
energy is not accessible, the static energy is used, or in case
the reserve energy is exhausted, then once more the static energy
has to be drawn upon; in either case the individual enters the
domain of the abnormal, of the pathological.

When the upper levels of static energy are used, the symptoms are
of a psychopathic or neurotic character. When the use of energy
reaches the lower levels of static energy, affecting the very
nutrition of the neuron, neuropathic manifestations are the result.
When the neuron itself is affected, that is the organic structure
is being dissolved, then organopathies result. It means the death
of the nerve cell.


FOOTNOTE:

[16] The principle of reserve energy was developed independently by
my friend, William James, and myself.




CHAPTER XXXIV

DYNAMIC ENERGY


Whenever the dynamic energy is exhausted and the levels of
reserve energy are reached, the individual affected begins to
feel restless, and if there is no access to the levels of reserve
energy, the individual gets scared. The fear instinct becomes
awakened, giving rise, after repeated unavailing attempts, to the
states of psychopathic neurosis. In states of depression, such as
hypochondria and more especially in states of melancholia, the
fear instinct is potent. The fear instinct is brought about in
the darkness of the night, when the individual is fatigued from
his day’s labor, when the external stimuli are at a minimum, and
reserve energy is not available. The fear instinct rises from the
subconscious regions to the surface of conscious activities.

Convalescent states as well as exhaustion from pain and disease,
such as fever or a shock from some accident, war-shock,
shell-shock, surgical shock predispose to the manifestation of the
fear instinct. Hence the caution of surgeons in the preparation
of the patient for a serious operation. For the result may be a
shock to the system due to the subconscious activities of the fear
instinct present in subconscious mental life, no longer protected
by the guardianship of the upper consciousness. And it may also
be shown, both by experiment and observation, that during the
subconscious states when the lower strata of dynamic energy are
reached, such as hypnoidal, hypnoid states, and sleep, that the
individual is more subject to fear than during the waking states.
We know how a sudden noise, a flash of light during drowsy states
or sleep startles one, and the same holds true of any stimulus. I
have observed the same condition of fright during hypnoidal states.

We must agree with the French psychologist, Ribot, when he comes to
the conclusion that “every lowering of vitality, whether permanent
or temporary, predisposes to fear; the physiological conditions
which engender or accompany it, are all ready; _in a weakened
organism fear is always in a nascent condition_.”

The fear instinct becomes morbid when the individual has to draw
on his reserve energy, and finds he is unable to do it. The cure
consists in the release of the reserve energy which has become
inaccessible. This can be done by various methods, but the best is
the method of induction of the hypnoidal state under the control of
a competent psychopathologist. The whole process consists in the
restitution of the levels of dynamic energy and the building up of
the patient’s active personality.

From our point of view, fear is not necessarily due to pain
previously experienced, it may be purely instinctive. The fear
instinct may be aroused _directly_, such for instance is the fear
of young children who have never before experienced a fall. In
fact we claim that the fear instinct and the restlessness which
expresses it antedate and precede pain. The fear of pain is but one
of the forms under which the fear instinct is manifested. The fear
instinct appears long before pain and pleasure come into existence.
This holds true not only of the lower animal life, but also of the
vague fear found in many a case of neurasthenia and functional
neurosis and psychosis. Ribot also calls attention to pantophobia.
“This is a state in which the patient fears everything, where
anxiety instead of being riveted on one object, floats as a dream,
and only becomes fixed for an instant at a time, passing from one
object to another, as circumstances may determine.”

It is probably best to classify fears as _antecedent_ and
_subsequent_ to experience, or fears as _undifferentiated_ and
_differentiated_.

When the dynamic energy is used up in the course of life
adaptations, and reserve energy is drawn upon, there may be danger
that the energy may be used up until the static energy is reached,
and neuropathic conditions are manifested. These conditions are
preceded by psychopathic disturbances. Associative life becomes
disturbed, and emotional reactions become morbid. There is a
degeneration or reversion to earlier and lower forms of mental
activity, and to lower instinctive life. The primitive instincts,
the impulse of self-preservation and the fear instinct, come to
the foreground, giving rise to the various forms of psychopathic
affections.

This process of degeneration and simplification is characteristic
of all forms of psychopathic conditions, though it may be more
prominent in some cases than in others. The type of mental life
becomes lowered and there is a reversion, a sort of atavism, to
simpler and more childish experiences, memories, reactions of
earlier and less complex forms of mental life. I have laid special
stress on this feature of psychopathic reactions in all my works on
the subject. What I emphasize in my present work is the fact that
psychopathic reactions are dominated by self and fear, which are
laid bare by the process of degeneration.

The patient in psychopathic states is tortured by his fears, he is
obsessed by wishes which are entirely due to his fear and deranged
impulse of self-preservation.

As the static energy is reached, and with lack of functional
energy of the dynamic character, the energy habitually used in the
ordinary relations of life, the patient experiences a monotony,
a void in his life activity. He has a feeling of distress, as if
something is haunting him, and possibly something terrible is going
to happen to him or his family. He may have a feeling of some
depression, and may suffer from a constant unquenchable craving
for new stimulations, run after new impressions and excitements
which pale in a short time on his fagged mind. He is restless,
demanding new amusements and distractions. He is distracted with
fear, conscious and more often subconscious,--which he is unable to
dispel or shake off. He seems to stand over a fearful precipice,
and he is often ready to do anything to avoid this terrible gap in
his life. Life is empty, devoid of all interest; he talks of ennui
and even of suicide; he is of a pessimistic, gloomy disposition,
his state of mind approaching a state of melancholia. He asks for
new sensations, new pleasures, new enjoyments which soon tire him.
He is in the condition of a leaking barrel which never can be
filled.

