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diff --git a/1226.txt b/1226.txt new file mode 100644 index 0000000..0837f49 --- /dev/null +++ b/1226.txt @@ -0,0 +1,15999 @@ +The Project Gutenberg Etext of The Journal of Abnormal Psychology + +Copyright laws are changing all over the world, be sure to check +the copyright laws for your country before posting these files!! + +Please take a look at the important information in this header. +We encourage you to keep this file on your own disk, keeping an +electronic path open for the next readers. Do not remove this. + + +**Welcome To The World of Free Plain Vanilla Electronic Texts** + +**Etexts Readable By Both Humans and By Computers, Since 1971** + +*These Etexts Prepared By Hundreds of Volunteers and Donations* + +Information on contacting Project Gutenberg to get Etexts, and +further information is included below. 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If you + don't derive profits, no royalty is due. Royalties are + payable to "Project Gutenberg Association/Carnegie-Mellon + University" within the 60 days following each + date you prepare (or were legally required to prepare) + your annual (or equivalent periodic) tax return. + +WHAT IF YOU *WANT* TO SEND MONEY EVEN IF YOU DON'T HAVE TO? +The Project gratefully accepts contributions in money, time, +scanning machines, OCR software, public domain etexts, royalty +free copyright licenses, and every other sort of contribution +you can think of. Money should be paid to "Project Gutenberg +Association / Carnegie-Mellon University". + +*END*THE SMALL PRINT! FOR PUBLIC DOMAIN ETEXTS*Ver.04.29.93*END* + + + + + +Scanned by Charles Keller with OmniPage Professional OCR software + + + + + +The Journal of Abnormal Psychology + + + + + +EDITOR +MORTON PRINCE, M.D.. LL.D. +Tufts College Medical School + +ASSISTANT EDITOR FOR BRITISH ISLES +ERNEST JONES, M.D., M.R.C.P. +London + +ASSOCIATE EDITORS + +HUGO MUNSTERBERG, M.D., PH.D. +Harvard University + +JAMES J. PUTNAM, M.D. +Harvard Medical School + +AUGUST HOCH, M.D. +New York State Hospitals + +BORIS SIDIS, M.A., PH.D., M.D. +Brookline + +CHARLES L. DANA, M.D. +Cornell University Medical School + +ADOLPH MEYER, M.D. +Johns Hopkins University + +WILLIAM McDOUGALL, M.B. +Oxford University + +VOLUME X + +1915-1916 + +RICHARD G. BADGER +THE GORHAM PRESS + +BOSTON + +Reprinted with the permission of The American Psychological +Association, Inc +JOHNSON REPRINT CORPORATION KRAUS REPRINT CORPORATION + + + +Volumes 1-15 of this title were published as +The Journal of Abnormal Psychology. + +Volumes 16-19 of this title were published as +The Journal of Abnormal Psychology and Social Psychology. + +first reprinting, 1964 + +Printed in the United States of America + + + +ORIGINAL ARTICLES--VOLUME X + + +Hysteria as a Weapon in Marital Conflicts. By. A. Myerson, M. D. +The Analysis of a Nightmare. By Raymond Bellamy +Analysis of a Single Dream as a Means of Unearthing the +Genesis of Psychopathic Affections. By Meyer Solomon, M. D. +An Act of Everyday Life Treated as a Pretended Dream and Interpreted by +Psychoanalysis. By Raymond Bellamy +Freud and His School (Concluded). By A. W. Van Rentergham, M. D. +Anger as a primary Emotion, and the Application of Freudian Mechanism to its +Phenomena. By G. Stanley Hall +The Necessity of Metaphysics. By James J. Putnam, M. D. +Aspects of Dream Life. The Contribution of a Woman Remarks Upon Dr. Coriat's +Paper, "Stammering as a Psychoneurosis." By Meyer Solomon, M. D. +Constructive Delusions. By John T. MacCurdy, M. D., and Walter L. Treadway, +M. D. +Socrates in the Light of Modern Psychopathology. By Morris J. Karpas, M. D. +Psychoneuroses Among Primitive Tribes. By Isador H. Coriat, M. D. +Two Interesting Cases of Illusion of Perception. By George F. Arps, M. D. +A Psychological Analysis of Stuttering. By Walter B. Swift, M. D. +The Origin of Supernatural Explanations. By Tom A. Williams, M. D. +Data Concerning Delusions of Personality. By E. E. Southard, M. D. +Sixth Annual Meeting of the American Psychopathological Association. +Discussion. +The Sex Worship and Symbolism of Primitive Races. By Sanger Brown II., M. D. +The Psychoanalytic Treatment of Hystero-Epilepsy. By L. E. Emerson, Ph. D. +On the Genesis and Meaning of Tics. By Meyer Solomon, M. D. +Scientific Method in the Interpretation of Dreams. By Lydiard Horton +A Case of Possession. By Donald Fraser +Sex Worship and Symbolism of Primitive Races (Concluded) by Sanger Brown +II., M. D. + + + +INDEX TO SUBJECTS + +(Figures with asterisks indicate original articles. Figures +without asterisks indicate abstracts, reviews, society reports, +correspondence and discussions. The names of the authors ar +given in parenthesis). + +American Psychopathological Association, Sixth Annual Meeting +Anger (Hall)* +Backward Child (Morgan) +Brain, Study of (Fiske) +Character (Shand) +Christianity, (Hannay) +Continuity (Lodge) +Criminal Types (Wetzel & Wilmanns) +Daily Life, Psychology of (Seashore) +Delinquent, (Healy) +Delusions, Constructive (MacCurdy and Treadway)* +Development and Purpose (Hobhouse) +Dream Analysis (Solomon)* +Dream Life (Anon)* +Dreams, Interpretation of (Horton)* +Dreams, Meaning of (Coriat)* +Everyday life, Psycho Analysis of (Bellamy)* +Feeble Mindedness (Goddard) +Freud and his School (Van Renterghem)* +Human Motives (Putnam) +Hysteria as a Weapon (Meyerson)* +Hystero-Epilepsy, Psychoanalytic Treatment of (Emerson)* +Laughter (Bergson) +Mental Disorders (Harrington) +Metaphysics, Necessity of (Putnam)* +Nightmare, Analysis of (Bellamy)* +Perception, Illusions of (Arps)* +Personality, Delusions of (Southard)* +Phipps Psychiatric clinic +Possession (Fraser) +Post-traumatic Nervous and Mental Disorders (Benon) +Primitive Races, Sex Worship and Symbolism in (Brown)* +Primitive Tribes, Psychoneuroses among (Coriat)* +Psychical, Adventurings in (Bruce) +Psychobiology, (Dunlap) +Psychology, Educational (Thorndike) +Psychology, General and Applied (Munsterberg) +Psychoneuroses, Treatment of * +Sexual Tendencies in Monkeys, etc (Hamilton) +Sleep and Sleeplessness (Bruce) +Social Psychology (McDougall) + + + +INDEX TO SUBJECTS +Socrates, Psychopathology of (Karpas)* +Stammering, Remarks upon Dr. Coriat's paper (Solomon)* +Stuttering, Experimental Study of (Fletcher) +Stuttering, Psychological Analysis of (Swift)* +Supernatural Explanations (Williams)* +Tics (Solomon)* + + + +CONTRIBUTORS TO VOLUME X +Anon. +Arps, George F. +Bellamy, Raymond +Brown, Sanger +Carrington, H. +Castle, W. E. +Clark, L. Pierce +Coriat, Isador H. +Dearborn, George V. N. +Elliott, R. M. +Emerson, L. E. +Fraser, Donald +Hall, G. Stanley +Harrington, Milton A. +Horton, Lydiard. +Holt, E. B. +Jones, Ernest +Karpas, Morns J. +MacCurdy, John T. +Myerson, A. +Putnam, James J. +Solomon, Meyer +Southard, E. E. +Swift, Walter B. +Taylor, E. W. +Treadway, Walter L. +Troland, Leonard T. +Van Renterghem, A. W. +Van Renterghem, A. W. +Williams, Tom A. + + + +THE JOURNAL OF ABNORMAL PSYCHOLOGY + +HYSTERIA AS A WEAPON IN MARITAL CONFLICTS + +BY A. MYERSON, M.D. + +Clinical Director and Pathologist, Taunton State Hospital Taunton State +Hospital Papers, 1914-5 + +THE progress in our understanding of hysteria has come largely through the +elaboration of the so-called mechanisms by which the symptoms arise. These +mechanisms have been declared to reside or to have their origin in the +subconsciousness or coconsciousness. The mechanisms range all the way from +the conception of Janet that the personality is disintegrated owing to +lowering of the psychical tension to that of Freud, who conceives all +hysterical symptoms as a result of dissociation arising through conflicts +between repressed sexual desires and experiences and the various censors +organized by the social life. Without in any way intending to set up any +other general mechanism or to enter into the controversy raging concerning +the Freudian mechanism, which at present is the storm center, the writer +reports a case in which the origin of the symptoms can be traced to a more +simple and fairly familiar mechanism, one which, in its essence, is merely +an intensification of a normal reaction of many women to marital +difficulties. In other words, women frequently resort to measures which +bring about an acute discomfort upon the part of their mate, through his +pity, compassion and self-accusation. They resort to tears as their +proverbial weapon for gaining their point. In this case the hysterical +symptoms seem to have been the substitute for tears in a domestic battle. + +Case History--Patient is a woman, aged thirty-eight, of American birth and +ancestry. Family history is negative so far as mental disease is concerned, +but there seems to have been a decadence of stock as manifested in the +steady dropping of her family in the social scale. She is one of two +children, there being a brother, who, from all accounts, is a fairly +industrious, but poverty-stricken farmer. Her early childhood was spent in +a small village in Massachusetts. She received but little education, +largely because she had no desire to study and no aptitude for learning, +although she is by no means feeble-minded. The menstrual periods started at +fourteen, and have been without any noteworthy accompanying phenomena ever +since. History is negative so far as other diseases are concerned. She +worked as a domestic and in factories until she was married for the first +time at the age of twenty. She had no children by this marriage. It is +stated on good authority that she took preventive measures against +conception and if pregnant induced abortion by drugs and mechanical +measures. At the end of eight years there was a divorce. Just which one of +the partners was at fault is impossible to state, but that there was more +than mere incompatibility is evident by the reticence of all concerned. +Shortly afterward, she married her present husband with whom she has lived +for about nine years. He is a steady drinker, but is a good workman, has +never been discharged, and, apparently, his drinking habits do not interfere +with the main tenor of his life. He lives with the patient in a small house +of which they occupy two garret rooms, meagerly furnished, though without +evidence of dire poverty. + +From her fifteenth year the patient has been subject to fainting spells. By +all accounts they come on usually after quarrels, disagreements or +disappointments. They are not accompanied by blanching, by clonic or tonic +movements of any kind, they last for uncertain periods ranging from five +minutes to an hour or more, and consciousness does not seem to be totally +lost. In addition she has vomiting spells, these likewise occurring when +balked in her desires. She is subject to headaches, usually on one half of +the head, but frequently frontal. There is no regular period of occurrence +of these headaches except that there is also some relation to quarrels, etc. +On several occasions the patient has lost her voice for short periods +ranging from a few minutes to several hours following particularly stormy +domestic scenes. + +On July 29 of this year she was suddenly paralyzed. That is to say, she was +unable to move the right arm, the right leg, the right side of the face, and +she lost the power of speech entirely; there was complete aphonia. This +"stroke" was not accompanied by unconsciousness, but was preceded by severe +headache and much nausea. During the three weeks that followed she remained +in bed, recovering only the function of the arm. Her husband fed her by +forcing open her mouth with a spoon. She did not lose control of the +sphincters. As she manifested no other progress to recovery despite the +administration of drugs, numerous-rubbings and liniments, the physician in +charge called the writer into consultation. + +Physical Examination Aug. 20--A well-developed, fairly well nourished woman, +appearing to be about thirty-five years of age. Face wears an anxious +expression and she shuns the examiner's direct gaze. Movements of the right +hand and arm are now fairly free. There is no appreciable difficulty in any +of its functions according to tests made for ataxia, strength, recognition +of form, finer movements, etc., in fact, she uses this hand to write with, +as she cannot talk at all. Such writing is free, unaccompanied by errors in +spelling, there is no elision of syllables and no difficulty in finding the +words desired. The face is symmetrical on the two sides. There is no +evidence of paralysis of the facial muscles. In fact, the cranial nerves, by +detailed examination, are intact, except in so far as respiration and speech +are concerned. The right leg is held entirely spastic, the muscles on both +sides of the joints, that is, flexors and extensors, being equally +contracted. It is impossible to bend this leg at any joint except by the use +of very great force. The reflexes everywhere are lively but are equal on +the two sides, and none of the abnormal reflexes is present, including in +this term Babinski, Gordon and Oppenheim. + +Sensation--There is very markedly diminished reaction to pin prick all over +the right side, including face, arm, chest, leg and tongue. In some places +complete analgesia obtains. Reaction to touch is likewise diminished and +recognition of heat and cold is impaired. + +Speech--There is complete loss of the ability to make any sound, either +voiced or whispered; that is to say, there is complete aphonia,-- there is +loss of all voice. The patient understands everything, however, and writes +her answers to questions rapidly and correctly. She can read whatever is +written, there is no difficulty in the recognition of objects, no evidence +of any aphasia whatever. + +The diagnosis--hysteria--can hardly be doubted. The history of headaches, +fainting spells without marked impairment of consciousness, vomiting spells, +hemianaesthesia, hemianalgesia, complete aphonia and an exaggerated +paralysis, not only of the right leg, but of the ability to thrust out the +tongue, while at the same time all other cranial functions were unimpaired +together with the apparent health of the individual in every other respect, +make up a syndrome hardly to pass unrecognized. + +Treatment--The patient was entirely inaccessible to direct suggestion, for +no amount of assurance that her leg was all right enabled her to move it. +When such suggestions were made, she shook her head firmly and conclusively, +and this is true of suggestions concerning speech. This point is of +importance in the consideration of the mechanism. Attempts at hypnotism +failed ingloriously. Psychoanalysis was deferred for the time, and recourse +was had to indirect suggestion and re-education. + +The first function to be restored was the power of bending the leg which +hitherto had been held entirely spastic. The patient was assured that while +she had lost the power of using the limb, a little relaxation of the muscles +of the front of the leg would permit it to be bent. Her attention was +distracted while at the same time a firm, steady pressure was put upon the +leg above and below the knee joint and advantage taken of every change in +the tone of the muscles involved in keeping the leg extended. Little by +little the leg was bent until finally it was completely flexed, this for the +first time in three weeks. Her attention was called to this fact and she was +assured that upon the physician's next attempt to bend her leg, resistance +would be lessened and she would be able to aid somewhat as well. This +proved true. Then the leg was only partly supported by the physician while +the patient was assured that with his help she would be able to bend it more +freely. From this, she passed on to the ability to move the leg without any +assistance on the part of the writer. After having been given exercise in +bending the leg for some twenty or thirty times, with complete restoration +of this ability, she was induced to get out of bed, and while standing erect +she was suddenly released by the physician. She swayed to and fro in a +rather perilous manner but did not fall. Finally, by gradation of tasks set, +by a judicious combination of encouragement and command, she was enabled to +walk. She was then put to bed and assured that upon the physician's next +visit she would be taught to walk freely. Meanwhile, the husband was +instructed that he must not allow her to stay in bed more than an hour at a +time and that she must come to the table for her meals. + +On the physician's next visit, two days later, it was found that the husband +had not been able to induce his wife to come to the table, and that he had +been unable to get her to walk. The physician then commanded her to get out +of bed, which she did with great effort. She was then put back to bed and +instructed to get up more freely and without such effort, demonstration +being a visual one, in that she was shown how best to accomplish the task +set. Finally, at the end of the visit, she was walking quite freely and +promised in writing, for she had not as yet learned to talk, that she would +eat at the table. + +The next day instruction was commenced along the lines of speech. Upon being +asked to thrust out her tongue, that organ was protruded only a short +distance, and she claimed, in writing, to be unable to protrude it further. +Thereupon it was taken hold of by a towel and alternately withdrawn from and +replaced into the mouth. After a short period of such exercise she was +enabled to thrust the tongue in and out. She was then instructed to breathe +more freely; that is to say, to take short inspirations and to make long +expirations, this in preparation for speech. She was unable to do this, the +expiration being short, jerky and interrupted. Thereupon the examiner placed +his two hands, one on each side of her chest, instructed her to inspire, and +when she was instructed to expire forced his hands against her ribs in order +to complete the expiratory act. After about fifteen or twenty minutes of +this combination of instruction and help the patient was able to breathe by +herself and freely. She was then instructed to make the sound "e" at the end +of expiration. This she was unable to do at first, but upon persistence and +passive placing of her mouth in the proper position for the sound, she was +able to whisper "e." From this she rapidly went on to the other vowel +sounds. Then the aspirate "h" was added, later the explosives, "p," etc., +until at the end of about two hours she was enabled to whisper anything +desired. Her husband was instructed not to allow her to use her pencil any +more, and she promised faithfully to enter into whispered conversation with +him, although it was evident that she promised this with reluctance. + +Upon the next visit, two days later, she was still whispering, and when +asked if she could talk aloud, shook her head and whispered "No," that she +was sure she could not. Efforts to have her make the sound "a," or any of +the vowels in a voiced manner failed completely. She was then instructed to +cough. Although it is evident that a cough is a voiced sound, she was able +to do this, in a very low and indistinct manner. She was then instructed to +add the sound "e" at the end of her cough. This she did, but with +difficulty. Finally, after much the same manoeuvering which has been +indicated in the account of how she was instructed to whisper, she talked +freely and well. When this was accomplished the husband was instructed to +have her dress herself and to take her to: some place of amusement, and to +keep her out of doors almost continuously. + +At all times the patient had complained of a pain in her side which she +claimed was the root of all her trouble. It had been "doctored," to use her +term, by all the physicians in the city and, it was alleged, came after she +had been lifting a paralyzed old lady in the house across the way. Despite +all treatment this pain had not disappeared and the various diagnoses +made--strain, liver trouble, nervous ache had not sufficed to console the +patient or to relieve her. There was no local tenderness, no pain upon +movement, but merely a steady ache. No physical basis whatever for this +trouble could be found. Her medicine for the relief of it was discontinued, +and so, too, were certain medicines she had been obtaining for sleep. + +Upon each visit the husband and wife had been informed by the physician that +he did not believe the trouble was organic in its nature, that he believed +it depended upon some ideas that the patient had, and that, furthermore, it +was the result of some mental irritation, compared for the purpose of fixing +the point to a festering sore and which, if removed, would permanently +eliminate the liability of such seizures. The patient and her husband were +informed that the physician intended to delve to the bottom of this trouble +and, by deferring investigation as to its exact nature until the symptoms +had practically disappeared, a way was cleared to obtain their complete +confidence, and at the same time to overcome any unwillingness to accept a +psychical explanation for such palpable physical ills. This latter point is +of importance in dealing with uneducated persons. For the most part, they +are intensely practical and materialistic, and a mere idea does not seem to +them to account for paralysis although, of course, such skepticism is +usually accompanied by superstitious credulity along other lines. Moreover, +by establishing himself as a sort of miracle worker (for so the cure was +regarded), it would be understood that curiosity was not the basis for the +investigation into the domestic life of the patient and her husband, but +that a desire to do more good inspired it. + +The physician started his investigation with the statement that he knew from +past experience that some conflict was going on between husband and wife; +that there was some source of irritation which caused these outbursts of +symptoms on the part of the patient, and that unless they told him what was +behind the matter his help would be limited to the relief of the present +symptoms. It was firmly stated that any denial of such discord would not be +believed, and that only a complete confidence would be helpful. + +The patient, who had been listening to this statement with lowered eyes and +nervously intertwining fingers, then burst out as follows: There WAS trouble +between them and there always would be until it was settled right,--this +with much emphasis and emotional manifestation. So long as he insisted on +living where they did, just so long would she quarrel with him. She did not +like the neighbors, especially the woman downstairs, she did not like the +room, she did not like anything about the place or the neighborhood, hated +the very sight of it and would never cease attempting to move from there. It +came out on further questioning that the woman downstairs, whom the patient +particularly disliked, was a storm center in that the wife was jealous of +her, although she adduced no very good reasons for her attitude. Moreover, +the patient stated that she wished to move to a district where she had +friends, though other sources of information showed that these friends were +of a rather unsavory character. Her husband was absolutely determined not to +move from his house. He stated that he would rather have her go away and +stay away than move from there; that the rent was too high in the place +where she wanted to move, and that the rent was suitable where they were. +Moreover, for his part, he hated his wife's desired neighborhood and would +never consent to changing his residence from the present place to the other. +It came out that her fainting and vomiting spells and headaches usually +followed bitter quarrels, and on other matters these symptoms usually placed +the victory on her side. On this particular point, however, her husband had +remained obdurate. It was shown that the present attack of paralysis and +aphonia, symptoms of an unusually severe character, followed an unusually +bitter quarrel which had lasted for a whole day and into the night of the +attack. + +The question arises at this point, "Why did this attack take the form of a +paralysis?" At first this seemed unaccountable, but later it was found that +the old woman for whom the patient had been caring had a "stroke" with loss +of the power to speak, though no aphonia. The patient had gone to work as a +sort of nurse for the old woman under protest, for she did not wish to do +anything outside of her own light housekeeping, although the added income +was sorely needed since work was slack in her husband's place of employment. +The pain in her side caused her to quit work as nurse, much to her husband's +dissatisfaction until she convinced him that her pain and disability were +marked. It was evident that despite the controversies and quarrels that +prevailed in the household, her husband sincerely loved her, for he stayed +away from his work during the three weeks of her illness to act as her +nurse. Moreover, he spent his earnings quite freely in consulting various +physicians in order to cure her. + +It was shown from what both the patient and her husband said, and from the +whole history of their marital life, that she had used as a weapon, though +not with definite conscious purpose, for the gaining of her point in +whatever quarrel came up, symptoms that are usually called hysterical; that +is to say, vomiting, fainting spells and pains without definite physical +cause. This method usually assured her victory by playing upon her husband's +alarm and concern as well as by causing him intense dissatisfaction. With +the advent of a disagreement which could not be settled her way by her usual +symptoms, there followed, not by any means through her volition or conscious +purpose, more severe symptoms; namely, spastic paralysis and aphonia, which, +in a general way, were suggested by her patient. There seems to have been, +and there undoubtedly was, a sexual element entering into this last quarrel; +namely, that she was jealous of the woman who lived downstairs, though +without any proof of her husband's infidelity. + +Both patient and her husband finally agreed to the physician's statement +that the symptoms were directly referable to the quarrels, although both +claimed that it had never occurred to them before, a fact made evident by +their questions and objections. No psychoanalysis was possible in this case, +for the man and woman belong to that class of people who feel that they are +cured when their symptoms are relieved. It may be argued, without any +possibility of contradiction, that a psychoanalysis would have revealed a +deeper reaching mechanism and that a closer relationship and connection +between the paralysis and other symptoms with the past sexual experiences of +the patient could have been established. This last claim may be doubted, +however, for there is always a gap between the alleged "conversion" of +mental states into physical symptoms, and this gap can in no case be bridged +over even by Freud's own accounts. The conversion always remains as a mere +statement and is a logical connection between the appearance of physical +symptoms and the so-called conflicts; in other words, it is an explanation +and not a FACT. Compared with the complex Freudian mechanism, with its +repressions, compressions, censors, dreams, etc., the conception of +hysterical symptoms as a marital weapon as comparable with the tears of more +normal women seems very simple and probably too simple. In fact, it does not +explain the hysteria, it merely gives a USE for its symptoms, and the writer +is driven back to the statement that the neuropathic person is characterized +by his or her bizarre and prolonged emotional reactions, which, in turn, +brings us back to a defect ab origine. And the Freudians, starting out to +prove that the experiences of the individual ALONE cause hysteria, by +pushing back the TIME of those experiences to INFANCY (and lately to foetal +life), have proved the contrary, that is, the inborn nature of the disease. + + + +THE ANALYSIS OF A NIGHTMARE + +BY RAYMOND BELLAMY + +Professor of Education, Emory and Henry College, Emory, Va. + +A FEW nights ago I experienced a very interesting nightmare, and, +immediately on awakening, I got up and recorded it, analyzing it as fully as +I was able. This is the first nightmare I have had for several years, and I +never was especially addicted to them. Two years ago I made an introductory +study of dreams,[1] and at that time dreamed profusely, but recently I have +been dreaming very rarely, and when I do dream the experiences are not at +all vivid. I use the term "nightmare" in a somewhat popular sense to mean a +painful or frightful dream accompanied by physical disturbances, such as +heart flutter and disturbances of breathing, and followed on awakening by a +certain amount of the painful emotion which was a part of the dream. +Accepting this definition, the experience which I have to relate was a +typical nightmare. A few words of explanation are necessary to give the +proper setting for the experience. At present I am teaching in the summer +school at this place and my wife is visiting her folks; during her absence, +in order to keep from getting too lonesome, I invited one of the young men +in the summer school to come and room with me and keep me company. With this +as an explanation, I shall copy the original account of the dream as nearly +as possible, making a few corrections of the barbarous language I used in +the half-asleep state. + +[1] At Clark University, 1912-1913. + +On the night of August 9, 1914, I went to bed at 11.40 o'clock and was soon +asleep. About 3.40 in the morning, the young man, F. K. S., roused me and I +awoke weak, scared, and with a fluttering heart; he said I had been making a +distressing sort of noise, but he could not distinguish any words. +Immediately, I judged that the dream was caused by my lying on my back, and +in an uncomfortable position. As a rule I do not sleep on my back, but for +some reason I had gone to sleep that way this time. Also, it had been +raining when I went to bed, and I had put the windows down, and the +ventilation was bad. + +The dream, as nearly as it was remembered, was as follows: I was with +somebody in a buggy and we drove down a hill, across a little stream, and up +the other hill, where we arrived at our destination. I seemed to find +trouble in getting a place to hitch, and I had to take the horse out of the +buggy and I think take the harness off. I distinctly remember that in the +dream this was a hardship to me, as it would have been in waking life, for I +am not a good hand with horses, and do not like to work with them. All this +is very hazy to me, and I do not know with whom I was driving, but think it +was a lady, possibly my wife. There were other people at this place and +other horses and buggies. (Could it be called a case of reversion to +childhood, in that there were only horses and buggies and no automobiles?) +There is a break in the dream here, and we were within some kind of a +building where there was a crowd of people. As it seems now, we were around +some kind of a rotunda, but this is very vague. The important part seems to +be that there were two people, a man and a woman, who were talking very +stealthily and earnestly to each other, and they soon drew me into the +conversation. It runs in my head now that the man was my father (who has +been dead for some years), though I am not sure about this, while there is +no recollection of who the woman was. Now it appeared that there was some +woman in the crowd who had some peculiar evil influence over every one and +whom everybody feared. This man and woman were planning to slip off from +this wicked woman and meet me and the one with me on the road, and in some +way, which is not now clear, we were to circumvent this bad woman and break +her power. The man explained and explained to me that we were to meet at +certain springs which were at the side of the road, but it seemed that I +could not get it into my head where they were, and I was afraid I would not +stop at the right place. At last I thought I knew where he meant, and told +him that I would stop there and wait until he came up, but then I happened +to think that he might be ahead of me anyhow, and could stop and wait for +me; then I was sure he would be ahead, for I remembered that I had to +harness and hitch up the horse and his was all ready. And now we seemed to +be getting our horses, and I remarked to him that I was not a bit good hand +at working with horses, and he expressed his sympathy that I had this work +to do. + +Here was a second break in the dream, and I was standing in a hallway, +looking through a window into a room. In this room sat my wife and the evil +woman whom everybody feared. She had learned our play (I was conscious of +this in the dream), and was determined to have her revenge, and prevent us +carrying out our plan. She had hypnotized my wife, and had her scared so +that she was in great mental agony. I heard her saying, "Now you are a big +black cat," or something much like this, at any rate making her think she +was a cat and at the same time leaving her partly conscious of who she was. +This woman looked exactly like a woman who lives in the neighborhood where +my wife is now visiting and of whom she has always been somewhat afraid +because of her sharp tongue and unpleasant ways. Immediately, I was filled +with a great fear for my wife and with a raging anger against the woman. I +broke out into calling her all kinds of names, especially saying, "You +devil, you devil," and trying to get through the window to her. I tore out +the screen, but had a great deal of difficulty in doing so. When I had +finally succeeded in tearing the screen out, I threw it at her head, but she +did not dodge, but sat boldly upright and seemed to defy me. Then I tried +to jump through the window to get to her, but was so weak that I could not +do so; this seems strange since the window was not more than three feet from +the floor. I was making unsuccessful attempts to get through, and was +railing at the woman when S. awoke me. I awoke weak, and for some time +continued to feel frightened, though not enough so to keep me from talking +and writing out the dream. I got up and put up the windows (since the rain +had stopped), and about this time a very fair explanation of parts of the +dream came to me. I immediately told it to S., in order to keep from +forgetting it, and then decided to write it down, which I proceeded to do. + +Parts of the dream seem to analyze very nicely, but there are parts which +seem to resist analysis; I did not try to force the analysis but gave only +the part which came spontaneously. In the first part of the dream I was +driving in a buggy, I crossed a creek and had trouble with unharnessing a +horse. Several times recently, I have mentioned the fact that I never liked +to work with horses, even when on the farm at home. I do not remember of +having mentioned this fact on the day of the dream, but Mr. C. had stopped +in to call on me that evening and had mentioned that he drove in in a buggy. +I had not seen the buggy and had wondered what he did with it, and had not +remembered to ask him. He had also told me that he was going to a place +called Yellow Springs; I knew about where Yellow Springs are, but could not +quite place them and had tried to figure out what direction he would go. +This seemed to come out very clearly in the dream, when I was trying to find +out where these unknown springs by the side of the road were. I had related +during the evening how I recently fell into a creek with my clothes on and +this probably accounted for the creek over which I drove in the dream. In +the dim second part of the dream, the rotunda seems to have resembled the +chapel of the new college building which is being builded, and about which I +was talking that afternoon. + +The last part of the dream seems to have been the important part, and in it +several of the Freudian mechanisms show up very plainly. Just before going +to bed, I had read an article about Vera Cheberiak, the Russian murderess of +the Mendel Beilis case, and how she is now engaged in suing different people +for slander. The article had described her as coolly and impudently sitting +up in court and seeming to realize her power over her enemies, and it had +also made a point of the great fear in which she is held. I had read another +article about the city of Salem, which has recently burned, and I had +remembered that it was the "witch" town of colonial days where people were +supposed to be turned into black cats. I had read still another article, +descriptive of country life, which described how a man had climbed a tree +after a cat which was eating young robins. I had just a day or two before +received a letter from my wife, which contained the news that she was going +to visit this woman whom she fears, but whom she must visit because of their +social relation As already mentioned, the woman in the dream looked just +like this one, and it will readily be recognized that the dream woman was a +condensation of Vera Cheberiak, a Salem "witch," and the woman whom my wife +fears. The fact that she was hypnotized into thinking she was a cat would +naturally accompany the Salem witch, and the cat in the apple tree, +concerning which I had read, might also have entered the dream. Aside from +these, there is another element which may have been instrumental in causing +my wife to be punished by thinking she was a cat. I once saw a woman who was +suffering from melancholia who thought she was a cat, and her mental +suffering seemed to me to be about the keenest of any that I have ever +observed, this possibly caused the dream-making factor to represent her as +thinking she was a cat. The hall, window and screen are also easy of +explanation. That evening I had examined a window which opens from our +bedroom into a hall, and had wondered whether we would continue to keep it +curtained this year or take the curtains away. When I put down the windows +to keep out the driving rain, I had had trouble with a screen much as I did +in the dream. + +The heart of the dream seems to be in this last scene. That morning (it was +Sunday) I had very unwillingly, and from a sense of duty, gone to a tiresome +and long-drawn-out church service. I had become so fatigued during the +service, and so disagreed with some of the things the preacher said, that I +was conscious of a mild desire to swear and throw something. I had +humorously mentioned this fact after the service, but there was quite an +element of truth in the jest. The dream gave me the chance of my life to +fulfil this desire, and I seized the opportunity by breaking into a stream +of profanity (not very successful profanity, I fear, as I never use it when +awake and therefore was not in good practice) and throwing the screen at the +woman. But was there not a deeper meaning than this in the dream? I think +so decidedly; it seems that it would be a lot of trouble to construct such a +tremendous nightmare just to give me an opportunity to swear and throw +something, because a preacher had been somewhat tiresome. There was +evidently a deeper and more subtle wish which was also fulfilled. That +evening I had walked up the railroad track with a crowd of young people and +where the paths crossed we had all split up and gone different directions. +Two young ladies had gone back to their boarding places across the campus, +and I had suggested to the young fellow with me that we go along with them. +However, he objected, and we walked back down the railroad track. Now, it +had occurred to me that he probably thought I was not within my bounds as a +married man when I wanted to walk back with these young ladies; something of +the same idea had come to me that day when some one had said in a +conversation, "Professor B. is the most satisfied man on the campus whose +wife is away." I had wondered if they thought I did not care for my wife and +vaguely wished I had some way of showing my love for her, and, more than +that, these suggestions had very naturally made me wonder if I really care +for her as much as I should. I could not have asked for a better opportunity +to serve and show my love for my wife than the dream gave me, and at the +same time it assured me of my affection for her. There is still another +element of repression in this and that is that I have for some time been +wanting to forcibly express myself against the unpleasant ways of this lady +whom my wife so fears. In the dream, I very freely and fully followed this +desire. + +This far I can go in the analysis and feel sure of my ground. It will be +noticed that I have not resorted to symbolism, and have made very little +technical use even of the Freudian mechanisms. I could very easily plunge +into symbolism and more elaborate analysis, but should I do so I fear I +would be in the same condition as a bright young scholar who made an +elaborate study of Freudian theories. He expressed himself by saying that it +was a "chaotic inferno." This analysis will seem very unfinished to many of +the well-trained readers of the JOURNAL, and so, in a way, it does to me, +but it may be interesting as the work of a layman rather than a trained +physician. I have not used the word "sexual" in this paper, but the reader +can judge for himself if the impulses would come under this heading, either +in the more narrow use of the term or in the broader meaning which Freud has +given it. For myself, I see no possible objection in employing the word +"sexual" in this connection. + +The uncertain parts of the dream are as interesting in a way as the others. +Why did I not know with whom I was riding, and why were the persons with +whom I talked more certain in their identity? Here, of course, is the place +where it would be easy to find a repression if such existed and--I +believe--if it did not exist. Whether there is such a repression there or +not I do not know, but I see no necessity for considering that there is one +there just because there is a dim place in the dream. In the study which I +made of dreams a year or so ago, I became convinced that there is a +principle of dream-making which has not been noticed. I will throw out a +suggestion here in the hope that some one will study it further, but will +give no elaborate discussion in this paper. Briefly, it is that only those +things appear in a dream which are necessary to express the meaning of the +dream. A few illustrations may make this clear. Every one has noticed the +rarity with which colors and sunshine appear in dreams; I have found, +however, that colors and sunshine always appear if there is any necessity +for their doing so. Some one dreams of a melon and looks to see if it is +ripe; he sees the red color; he dreams of a stream which he thinks is a +sewer and smells it to see if it gives off an odor and finds that it does; +he dreams of pulling his fishing line to see if there is a fish on it and +senses the pull of the fish; I have examples in abundance which go to +indicate that taste, smell, tactual, kinaesthetic, color sensation or any +other kind will appear in a dream when they are called for to complete the +meaning of the dream, but they are not common because they are very rarely +needed. Even in waking life we rarely think in these terms. If this little +principle prove true, it would be easy to understand why certain parts of a +dream are dim without going to the doubtful process of positing a +repression. The persons in the dream were not recognized simply because +there was no need for them to be; the dream expressed the pertinent meaning +just as well without them as with them. They were observed just as many of +us would observe the occupants of a street car in waking life; we could +possibly not describe, even partly, any one of the occupants of the car +which we used on our way to the office or home. + +Before leaving this nightmare, I want to call attention again to the somatic +elements. I was lying on my back and in a cramped position, the air was +closer than usual, and my circulation was naturally deranged. When I awoke I +was strongly inclined to give the physical elements a large amount of the +responsibility for the dream, and I have not found occasion to change my +mind in this matter. I think that even the inability to jump through the +window in the dream was caused by the weak and exhausted state of my body, +due to the poor circulation and cramped position. + + + +ANALYSIS OF A SINGLE DREAM AS A MEANS OF UNEARTHING THE GENESIS OF +PSYCHOPATHIC AFFECTIONS + +BY MEYER SOLOMON, MD., CHICAGO + +THOSE; of us who have devoted a certain amount of our time and energy to the +study of dreams have early come to realize the value of a dream as a +starting-point in the analysis of certain mental states, particularly those +of an abnormal character. + +Frequently, in the hopeless tangle of symptoms, complaints and disconnected +facts in the history as originally obtained, especially in old-standing +cases, one does not really know just where to begin, what to start with in +the first efforts to struggle with the problem of the ultimate genesis and +evolution of the condition which is presented to him at the particular +moment. Of course, by a careful review of the patient's past life history, +gone over by persistent questioning and cross-examination, one can begin +with the family history and step by step trace the history of the patient +from earliest childhood or infancy through the various stages and phases of +activity and development up to the very moment of examination. This may at +times appear quite dull, quite uninteresting and entirely unnecessary to +certain patients. For this reason and also for many other reasons, which I +shall not enumerate at this point it is at times well to resort to dream +analysis. And in analyzing dreams it is well to remember a fact, with which +I believe all psychoanalysts will agree, namely, that by a most thorough and +far-reaching analysis of a SINGLE DREAM, we can, by following out to the +ultimate ends the various clues which are given us and the various by-paths +which offer themselves to us in the course of the analysis--we can, I +repeat, should we be so inclined, root up the entire life history of the +dreamer. This may not be necessary in all cases. But, at any rate, if we +desired so to do for scientific purposes, we could arrive at such results. +In such an analysis we would, of course, first take up, individually, every +portion and every element of every portion of the dream, and by means of +each such lesser or greater element of the dream, we could arrive at a mass +of material, a wealth of information concerning the past experiential, +emotional, mental and moral life of the individual whose dream we were at +the moment analyzing. In fact, one could ferret out the full life history in +great detail, thus obtaining a complete autobiography leading far down into +the depths of the dreamer's mental life and into the inner world of his own. +With the material so obtained one could truly reconstruct the complete life +history, piecemeal, until the wonderful and inspiring structure of the +mental world of the dreamer would be reared, reaching far back to early +childhood and perhaps even to infancy, extending so far forward as to give +us a prophecy, based on the dreamer's dynamic trends and emotional trends +and leanings, of the probable future, stretching forth its tentacles in all +directions, and, uncovering the psychic underworld in its every part, +holding up before our eyes the naked mind, in its length, its breadth and +its thickness. + +I am not referring here particularly to the employment of the method of +hypnosis, especially as practiced by Prince, or to Freud's so-called free +association (which is frequently really forced association) or Jung's word +association methods. I am speaking only of analysis of the dream by ordinary +conversation and introspection, in the normal waking state. Of course, were +the latter method supplemented by these other methods, the results would be +so much the more complete and far-reaching. I may mention, specifically, +that the employment of Freud's free association method would be helpful here +in gathering information because, when employing this method, one +practically forces the one being analyzed to think by analogy and by +comparison, insisting that he tell you what a certain word or name or scene +or experience or what not reminds him of, what it resembles, what he can +compare it to, no matter how remote its connection, no matter how unrelated, +how far-fetched or how silly the association may appear in his own eyes--in +other words, we demand that he co-operate by suspending critical selection +and judgment. Although, as I say, Freud's, Jung's, Prince's and other +methods may be advantageously employed, still, it seems to me, although I +cannot yet state this in final or positive terms, that, at least in most +cases, such an unravelment and resurrection of the past life history can be +obtained by an analysis of the dream conducted in the ordinary, waking +state, and the usual conversational mode of history-taking and daily oral +intercourse. + +It needs no repetition or elaboration to convince psychoanalysts (I use the +term "psychoanalyst" in the broad, unrestricted sense of the word, including +the supporters of all possible schools or standpoints or methods in +psychoanalysis or mental analysis, and not limiting it to Freud's +psychoanalysis) of the essential and fundamental truth of this statement. I +shall, therefore, not unnecessarily lengthen this paper by endeavoring to +bring forth complete evidence of the truth of this assertion. + +As a matter of fact, this conclusion or generalization applies not alone to +dreams but to any single element in the objective or subjective world which +may be seized upon as the initial stimulus and from which, as a +starting-point, association of ideas, in ordinary conversation or aided by +any of the more or less experimental or artificial but valuable methods +heretofore mentioned, may be begun and continued ad libitum or even ad +infinitum, under the tactful guidance and judgment of the investigator. For +example, if I may be permitted to tread upon the dangerous path of +near-sensationalism or extremism, I may mention that were I to take even so +common, so widely used, and so relatively insignificant a word as the +definite article "the" as the initial stimulus, and have one of my fellowmen +or fellow-women (whose full co-operation, it is assumed, I have previously +obtained) give me one or more free or random word associations, and +thereafter, with these newly acquired elements, continued to forge my way +into the thickly wooded and unexplored recesses of the unknown and +mysterious forest of the mind, I doubt not but that I should achieve the +same results as if I had started upon my journey with a dream. If this be +true, and I firmly believe that it is, in the case of that universally used +and apparently inconsequential word "the," to which the normal person can be +expected to have such a large number of associations, of varying degrees of +intimacy or remoteness, how much truer is it when we have such a definite +mental fact or mental state as a dream as the starting-point of our hunting +expedition? + +The dream gives us something tangible to start with, something near at home +to the dreamer or patient, something interesting and amusing to him, +something baffling and so frequently unintelligible to him, and, as a +consequence, a more conscientious, earnest and wholehearted co-operation can +be obtained from the person whose mental life is being investigated. Here is +something vivid to him, something of personal interest to him. And so we can +look to him to lend us his aid in better spirit and in fuller measure than +might otherwise be obtainable. + +I have been referring in my previous remarks, for the most part, to +unravelment of the normal individual's life history. But my remarks are +equally applicable to a mentally disturbed individual's life history and to +the genesis of abnormal psychic states, particularly those to be met with in +the neuroses and psychoneuroses. + +So true is the generalization, indeed the truism or dictum here laid down, +that, in only the psychoanalyst knows how many instances, by the analysis of +a single, even the very first dream, one can arrive at the rock-bottom depth +of the trouble at hand--yes, at the very genesis of the condition. It is not +my intention in this paper to report such cases in full detail, since the +presentation of even a single such case would be too lengthy for publication +in an ordinary medical or other journal, and in many instances might well go +to make a good-sized book, a real autobiography of more or less interest, if +not to the average reader, at least to the psychoanalyst and to the person +who has undergone the psychoanalysis. Without attempting to present an +elaborate history or complete analysis, but rather merely to call attention +to the truth of the general problem which is being discussed in this paper, +I shall, however, mention a few definite illustrations of this sort. + +A man of sixty was brought to my dispensary clinic by his wife (I say +"brought" and not "accompanied" by his wife, advisedly). She accompanied him +into my examining room. He had an almost complete aphonia, spoke hoarsely +and in a whisper and presented all the signs of abductor laryngeal +paralysis; added to which there was a partial hemiplegia of the right side +involving the upper and lower extremities, but not the face or any of the +cranial nerves other than that supplying the right laryngeal abductor. I +shall not give any other points in the history except that this paralysis +was of four months' duration, there was some resistance to movements at the +elbow and knee, but Babinski and other indications of a central organic +lesion were absent. The results of the rest of the physical examination need +not be mentioned except that the patient presented evidences of +arteriosclerosis. The patient was of dull mentality, meek humble and +subservient; he was much below par mentally (I did not put him through any +special intelligence tests), had little information to offer, constantly +resorted to "I don't know" as a reply, and could co-operate but little. I +did, however, obtain the important bit of information that seventeen years +ago he had had an almost complete aphonia of several weeks' duration and +that one day, while on board ship, he became seasick, vomited, became +frightened, went to his room, and suddenly his voice returned to him. So +sudden was the transformation that many of his fellow-passengers insisted +that he had been deceiving them and had purposely simulated the condition he +had previously presented. The case was one of hysteria, the patient +presenting at the time of my examination signs of abductor laryngeal +paralysis (laryngological examination disclosed a right-sided abductor +palsy) and right-sided partial hemiplegia. + +For the next two visits the wife accompanied, or rather, brought the patient +to the clinic and I could get but little information and consequently +progressed but little. I asked him, in her presence, to come alone the next +time--which he did. The description of the onset of the attack, which was +furnished me on his previous visits, proved the hysterical nature of the +condition: he had suddenly been attacked by nausea and vomiting, fell to the +floor, lay there, more or less unconscious (as he described it) for five or +ten or more minutes, was assisted to his feet, went to his bed with +practically no assistance, a few hours later found that he could speak +little more than above a whisper, and in another few hours or more his right +side became weak and failed him. He had insisted that the onset came on +suddenly. He had denied any quarrels or trouble at home. Nothing could be +obtained from him as to his thoughts just prior to the attack or as to any +special emotional shocks. + +On his fourth visit I asked him to tell me any dream he had had recently and +which had made an impression upon him. He could give me no aid. Nothing +came to mind. I asked him if he had dreamed the night before, and he told +me he had had a dream the afternoon of the preceding day, during an +afternoon nap. Here is the dream: He found himself struggling with a +tremendous snake, the upper part of which was in human form, the features +being very hazy and not at all recalled. The snake was vigorously +endeavoring to enwrap itself about him and to strangle him, and he was +desperately and fiercely struggling to defend himself against it and to free +himself from it--and yet he could not fight it off. In desperation and in +fear he cried aloud for help. This was the end of the dream, for, at this +point, members of his family came rushing toward him to inquire what was +wrong with him, and due partly to shock and his own activity in the dream, +and partly perhaps to the noise of the footsteps and of the conversation of +those who came running toward him to inquire into the cause of his +distressful cries, he awoke. + +The thoughts and reveries just preceding the dream and the thoughts and +experiences during the morning preceding the dream, although the true +inciters of the dream, and although concerned with the central figure (his +wife) in this little drama, need not be detailed since the dream has a wider +and more deeply arising significance. + +I could not learn definitely from him whether the series of associated +thoughts turned first from his wife to his troubles with her, to her +attitude toward him, and then to her resemblance in this respect (her +nagging, pestering persistence and actual persecution of him) to a snake +which is endeavoring to enwrap itself about him, to strangle him, to +withdraw from him his very life's blood, etc. This may or may not have been +the line of associations just preceding the dream. + +He had no idea as to what the dream meant. Using free association, in +ordinary face-to-face conversation, I asked him what "snake" reminded him +of. The association came in a moment. He smiled, became embarrassed, said +it was foolish of him to tell me this, but it reminded him of his wife. He +had always looked upon his wife as a snake in human form. He had frequently +called her "snake" because of her conduct toward him. She had wound herself +about his life in snake-like fashion. + +And then came the story of their troubles. This was his second wife. She +was fifteen years his junior. He was meek, feeble, of weak will-power, +without initiative. She was domineering. Although his wife never told him +so openly and in so many words, he felt convinced that the trouble had begun +more or less because his wife's sexual libido was not satisfied in her +sexual relations with him. He admits that she is a passionate woman, her +sexual libido was of such strength that he, much older than she, and not too +strong physically, could but little gratify her. The first complaints and +the sole trouble which appeared on the surface were financial--he barely +made a living and she complained thereat continually, bitterly and +tyrannically. It seems that her complaint in this direction was justified. +It is difficult to determine just what role her lack of sexual gratification +played-- whether it only acted as stirring up the embers of dissatisfaction +(with his weekly earnings) which already existed, or whether it was the +basic factor, led to her dissatisfaction with her matrimonial choice, and +caused her to seek some more or less valid cause for complaint, in that way +permitting her, more or less consciously, to transfer her dissatisfaction +and discontent from the lack of sexual gratification to the hard pressed +financial condition (which perhaps she might, for that matter, have been +willing to endure, did she but obtain the full gratification of her sexual +craving). At any rate, both of these factors played their role in causing +domestic disagreement, one factor being openly acknowledged as the cause by +his wife, the other factor never mentioned by her, but believed by him to be +an important accessory, if not the main, fundamental and primary source of +the trouble. His wife, using his poor earning capacity as a weapon, and with +the demand for "more money" as her battle-cry, carried on a campaign of +complaint, grumbling, nagging, fault-finding, insult and abuse, but little +short of persecution, making conditions wretched and miserable at home. +Things at length became quite unbearable to him--so much so that, feeble in +willpower and lacking in initiative as he was and is, he was compelled to +leave home and live with his aunt, since his wife had practically deserted +him. Although she had sold out the furniture and the rest of the +furnishings of the home, and had pocketed the money thus received, she +repeatedly called at his aunt's home for no other purpose than to force him +to pay her sums of money for her weekly maintenance. On each such visit she +would act the tyrant, would storm and rage furiously, would subject him to +stinging rebukes and deliver biting tongue-lashings, causing him in +consequence to be much upset and nervous the rest of the day. The very +morning on which he had had the attack, which was followed by his present +trouble (partial aphonia and partial hemiplegia) his wife had paid him one +of these unusually stormy and noisy, and, to say the least, unwelcome +visits. She had carried the attack to such a point that our patient became +so emotionally upset (he is a harmless, emotional, kindly, unassuming and +indifferent sort of old fellow) that he suddenly was attacked with nausea +and vomiting, and, frightened, fell to the floor, with the consequences +above detailed. I need not go further into the history and analysis of this +case, but the story thus far elicited is more than sufficient to show that +here we have a specific instance in which, by the analysis of a single +dream, we have arrived at the genesis of an hysterical paralytic syndrome of +four months' duration. The analysis took but a few minutes. It may be +mentioned, in parentheses, that a full knowledge of the cause of the +condition did not lead to a disappearance of the palsy. In other words, as +we all know, knowledge per se does not lead to action or to the assertion or +development of the will-power. I may say, also, that the events here related +were not suppressed or repressed, for, as soon as the question of his wife +was taken up, the patient admitted that it was she who was the real cause of +his present conditions, and he thereupon detailed the story above related. +He assured me that he had always been fully aware that it was she who had +brought about his present condition, although, of course, he did not know +whether he had had an hysterical, apoplectic or other sort of attack. In +fact he believed his condition was permanent and incurable-- especially +since he had been treated at various neurological clinics for many weeks +past without the slightest improvement or progress. + +Were we to follow up this history we could unearth the full life history of +this patient, including the genesis of his early attack of aphonia. But I +deem this unnecessary and inadvisable in this paper, as mentioned +previously. + +Here, then, we have a definite case in which by the analysis of a single and +incidentally the first dream we have arrived at the genesis of the +psychoneurotic disorder. + +From this same standpoint I have studied another case, a married woman of +twenty-nine, with marked neurasthenic and hysterical symptoms (including +astasia-abasia, anesthesias, palpitation of the heart, throbbing sensations +in the stomach and a great many other symptoms). This case I studied for +upwards of four months, with almost daily visits to the hospital where she +was being cared for. I made quite an intensive study of her dream life and +of her past life history, and I find that had I taken the very first dream +which I obtained from her and conducted a thorough analysis with this dream +as my first mile-post, I would have arrived at a full genesis of the +condition, which was of ten years' duration. In this case, also, I must +repeat, there was no indication of repression, the patient having always +understood very well the origin and cause of her condition. Here, too, we +find that the knowledge alone did not lead to her recovery. This case I +shall report in detail at a later date. + +In this connection, I cannot keep from reciting the dream of a young girl of +twelve which I had the good fortune to study. She came to me complaining +about her throat. There was something dry, "a sticking" in her throat. She +did not know what it was. Would I look at her throat? I found nothing +abnormal, and was about to dismiss her when I observed that her hands were +bluish. I felt them. They were cold. I thought at once of probable heart +disease. I was soon informed that she had heart disease. She had been told +so by other doctors. This proved to be the case, as I learned on examining +her. + +Being keenly interested in this subject of dreams, I wondered whether, if +she were subject to periods of cardiac decompensation of varying degree, she +did not have dreams of a terrifying nature (about burglars, robbery and the +like), because of embarrassment of breathing during sleep, resulting from +her cardiac insufficiency and consequent circulatory and respiratory +disturbance. I asked her whether she had been dreaming much of late. She +told me she had had a dream the preceding night. What was it? I inquired. + +She had dreamed that she had died. Her mother had put her in a coffin, +carried her to the cemetery and then proceeded to bury her. Her mother had +first forced something into her mouth (it seemed to be a whitish powder), +and then lowered her into the grave and filled the grave with dirt. That is +all that she could remember. + +I shall not enter into a complete analysis or interpretation of this dream. +There is no doubt, however, to every psychoanalyst who has devoted his +attention to dreams, that the analysis of such a dream should prove most +interesting. It is also apparent that by taking up the various elements of +the dream and following them untiringly along the various trails and +ramifications which lead on in various directions, one could unmask the +entire life history of this twelve-year-old girl. + +I wish, however, to direct the reader's attention to only one aspect of this +dream--the death of the dreamer. She denied that she feared death or that +she thought of death because of her heart disease or from any other cause. I +next inquired: "Do you wish or have you ever wished you were dead?" The +reaction of the girl was immediate and intense. She stood frightened, +embarrassed; her eyelids twitched convulsively in rapid succession, her face +gradually assumed a suppressed crying expression, tears came to her eyes, +they soon flowed freely and rolled down her cheeks; she sobbed, and, through +her tears, she uttered, almost inarticulately, the one word, "Yes." A +convulsive, inspiratory grunt, a bashful, receding, turning away of the head +and body, a raising of the hands to cover her face and hide her tears, and +hasty, running steps to get away, while murmuring audibly "Let me go away," +followed rapidly one upon the other. I gently seized her hand, calmed and +reassured her. And, through sobs and tears, in almost inaudible tones, in +starts and spurts, and reluctantly replying to questions which were forced +upon her, producing replies which were literally drawn from her against her +will, she told me this little story: A little boy cousin of hers, three +years her junior, had begun school two years or so later than she, and yet, +in spite of this handicap, this little relative had outstripped her in +school, he being now in a higher grade than she herself was. She would not +be so much concerned or worried about this not-to-be-proud-of performance, +had not the boy's mother that week visited her home and there, in the +presence of other people, talked considerably about her boy's progress in +school, his rapid advance as compared with that of our little dreamer, her +relative stupidity and backwardness. And so this boy's mother had continued +for some time in the same strain. This caused our little girl to feel much +embarrassed--in fact, ashamed and mortified. She had felt that way for +several days past, it had made her cry, had made her feel miserable and +unhappy; so much so that she had wished she were dead. I shall not continue +this analysis further. But it is plainly seen that here too, by a single +dream, we have come upon life-experiences, viewpoints and mental material +which affords us efficient and sufficient weapons to boldly attack the +fortress of her full life history, her mental qualities, her trends, her +psychic depth, her mental makeup in its entirety, in its every dimension. + +It is interesting to note that on the morning following the experience which +I had with this child, she came to see me a second time, and, on my +examining her throat, it presented the typical picture of bilateral +tonsillitis, the final result of the initial sticking sensation in her +throat, which she had experienced the day before. After taking a culture +from her throat as a matter of routine to exclude a possible diphtheria, the +patient, greatly disturbed because of her newly-discovered trouble, burst +forth into bitter tears, and, still sobbing, rushed abruptly from the room. + +A week later, when I saw her again, she had regained her emotional +equilibrium and we reviewed her dream and its analysis without any special +signs of emotional disturbance. + +Very interesting, also, was my experience about a week following this when, +casually reciting this little girl's dream, its significance and her +conduct, to an old lady whom I know very well, I found that she too was +presenting all the signs of emotional upset, for, as I proceeded with my +recital, tears gradually came to her eyes, her face assumed a suppressed +crying expression, she tried to smile through her tears, and finally, unable +to control her emotions, she broke out into a free and unrestrained weeping +spell, following which I learned from her that the recital of this girl's +condition, her dream and its meaning, recalled to her mind her darling +daughter, a noble girl of sixteen years of age, who had died some fifteen +years ago, after a long period of incapacitation and a miserable existence +brought on by tonsillitis, chorea, rheumatism and, finally, heart disease, +with all the extreme signs and symptoms of broken cardiac and renal +compensation. Here, then, I had touched another complex, which, if followed +up, would lead me into the innermost depths and recesses of this old lady's +soul-life, into the holiest of holies of her mental life. + +The writer will be pardoned for not here giving fuller histories, or for not +carrying out the analyses to their ultimate goals, or for not giving the +interpretations of the two dreams presented. That was not the primary object +of this communication. + +I wish, in conclusion, to repeat that through the conscientious and most +far-reaching analysis of a single dream, or, in fact, of a single element of +a dream or a single element or stimulus in the objective or subjective +world, one may, at least not infrequently, unearth the full life history of +normal or abnormal individuals, and the genesis and evolution of +psychopathic affections. + +The reader may justly inquire why the analyst should resort to dream +analysis instead of taking the history of the case in the usual way. In all +cases the patient should be permitted to tell her story in her own way. +This method of procedure, with cross questioning, may and should indeed be +sufficient to unravel the case for us in most cases. But if we find that we +have not gained the confidence of the patient and have not that condition of +being en rapport with the patient which is essential for progress and +success in the analysis, one may resort to dream analysis, not so much for +the purpose of following the royal road to what the Freudian school calls +"the unconscious," but rather with the object of obtaining the confidence of +the patient and of having something definite to start with. + + + +AN ACT OF EVERYDAY LIFE TREATED AS A PRETENDED DREAM AND INTERPRETED BY +PSYCHOANALYSIS + +BY RAYMOND BELLAMY + +Professor of Education, Emory and Henry College, Emory, Va. + +A RECENT article by Brill, entitled "Artificial Dreams and Lying,"[1] +recalled to me a little work I did two years ago while engaged in making an +introductory study of dreams as a thesis at Clark University. The part +which is hereby submitted is a fragment of a larger work and, being only a +sort of side issue, was never included in the thesis proper. I have made +only such changes as were made necessary by the fact that this is a fragment +and needed one or two minor changes to make it complete. + +[1] Journal Abnormal Psychology, Vol. 9, No. 5. + +Let me say at the beginning that I have the greatest and most profound +respect for Freudian theories as interpreted by G. Stanley Hall and other +men of like scholarly ability, but I have never been able to accept the more +extreme form of Freudianism as interpreted by some of the most prolific +writers in this field. I have found that the charges made by Habermann[2] +are substantially true. I find it very helpful indeed, to try to interpret +my own dreams and to assist some of my students to do so according to the +Freudian formula, and to a certain point I believe these interpretations are +undoubtedly true. The question is to find the point beyond which the +interpretation becomes artificial. Personally, I believe that this will +always have to be decided finally by the individual himself rather than by +some outsider who insists on reading in a certain interpretation. I have +come to believe that it is possible for one to become trained to the point +at which he is able to decide just how far the interpretation goes, or, at +least, to approximate it. + +[2] Journal Abnormal Psychology, Vol. 9, No. 4. + +With these few introductory remarks I shall submit the paper, which was +written in 1912. I have not appended the rather long and cumbersome +bibliography from which I drew these references, but I can supply any +reference that is wanted. + +If we examine the Freudian system, we find that it is impossible to disprove +this theory of dreams. If we demonstrate that a dream has no sexual +connection whatever, they have only to say that it is the censor that +blinds, and, by resorting to symbolism and other such very present helps in +time of trouble, they show plainly that we were mistaken. The situation is +the same as it would be if I declared that what I saw as blue appeared +yellow to the rest of the world. The disproof of this and of Freudianism are +equally impossible. But, on the other hand, have the Freudians presented any +proof or argument on the affirmative side of this question? They are over +fond of saying, "Freud has proven thus and so," but in what did the proof +consist? The great answer to all objections has been to analyze dreams and, +so far as I know, the attempt has never failed to show that the dream in +question conformed to the prescribed requirements. And in truth, it is not +a difficult matter to analyze a dream a la Freud. After a little practice, +especially if one has a vivid imagination and is somewhat suggestible, It is +possible to find the repressed sexual wish in every dream. But if we use +such flexible and wonderful factors as the four mechanisms, and, above all, +symbolism, we can find the same things in any other experience. By this I +mean that if we take a bit out of our daily life, a dream of some one else, +a fictitious story, an historical incident, or any other pictured situation +and PRETEND THAT IT IS ONE OF OUR OWN DREAMS and apply the Freudian +analysis, we find that it serves for this purpose as well as a real dream. +When this is the case, it is absurd to put any faith in the analysis of real +dreams, when carried to extremes. + +As an illustration of the above statement, the following is a fairly typical +example. The supposed "dream" is a commonplace bit out of my daily life. +This is chosen at random (although Jones would say such a thing is +impossible) and subjected to a dream analysis. + +ANALYSIS OF FALSE DREAM + +Dream. I was walking along a street on a cold winter night. I looked down +at the cement walk and in this was set a piece of granite on which the +letters "W. H." were cut. Coming to the corner, I looked up and saw on a +short board which was nailed to a post, the name of the street, "Queen +Street," The street running at right angles to this was King Street, and I +turned and went down this. After walking a short distance, I came to a house +from a window of which a light was shining. The house number was "23." I +took a key from my pocket, unlocked the door and entered. + +Analysis. In attempting to analyze this (so-called) dream, I was amazed to +find with how many past longings and emotionally-colored experiences it was +associated. I first took up the letters on the sidewalk, and as I repeated +them, letting my mind be as blank as possible in order that the associations +might be free, I gained an immediate response. "W. H."--"Which House"--came +out as in answer to a question. With these words there was a definite visual +image of a young country farm youth standing talking to two persons in a +buggy. I remembered the incident in all its details. I was the young man and +these people were asking the way to a certain place, or at WHICH HOUSE they +should stop. As it so happened, I was at that time keeping company with a +young lady who lived at the very house concerning which they asked. I will +not go into detail any further at this point, for this is a real case and I +should be trespassing on personal ground. But any one who yet remembers his +boyhood courtship, with all its agonies and fears, its hopes and joys, its +disappointments and its pleasures, can see at a glance how important this +occasion is in throwing light on the meaning of the dream. Of course "W. H." +stood for "Which House." + +I seemed to get no further in my associations with these letters at this +time, and my thoughts spontaneously turned to the name of the street. +"Queen Street." Even more readily and completely than in the other case, +there came a whole complex of associations. First there was the name and +image of Miss Agnes Queen, whom I had known for years. But, strange to say, +the image was of this young lady standing and talking to a certain Mr. +Harding. I saw them together but once, and it seemed passing strange that +this incident should be the one remembered in connection with the name. But +the associations were rapidly progressing, and I mentally reviewed parts of +three or four years during which I was working and closely associating with +this Mr. Harding. Here I began to see some light. This Mr. Harding was in +all respects, at least as far as I knew him a man of good morals, but he was +much less particular in his social habits than I was. He was engaged to a +young lady all the time I was with him, and wrote letters to her constantly; +but this fact did not prevent him from paying attentions to other young +women, and I was aware that he was more familiar with them than +conventionality would warrant. In fact he made no attempt to be secret in +the matter, and often poked fun at me for my over sensitivity on the +subject. Here was the key to a whole lot of meaning. The first year I was +with him, I had no sweetheart or any lady friend on whom to center my +affection or to whom I could write. There were a number of young men in our +"squad," as it was called, and nearly all of them had correspondents and it +was a joke among us that I was "out in the cold world with no one to love." +In reality, this was not so much a joke for me at the time, as I tried to +give the impression that it was, and I longed for the very thing of which we +joked. The fact that I was out on the street on a cold winter night in this +dream symbolized being "out in the cold world," as we had used the term +then. + +I now took up the letters "W. H." again, and the words "White Horse" came in +response to the stimulus. With little hesitation I placed this as connected +with the Knights of the White Horse of whom Tennyson writes in his poems of +"King Arthur's Knights of the Round Table." I got very little out of this, +but still the White Horse was a band of men who were unrestrained in their +desires and bore about the same relation to King Arthur's Knights that +Harding did to me. However, the associations did not stop here but went on, +giving what at first seemed to be a meaningless list of words. "W. H." first +called up the words, "Wish Harding"; next, "Will Harding"; next, "With +Harding"; and last, "Walk Harding." In a minute it flashed on me what this +all meant. "I WISH to do as Harding is doing, to WALK the way he is WITH +him and I WILL." To walk up Queen Street meant, then, to follow his +example, as he at one time paid some attention to this Miss Agnes Queen. +Perhaps the reason why her name was selected instead of some others was +because his relations to her had been very slight and formal, and thus the +idea was easier for the censor to let into sleeping consciousness than it +would have been if some other names had been taken. "W. H.," then, +symbolized the four expressions that arose in the analysis. + +The meaning of "King Street" came last of anything in the dream, but I will +give it now. I did not seem to be able to get anywhere on this for some +time, and the idea kept presenting itself that it symbolized that I was king +of the situation which seemed innocent enough; but at last there came an +association with Nero as portrayed in "Quo Vadis." I then remembered how I +read this book while in the adolescent stage, and how a cousin made remarks, +very sensuous in their nature, about parts of it. I then got a vision of +the book, "Mad Majesties," which I saw on the library table not long since. +Next came a memory of the French kings as portrayed in the works of Dumas. +At this point, I realized that the idea suggested by the word king is very +often, though not always, an idea or image of a very loose person as far as +his social life is concerned. Thus to walk Queen Street or follow the +example of Harding finds a parallel in walking King Street or following the +example of a king. + +With the light in the window, I came into an entirely new field of +associations. I cannot go far into detail here as it would involve others +as well as myself, but suffice to say that the light in the window called up +a paper on the subject of light which was written by a Mr. X. and read in my +hearing. Now Mr. X. and I had both kept company with the same young lady at +different times, and here was another group of emotionally colored +experiences. However, the important function performed by the light was that +it symbolized (together with the house in which it was) the comforts, warmth +and pleasures of the very opposite condition from that of being "out in the +cold world with no one to love." + +The house number "23" is associated with at least two occasions. One Sunday +evening; a few of the boys of our "squad," myself among them, went out with +the daughter of our landlady, and one or two other young ladies and took a +boat ride in the park. It was a beautiful summer night and the park was full +of young people who were treating each other to very endearing caresses. +There were so many who wanted boats that only one boat was unoccupied, and +it was No. 23. It had been left because it was a hoodoo number, and the +other boaters were all superstitious. As we were not, we took this boat and +used it. My longing lonesomeness was about at its maximum height on this +night. The other occasion associated with this number is that I became +engaged when I was twenty-three years old and at that time desired greatly +to be married; but, as I was in school, it had to be postponed. + +Now the climax of the dream! I took a key from my pocket, unlocked the door +and entered. This is so plain that it hardly needs comment. Being in the +cold world, as symbolized by the cold street, I enter the warmth and comfort +of the lighted house. The key and lock are, of course, phallic symbols and +have special significance for me as I once took a young lady to a banquet at +which the favors were paper keys and hearts. Thus symbolically are fulfilled +all the longings I felt while with Harding, all my desires to be married +when twenty-three, all my adolescent courtship yearnings, and all my +remaining repressed sexual longings. + +As a point which may have a little bearing on this, I have recently received +a letter from Harding and in it was information that he is for a time away +from home, and I wondered if he is still careless in his behavior. + +This analysis will seem foolish in the extreme to many, and I am one of the +number, but my excuse is that I have copied as closely after the Freudians +as possible. I have only to invite a comparison. This is not a "made up" +dream, but a little bit out of my daily life; just an experience occurring +on the way home from the seminary. The analysis is real in the sense that +the associations arose as I have recorded them. + +Perhaps some ardent Freudian might find it in his heart to say that this +analysis only strengthened their position, as it showed how a whole sexual +background underlies our entire life, and therefore our dreams must have a +sexual origin. But the reason why I found a sexual solution of this was that +I started the analysis with a definite Bewnssteinlage, as Titchener would +call it, which consisted of a knowledge that I had started for a certain +kind of solution, and the whole course of the associations was governed by +this. If Freud had at first come into the possession of a theory that every +dream fulfills a fear, or pictures a state of anger or any other emotion, he +would have had just as good success in demonstrating the truth of his +statements. The following analysis will illustrate this. This is a real +dream, but before beginning the analysis, I took the attitude that the +analysis would reveal the fulfillment of a fear or show that the dream was +the dramatic representation of a feared condition as actually existing. It +took some time to get into this attitude, it is true, but when the result +was finally accomplished, the analysis was begun and the attempt was made to +follow the Freudian method as closely as possible under the changed +conditions. + +The Dream. On the night of February first, I dreamed that I was going down +a little hill in company with my brother and Mr. N. We seemed to be in +Colorado, and at the foot of the hill was a little stream which was very +pretty. There was a little waterfall, and a green pool below it, and a mist +hung over the pool. I am not sure I saw the color of this pool. There was +also a huge rock around which the water dashed. Some people were fishing in +the stream. Some one asked if we could see the rainbows, and Mr. N. replied +that he could see only one. I then looked carefully and saw a purple haze in +the mist over the pool and supposed this was what was meant. But, as I +continued to look, I saw a great number of rainbows, or at least patches in +the mist over the water which showed the spectral colors. These were about +two feet in diameter and extraordinarily beautiful. I was very anxious to +get some of the trout which I felt sure were In the stream. As we came +nearer, it seemed that the stream had overflowed and there were several +shallow pools not over a foot deep and eight or ten feet long. In these +pools could be seen fish by the dozen from a foot to eight feet long. I was +slightly troubled because it would muddy my shoes, but I began to try to get +some of them out. I got one very big one by the gill slit, but could not +manage him and had to let him go. I handled several in the dream, but do +not know whether or not I got any out. + + + +ANALYSIS OF DREAM SHOWING FULFILLMENT OF A FEAR + +I had some trouble in getting any light on this dream, but suddenly much of +the meaning became clear and a whole group of associations came up. +Undoubtedly the trouble I experienced at first was caused by the resistance +of the censor. I will give the associated memories first and explain them +later. + +I delight in fishing and have spent many happy hours fishing for trout In +the clear waters of the Colorado streams; but, strange as it may seem, it +was not a memory of any of these which come into consciousness. Instead, +there came up memories of three different instances, each accompanied with +definite visual imagery, and in such rapid succession that I could hardly +tell which came first. + +Six years ago last summer, I crossed the Ohio River to spend a day in +Carrolton, Kentucky, and on the way back, I bought some fish of a fisherman +at the river's edge. This man was barefooted and wore a little greasy wool +hat and very ragged clothes. I remember thinking at the time that his work +must be very degrading, and that the river fisherman must be about the +lowest type in that part of the country. I especially noticed his feet and +legs, which were bare to the knees, and which were so sunburned that they +hardly looked like parts of a white man's body. In the analysis of this +dream, the image of the man as he stood there and the memory of the incident +came back with great vividness. + +A year or two later, my brother and I were riding along the road at about +the same place, and we met a very miserable-looking specimen of humanity, +driving a poor limping horse to a rickety wagon in which were some pieces of +driftwood. My brother was in a "spell of the blues" at this time, and he +remarked that he was coming to just that condition as fast as he could. The +image and memory of this incident also came into consciousness as if it had +been waiting repressed just under the surface. + +The other memory was one in which I did not figure personally. A year or so +ago, my brother was telling me how he and his boy had gone to the river +several times and gone fishing with an old fisherman who lived there. My +nephew, like most boys, had a desire to become a fisherman or hunter, and my +brother had suspected that a little close acquaintance with the way a +fisherman lived would cure him of this desire; in this he was entirely +right, and after a few trips to visit the old fellow, he had expressed +himself as cured of any desire to live the beautiful, pleasant life of a +river fisherman. + +Without going any further, it can easily be seen that a fisherman symbolizes +for me everything that is synonymous with failure. Thus, when I stepped out +into the muddy water and began fishing I symbolically became a failure, a +no-account, a man who had failed in the struggle and had not achieved +success. The very fact that we came DOWN HILL to the place of fishing +shows, on the face of it, that a downhill career is symbolized. My brother +was with me, and that is easily explained as a dramatization of the fact +that I was accompanying him on that downhill road to the state of the man in +the rickety wagon which he had prophesied as his future. The water in the +shallow pools was muddy, and I stepped into it just after experiencing a +fear that I would get my shoes wet. Remembering the fisherman's bare brown +feet, this can be interpreted as nothing but a very strong symbolization of +a drop from a cultured and successful circle to a low and unsuccessful one. +I grasp a fish bigger than myself and struggle with it, but am compelled to +give it up. Another symbol: my work is plainly too big for me; this +question is too much for me to handle, and this thesis will ultimately have +to be given up as the big fish is. In fact, I cannot say that I succeeded in +getting ANY fish out of the water and, therefore, I shall never succeed at +anything I undertake, but will land figuratively, if not actually, in the +fisherman's hut. + +The Mr. N. who was with us, was cross-eyed which, in itself, seemed to have +no special meaning; but it immediately called up an image of a cross-eyed +man standing at the river's edge at Vevay, Indiana. This fellow was the +picture of ignorance and want. He was telling another man about catching a +big fish a few days before and how he liked that kind of fish boiled so +well, but he could not wait for it to boil, but had fried part of it and +eaten it that way. As I heard him relate this and watched his face, the +whole event seemed to me to be most disgusting. As I was watching him, some +one at my side told me that, because of a drunken spree, he had been +disfranchised. He was also a fisherman and another typical specimen of the +class. Mr. N., having the same facial defect, though in a much less +noticeable way, became identified with him, and I am again found walking +down the hill to oblivion in company with this brother in distress. This is +bad for Mr. N., but it cannot be helped. + +The rainbows seem bright enough, but they bring in another disquieting group +of associations. The rainbow is almost, if not quite, a universal symbol of +failure. We all know the old story of going to the end of the rainbow for a +pot of gold, and if we want to belittle any effort we say that the +individual is chasing the rainbow. So here I am again on the downhill road +between two failures, following the rainbow to a hopeless condition of muddy +uselessness. And if it were not bad enough to be following one rainbow, I am +following a great number which must mean that I shall always end in failure +whatever I undertake. + +But, besides this, the rainbow has special associations for me. The first of +these associations which came into consciousness was a little booklet made +by a Latin student and handed her professor. I had several years of Greek +and Latin under this teacher and at a certain place in the course, he asked +each student to make a little booklet of some kind, using as much +originality as possible, copy some favorite quotations from De Senectute and +hand in the finished product. Every year he gets these out and exhibits them +as a kind of inspiration. One of them had a rainbow and a pot of gold on the +cover. I spent a great deal of time and work on mine and made a more +elaborate booklet than any other that had been made, but I purposely left it +unfinished and inscribed a statement that this was to typify the kind of +work I did in that department. Of course it was a joke, but I have often +thought that there was method in this madness, and that it really +approximated the true state of affairs. This seeming chance association, +then, is closely connected with my fear of making a failure which is so +clearly dramatized in this dream. + +The fact that the dream is placed in Colorado is also important. Two years +ago, I spent the summer in Colorado and had a very delightful time, as was +natural, being on a wedding trip. But during this stay, I did make a total +failure at fishing. I had been a fairly successful trout fisher a few years +before, but I had forgotten the art and did not do enough fishing to +relearn. In other words, my dream gives me to understand that I cannot be +successful even in fishing. One evening my bride and I witnessed a most +beautiful sunset, a rainbow figuring largely in the scene. At this time we +were debating whether or not to go on farther West as I had originally +planned; but circumstances prevented this and instead of going on farther, +we came back East or toward the rainbow. This is just one more place where +the dream so clearly symbolizes a failure to do what I undertake. I will +not carry the analysis any further, though I could find associations by the +hundred which would strengthen the meaning given. + +Of course I am not at all conscious of having any such fear as this. In fact +I am rather inclined to be over-confident; but this is, of course, due to +the repressing influence of the censor and only strengthens the analysis. + +Examples could be given until the last trump is sounded and the world rolled +up like a scroll, but I do not want to keep any one so long. Whatever we +wish to make out of a dream--the dramatization of a fear, a joy, a joke +(really this is what the Freudians often do), a tragedy, anything that can +be suggested, the result can easily be accomplished if only we be allowed +the use of Freud's mechanisms and a moderate amount of symbolism. + +I have tried to show: First, that any situation or experience can be +analyzed with as good success as a dream, and second, that a dream may be +made to mean anything. In other words, with Freud's method, one can +demonstrate anything to suit his taste or belief. Long ago, the saying was +formulated that all roads lead to Rome. This being true, it must also be +true that all roads lead everywhere else. Freud employs a wonderful figure +of a mystical sphere, with its layers and cross veins and other +mineralogical characteristics, to represent the part of consciousness with +the repressed factor at the center well guarded. It would be far more to the +point if he should represent the whole of past experience as the surface of +a country, with its various roads connecting the different centers. The +stations would then represent the experiences, and the roads the association +tracks between them. If one should travel at random over these roads, he +would in time pass through all kinds of towns and cities, but if he started +in quest of a certain type, say mountain villages, he would arrive at his +goal much more quickly than he would otherwise. The Freudians themselves +acknowledge that they have difficulty in knowing when to stop the analysis. +Their plan seems to be to travel until the landscape suits them and then get +off and camp. + +Thus, while I have made no attempt to give positive proof or argument that +Freud's theory, in its extreme form is at fault, I have tried to +substantiate my argument that there has been no real argument on the other +side. And when a theory so spectacular and altogether out of the ordinary +is presented, the burden of the proof should very decidedly be thrown on the +positive side. We have no obligation or even excuse for accepting such a +theory on the mere presumption of the originator. + +And that Freud's theory is weird and fantastic is a self-evident fact. +Perhaps the Clark University student who very carefully worked it up a few +years ago went a little too far when he said it was a chaotic inferno, but +at any rate, it is far removed from celestial harmony. Sidis takes about the +sanest attitude possible when he refers to certain Freudian writings as +being full of unconscious sexual humor. He observes further as does Prince +and others that the Freudian school is in reality a religious or +philosophical sect. He says that Freud's writings constitute the +psychoanalytic Bible and are quoted with reverence and awe. Kronfeld, in a +most valuable criticism, says that in comparison with Freud's conception of +the vorconscious and its work, Henroth's Demonomania appears a modest +scientific theory. + +The attitude of the Freudians is, itself, worth noticing. They are very +prone to consider any criticism as very personal, and fly to the rescue with +all the fervor of a religious fanatic. A work on dreams, because it does not +bear out Freud in all details, calls forth thunderbolts from two continents. +This over-anxious attitude indicates that the belief in the theory is based +on an emotional condition rather than logical reasoning. Bernard Hart, who +is one of those happy individuals who get the best out of Freudianism, shows +the difference between the two kinds of belief by comparing our belief that +the earth goes around the sun and that the man who abuses a woman is a cad. +The cold, indifferent attitude toward the former is in marked contrast to +our warm lively interest in the latter, and the reason is that the belief in +the one is founded on scientific demonstration and in the other on our +feeling in the matter. If we allow this as a gauge by which to measure, it +is not difficult to place the Freudians. + +We must not overlook the immense opportunity for suggestion in the work of +psychoanalysis, both on the subject and the one who is in the work. The +Freudians vehemently deny that any of the results of dream analysis are +suggested into the mind of the dreamer, but the evidences are all on the +other side. Freud, in referring to psychoanalysis of hysterical patients, +says, "It is not possible to press upon the patient things which he +apparently does not know, or to influence the results of the analysis by +exciting his expectations." Such an attitude is fatal when it comes to a +question of accurate work. And no less important is the self-suggestion +practiced by the Freudians. When we read of Freud's long struggle in an +attempt to find something which he felt surely was to be found, we see that +he had abundant opportunity to acquire almost an obsession. The long years +since, which he has spent in analyzing dreams and making them all come out +right some way, would serve to more firmly ground his conviction, and the +same is true of his disciples. Put a man to drawing square moons for ten +years, and at the end of the time he will swear that the moon is square. + +A large portion of the scientific world seems to have gone mad over the term +"psychoanalysis." But this kind of work has been done by all peoples and +times under different names. There can be no objection to such an analysis +of a dream if it is done by the right person. The dream may be used to aid +the dreamer in finding out his own life, it is true, and when we understand +psychoanalysis as this process, and only this, it is not objectionable. But +if such is the case there is no need of all the mechanism and symbolism. The +preacher who uses the Old Testament stories of the wars with the Philistines +to illustrate a moral struggle is not to be criticised; but if he maintains +that they were written for that purpose, we should hardly feel inclined to +accept his position. A very inspiring message might be builded on the text, +"The ants are a people not strong, but they prepare their meat in the +summer"; but it is hardly possible that such thoughts were in the mind of +the writer. Just so, a dream or a story or any other situation may be used +to open the locked doors of a life, but to say that the dream has slipped +stealthily out of the keyholes and over the transoms and wonderfully, +mysteriously and magically clothed itself is quite another matter. + + + +FREUD AND HIS SCHOOL + +NEW PATHS OF PSYCHOLOGY + +BY A. W. VAN RENTERGHEM M.D., AMSTERDAM + +(Concluded) + +WE are frequently confronted with the question: "Just why does an erotic +conflict cause the neurosis? Why not just as well another conflict?" To +this the only answer is, "No one asserts that this must be so, but evidently +it always is so, in spite of anything that can be said against it. It is, +notwithstanding all assurances to the contrary, still true that love (taken +in its large sense of nature's course, which does not mean sexuality alone), +with its problems and its conflicts of the most inclusive significance, has +in human life and in the regulation of the human lot a much greater +importance than the individual can image. + +The trauma-theory (meaning what was in the beginning conceived by Breuer and +Freud) is therefore out of date. When Freud came to the opinion that a +hidden erotic conflict forms the real root of the neurosis, the trauma lost +its pathogenic significance. + +An entirely different light was now thrown upon the theory. The trauma +question was solved, and thrown aside. Next in order came the study of the +question of the erotic conflict. If we consider this in the light of the +chosen example, we see that this conflict contains plenty of abnormal +moments, and at first sight does not suffer comparison with an ordinary +erotic conflict. What is especially striking, seemingly almost unbelievable, +is the fact that it is only the exterior action, the pose, of which the +patient is conscious, while she remains unconscious of the passion which +governs her. In the case in question the actual sexual factor +unquestionably remains hidden, while the field of consciousness is entirely +governed by the patient's pose. A proposition formulating this state of +affairs would read as follows. + +In the neurosis there are two erotic inclinations which stand in a fixed +antithesis to each other, and one of these at least is unconscious. + +It might be said of this formula, that although perhaps it is adapted to +this case, possibly it is not adapted to all cases. Most people, however, +are inclined to believe that the erotic is not so widespread. It is granted +that it is so in a romance, but it is not believed that the most affecting +dramas are more often enacted in the heart of the citizen who daily passes +us by unnoticed, than upon the stage. + +The neurosis is an unsuccessful attempt of the individual to solve in his +own bosom the sexual question which perplexes the whole of human society. +The neurosis is a disunity in one's inmost self. The cause of this inward +strife is because in most men the consciousness would gladly hold to its +moral ideal, but the subconsciousness strives toward its (in the present-day +meaning) immoral ideal. This the consciousness always wants to deny. These +are the sort of people who would like to be more respectable than they are +at bottom. But the conflict may be reversed; there are people who +apparently are very disreputable, and who do not take the slightest pains to +limit their sexual pleasures. But looked at from all sides this is only a +sinful attitude, adopted, God knows for what grounds, because in them, back +of this, there is a soul, which is kept just as much in the subconsciousness +as the immoral nature is kept in the subconscious of moral men. (It is best +for men to avoid extremes as far as possible, because extremes make us +suspect the contrary.) + +This general explanation was necessary in order to explain to some extent +the conception of the erotic conflict in analytical psychology. It is the +turning-point of the entire conception of the neurosis. + +After Breuer's discovery, putting into practice the "chimney sweeping" so +justly christened by his patient this method of treatment has evolved into +shorter psychoanalytical methods, which we will now discuss in succession in +their main points. + +In his use of the primitive method, Freud depended upon the time saving of +hypnotism and upon the circumstance that many could not be brought into the +desired deep degree of provoked sleep. The aim of this operation was to call +up in the patient another state of consciousness, in which it would be +possible for him to remember facts which had given cause for the origin of +the phenomena, facts which thus far had remained hidden from the ordinary +daily consciousness. By questioning the patient when in this state, or by +spontaneous production of phantasies communicated by the patient while in +hypnosis, memories come to light and affects connected with them are relaxed +(these are abreagirt [rearranged], as the expression is) and the desired +cure is attained. This just-mentioned method (cathartic, cleansing) and +more especially the modified one, which aims especially at the promotion of +a spontaneous production of phantasies communicated by the patient while +under hypnotism, is still used in practice by some investigators. In what +follows we go still further back--Freud next sought for a method to render +hypnotism unnecessary. He discovered it by applying an artifice which he +had seen Bernheim use during a visit (1887) to the latter's clinic at Nancy. +Bernheim demonstrated upon a hypnotized patient how the amnesia of the +somnambulist is only an appearance. + +With this aim in view, Freud from then on ceased to hypnotize his patients +and substituted for that method, "spontaneous ideas." This means that when +the analysis of a patient who is awake is obstructed, and has come to a dead +stop, he is told to communicate anything which comes into his mind, no +matter what idea, what thought, even if the thing were very queer to him or +seemed meaningless. In the material thus obtained the thread should be found +leading to the semi-forgotten, the thing hidden in the consciousness. In +single cases--where the resistance toward bringing into consciousness the +forgotten or repressed thing, the complex, was slight--this method of +treatment very quickly attains its end, but in others where the resistance +was greater, the spontaneous ideas merely brought about indirect +representations, mere allusions as it were to the forgotten element. Here +favorable results either were not so readily obtained, or else were entirely +lacking. In conjunction with this, Freud planned a simple method of +interpretation by means of which, from the material thus obtained, the +repressed complexes could be brought to consciousness. + +Independently of Freud, the Zurich school (Bleuler, Jung) had planned the +association method in order to penetrate into the patient's +subconsciousness. The value of this method is chiefly a theoretical +experimental one; it leads to an orientation of large circumference, but +necessarily superficial in regard to the subconscious conflict (complex). + +Freud compares its importance for the psychoanalyticus; with the importance +of the qualitative analysis for the chemist. + +Not being completely satisfied with his method of spontaneous ideas Freud +sought shorter paths to the subconscious, and therefore undertook the study +of the dream-life (dealing with forgetfulness, speaking to one's self, +making mistakes, giving offense to one's self, and with superstition and +absent-mindedness, and the study of word quibbles taken in their widest +sense), to all of which we are indebted for the possession of his three +important books: "Die Traumdeutung?" (First edition 1900, third edition +1912); "Zur Psychopathologie des Alltagslebens" (1901-1907); "Der Witz und +seine Bedeutung zum Unbewussten" (1905). + +Because of the discovery of the repressed and the forbidden in the soul +life, the instructions contained in the three last-named works are of great +importance and of help to us in the study of the spontaneous ideas of the +patient brought to light by free association. But what is of more importance +for analysis is the study of what may well be termed Freud's masterpiece, +"Die Traumdeutung." + +Jung expresses himself as follows in regard to Freud's ingenious discovery. + +"It can be said of the dream that the stone which was despised by the +architect has become the corner-stone. The acorn of the dream, of the +ephemeral and inconsiderable product of our soul, dates from the earliest +times. Before that, men saw in the dream a prophecy for the future, a +warning spirit, a comforter, a messenger of the gods. Now we join forces +with it in order to explore the subconscious, to unravel the mysteries which +it jealously guards and conceals. The dream does this with a completeness +which amazes us. Freud's exact analysis has taught that the dream as it +presents itself to us, exhibits merely a facade, which betrays nothing of +the inmost part of the house. But where, by attention to certain rules we +are able to bring the dreamer to express the sudden ideas awakened in him in +talking over the sub-division of his dream, then it very quickly appears +that the sudden ideas follow a determined direction, and are centralized +about certain subjects, possessing a personal significance and betraying a +meaning, which in the beginning would not have been suspected back of the +dream, but which stand in a very close symbolical relation, even to details, +to the dream facade. This peculiar thought-complex, in which all the threads +of the dream are united, is the looked-for conflict in a certain variation +which is determined by the circumstances. What is painful and contradictory +in the conflict is so confused here that one can speak of a +wish-fulfillment; let us, however, immediately add that the fulfilled wishes +apparently are not wishes, but are such as frequently are contradictory to +them. As an example let us use the case of a daughter who inwardly loves her +mother and dreams that the latter is dead, much to her sorrow. Dreams like +this are frequent. The contents make us think as little as possible of a +wish-fulfillment, and so one might perhaps get the idea that Freud's +assertion--that the dream presents in dramatic form a subconscious wish of +the dreamer--is unjust. + +That happens because the non-initiated does not know how to differentiate +between manifest and latent (evident and hidden) dream contents. Where the +conflict worked over in the dream is unconscious, the solution, the wish +arising from it, is also unconscious. In the chosen example, the dreamer +wished to have the mother out of the way; in the language of the +subconscious it says: I wish that mother would die. We are aware that a +certain part of the subconscious possesses everything which we can no longer +remember consciously, and especially an entirely thoughtless, childish wish. +One can confidently say that most of what arises from the subconscious has +an infantile character, as does this so simple sounding wish: "Tell me, +father, if mother died would you marry me?" The infantile expression of a +wish is the predecessor of a recent wish for marriage, which in this case we +discover is painful to the dreamer. This thought, the seriousness of the +included meaning is, as we say, "repressed into the subconscious" and can +there necessarily express itself only awkwardly and childishly, because the +subconscious limits the material at its disposal, preferably, to memories of +childhood and, as recent researches of the Zurich school have shown, to +"Memories of the race," stretching far beyond the limits of the individual. + +It is not the place here to explain by examples the territory of +dream-analysis so extraordinary composed; we must be satisfied with the +results of the study; dreams are a symbolical compensation for a personally +important wish of the daytime, one which had had too little attention (or +which had been repressed). + +As a result of the dominant morals, wishes which are not sufficiently +noticed by our waking consciousness and which attempt to realize themselves +symbolically in the dream are as a rule of an erotic nature. Therefore it is +advisable not to tell individual dreams in the presence of the initiated, +because dream symbolism is transparent to one acquainted with its +fundamental rules. Therefore we have always to conquer in ourselves a +certain resistance before we seriously can be fitted for the task of +unraveling the symbolical composition by patient work. When we finally +comprehend the true meaning of a dream then we at once find ourselves +transposed into the very midst of the secrets of the dreamer and to our +amazement we see that even an apparently meaningless dream is full of sense +and really bears witness of extremely important and serious things +concerning the soul-life. This knowledge obliges us to have more respect for +the old superstition concerning the meaning of dreams, a respect which is +far to seek in our present-day rationalistic era. + +Freud correctly terms dream-analysis the royal road which leads to the +subconscious; it leads us into the most deeply hidden personal mysteries +and, therefore, in the hand of the physician and the educator is an +instrument not to be too highly valued. + +The opposition to this method makes use of arguments which chiefly (as we +will observe, from personal motives) originate in the still strongly +scholastic bent, which the learned thought of the present-day exhibits. And +dream-analysis is precisely what inexorably lays bare the lying morals and +the hypocritical pose of men, and now for once makes them see the reverse +side of their character. Is it to be wondered at that many therefore feel +as if some one were stepping on their toes? + +Dream-analysis always makes me think of the striking statue of worldly +pleasure which stands before the cathedral at Basel. The front presents an +archaic sweet smile, but the back is covered with toads and snakes. +Dream-analysis reverses things and allows the back side to be seen. That +this correct picture of reality possesses an ethical value is what no one +can contradict. It is a painful but very useful operation, which demands a +great deal from the physician as well as from the patient. Psychoanalysis +seen from the standpoint of therapeutic technic consists chiefly of numerous +analyses of dreams; these in the course of treatment, little by little, +bring what is evil out of the subconsciousness to the light and submit it to +the disinfecting light of day, and thereby find again many valuable and +pretendedly lost portions of the past. It represents a cathartic of especial +worth, which has a similarity to the Socratic "maieutike," the "obstetric." +From this state of affairs one can only expect that psychoanalysis for many +people who have taken a certain pose, in which they firmly believe, is a +real torture, because according to the ancient mystic saying: "Give what you +have, then shall you receive!" They must of their own free will offer as a +price their beloved illusions if they wish to allow something deeper, more +beautiful and more vast to enrich them. Only through the mystery of +self-sacrifice does the self succeed in finding itself again renewed. + +There are proverbs of very old origin which through the psychoanalytical +treatment again come to light. It is surely very remarkable that at the +height to which our present-day culture has attained this particular kind of +psychic education seems necessary, an education which may be compared in +more than one respect with the technic of Socrates, although psychoanalysis +goes much deeper. + +We always discover in the patient a conflict which at a certain point is +connected with the great social problems, and when the analysis has +penetrated to that point, the seemingly individual conflict of the patient +is disclosed as the conflict, common to his environment and his time. + +Thus the neurosis is really nothing but an individual (unsuccessful to be +sure) attempt to solve a common problem It must be so, because a common +problem, a "Question" which plunges the sick man into misery is--I can't +help it--"the sexual question," more properly termed the question of the +present-day sexual moral. + +His increased claim upon life and the joy of life, upon colored, brilliant +reality, must endure the inevitable limitations, placed by reality, but not +the arbitrary, wrong, indefensable limitations which put too many chains +upon the creative spirit mounting from out the depths of animal darkness. +The nervous sufferer possesses the soul of a child, that arbitrary +limitation which represses and the reason for which is not understood. To be +sure it attempts to identify itself with the morals, but by this it is +brought into great conflict and disharmony with itself. On one side it +wishes to submit, on the other to free itself--and this conflict we speak of +as the neurosis. + +If this conflict in all its parts were clearly a conscious one, then +naturally no nervous phenomena would arise from it. These phenomena arise +only when man cannot see the reverse side of his being and the urgency of +his problem. Only under these circumstances does the phenomena occur which +allows expression to the non-conscious side of the soul. + +The symptom is thus an indirect expression of the nonconscious wishes, +which, were they conscious to us, would come into a violent conflict with +our conceptions of morals. This shadowy side of the soul withdraws itself, +as has once been said, from the control of the consciousness; by so doing +the patient can exert no influence upon it, cannot correct it and can +neither come to an understanding with it nor get rid of it, because in +reality the patient absolutely does not possess the subconscious passions. +Rather they are repressed from out the hierarchy of the conscious soul, they +have become autonomous complexes, which can be brought again into +consciousness only with great resistance through analysis. Many patients +think that the erotic conflict does not exist for them; in their opinion the +sexual question is nonsense; they have no sexual feeling. These people +forget that in place of that they are crippled by other things of unknown +origin. They are subject to hysterical moods, bad temper, crossness, from +which they, no less than their associates, suffer. They are tortured by +indigestion, by pains of every sort, and are visited by the whole category +of other nervous phenomena. They have this in place of what they lack in the +sexual territory, because only a few are privileged to escape the great +conflict of civilized man of the present day. The great majority inevitably +takes part in this common discord. + +As specimens of dream-analysis I will give resumes of two histories of +illness told me by Dr. Jung. + + + +ANALYSIS AND CURE OF A CASE OF NERVOUS PROSTRATION + +A twenty-year-old banker's son, from a large city in Hungary, suddenly grew +sick two years ago, shortly after his father had suffered an attack of +apoplexy and paralysis of the right side. He is spiritless, restless, not +able to work, cannot use his right arm to write, is powerless to put his +attention on anything, sleeps badly, etc. No treatment has any helpful +effect. He is advised to seek distraction in Paris, but this, too, is of no +avail. Then, after months of torture, he came to Zurich to Dr. Jung, who +subjected him to analysis. At the second visit the patient behaved extremely +mysteriously; he was much disturbed and appeared to be under the influence +of an anxious dream, which he had dreamt that night. It required some effort +to induce him to tell this dream, and it was only after he had convinced +himself that no one could listen in the hall, that this story, not without +emotion, came out. + +"I see in a vault a coffin in which my father lies, and I beside him; in +vain I attempt to remove the lid, and in my horrible fear I awake." + +Some days were employed with the analysis of this dream. The explanation of +it is: he has a very strong father-complex. From childhood up he has always +been with his father, he has assumed the role of his father's wife, has +cared for him, lived for him. He often reproached his mother for not making +enough of the father, for not always cooking his favorite dish, for +sometimes contradicting him, etc. He was always around with his father, +worked at his office, served him in all sorts of ways, and anticipated all +his wishes. Now, when the father suddenly became an invalid, the conflict +arose. He identifies himself with the father. His father's invalidism +becomes his own, he cannot think any more, he cannot write any more, and he +sees death approaching. In the dream he is apparently dead, but his youth, +his strength refuses to die, and this is translated in his attempts to get +out of the coffin, which explains the fear. + +The explanation brings relaxation. After some days, during which the +patient communicates his secret thoughts in detail, he feels very much +better, his heavy burden has been rolled away, and he cannot find words +enough to express his thanks to the doctor. The latter points out to him +that however natural this feeling of thankfulness may be, it is partly a +symptom of the cure at his hands. He shows the patient how the latter, who +had seen through the analysis that his love for his father has been +exaggerated and morbid, had been able to control this, and how he now +transfers to him, the assisting physician, the need for love, freed from +suffering along the way of sublimated homo-sexuality. He impresses upon him +that he must now learn to moderate the sympathy, which he expresses too +feelingly, and that he must not desire to see another father in the doctor, +but simply a friend, who is teaching him to stand on his own feet and to +become an independent man. After a few more weeks the young man was entirely +cured of his neurosis, freed from his exaggerations and returned home a well +man. + +ANALYSIS OF A CASE OF SLEEPLESSNESS + +Once when traveling I made the acquaintance of a naturalist who not long +before had completed a famous exploring expedition in distant countries. +During this expedition he had been almost constantly in peril of his life. +Almost every night he had had to stay awake and watch so as not to be set +upon and killed. He had been back in England a short time and had +completely recovered from the privations and sufferings he had experienced, +but he suffered desperately from insomnia. On his return he had slept well, +but a month before his sleep had suddenly begun to be disturbed. + +Knowing me to be a neurologist, he asked my advice. I inquired about the +patient's former life, but discovered that my traveling companion was little +inclined to be communicative in this direction, in fact he was strikingly +reticent. To my inquiry about the immediate origin of the insomnia, he told +me it was immediately connected with a miserable dream which he had dreamt a +month past, and from which he had awakened in terrible anxiety. I asked him +to tell me this dream and gave him