Psychopathic individuals are in a state of the wicked “who are like
the ocean which never rests.” This misery of ever forming wishes
and attempting to assuage the inner suffering, this craving for new
pleasures and excitements, in order to still uneasiness, distress,
and the pangs of the fear instinct with its gnawing, agonizing
anxieties, brings the patient to a state in which he is ready to
drink and use narcotics. The patient seeks ways to relieve his
misery. The patient has used up all his available dynamic energy,
and being unable to reach the stores of reserve energy looks for
a key or stimulant to release his locked up reserve energies.
The patient is unable to respond to the stimuli of life, so he
attempts then the use of his static energy. This can only result in
producing psychopathic and neuropathic symptoms.

The patient needs to be lifted out of the misery of monotony
and ennui of life, he needs to be raised from his low level of
vitality, to be saved from the listlessness into which he has
fallen. The low level of energy makes him feel like a physical,
nervous, and mental bankrupt. This bankruptcy is unbearable to him.
He is in a state of distraction, distracted with the agony of fear.
Something must be done to free himself from the depression of low
spirits and from the low level of energy which keeps him in a state
devoid of all interest in life, accompanied by physical, mental and
moral fatigue. He is like a prisoner doomed to a life long term.

This constant craving for stimulation of energy, this reaction
to the anxiety of the morbid fear instinct is the expression
of exhaustion of available dynamic energy for the purpose of
normal life activity. The patient attempts to draw on his latent
reserve energy. Since this form of energy is not accessible to
the stimulations of common life, he tries to release the energy
by means of artificial stimulations, be it morphine, alcohol,
mysticism, Freudism, sexual and religious “at-one-ments” or by
other stimuli of exciting character. Unable to release energy by
fair means the patient is driven to the employment of foul means
for the stimulation of new sources of energy. The psychopathic
patient is driven by fear, by fears of life and death.

The morbid fear instinct in all cases is brought about by
exhaustion of energy, whether sudden or gradual. Fear is due to
exhaustion of lower levels of dynamic energy and to the inability
of liberation of stored up reserve energy. The more intense this
incapacity of utilization of reserve stores of energy be, the
more intense is the fear. When this condition is prolonged the
psychopathic symptoms become unendurable.

The experienced, thinking surgeon has learned the danger of this
condition in his operating room. Thus it is told of Porta, the
great surgeon of Pavia, when his patients died under an operation,
he used to throw his knife and instruments contemptuously to the
ground, and shout in a tone of reproach to the corpse: “Cowards die
of fear.”

The great physiologist Mosso gives a graphic description of
the effects of fear in a pathetic case that has come under his
personal observation: “As army surgeon, I had once to be present
at the execution of some brigands. It was a summary judgment. A
major of the _besaglieri_ put a few questions to one or two, then
turning to the captain said simply: ‘Shoot them.’ I remember one
lad, of scarcely twenty years of age, who mumbled replies to a few
questions, then remained silent, in the position of a man warding
off a fatal blow, with lifted arms, extended palms, the neck drawn
between the shoulders, the head held sideways, the body bent and
drawn backwards. When he heard the dreadful words he emitted a
shrill, heart-rending cry of despair, looked around him, as though
eagerly seeking something, then turned to flee, and rushed with
outspread arms against a wall of the court, writhing and scratching
it as though trying to force an entrance between the stones, like a
polyp clinging to a rock. After a few screams and contortions, he
suddenly sank to the ground, powerless and helpless like a log. He
was pale and trembled as I have never seen anyone tremble since. It
seemed as though the muscles had been turned to a jelly which was
shaken in all directions.”




CHAPTER XXXV

FEAR VARIETIES


The great psychologist Ribot classifies fears into pain fears,
and disgust fears. To quote from Ribot: “I propose to reduce them
(fears) to two groups. The first is directly connected with fear
and includes all manifestations, implying in any degree whatever
the fear of pain, from that of a fall or the prick of a needle, to
that of illness or death. The second is directly connected with
disgust, and seems to me to include the forms which have sometimes
been called pseudophobia (Gelineau). Such are the fear of contact,
the horror of blood and of innocuous animals, and many strange
and causeless aversions. Let us remark furthermore that fear and
disgust have a common basis, being both instruments of protection
or defense. The first is the defensive-conservative instinct of
relative life, the second the defensive-conservative instinct of
organic life. As both have a common basis of aversion, they show
themselves in equivalent ways: fear of withdrawal, departure,
flight, disgust by vomiting and nausea: The reflexes of disgust are
the succedanea of flight; the organism cannot escape by movement
in space from the repugnant object which it has taken into itself,
and goes through a movement of expulsion instead.”

I hesitate to accept Ribot’s classification, inasmuch as we have
pointed out that fear is prior to pain. In most lower animals
it is hardly probable that not having representations that
there is present a fear of pain in advance of the pain itself.
Fear under such conditions can only be awakened by an actual
sensory experience whether it be painful or not. In fact Ribot
himself agrees to the fact that “There is a primary, instinctive,
unreasoning fear preceding all individual experience, a hereditary
fear.”

Perhaps a word may be said in regard to the factor of disgust
as having a common basis with fear. It is only by a stretch of
imagination, if not by a stretch of words, that fear and disgust
can be identified. There may be fear where there is no disgust,
and there may be disgust where there is no fear. The two are
independent variables, and can hardly be referred to as one and
the same fundamental reaction, such as withdrawal and flight. The
object of disgust does not preclude approach. The avoidance or
aversion, the nausea and vomiting are all subsequent phenomena.
Disgust may even follow after an abuse of food, of pleasant or
necessary objects of nutrition, such as satiety.

The reactions of the fear instinct run the contrary way, approach
is precluded from the very start. Fear is not associated with
useful objects or events, unless it be in morbid states of fear.

And still fear and disgust may become intimately associated when
disgust and its objects awaken the fear instinct, and the fear
becomes the fear of disgust or of the disgusting object. Disgust is
more of a specialized character, and is associated with particular
events or specific objects, while fear, in its primitive form at
least, is more of a generalized character.

In the higher forms of life disgust may be so intimately related to
fear that the two become synthesized, so to say, and are felt like
one emotional state, the state becoming one of fear disgust. In
such cases the fear instinct, fear disgust, is a determining factor
of the morbid state. This is confirmed by clinical experience of
the various cases of psychopathic functional neurosis and psychosis.

In the various morbid states of the depressive types fear is
awakened long before any pain is actually suffered, or any
particular cause is found by the patient to account for the terror
that dominates his mental life. The fear comes first while the
representative cause is assigned by the sufferer as the cause of
the fear.

Similarly in the functional psychosis and neurosis the object,
experience, event, may be quite ordinary without any suggestion of
pain or distress in it. In fact, the experience may be indifferent
or even pleasant, but when associated with the fear instinct may
become the nucleus of a very distressing pathological state. The
experience is the _occasion_, while the fear instinct, the intimate
companion of the impulse of self-preservation, is the only cause of
functional psychopathic maladies.

The fear instinct in its primitive state is anterior to all
experiences of danger, pain, and suffering, as is the case in
most of the lower animals. In the higher animals where memory
is developed, the fear instinct is associated with some form of
representation, however vague, and then fear becomes posterior to
experience. In man both forms of fear are present. The anterior
form is specially found in children, while in adults the posterior
form is, under normal conditions, predominating. The primitive
anterior type of the fear instinct is by no means absent, in fact,
it is more overpowering, its effects are overwhelming when it comes
forth from the subconscious regions to which it is confined, and is
manifested under conditions of lowered vitality.

When the strata of dynamic energies are passed and the strata
of reserve energies are reached, the reserve energy not being
accessible, the fear instinct is elemental, fundamental, while the
fear of pain and of some definite representation of danger, or of
suffering is a secondary consequence. People may suffer from pain,
disease, and even danger, and still have no fear, while others may
have never experienced the pain or disease, and still be obsessed
by intense pangs of fear. Fear is _sui generis_, it is at the
foundation of animal life.

The fear instinct may be awakened directly by a sensory stimulus,
when, for instance, one finds himself in darkness and feels some
creeping, slimy thing, or when attacked suddenly with a club or a
knife. The fear instinct may again be aroused by an expectation, by
something to which his dynamic energies cannot respond adequately,
while the reserve energies are in abeyance, such for instance
as the expectation of some threatening event either to himself
or to the objects bound up with his life existence. When one is
threatened with some misfortune, with torture, death, or with a
mortal disease, or with a serious operation, or when confronted
with great danger against which his energies prove inadequate, in
such cases the fear is ideational. These types of fear may in turn
be either conscious or subconscious.

We may thus classify the fears as follows:

                 { Conscious
  I. Sensory     {
                 { Subconscious

                 { Conscious
  II. Ideational {
                 { Subconscious

The fear of the etherized or chloroformed patient is entirely
of the subconscious type. It is the arousing of subconscious
fear which, from the nature of the case, cannot be reached and
alleviated that gives rise to functional psychosis and neurosis.

From this standpoint it may be said that _psychopathic diseases
are subconscious fear states, in other words functional psychosis
or neurosis is essentially a disease of subconscious activities_.
This is, in fact, confirmed by my clinical experience and by my
psychopathological research work.

Dr. L. J. Pollock, professor of nervous diseases at Northwestern
University Medical School, made an extremely interesting “Analysis
of a Number of Cases of War Neurosis.” This analysis fully
conforms to the results obtained by me in my work on functional
psychosis and neurosis carried on for a great number of years.
It fully confirms the results of my studies, clinical and
psychopathological, that the causation, or etiology of functional
psychopathic states depends on fluctuations of the levels of neuron
energy, or physical exhaustion, fatigue, hunger and thirst, or
shock to the system, and more especially on the ravages of the fear
instinct, aroused during the dangers and horrors of war.

“Of several hundred cases which I observed in base hospitals in
France, copies of about 350 records were available. From these 200
of the more detailed ones were selected to determine the relative
frequency of some of the factors.... From the numerical group
has been excluded cases of emotional instability, timorousness,
hospital neuroses occurring as an aftermath of an illness or a
wound, the phobic reactions of gassed patients and constitutional
neuroses, and those not directly related to the war.

“Heredity as a factor plays but a small part, and the incidence of
neuropathic taint constituted little over 4 per cent.

“Of these 43 per cent followed shell fire, 36 per cent after
concussion as described by the soldier.... A definite history of
fatigue and hunger was obtained in 30.5 per cent. Both probably
occurred in a greater percentage, but were frequently masked by
other symptoms which occupied the patient’s attention to a greater
extent. Fatigue and hunger are important factors, not only because
they prepare the ground for an ensuing neurosis by breaking down
the defensive reactions, but also in that when the patient is more
sensitive and impressionable, the natural physical consequences of
fatigue are misinterpreted by him as an evidence of an illness, and
give rise to apprehension and fear.

“As frequently as fear is seen in some form or other in the
neuroses of civil life, so does it manifest itself in the war
neuroses. Fifty per cent of the cases admitted considerable fear
under shell fire. Concussion was the immediate precipitating cause
of the neuroses in 31 per cent of the cases. The symptoms of the
neuroses could be divided into those of the reactions of fear and
fatigue.”