hope that perhaps the analysis of this +might succeed in laying bare the cause of the insomnia. The substance of the +dream was as follows: + +"I was in a narrow gorge, formed by almost perpendicular walls of rock. This +made me think of a similar narrow gorge which, during my journey, I had +passed through at peril of my life. Upon a jutting rock a hundred yards +high above the abyss, I saw a man and woman standing, shoulder to shoulder, +both covering their eyes with their hands. They step forward and I see them +plunge downwards together, and hear their bodies falling to destruction. +Screaming wildly I awoke. Since that time I dare not let myself sleep for +fear of the repetition of this dream. + +The patient, accustomed to deadly peril on his long expedition, could not +explain to himself the anxiety caused by this dream. I called Mr. X's +attention to the fact that in my opinion an erotic conflict was concealed in +the dream, and asked him point blank whether he had taken part in a love +story. At this the patient grew deadly pale, struck the table with his fist +and said "That you should have guessed it!" Now the confession followed, how +he had had a love affair in which he had not cut a good figure and which +ruined a woman's life, and that afterwards he had been violently remorseful +and had lived with the idea of suicide. Then he had seized upon the +opportunity offered him to lead a dangerous expedition. He wanted to die and +here he would not find death ingloriously. + +It is clear that the two people upon the rocks above symbolized the two, who +went to meet destruction. + +Soon afterwards the travelers parted. A year later the newspapers contained +the report of the marriage of the famous explorer. The surmise is allowable +that the analysis of this dream was the cause of this fortunate solution. + +As I have already pointed out, the original cathartic method of Breuer and +Freud, explained to some extent, is still followed by some investigators, by +Muthman, Bezzola, Frank and many others. I had the opportunity in June and +July, 1912, of observing for some time the treatment of patients by Dr. +Frank in Zurich at his private clinic, and of gaining for myself a +satisfactory idea of his technique. Frank by no means rejects the Freudian +psychoanalysis with all its helps, but uses it only when he does not succeed +in hypnotizing his patient. Preferably, and in a great number of cases, he +uses, in a state of hypnotism, a cathartic method he originated. + +Where Breuer and Freud profited from the spontaneous or the provoked +somnabulistic state of the patient, and by questioning dug up the hidden +depths, Frank decided to be satisfied with a light hypnose, a state of +hypotaxie, which might be termed analogous to the half-conscious state of +the person who after taking a mid-day nap frequently denies having been +asleep. In this condition we can give an account on waking of what happened +around us. One sleeps and one does not sleep; the upper-consciousness then +can control what the sub-consciousness brings up. + +Frank says that, except in the peculiarity that he is satisfied with a +lighter degree of hypnose, his method differs from that of Breuer and Freud +in that generally he does not question the patient when under hypnotism, +neither suggests. Experience has taught him, he says, that the ideas loaded +with affect, spontaneously discharge. They are the very ones which would do +so in a dream, but are differentiated from the occurrences in the dream in +the sense that these last enter phantastically dressed, while the first +express themselves with the mental affects belonging to them, precisely as +they were lived through. + +Precisely as in the primitive-cathartic method, the affects pushing in here +are disemburdened here, but at the same time, the connection between the +existent sick-phenomena and the causes having a place here were +automatically conscious to the patient. In some cases suggestion is called +upon for help in order to free an affect or to direct the attention to the +expected scene. + +In most cases the process goes on itself, after the introduction of +hypnosis. If the sleep is too deep, then the ideas are transferred into real +dreams, which the patient immediately recognizes as such, or the production +of scenes discontinues; the superconsciousness no longer works. + +The scenes described are usually recalled by the patients, just as they were +experienced by them, even when taken from the earliest youth. The reality +of the events which happened in childhood, lived over again in hypnose, are +substantiated as much as possible by the patient's parents or associates. He +succeeds best in inducing this semi-sleep by exhorting the patient as he +closes his eyes not to bother about whether he sleeps or not, but to fasten +his attention upon the scenes which are about to present themselves; that +is, to think himself, so to speak, into the state of someone at a moving +picture show. + +As an example I give a fragment of a Frankian analysis of a case of + +FEAR NEUROSIS (ANGST-NEUROSE) + +Y. B., born 1883, a law clerk. Patient comes on the third of December, +1908, to Frank's consultation hour; he complains of periods of short breath; +during these he feels as if his heart were ceasing to beat, especially when +he is just going to bed. He feels then as if something heavy were striking +him on the chest, great restlessness, and a feeling of faintness comes over +him. After taking a glass of wine the condition is aggravated and becomes +insupportable. These attacks come once or twice a day, mostly in the +evenings. At times they keep off for eight or ten days. He lives +continually in an excited state, he suffers from palpitations of the heart, +from pain in the left thigh, pain in the left side, and at night cannot get +to sleep. + +Patient attributes this condition to an automobile accident which happened +to him on June 2, 1908. Even before this accident he had been a trifle +nervous on account of overwork. In the automobile accident he had been +thrown out, and had been thrown a distance of ten or fifteen yards. The +automobile, which was at high speed, had also plunged down the decline, but +luckily the patient was not caught directly under the machine. He did not +lose consciousness, and escaped with some scratches and a bad fright; it was +a marvel that he and the chauffeur escaped with their lives. He plainly +recalls thinking, during the fall, that his last hour had come, and even yet +is amazed how extremely untroubled he had been by that thought. The days +following the accident he felt as if his face were burning, and he was +inwardly agitated whenever he thought of an automobile. On June 30, 1908, he +was obliged to take a business journey. While seated in the station +restaurant it suddenly grew dark before his eyes. He could breathe only with +difficulty, his heartbeats were irregular and he had a strange sensation of +fear. This condition lasted the whole day. On the return journey his train +ran into an automobile truck. The patient was thrown to the floor of the +coupe by the shock. This incident made a great impression upon him; +nevertheless, for eight days he was free from the uneasiness already +described. After that an attack of fear again set in, continuing at +intervals, with periods of greater or lesser violence, until the present. + +December 7, 1908. A first attempt to induce hypnosis was successful. + +December 8, 1908. Patient goes to sleep immediately, becomes frightened and +gives frequent signs of terror. When awakened, he mentioned that he had had +a feeling as if he were falling into a hole, that had given him a very +strange sensation. The patient speaks while he sleeps; his +super-consciousness therefore remains awake and is able to take notice +directly of the scene taking place. After some minutes he sees in the +hypnosis a locomotive approaching. He cries out, "There it comes out of the +tunnel." He is afraid of being run over, and is terrified. Two years +previously he had been through this scene. He was standing on the track when +a train approached, and he was afraid of being run over. In his sleep, the +patient communicates the details and sees everything clearly. After a short +interval of complete rest, he begins to breathe heavily, his pulse quickens, +then he cries out in fright and excitement and dread, "Now it's coming, now +the auto's coming, it's turning over, we're under it, there it's riding over +us!" Gradually he quiets down again, and after a quarter of an hour, awakes. +He says he now feels something lifted from his chest, that he has slept +well, and feels better. He recalls everything. The train came out of the +tunnel with gleaming lights; this scene took place in the evening. The +automobile scene was reproduced precisely as he had taken part in it, no +detail escaped him; his breathing is unobstructed now, and he has no more +heart palpitations. + +On the day appointed for the seance I was unexpectedly obliged to go away. +When I wished to resume the treatment, January 9, the patient wrote me that +his condition was strikingly improved, the heart palpitations and feelings +of anxiety had not reappeared. His pleasure in life and work had returned +once more, his night's rest left nothing to be desired, his appetite was +excellent, therefore he thought that further treatment was not necessary for +the present. To a later inquiry, February 12, 1910, a year afterwards, I +obtained this answer: "Without exaggeration I am able to write you that in +my whole life I have never felt so well as now. There has been no question +of any nervous attacks or feelings of dread. My weight, which had gone down +to fifty-eight kilos during my nervous sickness, has gone up to seventy +kilos." + +When Frank shuts himself up with his patients in a room, from which all +outer noises are excluded as much as possible, by means of double windows +and doors, although he--by means of electric light signals visible to him +alone--keeps in touch with the servant outside, he has the patient recline +as comfortably as possible upon a low sofa. He kneels on a cushion at the +head, bends down over the patient and has the latter look upwards directly +into his eyes. Meanwhile he lets his left hand rest upon the patient's +forehead and gently presses the latter's eyelids with his thumb and +forefinger. As soon as the patient shows signs of weariness, he carefully +gets up, takes a seat next to the patient and continues carefully observant +of the latter's behavior and expression of countenance. He makes note of +everything that shows itself and rouses the patient after about a quarter of +an hour, unless the latter awakes spontaneously. Now he talks over with him +the material which has been procured and then has the patient go into a +renewed hypnosis, until the end of an hour. Sometimes the seances are +protracted when important scenes come up, and in the interest of the +treatment it might be lengthened to two or even three hours. + +Bezzola makes use of a small, light, black silk mask, which he puts on the +eyes of the patient. He induces hypnosis, and for the rest follows Frank's +technique already described. + +While analysts who avail themselves of hypnosis as a means of help have all +their patients take a reclining position, those who have given up hypnotism +in their treatment, have also given up this reclining position. Freud +continues to prefer having the patient assume a reclining position, and +takes his position with his back to the patient, behind the head of the +sofa. He considers that this manner of treatment induces the greatest +calmness in the patient and makes it easier for him to express himself and +to confess. He keeps as quiet as possible, listens with undivided attention, +does not take any notes during the seance, not wishing to give rise to the +suspicion that all the confession will be written down and perhaps seen by +other eyes. + +Jung receives the patient in his study just as he would receive any ordinary +visitor. He thinks that in this way the patient is put most at his ease and +that it makes him feel he is not considered as a patient, but rather as some +one who, being in difficulties, comes to ask advice and needs to tell his +troubles to a trusted friend. Even less than Freud does he take notes in the +presence of the patient. + +Stekel does as Jung, the only difference being that he remains seated at his +writing-table and makes notes of the most important points. + +The most satisfactory way for the uninitiated to make himself familiar with +the technique of psychoanalysis is to submit himself to psychoanalysis. For +that purpose one turns to an experienced analyst, and takes to him one's +ideas and dreams. Consequently I submitted myself for two months to +analysis from Dr. Jung, who in that way initiated me into the practice of +psychological investigation. The interpretation of one's own dreams, +reading and studying of the principal literature about analytical psychology +or deep psychology, as Bleuler calls it; and the application of what is thus +learned, at the start to simple, later to more difficult cases, must do the +rest in making an independent investigator in this branch of psycho-therapy. + +As has already been said, psychoanalysis aims at bringing into consciousness +all the forgotten things. When all the gaps in the memory are filled in, +when all the puzzling operations of the psychological life are explained, +then the continuance and the return of the suffering has become impossible. +The attainment of this ideal state is truly the attainment of Utopia. Most +certainly a treatment does not need to be carried so far. One may be +satisfied with the practical cure of the patient, with the restoration of +his power for work, and with the abolition of the most difficult functional +disturbances. + +It is applicable in cases of chronic psychoneurosis which exhibit no +difficult or dangerous phenomena. Among these are counted all sorts of +compulsive neuroses, compulsive thoughts, compulsive behavior and cases of +hysteria, where phobias and obsessions play a chief role, also somatic +phenomena of hysteria which do not need to be acted upon quickly, such as, +for example, anorexia. In acute cases of hysteria it is better to wait for +a calmer period before applying psychoanalysis. In cases of nervous +prostration this manner of treatment, which demands the serious co-operation +and attention of the patient, which lasts a long time and at first takes no +notice of the continuance of the phenomena, is difficult. This form of +psychotherapy places great demands on the physician's patience and +understanding. Psychoanalyses which last more than a year, are no rarity. It +cannot be applied to the seriously degenerated; to people who have passed +far beyond middle life, because among the last named the accumulated +material compasses too much; to those who are entangled in a state of great +fear and who live in deep depression. Analysis can be applied to the +neuroses of children. It is desirable in those cases for the physician to +be supported by a trusted person, as for example a woman assistant, but +preferably by parents enlightened sufficiently to observe the spontaneous +remarks of the child, to make notes of them, and communicate them to the +physician. According to the experiments undertaken by the Zurich school, the +expectation is justified within certain limits, that psychoanalysis will be +therapeutically useful in certain forms of paranoia and dementia praecox. + +I think that it will soon be said of psychoanalysis, as of so many other +systems which like it were decried and yet later were highly valued, that +the enemies of to-day are the friends of to-morrow. + +Whoever wishes to judge Freud must take the trouble to initiate himself +seriously into his doctrines, and use his methods for a long time in +practice, according to his instructions. + +Most of the condemnations are brought forward by investigators who judge a +priori, without acquaintance with the facts, upon uncertain theoretical +grounds and with prepossession against his sexual theory. + +Whoever initiates himself seriously into the practice of psychoanalysis, +will arrive at the conclusion that this new form of psychical curing +deserves, to a great degree, the attention of the physician and that it may +be considered as an enrichment of the armory of the psychotherapy, not yet +sufficiently valued. + +Does it render other forms of psychotherapy superfluous? There can be no +thought of that. + +Taking the pros and cons given here, we see that each of the forms of +psychical therapy deserves in its turn preference, and that all support and +complement each other. + +Jung, as well as Freud, both of whom have made their life's aim the +perfection of psychoanalysis, and who for that reason now concern themselves +exclusively with it, appreciate all forms of verbal treatment, as well with +hypnotism as without it. Hypnotic suggestion and suggestion given when awake +was used at an earlier period by both of them with good results, and they +still are not averse to using this method where quick comprehension and the +immediate subdual of a troublesome symptom is desired. + +The psychoanalyst follows the longer road, and assails rather the root of +the sickness; it works more radically; hypnotic treatment takes hold quicker +and is directed at the symptoms. + +Freud explains it in this manner: when one treats the patient by hypnotic +suggestion, one introduces a new idea from outside in exchange for the +morbid idea; if psychoanalysis is applied, then one simply eliminates the +morbid idea. Within certain limits the modus agendi of the two methods is in +absolute opposition. + +The suggestion method, substituting one idea for another, puts in something; +the analytical, expelling an idea, takes out something. Both aim at and +obtain the same end, a more or less lasting cure. Suggestion neutralizes, +stops the poison; analysis expels the harmful matter. The latter manner of +treatment is positive and the most decisive. + +"Don't we all analyze?" Bernheim inquires, and once more I agree that all +forms of psychotherapeutics do, but there is a difference in analysis. + +Superficial analysis can bring us a long way toward the goal. In many cases +it may suffice. But the profound, the Freudian analysis, is what we need if +we wish to attain the radical cure of psychoneurosis, as far as we can ever +speak of a radical cure. Many cases of illness do not lend themselves to +deep analysis. + +When, because of the nature of the illness, or the lifetime, or the feeble +intelligence of the patient, or because of temporary circumstances of a +moral or material nature, its adaptation is excluded or impossible, it is +advisable, especially in chronic cases-- to take refuge in the more +palliative forms of the psychic methods of cure. + +Thus the psychotherapeutic as moral leader fills the role of guide +(directeur-d'ames), one who helps along the doubter, encourages the toilers, +calms the frightened, arouses courage, keeps up hope and comforts where +comfort is needed. + +Pierre Janet, in his instructive book ("Obsessions et Idees Fixes"), +observes that one of his chronic patients gave him the pet name of "le +remonteur de pendules," an expression which luminously describes the role of +the physician of souls, who, tirelessly, day in, day out, lifts the burdens, +and for a time breathes new life into the depressed. + +Hypnotic suggestion, which induces sleep, stills pain, silences fear, +abolishes functional disturbances, works chiefly palliatively. The place for +its application is where quick comprehension is desired. In its simplest +form it resembles the treatment of a mother, who soothes her child with +pacifying words and loving touch, and rocks him to sleep, and also it +resembles the behavior of the father, who asserts his authority by force and +breaks down the childish opposition. We find hypnotic suggestion, perfected +and clothed in its scientific garment, in Liebeault's assertion: "It is a +cure of authority, of faith, of confidence, a cure which frequently performs +semi-miracles. Respect on one side, sympathy on the other, is what gives the +hypnotiser results." + +However highly we may value this last mentioned form of therapy, however +numerous the cures due to it may be, however indispensable it may be in the +practice of medicine, yet its splendor pales before the light which shines +forth from the cures which aim at reeducation and which are directed toward +the understanding. Those are the cures which make use of analysis. + +One method, which we will call the superficial analytical method, is +directed exclusively toward the upper consciousness and cures principally +through exhorting, convincing, exercising and hardening. Its sponsors are +Bernheim, Rosenbach, P. E. Levy, Dubois. At least it is true to its birth, +it has suggestion blood in its veins. + +The other method is the deeper: the Freudian analysis. This does not allow +itself to be satisfied with seeing only one side of the medal, it does not +limit its field of activity to the superliminal consciousness, in searching +for the causes of psychogenic illnesses, but it penetrates into the strata +which lie hidden under the threshold of the consciousness. + +Where the moral and the suggestive methods of cure are limited exclusively +to symptomatic treatment, the first form of educative therapy, limited +merely to a superficial analysis, is only partly symptomatic, but the second +form of educative therapy penetrates with its deep-going analysis to the +root of the trouble, and has as its aim a fundamental cure. + +Only too frequently the physician must be satisfied with the cure of the +symptoms, with lightening the load. He always strives to remove the cause. +Freud's great service is that he has opened before the physician a path +which leads to the cause. + +These lines of Vondel's seem as if composed for him: + + "The physician must not only know How high the pulse has mounted, And +where the sickness lies, which makes him groan with pain, But he must see +the cause, from where The great weakness of this sickness came." + + + +REVIEWS + +AN ELEMENTARY STUDY OF THE BRAIN, BASED ON THE DISSECTION OF THE BRAIN OF +THE SHEEP. By Eben W. Fiske, A.M., M.D. Illustrated with photographs and +diagrams by the author. The Macmillan Company, New. York, 1913. + +The study of the brain is confessedly a difficult subject, and particularly +so for the elementary student. There is certainly no royal road to its +conquest, but this is an added reason why an introduction to its study +should be made as simple as the subject permits, and also as interesting. +Dr. Fiske has attempted this task in this book, which he entitles "An +elementary study of the brain." The brain of the sheep is chosen as the +basis of study because of its availability, its relative simplicity of +structure, and its essential similarity to that of man. It appears to the +author, and we think with justice, that the subject should be approached +from a biological standpoint; hence, throughout the book, there is constant +reference to the evolution of nervous structure and to fundamental +conceptions of a biological character. Further than this, the relations of +cerebral anatomy and function, together with allied psychological +considerations, demand continual reference as a supplement to purely +anatomical considerations. The secret of exciting interest in any anatomical +study surely lies in a consideration of the function of the organ or +structure in relation to its anatomical form. Bare descriptions cannot and +should not inspire interest, whereas the driest anatomical facts, if seen in +their broader relationships, at once assume a significance in the student's +mind which may be attained in no other way. + +The first chapter is a brief statement of phylogeny, followed, as are +succeeding chapters, by directions to the student regarding means of study. +The second chapter concerns itself with ontogeny, and the student is wisely +advised to make drawings of various stages in the development of the brain +of one of the higher mammals. An actual brain is always to be preferred to a +model. The third chapter gives directions of a simple and practical sort as +to methods of removing the sheep's brain. Thereafter, chapters follow, +descriptive of the various surfaces of the brain, of sagital, horizontal and +transverse sections, and of certain of the internal structures and the brain +stem. + +A summary concludes the volume, and a very brief but well selected +bibliography. The illustrations are thoroughly adequate, the excellent +method being used of photographic reproductions, with accompanying +descriptive plates done in outline. In general, the book, modest though it +is, should prove a most admirable laboratory guide, not only for students of +zoology, but also for those who propose, as physicians, to make a final +study of the human brain. It is, no doubt, more difficult to write an +acceptable elementary text-book than a more complete treatise, but the +author, we have no hesitation in saying, has succeeded in this object, and +has added a book of positive value to the long list which has gone before. +The BNA nomenclature has been adopted in part, but by no means to the +exclusion of the old terminology, which is certainly a far more efficient +means of introducing an ultimate uniform nomenclature than an immediate +complete change to the BNA system. The text is well printed and readable, +and the proof reading in general good. We note, however, on page 86, that +the name Von Gudden is spelled with one d instead of two. E. W. TAYLOR. + + + +THE BACKWARD CHILD, A STUDY OF THE PSYCHOLOGY OF BACKWARDNESS: A PRACTICAL +MANUAL FOR TEACHERS AND STUDENTS. By Barbara Spoffard Morgan. G. P. +Putnam's Sons, New York, 1914. Pp. xvii plus 263. + +This book by Mrs. Morgan, which is somewhat unique and certainly very +different from other books on the same subject, promises to be one of the +most widely read educational works which has recently appeared. It is based +on two years' experience in an experimental clinic for backward children in +New York City and the author states that, "It is an effort to persuade +teachers and parents, in spite of a hide-bound educational system, to study +the children that interest them as individuals and to recognize their +faculties and tendencies." It "Looks to a future when teachers will so +understand every child's mental structure that his whole education will be +directed to the fortifying of his weak points and the development of his +tendencies." + +The author terms her process "mental analysis" and says it differs from the +Binet and Simon tests in that they are merely to classify children, and her +method discovers peculiarities and also gives the training necessary to +bring the child up to normal. She gives a psychological basis for her work +which will be surprising to many readers because of its great divergence +from the usual psychological treatment. The child's mind is considered as +having four primary processes, namely: (1) Sense Impressions, (2) +Recollections of Sense Impressions, (3) Association Channels (4) Abstraction +Processes. As the child grows older these are elaborated into Imagination, +Reasoning, and Expression. Attention is of three kinds: (1) Homogeneous +Attention or concentrating, which consists in attending to one thing for a +period of time; (2) Simultaneous Attention or observing, which consists in +giving attention to a number of things at once; and (3) Disparate Attention, +or giving attention to two or more things over a period of time. Memory may +be (1) Automatic, (2) Voluntary, or (3) Retentive. The function of the +tests is to determine just which one of these processes are weak or strong +and discover a method of education which is suited to the individual. Other +mental processes, such as sensation, perception, abstraction, and judgment +are discussed, and an interesting treatment distinguishing between the +analytic and synthetic type of mind is given. + +One of the most important parts of the book is the discussion of the way in +which the tests are given. She insists that the relation of the child and +the examiner be very personal and informal and that the process be varied as +much as possible in order to prevent crystallization. Many of the tests are +the same, or much the same, as those of Simon and Binet, but the greatest of +liberty is taken in adapting them to the particular case. Much use is made +of conversation, puzzle-pictures and other little friendly means by which +the personal characteristics of the child may be learned. After this is +done, the proper training of the child is to be selected and the effort made +to bring him back to normality, for which purpose, some quaint and +interesting devices are used. One case given is that of a little girl whose +senses of sound and form were defective and who therefore could not learn +her letters. These letters were pasted on the keys of a piano and she was +taught to play a piece with one finger, meanwhile chanting over the names of +the letters as they were struck. In this way her sense of sound was trained, +she learned her letters and gained ability to learn more and faster. +Abstraction may be strengthened by having the child measure distances with a +rule, first calculating the distance with his eye. The power of association +may be made stronger by having the individual sort words or pictures which +are pasted on slips of cardboard; he is to arrange them according to meaning +or according to the activities with which they have to do. Simultaneous +attention may be trained by such games as "Hide-the-thimble" or Jack-straws, +and homogeneous attention may be trained by some such action as hammering +nails in the upper left hand corners of all the squares on a board. +Imagination is developed by retelling stories, and invention by solving +puzzles; voluntary memory is strengthened by writing original rhymes and +automatic memory may be strengthened by having the child write out a list of +all the things in his kitchen or any other room with which he may happen to +be familiar. + +Different types of backward children are described and a few pages are +devoted to a discussion of hysteria. + +It is a book which will, in all probability, arouse considerable discussion +and which will find some warm friends and some determined enemies. As one +more publication calling attention to this important problem, it is of great +value and it will probably be read more widely than any other book in this +field which has appeared. Perhaps its greatest practical value lies in its +suggestiveness as to the ways in which one may use his personality and +initiative in dealing with backward children, rather than sticking so +closely to prescribed tests and methods. + RAYMOND BELLAMY. Emory & Henry College, Emory, Va. + + + +CONTINUITY: THE PRESIDENTIAL ADDRESS TO THE BRITISH ASSOCIATION FOR 1913. +By Sir Oliver Lodge. G. P. Putnam s Sons, New York and London, 1914. Pp. +v, 131. + +The most obvious particular wisdom of the present scientific period is +undoubtedly just that concept denoted by the title of this volume, +continuity. And this wisdom is advanced wisdom and, withal, wisdom which is +very expedient and even indispensable at this day, as a reaction required to +set right the over-specialization of recent minds thoughtful only of some +little branch of knowledge. Just in proportion as one esteems "authority" +will one give heed to the pronouncement of the presidential address before +the British Association, yet for its own intrinsic sake it is a piece of +work which cannot be ignored. + +Interesting and revolutionary as are the recent additions to philosophical +physics brought about by the discovery of radium and its like, it is the +other phase of this great physicist's mental trend which particularly +interests the student of human behavior-- that wisdom which gives him (as it +gave William James, and for a like reason), the bravery to look a bit beyond +the more or less materialistic confines of mere science into the broader +realm. And strange, is it not, that a man NEED be brave in this twentieth +century Domini to discuss spiritism and survival and telepathy? Only those +do it who cannot "lose their jobs." Can one indeed honestly doubt that many +an intelligent psychologist to-day is kept from investigating this pressing +phase of knowledge largely, or even solely, by the materialistic incubus +whose continuance still stands for an academic salary usually sufficient to +buy wife and children bread, if not a little meat? + +"Material bodies are all that we have any control over, are all that we are +experimentally aware of; anything that we can do with these is open to us; +any conclusions we can draw about them may be legitimate and true. But to +step outside their province and to deny the existence of any other region +because we have no sense-organs for its appreciation, or because (like the +ether) it is too uniformly omnipresent for our ken, is to wrest our +advantages and privileges from their proper use and apply them to our own +misdirection." . . . "I am one of those who think that the methods of +science are not so limited in their scope as has been thought: that they can +be applied much more widely, and that the psychic region can be studied and +brought under law too. Allow us anyhow to make the attempt. Give us a fair +field. Let those who prefer the materialistic hypothesis by all means +develop their thesis as far as they can; but let us try what we can do in +the psychical region, and see which wins. Our methods are really the same as +theirs--the subject-matter differs. Neither should abuse the other for +making the attempt." + +Here is this matter in a nutshell, and the evolution of cosmology in the +last few years makes this argument and this plea greatly more persuasive +still, for it forges one more link in the actual knowledge of continuity. + +Twenty-four pages of useful, explanatory notes follow in this volume, the +text of the Address. The book lacks an index. To those sapient ones who +have not already saved the important little work out of Science, the dollar +which this volume costs is a dollar well-spent, unless, indeed, philosophy +be to him but a reproach. GEORGE V. N. DEARBORN. Tufts Medical and Dental +Schools. + + + +ADVENTURINGS IN THE PSYCHICAL. By H. Addington Bruce. Little, Brown & Co., +1914. + +Professor Flournoy, in the Preface to his Spiritism and Psychology, made the +remark: "It will be a great day when the subliminal psychology of Myers and +his followers, and the abnormal psychology of Freud and his school, succeed +in meeting, and will supplement and complete one another. That will be a +great forward step in science and in the understanding of our nature." +(Page VI.) + +Any one who attacks the problem from this standpoint, in the right manner, +is to be commended; and this is, very largely, the method of attack taken by +a certain group of "psychical researches"; it is also the method of approach +of Mr. Bruce, in the book under review. Although it will probably contain +but little new to the student of abnormal psychology, it is, nevertheless, a +welcome and extremely sane presentation of the problems discussed; while, +for the general public, the effect of the book cannot be other than +beneficial,-- giving a sound and scientific view-point of many of these +obscure and outlying problems. + +Much of this book will be familiar to readers of the JOURNAL. The chapters +on the "Subconscious" (extended and amplified in his final chapter on "The +Larger Self"), "Dissociation and Disease," and "The Singular Case of B. C. +A.," contain a summary of material long familiar to general psychological +students--though this data has not been sufficiently popularized as +yet,--while the case of B. C. A. is a relief after the oft-quoted earlier +cases! + +The first chapter, "Ghosts and their Meaning," deals with apparitions of the +living, of the dying, and of the dead--according to the tentative +arrangement of these cases made by the English S. P. R. Most of these are +quoted from the Society's Proceedings, and the usual theories are offered to +account for them; in the case of apparitions of the dead, e. g., "ghosts," +the theory of deferred telepathic suggestion being held. This brings us +naturally to the second chapter, "Why I believe in Telepathy," which again +contains a summary of much of the S. P. R. work in this field; accompanied, +however, by some other cases and a few interesting incidents which fell +under the author's personal observation. The next two chapters deal with +"Clairvoyance and Crystal Gazing" and "Automatic Speaking and Writing" +respectively. Here, again, the bulk of the material is familiar to +psychical and psychological students; though it must be admitted that this +material is all excellently and carefully summarized. The author's attitude, +throughout, is strictly critical and scientific; and while he believes in +telepathy and other supernormal powers, he rejects spiritism as an +explanation, and his views throughout are temperate and modest. + +The remaining chapter, dealing as it does with "Poltergeists and Mediums," +takes us into the more dubious field of "physical phenomena"--spontaneous +and experimental--and cases are discussed which lie outside the province of +the psychologist,-- since they entrench more upon the domain of physics and +biology. As such they have been treated and discussed by the majority of +Continental savants. + +One word more regarding the famous medium, Eusapia Palladino, whom Mr. Bruce +refers to in several passages in this Chapter, referring to her in a +footnote on page 196, as "The discredited Eusapia Palladino, once the marvel +of two continents." May I take this occasion to repeat here what I have +often repeated in public and private, elsewhere? and that is, that I retain +my unshaken belief, amounting to a conviction, in the genuineness of +Eusapia's power, and that, despite the trickery which was undoubtedly +discovered here--and which had also been discovered, I may add, more than +twenty years before she ever came to this country--she yet possesses +genuine, remarkable powers of a supernormal character, and this belief, I +may say, is shared equally by all the continental investigators, who remain +unaffected by the so-called American expose. A statement of their attitude +is perhaps well summarized by Flournoy, in his Spiritism and Psychology +(Chap. VII); while I have published the records of the American seances-- +for those who may be interested--in my "Personal Experiences in +Spiritualism," where copious extracts from the shorthand notes of the +American sittings are given. + +To return, however: If there is a criticism to make of Mr. Bruce's book, it +is that it displays a lack of personal investigation and experimentation, +and bears throughout the ear-marks of a literary compilation. But this is, +after all, not a serious detraction from a work of this character,--which +is, as I have said before, excellently done. HEREWARD CARRINGTON. + + + +DES TROUBLES PSYCHIQUES ET NEVROSIQUES POST-TRAUMATIQUES, Par R. Benon. +Ancien interne de la Clinique des Maladies Mentales et de l'Encephale a la +Faculte de Paris, Medecin de l'Hospice General de Nantes (Quartiers +d'Hospice). G. Steinheil, editeur, Paris, 1913; pp. x-449. + +The author in this volume has written a clinical and medico-legal treatise +on traumatic nervous affections from a broad and philosophical standpoint. +The subject is treated under the following headings: "Generalities," in +which is discussed the historical development of our knowledge of the +effects of traumatism, the etiology, the evolution of the various +disturbances, and the legal side of the questions at issue. + +Following this introduction, under Chapter I, the general topic of what the +writer terms the traumatic dysthenias or the traumatic sthenopathies is +discussed under the following subheadings: (a) Simple post-traumatic +asthenia; (b) Post-traumatic astheno-mania; (c) Prolonged asthenia and +chronic traumatic asthenia, under which he includes traumatic neurasthenia, +traumatic hystero-neurasthenia, traumatic neurosis, and traumatic +psychoneurosis; (d) Chronic post-traumatic mania; (e) Periodic +post-traumatic dysthenias; (f) Asthenic mania and pathological anatomy. +Chapter II, under the general heading, "Traumatic Dysthymias: (a) Anxiety +post-traumatic hyperthymia; (b) Traumatic hypochondriasis and traumatic +hysteria; (c) Special hyperthymia of accidents; (d) Hysterical and traumatic +crises; (e) Prolonged or permanent post-traumatic disturbances of character +in children and adults. Chapter III, under the general heading, "Traumatic +Dysthymias": (a) Traumatic amnesia; (b) Post-traumatic Korsakoff syndrome; +(c) Traumatic mental confusion; (d) Post-traumatic agnosia; (e) +Post-traumatic dementias; (f) Systematized chronic post-traumatic deliriums. +Chapter IV, under the general heading, "Psychic states and Diverse +Post-Traumatic Neuroses": (a) Post-traumatic epilepsy; (b) Traumatic +aphasia; (c) Alcoholism, traumatism and hallucinatory conditions; (d) +Post-traumatic sensual perversions; (e) Pains, vertigos, deafness, etc., +following trauma; (f) Distant post-traumatic psychic disorders with cerebral +lesions; (g) Unclassifiable observations. To this comprehensive material is +added an appendix on the topic of psychic and neurotic disturbances as +indications for trephining. + +This outline of the contents of the book, which contains in addition many +subheadings, gives a sufficiently clear idea of its scope and of the pains +which the author has taken to subdivide his subject matter to the last +possible degree. Whether such a detailed classification has merit sufficient +to justify its complexity must be left to the individual reader to +determine. It may, however, with justice be said that the author has spared +no pains to illustrate by case reports the various phases of traumatic +disorder which he enumerates. He has a keen sense of the significance of +psychiatric knowledge in a proper understanding of the various results of +trauma, and lays special stress upon the breadth of the psychiatric field, +under which he properly enough includes the various so-called psychoneuroses +as well as epilepsy, tics and aphasia. He believes that one may only arrive +at a diagnostic criterion of such affections through the sensations and +emotions expressed by the patients. The somatic phenomena he regards as +always subordinate and accessory. Under this point of view, he attacks his +problem, and with considerable success An admirable brief historical review +of traumatism in relation to the nervous system constitutes a valuable +section of the book, in which he brings out the conflicting views which have +prevailed since the earlier work of Erichsen down through the fundamental +investigations of Westphal, Charcot, Knapp, Oppenheim and others. + +The author finds fault with the common use of the word traumatism in the +sense of trauma, and correctly draws attention to the fact that traumatism +should express a general condition, whereas, trauma should be used as +indicative of a local lesion. This distinction has been too often +overlooked, with resulting confusion. + +In general, the book represents a vast amount of painstaking thought and an +earnest but somewhat confusing attempt to bring light into the somewhat dark +places of a much-discussed subject, which has frequently been the source of +more or less acrimonious discussion. Not the least significant part of the +volume is the constant reference to the legal implications of the traumatic +affections. It should therefore be useful, not only to the physician, but +also to the legal profession. It will doubtless be used rather as a book of +reference than as a readable treatise. E. W. TAYLOR. + + + +VERBRECHERTYPEN. 1 Heft. Geliebtenmorder von Albrecht Wetzel und Karl +Wilmanns. Verlag Julius Springer, Berlin: 1913. + +With a better understanding of psychopathic phenomena, the underlying +psychology of criminology becomes more clearly defined. Maladjustment may +express itself in an insane outbreak, criminal act, or in an anti-social +deed, indeed, in all of them the underlying phenomenon is a psychopathic +condition which comes under the realm of abnormal psychology. The large +group of criminals SHOULD not be looked upon as a homogenous class, but the +individuality of criminal and the type of the delinquent act in reaction to +his heredity, mental make-up and environmental influences should be fully +considered. Herein lies the great value of Wetzel's and Willmann's +Monograph--these authors report three cases in which criminal acts were +attributed to abnormal mental life. + +The first case was that of a young man of twenty-three, who showed a +psychopathic personality with tainted heredity on the paternal side. He was +subject to convulsive attacks, which were regarded as hysterical and not +epileptic. In his intelligence he was above the average. He was engaged to +a young woman, and because she refused to marry him, he at first +contemplated to take his life, but later shot at her three times without +injuring her, and then made an unsuccessful attempt at suicide. His +delinquent act was determined not only by his environment, but also by his +peculiar type of personality, which was taken into consideration by the +court, and on this ground he was acquitted. + +In the second case, a young man of twenty shot his fiancee through the +temporal region, injuring her severely. Soon after committing this act he +surrendered himself to the police. He also showed striking evidences of a +psychopathic personality with a strong suggestion of epilepsy, but with +intact intelligence. He was given to periods of depression and was unstable +mentally. He was easily suggestible and his general conduct was not only +controlled by environmental influences, but also by his mood. Suicidal ideas +and jealousy played a very important role in his mental life; especially +they were marked when he began to keep company with the young woman. +Although his abnormal constitution was taken into account, nevertheless he +was punished by one year's imprisonment. During confinement he attempted +suicide, but was unsuccessful. Some time after his release he committed +suicide, the cause of which he assigned to an abortion that was induced by +his sweetheart. + +The third case is very interesting and rather intricate, by reason of the +fact that murder or double suicide was suspected. The following are the +details of this case: A young man of eighteen kept company with a young +woman about the same age, from another town. The girls of the town were +jealous of her and began to gossip about her to the extent of casting +aspersions upon her character, etc. The young man's father, without +investigating this case, forbade his son to marry her. However, the two +lovers would have frequent secret rendezvous, and his fiancee became +depressed over this scandalous and groundless rumor and also because of the +peculiar attitude her young man's father assumed. One evening the young man +returned home late, and upon confessing to his father of his secret meetings +with his fiancee, he was severely beaten and prohibited to see her again. + +A few days later the young man wrote a letter to his sweetheart, telling her +of his father's emphatic determinations, but soon they met again and she +suggested that they should die together on account of this gossip that was +circulated about her. A day following this meeting both of them were missed, +and after some search the young woman was found lying on the ground with two +shots in her head and one in the breast, and the young man was hanging from +a tree, in a near-by wood; the latter was resuscitated, but the former was +dead. It is interesting to note that the autopsy showed that death in her +case was due to strangulation and not to the bullets. This young man was +endowed with a psychopathic personality, and there was a history of short +attacks of depression. He received several head traumata and suffered from +enuresis in his early life. + +Following the resuscitation, he grew confused and excited, and within +twenty-four hours he recovered from the acute episode but showed incomplete +amnesia for his act. He stated that he remembered firing the shots, but had +no remembrance of strangulating her. Soon after this he passed into a +peculiar state of confusion; in addition, fabrications and retention defect +were also demonstrated. The cerebrospinal fluid revealed some abnormal +changes which were suggestive of an organic brain disease. The Wassermann +test was negative. Finally, he made a complete recovery except for the +incomplete amnesia. + +Since the death of the young woman was caused by strangulation, the question +had to be decided whether he was the cause of her death or she died as the +result of her own hand. The court favored suicide, and held that the bodily +injury was inflicted with the pistol by the young man. He received a lenient +sentence--only nine months imprisonment. In this case, the type of his +personality, and all the circumstances that led to the development of the +act were taken into consideration. + +Although the authors presented this subject purely objectively, yet their +studies are extremely interesting and important, and show conclusively the +importance of psychopathological methods in criminology. One who is +interested in this subject will find this monograph of great value and help. +It may also be added that the authors give a complete list of the casuistic +literature of the murder among lovers. MORRIS J. KARPAS. + + + +DEVELOPMENT AND PURPOSE. AN ESSAY TOWARDS A PHILOSOPHY OF EVOLUTION. By L. +T. Hobhouse, Martin White Professor of Sociology in the University of +London. Macmillan & Co., London: 1913; pp. xxix, 383. + +"Development and Purpose" is essentially the complement of Professor +Hobhouse's well-known and valuable "Mind in Evolution," published in 1901; +if it were rather a continuation than the complement, many would be pleased, +for the exposition already made practically guarantees a rich application, +were it undertaken, to matters still further "away" in the realm of thought. +The present volume lacks the multitude of scientific data and references +which make "Mind in Evolution" so important for the study of psychology (as +behavior or not as behavior, as the reader pleases), but it contains in +their space many timely discussions, in some cases seemingly prophetic, of +teleology in its relation to evolution. + +The seventeen chapters of the book (there is also an extremely thoughtful +Introduction and a full Index), are divided into two parts, one entitled +"Lines of Development" and the other "The Conditions of Development." The +reviewer's lazy cortex, and possibly those of other and more leisurely +readers, is made glad by a complete chapter-synopsis or syllabus, occupying +seven pages). So much of the whole treatise is suggested in the synopsis of +the first three chapters that it is well to give them in full, as follows: + +"I. The Nature and the Significance of Mental Evolution. (1) The biological +view regards Mind as an organ evolved to adapt behavior to the environment, +(2) and tends to reduce its action to a mechanical process. (3) Parallelism +in the end reduces Mind to an epi-phenomenon {an important undoubted fact +which has been often ignored by what are left of the Parallelists!] (4) The +object of Comparative Psychology is to determine empirically the actual +function of Mind in successive stages of development. (5) It involves a +social as well as an individual psychology. (6) The statement of the higher +phases also opens up philosophical questions, (7) and on the solution of +these depends the final interpretation of the recorded movement. + +"II. The Structure of Mind. (1) Mental operations are known in the first +instance as objects of consciousness. (2) Mind is the permanent unity +including consciousness and the sum of processes continuous with +consciousness and determining it. (3) These processes involve, but are not +identical with physical processes, constituting with them a psychophysical +unity. + +"III. The General Function of Mind and Brain. (1) The generic function of +Mind, as of the nervous system, is correlation (2) The special organ for +effecting fresh correlation is consciousness. (3) The deliverances of +consciousness arise from stimuli acting upon structures built up by +experience, (4) on foundations laid by heredity, (5) which supplies not only +specific adaptations, but a background to the entire life of consciousness." + +It would be hard to find a more concise, complete, and timely +formularization of the seeming trend of present resultants in this +particular direction than these sentences set forth for whomsoever will +ponder each carefully-built statement and really understand what it means as +part of a system. "Mind is the permanent unity including consciousness and +the sum of processes continuous with consciousness and determining it. These +processes involve, but are not identical with, physical processes, +constituting with them a psychophysical unity,"--this quotation might almost +serve as the motto of early Twentieth Century scientific philosophy. It +seems to the present reviewer to have almost as much philosophy in it as +Harold Hoffding's well-known sentence has of psychology: ("the unity of +mental life has its expression not only in memory and synthesis, but also in +a dominant fundamental feeling, characterized by the contrast between +pleasure and pain, and in an impulse, springing from this fundamental +feeling, to movement and activity"). It might be the creed of the +Neoidealism. + +Hobhouse's discussion of mechanism in relation to teleology and to the +universal harmony and reality is fairly representative of the drift of +thought as set forth by recent English and French writers such as J. S. +Haldane, Oliver Lodge and some of the prominent biologists, and by Henri +Bergson: "An organic whole is therefore like a machine in being purposive, +though unlike it in that its purpose is within." "A purposive process is one +determined by its tendency to produce a certain result, purpose itself being +an act [sic] determined in its character by that which it tends to bring +about. As such it differs fundamentally from a mechanical cause." "The +empirical and philosophical arguments point to the same general conclusion, +that reality is the process of the development of Mind." As a guide to +one's thinking, and as integrators of one's subconscious intuitions and +resultants, such concise formulae certainly have much value, especially +when, as here, clearly and ably expounded in the text proper. Tufts College. +GEORGE V. N. DEARBORN. + + + +BOOKS RECEIVED + +ABNORMAL PSYCHOLOGY. Isador H. Coriat. Pp. xvi and 428. 2d Ed. Moffat, +Yard & Co., 1914. $2.00 net. + +MENTAL MEDICINE & NURSING. Robert Howland Chase. Pp. xv and 244. J. B. +Lippincott Co., 1914. $1.50. + +THE TEACHING OF DRAWING. S. Polak and H. C. Whilter. Pp. 168. Warwick & +York, Inc. 85 cents. + +OUTLINE OF A STUDY OF THE SELF. Robert M. Yerkes, A.M., Ph.D., and David W. +LaRue, A.M., Ph.D. Pp. 24. Harvard University Press, Cambridge, 1914. + +EROS. Emil Lucka. Pp. xx and 379. G. P. Putnam & Sons. 1915. $1.75. + +COLLECTED PAPERS OF MARGARET BANCROFT. Ware Brothers Company, Philadelphia, +1915. + +EUGENICS: A SCIENCE AND AN IDEAL. Edgar Schuster. Pp. 263. Warwick & +York, Inc. 40 cents. + +LIFE AND WORK OF PESTALOZZI. J. A. Green. Pp. 393. Warwick & York, Inc. +$1.40. + +THE PSYCHOLOGICAL METHODS OF TESTING INTELLIGENCE. Wm. Stern. Translated +by Guy Montrose Whipple. Pp. 160. Warwick & York $1.25. + + + +THE JOURNAL OF ABNORMAL PSYCHOLOGY + +ANGER AS A PRIMARY EMOTION, AND THE APPLICATION OF FREUDIAN MECHANISMS TO +ITS PHENOMENA[*] + +[*] Read at a meeting of the American Psychopathological Association, New +York City, May 5, 1915. + +BY G. STANLEY HALL + +THE exact sciences consist of a body of truth which all accept, and to which +all experts strive to contribute. Philosophy, however, like religion, has +always been broken into sects, schools or parties, and the body of truth +which all accept in these fields is relatively far less, and the +antagonistic views far greater. Normal psychology, which a few decades ago, +started out to be scientific with the good old ideal of a body of truth +semper ubique et ad omnibus, is already splitting into introspectionists, +behaviorists, genetic, philosophical and other groups, while in the new +Freudian movement, Adler and Jung are becoming sectaries, the former drawing +upon himself the most impolitic and almost vituperative condemnation of the +father of psychoanalysis. With this latter schism we are not here concerned, +but we are deeply concerned with the more general relations between the +psychologists of the normal and those of the abnormal; with a very few +negligible exceptions psychoanalysis has hardly ever had a place on the +program of our American Psychological Association, and the normal has had +little representation in your meetings and publications. This I deem +unfortunate for both, for unsatisfactory as this sadly needed rapprochement +is on the continent, it is far more so here. That the normalists in this +country so persistently ignore the unique opportunity to extend their +purview into the psychopathological domain at the unique psychological +moment that the development of Freudianism has offered, is to me a matter of +sad disappointment and almost depression. In reading a plea for Freud in our +association of normalists, I am a vox clamantis in deserto and can evoke no +response, and even the incursions of psychoanalysis into the domain of +biography, myth, religion and dreams, have not evoked a single attempt at +appreciation or criticism worthy of mention by any American psychologist of +the normal. I have sought in various ways the causes of this reticence, not +to say ignorance. While I received various answers, the chief one was to the +effect that the alleged hypertrophy of sex in its gross pathological forms, +and the conviction of the kind and degree of sex consciousness found in the +many hundreds of analyzed cases, are so unique and constitute the very +essence of the neurotic and psychotic cases, and conscious and unconscious +sex factors are slight or absent in most normal cases, that these patients +and their doctors alike are sex-intoxicated, and that the Freudian +psychology applies only to perverts and erotomania or other abnormal cases. +To ascribe all this aversion to social or ethical repression is both shallow +and banousic, for the real causes are both manifold and deeper. They are +part of a complicated protest of normality, found in all and even in the +resistance of subjects of analysis, which is really a factor which is basal +for self-control of the varying good sides of which Freudians tell us +nothing. The fact is that there are other things in the human psyche than +sex, and its ramifications. Hunger, despite Jung, fear despite Sadger, and +anger despite Freud, are just as primary, aboriginal and independent as sex, +and we fly in the face of fact and psychic experience to derive them all +from sex, although it is freely granted that in morbid cases each may take +on predominant sex features. In what follows I can only very briefly hint at +the way in which some of the Freudian mechanisms are applied to one of the +emotions, viz., anger. + +Anger in most of its forms is the most dynamogenic of all the emotions. In +paroxysms of rage with abandon we stop at nothing short of death and even +mutilation. The Malay running amuck, Orlando Furioso, the epic of the wrath +of Achilles, hell-fire, which is an expression of divine wrath, are some +illustrations of its power. Savages work themselves into frenzied rage in +order to fight their enemies. In many descriptions of its brutal aspects, +which I have collected, children and older human brutes spit, hiss, yell, +snarl, bite noses and ears, scratch, gouge out eyes, pull hair, mutilate sex +organs, with a violence that sometimes takes on epileptic features and which +in a number of recorded cases causes sudden death at its acme, from the +strain it imposes upon the system. Its cause is always some form of +thwarting wish or will or of reduction of self-feeling, as anger is the acme +of self-assertion. The German criminalist, Friedrich, says that probably +every man might be caused to commit murder if provocation were sufficient, +and that those of us who have never committed this crime owe it to +circumstances and not to superior power of inhibition. Of course it may be +associated with sex but probably no human experience is per se more +diametrically opposite to sex. Some temperaments seem to crave, if not need, +outbreaks of it at certain intervals, like a well-poised lady, so +sweet-tempered that everybody imposed on her, till one day at the age of +twenty-three she had her first ebullition of temper end went about to her +college mates telling them plainly what she thought of them, and went home +rested and happy, full of the peace that passeth understanding. Otto Heinze, +and by implication Pfister, think nations that have too long or too +assiduously cultivated peace must inevitably sooner or later relapse to the +barbarisms of war to vent their instincts for combat, and Crile thinks anger +most sthenic, while Cannon says it is the emotion into which most others +tend to pass. It has of course been a mighty agent in evolution, for those +who can summate all their energies in attack have survived. But few if any +impulsions of man, certainly not sex, have suffered more intense, prolonged +or manifold repressions. Courts and law have taken vengeance into their +hands or tried to, and not only a large proportion of assaults, but other +crimes, are still due to explosions of temper, and it may be a factor in +nearly every court case. Society frowns on it, and Lord Chesterfield says +the one sure and unfailing mark of a gentleman is that he never shows +temper. Its manifestations are severely tabooed in home and school. Religion +teaches us not to let the sun go down upon our wrath and even to turn the +other cheek, so that we go through life chronically afraid that we shall +break out, let ourselves go, or get thoroughly mad, so that the moment we +begin to feel a rising tide of indignation or resentment (in the +nomenclature of which our language is so very rich, Chamberlain having +collected scores of English expressions of it), the censorship begins to +check it. In many cases in our returns repression is so potent from long +practice, that the sweetest smile, the kindest remarks or even deeds are +used either to veil it to others, or to evict it from our own consciousness, +or else as a self-inflicted penance for feeling it, while in some tender +consciences its checked but persistent vestiges may become centers of morbid +complexes and in yet other cases it burrows and proliferates more or less +unconsciously, and finds secret and circuitous ways of indulgence which only +psychoanalysis or a moral or religious confessional could trace. + +I. Anger has many modes of Verschiebung, both instinctive and cultivated. +One case in our returns carries a bit of wood in his vest-pocket and bites +it when he begins to feel the aura of temper. Girls often play the piano +loudly, and some think best of all. One plays a particular piece to divert +anger, viz., the "Devil's Sonata." A man goes down cellar and saws wood, +which he keeps for such occasions. A boy pounds a resonant eavespout. One +throws a heavy stone against a white rock. Many go off by themselves and +indulge in the luxury of expressions they want none to hear. Others take out +their tantrum on the dog or cat or perhaps a younger child, or implicate +some absent enemy, while others curse. A few wound themselves, and so on, +till it almost seems, in view of this long list of vicariates, as if almost +any attack, psychic or physical, might thus be intensified, and almost +anything or person be made the object of passion. Be it remembered, too, +that not a few look, do, think, feel their best under this impulsion. + +II. Besides these modes of Abreagierung there are countless forms of +sublimation. In anger a boy says: I will avenge myself on the bully who +whipped me and whom I cannot or will not whip, by besting him in his +studies, class-work, composition, or learn skilful stunts that he cannot do, +dress, or behave better, use better language, keep better company, and thus +find my triumph and revenge. A man rejected or scorned by a woman sometimes +makes a great man of himself, with the motivation more or less developed to +make her sorry or humiliated. Anger may prompt a man to go in to win his +enemy's girl. A taunt or an insult sometimes spurs the victim of it to +towering ambition to show the world and especially the abuser better, and to +be able to despise him in return; and there are those who have been thus +stung to attempt greatness and find the sweetest joy of success in the +feeling that by attaining it they compensate for indignities they suffered +in youth. In fact, when we analyze ambition and the horror of +Minderwertigkeit that goes with it, we shall doubtless find this factor is +never entirely absent, while if we were to apply the same pertinacity and +subtlety that Jung in his "Wandlungen" has brought to bear in working over +the treacherous material of mythology, we might prove with no less +verisimilitude than he has shown the primacy of the libido that in the +beginning was anger, and that not Anaxagoras' love or the strife of +Heraclitus was the fons et origo of all things, that the Ichtrieb is basal, +and that the fondest and most comprehensive of all motives is that to excel +others, not merely to survive, but to win a larger place in the sun, and +that there is some connection between the Darwinian psychogenesis and Max +Stirner and Nietzsche, which Adler has best evaluated. + +III. Anger has also its dreams and reveries. When wronged the imagination +riots in fancied humiliation and even tortures of an enemy. An object of +hate may be put through almost every conceivable series of degradation, +ridicule, exposure and disgrace. He is seen by others for what our hate +deems him to be. All disguises are stripped off. Children sometimes fancy a +hated object of anger flogged until he is raw, abandoned by all his friends, +an outcast, homeless, alone, in the dark, starving, exposed to wild animals, +and far more often more prosaic fancies conceive him as whipped by a parent +or stronger friend, or by the victim himself later. Very clever strategies +are thought out in detail by which the weaker gets even with or vanquishes +the stronger, and one who suffers a rankling sense of injustice can hardly +help day-dreaming of some form of comeuppance for his foe, although it takes +years to do it. In these reveries the injurer in the end almost always gives +up and sues for mercy at the feet of his quondam victim. So weird and +dramatic are these scenes often that to some minds we must call anger and +hate the chief springs of the imagination. A pubescent girl who was deeply +offended went off by herself and held an imaginary funeral of her enemy, +hearing in fancy the disparaging remarks of the bystanders, and when it was +all over and the reaction came, she made up with the object of her passion +by being unusually sweet to her and even became solicitous about her health +as fearing that her revery might come true. We all too remember Tolstoi's +reminiscences when, having been flogged by his tutor, he slunk off to the +attic, weeping and broken-hearted, and finally after a long brooding +resolved to run away and become a soldier, and this he did in fancy, +becoming corporal, lieutenant, captain, colonel. Finally came a great +battle where he led a desperate charge that was crowned with victory, and +when all was over and he stood tottering, leaning on his sword, bloody and +with many a wound, and the great Czar of all the Russias approached, saluted +him as saviour of his fatherland and told him to ask whatever he wanted and +it was his, replied magnanimously that he had only done his duty and wanted +no reward. All he asked was that his tutor might be brought up and his head +cut off. Then the scene changed to other situations, each very different, +florid with details, but motivated by ending in the discomfiture of the +tutor. In the ebb or ambivalent reaction of this passion he and the tutor +got on better. + +IV. Richardson has collected 882 cases of mild anger, introspected by +graduate students of psychology, and finds not only over-determination, +anger fetishes and occasionally anger in dreams with patent and latent +aspects and about all the Freudian mechanisms, but what is more important, +finds very much of the impulsion that makes us work and strive, attack and +solve problems has an element of anger at its root. Life is a battle and for +every real conquest man has had to summate and focus all his energies, so +that anger is the acme of the manifestation of Schopenhauer's will to live, +achieve and excel. Hiram Stanley rather absurdly described it as an epoch +when primitive man first became angry and fought, overcoming the great +quaternary carnivora and made himself the lord of creation. Plato said +anger was the basis of the state, Ribot made it the establisher of justice +in the world, and Bergson thinks society rests on anger at vice and crime, +while Stekel thinks that temper qualities should henceforth be treated in +every biography and explored in every case that is psychoanalyzed. Hill's +experiments with pugilism, and Cannon's plea for athletics as a legitimate +surrogate for war in place of James' moral substitute, Frank Howard's +opinion that an impulse that Darwin finds as early as the sixth week and +hardly any student of childhood later than the sixth month, and which should +not be repressed but developed to its uttermost, although carefully directed +to worthy objects, are all in point. Howard pleads for judicious scolding +and flogging, to be, done in heat and not in cold blood, and says that there +is enough anger in the world, were it only rightly directed, to sweep away +all the evils in it. In all these phenomena there is no trace of sex or any +of its symbols, and sadism can never explain but must be explained by it. My +thesis is, then, that every Freudian mechanism applies to anger as truly as +it does to sex. This by no means assumes the fundamental identity of every +feeling-emotion in the sense of Weissfeld's very speculative theory. + +In this very slight paper I am only trying to make the single point which I +think fear and sympathy or the gregarious or social instinct would still +better illustrate, although it would require more time, that the movement +inaugurated by Freud opens up a far larger field than that of sex. The +unconscious that introspectionists deny, (asserting that all phenomena +ascribed to it are only plain neural mechanisms, and therefore outside the +realm of psychology,) the feelings which introspection can confessedly never +tell much about and concerning which our text-books in psychology still say +so little: studies in these fields are marking a new epoch, and here the +chief merit of Freudism is found. + + + +THE NECESSITY OF METAPHYSICS + +BY JAMES J. PUTNAM, M. D. + +SOME years ago, at the Weimar Congress of the International Psychoanalytic +Association, I read a paper on the importance of a knowledge of philosophy +and metaphysics for psychoanalysts regarded as students of human life. +Perhaps if I had had the experience and ability to contribute the results of +some original analytic investigation on specific lines, I should not then +have ventured into the philosophic field. Perhaps, indeed, if those +conditions now obtained I should not be bringing forward similar arguments +again, and if any one feels tempted to maintain that philosophic speculation +is a camp of refuge for those who, in consequence of temperamental +limitations and infantile fixations which ought to be overcome, draw back +from the more robust study of emotional repressions on scientific lines, I +should admit that the allegation contains an element of truth. But in spite +of this, and in spite of the fact that there is some truth also in the +statement that the effects--good and bad--of emotional repression make +themselves felt, as a partial influence, in all the highest reaches of human +endeavor, including art, literature, and religion;--in spite of these +partial truths, philosophy and metaphysics are the only means through which +the essential nature of many tendencies can be studied of which +psychoanalysis describes only the transformations. And this being so it is +perhaps reasonable that one paper should be read at an annual meeting such +as this, where men assemble whose duty it is to study the human mind in all +its aspects. + +I presume that just as, and just because men have minds AND bodies, an +evolutional history in the ordinary sense and a mental history in a sense +not commonly considered, so there will always be two, or perhaps three, +parties among psychologists and men of science, and each one, in so far as +it is limited in its vision, may be considered as abnormal, if one will. I +decline, however, to admit that the temperamental peculiarities of one group +are more in need either of justification or of rectification through +psychoanalysis than those of the others. It is probably true that emotional +tension often plays a larger part among persons who love a priori +reasoning--the "tender-minded" of Dr. James--than it does in those who work +through observation; but on the other hand exclusively empirical attitude +has its limitations and its dangers. Philosophy and metaphysics deal more +distinctively with essential function--that is with real existence,--while +natural science and the genetic psychology (of which psychoanalysis, +strictly speaking, is a branch) deal rather with appearances and with +structure. Both are in need of investigation. The FORM which art, religion, +and literature assume is determined by men's personal experiences and +special cravings. The essential motive of art and religion is, however, the +dim recognition by men of their relation to the creative spirit of the +universe. + +No one can doubt that function logically precedes structure; or if any one +does doubt this, he need only observe his own experience and see how in +every new acquisition of knowledge or of power there come, first, the +thought, the idea, then the effort, next the habit, and finally the +modification of cerebral mechanism, in which the effort and the habit become +represented in relatively permanent and static form. In fact, the crux of +the whole discussion between science and metaphysics turns on, or harks back +to the discussion between function and structure; and it is the latter, in +the sense in which I mean the word, that has had of late a too large share +of our attention. + +The enterprise on which we are all of us embarked,--whether we define it as +an investigation, pure and simple, into human nature and human motives, or +as a therapeutic attempt to relieve invalids of their symptoms,--is a larger +one than it is commonly conceived of as being. Each physician and each +investigator has, indeed, the right to say that for practical reasons he +prefers to confine his attention to some single portion of one or the other +of these tasks, be it never so small. But each one should regard himself as +virtually under an obligation to recognize the respects in which this chosen +task is incomplete. Every physicist is aware that there is some form of +energy underlying, or rather expressing itself in, light and heat and +gravitation. Physicists do not study this form of energy, not because they +do not wish to but simply because they cannot do so by the only methods that +they are allowed to use. But, as a reaction of defense, they sometimes +assert that no one else can do so either, that this underlying energy cannot +be explained. To say this is, however, in my judgment, to misappreciate +what an explanation is. + +To explain any matter is to discover the points of similarity, or virtual +identity, between the matter studied and ourselves. But in order to do this +thoroughly, or rather in order to do it with relation to the essential +nature of some form of energy (the "Libido," for example, considered as an +unpicturable force) one must first consider what we, the investigators, are, +not at our less good, but at our best. It is with us, as given, with our +best qualities regarded as defining in part the Q. E. D. of the experiment, +that the investigation must begin. The nature of any and every form of real +underlying energy or essence must be defined in terms of our sense of our +own will and freedom. And this means that we must conceive and describe +ourselves, and expect to conceive and to describe the powers that animate +us, no longer as a system of forces subject to the so-called laws of nature +(which are, in reality, not immutable) but as relatively free, creative +agents; no longer as the product of the interplay of instincts, but as +individuals possessed of real reason, real power of love and real +self-consistent will. To claim to study the effects of the "Libido," to +which we ascribe the vast powers with which we are familiar, yet fail to +seek in it what would correspond to our own best attributes, would be to lay +aside our duties as students of human nature. It would be to confine our +attention to the "structure" of the mind, the form under which it manifests +itself, without having studied the laws of its action under conditions which +are more favorable to its development. + +It must, now, have struck students of psychoanalytic literature that a +marked tendency has been shown toward supplementing the study of +structure,--that is, the detailed history of men's experiences and +evolution, regarded as sequences of phenomena,--by the study of the function +or creative energy for which the experiences stand. Silberer, whose work is +endorsed by Freud, has gone to a considerable length in this direction; and +the whole tendency of Freud's insistence on the relevancy, in the mental +sphere, of the law of the conservation of energy has been a movement, +though, I think, a narrow one, in this direction. More recently, Jung has +emphasized the importance of this tendency, and has dwelt more strongly, as +I think, than the facts warrant, on the supposed unwillingness of Freud to +recognize its importance. + +Behind the experiences of childhood, for example, lie the temperamental +trends of childhood, and it is these with which we really need to get +acquainted; for these trends, if not the whole causes and equivalents of the +experiences which are recounted to us by our patients, constitute the +conditions without which the latter would not have been what they became. + +But Jung himself, strangely enough, in both of his carefully prepared +arguments, specifically rejects all intention of dealing "metaphysically" +with this theme, in spite of the fact that every movement toward a fuller +recognition of creative energy is nothing less than metaphysics, even though +not in name. + +The skilled observer, scrutinizing the motives and peering into the history +of the person whose traits and trends he is called on to investigate, must +see, in imagination, not only a vast host of acts, but also a vast network +of intersecting lines of energy of which the casual observer, and even the +intimate friend, may be wholly unaware. We call these lines of energy by +many special names,--"Libido" or "Urlibido," first of all, then love and +hate and jealousy, and so on. + +What are these lines of energy, and how can we study them to the best +purpose? Obviously they are incomplete editions of the love and reason and +will the laws of which we can study to best advantage in ourselves and in +men where they are displayed in their best, that is, in their most +constructive form. To make such studies is to recognize metaphysics, but +instead of doing of doing this tacitly and implicitly we should do it openly +and explicitly. + +The study of human nature should, in short, begin at the top, rather than at +the bottom; just as, if one had to choose what phase of a symphony one would +choose in order to get an idea of its perfection, one would take some +culminating moment rather than the first few notes simply because they were +the first. To be accurate, one could not do justice to the symphony except +by studying it as a whole, and similarly one should study the man as a +whole, including his relations to the universe as a whole. It is as wholes +that great poets conceived of their poems and great artists of their +pictures, and it is as a whole that each and every human life, standing as +it does as the representative of the body of the universe, and the spirit of +the universe, on the other, should implicitly be viewed. + +The psychologist should sympathize deeply with the anatomist and the +physiologist and the student of cerebral pathology, but equally deeply with +the philosopher and the metaphysician who study the implications, present +although hidden, that point to the bonds between the individual and the +universe. To fail to recognize that these bonds exist,--as is done when the +attempt is made to study human beings as if they were really and exclusively +the product of their historic past conceived of in an organic sense,--would +be to try to build one-half of an arch and expect it to endure. The truth +is, we do not, in my opinion, genuinely believe that a human is nothing but +the product of his organic past, or the product of his experience. + +We believe, by implication, in our metaphysical selves and our corresponding +obligations, more strongly than we have taught ourselves to recognize. But +to this fact we make ourselves blind through a species of repression, just +as many a child, confident of its parents' affection, assumes, for his own +temporary purposes, the right to accuse them of hostile intentions which +they do not entertain. + +We forget, or repress, the fact that the mind of man cannot be made subject +to the laws of physics, and yet we proceed to deal with the phenomena +dependent on the working of the mind of man as if these laws actually did +prevail. + +The misleading effects of this tendency are clearly seen where it is a +question of the conclusions to be drawn from the researches, admirable in +themselves, made under the influence of the genetic method. + +The notion seems to prevail that we should prepare ourselves for the +formation of just ideas with regard to the mode in which the higher +faculties of men come into existence by wiping the slate clean to the extent +of assuming that we have before us no data except some few acts or thoughts +that are definable in the simplest possible terms, and then watching what +happens as the situation becomes more complicated. But one is apt to forget, +in doing this, that there is one thing which we cannot wipe off the +slate,--namely, ourselves, not taken in the Bergsonian sense alone, but as +fully fledged persons, possessed of the very qualities for which we +undertake to search, yet without the possession of which the search could +not begin. This does not, of course, militate against the value of these +genetic researches in one sense. The study of evolutional sequences is +still, and forever will be, of enormous value. But it does not teach us +nearly as much of the nature of real creativeness as we can learn through +the introspection of ourselves in the fullest sense; and I maintain that +psychoanalysts are persons who could do this to advantage. + +Is not the notion that through the careful watching of the sequences of the +evolutionary process, as if from without, we can get an adequate idea of the +forces that really are at work, exactly the delusion by which the skillful +juggler tries to deceive his audience when he directs their attention to the +shifting objects that he manipulates, and away from his own swiftly moving +hands? + +My contention is that there are other means of studying the force which we +call "Libido" besides that of noting its effects. The justification for this +statement is that the force itself is identical, in the last analysis, with +that which we feel within ourselves and know as reason, as imagination, and +as will, conscious of themselves, and capable of giving to us, directly or +indirectly, the only evidence we could ever hope to get, for the existence +of real creativeness, spontaneity and freedom. + +Every work of art, worthy of the name, gives evidence of the action not +alone of a part of a man, but of the whole man; not only of his repressed +emotions, but of his intelligence and insight, and of relationships existing +between his life and all the other forms of life with which his own is +interwoven. + +Unity must prevail throughout all nature. Either we are,--altogether, and +through and through, our best as well as our less good,--nothing but the +expression of repressed cravings, in the sense that they or the conflicts +based on them constitute the final causa vera of all progress; or else the +best that is in us and also our repressed cravings are alike due to the +action of a form of energy which is virtually greater than either one of +them, inasmuch as it has the capacity of developing into something greater +than either. + +This is the agency which we should preeminently study and it is best studied +under conditions when, instead of being obviously subject to repression, it +is most free from repression. That is, it is best studied as it appears in +the thoughts and conduct of the best men, at their best, their most +constructive moments. + +We cannot use our power of reason to deny our reason; for in so doing we +affirm the very thing which we deny. Nor are we under the necessity of using +our reason to affirm our reason, since that is the datum without which we +cannot undertake our task. + +If this view is sound, what practical conclusions can we draw from it? I +wish to insist on this question because it was distinctly and positively +with the practical end in mind that I ventured to write this paper, and I +suggest the following as a few of these conclusions. + +(I) We should not speak of the "Libido," in whatever sense this word is +taken, as if it were a fixed quantity, like so much heat, or so much fluid, +that is, as representing so much mesaurable force. One current notion which +has played a very useful part in psychoanalytic work, yet is misleading in +its tendency, is that the "Libido" may be likened to a river which if it +cannot find an outlet through its normal channel is bound to overflow its +banks and perhaps furrow out a new path. This conception is based on this +same law of the conservation of energy to which reference has been made. +If, however, I am right in my contention that the "Libido" is only one +manifestation of an energy,-- greater than simply "vital,"--which can be +studied to the best purpose only among men whose powers have been cultivated +to the best advantage, then it will be seen that this conception of "Libido" +as a force of definite amount is not justifiable by the facts. + +One does not find that love or reason is subject to this quantitative law. +On the contrary, the persons whom most of us recognize as of the highest +type do not love any given individual less because their love takes in +another. The bond of love holds not only three, but an indefinite number. + +The same statement may be made with regard to reason and to will. The power +and quantity of them are not exhausted but are increased by use. + +I maintain, then, that although the "Libido," in so far as it is regarded as +an instinct, does not stand on the same footing with the reason and +disinterested love of a person of high cultivation and large views, neither +does it stand on the same footing with the physical energy that manifests +itself in light and heat and gravitation. + +When we come to deal with man and any of his attributes, or as we find them +at any age, we ought to look upon him, in my estimation, as animated in some +measure by his self-foreshadowing best. And whether it is dreams with which +we have to do, or neurotic conflicts, or wilfulness, or regression, we shall +learn to see, more and more, as we become accustomed to look for evidences +thereof, the signs of this sort of promise, just as we might hope to learn +to find, more and more, through the inspection of a lot of seeds of +different plants, the evidences which would enable us to see the different +outcomes which each one is destined to achieve, even though, at first, they +all looked just alike. + +(2) The next point has reference to "sublimation." This outcome of +individual evolution, as defined by Freud, has a strictly social, not an +ethical, meaning. Jung also, in the interesting paper referred to, in his +description of the rational aims of psychoanalysis, makes sublimation +(though he does not there use the word) the equivalent of a subjective sense +of well being, combined with the maximum of biologic effectiveness. + +"Die Psychoanalyse soll eine biologische Methode sein, welche das hoechste +subjektive Wohlbefinden mit der wertwollsten biologischen Leistung zu +vereinigen sucht." + +But in my opinion, while it may be true that the psychoanalyst may often +have reason to be thankful if he can claim a therapeutic outcome of this +sort, the logical goal of a psychoanalytic treatment is not covered by the +securing of a relative freedom from subjective distress, even when combined +with the satisfactory fulfillment of one's biologic mission. A man has +higher destinies than this, and the sense of incompleteness felt by the +neurotic patient, which was emphasized by Janet and is recognized by us all, +must be more or less painfully felt by every man whose conscience does not +assure him that he is really working for an end greater than that here +specified. The logical end of a psychoanalytic treatment is the recovery of +a full sense of one's highest destiny and origin and of the bearings and +meanings of one's life. + +On similar grounds I think that the conflicts to which all men find +themselves subjected, must be considered, in the last analysis, as conflicts +of an ethical description. For it is only in ethical terms that one can +define one's relation to the universe regarded as a whole, just as it is +only in ethical terms that a man could describe his sense of obligation to +support the dignity of fine family traditions or the ideals represented by a +team or a social group of which he felt reason to be proud. I realize that a +man's sense of pride of his family, his team, or his country may be a +symptom of narcistic self-adulation; but like all such signs and +symbols--the symbol of the church tower, for example--this is a case where +two opposing meanings meet. + +Every act and motive of our lives, from infancy to age, is controlled by two +sets of influences, the general nature of which has here been made +sufficiently clear. They correspond on the one hand, to the numerous partial +motives which psychoanalysis studies to great advantage, and on the other +hand, to the ethical motives which are only thoroughly studied by +philosophy. + +(3) Another conclusion, which seems to me practically of great importance, +follows from this same view. Every one who has studied carefully the life +histories of patients, especially of children, and has endeavored in so +doing to follow step by step the experiences through which they reach the +various mile-stones on their journey, must have been astonished to observe +the evidences of PREPAREDNESS on their part for each new step in this long +journey. Human beings seem predestined, as it were, not only in a physical +but in a mental sense, for what is coming, and the indications of this in +the mental field are greater than the conditions of organic evolution could +readily account for. The transcendency of the mind over the brain shows +itself here as elsewhere. + +We are told that our visions of the unpicturable, the ideal world, which our +imagination paints and which our logical reasoning calls for as the +necessary cap or final corollary to any finite world which our intelligence +can actually define,-- that such visions are nothing but the pictures of +infantile desires projected on to a great screen and made to mock us with +the appearance of reality. + +I have nothing whatever to say against the value of the evidence that a +portion of our visions are of this origin. In fact, I believe this as +heartily as does any one. But I desire strenuously to oppose the view +tacitly implied in the statement of the projection theory just cited, the +acceptance of which as an exclusive doctrine would involve the virtual +rejection of our right, as scientific men, to rely on the principle that the +evidence afforded by logical presuppositions and logical inference is as +cogent as that furnished through observation. + +It is, in my opinion, just because we all belong to a world which is in +outline not "in the making" but completed,--because, in short, we are in one +sense like heirs returning to our estates,--that this remarkable +preparedness of each child is found that impresses us so strongly. The +universe is, in a sense, ours by prescriptive right and by virtue of the +constitution of our minds. But the unity of such a universe must, of +course, be of a sort that includes and indeed implies diversity and conflict +as essential elements of its nature. + +Psychoanalysts should not make light of inferential forms of reasoning, for +it is on this form of reasoning that the value of their own conclusions +largely rests. We infer contrary meanings for words that are used +ostensibly in one sense, and we infer special conflicts in infancy of which +we have but little evidence at hand, and cravings and passions of which it +may be impossible to find more than a few traces by way of direct testimony. + +Our immediate environment and the world that surrounds us in that sense, +appear to our observation, indeed, as "in the making." But besides the power +of observation which enables, and indeed forces us to see the imperfection +in this environmental world, we possess, or are possessed by, a mental +constitution which compels us, with still greater force, to the belief in a +goal of positive perfection of which our nearer goals are nothing but the +shadow. + +It is because I believe in the necessity of such reasoning as this that I am +not prepared to accept the "Lust-Unlust" principle (that is, to use +philosophical terms, the "hedonistic" principle) as representing the forces +by which even the child is finally animated. Men do not reach their best +accomplishments, if indeed they reach any accomplishment, through the +exclusive recognition, either unconscious or instinctive, of a utilitarian +result, or a result which can be couched in terms of pleasure or personal +satisfaction as the goal of effort. They may state the goal to themselves in +these terms; but this is, then, the statement of what is really a fictitious +principle, a principle in positing which the patient does but justify +himself and does not define his real motive. Utilitarianism and hedonism +and the pleasure-pain principle, useful though they are, are alike imperfect +in that they refer to partial motives, partial forms of self-expression; +whereas that which finally moves men to their best accomplishments and makes +them dissatisfied with anything less than this, is the necessity rather than +the desire to take complete self-expression as their final aim. The partial +motives are more or less traceable as if by observation. The larger motives +must be felt and reached through inferential reasoning, based on observation +of ourselves through careful introspection. + +Finally, the practical, therapeutic question arises, as to what measures the +psychoanalyst is justified in taking to bring about the best sort of outcome +in a given case? + +It is widely felt that the psychoanalyst would weaken his own hold on the +strong typically analytic principles through which painful conflicts are to +be removed if he should form the habit of dealing with ethical issues, and +talking of "duties", instead of stimulating his patients to the discovery of +resistances and repressions, even of repression the origin of which is not +to be found within the conscious life. Yet,--parallel, as one might say, +with this clear-cut standard of professional psychoanalytic obligation, the +force of which I recognize,--it has to be admitted that there are certain +fairly definite limitations to the usefulness of psychoanalysis. As one of +these limitations, well-pronounced symptoms of egoism, taking the form of +narcissism, are to be reckoned. These symptoms are not easily analyzed away. +But if one asks oneself, or asks one's patients, what conditions might, if +they had been present from the outset, have prevented this narcistic outcome +(Jehovah type, etc.), the influence that suggests itself--looming up in +large shape--is just this broad sense of ethical obligation to which +repeated reference has here been made. If these patients could have had it +brought home to them in childhood that they belonged, not to themselves +conceived of narrowly (that is, as separate individuals) but only to +themselves conceived of broadly as representatives of a series of +communities taken in the largest sense, the outcome that happened might +perhaps have been averted. + +And what might have happened may still happen. What is to be done? Each +physician must decide this for himself. He should be able both to do his +best as a psychoanalyst and at the same time help the patient to free +himself from that sort of repression in consequence of which he is unable to +see his own best possibilities. But he cannot do this unless he has trained +himself to see and feel in himself the outlines of this vision any more than +he could help the patient to rid himself of an infantile complex if he did +not appreciate what this complex means. We must trust ourselves, as +physicians, with deadly weapons, and with deadly responsibilities, and we +ought to be well harried by our consciences if we should do injustice, in +using them, either to our scientific or our philosophic training. + + + +ASPECTS OF DREAM LIFE[*] + +[*] It should be stated as possibly bearing on the interpretation of the +dreams recorded by the author, who is well known to me, that she is the +subject of an intense and unusual obsession of hatred of an obtrusively +pathological character against a relative. The psycho-pathology of the +obsession, of which I have an intimate knowledge, has not been determined. +A reasonable interpretation is that the main etiological factor is jealousy. +She has undergone prolonged psychoanalytic treatment by a skilled +psycho-analyst without improvement of the obsession and without revealing a +satisfactory explanation of its pathology. To what extent the contents of +the dreams have been determined or coloured by culture acquired by this +treatment and by the study of Freudian doctrines is also a question +deserving of consideration.--Editor. + +The Contribution of a Woman + +IT is an easy matter to accept upon authority a given scientific theory and +bring to its support certain selected evidence, but quite another to +carefully observe and report phenomena, inspired, influenced and guided +indeed by the scientific-theory but drawing conclusions no wider or deeper +than individual insight warrants. Scientific knowledge advances not by ready +acceptance of theories but by original observation and experiment and the +following study of dreams is offered as fulfilling in some degree the latter +requirement. While there is a certain familiarity on the part of the writer +with the general theory advanced by Freud and with his principles of +interpretation, there is no acquaintance at first hand with his Die +Traumdeutung, the reading of which has been postponed lest there be excess +of influence. + +No apology is offered for this invasion of the domain of psychology by a +layman. The laboratory of the mind is open to all and he who has missed +conventional training may yet chance upon valuable facts and their +interpretation. Neither is apology offered for the intimate nature of the +data reported. Belonging as dreams do to the most personal and private life +of the individual it is nevertheless true that continued and careful study +of this form of mentation insensibly alters one's attitude so that at length +the dream appears as a fact of nature, impersonal and objective. + +It is a common remark that if one tells his dreams their number will +increase but this increase is probably only apparent. With attention the +products of the dream-self become more accessible until one who is practiced +in introspection can raise the number of his remembered dreams from one in +two or three nights to five, ten, or even fourteen in a single night. Even +at this maximum of remembrance one feels that but a fraction of the mind's +nocturnal activity is recalled. Images emerge in consciousness and fall back +into obscurity before the waking thought can grasp them. Or it may be more +accurate to say that upon awakening consciousness rises from level to level. +It sometimes happens that when first awake I recall several dreams which +vanish utterly as a sudden shifting of consciousness occurs. Then, upon this +new level, a new set of dreams appears. There is reason to believe that in +thinking again of a dream which has once been recalled it is not the +original dream experience which comes to mind but the copy made in the +waking consciousness when it first emerged. On the other hand visions +recognized as dreams belonging to a long past time occasionally float into +the mind giving rise to the suspicion that they have not before reached the +waking consciousness. It is possible that all dreams are recorded in the +depths of the mind, themselves influencing and merging with later dreams. + +The number of my dreams recalled and written out during three years closely +approaches five thousand and without doubt the total number far exceeds +this. I am inclined to the belief that constantly, by day as well as by +night, we are dreaming; that unnoticed and independent trains of thought are +carried on. At times when resting if I fall into an abstracted state--not +of set purpose--I find myself in the midst of a stream of thought appearing, +for the moment, perfectly natural, familiar and intelligible, as if I knew +the beginning and end of the matter. But only for a moment will +consciousness remain at this lower level. There is a sudden return to the +normal plane, the passage fades from memory and I wonder what on earth it +was all about. These phases of subconscious activity differ from dreams +proper in the absence of visual images. The ideas are embodied in words, +heard with the mind one might say. The source may be the same as that of the +night visions but it is evident that during the day the incessant +stimulation of the eye from without leaves no opportunity for the emergence +of the secondary visual images pertaining to subconscious ideas, which, we +are told by Dr. Morton Prince, furnish the perceptual elements of the dream. +The other senses are sometimes represented. Often we are performing, or +trying to perform, some action. But dreams are predominantly visual. Goethe +has said, "I believe men only dream that they may not cease to see." + +An account of the probable genesis of the memory images not only furnishes a +clue to the mechanism of dreaming but to the underlying conditions as well. +The lowest forms of life possess no image-forming power. They have no sense +organs; sensation is diffused over the entire form and undifferentiated. +Gradually, as the scale of life is ascended, certain parts of the organisms +become specially sensitive to certain stimuli and eventually individual +organs give separate and distinct reports of phenomena. A substance +hitherto merely felt, is seen, heard, smelled, tasted. The passage from +sensation to perception occurs when but one or two of the sense organs are +stimulated by an object, yet, because of nervous connections established +during former more close and complete experience of the object the remaining +sense organs are faintly roused, sending into consciousness copies of former +sensations. Thus the whole is present to mind while but a part to sense. In +the developing brain the store of memory images of various kinds would +rapidly increase and these images would come at length to have a more or +less independent existence. It is probable that the next step in the making +of mind was the synthesis of one set of sense impressions to form an idea of +the object, the first abstraction, and thenceforth a sensation gave rise to +an idea. There is at this stage no impulse to explain sensations, but +involuntarily, from the store of memory images, and from the reservoir of +ideas above, emerges a representation of the exciting object. If this is one +to which the organism is accustomed the resulting complex in the highest +nerve centers fits the subject, but as evolution proceeds and environment +and capacity for sensation grow more complex, new stimulations occur. In the +absence of the capacity for knowledge and understanding of the object the +developing mind, true to its law, brings forward mental images most nearly +related--those which fit in one or two respects,--and thus we have the birth +of analogy, "the inference of a further degree of resemblance from an +observed degree of resemblance." + +To look at one's self is a late endowment. The kitten pursues its own tail +but would chase that of its mother with equal ardor. I once saw a monkey +searching industriously with eyes and hands upon its own body. The sight +was startling. I had never before seen an animal look intelligently at +itself. It was long before man distinguished his self from the world +without, and longer still before he began to understand himself. Physical +and mental phenomena, pain and pleasure, could not be tracked to their +sources and so came to be expressed in terms of the world of nature, and for +a reason precisely similar that portion of the self functioning in sleep +makes use of symbolism. Occasionally the higher thought centers are involved +but the typical dream is the product of a restricted, primitive self, +lacking the resources of the complete personality and limited in power of +expression. In dreams we are deficient in self-consciousness because it is +only a partial self that dreams. Our wishes are rarely given clear and +definite expression for the reason that the section of the mind then active +is incapable of clear, definite and adequate concepts. Symbolism and +reasoning by analogy are the resources of the mind until the power of +knowledge dawns. + +Predicating then a dream-self by its nature largely restricted to the use of +symbolism and having at its disposal a vast store of images endlessly +susceptible to influences which combine and alter their form, we reach the +crucial question, what initiates the dream? This is by no means a mere +purposeless thronging of visual images as occasionally happens in the period +preceding sleep when faces, forms and scenes flit aimlessly before the +mind's eye, some bare replicas of stimulations of the eye from without, +others the attendant visual images of past thoughts and experiences and +their distorted combination. Somewhat closer to actual dreaming is the rise +of images accompanying present bodily and mental states. I sometimes see a +body in the posture my own body has that moment assumed and one night, when +recalling a passage from Wilhelm Meister, I saw a young man seated +bareheaded on a doorstep, plainly a picture of Wilhelm at Marianna's +threshold. In the last example we come definitely upon a vision induced from +within, an idea working downward upon the visual centers. Still nearer +dreams, indeed if occurring in sleep they would be classed with them, are +the purely imaginative pictures whose cause is as mysterious as that of the +actual dream. Fire in the wall near the pantry door, a garden with a woman +rising from a clump of bushes, high, rocky mountain tops, a perpendicular +wall of rock and against it a man on a ladder reaching for a flower, a long +vista ending with a pillared temple on a hill,--these are a few of my +visions before sleep. But to return,--why the dream? Are all or most dreams +sexual? Can we say with Freud that they express the fulfillment of repressed +desires? + +It is not my purpose to attempt a complete answer to this question as I am +far from understanding even the majority of my own dreams. Broadly speaking +I should say that considering the amount and complexity of the material on +hand which the mind may use and the probable inconceivable number of dreams +it is unlikely that all are concerned with this matter. This question may +well be allowed to rest for the present. But certain convictions have arisen +in my mind as the result of the study of hundreds of personal dreams, +convictions which do not rest upon the arbitrary interpretation of accepted +symbolism, though I am far from questioning the validity of this procedure. +I venture little beyond the region illuminated by individual insight though +examples are cited far exceeding my power of interpretation. + +The sexual theory of dreams has by some authorities been characterized as +greatly over-emphasized, as failing to take account of other factors and +interests of human personality. To those critics let me present the matter +briefly and simply. The very fact of a person's being alive today +presupposes an ancestry stretching backward through uncounted ages, an +ancestry whose chief function, up to very recent times, was sexual and +reproductive. Modern interests, business, social, intellectual, religious, +artistic and philanthropic, which today loom so large, are a recent +innovation, occupying in comparison with the period when they were not but a +moment of time. In a vertical section of man--both racial and individual, +they are seen to constitute but a superficial layer, from a contemporary +standpoint predominant and paramount but in the light of the ages secondary +and unstable. Biologically a woman is only an agent for the reproduction of +her kind; more than this, with mind, all save the conscious, socially and +ethically restricted sections, set toward the same end and toward the means +for its accomplishment. There is no gainsaying this fact and in my dreams +which yielded to analysis it stands paramount. I am inclined to disregard +the theory of a "censor" for the reason that after I had admitted to my +thought and frankly considered certain facts, by a thousand devious hints, +by a thousand subterfuges, my subconsciousness continued to express these +same facts by means of obscure symbolism. As the savage seizes upon one link +in a chain of events expecting thereby to repossess the whole, as the native +of Borneo makes a wax figure of his enemy in the belief that as the image +melts, the enemy's body will waste away, as the women of Sumatra when sowing +rice let the hair hang loose down their backs in order that the rice may +grow luxuriantly and have long stalks, so this woman, this under-self, +ignorant of the true law of cause and effect, and unable to form definite +concepts, instinctively selects from the innumerable memories and visual +images at her disposal those having relation to her unfulfilled function and +forms a picture or weaves a tale, expecting through the performance of some +remotely associated act the complete result. + +To the events of an hour or so, supremely significant from a biological +standpoint, are related a very large number of my dreams. Again and again +events of that day and of the preceding days form the basis of dreams; +trivial circumstances are revived one by one and fragments of the experience +itself are seized, distorted and each woven into what I can no longer term +"the baseless fabric of a vision." For instance the day preceding I broke +my umbrella and found a shop where it was mended. In dream after dream +appears that broken umbrella under various circumstances and when I ask the +reason for its apparent importance I can not escape the conclusion that the +article in question stands for a period of time, a series of events, in +which the dream-self would again be placed. Apparently on that road +opportunity lay in waiting, therefore by any means at her disposal must that +path be regained. Involuntarily the language of metaphor is assumed in +attempting to describe a process so far removed from actual knowledge. Still +are we driven to avail ourselves of the expedient of primitive man. + +Of the dreams presently to be cited only a part fall within the category of +analogical reasoning. In none of the examples is a complete analysis +attempted. The mind of each reader may carry the solution of the problem as +far as it will. I am content merely to furnish a clue. That each dream is +of great significance must not be assumed. But that each one, even though it +appear a mere fanciful reverie, means SOMETHING can hardly be doubted. At +the outset it is acknowledged that the dreams recorded followed a period of +intense emotion when, through the exigencies of life the strongest instinct +of humanity required control and repression. Further the writer is a +musician and a botanist, and especially interested in biological and social +problems. Study of the latter subjects was continued throughout the period +in question. It must be confessed also that though loth to accept the +sexual theory of dreams, once convinced of its at least partial truth I was +on the watch for confirmation. I expected sexual symbolism. On the other +hand each dream was absolutely spontaneous, an utter surprise, having no +slightest likeness to any creation of my waking mind and seeming to rise +from a region so remote as to be not myself. It should be noted also that +the greater number of the nearly five thousand remembered dreams, all but +very few in fact, would have remained in the limbo of the unconscious but +for the persistent and trained effort which rescued them from oblivion. +Neither by, nor apparently for my waking self were they formed. + +Each individual mind, besides sharing in the symbolism common to mankind, +has doubtless its own particular and special forms. For instance during the +period covered by my study no less than ninety different varieties of plant +life figured in my dreams, not including indefinite ferns, moss, grass, +weeds and trees, and several plants noted somewhat in detail yet unlike any +form known to me. Of the recognizable plants a number were used somewhat +cleverly for their analogical significance. Of these may be mentioned the +snowball and hydrangea whose flowers as every botanist knows are sterile, +the size of the individual blossom being gained at the expense of loss of +stamens and pistils. These plants were plainly used to indicate barrenness +and the predominance of traits other than sexual. The keen critic will here +interpose an objection. How is the primitive, unreasoning dream-self able +to make use of symbolism whose import is known only to higher and developed +states of mind? The force of the objection is granted and without attempting +fully to answer it I will say that the likeness of the primitive mind of the +race to that surviving in the highly evolved individual is only partial. +Like tendencies exist but the influence of a great body of knowledge above +inevitably alters the action of the latter. Maidenhair fern stood +indubitably in several instances for the pubic hair, once surrounding a +cluster of trailing arbutus when talcum powder of that fragrance had been +used on the body. I dreamed of Linnaea borealis, the little twin-flower, in +connection with a woman who a few days before when told of the birth of +twins to a friend, said, "That is the way to have them come." Lettuce, for +its milky juice obviously, appeared in two bunches on the front of the waist +of a woman into whose house I had broken by leaning against a screen door, +and a lawn bordered by cowslips, our common name for Caltha palustris, +certainly represented a certain lawn that a friend told me had been kept +mown by the cows feeding upon it when driven from pasture. + +In each of the above instances the floral symbolism was part of an elaborate +dream having wider significance leaving no doubt as to the accuracy of my +conclusions. A particularly interesting and devious use of flowers occurs +in the following dream--I am in front of a certain house over which, in the +dream, is growing a vine having white, star-like, fragrant blossoms. I want +one flower and the woman living there says I may have it. The name of the +vine seems to be "Dyak." There is no plant having that name but a few +months before I was reading of the Dyak girls of Borneo who "are very +careful of their clothing, and often very vain, but when they are married +they frequently become exceedingly untidy." I quoted the passage in an +article thus fixing it in my mind. The link with the dream consists in the +fact that the woman living in the vine-decorated house is, in reality, +notoriously untidy. Her two daughters as they approached womanhood greatly +improved in the daintiness of their garb, and one had become pregnant-- +outside marriage. Another dream:--I see a friend, by name Anna, stoop and +pull from the ground a tiny lily-of-the-valley plant. It has no roots. I +say, "What a pity." This dream had no meaning until into my mind came the +thought of another Anna, a young girl who was led astray and who, I had just +been told, had taken medicine to terminate her pregnancy. When I learned of +this I had thought of the loss of the incipient life. The same night I +dreamed of going upstairs in a shed or barn. At the top of the stairs +something--a door--is in the way. I go by it. A child is there. Again:--I +am crossing a level field and come upon little star-like flowers which I try +to analyse. I find many with pistils but no stamens,--the pollen bearing +organs which effect fertilization. I wonder if they will keep fresh until I +reach home. Once more:--I approach a city. I see woods and two gardens, +either flower or vegetable, from which comes music. On a mound wild flowers +are growing, some white, some small and dark. I gather them. Then very +remote and vague,--my brother is there. I see a long snake which my brother +puts on(?) and covers my flowers. Still another vision was of a branch of +beautiful; fragrant apple blossoms growing through the wall of a room. Some +of the flowers were pistillate, some staminate,--a condition false to nature +as regards the apple. + +A dream, which in common with many others, seems not the fulfillment of a +wish but the symbolical expression of a bodily and mental state, is the +following:--After a day of very great physical restlessness I dream that I +am walking in a path by a river. I can not see the water for the +over-hanging trees beneath whose branches grow quantities of Impatiens +fulva, the spotted touch-me-not,--named from the sudden bursting of the pod +when touched. The plant in question I had not seen for some time and the +fitness of the symbolism to the bodily state was too close to be accidental. +After a walk in the spring when the ground was white with the cotton-tufted +seeds of the poplar and I thought if all germinated how overwhelmed we +should be with poplars, I dream that I am sweeping a floor upon which cotton +is scattered, some of which flies and is caught in my hair. I dream of +walking under pine trees whose pollen falls on me, and finally--though +examples of the significant use of plants are by no means exhausted--I have +upon awakening the vision of a pine tree growing from my nose. This strange +anomaly becomes intelligible when I recall that a friend told me that the +pores of her nose were enlarged, and I said mine were also; we had been +talking of a quotation from Emerson relating to nature's fecundity; my +friend was soon to be married; and a line from Emerson often in my thought +is that in regard to pines "throwing out pollen for the benefit of the next +century." + +For a musician to dream of playing, or of trying to play, upon an organ or +piano is apparently the most natural thing in the world and an attempt at +interpretation is, to uninstructed common sense, a journey far afield. Yet +the strange and striking variations introduced and the hindrances to my +accomplishment of the act invest the dream with marked significance. For +instance:--It is after church service and I want to play upon the pipe +organ. I find my music. The stool is a kettle of water with a board over +it. A stream of water comes from the organ. There is a horse near which +kicks or bites me. Again:--I play on the piano to a friend who is a German +scholar the opening theme of the Tristan and Isolde Prelude. My friend +tells me the pronunciation of the title of the opera and it sounds to me +like Froebel. That the name of the world-famous music drama, the apotheosis +of passion, should be transformed to that of the notable child educator is +nonsense or otherwise according to the observer's point of view. Another +dream:--Some children want me to play and I go to the piano and try to play +the Spring Song. But the piano stops sounding; only a few bass notes +respond. I dream that a table of sheet music is on fire. Sometimes the +music is too far away or too high for me to see: the notes are flowers, or +books, or animals, or "hanging objects," or queer figures; in the book from +which I play are pictures of the sea, a ship, a person, and birds--sea +gulls, among them. The bed becomes an organ upon which I try to play. I +begin to play the Witches' Dance and there are not enough keys to the piano. +Again the keys are covered by a cloth or there are no keys. An organ behind +me is played and I see no organist, or I move the pedals of an organ and +music begins before the instrument is open. I try to play and the stops are +wrong. Often I search frantically for the hymn given out by the minister +and can not find it. Once I picked flowers in its place, drooping racemes of +sweet alyssum, which I gave to a woman. Oddest of all on the keys of a +piano I see a small boy who salutes me. Lastly, I play for children to +sing. At the top of the page of music are whole notes--easy to play; below +there are whole notes in groups of two, joined like confluent living cells. + +There are several examples of punning to record--not brilliant, even +somewhat vulgar yet interesting as exhibiting varieties of mental action. I +dream that I am at a barn yard trying to hold the gate shut. In the yard are +two men, each with an animal, a kid, one light, one dark. The light kid is +unmanageable, pawing and shaking its head. Some days elapsed before the +interpretation dawned upon me but once noted could not be doubted. Several +weeks previously I had a business engagement and of two pairs of +gloves--kids--I hesitated which to wear. I was to do some writing +necessitating their removal and as one fastening of a light glove was +difficult I fixed upon the dark pair, as to ask help would under the +circumstances, have proved exceedingly embarrassing. + +A friend had informed me of her approaching marriage. I dream of eating at +a table with her. I take meat but she wants me to do she does. So I return +the meat I had chosen and take spare-rib. This variety of meat I had neither +eaten nor thought of for months and the conclusion that the reference is to +the story of Adam and Eve is inevitable. I dream of eating at the table of +a friend. I am a little sick and cannot eat all that is given me. My friend +points smilingly to a package of stuffed dates on my plate. One date is +apart from the package. This dream relates unmistakably to a day when I had +a pressure of engagements and had not time to eat; when I did feel slightly +ill, and when one very significant engagement was made unexpectedly--a date +apart from the others. A kiss of her lover upon the lips of a young girl +becomes in my dream a piece of court plaster on her upper lip, and a woman +about whose prospective marriage some one asked, returns, in my night vision +to a university to obtain the degree of B. Ed., which in sleep I took to +indicate Bachelor of Education but which is open to a different +interpretation. + +Visions of natural scenery are most remote, strange, beautiful and +delightful. They are doubtless composites of actual localities but in their +construction and use fine powers of imagination are at work and real life +seems left far behind. In my dreams of this type the ocean stands as a +symbol of Life itself, of the mighty and profound procreative force the +entrance into whose domination is the crisis of existence. For this +experience is demanded the mightiest symbol. It is evening. I am on the +seashore with my father and mother. Greatwaves are rolling in. I look +backward and see one wave break where we have passed. My mother is afraid +but we cannot turn back. I am calm. Then--this immediately follows--I am +in a kind of tunnel and fear that I shall suffocate. This and the following +might be construed as symbolising my own birth. I am in a boat on the ocean +with my mother. The waves are tremendous and as she goes out on deck to +close a great door I fear she will be washed away. But she is safe. Next +there is a violent jar and the boat is aground. Then I see down a city +street. In a particularly impressive dream I approach the sea at early +morning. I think I shall see the sun rise from the water. I go over a hill +to reach the ocean which is frozen near the shore. I go into a little house +and when I come out I can not close the door. The wind is high and the +waves enormous. Then there is calm and I see a man on horseback in the +water. Next a fog rises and out of the mist a little boat comes toward me, +the oars flashing like silver. Then a little boy comes ashore. There are +strange dreams of a frozen ocean, and of being out in a small boat with a +friend, soon to be married, with ships passing and we afraid. I am near the +ocean and longing to see it, and once trying to go with some one to see the +foundation of the sea but am hindered. + +Among visions of mountains is the following.