These results corroborate my work on neurosis as due to exhaustion
of Neuron Energy and Self-Fear.

In fact, in one of my works written at the beginning of the war, I
predicted the wide occurrence of what is known as shell shock, war
shock or war neurosis. The prediction was fully corroborated by the
facts.

Fear, Self, Reserve Energy, and Fatigue are the main factors in
the formation of the psychopathic or neurotic condition. Janet,
in a recent article of his, lays stress on the fear states in
psychopathic affections and refers these conditions to the levels
of vital energy. There is no doubt that Janet lays his finger on
the very heart of the psychopathic diathesis.

In my work I come to a similar conclusion only I lay more stress on
the fear states, being referred to the fundamental instinct present
in all animal life as a primordial condition of existence. This
instinct is intensified and extended in the psychopathic diathesis.

The level of energy and the fear instinct are vitally
interdependent. A low level of energy, especially a dissociation
or inhibition of the store of reserve energy, arouses an excess
of reaction of the fear instinct, and _vice versa_ the excessive
reaction of the fear instinct locks up the stores of reserve
energy, thus intensifying and extending the psychopathic states
with their fear-fatigue conditions. Janet refers indirectly to the
impulse of self-preservation which is of the utmost consequence in
psychopathic affections. On the whole, I may say that my work and
clinical experience are in accord with that of the great French
psychopathologist.

Where the fear instinct, self, and inhibition of reserve energy are
present, then any emotion, even that of love, and devotion, will
give rise to psychopathic states. This psychopathic state is not
produced, because of the intensity or repression of the emotion,
but because of the underlying subconscious predisposition to
fear-instinct, self-preservation, and inhibition of reserve energy.

The feelings of inhibited reserve energy produced by fear and
self, make the individual hesitate in decision, in action, and
finally demoralize and terrorize him. These conditions take away
from him all assurance and security of life and action, and hold
him in a perpetual state of anxiety until he becomes completely
incapacitated for all kinds of action and reaction.

Events that threaten the impulse of self-preservation of the
individual, such as misfortunes, shocks, losses, tend to bring
about psychopathic states, on account of the aroused fear instinct,
on account of the impulse of self-preservation, and sudden
inhibition of the stores of reserve energy. Events that may lead
to dissolution of personality are, hence, attended with intense
anxiety.

As we have seen, an intense state of fear, conscious or
subconscious, produces a state of aboulia, a state of indecision,
a state of incompletion of action, a state of insufficiency, a
paralysis of will power, and a sense of unreality, all of which
are intimately interrelated. For the fear instinct, when intense,
inhibits and arrests the will and paralyzes action. _The patient
fears, not because he is inactive, but he is inactive, because he
fears._

The impulse of self-preservation, the fear instinct, and the
principle of subconscious reserve energy give an insight into the
multiform symptomatology of the psychopathic diathesis.

The following classes of people are subject to psychopathic
affections:

(I) Childless people.

(II) People who had been afflicted with various diseases in
childhood.

(III) Children of sickly, nervous, psychopathic parents who have
kept their progeny in a constant state of anxiety, full of terrors
and troubles of life.

(IV) People who had been affected by a series of shocks and fears
in childhood and youth.

(V) People whose parents suffered long from various systemic
diseases, especially cardiac and tubercular troubles.

(VI) In a large family of children the first, or last child, or
sickly child of psychopathic parents.

(VII) The only child, or sickly child, especially of a widowed
parent who is of a psychopathic diathesis.

_In all these cases the psychopathic state is due to early
cultivation of the fear instinct, self-impulse, and low level or
dissociated state of vital reserve energy._




CHAPTER XXXVI

CONTROL OF THE NEUROTIC[17]


The first thing in the examination and treatment of neurosis is
the elimination of any physical trouble. It is only after such an
elimination that one should resort to psychotherapeutic treatment.

In psychopathic or neurotic diseases one should take into
consideration the fact that the patients are characterized by
the tendency of formation of habits which are hard to break. The
patients are apt to ask that the same thing be done again and
again for the simple reason that it has been done several times
before. In other words, _psychopathic neurosis is characterized
by automatism and routine_. This tendency to _recurrence_ is
characteristic of all forms of primitive life as well as of mental
activities which are on the decline,--it is the easiest way to get
along.

Effort is abhorrent to the patient. He is afraid of change in the
same way as the savage is afraid of any novelty or of any change
in custom. Tradition is holy, and in a double sense, because it
has been handed down by former generations, regarded as divine and
superior, and because the new is strange and, therefore, may prove
dangerous and of evil consequence. What has not been tried may
prove harmful, pernicious, and even deadly. The old has been tried
and approved by generations and the consequences are known, while
the new may be in alliance with evil powers. This holds true in all
cases obsessed by the impulse of self-preservation and the fear
instinct. What the patients have tried several times and what has
proved good and pleasant is demanded by the patient to be repeated;
the new is not known and may be risky, dangerous. I have great
difficulty in making changes in the life of advanced psychopathic
cases, because of the fear of the new, _neophobia_. Once the change
is made, and the patient becomes adapted to the new way, then the
old way is shunned. In short, _neophobia is an essential trait of
psychopathic patients_.

The physician must take this trait of neophobia into account, and
as the patient begins to improve, he must gradually and slowly wean
the patient of this phobia, inherent in the very nature of the
malady. The patient must learn to do _new_ things, and not simply
follow mechanically a régime, laid out by the physician.

_The patient’s life must become personal._ The patient should be
made to change many of his ways, and above all he should learn to
follow reason, rather than habit and routine. Everything, as much
as possible, should be reasoned out,--he should be able to give a
rational account of his habits and actions. Whatever appears to be
a matter of routine, irrational and unaccountable habit, simply a
matter of recurrence, of repetition of action, should be discarded,
should be changed to actions and adaptations for which the patient
could give a rational account.