--I see high and beautiful +mountains as I stand on a bridge. I hear the squeal of a horse. Then stones +fall from a mountain-top into the stream and spirals of bright water rise to +meet them. After receiving from a man of vigorous, vital personality an +atomizer for a slight hay fever, I dream of high mountains and at the foot +of one is an irregular patch of red sunlight. Above are two houses, not +side by side. In front of them is a fine, slanting veil of rain. A dream in +which indications of the reputed "father complex" may be found is one of my +father and myself in a team at the top of a high mountain, at the end of the +road. My father wants to drive off among the peaks but I fear that we shall +be lost. I dread the night there but think I can call for help. Somewhat +similar is the following.--I am in a high, steep place with my father. I +fear. He moves a stone and in the hollow of a rock I see moss or fungus. +There are often brief, passing dreams in which no person figures. I see a +bridge across a chasm; it is long and extends beyond where a bridge is +necessary. I see two rivers join and wonder what the resulting stream is +called. I see a river from the side of which emerges a spring of water and a +new stream. A small, steep hill, snow-capped. A river with water above the +banks. + +To dream of moving to an old house--what signifies this? Apparently +nothing. If one is to dream it must be of something--houses or people or +scenery. But to dream often of going to live in an ancient house,--of trying +to find in it my room; mosquito netting at the window, not quite tight; from +my room into a smaller one a door which I try to fasten but can not because +at the bottom it is a swaying curtain, the wall paper loose and a mouse hole +near the floor; a long, sunshiny room where I see what appears to be a rat +but which becomes a little kitten, weak from long confinement, that follows +me from room to room and at last through a door leading to a porch;--why all +these accessories? Once I go through many rooms--furnished but +uninhabited--and come to an upper bed chamber where, upon a couch, lies a +woman, quite dead I think; but presently she moves one hand. Again I go +through room after room until I reach one where still another woman--or is +it the same--lies dead on the bed. As I look she becomes a beautiful child +who has lain there forty years. The child stirs and opens its eyes; I think +something should be done to keep it alive but the eyes close, and sleep, or +death, reigns again. After calling upon an expectant mother who showed me +her layette, all white and blue, I dream that I go in an old house to a room +with blue papered walls, a blue and white spread on the bed and a case of +books, one of which is Dickens' Great Expectations. In one old house I find +the bulbs of some plant sprouting on a shelf; in another I open the stove +and find to my surprise that fire is still there. In still another house I +see behind the stove a closed door which I long to open. I go about the +house, up steep, worn stairs, down again and out into a garden where there +is a single strawberry and I think staminate and pistillate plants should be +set out to insure fertilization. Always I think of the closed door and +presently I return to the house and enter the room behind the stove. On the +floor is a green veil of firm texture. And at last there are cobwebs on the +ceiling of my old house and I still search for my room. + +After the presentation of this array of symbolism quite spontaneously the +interpretation arose in my mind. The old house is the recurring abode of +life. I would dwell there and take my place in the line of succession. +Quite in line with this symbolism was the very beautiful dream of a young +woman not many months before her bridal which I give in her words--"With a +crowd of unknown people I was to visit and go over a haunted house. The +living room was nicely furnished in antique furniture and the whole house +was very still. We went upstairs, and it passed through my mind that people +who were dead and gone had moved through the rooms. I was coming down the +stairs when suddenly a pipe organ burst forth. That was the haunted +part--music in the air, no organ at all. We were awestricken and I awoke +with the same feeling." In dreams of this character we find it necessary to +predicate a creative, myth-making tendency in the structure of the mind by +means of which currents of life flowing beneath all thought become +articulate. + +Coming now to examples of reasoning by analogy directly expressive of the +desire for maternity, I wish to make still more plain my view of the reason +for symbolism. Maternity is untold ages old; intelligent comprehension of +the function very recent. That portion of the mind functioning in +dreams--that is in the majority of dreams--is unable to picture the process +and its necessary antecedents. (Frankly sexual dreams occurred to me very +rarely.) Instinctive acts are the last to be made objects of thought; a +relatively high degree of mental development is necessary before the +requisite detachment from the process can be obtained and as we have seen +this detachment is beyond the power of the self that dreams. Hence the +recourse to analogy and symbolism. + +I call upon a woman who is pregnant and whose face is slightly bloated. In +that night's dream I look in a mirror and see that my face is plump. I think +I am too old. I see on the street a young girl in short skirts wheeling a +baby carriage. My friend tells me that the girl is a mother. That night I +dream of being in a shop to buy an article which I in reality intended to +purchase and in addition looking at a dress for a girl of twelve or +fourteen. I hear of a pregnant woman who ran away and worked for a time in +a mill and a night or two after I have a dream of a devious walk with many +details which finally ends at a kind of factory. An expectant mother tells +me of her trip to a neighboring town where a friend gave her a tiny +crocheted jacket. Soon after I start in a dream for that town, afoot, in +the dark, without lantern or money, and hampered and stumbling, make the +weary journey. + +A dream which upon analysis proves extremely interesting is the following:-- +I come out from a house and stand looking at other houses. I am waiting for +some one, and look toward the street. In the yard I see a large elm tree +nearly sawed off but at one side the wood is continuous,--to indicate that +the tree is still alive. I look up. A bough sways and I am dizzy. I think +the bough will fall. Beneath the tree is a sick woman on a couch. Until the +clue was found this appeared a mere aimless mixture of imagery but one +circumstance makes it very clear. Shortly before I was reading a book on +biology and in the section devoted to the influence of environment on +organisms a portion of the trunk of an elm tree was shown and the influence +of various factors noted as indicated by the annual rings of growth. One +considerable variation was due to the fact that children had swung from one +limb of the tree. At the time of reading the fact made so slight an +impression that after the dream some time elapsed before I recalled it and +then so faintly that I had to refer to the book for verification. Thus we +see upon what slight and obscure basis a dream may be constructed. + +That all dreams do not originate in one section or at one level of the mind +is quite evident. The range extends from those which almost merge with +waking thought to creations strangely remote and primitive. When I dream +that Goethe is a guest at my home and I am trying to ask him in regard to +Faust, Wilhelm Meister and Mignon,--when after reading of x-rays, ether +waves and electrons wake with the thought, "To solve the problem of matter +would prove materialism,"--when I dream that I am conversing with a +conservative friend who says that he does not like new religions and I reply +that Moses and Jesus were new once, it is plain that a different stratum of +mind is operative than when I dream that I am in an old fort and chased by +three rats, or that a snake is on my bed and my father kills it with a +pitchfork, or strangest of all, that I throw an egg at the plug of a sap +bucket which it hits and then flies to the left; it is rotten. Again, a +very vague dream, I, see two eggs and then am climbing inside a kind of +tower. A dream which immediately preceded the menstrual period, is as +follows:--I pass a narrow, dark canal which seems to be under cover. On the +very brink is a child and I fear it will fall in. A man is there whose +business it is to save the child but be does not. That this indicates the +impending passage from the body of the ovum can hardly be doubted. Under +like conditions--this before sleep--I see a doorway filled with flowers. + +It was natural that after a time I should wonder what event of the day would +be woven into a dream; as I performed certain acts I found myself wondering, +will this appear tonight, and how? One Sunday I walked across lots to church +and on the way picked a twig of balm of Gilead poplar keeping it with me +through service for its fragrance. That night I dream that I am in a +pasture looking for fertile fronds of the cinnamon fern which I fail to +find. I see cows and am afraid.--This based on reality of a few days +before.--At length by a stone I find a fern coiled as in spring. This +becomes a squirrel, the male comes, and then they are lions. The male has a +sprig of leaves which he lays at the feet of the female and which she eats. +I want to know what the leaves are but fear to look closely because of the +lion. I found it difficult to deliberately influence dreams by suggestion. +The dream-self is not to be coerced and usually I over-did the matter. Most +of my examples deal with flowers and perhaps the most apposite is the +following:--I plucked a stem of blossoms of white everlasting and wore it +inside my waist on my bosom all day, asking as I fastened it in,--How will +this reappear in my dream? The following morning as consciousness returned, +I had a vision of a baby's bottle filled with milk and beyond it, more +faint, another similar bottle. It is fair to say that this outcome was +entirely unexpected. Another night after watching Venus, low in the +southwestern sky, I dream that I am molding a statue--strangely enough the +arms as the reference is to the Venus de' Melos--and the figure is that of a +young woman of immoral life. + +My store of dreams is so great and varied that the forms of symbolism are by +no means exhausted. The reception of mail is a favorite subject and here +again one may say that this is the most natural of dreams and quite its own +excuse for being. But strange things come in the mail,--pieces of turf in +which are growing tiny plants, boxes of rice, jelly, breakfast food, cooked +fish still warm; and once a sack of mail is emptied upon my door-stone--not +by the postman but by a man who the day before drove past with a little +child. Other recurring motifs are strawberries, yeast, Bologna sausage, ice +cream-- once poured over slices of clear, transparent fruit which I eat, +this very plainly referring to the fertilization of the eggs of fish about +which I read the preceding evening:--"As soon as the female finishes +spawning the male will approach the eggs and eject a milky fluid over them +to effect fertilization. If this is successful the spawn will have a clear, +glassy appearance." The dream-self can turn anything to its use,--I read of +certain suffrage activities in England and forthwith dream that I attend a +suffrage meeting. But the house at which it is held is in reality the home +of a woman nearly my age, who is pregnant. + +I pass over all the dreams obviously of an infantile character, and likewise +those of travelling and of packing for a journey. More unusual is the dream +of a flight of birds which twice occurred under conditions which left no +doubt as to its sexual character. A house having a wet sink and a dry one is +the verdict of my dream-self regarding a home in which the woman can bear no +more children because of physical disability; and a railway station where I +go down the steps, pick from the floor a flower--wondering if it is all +right,--reach a restaurant in which seventy have that night been served and +where I lose my flower, symbolizes a house of prostitution mentioned in +Chicago's famous report where one woman served sixty men in one night and +was said to have seven thousand dollars in the bank. Beneath convention +strange unconvention lurks. A young woman of irregular life appears in my +dream as one with soiled skirts, and, very vaguely, some one's else skirts +are soiled also. After seeing a print of Tompkins' painting, Hester Prynne, +heroine of The Scarlet Letter, I dream that I go to a shop, where I have +great difficulty because of darkness, to buy some dark green silk for +embroidering a letter somewhere on my dress. Not to pander to the base in +human nature are these details given but to make known life's realities to +those who are blinded by theories. The frank and honest truth is never foul +and monstrous. Society can be renovated only when all the facts are brought +to light. + +In conclusion I give the dreams of a single night:--First, a drunken man and +girl in the same team; I think they should not be there. Then I am on a +porch looking off at a headland with ice at the foot. Farther up the hill +are quantities of ice--a sheet of it over the ground and in one place it is +as if water had been poured and allowed to freeze. In the midst of this +last, which is not on the hill, is a fine and shapely tree with the ice +about it very smooth and shining and slanting somewhat. I think it is a good +place for skating. In the morning as I recalled this dream, quite abruptly +into my mind came the remark of Philina in Wilhelm Meister, after seeing a +woman "great with child," "It were prettier if we could shake children from +the trees." Next I see far off high mountains with sunlight on the summits. +Then I am in a porch enclosed by a wire screen; by me is a woman. From the +window of a building outside, which seems to be a hospital without funds, a +woman looks at me. I want to see far off and shade my eyes with my hands. +I think I must cut the screen in order to see clearly. Then I see a rampart +and beyond it is the ocean. I hear a bird, a robin, on the rampart. Near +it is another bird, large, gray and strange. Then it is a rooster. The key +to this dream lies in the fact that the day before I received an appeal for +financial aid from a hospital and the printed request showed the picture of +a row of nurses each with a tiny baby in her lap. Finally I go into a +bed-room. On the bed is a baby. I uncover it and it moves and cries. It +wants its mother and I go to find her. + +That the mind which dreams is not uncognizant of the hopelessness of its +aspirations is strangely indicated by the following for which at the time I +found no direct exciting cause:-- I see two long lines of seeds planted and +at the end of the rows tiny lettuce plants. Near by are apple trees in +blossom. But it is autumn. + +Bergson at the close of his essay on dreams hints that the mind may +transcend its conjectured limits and be influenced in profound slumber by +telepathy. This is but an hypothesis which must long await verification. My +own dreams which apparently forecast the future are out-numbered by +erroneous forecasts and one vivid dream of the death of a friend though +coinciding as to the day, is not of great value as evidence as I had been +expecting the news for weeks, and further, beyond the surface portent the +dream is remotely allied in certain details with more personal and vital +memories. + +Though the dream process may to a certain extent be made verbally +intelligible he who studies it most best realizes the attendant mystery. +Dream-self, subconscious ideas, visual images,--these are but terms which +bridge the abyss of our ignorance. Further exploration of the mystery is of +value not only from the standpoint of pure science, to whose domain there is +no limit, but also in the interest of education, health, sanity and +morality. It is neither necessary nor wise for all persons to study their +dreams, but for those who shape the growing thought and conduct of the world +a knowledge of even the remotest outposts of human mentality is supremely +important. + + + +REMARKS UPON DR. CORIAT'S PAPER "STAMMERING AS A PSYCHONEUROSIS"[1] + +[1] Dr. Isador H. Coriat's paper with this title appeared in the Journal of +Abnormal Psychology, Volume IX, No. 6, February-March, 1915. + +A CRITICISM + +BY MEYER SOLOMON, M. D., CHICAGO + +I have frequently wondered whether those of us who oppose the dissemination +of the Freudian theories, at least as they are being and have been applied +to the psychoneuroses and to psychopathology in general, have solved the +problem as we should have solved it or fought the fight as we should have +fought it. It has not infrequently seemed to me that our plan of battle, our +campaign, the battle we have in a way waged, was not as consistently planned +and as well organized as it should have been and as the occasion really +demanded. There were many lines of attack open for us. We could, if we so +wished, have made generalized and wholesale attacks upon all that Freudism +stood for regardless of whether, in certain principles, it was right or +wrong. This some have actually done. Although this method is not in my +opinion fair or scientific, yet, so reckless and so uncritical have been +many of the Freudians, and the foremost Freudians at that, in their +declarations and conclusions, that I can readily see how one may be prompted +to resort to unmitigated ridicule and general condemnation of the entire +system, the standpoints and the conclusions that have been made the bulwark +of the Freudian movement. Others have adopted a different method of dealing +with the situation. They have entirely ignored the Freudian school and all +that it stands for, and have permitted the members of this school to go to +ever greater and greater extremes and excesses, with the more extensive +elaboration of their system, so that eventually the error of their ways +would be apparent to all, since the final conclusions to which they would be +led would be openly fallacious and give proof positive that the foundation, +the psychology upon which as a basis the Freudian system of interpretation +and analysis has been erected, was defective to such an extent that it would +crumple into disintegrated portions under the heavy load of the unsupported +superstructure. This method has by no manner of means been unsuccessful. + +A third standpoint to be assumed is that in which replies to or criticisms +of individual articles, rather than criticisms of a general nature and +applicable to the Freudian psychology or method or conclusions in toto, is +adopted as the proper method of dealing with the situation with which we +found ourselves with the advent and spread of the Freudian movement. This +last-mentioned method is probably the most desirable of the three methods +which have been here mentioned. + +And it is the method which I shall follow in this criticism of Dr. Coriat's +paper, because, among other reasons, I believe it is the fairest to all +concerned. + +It is not my purpose to take up for discussion the various statements, made +by Dr. Coriat, with which I disagree, but rather to consider only the +question of the correctness or incorrectness of the general thesis which he +has presented. + +The reasons for my entering into a criticism of this particular article by +Dr. Coriat may be stated as follows: In the first place I am interested in +the general problems of psychopathology, and of the psychoneuroses in +particular. In the second place I am somewhat unusually interested in the +problem of stuttering.[2] This latter interest has two main sources of +origin: (1) I am deeply interested in the question of stuttering because of +my general interest in neurology and psychiatry, including the speech +disorders, under which heading stuttering finds its place; (2) I have +myself, from earliest childhood, suffered from this affection and so find +myself naturally much interested in the subject. + +[2] In this paper I shall use the terms "stammering" and "stuttering" +interchangeably. + +It is not out of place, it seems to me, to at once answer one of the stock +arguments which certain Freudians have been in the habit of offering as a +reply to those who criticized their theories and conclusions. I refer to the +argument or rather the insistence that those who oppose the spread of the +Freudian ideas are themselves unconscious illustrations of the truth and +accuracy and general applicability of the Freudian dicta. In this argument +they accuse their opponents of unconsciously indulging in or being victims +of a defense mechanism, as a means of self-justification and +self-rationalization, based on repression, sexuality, etc., in order that +their hidden, unconscious, repressed, forgotten desires, tendencies and +inclinations may not be brought to the surface and consciously acknowledged. +In other words, in my particular case (my present criticism of Dr. Coriat's +paper), I could, perhaps, be accused, by those Freudians who are in the +habit of resorting to this charge as their own method of self-justification +and self-rationalization, as the path of least resistance and as a loophole +through which they can escape from meeting the situation presented to them +by a frank self-examination and acknowledgment of error or by a fair and +satisfactory response--I could be accused, I repeat, of showing, by the very +fact of my criticism, that all that Dr. Coriat stated concerning the origin +and nature of stammering was true. + +In replying to this oft-repeated and oft-resurrected assertion, I need not +be detained for any great length of time from proceeding to the +consideration of those facts which are the real purpose of this paper. I +need only say, in parentheses, that it does seem to me that there surely are +a few anti-Freudians (and I may here include myself) who are perhaps, who +knows, capable of that degree of unprejudiced self-criticism and intensive +self-analysis which is necessary for the purposes of making ourselves +eligible for candidacy as critics of the Freudian theories and dogmata. I +may go further and gently suggest that it even seems to me that there may be +some others of us who are capable of as great a degree of such +self-criticism and self-analysis as, and it may even be of a greater degree +than, many of those who have been making this claim. I am content to leave +this point to the sound judgment and good sense of the average reader of +these pages. + +The second point that I should bring out in this connection is as follows: +That which is of fundamental importance and of basic significance in the +life of the psychoneurotic or the stutterer, that which is the fundamental +and essential motive force which controls the psychoneurotic and the +stutterer is also true, but in greater or less degree, for all of those who +are not within the confines of this group.[3] And as a further statement I +must assert that whatever is deemed to be the essential and primary cause +for stuttering must also be applicable, in the same way but in different +degree, to all the other manifestations of speech disorder such as the slips +of the tongue, and many other of the psychopathologic acts of everyday life. +Consequently, if the Freudian theories of sexuality are directly applicable +to the problem of stuttering, it follows that they must likewise be +applicable to all the other disturbances of speech just referred to. For, +if followed out to the very end, we shall find that the possible mental +content and mental mechanisms are the same for all psychopathologic acts, +whether of everyday life or distinctly abnormal and outside the pale of our +average range. If sexuality lies at the bottom of stuttering, it must be at +the root of all other psychopathologic acts, of whatever nature, of whatever +degree and wherever and whenever found. I cannot devote the time in this +place to enter into an elaborate discussion to prove the truth of this +thesis. But I can gain my point more easily and more directly in another +way. Although Freud and his followers have not stated, in just so many +words, that the psychopathologic acts of everyday life have the same hidden +mental content that the psychoneuroses have (although it is my contention +that this conclusion is but a natural extension of their sexual theories +concerning the psychoneuroses), yet we do find that Freud and the Freudian +school in general apply their sexual theories to the whole group of the +psychoneuroses. Now, since stuttering is a psychoneurotic disorder of a +certain special type, it is understood that they must believe that +stuttering, as a matter of course, comes within the rubric of their +generalization. As a matter of fact, if their sexual theories were at first +applied only to stuttering, as they were originally applied to hysteria, it +would mean that, by a process of reasoning, the Freudian school would have +to apply their dicta to all of the psychoneuroses. This was, in truth, just +what did occur, beginning with hysteria. And it is seen that the same thing +would have happened had they begun with stuttering. I contend, further, but +I shall not endeavor in this place to prove the correctness of my +contention, that what is absolutely and without exception, fundamentally and +essentially true of the psychoneuroses is likewise true, in different +degree, of the psychopathologic acts of every day life. This would be the +conclusion to which I would be forced if I started with any one of the +psychoneuroses, whether it be hysteria or stuttering. One can thus see that +my statement that if Freud's theories are true for stuttering they must of +necessity be true for all psychopathologic acts of whatever sort is quite +true.[4] I could go much further and prove that if Freud's theories were the +primary and basic explanation for stuttering they must be applicable to all +manifestations of human mental energy, which to me would mean that they are +no less true of all vital energy, human or otherwise. In other words, the +solitary application of Freud's conception to the problem of stuttering +would lead us, by logical steps, to the ultimate conclusion that the vital +energy was sexual--a conclusion with which Jung will not agree. And let us +not forget, too, that the term "sexual" would here be used in a +psychological sense, so that, in fact, Freud's theories of sexuality as the +explanation of stuttering would lead us, step by step, to a psychosexual +conception of the universe. And is this not exactly what the Freudian school +has assumed? + +[3] Freud himself agrees that his sexual theories apply to all mankind and +that the psychoneurotic differs from others in not being able to +successfully and completely repress or sublimate the undesirable sexual +trends. + +[4] Freud himself agrees psycho-pathologic acts of everyday life are the +formes frustes of the psychoneuroses and that this shows that we are all +slightly nervous. + +I fear that I have not made myself as clear as I should and as I should like +to, but at the risk of being misunderstood, or of not carrying the reader +with me in my argument, I shall not enter into any further discussion of +this aspect-- the wider meanings of Dr. Coriat's paper. + +As can be judged from the above remarks, it was no surprise to me to see +such a paper on stuttering as Dr. Coriat's. To be sure it was tacitly +understood, by those who could read between the lines, that this must be the +belief of the Freudian school, since their conclusions were said to be true +of all the psychoneuroses. + +I had also known that a few Freudians abroad had arrived at conclusions +similar to those presented by Dr. Coriat, but since, so far as I knew, no +paper along this line had appeared in the English or American journals, I +did not give the subject any serious or special consideration and had not +the slightest idea of refuting the statements. When, however, Dr. Coriat's +paper appeared, I concluded that it was not out of place for me at this time +to enter into a criticism of these views. + +I have felt on many occasions that too many of the statements made by +members of the Freudian school have been left unchallenged, with the result +that the views promulgated have received quite widespread dissemination; so +much so that many believe that the sensational and unsupported views which +have come to their ears are accepted as the untarnished truth by most or all +psychopathologists, and were a definitely proven and generally accepted part +of psychopathology. It is therefore not at all surprising to find so many +workers in other fields of medicine who believe that the terms +"psychopathology" and "Freudian psychoanalysis" are synonymous, one and the +same thing. + +This also is one of the motives which prompts me to write these lines. + +I am furthermore impelled by the purely scientific desire for truth and +accuracy, as applied in particular to the problem of stuttering. + +And last, but by no means least, I see a serious danger to the community in +the uncritical acceptance and the widespread dissemination of the views +promulgated by the Freudian school. + +Let me assure Dr. Coriat that I regret very much that I find myself +compelled to take the field against him or rather his paper in this +connection, and that no personalities enter into the question at issue, but +that it is a purely scientific problem, which demands the freest discussion, +from all sides. Each of us is entitled to his personal opinions in this +matter. The question of sincerity and honesty of purpose is not at all +breathed. It is purely a matter of "What is the truth?" + +And it shall be my object in the following brief discussion not to give my +personal views upon this subject, nor even to dissect each and every +statement in Dr. Coriat's paper with which I find myself at issue, but +merely to show wherein Dr. Coriat is in most serious error. + +I shall confine myself to the question of the application to stammering of +the sexual theories so rampant in Freudism. Besides, I shall avail myself +of the privilege of giving, in Dr. Coriat's own words, the gist of his +theory or concept. + +"The attempt to repress from consciousness into the unconscious certain +trends of thought or emotions, usually of a sexual nature, is the chief +mechanism in stammering." This is the only place in the article where Dr. +Coriat expresses any doubt as to the universal validity of his theory for +all cases of stuttering. But I consider this merely as a slip of the tongue +or pen, because in the other portions of the paper the conclusion concerning +the sexual basis of stammering is unqualifiedly made general, and I find +that even on the very next page, at the conclusion of the paragraph of which +the sentence just quoted is the beginning, there occurs the statement that +"the fear in stammering is a deflection of the repressed sexual impulse or +wish." With this beginning Dr. Coriat proceeds to explain: "Thus the +repressed thought, because of fear of betrayal, comes in conflict with the +wish to speak and not to betray (the secret through words[5]). Hence, the +hesitation in speech arises and as the repressed thoughts gradually are +forced into the unconscious, there finally develops the defective speech +automatism, either stammering or a spastic aphonia. This arises in childhood +after the child has learned to speak." + +[5] Words in parentheses mine but taken from Dr. Coriat's paper; for +explanatory purposes. + +Moreover, "the hesitation of stammerers on certain words or letters is due +to disturbing complexes. The stammering does not cause the inhibition, it +is the inhibition which is at the bottom of the stammering." + +"Two types of stimuli lead to stammering, either internal conflicts, or +external instigators which throw these conflicts into activity. The internal +conflicts are either conscious or unconscious fear of betrayal (and +therefore a wish to retain a secret), and this mental attitude leads to the +dread of speaking, a genuine conversion of morbid anxiety into defective +speech. . . . The external stimuli act like dream instigators, for instance +the fear of speaking to relatives or to intimate friends may be based upon +the fear that the unconscious wishes may be discovered and this stimulates +the unconscious anxiety, whereas with strangers, speech is free, because the +dread of discovery is absent." + +"Thus," says Dr. Coriat, "the beginning of stammering in early childhood . . +. is caused by the action of unconscious repressed thoughts upon the speech +mechanism, the repressed thought obtruding itself in speech." + +In brief it is contended by Dr. Coriat that the stammering arises as a +defense or compensation mechanism, the object of which is to keep from +consciousness certain painful memories and undesirable thoughts, in order +that they may not be betrayed in speech. In fact, as Dr. Coriat says, "all +stammering, with its hesitation, its fear, its disturbing emotions, is a +kind of an association test in everyday life and not a phonetic disturbance. +It is a situation phobia, the same as phobias of open or closed places." + +Consequently, according to this view, stammering is purposeful and +intentional and not accidental. This purposiveness is psychological and +individualistic. It is resorted to by the individual for very definite, +intimate, personal reasons. It is due to unconscious, repressed hidden +complexes which crowd or press between the words of syllables, as Stekel +puts it, and which produce the inner resistance which inhibit the free flow +of speech. + +It is asserted that these hidden, repressed, unconscious thoughts are +related to the sexual impulse or wish. + +Dr. Coriat enumerates the types of repressed complexes in childhood which +may bring about stammering as follows: + +1. Repression of sexual acts or secrets and the fear of betrayal. 2. +Typical Oedipus complexes, with a fear of betrayal of the hate for the +father and a consequent embarrassment of speech in his presence. 3. +Masochistic phantasies, wondering and imitating how it would sound to talk +with the tongue cut out. 4. The fear of pronouncing or saying certain +sexual and, therefore, tabooed words, and thus betraying what the child +thinks, his hidden thoughts. + +The stammering may then arise as a wish to say or think certain tabooed +words and the wish encounters a prohibition from within. These words may +relate to certain anal, urinary or sexual functions which are recognized by +the child as unclean, and thus forbidden to pronounce. 5. As a +manifestation of anal eroticism, that is, holding the feces so that he could +talk while trying to conceal the act. + +. . Talking at these times would be difficult, because talking would take +away the muscular tension for withholding the feces." + +At another place Dr. Coriat assures us that "the dreams of stammerers are +interesting because these dreams reveal their wishes to talk freely, their +resistances and transferences and, also, their reversions to childhood when +the stammering arose as an embarrassment complex or as a gainer of time to +conceal their sexual thoughts or libido." + +I have presented Dr. Coriat's views so fully and quoted him so much at +length in order that there may not be any question of the absolute accuracy +of my statements. + +What does this mean to the one who has followed the trail of the Freudian +movement? The meaning is plain. It is like the handwriting on the wall. +Dr. Coriat has permitted himself to be deluded by the Freudian sexual +theories and their application to the psychoneuroses, and in this special +instance to stammering. + +What does this imply? It implies that Dr. Coriat accepts the Freudian +theories en masse. Hence, to discuss this subject in a thorough way I +should have to take up for discussion the various aspects of Freudian +psychoanalysis. This would include a consideration of the method employed, +the psychology, the attitude or standpoint assumed, the "art of +interpretation" developed, and the real meanings, in their wider and more +extended sense, of various unsupported, unfounded, dogmatic and untrue +conclusions of a theoretical and practical nature. This cannot, it is +obvious, be expected in this place. Attempts of a certain sort in this +direction have been made by me in previous communications.[6] In the not +very distant future I shall endeavor more successfully to cope with some of +the problems mentioned. + +[6] See, for example, the Psychoanalytic Review, January 1915 and the +Journal of Abnormal Psychology, June-September, 1914. + +With respect to the general problem of sexuality I may say that I have +recently[7] taken up, for separate dissection, the conception of sexuality +assumed by Freud and his followers. The present paper should, I feel, be +read in connection with this particular paper, since it will, in a way, +clear the field of many of the misunderstandings in interpretation. +Everything depends upon what one means by "sexuality" or "sexual impulse" or +"sexual tendency." Unless a mutual understanding is arrived at on this +subject of sexuality, little advance toward the dissipation of conflicting +views of Freudians and anti-Freudians can ever be had. And permit me to +mention in this place that it is the Freudians themselves and not their +opponents who are most to blame. Until the Freudian school decidedly and +once for all gives up its false and distorted viewpoint of man's sexual +impulse and of human mental life, little progress of a worth-while nature +can be made by them.[8] + +[7] "A Critical Review of the Conception of Sexuality Assumed by the +Freudian School." Medical Record, March 27, 1915. + +[8] Owing to the fixed, systematized theories of the Freudian school, I +believe that little co-operation can be expected from it. We can only +prevent the dissemination of their dangerous sexual theories. + +Starting out, then, with certain concepts or theories which are basically +wrong and can be summed up by stating that they assume an individualisitic, +psychosexual conception of life and interpretation of vital phenomena, and +with a psychology and a sexology which is radically wrong in its sweeping +and dogmatic conclusions, Dr. Coriat, who has obviously accepted these +theories as actualities, else he could not have arrived at the ideas +concerning stammering which he presents in his paper, builds up or accepts +an imaginatively constructed theory which he applies in full force to the +problem of stuttering, and into which he crowds the phenomena of a physical +and mental order which are manifest in this intermittent, special +psychoneurotic disorder. As a natural consequence all the faults of Freudism +have been transported to the elucidation of the genesis, nature and +evolution of stammering. And this means that the theories of universally +acting psychical repression, of the unconscious, of the endopsychic censor, +of the significance of resistance and amnesia, of the employment of highly +complicated and phantastic symbolism, of the manifestations of sexuality and +so forth have been made use of in a high-handed, uncalled for, unnecessary +and unscientific manner to prove the truth of the thesis with which the +author set out upon his journey. + +It is no wonder that in such a fashion and with such concepts the +conclusions above cited were arrived at. Indeed, work along this line was +unnecessary, except in a purposively corroborative way, if the theories of +Freud in the case of the whole group of psychoneuroses is once seized upon +and accepted as the basic truth. The problem for Dr. Coriat is to prove the +truth of Freud's conceptions as laid down in his psychology and sexology, +upon which his psychopathology is built. + +I must stoutly protest against an evasion of the real issues by the leaders +of the Freudian movement. Let them retrace their steps and first prove the +truth, soundness and validity of their psychological and sexual theories and +cease pressing on to pastures new, as Dr. Coriat has done here in the case +of stuttering. If they are not prepared to do this, or are unwilling so to +do, I do not believe that they are entitled to continue to inflict upon +others views which have little real foundation in fact, which are unproven, +unfounded, purely speculative, imaginative, pure figments of the +imagination, a delusion and a snare. I have elsewhere[9] given credit to +Freud and his co-workers where I think they deserve it. But that should not +deter me from protesting against their evasion of the issues, their +befogging of the problems involved, their failure to prove their case or to +offer satisfactory replies to criticism which is given in a fair and frank +fashion. + +[9] "A Plea for a Broader Standpoint in Psychoanalysis." Psychoanalytic +Review, January, 1915. + +The method of burying one's head in sand, after the manner of the ostrich, +and the refusal to see that which is pointed out or which stares one clearly +in the face, cannot go far to establish one's case or as a method of +defense. And the same thing applies to that oft-repeated and tiresome +retort: "You do not (or perhaps you cannot) understand our theories and +viewpoints." Or that other evasive accusation, rather than reply: "Your +lack of understanding is of itself proof positive that our theories are +absolutely correct in every detail." Or "Your attack or criticism just +completely and undoubtedly proves our case. You are prompted by those very +mental mechanisms and by that self-same mental content--meaning all the time +the sexual content and sexual mechanisms--which we have been trying to +explain to you so that you might understand us." + +In response to this I should like to ask the Freudian school what it means +by "censor," "wish," "unconscious," "sexual," and other similar and +constantly used terms which form the stronghold of their defenses. I have +shown,[10] at least to my own satisfaction, that the conception of sexuality +is not at all clear to any of the Freudian school, including Freud himself. +This should by no means be so. Surely the terms which are constantly used +and are the sine qua non of their theories should have a definite meaning of +some sort, at least to the Freudians themselves. Mystical and metaphysical +implications should not continue to find a sheltering place in the province +of psychopathology. They should be uprooted and driven forth from the dark +and hidden recesses into the light and open highways. + +[10] Loc. cit. + +These statements have a direct application to the paper which I have +undertaken to criticize. It is all very well and very commendable to come +forward with new theories. They are entertaining, interesting and make one +think, even if they are not at all true. But it should be definitely and +plainly stated that we are dealing with theories and not with facts, that +the theories will be considered theories until they are proven to be facts, +and that if they are disproven, they should be thrown into the rubbish heap +or discarded, or else they should be modified to meet with the facts and +actual conditions--as they are and not as they ought in our opinion to be or +as we should like them or as we imagine them to be. Here we are confronted +with a problem (stammering) which has been the subject of much study and +discussion by many men. Theories have been carefully and guardedly +formulated by most workers in this field. Many of them were, it is true, in +error in their conclusions or viewpoints. They were, as it were, on the +wrong trail. + +Here is a problem of the greatest interest and of the greatest importance-- +one which should demand the most careful research and the most positive +deliberation and consideration, with prolonged and intensive study and +observation of cases, combined with self-scrutiny and self-analysis and +self-knowledge (which means a keen insight into human nature and the human +mind in its manifold workings). Here is a serious, concrete problem of great +practical importance. Its solution and elucidation means much. And he who +comes forward with an explanation of this problem should be expected to give +conclusive proof of his conception and for his conclusion. And we should, +justly and as a matter of course, expect and demand it. + +And what proof has Dr. Coriat given us for his conclusions? Here and there +scattered through his paper one finds a few conclusions or explanations of a +concrete nature, but they are his interpretations of the facts and not the +facts. No real, in fact not a vestige of proof is offered. The few dreams +which he presents do not, to the inquiring and demanding reader, show +anything which permit of the conclusions which Dr. Coriat draws with +reference to their meaning or significance. He seems to have interpretated +(rather than analyzed) them in typical Freudian fashion. And, furthermore, +even if his interpretations of the few dreams which he presents and which +were taken from different cases were true, of what significance would that +be? What right would we thus have of drawing conclusions which apply to all +cases of stuttering (and, as mentioned earlier in this paper, to many other +related states of a normal and abnormal nature)? Not the slightest. + +Not a single case has been presented in proof of the conclusions drawn in +the paper. Surely this is not what we have been accustomed to expect in +other fields of medicine, especially when the conception newly put forth is +entirely novel, sensational, revolutionary, contrary to all former beliefs, +and based on theories and conclusions which have been for some time and +still are a centre of storm, of wordy argumentation, and even of insult and +abuse--at any rate sub judice, + +Has the science and practice of psychopathology come to the stage when +theories of any sort can be given to the reading public as fact, and no +actual proof therefor presented? + +I venture to say that in no other department of medicine or in fact in no +other aspect of life would scientific men tolerate such presentation and +promulgation, despite opposition and disproof and with no tangible or +definite evidence or proof. Nor would men come forward to offer +revolutionary, let alone dangerous theories, for general consumption, with +so little proof, as is being laid on the platter for psychopathologists. + +I find no evidence offered by Dr. Coriat to bolster up the conclusions of +his paper. + +In response to a question asked by one of those who discussed his paper in +which he was requested to explain how he knew that stammering begins by +concealing something, Dr. Coriat stated: "I have had an opportunity of +examining a number of stammerers and subjecting them to a complete +psychoanalysis, studying all the paradoxical mental reactions and in nearly +every case this concealment of some sexual secret of childhood came up. It +is easy to establish a certain relationship between the speech embarrassment +and the concealed sexuality." + +There is, as is seen, no other proof for this theory (that is all that one +call it) of Dr. Coriat and the Freudian school in general, than his or their +say-so. Those who are acquainted with the method of arriving at conclusions +adopted by the Freudian school will demand more than this as proof of either +the "concealment" of some "sexual secret" of childhood (and where lives +there a man or woman that has not sexual memories, not necessarily secrets, +of some sort or other, related to the period of puberty or antedating it by +a certain varying period?) or the establishment of a relationship other than +co-existence or coincidence, between the speech embarrassment and the +"concealed sexuality" (just as if even proof of the existence of this +relationship was sufficient testimony of the causative operating influence +of the latter). + +I could discuss Dr. Coriat's paper from many angles, and in each case show +that its conclusions were not only unsupported but impossible.[11] But in +the above remarks I have presented sufficient evidence, I believe, to carry +out the objects of this criticism. + +[11] The ideas in the paper are, in fact, absurd. If definite, practical, +clinical issues were not involved matters might be different. But the +situation is serious yes, dangerously antisocial, since the practical +application of these theories to human beings is the point of greatest +interest. + +The reader should not lose sight of the cold but important fact that the +application of Freud's sexual theories to stammering in children is, in my +humble opinion, fraught with the greatest danger. I cannot do otherwise +than look upon this as positively anti-social. It would, it is my belief, be +a glaring and rife source of danger to the community and to society in +general for these ideas to be spread broadcast. Freud himself has shown that +the child, before puberty, with his more or less undifferentiated sexual +impulse, may be swept along into any one or more of the sexual aberrations +or to intrafamilial sexuality. These goals exist only as POSSIBILITIES and +should not, I contend, be referred to as predispositions or tendencies +(almost as if they were instincts). The direction of the child's thought +along this line before or at or after puberty may prove disastrous in one or +more of many different ways. + +Think of hinting at or talking about or harping upon matters of this sort to +children, let alone to adults of the usual sort! It would be nothing less +than a crime to society, to the family and to the growing child. In this +respect I look upon the application of the Freudian theories as a distinct +and glaring danger to the individual, to the family and to the community. + +Efforts to stem the tide from flowing in this direction should be +unfettered. It means much for humanity. + +Even hinting (to the children) in a remote way about the various aspects of +sexuality described by the Freudian school should not find its place and has +no place in treating stammering per se in children. + +Think of the effect of continual conversation and thinking of this sort upon +a child at or before puberty, or at adolescence, or even upon an individual +in adult life! His thoughts are continually drifted to his urogenital organs +and the sexual possibilities of all sorts of human relationships, +intrafamilial as well as extrafamilial. + +The Freudians may object to any statements to the effect that they tell +their patients about these sexual theories. I find Jones,[12] for instance, +declares that Freud "deliberately withholds from his patients all knowledge +of psychoanalyses except what they discover for themselves." Even granting +this, the patient doesn't have to wait long or think much before he does +discover for himself just what the Freudians mean. + +[12] Ernest Jones: Professor Janet on Psychoanalysis; A Rejoinder. Journal +of Abnormal Psychology, Feb.-Mar., 1915, p. 407. + +But Freud[13] himself contradicts this statement by Jones when he says: "If +with my patients I emphasize the frequency of the Oedipus dream--of having +sexual intercourse with one's own mother--I get the answer: 'I cannot +remember such a dream.' Immediately afterwards, however, there arises +recollection of another disguised and indifferent dream, which has been +dreamed repeatedly by the patient, and the analysis shows it to be a dream +of this same content--that is, another Oedipus dream." + +[13] Brill's translation of Freud's Interpretation, p. 242. Italics mine. + +Then again, listen to Brill:[14] "With reference to the question of +determining that a person is homosexual. + +[14] The Conception of Homosexuality, Journal of American Medical +Association, August 2, 1913. See Brill's discussion on pages 339-340. + +"A patient came to me who was said to have nothing the matter with his +sexual life, but who had convulsions. I had seen him not more than three +times when I said to him: 'You are homosexual,' and I explained what I +meant. He told me that while at college he never indulged in sexual acts, +and that for this reason he used to wrestle, during which he would have +ejaculation, and he selected his partners. Unquestionably from the beginning +of his existence he was homosexual, although he was able to have sexual +intercourse with his wife, but he was compelled to marry when quite young; +he was 'prodded into it,' as he said. He came to me to be treated for +neurosis, but the neurosis was simply the result of homosexual lack of +gratification. + +"We should be particularly careful not to suggest anything. I never tell a +patient that he is homosexual. Be reasonably sure that he is homosexual and +you need not hesitate to tell him so." + +It all depends on what one means by "reasonably sure" or what kind of and +how much evidence one requires or demands to be "reasonably sure." + +Furthermore the mass of popular Freudian literature is not by any means +hidden from the patient. + +In conclusion I may remind the members of the Freudian school that it +behooves them to undergo that same self-analysis and self-scrutiny which +they justly advise others to have. If they do this in a truly critical and +impartial way they will find that the opposition which they have met has not +been without foundation. They will find that there are serious and +all-pervading flaws in their psychology and sexology, and that this is +responsible for their one-sided and distorted analyses and interpretations. +Most of the trouble will be found in the method of interpretation, flowing +out of their attitude. They will find that they have been advocating a +system of theories and conclusions which have been followed as a religion, a +cult, a creed. And they will correct the errors which are so patent to so +many of the rest of us. + +It is or should be evident to him who reads between the lines and surveys +this question as from a mountain top, that there is not the slightest proof, +not one jot of testimony in support of the ideas which Dr. Coriat has given +us in his paper. + +As a final word I cannot refrain from remarking that it will be a sad day +for humanity and for society when psychoneurotics of whatever sort, +stammerers, normal individuals with their psychopathologic acts of everyday +life, and all the rest of us, particularly children, shall be subjected to +Freudian psychoanalyses, with the numerous sexual theories and sexual +implications with regard to everything of vital or human concern, as seen +especially in family and social relations. A study of the origin, nature and +evolution of these is not only not out of place, but on the other hand finds +a distinct place of honor for purely scientific purposes. Theories, however +unfounded and untrue, may, not inappropriately, be offered for this purpose. +But we come upon a decidedly different situation when we have to deal in a +practical sort of way with individuals, particularly children, who are the +objects of the experimental application of full-blown theories. Especially +is this so in the case of sexual theories. + +Propagation of such views concerning the origin and nature of stammering as +are presented to us in Dr. Coriat's paper should be sternly discountenanced. +Nay more, they should be unflinchingly denied and even severely condemned. +I, for one, protest vigorously against the propagation of such views, +especially when they represent nothing more than an inflated theory. + +The writer wishes to assure Dr. Coriat and the reader that his remarks are +intended in a thoroughly impersonal sort of way. He is concerned only with +the problems involved. Personalities do not at all enter into the +proposition. He hopes that his criticism will be accepted in the same spirit +in which it is given. If, to the reader, it may seem at times that the +writer has spoken too strongly, he can only say in defense that he has +seized upon this occasion as the time and the place to so express himself +briefly, frankly but without malice. The situation more than demands such +outspoken expression of opinion. + + + +ABSTRACTS + +THE PSYCHIC FACTORS IN MENTAL DISORDER. Milton A. Harrington, Am. Jour. of +Insanity. Vol. LXXI, No. 4, p. 691. + +The writer has taken the scheme of the instincts which William McDougall has +given in his book, entitled "An Introduction to Social Psychology" and has +attempted to show how it may be used in studying the problems of mental +disorder. The paper falls into three parts. In the first part McDougall's +conception is presented, modified, however, so that it may be better fitted +to the needs of the psychiatrist. Briefly it is as follows: + +Man has instincts as well as the animals and all his mental activity is due +to impulses coming from these instincts. An instinct may be defined as an +innate specific tendency of the mind which is common to all members of any +one species and which impels the individual to react to certain definite +kinds of stimuli with certain definite types of conduct, without having +first learned from experience the need of such conduct. For example, there +is an instinct of pugnacity which impels us to attack that which injures us +or interferes in any way with the attainment of our desires, an instinct of +flight which impels us to seek escape from danger, a parental instinct from +which come the impulses that lead us to protect and care for our young. +But, beside impelling the individual to react to certain definite kinds of +stimuli with certain definite types of conduct, an instinct, when +stimulated, gives rise in every case to an emotion which is characteristic +of it. For example, with the instinct of pugnacity, we have the emotion of +anger; with that of flight, the emotion of fear; with the parental instinct, +the emotion of love or tender feeling. An instinct, therefore, is regarded +as a mechanism made up of three parts: + +First, an afferent or cognitive part, through which it is stimulated. + +Second, an affective part through which it gives rise to the emotion which +is characteristic of it. + +Third, an efferent or conative part through which it gives rise to a +characteristic type of conduct. + +McDougall gives a list of about twelve instincts, each with its accompanying +emotion. These he regards as primary and the source of all thought and +action. + +Considering the instincts from the standpoint of evolution, one may assume +that they first developed in extremely low forms of life in order to produce +the few and simple reactions of which animals low in the scale are capable. +One might almost say in regard to such primitive organisms, that for each +situation an instinct is provided and the situation calls forth its +appropriate reaction almost as automatically as the pressing of an electric +button causes the ringing of a bell. But, as animals rise higher in the +scale, the kinds of conduct required become more varied and complex. For +example, an impulse from the flight or fear instinct, in the lower animals, +will always produce some simple reaction such as flight or concealment. +But, in man, the forms of conduct, to which it gives rise, may be extremely +varied. Thus in one case a man may be impelled to run away, in another to +work hard at some disagreeable task in order to escape the harm which might +result if he failed to do so. This capacity to direct the instinctive forces +into various forms of activity, we call the capacity for adjustment and we +may assume that it depends upon the operation of certain mechanisms which we +may call the mechanisms of adjustment. The mind may, therefore, be regarded +as made up of certain instincts from which come the impulses that give rise +to all our mental reactions and certain mechanisms of adjustment by which +these impulses are directed into the most useful forms of activity. + +This conception of the human mind enables us to form some idea of how a +mental disorder may arise from purely mental causes; for it is obvious that +conditions may sometimes arise when the mechanisms of adjustment will prove +inadequate to the demands made upon them, when they will be unable to +control the instinctive forces or find for them satisfactory outlet and, as +a result, these impulses will escape by undesirable channels, giving rise to +forms of thought and action which we recognize to be abnormal. To show that +this theory may be successfully applied to explain the facts of abnormal +psychology, the analysis of an illustrative case is presented. This case, +which is worked out in considerable detail, forms the second section of the +paper. It is the case of a young man who, partly owing to inherited +tendencies and partly to environment, developed during early life certain +habits and characteristics which, when he approached maturity and the sexual +instinct awoke to its full activity, caused the impulses from this instinct +to be directed into wrong channels, giving rise to a psychosis which took +the form of a catatonic stupor. + +The conception of mental disorder here presented inevitably leads to certain +views regarding the causes which give rise to it. Since mental health is +dependent on capacity for adjustment being equal to the demands made upon +it, mental disorder must always be due to failure to maintain this +relationship between capacity and needs. The causes of insanity must +therefore be of two kinds: + +First, those which make the task of adjustment so difficult as to overtax +the capacity. + +Second, those which lessen the capacity so that it is unequal to the demands +made upon it. + +The third section of the paper is a brief discussion of what these causes +are and how we should deal with them. Author's Abstract. + + + +A STUDY OF SEXUAL TENDENCIES IN MONKEYS AND BABOONS. By G. V. Hamilton. +Journal of Animal Behavior, September-October, 1914, vol. 4, No. 5, pp. +295-318. + +The writer asserts that the work and problems in sexuality in human beings +place upon the animal behaviorist an obligation to lay the necessary +foundations for a scientific and thoroughly comprehensive investigation of +sexual life. This has led him to formulate the following two problems in +animal behavior: (1) Are there any types of infra-human primate behavior +which cannot be regarded as expressions of a tendency to seek sexual +satisfaction, but which have the essential objective characteristics of +sexual activity? (2) Do such sexual reaction-types as homosexual +intercourse, efforts to copulate with non-primate animals and masturbation +normally occur among any of the primates, and if so, what is their +biological significance? + +The author presents a list of the subjects (monkeys and baboons) employed in +his study; gives a description of the environmental conditions in his +laboratory which is in the midst of a live oak woods In Montecito, +California, about five miles from Santa Barbara; gives a list of the types +of situations that were arranged by the observer or encountered by the +subjects in consequence of their spontaneous activities, and under each +description of a typical situation one or more detailed descriptions of +typical responses thereto; and finally offers the classification of sexual +tendencies as expressions of reactive tendencies observed. + +The author then enters into a discussion of the use of the term reactive +tendency, and explains that this term, according to his definition, is meant +to explain something more specific than an inclination to direct activity +toward one of a limited number of general ends, and to include both the +innate and the acquired features of an individual's reactive mechanism. + +He then presents his conclusions which I shall here include in full and +verbatim, because of the fact that these findings should prove of great +importance, especially in the light of Freud's theories of infantile +sexuality. The author states that "At least two, and possibly three, +different kinds of hunger, or needs of individual satisfaction, normally +impel the macaque toward the manifestation of sexual behavior, viz., hunger +for sexual satisfaction, hunger for escape from danger and, possibly, hunger +for access to an enemy. + +"Homosexual behavior is normally an expression of tendencies which come to +expression even when opportunities for heterosexual intercourse are present. +Sexually immature male monkeys appear to be normally impelled toward +homosexual behavior by sexual hunger. The fact that homosexual tendencies +come to less frequent expression in the mature than in the immature male +suggests the possibility that in their native habitat these animals may +wholly abandon homosexual behavior (except as a defensive measure), on +arriving at sexual maturity. + +"Homosexual behavior is of relatively frequent occurrence in the female when +she is threatened by another female, but it is rarely manifested in response +to sexual hunger. + +"Masturbation does not seem to occur under normal conditions. + +"The macaque of both sexes is apt to display sexual excitement in the +presence of friendly or harmless non-primates. + +"It is possible that the homosexual behavior of young males is of the same +biological significance as their mock combats. It is clearly of value as a +defensive measure in both sexes. Homosexual alliances between mature and +immature males may possess a defensive value for immature males, since it +insures the assistance of an adult defender in the event of an attack." +MEYER SOLOMON. + + +AN EXPERIMENTAL STUDY OF STUTTERING. By John Madison Fletcher. American +Journal of Psychology, April, 1914; Vol. XXV, pp. 201-255. + +This paper is a dissertation submitted to the faculty of Clark University, +Worcester, Mass., in partial fulfilment of the requirements for the degree +of Doctor of Philosophy. It is thus from the Psychological Laboratory of +Clark University. + +This interesting study of Fletcher includes some general remarks in the +introduction, the question of differentiation and definition, the +physiological aspects (including breathing, vocalization, articulation and +accessory movements), psychophysical changes (including volumetric changes, +changes in heart rate and galvanic changes), a consideration of the +interpretation of the results, the psychological relations (including +emotions, attitudes, imagery, responsibility for Aufgabe, psychoanalysis, +and association), heredity and conclusions. A valuable bibliography is +added, and seven illustrative plates complete the paper. + +Fletcher would reserve the word "stammering" for mispronunciation or +incorrect speech, this stutter being anatomical (due to malformation of one +or more organs of articulation) or developmental (due to incorrect +functioning of the organs of articulation resulting in certain cases of +immaturity, such as lisping). Stammering, in this sense, is of no +psychological interest. The reviewer is in favor of employing the terms +"stammering" and "stuttering" synonymously, as is the practice in England +and America. The writer (Fletcher) finds that he cannot accept the Freudian +interpretation of stuttering which has been offered by a number of different +members of that school. + +Although the entire paper is of interest and of value to the student of +psychopathology, the purposes of this review can best be served by citing +the following conclusions of the author: The motor manifestations of +stuttering are found to consist of asynergies in the three musculatures of +speech--breathing, vocalization and articulation. Certain accessory +movements, which tend to become stereotyped in each individual and which +consist of tonic and clonic conditions of other muscles not involved in +normal speech, accompany these asynergies. The type of asynergy and more +particularly of accessory movements differ so widely that it is impossible +to state that any special form of breathing, or articulation, or of +vocalization is the fundamental factor in stuttering. Disturbances of pulse +rate, of blood distribution and in psychogalvanic variations, appearing +before, during and after the speaking interval, and the intensity of which +varies approximately with the severity of the stuttering, accompany the +motor manifestations of stuttering. The essential condition in stuttering is +the complex state of mind, the quality rather than the intensity of these +feeling states governing the rise of stuttering. Such feeling states as +fear, anxiety, dread, shame, embarrassment, in fact, those feelings that +tend toward inhibition and repression, are most likely to precede +stuttering, and probably operate in a vicious circle as both cause and +effect. The permanent condition of nervousness thought to be characteristic +of stutterers should be regarded as effect rather than cause. The states of +feeling that have to do with the production of stuttering vary in degree +from strong emotions to mere attitudes or moods, the latter being often so +slight in degree that it is difficult for the subject to report their +presence. Stuttering also seems to be affected by the quality of mental +imagery, by attention and by association. The affective and emotional +experiences associated with the pronunciation of sounds rather than the +nature of the sounds themselves determine the rise of stuttering. The +author's final remarks are: "Stuttering, therefore, seems to be essentially +a mental phenomenon in the sense that it is due to and dependent upon +certain variations in mental state. Hence the study of stuttering becomes a +specifically psychological problem; and it seems evident that a detailed +analysis of all the various aspects of the phenomena of stuttering will +furnish important contributions to general psychology." MEYER SOLOMON. + + + +REVIEWS + +THE FOUNDATIONS OF CHARACTER. By A. F. Shand. Macmillan and Company, +London, 1914. Pp. xxx, 532. + +In his preface the author says: "A great difficulty which I have found in +the course of my work has been to collect the facts or observations of +character on which I had to rely. Such material as I have obtained has been +drawn much more from literature than from any other source; and this was +inevitable, because psychology has hardly begun to concern itself with these +questions." This reproach levelled against psychology rebounds on the +author, for throughout the book he shows himself evidently unacquainted with +those branches of psychology, notably the medical ones, that have +contributed so brilliantly and extensively to the science of characterology. +It need hardly be pointed out, further, that to rely on second-hand +material, which cannot be checked, analysed, or immediately studied, as the +living facts can is a procedure that is open to insuperable objections. + +The author repudiates any analytical approach to his problems, preferring +what he terms "a concrete and synthetic conception of character," and so +"avoids breaking up the forces of character into their elements, and being +driven to consider the abstract problem of their mutual relation." His +method consists in assuming the existence of these forces, as part of his +working hypothesis, and in formulating general laws based on a study of +them. As he himself puts it, "It is in the first place a method of +discovery rather than of proof;--a method reaching no further than a +tentative formulation of laws; for organising the more particular under the +more general; for interpreting the generalised observations which every +great observer of human nature forms for himself, and by this interpretation +making some advance towards their organization. "It follows from this that +the book is predominantly descriptive in nature, and in this field it must +be said that the author has accomplished great work, one that will be of +almost indispensable value to future students of the various emotions. + +The book is really a study of the emotions rather than of character, and so +we have to pay special attention to what the author has to say concerning +them. As is well known, he formulated some years ago a special +conception--it can hardly be called a theory--of the emotions, and the most +novel part of the present work is the way in which this conception is +expounded and elaborated in detail. He rejects the usual sense of the term +in which it is taken to express a certain degree of elaboration of the +affective aspect of the mind, and adopts a much wider definition in which +the conative, affective, and cognitive aspects are all represented. +"'Emotion' for us will connote not feeling abstracted from impulse, but +feeling with its impulse, and feeling which has essentially a cognitive +attitude, however vague, and frequently definite thoughts about its object." +He distinguishes, none the less, between an emotion and the entire system to +which it belongs. It is the part of the system that is present in +consciousness, there being two other parts that are not; namely, the +processes connected with it in the body, and the executive part concerned +with its outward expression and modes of behaviour. The three main primary +emotions are fear, anger, and disgust; other are curiosity, joy, sorrow, +self-display, and self-abasement. The four emotional systems of anger, fear, +joy and sorrow have an innate connection not only with one another, but also +with every other primary system. Most of the book is taken up with a very +detailed study of the emotions just enumerated, and in this study the author +insists on the functional point of view, constantly enquiring into the +dynamic aspects and tendencies of the emotion under consideration. This is +perhaps the only respect in which it could be seen that the book was written +within the last forty years. + +Mr. Shand's view of the relation between the emotions and the instincts has +led to an animated controversy with Dr. McDougall, published in the +Proceedings of the Aristotelian Society for 1914-1915. According to the +latter writer, every emotion has a corresponding instinct, and is merely the +affective aspect of this instinct. Mr. Shand, on the contrary, holds that +there are vastly more instincts than emotions, that a given instinct may +enter into several different emotional systems, and that each emotional +system may at various times, and according to its needs, make use of almost +any number of different instincts. The reviewer is unable to determine +whether these different points of view have any further implications than a +difference in the definitions adopted by the two writers. McDougall +obviously employs the term instinct in a much more comprehensive and +inclusive sense than Shand does. + +In the discussion of this interrelation there occurs, by the way, the +following suggestive passage: "There are no fears so intense as those which +arise in situations from which we cannot escape, where we are forced to +remain in contemplation of the threatening events. There is no anger so +intense as when the blood boils and all the sudden energy that comes to us +cannot vent itself on our antagonist. The arrest of an instinct is that +which most frequently excites the emotion connected with it; and therefore +we feel the emotion so often before (or after: Reviewer) the instinctive +behaviour takes place, rather than along with it." This seems to +after-shadow the modern views on intrapsychical conflict and abreaction. + +Another conception peculiar to the author, first propounded in 1896, is that +regarding the sentiments. Sentiments, in the author's sense, are "those +greater systems of the character the function of which is to organize +certain of the lesser systems of emotions by imposing on them a common end +and subjecting them to a common cause." A constant conflict seems to go on +between the organizing tendency of these sentiments and the tendency of the +constituent emotions to achieve freedom and autonomous action, a conception +quite in harmony with the modern views of "complex-action," although Shand's +"sentiments" are far from being synonymous with either "complexes" or +"constellations" in our sense. The implications that follow from his +conception of the sentiments, and the importance he attaches to it, are well +shown by the following interesting passages. "The result of the modification +which the systems of the emotions undergo in man, and especially the +multiplication of the causes which excite and sustain them, is (1) to make +man the most emotional of animals, and (2) to render possible the debasement +of his character. For that which is a condition of his progress is also a +condition of his decline,--the acquired power of ideas over emotions, and +the subsequent power of each indefinitely to sustain the other. Hence the +existence of the emotions constitutes a serious danger for him though not +for the animals, and the balance which is lost when the emotions are no +longer exclusively under the control of those causes which originally excite +them can only be replaced by the higher control of the sentiments. There are +then three stages in the evolution of emotional systems; the first and +primitive, in which they are under the control of the stimuli innately +connected with their excitement, undergoing a certain change through +individual experience, but not radically altered; the second, in which they +become dangerous and independent systems; the third, in which they are +organized under the control of the new systems which they are instrumental +in developing." "There are three principal stages in the development of +character. Its foundations are those primary emotional systems, in which the +instincts play at first a more important part than the emotions; in them, +and as instrumental to their ends, are found the powers of intelligence and +will to which the animal attains. But even in animals there is found, some +inter-organization of these systems, or, at least, some balance of their +instincts, by which these are fitted to work together as a system for the +preservation of their offspring and of themselves. This inter-organization +is the basis of those higher and more complex systems which, if not peculiar +to man, chiefly characterize him, and which we have called the sentiments, +and this is the second stage. But character, if more or less rigid in the +animals, is plastic in man: and thus the sentiments come to develop, for +their own more perfect organization, systems of self-control, in which the +intellect and will rise to a higher level than is possible at the emotional +stage, and give rise to those great qualities of character that we name +"fortitude," "patience," "steadfastness," "loyalty," and many others, and a +relative ethics that is in constant interaction with the ethics of the +conscience, which is chiefly imposed upon us through social influences. And +this is the third and highest stage in the development of character, and the +most plastic, so that it is in constant flux in each of us; and the worth +that we ascribe to men in review of their lives, deeper than their outward +success or failure, is determined by what they have here accomplished." + +We have given some indication of the positive side of the book, one which +deserves great praise for both its matter and style. On the negative side we +have to remark on the following important omissions. As was mentioned to +start with, no acquaintance whatever is shown with either the methods or +findings of what may broadly be called medical psychology, the only +psychology that has at its disposal the material on which a science of +character could be founded. That the important work of Klarges on +characterology is not considered may be accounted for by the fact that there +is not a single German reference given in the whole book. In the second +place, the genetic point of view is almost completely overlooked, one of +cardinal importance in such a field. Thirdly, the whole subject of the +unconscious is treated as non-existent. It is a complete misnomer to entitle +a book on descriptive psychology "The Foundations of Character" when no +notice whatever is taken of that region of the mind where the very springs +of character take their source, and where the most fundamental features of +character are to be found. Last, but not least, is the absence of any study +of the sexual instinct and emotions, surely of cardinal importance for any +investigation of character. Apart from the general contributions made by +this instinct to character, one thinks of such clearly-cut pictures as the +masochistic, voyeur, and anal types of character. + +An inadequate index closes an unsatisfactory, though in many respects +valuable, book. We note no fewer than twelve references to "Seneca," but +none to "sex" or "shame;" sixteen to Hudson, but none to Freud, Janet, +Prince, Adler, or Klarges. ERNEST JONES. + + + +AN INTRODUCTION TO SOCIAL PSYCHOLOGY. By William McDougall. Published by +John W. Luce & Co., Boston, 1910. + +Although this book was published a few years ago, nevertheless it seems +sufficiently important to the reviewer to have it brought prominently before +psychopathologists. + +In the introduction McDougall reminds us that the instincts are the prime +movers, the mental forces, the sources of energy, the springs of human +action, the impulses and motives which determine the goals and course of all +human activity, mental and physical. These instincts, being the fundamental +elements of our constitution, must be clearly defined, and their history in +the individual and the race determined. For this purpose, comparative and +evolutionary psychology is necessary, for the life of the emotions and the +play of motives in mental life are the least susceptible of introspective +observation and description. "The old psychologising," says McDougall, "was +like playing 'Hamlet' with the Prince of Denmark left out, or like +describing steam-engines while ignoring the fact of the presence and +fundamental role of the fire or other sources of heat." A knowledge of the +constitution of the mind of man is a prerequisite for any understanding of +the life of society in any or all of its many aspects. And this applies to +psychopathology. I venture to assert that had certain individuals read and +digested a book of this sort it might have been a prophylactic against an +exclusively sexual conception of human conduct. + +The work is divided into two sections. Section one deals with the mental +characteristics of man of primary importance for his life in society, while +section two is concerned with the operation of the primary tendencies of the +human mind in the life of societies. The successive chapters of the first +section take up in order the following questions: the nature of instincts +and their place in the constitution of the mind, the principal instincts and +the primary emotions of man; some general or non-specific innate tendencies, +the nature of the sentiments and the constitution of some of the complex +emotions; the development of the sentiments; the growth of +self-consciousness and of the self regarding sentiment; the advance to the +higher plane of social conduct; and volition. In the second section the +author considers the reproductive and the parental instincts, the instinct +of pugnacity, the gregarious instinct, the instincts through which religious +conceptions affect social life, the instincts of acquisition and +construction, and there is a final chapter on imitation, play and habit. + +McDougall dividends the instincts into specific tendencies or instincts and +general or non-specific tendencies. He calls attention to the abuse of the +term "instincts" and himself defines an instinct as an inherited or innate +psychophysical disposition which has the three aspects of all mental +processes: the cognitive, the affective and the conative--or a knowing of +some object or thing, a feeling in regard to it, and a striving towards or +away from that object. "The continued obstruction of instinctive striving +is always accompanied by painful feeling, its successful progress towards +its end by pleasurable feeling, and the achievement of its end by a +pleasurable sense of satisfaction." He reminds us that "the emotional +excitement, with the accompanying nervous activities of the central part of +the disposition, is the only part of the total instinctive process that +retains its specific character and remains common to all individuals and all +situations in which the instinct is excited." We may experience the +emotional excitement and the impulse to the appropriate movements of an +instinct or the re-excitement of an instinctive reaction in its affective +and conative aspects without the reproduction of the original idea which led +to its excitation. Pleasure and pain but serve to guide these impulses or +instincts in their choice of means towards these ends. + +One of McDougall's important conclusions is that "each of the principal +instincts conditions some one kind of emotional excitement whose quality is +specific or peculiar to it, and the emotional excitement of specific quality +that is the affective aspect of the operation of any one of the principal +instincts may be called a primary emotion." This is McDougall's definition +of emotion. + +McDougall then takes up for discussion and analysis the principal instincts +and the primary emotions of man which include the following: the instinct of +flight and the emotion of fear; the instinct of repulsion and the emotion of +disgust; the instinct of curiosity and the emotion of wonder; the instinct +of pugnacity and the emotion of anger; the instincts of self-abasement (or +subjection) and of self-assertion (or self-display) and the emotions of +subjection and elation (or negative and positive self-feeling); the parental +instinct and the tender emotion, and such other instincts of less +well-defined emotional tendencies as the instinct of reproduction (with +sexual jealousy and female coyness), the gregarious instinct, the instincts +of acquisition and construction; and the minor instincts of crawling, +walking, rest and sleep. McDougall denies the existence of such instincts as +those of religion, imitation, sympathy and play. + +There then follows a consideration of some general or nonspecific innate +tendencies or pseudo-instincts which are not specific instincts with special +accompanying emotions, and this leads to the analysis of sympathy or the +sympathetic induction of emotion, suggestion and suggestibility, imitation, +play, habit, disposition and temperament. + +The sentiments are now taken up for analysis and definition. A sentiment, +according to McDougall, who accepts Shand's definition, is an organized +system of emotional tendencies or dispositions centred about the idea of +some object. Among the complex emotions not necessarily implying the +existence of sentiments McDougall includes admiration, awe and reverence, +gratitude, scorn, contempt and loathing, and envy. Among the complex +emotions implying the existence of sentiments he considers reproach, +anxiety, jealousy, vengeful emotion, resentment, shame, joy, sorrow and +pity, happiness, surprise. The nature and the constitution of the sentiments +and the complex emotions comes in for very illuminating analysis. The +chapters on the growth of self-consciousness and of the self-regarding +sentiment, the advance to the higher plane of social conduct, and volition +are to be considered among the best chapters of this very excellent work. +The discussion and analysis is very penetrating and clear. It is well worth +while presenting the following abstract of the chapter on volition: All +impulses, desires and aversions, motives or conations are of one of two +classes: (1) from the excitement of some innate disposition or instinct; and +(2) from excitement of dispositions acquired during the life of the +individual by differentiation from the innate dispositions, under the +guidance of pleasure and pain. When in the conflict of two motives the will +is thrown on the side of one of them and we make a volitional decision, we +in some way add to the energy with which the idea of the one desired end +maintains itself in opposition to its rival. The idea of the self, or +self-consciousness, is able to play its great role in volition only in +virtue of the self-regarding sentiment. The conations, the desires and +aversions, arising within this self-regarding sentiment are the motive +forces which, adding themselves to the weaker ideal motive in the case of +moral effort, enable it to win the mastery over some stronger, coarser +desire of our primitive animal nature and to banish from consciousness the +idea of the end of this desire. + +Volition, therefore, following McDougall, may be defined as the supporting +or re-enforcing of a desire or conation by the cooperation of an impulse +excited within the system of the self-regarding sentiment. The sentiment of +self-control is the master sentiment for volition and especially for +resolution. It is a special development of the self-regarding sentiment. The +source of the additional motive power, which in the moral effort of volition +is thrown upon the side of the weaker, more ideal impulse, is ultimately to +be found in that instinct of self-display or self-assertion whose affective +aspect is the emotion of positive self-feeling. These remarks are given more +or less verbatim. + +McDougall next analyzes strength of character which he differentiates from +disposition and temperament which are innate. In section two, as stated +previously, the author takes up for separate and more minute analysis the +family (the reproductive and the parental) instincts, the instinct of +pugnacity, the gregarious instinct, the instinctive bases of religion, and +the instincts of acquisition and construction. Imitation, play and habit +receive separate treatment in the final chapter. + +The reviewer can freely recommend this book as one of the best, if not the +best book of this sort that has come into his hands. His personal opinion is +that it is the best. McDougall presents us with an acceptable and clean-cut +classification of the instincts, emotions and sentiments, he accurately +defines these terms, he gives the analysis and constitution of these +instincts, emotions and sentiments, and develops the motive sources of human +conduct. He adopts many original and novel standpoints. He is an +independent thinker. He has here presented us with a book which, because of +its clearness and its frank meeting of the problems, is of the utmost value +to the psychopathologist and the psychiatrist. In fact the contents of just +such a work as this should be the first lesson of every worker in this +field. In this way only can he really begin to understand human conduct. + +This work should find its place in the forefront of those books which should +be read and digested by all workers in any of the social sciences. + +For the reviewer it has been a genuine pleasure to read and to review this +book and he most heartily recommends it to the reader of these pages. MEYER +SOLOMON. + + + +BOOKS RECEIVED + +THE THEORY OF PSYCHOANALYSIS. By C. G. Jung. Pp. 133 and Index. Nervous +and Mental Diseases Monograph Series, No. 19, 1915, $1.50. + +PSYCHOLOGY AND PARENTHOOD. By H. Addington Bruce. Pp. IX plus 293. Dodd, +Mead & Co., 1915. $1.25 net. + +THE INDIVIDUAL DELINQUENT. By William Healy. Pp. XV plus 830. Little, +Brown & Co., 1915. $5.00 net. + +HUMAN MOTIVES. By J. J. Putnam. Pp. XVII plus 179. Little, Brown & Co., +1915. $1.00 net. + + + +THE JOURNAL OF ABNORMAL PSYCHOLOGY + +CONSTRUCTIVE DELUSIONS[*] + +[*] Read at the sixth annual meeting of the American Psychopathological +Association, May 5, 1915, New York City. + +JOHN T. MACCURDY, M. D. Psychiatric Institute, Ward's Island + +and + +WALTER L. TREADWAY, M. D. Assistant Surgeon, U. S. Public Health Service + +MOST psychiatrists state or tacitly assume that dementia praecox is a +disease of a steadily progressive nature, where the first symptom of +dementia is a signal for relentless degradation of the patient's mental +capacity except in the sphere of the more mechanical, intellectual +functions. Yet the experience of every institutional physician denies the +universality of this deterioration, and the statistics in any good text book +demonstrate that many cases are "chronic" rather than "deteriorating." +Woodman[1] has made a careful study of 144 such chronic cases, and shows +what a surprisingly large proportion of these develop a good adaptation to +the artificial environment of the institution. So far as we know, however, +no one has attempted to formulate any definite features of onset which could +be taken as a guide in determining the gravity of the mental derangement. +In fact Bleuler states categorically that "up to the present no correlation +has been discovered between the symptoms of onset and the gravity of the +outcome." Kraepelin has split off from dementia praecox a separate +psychosis--Paraphrenia systematica--which he timidly defends as a clinical +entity apparently because the course is a long one and the deterioration +less marked than in dementia praecox. But he gives us no concise prognostic +data; in fact one feels on reading his paper that the diagnosis must be made +post hoc. This problem is manifestly of equal importance from the social +and the scientific standpoint: until we can predict the outcome our +treatment must be empiric and palliative; we confess ourselves ignorant of +the disease process if we cannot make a prognosis. + +[1] R. C. Woodman, N. Y. State Hospital Bulletin, Vol. II, No. 2, 1909. + +It is possible to make certain a priori speculations as to prognostic +criteria based on classification and what that implies. We know that pure +paranoia is not a deteriorating psychosis--that it does not necessarily +preclude the possibility of considerable social usefulness--and that it +grades off almost imperceptibly into dementia praecox. The features +differentiating these two diseases should therefore supply us with data for +determining the prognosis. A case undoubtedly, praecox, which shows markedly +the differential features of paranoia, should have a proportionately better +outlook. In a vague way our common sense uses this standard when it makes us +"feel" that the case will have a long course which shows a relatively well +retained personality in conjunction with praecox symptoms. But "feelings" +are hardly objective criteria. What symptoms may we make use of? We may +say that the praecox patient as opposed to the paranoia has a poverty or +inappropriateness of affect, a scattering of thought and a lack of +systematization in his delusions. The weakness of will on which Kraepelin +lays so much stress may be included, though that can probably be derived +from the scattering of thought. What of these symptoms may be analyzed for +our purpose? Affect changes and dissociation in the stream of thought are +themselves signs of the deterioration we wish to predict; to make use of +them we should have at hand some theory as to the relation between their +quality and quantity, and that we have not. There remains the content of +the psychosis, a definitely objective material with which to work. This is +naturally a big problem--almost as wide as insanity itself--and one brief +communication cannot pretend to solve it. What we wish to do is merely to +put forward tentatively the claim of one type of delusion formation to +prognostic value. + +Now if delusions are to be an index to deterioration they must in some way +hold a mirror to the changes in the personality, repeat them or prefigure +them. If we generalize our conception of functional dementia, we can say +that one of its most striking features is a destruction of the faculty of +appropriate reaction, a loss of what one may term the sense of reality. The +patient in direct proportion to the degree of his dementia loses his +capacity to recognize the reality of his environment or his relationship to +it, and builds up more and more a world of his own in which he lives +untroubled by the demands of adaptation. No one who has ever argued with a +paranoic will forget how keen a sense of reality he may retain, how logical +his arguments are, and how reasonable his delusions appear, if only some one +point be granted. With the praecox, however, the opposite impression may be +quite as striking. His delusions are bizarre, inconsistent, kaleidoscopic; +he has no logical explanation and cannot even state them consecutively. And +all gradations from pure paranoia to dementia praecox seem to have +corresponding losses in the sense of reality as embodied in delusions. + +May we not hope to find in the content of the psychosis some objective +criterion as to the degree in which the sense of reality is lost, with all +that it implies? + +But what takes the place of the sense of reality or what causes it to go? +With what tendency of the psychotic individual is it in conflict? The answer +is a psychological truism--the indulgence in fancies. Imagination, of +course, is essential to every human being, no purposeful action can be +instituted without its first being carried out in imagination. Phantastic +thinking begins when the subject fails to apply the test of reality to his +mental image and exclude it if it be not adapted to realization. If +environment or internal inhibitions prevent this realization, however, the +craving: lying back of the fancy must be diverted to a more practical +channel--the normal solution--or the fancy must persist in spite of its +impracticability. This latter process is the germ of the psychosis. But not +its development. A certain compromise may be reached--he who digs for gold +in his back-yard is not so crazy as he who reaches out his hand for the +moon. Nor is the paranoic who chooses to put his interpretation on the +surliness of his employer as far estranged from reality as the praecox who +recognizes his employer in the person of the physician. The content of the +psychosis may then express the relative strength of the two antagonistic +factors, sense of reality and fancy, the two factors whose relative +importance decide the issue for sanity or insanity. + +It is easier to imagine than to act, so no human being is free of this +tendency. But what does the normal man do? He diverts these thoughts into +channels where fancy has a legitimate place--he writes romances; he imagines +himself using an instrument to talk with his friend miles away and invents +the telephone; he imagines a better society than the one which galls him, +and writes a "Utopia"; above all he theorizes and speculates. According to +his age or ability these speculations give us alchemy or chemistry, +astrology or astronomy, magic or religion, spiritism or psychology, the +were-wolf or psycho-analysis, phrenology or psychiatry, and so on. Now +three generalizations can be made about these primitive or elaborated +philosophizings: first, they all represent a constructive tendency; second, +the degree to which this constructive tendency is exhibited is historically +a measure of the cultural development of any age, an index of the +development of the sense of reality of the time, that is, the particular +speculation is not only accepted as reasonable but has its practical +application for the period; and third, the more primitive forms of these +speculations are represented in the delusions of insane, particularly +dementia praecox, patients. Following a suggestion of Dr. Hoch we have +termed these ideas "constructive delusions." As they correspond to what was +historically a compromise between reality and phantasy, they should +represent a corresponding mildness or severity in the psychosis where they +appear. Our observations--far from being extensive--have so far demonstrated +this that we feel justified in offering the hypothesis that when such +delusions are present one can base a mild prognosis on their presence with a +rather specific relationship between the crudity of construction and the +degree of deterioration. It must be borne in mind, however, that we make no +claim as to the invariable presence of such delusions when marked +deterioration does not take place. We hope only to show that when present +this particular form of content may constitute a valuable prognostic guide, +as it represents the degree to which the patient has gone in recapitulating +the history of his civilization. + +It should be understood that we are not describing highly unusual cases; +many such have been published. A highly typical one is given by Freud in +his analysis of the Schreber case.[2] In this extremely stimulating paper +Freud puts forward the claim that all delusions are an attempt at regaining +health on the part of the psyche. From a broad psychological standpoint, +this is undoubtedly true but the generalization is too wide to be of any +practical psychiatric value. Moreover, by choosing for analysis a case +which was neither dementia praecox nor paranoia but a combination of the +two, he reaches conclusions which are valuable additions to our knowledge of +psychotic processes but merely confuse the issue as to the specific +mechanisms of paranoia and dementia praecox. In Schreber a profound +psychotic reaction corresponded to crude formulations of his fancies, +whereas, when he built these ideas into constructive speculations, he became +relatively sane and an efficient citizen. If Freud had emphasized the point +that this later formulation was more than a vehicle for the cruder thoughts, +that it contained components which were potentially of social value, which +implied a broader contact with the world--had he done this--then the present +paper would be superfluous. + +[2] Psychoanalytische Bemerkungen uber einen autobiographischen beschrieben +Fall von Paranoia (Dementia paranoides). Jahrb. f. psychoanalyt. u. +psychopath. Forschungen, Jahrg. III. + + + +The first case we wish to present, John McM., is at present thirty-six years +of age, unmarried, a Catholic. For at least nine years he has been +objectively psychotic, though, according to his own account his delusional +habit of thought began seventeen years ago. He had little education but made +the most of it and has read widely (for one of his station) on such topics +as socialism. He was always somewhat distant and did not make friends +easily. From early childhood he was antagonistic towards his father and +brother and, since his mother's death six years ago, to whom he was strongly +attached, towards an aunt as well. He has struck both his father and his +aunt. His antagonism towards his father is of great importance as a +determinant for his later symptoms. When young he feared him, as he grew +older disputed his authority and, according to the father, always disobeyed +him. He was always shy with women and, as we shall see, his first conflict +in the sexual sphere was solved by a psychotic reaction. Once an efficient +salesman, for the past nine years he has drifted from one position to +another. As he says himself, he lost ambition after he decided not to get +married, and concluded he would not attempt to gain worldly possessions, but +merely enough to subsist on. His early life showed not so much tendency +towards elation and depression as towards imaginative thinking with a +leaning towards day-dreaming and "mysteries." Of late years his reading has +been confined to sexual topics, as discussed by various quacks, astrology, +phrenology, Christian Science, and religion. Although he said he discovered +God for himself he never gave up the Catholic religion. Gradually his energy +has been so engrossed by these interests that he lost position after +position as a result of continually talking of his ideas to his fellow +workers or employers. This tendency eventually led to his commitment, but as +long ago as 1906 a physician said he was insane. For the past six years he +has been cross, stubborn and self-willed so that none of family dared to +speak to him. He even left home and took a furnished room by himself. In +spite of this evident anti-social tendency he speaks of himself as having +been filled during this period with a great hope; he has been looking into +the future and content that he will reach the goal and sees happiness in the +future. For some months he had talked much of the world coming to an end +and said that those who had money should spend it as it would soon do them +no good. He wanted every one to divide his money with him as, he said, +everything belonged to God. Many people were against him and he wrote +letters about this to various officers. It was when he showed some of these +to an assemblyman that he was advised to go to Observation Pavilion. + +When he arrived at Manhattan State Hospital he was quiet and agreeable, +cooperated readily with his examination and seemed to take his incarceration +as a matter of course, though he has always had mild arguments to prove that +he should be allowed parole. A certain degree of deterioration is evidenced +by his failure to make much of an effort in this direction, although such +effort would be immediately successful. In his manner he was quiet, +occasionally somewhat affected and when talking of his ideas was apt to +assume an expression bordering on ecstasy. At no time did he show an +inappropriate affect or any evidence of scattering or flight. He could talk +quite objectively of his idea. He had had only one halucinatory experience +and even it should, perhaps, be called merely an illusion. "On the 14th of +March, 1912," he said "I came face to face with God Almighty. He spoke in a +Jewish dialect and was dressed as a carpenter." The patient was in the +Cathedral at the time and that night he had a vision of this man, though +this may have been just a dream. He also heard Bishop H. speak of the man +who had come to prepare the world for the second coming of Christ. The +bishop looked at this patient which meant that he, the patient, was the man. + +Before detailing his ideas it may be well to outline their general tendency. +In his psychosis he succeeded in fulfilling the wish of the Persian enemy of +reality: + + "Ah, Love, could you and I with Him conspire +To grasp this sorry scheme of things entire, +Would we not shatter it to bits and then +Remould it nearer to the heart's desire." + +By the simple expedient of translating his interest from this world to that +of spirits he built up a new Heaven and a new Earth, where he was supreme +and his chief enemy, his father, was subject to him. Beginning with +astrology he found that his father's sign and his showed different +characters, the father's strong in earthly affairs, while the patient's +showed preeminence in spiritual qualities. Passing from astrology to the +Heavens, he discovered that his father had been Jehovah, while he had been +Christ. There had been a struggle between them in which the father had been +temporarily successful. But when his father's spirit had entered into a +body, he had become subject to Christ. In the Heaven to come, Jehovah was +to give way to precedence to Christ, was to enjoy with the Virgin Mary, his +mother, a union of love, as much more fervid as it was to be free from +carnal features. In extolling this life of the spirit the patient excluded +that physical problem which had caused him so much trouble-- the adult +sexual demand which, in the form of marriage he could not agree to meet nor +yet to put out of his mind. At the same time this religious formulation +gave him a comfortable ascendancy over his hated rival, his father. But it +gives him more than this: he has a mission, he says, he must prepare the way +for the new world, the new heaven. This is an objective interest and it is +that, we think, which has a causal connexion with his mild degree of +deterioration-- for he has been what we must regard as a praecox for many +years and yet has lost so little of his personality that to a layman he +would certainly be regarded as little more than a crank. Where his system +fails of having a sane outlet it is of course in the fact that his prophecy +has little to do with anything of advantage to others. It is merely a cover +for self-glorification. + +At nineteen he talked to his friend W. of sexual matters, and, being +troubled with constipation and "rheumatism" at the time, he asked the +physician who was treating him as to whether he should indulge himself +sexually. The physician told him to, but he worried over this advice and +went to a priest, who said for him to get married. This he did not wish to +do, and so turned his attention to astrology and phrenology, the other +subjects which his friend talked of. That this was only a cover for his +original sex problem is shown by his conclusions: that he had a weakness in +amativeness--"the faculty of sexual power," his "concentration" on sexual +matters was poor. "If I had more amativeness there would be trouble; I am +glad I haven't so much. I was always more of a companion to my mother, and +when I wasn't with her I went to the theatre with W." He and his father, he +learned, had strong faculties of destructiveness; the patient, however, +could control his by reasoning; his reasoning was so strong that he could +even control his father and settle disputes between father and mother. +Phrenology also taught him his intellectual superiority to his father in +other ways. + +From phrenology he learned there was a time to be born; from this he passed +to astrology. His father had arranged that he should be born in the sign of +Virgo, which guaranteed his truthfulness and obedience to his father. He +explained this by speaking of Adam and Eve disobeying God, from whose sexual +intercourse all evils sprang. Manifestly, then, it was his father's +arrangement that he should have to abstain from sexual intercourse. + +His father was born in the sign Gemini; this is a fighting sign; the father +selected this sign himself, by his great fighting power; the sign is not a +spiritual one but a worldly one, and shows avarice in great grasping of +worldly things. He never thought that his father was so great, until three +or four years ago. He wrote a minister, asking him what became of God the +Father; he asked another man about religion, and was told how obedient +Christ was to his foster-father Joseph. He thought of how disobedient he +was to his father, and then decided that his father was the God, the Father, +and in the Kingdom of Heaven he was called Jehovah. (Here he identifies +himself with Christ). He says about this "I tried to reason myself away from +it many times, but was finally convinced"--The father came to this world as +John; Jehovah was the patient's father in the other world. In the other +world he had a falling out with the father, and now the father has that +revenge in his soul. He had some kind of a falling out, a fight; his father, +then Jehovah, ruled the third Heaven; one of the twelve, which he says is +about the earth, the earth making the thirteenth; this formulation he +derived from astrology: the first Heaven Aries, the second Taurus, and the +third Gemini, etc. + +His father was born in the sign of Gemini, whose symbol is the twins, which +means a duel; and people born in this sign have a dual nature; the father +had a dual nature; and when the father ruled in the third Heaven as Jehovah, +a duel took place between the patient and the father, and the son's spirit +was separated from a body and roamed about. After a time the patient's +spirit got back into the Kingdom by worrying the father, but he was never +admitted in the form of a body. The father and son while still in a body +could both create man and woman; the patient then knew all about creation, +and was endowed with all the powers the father possessed, and helped the +father to build up that kingdom; but when the patient's spirit was separated +from the body his powers became less, so that he could not create a human +being. His physical personality was weakened by this, but the spirit of love +was increased; the father had carried revenge in his soul since then. The +patient was never a ruler of a Heaven, but "I was my father's son--I was +next to him--the sons never become rulers unless they win out;" the +patient's spirit remained out of his body until he was born into this world; +the patient's father came to this world as John, and married Mary McE.; when +the father came on earth he placed himself under the jurisdiction of Christ +this came about automatically when the father was born. + +In the next Heaven the patient will be on the same plane as Christ, but +perhaps in a lesser degree. There can be only one father, and he will be +under Christ's jurisdiction. Christ will be supreme. He is part of the +Trinity; there is one God as three united persons; they agree on everything; +Father, Son, and Holy Ghost. These will be possessed of equal powers, but +one will be looked upon as the father, and another Son, and another the Holy +Ghost. In the new Heaven he will have equal rights and powers with the +father. + +After the father married two children were born, brothers, the younger being +the patient. He says about this that he was born in the usual way, "The +spirit entered the womb of the mother from outside, and from the seed of the +father, and I was born by the will of the father." Christ was born of Mary +through the will of Jehovah--simply the spirit entered the womb and the word +was made flesh. When the father lived as Jehovah he created Adam and Eve, "I +was simply my father's son and son of Jehovah--perhaps my name was John, +which had some great meaning"--Jehovah was the greatest spirit in the +universe, but is not now, for when he was born he placed himself under the +jurisdiction of Christ; his name is now John, the patient's father. Christ +was selected to be the son of Jehovah; he was selected by Jehovah because +Jehovah had a great personality; his father arranged all of this, and he +even selected the sign that the patient was to be born in. When asked who he +is, he said, "I am who I am--When I was positive that I am who I claim to +be." + +When the patient's spirit was thrown out of the body, it caused Adam and Eve +to be created--Eve was a great spirit in the third heaven--the father +thought that if he could create two persons, and they were congenial to each +other, that Adam's soul would be increased or developed by being in company +with Eve. When Adam and Eve were created they were not to have sexual +intercourse; they were merely to come in contact by spoken words--love could +exist without intercourse; it started all the trouble. To Adam and Eve two +sons were born, and the brotherly love that existed turned to fire and +hatred. They probably became jealous of each other, and so one deceived the +other. At one time he said that perhaps the mother made more over one than +she did the other; again, perhaps father and mother might have favored one +more than the other; hence jealousy arose; his brother was born in the sign +of Capricorn, which ordinarily is a sign which is congenial to Virgo; his +brother, however, is a crank and not congenial; the brother is jealous of +the patient, because the mother favored the patient. + +He did not take his mother's death to heart, as he had expected for two +years that she would die. His aunt said that he told her it was a good +thing the mother was dead. He says that in the other heaven, Jehovah's wife +was Martha, a sister of the Virgin Mary. In this life she was Mary; the +father may have had many wives in the third heaven; perhaps his mother's +sisters were his wives, as they seem attracted to him. His mother's soul +existed before birth, lived in Jerusalem in the time of Christ, and was +Mary's sister. His mother was born in the eighth sign and could be trusted +with great secrets; his mother kept things to herself. She was both feminine +and masculine; that is, she was strong and sociable. In the sign in which +he was born they have great spiritual conception, keen, searching and +penetrating vision; The symbol is the Virgin, and pride makes them more +feminine than masculine, and they are sensitive; he at one time was more +feminine than now, which was due to his sensitiveness. The sign of Virgo is +the mid-heaven, where love is more intent; there they understand each other, +and there is no disagreement. "The magnet of the male and the magnet of the +female are attracted, and they agree with each other in words spoken; this +is true love, like that which existed between Christ and the Virgin Mother; +the Virgin Mother was born in that sign--there's where she got her name." + +When he dies the soul of his mother will enter heaven. + +In heaven Christ is to raise his mother's soul from purgatory, and she will +become the Virgin Mary. A spirit rapping in the house, which began shortly +after his mother's death, is her spirit and his guardian angel. + +Jehovah was jealous of Christ as a greater spirit, so had him crucified. +Joseph was also jealous of Christ because Mary loved him more. + +Further ramifications of his ideas are the cruder conceptions that semen is +the equivalent of thought, and that thoughts of women cause him to have +nocturnal emissions. Semen comes from food; to the sacrament he gives a +definitely sexual significance, and it was following communion that he +realized that he was Christ. + +At one time he thought he could live, and that he could marry a girl and not +have sexual intercourse; because if he got married and had sexual love +trouble would arise. He was convinced by what he saw of his friends and +every one else he knew, his aunt, his mother and father, that they did not +get along well. The Divine Power knowing that this could not be in this +world, broke the affections he had for this girl; and he concluded he would +never get married. From a worldly point of view he knew that he was a +failure; he had failed in all his business. But he did not care for worldly +things. When he reached this point he knew that he had a mission to +perform, and began to write and preach religion to people who were qualified +to understand. He wrote many letters, all dealing with religion, saying that +he had to get things ready for the second coming of Christ; that he was the +successor of Christ; and that he was to get things in readiness for the +union of religion; when there should be one Shepherd and one Fold. + +Case 2. The next case differs from the first in that the emphasis in the +ideas was laid more on spiritistic and astrological than on religious lines. +Another difference in the problems solved by the psychosis is that the +personality of the patient was not incompatible with an outlet to the adult +sexual demand through the channel of prostitution but a basic similarity +lies in the fact that the delusions center around attachment to her father, +again a family situation. The patient is an unmarried woman now forty-seven +years of age, of whose early life we know nothing. She had applied for aid +to a charity organization who, becoming suspicious on the report of a police +captain that the woman was a street walker, sent her to the Cornell +Psychopathological Clinic for mental examination. She had some petty +complaints of not being fed properly where she lived, of things not being +clean there and of the women around her being queer. Then she launched +spontaneously into her delusional story, needing very few questions to +stimulate a fairly complete recital. Throughout an her talk she showed no +abnormalities in her train of thought. She talked in a quiet way of her +"knowledge" but with enthusiasm, smiling frequently but more in a satisfied +or sociable way than with any silly expression. There was not a trace of +ecstasy in her expression. It would have been hard to say definitely that +she had any inappropriate affect. At a later interview, however, she +admitted recent acts of prostitution with no embarrassment whatever. + +Her psychotic experiences began some ten years ago when she entered into +illicit relations with an elderly married man R., in the South. A year +before she had met a "mastermind" who told her that she would never be seen +in the right light. Everything came as he predicted. Her lover soon lost +his sexual capacity and so began to show his power by keeping her under his +control but still at arm's length. But she has fooled him for now she has +his power. This power was in the form of "influences." When they worked on +her she would have a throbbing like a typewriter in her head, and would then +be forced to some act. Such acts included affairs with various men and +through R.'s influences she also lost many positions. For some time she +tried to get him to support her, as it was his "influences" that had ruined +her, but he merely called her a blackmailer and had her put out of his +office. Soon, however, as the result of visions she learned that her father +(who is dead) had become Christ in the other world. It was all his influence +that had been acting on her through the medium of R. From Astrology she +learned that she had been born under two planets--Jupiter, Influence; and +Neptune, Spiritual. Her father's sign was Neptune and he was therefore a +spiritual man. Shortly after his death, she had a vision of him floating up +towards the moon and then she knew that he was joining her ethereally. She +had visions of this Father-Christ. + +When we turn to the constructive side of these delusions we find that she +regards all her experiences as having been designed by the Father-Christ to +give her training, training that would increase her psychic powers. For +instance, she said part of her training had been frequent accusations of +dishonor with men she never knew. She had to acquit herself of these +charges; thus she gained power. Then she found that she did not even need to +expostulate. She could defy them, defy the whole world. As soon as she knew +she was not guilty she felt power. Things she WAS guilty of, she knew were +right for her, because she gained power by these experiences. This was +because through them she learned spiritistic facts and knowledge is power. +According to her system one mind acts over another by greater penetrating +power, though the recipient must be powerful too. Sometimes she found that +she had to be reduced by lack of food or other privation to receive +influence. Naturally, too, she could communicate with the dead and had many +examples of this power to offer. She had learned, also, about the influence +of the planets over the human brain and how to learn of conditions which +exist for any person--what he should avoid and what to accept. As the +patient was only seen for little over an hour the details of her system of +ideas could not be obtained but she assured the examiner that she never +could tell all she knows about the spirit world. In general, however, she +said that all her knowledge was useful to her and she could give it to +others individually without effort to herself but that she had no way of +giving it directly to the world. If she had a rest and got well connected +socially perhaps she might be able to do it. People who had met her casually +told her that she had done them good. But she could never tell them about +having seen Christ, they don't understand. The egoism of her faith is shown +by her statement that, having met Christ in practical life, she had no more +use for any church or ritual. Her great hope was for the future. When she +passed away, she was to develop her powers more and when reincarnated was to +come back with the big minds of the world. Once she had a vision of herself +in some high trees and the "Master mind" told her what it meant. In the +future she would have a great mind. She has it now, but the circumstances of +her life are such that it is not recognized. + +The essential feature of this case, for our purpose, is that we have in this +woman a paranoid psychosis of a definitely dementia praecox type which after +ten years has shown only suggestive signs of deterioration in her lack of +purpose in work, and her dulling in emotional response. This failure to +deteriorate seems to stand in definite relationship to her system of ideas. +That these have a constructive tendency is shown by the translation of her +cruder thoughts into the setting of the occult with the suggestion of +propaganda and in their pragmatic value. With her "new religion" she has +provided herself with an argument in favor of a life of desultory +prostitution and general vagabondage. She was advised to go to a hospital +but refused, though she will certainly be committed soon, as it is +inevitable that she will run counter to society in some way. + +Such cases as these first two are familiar to you all and these have been +chosen for this paper practically at random. Any large hospital will provide +dozens of similar history whose clinical pictures would serve as well as +what we have given. The next two cases represent two special types of +psychoses: one a chronic manic and the other a definite praecox with +recurrent attacks. Any institutional physician is familiar with the +chronically elated patient, who has become a hospital character-- a good +worker often who seems to be sufficiently repaid for his toil by the +privilege of stopping the passerby to expound his ideas. Such a case is +usually diagnosed as a chronic manic or a dementia praecox, according to the +taste of the examiner. + +Numerous works have demonstrated how the symbolism of the modern fraternal +organization has grown out of alchemy, mysticism and rosicrucianism. Some +centuries ago these symbols were charged with a literal meaning. If a man, +however, in the 20th century attaches a similar significance to these +symbols he is rightly adjudged insane. For instance, no one in a modern +civilization can retain his mental balance and believe in a literal, +physical rebirth. The patient whose case we shall now briefly recite had +done this. He was observed at only one set interview because it was found +that a few questions, apparently innocent, led to the awakening of some +cruder ideas to which he reacted rather strongly with the statement that the +physician was accusing him of harboring murderous designs which were, as a +matter of fact, not even remotely suggested. The patient C. G., is a Hebrew, +married, age sixty-one. When forty he had an attack of excitement lasting a +few weeks. He was admitted to the Manhattan State Hospital in October 1899 +and remained till April 14, 1900 with a similar attack. He was readmitted +in April 1901 again in an excitement and has remained there ever since. It +is claimed that these attacks were all preceded by a spree. The records of +these admissions state that he was excited for some years, apparently with +exacerbations, during which he is frequently noted as being delusional and +hallucinating. No content is noted so that we cannot give the development of +his ideas. He does not hallucinate now. All we know is that for five or six +years he was a rather intractable patient, who worked intermittently but +that of more recent years he has sufficiently adapted himself to the +hospital environment to be granted ground parole which he uses largely to do +a considerable amount of quite useful work. Any one who has once talked to +him is saluted from a distance with the words--"Pleased to meet you, +Doctor!" "Five fingers up!" or "Da liegt der schwarze Hund begraben!" All +this is followed by an elated volubility. When asked what "Pleased to meet +you!" meant, he said that was the password for entrance to the "Fellowship +Lodge" of a certain fraternal order. He produced a match box with the +insignia on it of a Grade in the Lodge. With this match box, once off +Ward's Island, he insisted that it could get him his bread all the world +over and hundreds of friends. He would never have been committed had he not +been drunk and forgotten to make use of his signs. The world belongs to the +Fellowship of Men. He spoke of his wife's ill treatment of him and then +went on to "I am married to the American flag and it will go to the grave +with me." This referred, he explained, to joining the red, white and blue +lodge. "Five fingers up!" was shaking hands, the clasped hands on his match +box. These hands, he said, were those of Moses and the Lord, for Moses was a +"Fellowman," which is like the Fellowship of the Father, Son, and Holy +Ghost. However, he went on to say that Moses, the Trinity and God were all +a dream; Israel and the High Grade are real--the High Grade is the Lord. G. +stands for God and he belongs to the G Lodge, therefore he belongs to God's +Lodge. But he has a uniform of the High Grade at home, so he must be the +High Grade himself. By using the symbols of his order in this way he +disposes of his wife who has not treated him well, identifies himself with +God (while he abolishes the regular God) and endows himself with the +supremest power in a Lodge which he regards as omnipotent in the world. +Another group of his ideas refer to his race. He has been put on Ward's +Island as a result of the great struggle between Christians and Israel. But +Israelites are the head of the Fellowship Lodge, so all Christians must +follow him, the patient. + +This is the explanation of "Da liegt der schwarze Hund begraben!" He is like +a dog in the house and he is considered to be nobody, a corpse on the floor. +But he really lies here buried--the missing man of the tribe. Once off +Ward's Island, therefore, he will come to life as head of Israel, and head +of the omnipotent Lodge. Patiently, hopefully, he awaits rebirth. The +egoism of these ideas is obvious. Wherein do the constructive factors lie? +Simply in this: this expansiveness could easily be formulated directly. But +he does not do so. His ideas include two objective and potentially +altruistic interests his lodge and his race. He is interested in them; in +fact one can probably say that it is just in so far as he is insane that the +selfish determination for these interests become manifest. + +We have also studied two cases of recurring excitements in patients one of +whom was an evident praecox, the other of doubtful classification. Both +showed queer behavior during their intervals with mild indications of their +ideas which gained freer expression in their attacks. These episodes showed, +of course, markedly a typical feature in a tremendous amount of queer +behavior and more excitement than true elation. As there was nothing in +their ideas essentially different in principle from the cases already +quoted, they need not be further detailed. + +The last case, R. E. O'M., is one of no less interest from a formal +standpoint than from a psychological one, while the trend presented is so +copious that it can well serve as a resume of the cases we have just +recited. He is now an unmarried man of thirty-three, and although he was +diagnosed dementia praecox ten years ago is now earning $1200 year as a +stenographer in the government service. His father was an Irishman banished +from Great Britain because of his political agitations. His mother was a +French woman of Huguenot extraction who died of cancer before the patient +reached his teens but to whom he was greatly attached. He has a sister two +years older than himself, given to hysteric attacks, for whom his love is +"Platonic," to use his own term. Although of more than normal intellectual +vigor, judging by his success in school work, he probably always had a +psychotic tendency. At seven or eight he saw a vision of God in the clouds; +at puberty he masturbated considerably and used to stand before the mirror +and "hypnotize" himself. In the fall of 1903 (then twenty-one) he was +staying at a summer hotel where he met a girl who made love to him, when he +began to have frequent emissions. Being caught together out in a storm, in +an effort to protect her his hand found its way to her hair. He was greatly +upset. On returning to the hotel he endeavored to avoid her, and, his father +being slightly ill, he became convinced he was going to die. A month or so +later he moved from Baltimore, which had been his home, and began employment +with the government in Washington. He had more emissions and immediately +developed hysterical heart trouble, and from his retrospective account also +had ideas of people influencing him. A year later (June 1905) a frank +psychosis with considerable manic flavor developed. Secretary of State Hay +had died, and peace negotiations between Russia and Japan were in progress. +He got the idea that he was to succeed Hay (whose face he saw in the clouds) +and that he would make peace between the nations. The accompanying +excitement was so intense that when he came to see his father in Baltimore +the latter had him committed to the Sheppard and Enoch Pratt Hospital.