We must remember that the patient lives in the condition of
recurrent mental states, that his mental activity, as I have
pointed out, follows the laws of recurrence, characteristic of
the type of recurrent moment consciousness.[18] It is, therefore,
the physician’s object to lift the patient out of this low form
of mental activity to the higher types of rational, personal life
in which the patient can rise above the perturbations of life,
above the pettiness of existence with its worries and fears. This
procedure is essential.

We can realize how pernicious are those schemes which physicians
and many people in sanitariums lay out for the patients just to
keep them busy for the time of their stay under special care. As
soon as the patients leave, they are in the same predicament as
before. The patients wish to have their lives conducted in the same
mechanical, automatic routine. In this way they are really on the
same low plane of mental life, on the plane of recurrent moment
consciousness, a type which forms the pathological web and woof of
the patient’s life.

Unless the patient is lifted out of this low, mean, and animal form
of conscious activity, he cannot be regarded as cured. Instead of
having the patient’s life saturated and controlled by the recurrent
automatisms of the fear instinct, he should learn to be controlled
by the light of reason. “A free man is he,” says Spinoza, “who
lives under the guidance of reason, who is not led by fear.”
Epicurus and the ancient Epicureans laid special stress on the
necessity of getting rid of fear through reason, enlightenment, and
education. Thus the great poet Lucretius:

“The whole of life is a struggle in the dark. For even as children
are flurried and dread all things in the thick darkness, thus we in
the daylight fear things not a whit more to be dreaded than those
which the children shudder at in the dark and fancy future evils.
This terror, therefore, and darkness of mind must be dispelled
not by the rays of the sun and glittering shafts of day, but by
knowledge of the aspect and law of nature.”

As Carlyle tersely puts it: “The first duty of a man is still that
of _subduing Fear_. We must get rid of Fear; we cannot act at all
till then. A man’s acts are slavish, not true but specious (we may
add psychopathic); his very thoughts are false, he thinks too as
a slave and coward, till he has got Fear under feet.... Now and
always, the completeness of his victory over Fear will determine
how much of a man he is.”

The patient complains of lack of confidence. This is a
pathognomonic symptom of psychopathic states. At the same time
there is confidence in the symptom complex which is often described
by him with microscopic minuteness. The patient has no doubt about
that. He is in search of some one who can overcome this symptom
complex in a way which he specially approves. The patient matches
his morbid self-will against the physician’s control. The physician
is not to be subdued by the authority of the diseased personality,
he should not let himself be controlled by the ruling symptoms of
the patient’s life. Either the physician meets with _opposition_,
and after some time, must give up the treatment of the case, or
he is victimized by the patient’s demands, and must comply with
them. In the latter case the patient may stick to the physician
for some time. In both cases the patient is not really cured. It
is only when the _diseased self_ becomes subdued and falls under
the physician’s control, it is only then that a cure is really
possible, it is only then that the normal healthy self may come to
the foreground.

The first and foremost characteristic of psychopathic states is the
narrowing down of the patient’s life interests. He begins to lose
interest in abstract problems, then in that of his own profession
or occupation, then he loses interest in the welfare of his party
or his country, and finally, in his family, wife, and children.
Even in the case of love, the psychopathic patient seeks to utilize
the person he loves for his own, neurotic benefit, namely, his
neurotic comfort and health. He loves the person as a glutton
likes his meal, or as a drunkard his liquor. The self becomes
narrowed down to health, the key to his supposed spiritual life.
Self-preservation and fear permeate the patient’s life.

We notice that the patient’s life activity, especially his
mental functions, becomes narrowed down. His attention becomes
circumscribed to a few subjects and objects. This is the limitation
of the _extent_ of attention. There is afterward a limitation
of the _temporal span_ of attention. The patient cannot keep
his attention on any subject for any length of time. This span
of attention becomes more and more limited with the growth and
severity of the psychopathic malady. If the patient is educated and
has had an interest in various subjects, the latter become more and
more limited in scope. Finally the patient becomes reduced to the
least amount of effort of the attention, and that only for a brief
period of time. When the trouble reaches its climax, the patient
loses all interest and capacity of reading and of studying. He
cannot think, he becomes less and less original in his thoughts,
he becomes even incapable of thinking. The patient’s whole mind
becomes limited to himself and to the symptoms of his disease.

Along with it the fear instinct grows in power, inhibiting all
other activities. There is a limitation of the patient’s personal
self. The personality becomes reduced to the lowest levels of
existence, caring for his own selfish pains and small pleasures,
which are exaggerated and magnified to an extraordinary degree. In
other words, the _personal_ life of the patient becomes more and
more limited as the pathological process goes on. It becomes harder
and harder for the patient to take an active interest in life.

It is clear that under such conditions the tendency of the patient
is to rest and brood about himself, and keep indulging his limited
interests, which get still more narrowed as the pathological
process becomes more extensive and intensive. Under such conditions
it is suicidal to indulge the patient and suggest to him a _rest
cure_, a cure which lies along the line of the disease process,
thus tending to intensify the disease. What the patient needs is
to change his environment, and be put under conditions in which
his interests of life can be aroused. His life activities should
be stimulated to functioning on the right lines, laid out by
physicians who understand the patient’s condition. _Rest is harmful
to the neurotic. What the patient needs is work, work, and work._

What we must remember in the treatment of psychopathic patients is
the fact that we deal here with the aberrations of the impulse of
self-preservation, the most powerful, the most fundamental, and
the least controllable of animal impulses, accompanied with the
fear instinct, which is the most primitive of all animal instincts.
This morbid state of the impulse of self-preservation must be fully
realized before any treatment is begun. The physician must also see
and study closely the line on which the self-preservation impulse
is tending, and comprehend the associations along which the impulse
takes its course in the history of the patient and in the symptom
complex.

What one must especially look after is the elusive feeling of
self-pity which manifests itself under various garbs, and hides
itself under all kinds of forms. As long as the patient is
introspective and has the emotional side of self-pity present, so
long is his condition psychopathic.

The extreme selfishness and the uniqueness with which psychopathic
patients regard their own condition should be eradicated from
their mind. It must be impressed on them that their case is quite
common, and that there is nothing exceptional about them. It
must be made clear to them that the whole trouble is a matter of
mal-adjustment, that they have developed inordinately the impulse
of self-preservation and the fear instinct until their mental life
has become morbid and twisted. The whole personality has to be
readjusted. It is the special tendency of psychopathic patients to
regard themselves as unique, privileged above all other patients,
they are a kind of geniuses among the afflicted, possibly on
account of the special endowments possessed by them, gifts of quite
exceptional and mysterious a character. “Have you ever met with a
case like mine?” is the stereotyped phrase of the psychopathic,
neurotic patient. As long as the patient entertains that conception
of _nobility_, the impulse of self must still be regarded as morbid.

The neurotic must be made to understand clearly that there is
no aristocracy in disease, and that there is no nobility of the
specially elect in the world of morbid affections, any more than
there is in the domain of physical maladies.

The egocentric character of the psychopathic patient puts him in
the position of the savage who takes an animistic, a personal view
of the world and of the objects that surround him. Natural forces
are regarded as dealing with man and his fate, often conspiring
against man. Magic is the remedy by which the savage tries to
defend himself, and even to control the inimical or friendly
natural forces or objects, animate and inanimate, with which he
comes in contact. This same attitude, animistic and personal, of
the primitive man is present in the psychopathic patient. The
patient is afraid that something fearful may happen to him. Against
such accidents he takes measures often of a defensive character
which differ but little from the magic of the savage and the
barbarian. That is why these patients are the victims of all kinds
of fakes, schemes, panaceas of the wildest type, unscrupulous
patent medicines, absurd régimes, mental and religious, whose
silliness and absurdity are patent to the unprejudiced observer.
The mental state of the psychopathic or neurotic patient is that
of the savage with his anthropomorphic view of nature, with his
fears based on the impulse of self-preservation. _The psychopathic
patient is in a state of primitive fear and of savage credulity
with its faith in magic._

The emotional side of the impulse of self-preservation and of the
fear instinct should always be kept in mind by the physician who
undertakes the treatment of psychopathic cases. The physician must
remember that the emotions in such cases are essentially of the
instinctive type, that they therefore lie beyond the ken of the
patient’s immediate control and action of the personal will. The
physician should not, therefore, be impatient, but while protecting
the invalid against the fears that assail the latter, he should
gradually and slowly undermine the violence of the impulse of
self-preservation and the anxiety of the fear instinct. For in
all psychopathic maladies the main factors are the impulse of
self-preservation and the fear instinct.


FOOTNOTES:

[17] The discussion here is necessarily brief. The reader is
referred for details to my work “The Causation and Treatment of
Psychopathic Diseases,” Ch. XVII, General Psychotherapeutic Methods.

[18] See Sidis, “The Foundations,” Part II, Moment-Consciousness.




CHAPTER XXXVII

REGAINED ENERGY AND MENTAL HEALTH


The _principle of reserve energy_, developed independently by
Professor James and myself, is of the utmost importance to abnormal
psychology. The principle is based on a broad generalization
of facts--psychological, physiological and biological--namely,
that far less energy is utilized by the individual than there is
actually at his disposal. A comparatively small fraction of the
total amount of energy, possessed by the organism, is used in its
relation with the ordinary stimuli of its environment.

The energy in use may be regarded as _kinetic or circulating
energy_, while the energy stored away is _reserve energy_. There
must always be a supply of reserve energy requisite for unusual
reactions in emergency cases. Those organisms survive which have
the greatest amount of reserve energy, just as those countries are
strong and victorious which possess the largest amount of reserve
capital to draw upon in critical periods.

As life becomes more complex, inhibitions increase; the thresholds
of stimulations of a complex system rise in proportion to its
complexity. With the rise of evolution there is a tendency to
increase of inhibitions, with a consequent lock-up of energy
which becomes _reserve_. Now there are occasions in the life of
the individual, under the influence of training and emotional
trauma, when the inhibitions become unusually intense, tending to
smother the personality, which becomes weakened, impoverished in
its reactions, and is unable to respond freely to the stimuli of
its environment. The inhibited system becomes inactive and may be
regarded as _dissociated_ from the cycle of life.

In case of an emotional trauma there is often a breach in the
continuity of association. The affected system becomes dissociated
from the rest of the personality, and is like a splinter in the
flesh of the individuality. Its own threshold, when tapped,
may be very low, but it is not directly accessible through the
mediacy of other systems; hence its threshold appears unusually or
pathologically high. When the inhibitions are very high they must
be removed. This removal of inhibitions brings about an access
to the accumulated energy of the inhibited systems. In case of
disjunction or break of continuity we must stimulate the dormant
reserve energy of the systems, and thus assist the process of
repair and bridge the breach of associative continuity. A new,
fresh, active life opens to the patient. He becomes a “reformed”
personality, free and cheerful, with an overflow of energy.