[3] He +remained there for one year and eight months, during which time his mood +showed great variability. At times he would be elated, again depressed or +anxious, often silly with irrelevant laughter. Towards the end of his +admission he had quite long intervals when he appeared normal. Eight months +after his discharge he began to have monthly attacks lasting from one to two +weeks. At the beginning of 1911 he came under the observation of one of us +at the Johns Hopkins Hospital Dispensary. His case was followed minutely +for some months when the following extraordinary clinical picture was seen +to develop with regular periodicity. His interest would gradually withdraw +from his work and an abstracted, "dim" look come into his eyes. He ceased +to sleep either day or night. Ideas, in the intervals latent, would become +more insistent, and he talked of them in a distracted way with occasional +silly laughter and some scattering. At the same time he would show +considerable physical unrest: rocking in his chair, nodding his head, +sucking with his lips, and making occasional grimaces. A sharp word would, +however, bring him to reality and normal behavior and speech, or the same +result could be obtained by his own volition. In fact sufficient effort from +either without or within could, it was several times demonstrated, postpone +the further development of these symptoms for several days. Inevitably, +however, control over his psychosis was lost. He became more excited; was +assaultive till chastised by his father, after which that symptom no longer +appeared; he would give none but irrelevant answers to questions; he +masturbated openly. In the next phase he refused to answer questions +altogether, sat in a chair by the window, rocking and tapping the floor or +wall with his feet; reading a paper in a whisper or tearing it into scraps; +spitting on the floor, his clothes or the window pane and then drawing +pictures with his finger on the wet glass; intermittently chanting the same +air over and over again with words, totally indistinguishable, except for +the name "Jesus Christ" apparently interpolated irregularly in the course of +the song. All this time he wore a silly smile occasionally breaking into a +low chuckling laugh devoid of real emotion. In a short time his clothes and +his immediate surroundings were in a state of horrid filth from his saliva +and the torn papers. Towards the end of the attack he ceased making any +sounds, simply rocked, spat and grinned. He would often pass twenty-four +hours without emptying his bladder, though he never wet nor soiled himself. +Few psychiatrists would have required more than a casual examination to give +a diagnosis of hopeless deterioration, if they saw the patient only in the +latter stage of one of these attacks. Yet in from seven to fourteen days +after the first onset he would go to bed, sleep well, and in the morning +appear perfectly normal and resume his efficient work. And this story had +been repeated regularly once a month for four years! When normal his memory +was hazy for the external events occurring during his attack, corresponding +with his objective lack of contact with his environment, but the +recollections of his ideas showed that he had been living in a perfect riot +of fancies. The inference from this is inevitable that what we regard as a +"Trendless praecox" or a taciturn dement may simply be one who does not +choose to talk and not necessarily a vegetative wreck with neither delusions +nor hallucinations. + +[3] For the privilege of using observations made on this patient at the +Sheppard and Enoch Pratt Hospital, we wish most heartily to thank the +Superintendent, Dr. Edward N. Brush. + +His ideas were found to be no less interesting than his formal picture. In +fact, if the theory we are now advancing be correct and we had had it then, +we believe it would have been possible to state at the time of his first +attack that his psychosis would not show rapid deterioration; we might even +have gone further and predicted that he would reach some such stage of +relative sanity as he now enjoys. He has presented three types of ideas. +The first is crude expressions of bald sexual fancies; the second is +transitional in that--as many praecox patients do--he gave these ideas a +religious or philosophical setting, but in the hallucinations and delusions +embodying them, still retained his personal connection with the fancies. For +instance, he identified himself with Christ, or he suffered from +psychological influences exerted by others on him. These two types occurred +only during attacks. The third type represented the real constructive +tendency, during his "normal" intervals when he objectivized these ideas in +the form of speculations as to the origin of life, the laws of society, +religion, etc. The second type--the transitional--represented reciprocally +two tendencies: in the psychosis it showed his constructive, healing +capacity, while the development of such fancies, as allied himself directly +with his speculations when "normal," was invariably the signal for another +attack, the severity of which was in direct proportion to the crudity which +his formulations reached. The complexity and number of his theories when +going about his work was tremendous, which could be partially accounted for +by his omnivorous reading. He read all sorts of historical, occult, +scientific and philosophical works, the material of which he absorbed only +in so far as he could weave it into the fabric of his depraved speculations. +This colored his transitional ideas as well, for in each attack he would +have a new dramatization of his fancies determined by what he had just been +reading. To present these ideas with anything like completeness would take +hours. We must be content, therefore, with a few fragmentary examples. + +The more important of his crude ideas were: His trouble was caused by loss +of semen (his attacks were always ushered in by emissions), to prevent which +he sometimes put rubber bands around his penis; numerous homosexual fancies, +he was a woman, he had a vagina, there was a maiden head in his forehead +which was operated on to cause him to lose semen; different people made +immoral proposals or had designs on his virginity. These people he all +identified directly or indirectly with his father. Finally there was an idea +that his mother's marriage with his father was not right, that he was not +his father's son, and that his father was inimical to him. He talked of +killing different persons whom at other times he identified plainly with his +father. During an attack he assaulted his father; not infrequently he would +take his father's picture from the wall and spit on it. The relations +between his father and mother were adulterous, he claimed. + +If we now take the crude homosexual fancies and study their first +elaboration we find that he had many ideas about eunuchs. They worked on him +by psychological influence. The eunuchs, who could control sun and moon, +influenced him through them. Once he had a vision of the sun approaching him +with which he was physically connected; the vision would disappear if he +lost his virginity. These influences when referred to himself were agencies +causing loss of semen, so that he would become a eunuch himself. At the +time of his heart attack and later he thought there was a snake around his +heart. This was a man who had turned himself into a snake in order to +incorporate himself into the patient's body. His religious fancies +apparently began with his delusion that he was Christ and in connection with +this we find he had the theory that Christ was a virgin. One setting of his +"psychological influence" experience, when he was in bed in one room and +eunuchs were influencing from the next. he duplicated by saying he was +Jesus Christ in one room and God was in the next. He explained after one of +his attacks that his attention was fixed on the windowpane on which he spat +because there was a flower there. During an attack he was heard to say +something about the struggle of men against being raped by ions and flowers. +In these primitive elaborations we find an effort at distortion, a getting +away from the absolutely crude and that the added elements which cause this +distortion are in the form of ideas which imply a certain degree of +philosophizing. The truly constructive delusions appear when he has ceased +to dramatize these theories with himself as the hero and treats them +objectively. We then find that eunuchs are very important people in his +philosophy (the medium of their power we shall see shortly). All women are +eunuchs because they have no testicles. There is no difference between men +and women; if a woman is stronger than her husband, he takes on her +qualities. In India men suckle the children. He says that this is a +well-known fact. A person could change himself into a cancer and so get into +another's body. This is perhaps an echo of something he had read of +Ribbert's theory of neoplasms. Another pseudoscientific theory concerns a +method of reproduction which could be developed, he thought. If a +beautiful, strong man reaches his normal growth, all life above that is +moulded by his ideals. He can develop within himself another personality +which may be divorced from his body. Immaculate Conception takes place this +way. An argument he had in favor of this view was prenatal influence and the +strong influence a woman's belief is supposed to have on pregnancy. Eunuchs +control the sun and moon. The Jews have a secret process of eunuchry; they +have a way of inserting an instrument (a drawing of which he made, showing +distinctly phallic features) by psychological means into the glands or +bodies of men, thus cleaning them out. The eunuchs of the Romans used to +cure their fellow countrymen of snakes growing around the heart by +ingratiating themselves into persons, thus displacing the snakes and killing +them. The government has many eunuchs in their employ. The influences of +these men are malign or beneficial. They can injure enemies of the +government or the government can incorporate them into bodies of other men +to save the latter. All cardinals, most diplomats and many missionaries are +eunuchs. The psychological influence exerted by such individuals may cause a +loss of blood to their victims or they may use this power beneficially. The +Romans, for instance, put blood of crucified people into the hands of +eunuchs, who impregnated it by psychological influence into others. This +would save their lives and eventually save the nation. + +The ideas we have mentioned showing rivalry with his father, apparently in +relation to his mother, were largely elaborated in political and religious +disguises in their transition states, which in turn led to an objective +interest in politics and religions. He spoke of killing the President which +may be taken as a disguise for killing his father since he often claimed +that his father was this or that ruler. He also spoke of killing one of his +employers. He was prone to speak of his father as Edward VII. His envy of +this situation of authority was shown when he once told the physician that +his face was suspended in the face of the physician who was a King of +England. But not the real King, he added, Edward VII was the real King. +Again he said that he was Robert Emmet and the physician was Lord Norbury, +the judge who convicted Robert Emmet, after whom the patient was named. In +that role the physician told him it was all up, that there was no more Irish +race. (It must be remembered that his father was a Fenian.) A fruitful +source of speculations about international politics was found in the +transitional ideas he expressed about the extraction of his parents. +Beginning with his cogitations about the friction which actually existed +between his parents, he ascribed this to their differing nationalities and +religions. This led in turn to his fancying that on both sides his blood +was drawn from many sources. He was particularly fond, for instance, of +identifying his father with Hebrews, or Chinese; his mother with Romans, +Italians or Spaniards. His original interest in the union (or disharmony) +of his parents was easily transferred to this international setting and most +of his attacks were heralded by dramatizations of political ar international +situations with which he was intimately connected. This was true of his +first attack when he had an idea that he was to succeed Secretary Hay and +make peace between Russia and Japan (his mother and father). On recovery +these fancies were objectivized into a most intense interest in diplomacy. +He knew the history and achievement of every diplomatist in Europe, though +of course his data were always being distorted to fit with his insane +theories. Intermarriage, for example, was the cause of political trouble. +He developed the ideas as follows: When an Irishman marries one of another +race a confusion of races results; this was what took place in the tower of +Babel; this is what causes disunion between states. He elaborated, too, on +popular associations of certain customs with certain peoples. Gypsies, it is +popularly supposed, frequently abduct children. With the patient this became +an elaborate theory about an Egyptian custom or Egyptian influence. The +Egyptians, he said abducted children and brought them up as their own +acquiring a sinister influence over them because of the belief the children +had that these adults who were their guardians were their real parents. In +one attack he spoke of his father as "An Egyptian influence." This is +plainly the same idea as he put into another form when he remarked that he +would be all right if he could become English. When in his free intervals, +he made it a practice sedulously to cultivate English people. + +This undercurrent of rivalry with the father came out in a religious +disguise as well. His first attack when he was for many months interned he +described as a religious mania. By means of identifying himself with Christ +he dramatized both his subjugation and defiance. He went through many +crucifixion experiences; said he was commanded by God. On the other hand he +said Christ was a virgin and retained his virginity in order that he might +discover the secrets of the elders. For this reason he was crucified. The +crudest expression he gave of defiance in a religious form was when he said +"I was two persons in one--God and Jesus Christ. God was damned." The more +constructive tendency was shown by his fasting. This was due to an +experience of some duration when he was translated back to the first +century, was in a convent (sic!) and was tempted by the devil to eat. His +fasting, he claimed, saved the other patients. His most constructive +delusion was that all the churches would come together and then there would +be only one church. During his first attack this was his "prophecy," during +his saner intervals there were endless ramifications of this idea which are +too tedious to recite. It is important to note as evidence of the purely +psychotic character of his ideas that he has never been either religious in +his spirit or in action a propagandist. + +Perhaps the most luxurious fancies this patient evolved were around the +theme of semen. We have seen that his emissions were his constant worry, an +increase in their frequency heralded an attack and he was convinced that if +he could but retain this secretion he would be permanently cured; nay more, +if he could retain enough he would grow to be like the giants of old. +Whenever he had an emission he felt on waking a pain in his head and could +never get totally rid of the idea that this was cancer. In his attacks the +cancer was the result of a homosexual assault and in his intervals he +elaborated theories as to the origin of cancer; it came from friction, +therefore coitus could produce it, it might be the result of adultery or +cancer of the breast could come from a man rubbing his penis on the breasts +of a woman; the cancer germs might come from semen if one believed in cancer +and in germs. Life both as vital force and in the biological sense he +identified with semen. Psychic activities too had the same origin which he +explained thus: food taken into the mouth goes into the stomach and becomes +chyle, chyle passes to the scrotum, thence to the spine and brain. Brain +power is in direct proportion to the amount of semen retained. We see now +why eunuchs had such power according to his philosophy. By childish +reasoning, since they could not have emissions, their semen must be +retained. He spoke of psychological influence in these terms: "It is the +transformation from the moisture state of the life principle to the moist +electric state of warmth and its transference from the central ducts and +glands to the head and being thrown out of the head in waves from the top of +the head and eyes. It redounds to the other person's good. Have an eunuch +near you--it tends to make semen go to the head and gives the mental mouth +something to think of. It could be used in a baleful way if one had will +power over another person like hypnotism--(Svengali and Trilby)--In +hypnotism the will goes on the same lines as psychological influence." The +Jews, he said, lay around temples so much that their life had to go into +sensuality or wisdom and it mostly went into wisdom. Continual seminal +losses, he claimed, would lead to a change in personality. "Life," he said, +permeated nature, it could not be lost. Wind was thus identified with it: +"life" goes on a sheet (from an emission), the sheet is washed and the +"life" passes to the water, then is taken up by the air and breathed. Thus +he suffered both immediate and remote effects from emissions. The first +result was to make him incapable of work; by breathing in the "life" later +on he became a degenerate. Wind or the spiral movements of air was another +origin of life. Wind is a spirit, in defence of which he quoted the Greek +pneuma. The words wind and word are the same, the former being derived from +the latter through wird. (Cf. "In the beginning was the word," or "The word +was made flesh"). A cyclone is an effort hampered by civilization of what +the world was originally. Life began as a spiral movement of air. Wind as +the origin of life could be duplicated by mechanical methods or eunuchry. +The sun he claimed was an accident. Men lived for centuries without it, +till an accident, internally, led to vital forces being emanated and that +was the origin of sun. The accident was the cutting of some man's testicles. + +Now what was his further course? We have seen that in his attacks he +expressed resentment against his father's domination. At the beginning of +one of them, for instance, which he said was brought on by "Egyptian +influence," he had a dream of an old Hebrew play of father and son. In this +play they were trying to make him return to the old situation of bondage to +his father. This bondage was an actuality. Owing to his monthly attacks he +could hold no regular position and so worked for his father. The latter gave +him no money except occasional small silver but bought for him clothes or +anything else he might need. A psychotic man of nearly thirty, with a +feminine character, he was hopelessly dependent on his father. It is small +wonder that he sought relief in recurring psychotic episodes. But a change +came. On May 12, 1911, his father died suddenly of heart trouble. The +patient was beginning to go into an attack at the time but pulled himself +together, managed the funeral three days later, got his sister home, who had +a hysterical attack at the grave, and then proceeded to indulge in his +postponed attack. The sister was unable to care for him so he was sent again +to the Sheppard and Enoch Pratt Hospital. In a few days he recovered. He +was then talked to, told that this baleful relationship was over and that +there was no longer any reason for his having attacks. With the exception of +one attack at the beginning of 1912 he has had none, and seems to be able to +maintain the mental equilibrium that previously characterized his intervals. +For two and a half years he has been employed in the Customs House, +Baltimore, a position which he secured by competitive examination, and has +received an advance in salary from $900 to $1200 a year. He was recently +written to and replied in exceptional literary form detailing more of his +ideas. They seem to be essentially similar to those held four years ago. +One may be quoted. A favorite "scientific" method with him has always been +(from boyhood, he said) to divide up or distort words so as to get at their +true meaning. This is now his explanation of the word "cancer." + +"You may remember the origin of the word 'cancer' was once the topic of our +meeting and strangely this matter has kept revolving itself in my mind ever +since. My new solution is 'Kahns' and 'Ur.' You know there are a good many +people named 'Kahn' and as probably you have noted in the Bible allusion to +the ancient race of the name 'Ur.' Now, you can place what construction you +will on the combination. There are several; here is one: I have heard it +stated that the word 'Ur' originally meant 'wife' hence, from our point of +view the solution is easy, Kahn's Ur or Kahn's wife, but what has puzzled me +is what she is doing in so many people. + +"Here's another: Signifying the overcoming of the Jew by Ur or Kahn by Ur +(Kahn by 'er) much on the same principle as the words 'Spanish-American' and +'Graeco-Roman' are used with reference to the late 'unpleasantness' and the +ancient one. + +"Here's another: Simply meaning that Kahn is not a Jew at all but simply an +Ur. + +"So you see I have not altogether forgotten some of the topics of our +meeting." + +If our claims be allowed we should be able to make some deductions of value +to psychiatric theory. The first is an explanation of scattering of +thought. We find that, in all our cases showing constructive delusions, the +utterance of these highly elaborated fancies is not accompanied by +scattering. On the other hand it is an every day experience that a dementia +praecox patient may show no scattering when conversing on indifferent +subjects but that his train of thought loses logical sequence when he +launches into his ideas. These findings may be reconciled by studying the +reaction with types of ideas such as the last patient showed. In his +intervals he was (and is) continually busy with delusional thoughts but of a +constructive character, but was never scattered as long as these were alone +present. As soon, however, as an attack commenced and cruder ideas appeared +he became scattered. Where were these crude ideas in the intervals? They +were represented in his constructive delusions it is true, but in their +native form they did not appear. The cruder fancies must therefore have +been in the unconscious during his intervals. Now actual verbatim records +show with him that these crude ideas did not come to expression in logical +sequence but that each appeared in response to an idea previously in his +consciousness which was a distorted formulation of the crude fancy next to +appear. His utterances during these attacks would have a logical sequence if +they were translated into terms of the underlying crude ideas. The +scattering, therefore, was due to the fact that his utterances were a +mixture of crude and elaborated fancies. Had they been entirely one or the +other there would have been no scattering. During his intervals he dealt +with objective fancies and was logical. As these fancies, however, could be +easily demonstrated to be derived from the unconscious crude ones, which +appeared during his attacks, we are safe in assuming that one factor at +least in the production of an attack was the lifting of some inhibition +which kept the cruder ideas from entering consciousness except in a form in +which they could be objectively viewed and so logically arranged. Scattering +of thought therefore arises from the intermittent action of this censor or +from an incomplete abolition of the inhibition allowing varying formulations +of the crude ideas to gain expression which have no logic surface +connection. If entirely done away with, of course, the latent ideas +appearing in perfect crudity would have a logical connection. The content +of consciousness is what is within the sphere of introspection. We can +therefore say that the praecox who is scattered really does not know his own +ideas. This is, of course, an every day experience for those who examine +such patients. A suitable case left to himself will give expression to a +limited number of delusions which he does not correlate. A few suggestive +questions, however, will educe a mass of delusions, which when pieced +together demonstrate the logical unconscious ideas that give rise to them. +If such a patient be asked "What are your ideas?" he can give no reply. Ask +him, however, if any one is mistreating him and you will start a train of +thought in which one fancied insult leads to another or to delusions which +do not represent mistreatment at all. On the other hand approach a patient +with constructive delusions with the same question as to his ideas and he +will produce a theory of the universe, often with a chronological account of +how these ideas developed. He is insane in that his fancies do not reach an +outlet in action being an end in themselves; but he is sane in so far as he +keeps his ideas within the range of introspection and has not allowed them +to become autonomous. The inferences from this to the laws of normal +association are obvious. + +The second point is really a historical one. Psychiatrists are often asked, +"Was Joan of Arc crazy?" "Was Saint Louis a dementia praecox?" In an +endeavor to answer such questions wise books have been written detailing the +"psychoses" of historic or religious leaders. There is probably not a single +delusion expressed by any one of the patients whose cases have just been +recited that is not duplicated or paralleled by the belief of savants of a +few centuries ago or the uneducated of to-day. The last patient said "All +nature is artificial, man made it all. All the world would disappear, if man +lost the power of reproducing. The reproduction of nature by man is founded +on faith--constant reiteration and association with a thing will produce +that thing." Is this not analogous to the working hypothesis of the +alchemists? The more sincere among them sought salvation for their souls. To +gain this they worked with metals to which they ascribed abstract or moral +qualities. Their metallurgy was primarily symbolic, yet they seriously +hoped for results by working with symbols. And to what extent of absurdity +and crudity did they go? Many of their metallurgic terms were sexual +processes. Their "prima materia" was called by the name of many of the +secretions or excretions of the body. A whole school--the +Seminalists--adhered to the view that the great original substance was +semen. Other thought it was hermaphroditic. Paraceleus spoke of the birth +of monsters as a result of sodomy. A natural history[4] written three +centuries ago tells of semen being carried by wind. Notoriously there was +no limit either to the absurdity or crudity of these conceptions. Were these +men--the wisest of their time--insane? Here again we may quote the last +patient--"Insanity," he says, "is the elemental human mind left to itself, +unimproved by other minds." The last is the important phrase. What minds +were there to improve those of the alchemists? What critic was there to +tell Joan of Arc that visions and voices were pathological? That was the +regulation form of inspiration in her day. Comparative mythology like a +comparison of mysticism, alchemy, rosicrucianism and masonry shows that the +human mind left to itself will formulate similar ideas. These ideas, +however, are modified by the advance of learning as time goes on. The +individual whose critical faculty allows him to maintain an idea +incompatible with the knowledge of his age and his fellows is insane. + +[4] The Historie of Foure-Footed Beastes, by Edward Topsell, London, 1607. + +Our last point is a corollary to the claim we have just made. It has been +the sport of iconoclasts for many years to discount all religious beliefs as +psychopathic. This is not the forum where the problem of science versus +religion may be discussed but these cases have certain features which should +warn us to be wary of such generalizations. We have seen that religious +formulations have been used to embody crude fancies. That does not preclude +the possibility of the formulations having an actual basis. A flag may gain +its importance to a given individual because it symbolizes for him his +native land but that does not prove that the flag has not an existence of +itself. This, however, is a matter of logic and not of psychiatry. Let us +now grant that all religious formulations have an unconscious origin. But +there still remains a wide gulf between patients such as we have been +describing and the devout church-goers. The former show in their productions +how their religious ideas arise, their egocentric quality is patent, they +manifestly are but thin cloaks for selfish wishes. The latter, however, +never in consciousness connect their religious formulations with their +subjective creations. To the true believer his God is as objective a +reality as is the electron of the physicist. Finally, real religious faith +has a pragmatic value. Granting it be only a theory it nevertheless produces +results in conduct. This is in sharpest contrast to religious delusions. +They never lead to sustained effort, they bring with them no social +potentiality. They exist for the comfort of the patient alone. + +To sum up: We have endeavored to establish the claim that delusions in +dementia praecox which takes the form of objective speculations rather than +subjective experiences are an evidence of a milder psychotic reaction and +hence warrant a prognosis of chronicity rather than deterioration. From the +cases presented we argue that scattering of thought arises from a failure to +formulate underlying fancies in an objective way; that the insanity of ideas +depends not on themselves but on the critical judgment of the age which +produces them, and lastly that there are essential psychological differences +between creeds and religious delusions. + + + +SOCRATES IN THE LIGHT OF MODERN PSYCHOPATHOLOGY + +BY MORRIS J. KARPAS, M. D. + +Assistant Resident Alienist, Psychopathic Department of Bellevue Hospital of +New York + +(Read before the Vidonian Club, New York, October 16, 1914.) + +"CONSCIOUSNESS had reached this point in Greece, when in Athens, the great +forum of Socrates, in whom subjectivity of thought was brought to +consciousness in a more definite and more thorough manner, now appeared. +But Socrates did not grow like a mushroom out of the earth, for he extends +in continuity with his time, and this is not only a most important figure in +the history of philosophy--but perhaps also a world famed personage." +Hegel. + + + +"When Columbus set sail across the untraversed western sea, his purpose was +to reach by a new path, a portion of the old, known world, and he lived and +died in the belief that he had done so. He never knew that he had +discovered a new world. So it was with Socrates. When he launched his +spiritual bark upon the pathless ocean of reflected thought, his object was +to discover a new way to the old world of little commonwealths and narrow +interests, and he probably died thinking he had succeeded. He did not dream +that he had discovered a new world--the world of humanity and universal +interests. But so it was; and tho mankind are still very far from having +made themselves at home in that world, and from having availed themselves of +its boundless spiritual treasures, it can never be withdrawn from their +sight, or, the conquest of it cease to be the object of their highest +aspirations." Thomas Davidson. + + + +INTRODUCTION + +The Hellenic influence upon the intellectual development of the world is +infinite. The intellectual force emanating from the sources of Greek art, +literature and philosophy permeated thru the ages and have helped to shape +the destiny of our civilization. "Except the blind forces of Nature," says +Sir Henry Sumner Maine, "nothing moves in this world which is not Greek in +its origin." [1.] Without a shadow of doubt, Greek Philosophy forms the firm +background of progressive and reflective thought in all its phases and +ramifications. + +In the history and evolution of Hellenic thought, we find two tendencies of +inquiry,--one dealing with the objective manifestations of the universe, and +the other directed towards the study of the mind. To the former class +belong Thales, Anaximander, Anaximenes, Pythagoras, and others that +attempted to discover some principle for the explanation of the natural +phenomena. To accomplish this end, mathematics, physics, metaphysics, etc., +were resorted to. The other great epoch, which may be termed the +Renaissance of Greek Philosophy, was conceived by the Supreme Greek thinker, +Socrates, who forms the subject thesis of this paper. + +Socrates was the father of psychology and the grandfather of modern +psychopathology. He was the first one that attempted to study man from the +point of view of subjectivity. In the words of Snyder, "In Socrates, the +human mind burst forth into knowing itself as thinking."[2.] And Zeller very +thoughtfully remarks: "The interests of philosophy being thus turned away +from the outer world and directed towards man and his moral nature, and man +only regarding things as true and binding of the truth of which he was +convinced himself by intellectual research, there appears necessarily in +Socrates a deeper importance attached to the personality of the +thinker."[3.] In Phaedrus, Socrates speaks: "I am a lover of knowledge, and +in the cities I can learn from men; but the fields can teach me +nothing."[4.] Although Aristophanes pictures Socrates in the clouds as +preaching natural philosophy, yet there is no authentic record of this. + +The source of information regarding the biography of Socrates and his +philosophy comes from two authors, Xenophon and Plato. The former portrays +him as a moral philosopher and in his book, Memorabilia, he seems to +eulogize his master. The latter however presents him as a thinker, and it +is maintained by many critics that Plato put into the mouth of Socrates his +own ideas. It is lamentable that this great philosopher committed nothing +of his monumental work in writing. + + + +THE PERSONALITY OF SOCRATES + +It is difficult to construct a biographic sketch of Socrates in a +chronological and systematic order. He was born in the year 469 B. C. His +father was Sophroniscus, a sculptor, and his mother Phaenarete, a midwife. +He followed his father's vocation and it is believed that he showed poor +skill in the profession. We know nothing of his early intellectual and moral +development. Since he was bred in Athens, he most probably received the +usual education peculiar to that age. He was a soldier and took part in +military campaigns and wars. It is maintained that in military life he +displayed considerable bravery, endurance and fortitude. The exact date of +his appearance in public arena is difficult to ascertain, however, "in the +traditions of his followers he is almost uniformly represented as an old, or +as a gray-headed man."[5.] + +There are distinctive traits in the personality of Socrates that are worthy +of emphasis because of their dynamic import. + +He was described as eccentric in his general mode of conduct. He "strutted +proudly barefoot along the streets of Athens; he was careless and shabby in +his dress; in his manner he was affected and haughty and was subject to +ecstatic trances and visions. During these trances he would maintain a +standing posture for hours, buried in his thoughts, and was quite oblivious +to the external world. There was a celebrated occasion in the camp at +Poteidaice, when Socrates was not quite forty; on that occasion he stood +motionless from early morning on one day till sunrise on the next, right +through a night when there was a very hard frost. When the sun rose he said +his prayer and went about his business." [6.] It is also claimed that he +would give vent to bursts of anger and fiery passion. + +Ever since early boyhood Socrates is supposed to have heard an inner voice, +which he called a divine sign. It came to him quite often both on important +and on insignificant occasions. According to Xenophon, this voice gave him +both negative and positive warnings; however, Plato holds that this voice +only exercised its influence in opposing the execution of certain things. +"And not only was he generally convinced" says Zeller, "that he stood and +acted in the service of God, but he also held that supernatural suggestions +were communicated to him, not only through the medium of public oracles, but +also in dreams, and more particularly by a peculiar kind of higher +inspiration which goes by the name of the Socratic daimoviov."[7.] + +Even by his contemporaries he was regarded as singular and eccentric and his +general behavior was ever foreign to his compatriots. Indeed Lelut [(8)] +boldly asserts that Socrates was "un fou." Nevertheless "attempts were not +wanting to excuse him," so writes Zeller, "either on the ground of the +universal superstition of his age and nation, or else of his having a +physical tendency to fanaticism."[9.] + +Another interesting feature in the life of Socrates is that he married late +and that his matrimonial life was far from being happy, and in the words of +Schwegler, "He nowhere shows much regard for his wife and children; the +notorious, though altogether too much exaggerated ill-nature of Xantippe, +leads us to suspect, however, that his domestic relations were not the most +happy."[10.] It is also important to note that there was a turning point in +the history of his life when he took up the preaching of philosophy. It must +be borne in mind that he took no money for his teaching and at the same time +he left his wife and children destitute. In regard to this Draper remarks, +"There is surely something wrong in a man's life when the mother of his +children is protesting against his conduct, and her complaints are +countenanced by the community."[11.] + +It is also significant that Socrates displayed a certain degree of +masochism; our historians tell us that Socrates would deny himself bodily +comforts and insist on enduring hardship. Xenophon in Memorabilia says: +"But they knew that Socrates lived with the utmost contentment on very small +means, that he was most abstinent from every kind of pleasure, and that he +swayed those with whom he conversed just as he pleased by his +arguments."[12.] Again, "Is it not the duty of every man to consider that +temperance is the foundation of every virtue, and to establish the +observance of it in his mind before all things? For who, without it, can +either learn anything good or sufficiently practice it? Who, that is a +slave to pleasure is not in an ill condition both as to his body and his +mind? It appears to me, by Juno, that a free man ought to pray that he may +never meet with a slave of such a character, and that he who is a slave to +pleasure should pray to the gods that he may find well-disposed masters; for +by such means only can a man of that sort be saved."[13.] And, "He appeared +also to me, by such discourses as the following, to exhort his hearers to +practice temperance in their desires for food, drink, sensual gratification, +and sleep, and endurance of cold, heat and labor."[14.] + +Although he condemned poederastia, yet he was always fond of the male sex, +particularly of the young. This, however, may be explained on the ground +that his object was to appeal to the young. Nevertheless, dynamic psychology +demands a deeper meaning for such a motive. In this connection it would be +interesting to quote Xenophon: "As to love, his counsel was to abstain +rigidly from familiarity with beautiful persons; for he observed that it was +not easy to be in communication with such persons, and observe continence. +Hearing, on one occasion, that Critobulus, the son of Criton, had kissed the +son of Alcibiades, a handsome youth, he asked Xenophon, in the presence of +Critobulus, saying, "Tell me, Xenophon, did you not think that Critobulus +was one of the modest rather than the forward, one of the thoughtful rather +than of the thoughtless and inconsiderate?" Certainly," replied Xenophon. +"You must now, then, think him extremely headstrong and daring; one who +would even spring upon drawn swords, and leap into the fire." "And what," +said Xenophon, "have you seen him doing, that you form this opinion of him?" +"Why, has he not dared," rejoined Socrates, "to kiss the son of Alcibiades, +a youth extremely handsome, and in the flower of his age?" "If such a deed," +returned Xenophon, "is one of daring and peril, I think that even I could +undergo such peril." "Unhappy man!" exclaimed Socrates, "and what do you +think that you incur by kissing a handsome person? Do you not expect to +become at once a slave instead of a freeman? To spend much money upon +hurtful pleasures? To have too much occupation to attend to anything +honourable and profitable? And to be compelled to pursue what not even a mad +man would pursue?" "By Hercules," said Xenophon, "what extraordinary power +you represent to be in a kiss!" "Do you wonder at this?" rejoined Socrates; +"are you not aware that the Tarantula, an insect not as large as half an +obolus, by just touching a part of the body with its mouth, wears men down +with pain, and deprives them of their senses?" "Yes, indeed," said +Xenophon, "but the Tarantula infuses something when it bites." "And do you +not think, foolish man," rejoined Socrates, "that beautiful persons infuses +something when they kiss, something which you do not see? Do you not know +that the animal, which they call a handsome and beautiful object, is so much +more formidable than the Tarantula, as those insects instil something when +they touch, but this creature, without even touching, but if a person only +looks at it, though from a very great distance, instils something of such +potency, as to drive people mad? Perhaps indeed Cupids are called archers +for no other reason but because the beautiful wound from a distance. But I +advise you, Xenophon, whenever you see any handsome person, to flee without +looking behind you; and I recommend to you, Critobulus, to absent yourself +from hence for a year, for perhaps you may in that time, though hardly +indeed, be cured of your wound." Thus he thought that those should act with +regard to objects of love who were not secure against the attractions of +such objects; objects of such a nature, that if the body did not at all +desire them, the mind would not contemplate them, and which, if the body did +desire them, should cause us no trouble. For himself, he was evidently so +disciplined with respect to such matters, that he could more easily keep +aloof from the fairest and most blooming objects than others from the most +deformed and unattractive. Such was the state of his feelings in regard to +eating, drinking, and amorous gratification; and he believed that he +himself, with self-restraint, would have no less pleasure from them, than +those who took great trouble to pursue such gratifications, and that he +would suffer far less anxiety."[15.] + +There is another interesting anecdote which is worthy of mention: "The +Syrian soothsayer and physiognomist, Zopyrus, saw in the countenance of +Socrates the imprint of strong sensuality. Loud protests were raised by the +assembled disciples, but Socrates silenced them with the remark: 'Zopyrus is +not mistaken; however, I have conquered those desires.' "[16.] + +It is also evident that Socrates' mother must have played some role in his +mental life. It should be recalled that at first he followed his father's +profession, which seemingly made no impression upon him, and later he took +up his new vocation, preaching philosophy, which he loved to identify with +that of his mother, and indeed by reason of this the positive side of the +Socratic method is known as "the art of intellectual midwifery." "Socrates +compared himself," writes Schwegler, "with his mother, Phaenarete, a +midwife, because his office was rather to help others bring forth thoughts +than to produce them himself, and because he took upon himself to +distinguish the birth of an empty thought from one rich in content."[17.] + +Further evidence of the deep reverence for his mother is seen in Memorabilia +where his eldest son, Lamprocles, finds fault with his mother, and Socrates, +though apparently entertaining very little love for his wife, yet takes up a +defensive attitude towards her and offers the following argument to his son: +"Yet you are displeased at your mother, although you well know that whatever +she says, she not only says nothing with intent to do you harm, but that she +wishes you more good than any other human being. Or do you suppose that your +mother meditates evil towards you?" "No indeed," said Lamprocles, "that I do +not imagine." "Do you then say that this mother," rejoined Socrates, "who is +so benevolent to you; who, when you are ill, takes care of you to the utmost +of her power that you may recover your health, and that you may want nothing +that is necessary for you, and who, besides, entreats the gods for many +blessings on your head, and pays vows for you, is a harsh mother? For my +part, I think that if you cannot endure such a mother, you cannot endure +anything that is good." [18.] + +And in Crito, Socrates relates a dream shortly before his death, in which +his mother appeared, and to quote Plato: "Crito says, 'And what can this +dream have been?' Socrates replied, 'I thought a woman came to me, tall and +fair, and clothed in white, and she called me and said 'Socrates, Socrates, +in three days' time you will come to the fertile land, Phthia.' "[19.] + +To sum up briefly, the personality of Socrates showed some psychopathic +traits. It must also be borne in mind that in that critical period, middle +age, a sudden change occurred in his mental life when he suddenly commenced +to exhibit profound interest in preaching philosophy. Moreover, it must be +emphasized that he apparently reacted to hallucinations of an auto psychic +nature. The self-asceticism, and most probably the mother-complex cannot be +passed without mention. Although he presented these negative qualities, +nevertheless he left a great school of philosophy, which beyond doubt is +still felt in the intellectual and moral world. Despite this, Athens +committed an unpardonable crime in putting Socrates to death. He, like +other martyrs, shared the same fate of the mob. Lowell's verse very justly +applies to Socrates: + + "Truth forever on the scaffold; Wrong forever on the throne."[20.] + +With this characterization of Socrates, we are now in a position to discuss +that part of his philosophy which has a definite bearing on modern +psychopathology. Three important phases of his philosophy come under +consideration: + +1. The dialectic method; 2. The conception of virtue; 3. Know thyself. + + + +THE DIALECTIC METHOD + +In Socratic philosophy the Dialectic Method occupies a lofty position. By +this method he was enabled to penetrate deeply into human nature and unfold +all phases of man's experience. Aristotle characterizes this method as the +induction of reasoning and the definition of general concepts. Gomperz, +speaking of the great zeal that Socrates exhibited in this method, says, "to +him (Socrates), a life without cross-examination, that is, without dialogues +in which the intellect is exercised in the pursuit of truth, is for him not +worth living."[21.] And Schwegler pertinently asserts "that through this art +of midwifery the philosopher, by his assiduous questioning, by his +interrogatory dissection of the notions of him with whom he might be +conversing, knew how to elicit from him a thought of which he had been +previously unconscious, and how to help him to the birth of a new +thought."[22.] + +Briefly stated, the Dialectic Method is divided into two parts, the negative +and the positive. The former is known as the Socratic Irony. By this +method the philosopher takes the position that he is ignorant and endeavors +to show by a process of reasoning that the subject under discussion is in a +state of confusion and proves to the interlocutor that his supposed +knowledge is a source of inconsistencies and contradictions. + +On the other hand, the positive side of the method, "the so-called +obstetrics or art of intellectual midwifery"[23] leads to definite +deductions. To illustrate the two phases of this method, the following +example may be taken. A youth of immature self-confidence believed himself +to be competent to manage the affairs of state. Socrates would then analyze +the general concept of the statecraft, and reduce it to its component parts, +and by continuous questions and answers would show to this supposed +statesman that he was lacking true knowledge. Again, a young man of mature +judgment, but of an exceedingly modest temperament, being reluctant to take +part in the debates of the Assembly, Socrates would prove to him that he was +fully competent to undertake such a task. + +In a word, the Socratic method presents two striking tendencies; one +destructive, the other constructive; the former annihilates erroneous +conceptions, and the latter aids the building up of a healthy mental world, +in which men may find pleasure. In a broad sense, the dialectic method bears +some resemblance to the psychoanalytic, inasmuch as both seek to analyze +human nature in the light of individual experience; to find the ultimate and +predominating truth underlying such an experience; both attempt to make the +individual realize the extent of his limitations and capacity of adjustment +by subordinating the antagonistic forces and at the same time aiding the +construction of a world of healthy concepts. + + + +SOCRATIC CONCEPTION OF VIRTUE +Before attempting to discuss the Socratic Conception of Virtue, it is +important to call attention to two facts; + +1st, The principles of mental life, and + +2nd, The Greek conception of the state. + +Roughly speaking, mental life is composed of two parts; the unconscious, or +instinctive, and the conscious. In the early development of the child, +mental adjustment is purely instinctive or unconscious. As the child grows +older, the unconscious life becomes gradually subordinated to the +conventional and cultural requirements. The influence of education, +religion, morality and environment begin to exert their influence upon the +child and the conscious life commences gradually to assert itself. The +characteristic difference between a very young child and the conventional +adult, lies in the fact that the former's behavior is not controlled by +conventionalities or tenets, whereas the latter conforms with all the rules +and customs of society. + +The Greeks entertained a very high idea of the function of the state. It was +invested with a high moral value and pedagogic aim. In fact, Plato's +republic demonstrates this very well. An important point must be emphasized, +that the state exercised a potent influence upon the development of the +conscious life of the individual. + +Now we can understand the Socratic Conception of Virtue in relation to the +conscious and unconscious life. What Socrates maintained was that true +virtue must depend upon knowledge; hence knowledge is the strongest power of +man and cannot be controlled by passion. In short, knowledge is the root of +moral action, and, on the other hand, lack of knowledge is the cause of +vice. In other words, no man can voluntarily pursue evil, and to prefer evil +to good would be foreign to human nature. Hence, in the Socratic sense, in +the unconscious lies the root of antisocial deeds, and, as Forbes puts it: +"Socratic view of sin, in fact, keeps it in a region subliminal to +knowledge. The sinner is never more really than an instinctive man, an +undeveloped, irrational creature; strictly speaking, not a man at all."[24.] + +Since Socrates identified virtue with knowledge, and made knowledge a +conscious factor in mental life, it is evident that education, environment, +religion and conventionality are the determining factors in the cultivation +of the conscious. "What may be called institutional virtue," writes Snyder, +"is for Socrates the fundamental and all-inclusive Virtue, the ground of the +other Virtues. He believes in the State, obeys the Laws, performs his +duties as a citizen. This does not hinder him from seeing defects in the +existent state and its Laws, and trying to remedy them. Indeed, his whole +scheme of training in Virtue is to produce a man who can make good Laws, and +so establish a good State. 'What is Piety?' he asks, not a blind worship of +the gods, but worship of them according to their laws and customs, which one +must know. That is, one must know the law of the thing, the time of mere +instinctive action and obedience is past." [25.] And Zeller expresses +himself in a similar manner: "Of the importance of the state and the +obligations towards the same, a very high notion indeed is entertained by +Socrates:--He who would live amongst men, he said, must live in a state, be +a ruler or be ruled. He requires, therefore, the most unconditional +obedience to the laws, to such an extent that the conception of justice is +reduced to that of obedience to law, but he desires every competent man to +take part in the administration of the state, the well-being of all +individuals depending on the well-being of the community. These principles +were really carried into practice by him throughout his life. With devoted +self-sacrifice his duties as a citizen were fulfilled, even death being +endured in order that he might not violate the laws. Even his philanthropic +labors were regarded as the fulfillment of a duty to the state; and in +Xenophon's Memorabilia we see him using every opportunity of impressing able +people for political services, of deterring the incompetent, of awakening +officials to their sense of their duties, and of giving them help in the +administration of their offices. He himself expresses the political +character of these efforts most tellingly, by including all virtues under +the conception of the ruling art."