The hypnoidal state is essentially a rest-state characterized
by anabolic activity. There is a restitution of spent energy;
inhibitions become removed, and access is gained to “dormant”
systems or complexes. The awakened “dormant” complex systems bring
with them a new feeling-tone, a fresh emotional energy resulting in
an almost complete transformation of personality.

As an illustration of the transformation effected I take at random
the following extracts from some of the letters written to me by
patients who have experienced this welling up of reserve energy:
“Indeed, were I to fill this entire sheet with expressions of the
gratitude which wells up from my inmost heart it would be only a
beginning of what I feel. Surely the darkness of the world has been
dispelled since this _new light_ has illuminated my soul, and _I
feel that this wondrous light will never fail me_. It were vain to
attempt to thank you for this wonderful transformation.”

A letter from a patient reads: “You will be glad to know that all
is well with me. Life is one happy day. I am a marvel to my friends
in the way of happiness and cheer. I have to confess that I feel
almost wicked to be so happy.”

Another letter runs as follows: “Next to the gladness in my own
restoration, I am rejoiced at the wonderful transformation that
has come to my dear friend T---- from your treatment. She writes
me most enthusiastically of her steady and sure progress toward
the goal of perfect health, of her strength to take up the home
duties which had been so burdensome, and she now finds a delight
in the doing of them, and of her husband’s and friends’ joy in the
transformation that has been wrought in her.”

A patient writes: “Your treatments cut a deep channel in my
subconscious life, one from which if I do happen to wander astray
is for only a short time; then I am carried right back in the
trend. In fact, there exists a deep indelible, happy and cheerful
impression incorporated in my subconscious life that it is
impossible to eradicate.... You have laid a concrete foundation
upon which I am building, little by little, a structure that some
day you will be proud of, and for which words are insufficient to
express my profound gratitude.”

Another patient writes: “The big result of your treatment was
restoring my faith and arousing my ambitions. I never think of
suicide. I only want to live and work and redeem myself. I have
never been so happy and I have never worked harder.... I feel the
most extraordinary eagerness; a strange, irrepressible enthusiasm;
and an absolute conviction of the truth and beauty of work, of my
work. I dare not think of failure, and yet success as I conceive
it is too wonderful ever to come. The brave will of life in me
permitting, I shall some day approximate my prayer, my dream, my
vision; and then I must let the earth know you are responsible.”

The following extract of a letter, written to me by a patient,
an experienced English surgeon, now in charge of a hospital in
England, whose case was severe and chronic, dating from early
childhood, is valuable, both on account of his medical training and
his mental abilities which make him an excellent judge as to the
fundamental change and cure effected:

“It is now exactly two years since I was undergoing treatment at
your kindly and sympathetic hands. I remember that you once told me
that the seed sown by you would probably take this length of time
to come to fruition. Therefore, it may not be without interest to
you to receive a supplement to many other letters in which I will
endeavor to summarize my progress--for the last time.

“I have no longer even the least lingering doubt that you can count
me among your most brilliantly successful cures. I say this after
many--too many--heart searchings which are probably characteristic
of my somewhat doubting temperament. At first, I was disappointed
with the whole business: I suppose I looked for strange and
dramatic events to occur which would change my whole personality
and temperament in a short time. Nothing so exciting happened; I
left Portsmouth still feeling that I owned the same name, and very
much the same ‘ego’ that I arrived with. I was unaware that any
profound psychological operation had taken place. To be candid, I
did not think it had--the beginnings, no doubt, were there--but no
more. But now when I carry my mind back to the type of obsession
which used to assail me--is there any change? Good God! I behold
a miracle, although it has come about so silently that I can only
realize the difference by comparing the present with the past.
In conclusion I can only send you my undying gratitude.... You
have saved me from what, I honestly believe, would have one day
resulted in deliberate suicide which I often contemplated as the
one solution of my trouble....”

These extracts are typical of many others, and clearly show the
enjoyment of new strength and powers until now unknown to the
patient. Fresh reservoirs of reserve energy have been tapped and
have become available in an hour of dire need. The patient has
light and strength where there were darkness and depression. We
are confronted here with the _important phenomenon of liberation
of dormant reserve energy_. The patient feels the flood of fresh
energies as a “marvelous transformation,” as a “new light,” as a
“new life,” as “a something worth more than life itself.”

The hypnoidal state helps us to reach the inaccessible regions
of dormant, reserve energy, helps to break down inhibitions,
to liberate reserve energies and to repair the breaches or
dissociation of mental life. The painful systems become
dissociated, disintegrated and again transformed, reformed, and
reintegrated into new systems, full of energy and joy of life.

The banishment of credulity, the cultivation of the upper,
critical consciousness, the rational control of the subconscious,
the moderation of the self-impulse, the regulation of the
fear-instinct, and the access to the vast stores of subconscious
reserve energy, all go to the formation of a strong, healthy-minded
personality, free from fear and psychopathic maladies.




INDEX


  Affections, neurotic, 59

  Aphonia, 234, 248

  Aristotle, 320

  Automatic writing, 258, 260, 262

  Automatic state, 121


  Bacon, 301

  Bain, 39, 56

  Bernheim, 306

  Binet, 255

  Bramwell, 112


  Carlyle, 49, 314

  Catalepsy, 212, 218, 234, 244

  Cataplexy, 67, 96

  Characteristics of morbid states, 73, 74

  Charcot, 325

  Civilization, 273, 274

  Claperèdé, 95

  Compayré, 40

  Consciousness, 77
    will-, 77

  Conversion, 312, 319

  Crile, 53


  Dämmerzustände, 220, 221

  Darwin, Ch., 47, 57, 274

  Demoor, 131

  Diathesis, psychopathic, 285

  Differentiation of neurotic states, 113

  Disturbances, neurotic, 58

  Donley, John, 102, 103

  Dormant systems, 371

  Dostoevsky, 25


  Egocentric, 366

  Energy,
    circulating, 369
    dynamic, 335, 339
    kinetic, 369
    neuron, 333, 339, 354
    organic, 335
    reserve, 334, 354, 369
    restitution of, 336
    static, 334, 335

  Epictetus, 320

  Eugenics, 276, 285


  Fear, attacks, 226
    instincts, 23, 24, 26, 42, 48, 55, 128, 164, 325, 354, 364
    stages of, 27

  Fear suggestion, 324
    symptoms and description, 57, 60
    types of, 351

  Frazer, 297

  Functional psychosis, 42, 43


  Galton, 74, 146, 310


  Hall, Stanley, 70

  Haller, 46

  Hallucination, 250, 254, 255
    hypnotic, 256
    pseudo, 224

  Health, 130

  Hegel, 320

  Heredity, 271, 278, 353

  Hypnagogic state, 92

  Hypnapagogic state, 92

  Hypnoidal state, 66, 91, 93, 95, 98, 101, 102, 106, 109, 113, 176,
        264, 328

  Hypnoidization, 101, 102, 109, 110

  Hypnosis, 93, 96
    nature of, 95, 96


  Individuality, struggle for, 21


  James, William, 34, 320, 321

  Janet, 355


  Kirchner, 67

  Kraepelin, 50


  Liebault, 306

  Life energy, 332


  Maladies, 164
    neurotic, 164
    psychopathic, 58, 368

  Meltzer, 334

  Metaphysics, 312

  Mitchell, T. W., 103, 106, 107

  Minot, 334

  Mosso, 46, 277, 326, 345

  Münsterberg, 305

  Mysticism, 75, 76, 139, 312, 319


  Nerve cell organization, 77
    inferior, 77
    superior, 77

  Neuropathies, 62, 63, 65

  Neurosis, 42, 44, 60, 171, 178, 271, 276, 285
    forms of, 61

  Neurotic patients, 118, 130, 160

  Neurotic states, 136


  Organopathies, 61, 63, 65


  Parasitism, neurotic, 131

  Pascal, 274

  Percept, nature of, 251

  Perez, 33

  Personality, 86, 89

  Pfleiderer, 317

  Plato, 320

  Pollock, 352

  Prayer, 312, 319, 329

  Preyer, 33

  Principle of contrast, 139
    of differentiation, 143
    of diminishing resistance, 143
       dissociation, 142
       dominance, 144
       dynamogenesis, 144
       embryonic psychogenesis, 137
       fusion or synthesis, 138
       inhibition, 144
       irradiation or diffusion, 142
       mental contest and discord, 145
       modification, 148
       proliferation and complication, 138
       recession, 140
       recurrence, 137

  Psychoanalysis, 7, 9, 192, 330

  Psychognosis, 120

  Psycholepsy, 216

  Psychopathic affections, 65, 115, 121, 130, 161, 284, 356

  Psychosis, functional, 41, 44, 277


  Ribakov, 171

  Ribot, 33, 75, 340, 341

  Romanes, 40

  Routine, 121, 358

  Royce, J., 320


  Schopenhauer, 320

  Self-preservation, 19, 23, 26, 128, 147, 164, 182, 311, 325, 368

  Self, subwaking, 86, 89, 90

  Seneca, 320

  Sensory elements, 251
    primary, 251
    secondary, 251

  Sex, instinct, 132

  Sherrington, 52, 70

  Sleep, 66, 95, 96, 110

  Somatopsychosis, 64

  Stammering, 234, 242

  States
    hypnagogic, 92
    hypnapagogic, 92
    recurrent, 223, 360
    sleeping, 337
    waking, 336

  Struggle for individuality, 21

  Subconscious, the, 77

  Suggestibility, 79, 80, 85
    abnormal, 81
    laws of, 81, 82
    normal, 81

  Suggestion, 79
    post-hypnotic, 259, 260

  Sully, 41

  Superstition, 38, 264, 305

  Synæsthesia, 252, 254


  Taboos, 281, 308, 311
    apparition, 259

  Trance states, 79


  Weir-Mitchell, 160
    rest treatment of, 165

  Writing, automatic, 258, 260, 262




  TRANSCRIBER’S NOTE

  Obvious typographical errors and punctuation errors have been
  corrected after careful comparison with other occurrences within
  the text and consultation of external sources.

  Except for those changes noted below, all misspellings in the text,
  and inconsistent or archaic usage, have been retained.

  Pg 41: ‘In certain types of funtional psychosis’ replaced by
         ‘In certain types of functional psychosis’.
  Pg 102: ‘Relaxtion of nervous’ replaced by ‘Relaxation of nervous’.
  Pg 113: ‘to the crystillization’ replaced by ‘to the crystallization’.
  Pg 123: ‘Phychoanalysis and Christian’ replaced by ‘Psychoanalysis
           and Christian’.
  Pg 157: ‘patient was aways’ replaced by ‘patient was always’.
  Pg 166: ‘later life developd’ replaced by ‘later life developed’.
  Pg 187: ‘who reasurred me’ replaced by ‘who reassured me’.
  Pg 265: ‘process of matabolism’ replaced by ‘process of metabolism’.
  Pg 281: ‘_the reductio ad absurdum_’ replaced by
          ‘the _reductio ad absurdum_’.
  Pg 336: ‘Diagram IV’ was sideways, and has been rotated 90°.
  Pg 351: ‘are in abeyanace’ replaced by ‘are in abeyance’.
  Pg 375: ‘stores of subconscous’ replaced by ‘stores of subconscious’.

  Index:
  ‘Münsterburg’ replaced by ‘Münsterberg’.