[26.] + +To recapitulate briefly; the Socratic conception of the unconscious conforms +in many respects with our present knowledge of it, especially insofar as our +psychoanalytic experience shows us conclusively what a potent factor is +exercised by the unconscious in the determination of psychotic and neurotic +phenomena. Indeed in the Socratic sense such manifestations are anti-social +and cannot be identified with virtue, hence they are not conscious. One may +say that Socrates unconsciously conceived the modern idea of the dynamics of +the unconscious. + + + +KNOW THYSELF + +The great Socratic Maxim, "Know Thyself," is one of the strongest moral +precepts in Ethics. Although the sophists had already called attention to +the fact that "man is the measure of all things," however they applied to +the individual and not to human nature in general. "But Socrates proclaimed +that this self-knowing Ego knows itself likewise as object, as the principle +of the world, in which man is to find himself in order to know it."[27.] + +To know one's self implies calmness of self-possession, fearlessness and +independence. Furthermore it leads one to a striking realization of one's +limitations and shortcomings, which form the foundations of success, and, as +Forbes expresses it, "in this self-knowledge is the secret of blessing and +success in the handling of human affairs, and right relationship with +others."[28.] + +Socrates, discussing his maxim with Euthydemus, gives a clear and +comprehensive idea of this interesting subject: "Socrates then said: 'Tell +me, Euthydemus, have you ever gone to Delphi?' 'Yes, twice,' replied he. +'And did you observe what is written somewhere on the temple wall, Know +Thyself?' 'I did.' 'And did you take no thought of that inscription, or +did you attend to it, and try to examine yourself to ascertain what sort of +a character you are?' 'I did not indeed try, for I thought that I knew very +well already, since I should hardly know anything else if I did not know +myself.' 'But whether does he seem to you to know himself, who knows his own +name merely, or he who (like people buying horses, who do not think that +they know the horse that they want to know, until they have ascertained +whether he is tractable or unruly, whether he is strong or weak, swift or +slow, and how he is as to other points which are serviceable or +disadvantageous in the use of a horse so he), having ascertained with regard +to himself how he is adapted for the service of mankind, knows his own +abilities?' 'It appears to me, I must confess, that he who does not know his +own abilities, does not know himself.' + +" 'But is it not evident,' said Socrates, 'that men enjoy a great number of +blessings in consequence of knowing themselves, and incur a great number of +evils, through being deceived in themselves? For they who know themselves +know what is suitable for them, and distinguish between what they can do and +what they cannot; and, by doing what they know how to do, procure for +themselves what they need, and are prosperous, and by abstaining from what +they do not know, live blamelessly, and avoid being unfortunate. By this +knowledge of themselves too, they can form an opinion of other men, and, by +their experiences of the rest of mankind, obtain for themselves what is +good, and guard against what is evil.' + +"But they who do not know themselves, but are deceived in their own powers, +are in similar case with regard to other men, and other human affairs, and +neither understand what they require, nor what they are doing, nor the +character of those with whom they connect themselves, but, being in error as +to all these particulars, they fail to obtain what is good, and fall into +evil. + +"They, on the other hand who understand what they take in hand, succeed in +what they attempt, and become esteemed and honoured; those who resemble them +in character willingly form connections with them; those who are +unsuccessful in their affairs desire to be assisted with their advice, and +to prefer them to themselves; they place in them their hopes of good and +love them, on all these accounts, beyond all other men. + +"But those, again, who do not know what they are doing, who make an unhappy +choice in life, and are unsuccessful in what they attempt, not only incur +losses and sufferings in their own affairs, but become in consequence, +disreputable and ridiculous, and drag out their lives in contempt and +dishonour. Among states, too, you see that such as, from ignorance of their +own strength, go to war with others that are more powerful, are, some of +them, utterly overthrown, and others reduced from freedom to slavery."[29.] + +What Socrates attempts to show, is that self-knowledge is conducive to human +happiness. Indeed, sanity in a broad sense, depends upon insight into one's +true knowledge of his limitation and capacity for adaptation. However, +Socrates holds that madness is not ignorance, but admits that for "A man to +be ignorant of himself, and to fancy and believe that he knew what he did +not know, he considered to be something closely bordering on madness. The +multitude, he observed, do not say that those are mad who make mistakes in +matters of which most people are ignorant, but call those only mad who make +mistakes in affairs with which most people are acquainted; for if a man +should think himself so tall as to stoop when going through the gates in the +city wall, or so strong as to try to lift up houses, or attempt anything +else that is plainly impossible to all men, they say that he is mad; but +those who make mistakes in small matters are not thought by the multitude to +be mad; but just as they call 'strong desire' 'love,' so they call 'great +disorder of intellect' 'madness.' "[30.] + +This Socratic principle plays an important role in psychopathology; in +psychoanalysis, what the physician does is to acquaint the patient with the +unconscious mental processes, thus putting him in full knowledge of his +condition to enable him to adjust himself to his environment. In mental +diseases the prognosis of a psychosis is not looked upon so gravely when the +patient has some realization of his situation, and likewise the recovery +from a mental infirmity is more hopeful when the patient exhibits +considerable insight into his condition. It is a well known fact that in a +malignant psychosis, self-knowledge does not exist, and this in part is +responsible for its malignancy. On the other hand the benignant nature of a +psychoneurosis may be in part attributed to the patient's appreciation of +his affliction. + +However, the Socratic maxim has another moral and social value, that is, by +only knowing one's self can one understand his fellowmen. Indeed, Plato +makes Socrates say, in Phaedrus, that it is ridiculous to trouble one's self +about other things when one is still ignorant of one's self. It is well +known to every psychoanalyst that a patient cannot be analyzed by the +physician unless the latter has conquered his own resistances and adjusted +his complexes. The Immortal Poet, Shakespeare, truly says: + +"This above all--to shine own self be true And it must follow as the night +the day, Thou canst not then be false to any man. " +Hamlet Act I, III. + + + +BIBLIOGRAPHY. + +[1.] Sir Henry Maine--Village Communities and Miscellanies, Page 238. Amer. +Ed. + +[2.] Denton J. Synder--"Ancient European Philosophy," page 216. + +[3.] Zeller--"Socrates and the Socratic School, 1877--London," Page 116. + +[4.] Plato--Phaedrus. + +[5.] Schwegler--"History of Philosophy," Page 63. + +[6.] Gomperz--"Greek Thinkers," Page 87. + +[7.] Zeller--"Socrates and the Socratic School," Page 81. + +[8.] Lelut--"Du Demon de Socrates--1836. + +[9.] Zeller--"Socrates and the Socratic School," Page 83. + +[10.] Schwegler--"History of Philosophy," Page 84. + +[11.] Draper--"Intellectual Development of Europe," Vol. I, Page 147. + +[12.] Xenophon--"Memorabilia," Page 8. (Dutton & Co., Every Man's Library). + +[13.] Ibid--"Memorabilia, Page 29. + +[14.] Ibid--"Memorabilia" Page 35. + +[15.] Ibid--"Memorabilia," Page 21-23. + +[16.] Gomperz--"History of Philosophy," Page 48. + +[17.] Schwegler--"History of Philosophy," Page 75. + +[18.] Xenophon's "Memorabilia," Page 417-418. + +[19.] Plato--"Crito." + +[20.] Lowell's "Present Crisis." + +[21.] Gomperz--"Greek thinkers," Page 59. + +[22.] Schwegler's "History of Philosophy," Page 75. + +[23.] Ibid--"History of Philosophy," Page 741. + +[24.] Forbes--"Socrates" Page 191. + +[25.] Denton Snyder--"History of Ancient European Philosophy," Page 248-249. + +[26.] Zeller--"Socrates and the Socratic School," Page 167. + +[27.] Denton Snyder--"History of Ancient European Philosophy," Page 234. + +[28.] Forbes--"Socrates," Page 173. + +[29.] Xenophon--"Memorabilia," Page 121-123. + +[30.] Ibid--"Memorabilia," Page 97-98. + + + +PSYCHONEUROSES AMONG PRIMITIVE TRIBES[*] + +[*] Read by title at the Sixth Annual Meeting of the American +Psychopathological Association, New York, N. Y., May 5, 1915. + +BY ISADOR H. CORIAT, M. D. First Assistant Visiting Physician for Diseases +of the Nervous System Boston City Hospital, Instructor in Neurology, Tufts +College Medical School + +THE complex construction of a psychoneurosis in an adult, due to the +influence exerted by the multiplicity of factors of civilization and +cultural advancement, is sometimes so bewildering as to almost defy all +attempts at analysis. In children, the organization of a psychoneurosis is +usually very simple, almost monosymptomatic, and in children too, we often +discover these neuroses in the actual process of making. When adult life is +reached, the individual has left behind him all the factors of his childhood +life and all the repressed experiences and desires which tend to produce his +adult characteristics. Among adults of primitive races however, where the +mental organization is far less complex than that of civilized man, certain +psychoneurotic disturbances are found, which if analyzed, might disclose the +mental mechanisms of these disturbances reduced to their simplest terms. + +It has been my good fortune to be able to secure data of this sort, +pertaining to certain curious nervous attacks which occur among the +primitive races of the Fuegian Archipelago. These facts were supplied me, +following along the lines of a questionnaire, by the well known explorer +Charles Wellington Furlong, F. R. G. S., who in 1907-1908, was in charge of +the first scientific expedition to cross through the heart of Tierra del +Fuego. Mr. Furlong's keen powers of observation, have made the data +unusually complete. While he had no theory to offer in explanation of the +attacks as seen among these primitive tribes, yet it is interesting to note, +that certain of the facts corroborate the well-known ideas of sexual +repression as elaborated by Freud. The mental organization of these people +likewise, seems to substantiate certain psychoanalytic conceptions. For a +clear comprehension of these attack, certain preliminary anthropological and +geographical data are necessary. + +The following data relates to the running amuck or outburst, among the +Yahgan and Ona tribes of the Fuegian Archipelago. This data was obtained in +1907 and 1908 during expeditions through the regions of the Fuegian +Archipelago. + +The Yahgans, some forty years ago, numbered perhaps 2,500 but in 1908 had +been reduced through contact with civilization and principally through an +epidemic of measles to 173. These peoples are canoe Indians and inhabit +today the island coasts from Beale Island to the Wollastons inclusive, in +the neighborhood of Cape Horn; from about 54 degrees 50' S. Lat. to about 55 +degrees 56' S. Lat., making them the southern-most inhabitants of the world. +The Ona Indians, a taller and finer race physically, who are foot Indians, +occupy the mountain and forest regions of southern Tierra del Fuego from +approximately 53 degrees 50' S. Lat. to 55 degrees 3' S. Lat. The Onas +formerly occupied the entire northern half of Tierra del Fuego and possibly +numbered some 3,000, but through contact and warfare with the whites, who +drove them south off the open lands of the north, they have been reduced to +about 300. These peoples are of a light cinnamon colored skin, black +haired, and of a decided Amerindian type. The Onas are above average +stature, the Yahgans below it. + +It is not an infrequent occurence for individuals among both the Yahgans and +Onas to be subject to sudden outbursts of furor and violence. At such times +the individual will generally dash from the wigwam and rush wildly away, and +will continue running until nearly or completely exhausted. The one +afflicted may dash madly through the woods or sometimes climb up dangerous +cliffs. At such times, however, it is the custom of some of the men to +follow closely behind to see that harm does not come through injury against +trees, stumbling, or falling from the cliffs. However, at such times they +rarely touch the afflicted one except to prevent harm, and finally will lead +him back to the camp, when the attack is over or when he is exhausted. + +While the attack occurs both among men and women, it seems to be more +prevalent among men. The individuals in whom these attacks predominate are +men in the prime of life, ranging from 25 to 35 years of age. These people +are polygamous and as it is the custom for the old men to marry young girls, +thus leaving the old women to the younger men, which in many instances +causes a scarcity of women, it leaves a somewhat undesirable condition. + +In many instances the character of the attack confines itself to the mad +rushing away, as above described, at other times attempts to injure or kill +others are made. For instance, a rancher of Tierra del Fuego, was in the +company of some Onas when suddenly a hatchet whizzed by him, barely missing +his head, and buried itself in a log of the Indian shelter. This was the +result of an attack which seized upon one of the Onas who was afflicted thus +from time to time. The actual outburst in this case was sudden, although it +is difficult to tell how long it might have been coming on in the form of +brooding, which seems to be a premonitory phase of this condition. + +Concerning a personal experience with one of the early phases of an attack, +Mr. Furlong states as follows:--"I am fully convinced that one night, while +camping alone with Onas in the heart of the Fuegian forests, that my head +man Aanakin, who had a good many killings to his credit, was brooding as he +sat in his wigwam, which opened towards the fire; he watched me for nearly +an hour with an attitude and expression which reminded me of the look a dog +takes on sometimes before he snaps. Aanakin I knew to be of a very moody +nature but this particular mood was so marked and portended evil so +noticeably toward me without any apparent cause, that I decided to do +something to break its mental trend. So putting fresh wood on the fire, to +make a more brilliant blaze, I walked directly into his wigwam and motioned +to one of his two wives, who were lying beside him. There was a passing +look of half-anger, half-surprise, but I gave no time for his mind to dwell +in the same mood, for simultaneously I produced my note book and pencil and +began to make drawings of animals and other things they were familiar with. +They like to watch one draw and name the thing, and so I kept them busy for +perhaps an hour, and finally had them in gales of laughter. I am quite +convinced that I forestalled an attack or a condition akin to it." + +It seems that an attack usually begins suddenly. However, an instance is +given where an Ona became moody and realized that one of these attacks was +coming on and putting his hands together begged to have his wrists and feet +bound in order that he would not do himself or others any harm, or that it +would not be thought that he meant to kill and consequently be shot in self +defence. This would in a way seem to indicate that there was no amnesia for +the attack, as the Indian undoubtedly realized what he had done in previous +attacks. + +The moody state and the realization of what might follow as the attack comes +on demonstrates a sense of uneasiness as the premonitory symptom of an +attack, which ends in a state of utter exhaustion and sleep. The normal +condition is resumed, practically on the awakening from sleep and recovery +of strength. + +From a description of Donald McMillan the explorer, the Eskimo Piblokto +strongly resembles these attacks of the Ona and Yahgan Indians with the +exception that Piblokto was particularly prevalent among the women. + +How an attack begins is shown by the case of Aanakin, an Ona of Furlong's +expedition. A certain form of melancholia, brooding or moodiness, seems to +precede many of these attacks, with a realization sometimes that an attack +is coming upon them. The Onas not being naturally a quarrelsome people, it +may be that this realization and foreboding of the attack accounts for their +tendency to run away from their associates, when they have endured the +strain as long as they can, thus placing themselves in a position to avoid +deliberate attack or injury to those about them. + +It was further stated, in answer to the questionnaire--"I cannot give you +absolute data regarding laughing or crying in an attack, screaming, yells, +foaming at the mouth, biting of tongue, tearing of clothes, although I am of +the opinion that any or all of these things may and do occur. As to violent +resistance, the case, where the man wished to be bound, would show there was +violent resistance, and it is probable that partly for this reason the Onas +and Yahgans do not molest the afflicted except to prevent them from harming +themselves, preferring to wait until the paroxysm exhausts them. I cannot +state positively as to whether the attack is explained by the natives as +being due to an evil spirit. While these people are polygamous, though +having no religious form of worship, they usually believe when any one has a +disease that something has entered them or some one who dislikes them has +surreptitiously sent some small animal or an arrow into them. Among the +Yahgans the 'Yuccamoosh' (doctors) or magicians proceed to pretend to +extract these objects by a form of squeezing and hugging the patient, in the +meantime blowing, hissing, etc., to force the object or evil out. I have +never known of their doing this, however, to a person suffering from an +attack. + +"I am unable to supply any direct data as to the relation of love, hunger, +sexuality, death of relatives or absent relatives to an attack. On the death +of a relative the Yahgans go through incantations in the form of a sort of +weird death chant, which they often sing in unison at certain times of the +day and night. They paint their faces to show the death to strangers, but +they rarely mention the name of the dead, in fact by most it is considered +an offence to do so. They say simply 'He is gone,' 'He is no more'; they +feel the loss of relatives very keenly and sorrow for them, and sometimes +become violent with grief and rage. + +"Regarding the primitive type of mental organization among these +natives,--despite Darwin's first opinion of them, which was subsequently +modified, I consider these people inherently intelligent, though of a very +primitive type as far as their culture is concerned, probably the most +primitive in this hemisphere, perhaps in the world, as the Onas are today +living in the Stone Age. Dr. E. Von Hornbostel of Berlin University, who +has collaborated with me in making a special study of my phonographic +records of their songs, informs me that these songs are the most primitive +American-Indian songs of which they have any record." Of importance for a +clear understanding of the mental traits of these Indian tribes, as the +source from which these attacks develop, are the study of their dreams, +their system of taboos and their myths. So far as could be determined from +the data supplied, the dreams of these primitive races strongly resemble the +dreams of children, as these aboriginal tribes possess many childlike +attributes. In fact up to a certain age the civilized child is really a +little savage, with his strong egotism and feelings of rivalry, his taboos, +his jealousies and his few or no altruistic tendencies. In the child as in +the savage, the wish and the thought are synonymous, both want their desires +immediately gratified, although such gratification may be impossible in +reality. The dreams of the Yahgan Indians are simple wish fulfilments, +without disguise or elaboration, like the dreams of a civilized child. + +The Yahgan attitude toward death is the same as that of many primitive +races. Any reference to death is strongly tabooed amongst them and to +transgress this taboo, exposes the individual to grave danger and severe +punishment, even the punishment of the thing tabooed. Thus the person who +transgresses this taboo becomes himself taboo by arousing the anger or +resentment of other members of the tribe. However, a certain ambivalent +tendency seems to be present, for while the word death and the mention of +the dead is prohibited, yet they feel deep grief and sorrow for dead +relatives. Transgression of the taboo may arouse the other aspect of the +ambivalent attitude, (for instance anger instead of sorrow) and it thus +becomes a source of danger to the guilty individual and so by contagion and +imitation to the community. This ambivalent tendency which leads to taboos +is prominent among primitive races as well as in civilized children for +instance, in the latter, the taboo of pronouncing certain words which leads +to stammering or the taboo of objects possessing a sexual significance in +producing kleptomania. As civilization and cultural advancement increase or +as the child becomes the adult, the taboo tendency gradually declines, yet +under certain conditions it may manifest itself as a psychoneurotic symptom. +Since these particular primitive races have no conception of immortality, +this taboo cannot be a religious or a moral obligation or prohibition, but a +social phenomenon for the benefit of the tribe or for the physical welfare +of the individuals comprising the tribe. Freud also has pointed out how the +avoidence of the names of the dead because of fear of offence to the living +is found among certain South American tribes. + +A third factor of importance is a study of their myths. These are the +savage's day dreams. The relation between myths and dreams is well known, +both having their roots in the unconscious thinking of the race. In the +individual this unconscious mental process produces dreams, in the race and +society, myths. Only one instance will be cited, the legend of the Yahgan +Indians concerning the creation of the first man and woman. When one of the +tribe was asked how the first human being came into the world, he replied +that a long time ago the first man came down from the sky on a rope and +later, the woman followed. Here is a striking instance of how an adult +Indian had applied his knowledge of individual births literally to a cosmic +process, a genuine creation myth as a form of symbolic thinking. There seems +little doubt in this case, that the sky, which to all savages appears like a +bowl, represented the uterus and the rope, the umbilical cord. The +resemblance of this myth to certain birth and parturition dreams, as +encountered in the psychoanalytic investigations of civilized adults, is +certainly striking. + +How is this mass of material to be interpreted? The mental traits of these +people, as shown by an analysis of their taboos, myths and dreams, are very +primitive in organization, in fact, according to Mr. Furlong, they represent +the most primitive types of culture in the world and are today actually +living in the Stone Age. Individuals of such primitive mental traits have +not learned to successfully repress their emotions and hence are liable to +sudden emotional outbursts. Substitution and repression in civilized races +are utilized to cover our complex and multifarious ways of expressing our +social wishes and wants. In the savage there is little or no repression and +substitution, because his desires are simple and easily satisfied. + +These primitive people therefore resemble children, without inhibitions or +repressions and hence their attacks of violence and furor as above described +are sudden emotional reactions, perhaps hysterical, but without any +phenomena of conversion. The relation of the attacks to an unsatisfied +sexual craving is shown by the fact that the attacks occur only in young men +whose libido remains unsatisfied, because according to tribal custom they +are compelled to marry old women, or, in the words of the explorer who lived +among these people, "old derelicts." This factor, combined with the +observation that the victims of the attacks are free from loss of +consciousness and amnesia and the absence of an absolute evidence pointing +to foaming at the mouth or biting of the tongue, would seem to indicate that +the outburst was hysterical rather than epileptic in nature. It would thus +correspond to the Piblokto of the Eskimos as described by Brill. This +resemblance was also noted by the explorer in his comparative description of +the two disorders. + +It seems that the attacks themselves are motivated, not so much by the +actual gross sexual as by an ungratified or only partially gratified love +which would occur in a man who is compelled by social and tribal custom to +marry an old woman. Among the Eskimos this factor is at work in the women, +among the Fuegians in the men. Conversion phenomena were absent, because +their mental organization is very simple, in the same way that childhood +hysteria is free from conversion symptoms or at the most is monosymptomatic. + + + +REFERENCES + +A. Brill--Piblokto or Hysteria among Peary's Eskimos. Journal of Nervous +and Mental Disease, Vol. 40 No. 8--1913. + +S. Freud--Totem und Tabu--1913. + +E. Kraepelin--Vergleichende Psychiatrie. Centralblatt f. Nervenheilk. U. +Psychiatrie. Bd. XV. July, 1904. + + + +TWO INTERESTING CASES OF ILLUSION OF PERCEPTION + +BY GEORGE F. ARPS + +The Ohio State University + +THE first case here reported came to the notice of the writer through the +attending physician; the second case was reported by the father of the child +after the attending physician had failed of satisfactory treatment. The +second case is especially interesting and serviceable in connection with the +phenomenon of visual space perception. + +The first case is that of a boy, nine years of age, healthy, vigorous, who +in his play ground and street reactions parallels that of any normal boy of +his age. Aside from measles and an occasional disturbance of digestion he +has been singularly free from childhood's common diseases. The father and +mother are strong Hanoverian Germans holding with puritanic strictness to +the dogmas of the Lutheran religious faith. So far as is ascertainable there +can be no question of faulty inheritance, at least not so far as the +immediate parents and grandparents enter into the problem. + +The child upon retiring and usually while still wide awake uttered wild +screams of terror. Upon inquiry the child complained of falling and +clutched vigorously to the bed clothes and the arms of the parents. Usually +the phenomenon disappeared when he was taken out of bed and walked about but +reappeared when he lay down. He complained of pain in his eyes, neck and +fore- and after-parts of his head. No amount of persuasion dispelled the +illusion. It should be emphasized that the illusion occurred in full waking +state and rarely as a dream. + +An attempt was made to correlate the illusion with the momentum of the day's +activity. According to the parents the illusion appeared in aggravated form +when the neighborhood boys congregated in a cluster of trees at the edge of +the village and when playing "train" in which case the barn-top functioned +as the locomotive while a high board fence and an adjoining neighbor's barn +functioned as the cars and caboose respectively. + +The village physician offered no explanation. He prescribed a hot bath and +a "closer supervision of the evening meal." The dilatation of the cutaneous +capillaries consequent to the bath lowered the cerebral circulation and to +some extent reduced the intensity of the illusion. + +The cue to the cure appeared when the child, in expressing his fear, +complained because he could not see the parent who sat beside him on the +bed. Upon lighting the room the child seemed pacified but still held tightly +to anything within reach. As a rule the illusion disappeared within thirty +minutes after illumination. It was then suggested that the child be put to +bed in a well lighted room. This was done but the phenomenon reappeared +although in a less aggravated form. Degree of illumination and intensity of +the illusion appeared related. The phenomenon failed to appear at all when a +coal oil lamp was placed beside the bed not over two feet from the child's +head. For six months the boy went to sleep facing the full glare of the +lamp. Gradually the lamp was removed until it occupied a position in the +hall. Whenever the illusion recurred the lamp was replaced in its original +position. + +It is quite probable that the intensity of the visual stimulus (the lamp) +deflected the nervous current from the neural processes underlying the +illusion and thus changed the direction of attention. Any intense +distraction, other than the one employed, would probably have served the +same purpose. At the end of a year and a half the phenomenon entirely +disappeared. + +The second case is that of a six-year-old girl, the daughter of highly +educated parents. With reference to this case two interesting phenomena +were observed: (a) that of mirror-writing of the common variety and (b) +that of ambiguous interpretation of the retinal impressions. + +The phenomenon of mirror-writing here observed parallels that of many other +cases in which the left-right direction is reversed. These commoner cases +take on an added interest when considered in connection with a case of +double space inversion. Such a case is on record.[1] The double inversion +consists in writing all verbal symbols and digits up side down and backward. +In this case the boy had perfect pseudoscopic vision at the beginning of his +school work. Stratton, by a system of lenses, artificially produces the +same distortions and throws some light on the phenomenon.[2] + +[1] G. F. Arps, a Note on a Case of Double Space Inversion. Annals of +Ophthalmology, July, 1914, Vol. XXIII, p. 482. + +[2] Psychological Review, Vol. IV, pp. 341-360 and 463-481. + +It is in the phenomenon of ambiguity in the interpretation of the retinal +eye processes that this case finds its value. At the dinner table the child +complained of the decrease in size of a number of objects in the room, +especially was this true of the apparent size of the father's head. The +frequency of the complaint led the father to seek the advice of an occulist +who pronounced the child's vision perfect in every way. Over and over again +while seated at the dinner table the child would exclaim, "O father how +small your head is!" + +The explanation of this phenomenon is found in the method employed to +dispell the illusion. It was suggested that, at the moment of the +appearance of the phenomenon, the child be requested to fixate the end of +the father's index finger which was revolved, in the air, to form various +geometrical figures. This had the desired effect. Clearly we have here a +case of the object altering its apparent size without altering its distance. +Under normal conditions a change in size is followed by a corresponding +change in the distance. It is probable that we have here inadequate +convergence and that the optic axes do not intersect at the object but +beyond, so that the axes are more or less parallel. Thus the feeling of +convergence is less intense than experience teaches is necessary to perceive +the object as such a size and at such a distance. If degree of convergence +is a criterion for distance and if distance is a measure for the apparent +size of an object then we have the conditions necessary for the appearance +of the illusion. + +Here we have the retinal image constant for the apparent and the real size +of the object (head). Obviously the retinal processes are constant for the +two interpretations of magnitude and the ambiguity is due to the concomitant +factor of convergence. + +The conditions necessary to decrease the real size of an object while still +maintaining an unaltered image are produced without artificial means. +Wheatstone, a long time ago, arranged his stereoscope so that a negative +correlation obtained between the degree of convergence and size of the +retinal image.[3] + +[3] Philosophical Transactions, 1852. + +Very interesting is the fact that Stratton demonstrated by artificial means +what was naturally the case in that of the boy reported in the Annals +referred to above. Wheatstone demonstrated by artificial means what was +naturally the case in that of the girl here reported. + + + +REVIEWS + +FEEBLE-MINDEDNESS, ITS CAUSES AND CONSEQUENCES. By H. H. Goddard. The +Macmillan Co., N. Y., 1914. 599 pp., illustrated. + +Two comprehensive attempts have been made in recent years to study the +inheritance of mental abnormality, one in England at the Eugenics Laboratory +of the University of London, the other in this country under the leadership, +more or less immediate, of the Eugenics Record Office. Both the English and +the American school of workers agree that different grades of mental +ability, mental defect and insanity are strongly inherited. But the two +schools have reached very different conclusions as to the manner of +inheritance of mental traits and mental defects. Each school entertains +profound disrespect for the scientific methods and conclusions of the other +and with the frankness and honesty which devotion to truth demand has freely +criticised the other. By this criticism, at the bottom friendly though +sometimes caustic, science has undoubtedly profited. The later work of each +school begins to show the chastening influence of adverse criticism. + +The English school has leaned backward in its devotion to the inductive +method of accumulating inheritance data, ostensibly without prejudice for or +against any particular theory but in reality with an ill-concealed bias +against anything savoring of "Mendelism." The American school recognizing +in Mendelism a great advance and an important instrument for the discovery +of new truth, has ignored the possibility that other undiscovered laws of +heredity may exist and has cast aside as superfluous the valuable biometric +tools wrought with much patient toil by Galton and Pearson. It will be the +part of wisdom for students of genetics to imitate the hostile attitude of +neither school, but to utilize the positive results of both. This is what +Dr. Goddard has done in the work under review. + +He apparently began studying the inheritance of feeble-mindedness without +theoretical prejudice, but with a practical end in view, to discover, if +possible, the causes of feeble-mindedness so as to deal intelligently with +the inmates of the Vineland (N. J.) institution with which he is connected. +Goddard received inspiration and suggestion from the Mendelian principles +which dominate the work of the Eugenics Record Office, but has published his +observations in detail so that the reader may test by them any theory he +likes. This method can not be too highly commended for it gives permanent +value to the publication, however much prevailing theories may change. The +book contains a detailed study of 327 "cases," each being the family history +of a different inmate of the Vineland institution, as made out by trained +investigators who visited the homes of the inmates and held interviews with +their parents, relatives, friends and neighbors. English criticism of +American work of this sort had prepared the reader to expect carelessness of +method and inaccuracy in the accumulation of data, but Dr. Goddard is +evidently on his guard against this. He goes very fully into the method of +obtaining and verifying the data, and in doing so gives a very strong +impression that the data are "reliable." His treatment of the data is also +cautious but thorough, so that when he works his way to a conclusion it +stands firmly established. The conclusions reached are numerous and +important, but the one of greatest theoretical interest is this, that +feeble-mindedness is inherited as a simple recessive Mendelian +unit-character. This conclusion, so far as earlier publications were +concerned, might be regarded as insufficiently established, but the evidence +presented in this work renders it, I think, beyond question. Goddard was +himself apparently considerably surprised at the conclusion reached. He had +expected to find different kinds or grades of mental defect independently +inherited as units and confesses to leanings toward views of the +physiological independence of different mental functions, but his "cases" +give him no evidence of such inheritance. He finds only that feeble minds +are minds of arrested development in regard to all functions, and that +different grades of feeble-mindedness correspond with different stages of +normal mental development completely arrested. How different grades may +occur in one and the same Mendelian unit is apparently a puzzle to Goddard, +who does not attempt its explanation. It is indeed an absurdity to the "pure +line" Mendelian, but not to one who appreciates the fact that Mendelian +units are subject to quantitative variation sometimes continuous, sometimes +discontinuous. An example of the former is found in the hooded pattern of +rats,[4] of the latter in albinism and other Mendelizing characters which +assume multiple allelomorphic conditions.[5] Pearson has steadfastly refused +to admit that albinism in man is a Mendelizing character, because it may +assume various forms ranging from colorless to quite heavily pigmented +conditions (blondes). We now find that albinism in guinea-pigs shows an even +greater range of variation,[6] yet there can be no doubt of its fundamental +unity as a Mendelian character, each grade of which is allelomorphic to +every other grade and to normal pigmentation. + +[4] Castle and Phillips, 1914, Publ. No. 195, Carnegie Inst. of Wash. + +[5] Castle and Fish, Amer. Nat., Feb., 1915. + +[6] Wright, S. Amer. Nat., March, 1915. + + +Goddard's findings as regards feeble-mindedness fit in perfectly with this +scheme. That Goddard was unaware of it when his conclusions were reached is +all the more evidence of their soundness because it shows that they were +reached independently. Among albinos every higher grade of pigmentation +dominates all the lower grades in inheritance, and so apparently it is with +mental development; the higher grades dominate the lower. At every point +there appears to be agreement in method of inheritance between albinism and +feeble-mindedness. Each is a unit character but showing graded allelomorphic +conditions which correspond probably with different stages of arrested +development of pigmentation or mentality respectively. + +The fact noted by Goddard that the feeble-minded resemble savages, that is +backward races of low mentality, has much interest to the student of +evolution. It indicates that the evolution of intelligence has occurred by +a gradual progressive advancement, stages in which reappear as the higher +grades of feeble-mindedness. Of course it is not certain that the +ontogenetic stages, at which mental development may be arrested, correspond +accurately with earlier phylogenetic stages, but the idea receives +considerable support from the observed resemblance between the mentality of +morons and that of savage peoples, if the observation may be accepted as +accurate. I do not understand however that Goddard makes any claim to +first-hand familiarity with the mental life of savages, so that no great +emphasis should be laid on the point. But the mere fact that RETROGRESSIVE +variation in mentality is GRADED favors the view that its PROGRESSIVE +evolution has been gradual, rather than the view that it has arisen by +mutation or sudden loss of inhibitors. (Bateson, Davenport). + +Goddard points out that a high grade moron may be a useful and +self-supporting member of society in some environments (usually rural) +whereas he would be quite helpless in the keen competition of urban life. +This suggestion leads the reader to wonder whether many peasant and peon +populations of the old and new world represent survivals of an older and +lower grade of mental evolution than has been attained in the more advanced +nations, or whether it is merely lack of opportunity that makes these +populations backward. The fact that in every generation great men come from +the lower social levels shows that the lower classes are not entirely devoid +of capacity; nevertheless it seems probable that a low grade of intelligence +would stand a better chance of escaping elimination in the struggle for +existence when placed in a simple environment than when placed in a complex +one. Consequently, under modern conditions, we might expect a peasant or +peon population to average lower in mental capacity than a community more +advanced in civilization. Whether the peasant population would equal in +average intelligence a band of North American Indians or a tribe of native +New Zealanders is very doubtful, for in such peoples natural selection for +intelligence was undoubtedly severe because of their intense struggle with +nature and with other tribes, unaided by the accumulated knowledge and tools +of civilized communities. Among such peoples greater demands were probably +made on inborn intelligence than among modern industrial populations. + +As regards the CAUSES of feeble-mindedness Goddard's findings are wholly +negative, but not less valuable on that account. His case histories +statistically studied indicate no causal relation to a number of reputed +agencies in the creation of feeble-mindedness, such as alcoholism (which he +regards as oftener a symptom than a cause), tuberculosis, sexual immorality, +insanity, syphilis, accident and consanguinity. He recognizes HEREDITY as +its principal source, i. e. he recognizes feeble-mindedness as a stage of +mentality already existing and transmissible by the ordinary mechanism of +heredity, but does not attempt further to account for it, either as a +survival or as an atavism. + +That humanitarian governments by shielding and supporting the moron without +putting a limit on his naturally high reproduction will speedily increase +this class at the expense of the more intelligent classes of the community +is self-evident, if it is admitted that feeble-mindedness is hereditary, as +all who have investigated the matter carefully now declare. Goddard shows +further that a large percentage (probably more than half) of the alcoholism, +pauperism, prostitution, and crime, of the United States are directly +traceable to hereditary feeble-mindedness, another strong reason for taking +measures to reduce it. + +How is this to be done? Goddard has no cure-all to offer but urges first of +all that the mental grade of each individual be accurately determined and +education and occupation be provided suited to his capacity. This will tend +to make the moron a useful and contented member of the community, not a +menace to it. Segregation is recommended so far as practicable, but in view +of the large number (estimated at 300,000 to 400,000 in the U. S.) Goddard +considers segregation of all impracticable. Nevertheless he urges further +and energetic efforts in this direction, that as many as possible may be +segregated as a safeguard against their reproduction. In individual cases +"sterilization wisely and carefully practiced" must be employed to insure +non-reproduction. + +In this volume there is a pleasing absence of the rant which pervades some +eugenic literature. The author has something of importance to contribute to +science and he presents his contribution in a sober, dignified manner in +keeping with the important character of his contribution. W. E. CASTLE. + + + +CHRISTIANITY: THE SOURCES OF ITS TEACHING AND SYMBOLISM. By J. B. Hannay. +(Francis Griffiths, London; pp. 394). + +This is an attempt to expound the symbolism of the Christian religion. It is +divided into three main parts: ancient cults (phallism and sun worship); +ancient cults in the Old Testament; ancient cults in the New Testament. The +author's main thesis can be stated in a sentence: the essential constituents +of every religion, and the underlying meaning of its symbolism, are +phallicism and sun worship. Of these the former is the more important, more +primary, and more wide-spread; the latter is a superimposed layer better +adapted to more civilized and educated people, but rarely penetrating into +the hearts of the common people to the extent that the former has. "The +great branches under which all the religious systems of the past have +developed may be classed as based, on the one hand on the consideration of +our world and the continuity of life upon it, expressed in Phallic +symbolism, and on the other hand, on the Sun as the great giver and +sustainer of man, expressed in Solar symbolism." (p. 21). "As the Phallic +cult was much the older, it retained its position after the rise of the +Solar cult. It required a much higher intelligence to grasp the facts of +Solar worship, so it never entered the 'hearts' of the common people as did +the Phallic worship, but it had a much more intelligent priesthood, and was +the arbiter in all questions of dates, and regulated al) feasts; and, what +was more important to the people, fixed the time for payments of debts or +interest, and regulated the times of sowing and harvesting, so it became a +much more 'official' religion than Phallism." In support of these +conclusions the author marshals a huge number of facts, so that the work +becomes a veritable encyclopaedia of symbolism. + +Now in spite of the fact that the reviewer fully accepts the main thesis of +the book, as stated above, and therefore has no prejudice or hostility on +the score of the conclusions encunciated being distasteful, his judgment of +the book is entirely unfavourable, for the following reasons: In the first +place, any presence of the book to be a scientific, and therefore impartial, +contribution to knowledge is invalidated by the author's moral bias evident +from beginning to end, against religion in general, and Christianity in +particular, which he maintains is the most phallic of all religions. His +point of view is that of the older rationalists, to whom religion is nothing +but an unfortunate instinct for "delight in the miraculous," expressing +itself in phallic and sun worship, and fostered by the exploiting tendencies +of priests. His desire seems to be, in writing the book, to "show up" +religion and, by discrediting it, hasten its end. + +In the second place, there is not a single new idea in all its closely +packed pages, and therefore no excuse for writing them, since the material +here laboriously brought together is easily accessible in other books. It +never seems to dawn on the author that pointing out the sexual basis of +religion, which countless other writers have already done, is but the +beginning of the problem, the starting-point of all sorts of complex +riddles. Having dogmatically divided all religious symbols into male and +female, he is self-satisfied enough to think that he has explained religion. +There is no inkling of the points of view suggested by such words as +determinism, significance, genesis, so familiar to the modern psychologist. + +Side by side with all this goes a disorderly arrangement and very imperfect +powers of criticism. The latter feature is especially marked in the field +of etymology, where the author fairly lets himself run wild. The following +gem is a typical example (p. 110): "Bacchus became degraded into the God of +Wine, and his fetes became drunken orgies, but he was originally the +beneficent sun who ripened the fruits, and hence God of Wine, from which, +indeed, is derived the English name of all our gods, angels, prophets, or +even parsons,--"divines," "dei vini," "Gods of Wine." Jesus was the "True +Vine." + +The merits of the book are that it may direct the attention of some people +to the connection between sex and religion, if there are any who are still +unaware of this, and that it possesses a good index that may be useful to +readers with limited facilities for looking up particular symbolisms; it is +also well illustrated. ERNEST JONES. + + + +LAUGHTER: AN ESSAY ON THE MEANING OF THE COMIC. Henri Bergson. Translated +by C. Brereton and F. Rothwell. (Macmillan, London, 1913. Pp. 200). + +In this stimulating little book Professor Bergson propounds his theory of +the comic, which is shortly to the following effect. Noting first that +laughter is purely a human phenomenon, and therefore probably has a social +significance, he seeks for this by trying to define what are the essential +features of the comical. He reduces the various characteristic features in +the main to one, namely, automatism on the part of the comical person or +thing. This automatism is of a special kind; especially is it an automatism +that is out of place, that occurs at the expense of spontaneity, vitality, +and freshness. It may thus be defined as "something mechanical in something +living," "a kind of absentmindedness on the part of life." "The comic is +that side of a person which reveals his likeness to a thing, that aspect of +human events which through its peculiar inelasticity, conveys the impression +of pure mechanism, of automatism, of movement without life." "To imitate +anyone is to bring out the element of automatism he has allowed to creep +into his person. And as this is the very essence of the ludicrous, it is no +wonder that imitation gives rise to laughter. "This bald statement of +Bergson's conclusion is, in the reviewer's opinion, made very convincing by +the delicate analysis he proffers of numerous illustrations. + +Up to this point Bergson's theory of the comic fairly well coincides with +that of Freud. The latter author, it is true, summarises his conclusions in +different language. But the meaning is not very different. For him the +feeling of comicality is an "economy of ideational expenditure," and it is +evoked by the sight of another person who in a given performance displays +either a lack of mental activity or an excess of physical, i.e., who is +either stupid or clumsy. Compare this formulation with Bergson's. The latter +says that the opposite of the comic is gracefulness, rather than beauty. "It +partakes rather of the unsprightly than of the unsightly, of rigidness +rather than of ugliness." The replacement of mental by physical activity is +insisted on in the following passage: "Any incident is comic that calls our +attention to the physical in a person, when it is the moral (i. e. mental) +that is concerned." Again, he compares a comical person to "a person +embarrassed by his body." His automatism is essentially a lack of mental +nimbleness, a formal lack of mental elasticity, a defective capacity for +rapid adjustment, in short, a mental laziness. And especially is this defect +one of consciousness. The failure is on the part of the higher mental +activities, which should be the most alert, and what happens is a relapse +into unconscious, automatic modes of functioning, a form of absentmindness. +"The comic is that element by which the person unwittingly betrays +himself--the involuntary gesture or the unconscious remark. Absentmindedness +is always comical. Systematic absentmindedness, like that of Don Quixote, +is the most comical thing imaginable . . . . . . . No one can be comical +unless there be some aspect of his person of which he is unaware, one side +of his nature which he overlooks; on that account alone does he make us +laugh." + +In substantial agreement on this general conclusion as to mental rigidity +and bodily clumsiness, the two views diverge from here. According to +Bergson, the comic presupposes "something like a momentary anaesthesia of +the heart;" "laughter is incompatible with emotion." For Freud this absence +of emotion is much more characteristic of humour than of the comic, two +matters that Bergson quite fails to distinguish. Then, whereas Freud +explains the subjective side of the comic purely on hedonic principles, +Bergson sees in it an important social function. According to him, laughter +is one of society's weapons for dealing with tendencies that threaten to +diverge from the conventional and accepted norm. It "restrains eccentricity" +and "corrects unsociability." "Any individual is comic who automatically +goes his own way without troubling himself about getting into touch with the +rest of his fellow-beings. It is the part of laughter to reprove his +absentmindness and wake him out of his dream . . . . Each member must be +ever attentive to his social surroundings; he must model himself on his +environment; in short, he must avoid shutting himself up in his own peculiar +character as a philosopher in his ivory tower. Therefore society holds +suspended over each individual member, if not the threat of correction, at +all events the prospect of a snubbing, which, although it is slight, is none +the less dreaded. Such must be the function of laughter. . . . It represses +separatist tendencies." "Unsociability in the performer and insensibility +in the spectator--such, in a word, are the two essential conditions." This +interesting theory leaves some questions unanswered. Why, for instance, +should onlooking society remain emotionally cold in one case, and merely +laugh, and in another case adopt much graver measures? Bergson deals with +this point rather imperfectly. It is not the seriousness of the case that +decides, for "we now see that the seriousness of the case is of no +importance either: whether serious or trifling, it is still capable of +making us laugh, provided that care be taken not to arouse our emotions." +Nor is it the immoral nature of the deviation from the normal. "The comic +character may, strictly speaking, be quite in accord with stern morality. +All it has to do is to bring itself into accord with society." "It is the +faults of others that make us laugh, provided we add that they make us laugh +by reason of their UNSOCIABILITY rather than of their IMMORALITY." The most +specific criterion seems, in Bergson's opinion, to be that of vanity. "It +might be said that the specific remedy for vanity is laughter, and that the +one failing that is essentially laughable is vanity." + +We may briefly refer to some other matters dealt with more incidentally; +wit, and the relation of the comic to art and to dreams. The discussion of +wit is perhaps the weakest part of the book. No analysis is given of the +different forms of wit, and the important subject of what may be called its +technique is quite passed by. Wit is identified in a superficial manner with +the comic in general, the fundamental differences between the two, which +Freud has dealt so exhaustively with, being altogether ignored. Bergson +gives a more interesting and profitable study of the relation of the comic +to art; especially of the nature of comedy as distinct from other forms of +drama. According to him, comedy portrays character types rather than +individual persons. He repeatedly insists on this point, adding that "it is +the ONLY one of all the arts that aims at the general; so that once this +objective has been attributed to it, we have said all that it is and all +that the rest cannot be." Further, "comedy lies midway between art and +life. It is not disinterested as genuine art is. By organizing laughter, +comedy accepts social life as a natural environment, it even obeys an +impulse of social life. And in this respect it turns its back upon art, +which is a breaking away from society and a return to pure nature. "The +discussion of the relation of the comic to dreams is, on the other hand, +less satisfying. Comic absurdity is stated to be of the same nature as that +of dreams. The main point of resemblance seems to be that in both cases +there occurs an absence of social contact. In both there is a mental +relaxation from the effort of "seeing nothing but what is existent and +thinking nothing but what is consistent." This really applies much more to +wit than to the comic itself. + +As may be expected, the whole book is written in Professor Bergson's +pleasing style, and is full of suggestive hints and fresh points of view. +The most significant contribution, one which pervades the book throughout, +is the view of laughter as a social censor. Even if this hypothesis is +substantiated by detailed investigation, however, it cannot rank as a +complete theory of laughter, or of the comic, until it is supplemented by +some explanation, not given by the author, of the most striking feature of +laughter, its capacity for yielding pleasure. + +It only remains to say that the translation is literally excellent. ERNEST +JONES. + + + +ADDRESSES AND PAPERS AT THE OPENING OF THE PHIPPS PSYCHIATRIC CLINIC, JOHNS +HOPKINS HOSPITAL. The American Journal of Insanity, Special Number, Vol. +LXIX, No. 5. The Johns Hopkins Press, 1915. + +This special number of the American Journal of Insanity contains the +exercises and papers delivered at the opening at the Phipps Psychiatric +Clinic at the Johns Hopkins Hospital, Baltimore, Md. The contents of the +entire volume should prove to be of the greatest interest to all students +and lovers of psychiatry. The volume opens with a brief but fitting +Introduction by Dr. Adolf Meyer, Director of the Clinic, a man to whom +American psychiatry owes so much for the stimulus and inspiration which he +has injected into others. This is followed by A Word of Appreciation by +Henry D. Harland, President Trustees, The Johns Hopkins Hospital, some brief +remarks on The Psychiatric Clinic and the Community by Stewart Paton, the +heart-to-heart talk on Specialism in the General Hospital by Sir William +Osler, and a short talk on The Purpose of the Psychiatric Clinic by Prof. +Adolf Meyer. There then follow a series of fascinating and inspiring +papers, as follows: The Sources and Direction of Psychophysical Energy, by +William McDougall; Autistic Thinking by E. Bleuler; Personality and +Psychosis by August Hoch; The Personal Factor in Association Reactions by +Frederic Lyman Wells; A Study of the Neuropathic Inheritance by F. W. Mott; +On the Etiology of Pellagra and its Relation to Psychiatry by O. Rossi; +Psychic Disturbances Associated with Disorders of the Ductless Glands, by +Harvey Cushing; Primitive Mechanisms of Individual Adjustment by Stewart +Paton; Demenzprobleme by K. Heilbronner; The Inter-relation of the +Biogenetic Psychoses by Ernest Jones; Prognostic Principles in the +Biogenetic Psychoses, with Special Reference to the Katatonic Syndrome by +George H. Kirby; Anatomical Borderline between the So-called Syphilitic and +Metasyphilitic Disorders in the Brain and Spinal Cord by Charles B. Dunlap; +and Mental Disorders and Cerebral Lesions Associated with Pernicious Anemia +by Albert Moore Barrett. The number is concluded by the penetrating Closing +Remarks of Prof. Adolf Meyer. + +The papers by Mott, Rossi, Cushing and Heilbronner are of the greatest +interest. The discussions by McDougall and Bleuler are fascinating and +uplifting. McDougall's paper is a masterpiece. Kirby, Jones and Hoch +present us with the modern standpoints in the conception of the psychoses. +Throughout the volume one sees the adoption of the broad biological +standpoint in mental life. The adoption of the term "biogenetic psychoses" +is indicative of the general trend. The adoption of this well-chosen phrase +is, I venture to suggest, the product of Dr. Meyer. + +The reviewer regrets that the papers do not very well lend themselves for +brief reviews. Furthermore, he would not attempt to briefly present the +views which have been so lucidly and succinctly expressed by the individual +writers. + +Prof. Meyer is to be commended for the very splendid program presented at +the opening exercises of the Phipps Psychiatric Clinic. + +May it be a lasting inspiration for those who drink at the fountain of +psychiatry and psychopathology. MEYER SOLOMON. + + + +BOOKS RECEIVED + +SLEEP AND SLEEPLESSNESS. By H. Addington Bruce. Pp. IX + 219. Little, Brown +& Co., 1915. $1.00 net. + +THE MEANING OF DREAMS. By I. H. Coriat. Pp. XIII + 194. Little, Brown & +Co. $1.00 net. + + + +THE JOURNAL OF ABNORMAL PSYCHOLOGY + +A PSYCHOLOGICAL ANALYSIS OF STUTTERING[*] + +[*] Paper read May 6, 1914, at Albany, New York, before the American +Psychopathological Association. + +Copyright 1915 by Richard G. Badger. All rights reserved. + +BY WALTER B. SWIFT, A.B., S.B., M.D. + +Instructor in Neuropathology, Tufts College Medical School, In Charge Voice +Clinic, Boston State Hospital, Psychopathic Department. + +THE object of this paper is to carry the analysis of stutter phenomena +deeper than before. In my last year's paper I showed that chronologically +the diagnosis of dyslalia mounted step by step from a material external +affair, up through the nerves until we came to the basal ganglia. I showed +conclusively that it was an involvement that did not exist in any of these +places. I further took steps to demonstrate and present evidence that +indicated that dyslalia was in its essence some trouble with the +personality. I mean by this: that the trouble was located in the nervous +system beyond the lower sensory areas of the sensorium; and also above the +lower motor areas on the motor side. By the broad term "personality" I mean +the total of the activities and interrelations of mental activities that +occur above our lower sensory and motor areas. The paper of last year +clearly located the trouble vaguely in this region of the personality. + +Since that time I have been interested to ascertain just what the nature of +this changed personality is. In order to do so, I have carried on an +investigation that has reached interesting conclusions. To me it is new +truth. It may not be all the truth, but as far as it goes, and as for what +it is, it surely is truth and a new finding! This research is an effort to +show not only where it is but WHAT IT IS. + +The method was as follows: For the purpose of finding out some of the +activities going on in the area of collaboration during speech, I asked my +stuttering patients two simple questions. I thus found that their methods of +collaboration complied to a certain mental type. + +Then I carried this same method into the study of normal individuals in the +collaboration of their ideas, just before and during speech in order to +establish a norm; and to see whether or not it differed from my preliminary +test of stuttering cases just mentioned. It did, and therefore I formulated +a series of questions in order to pin the type of collaboration down to +certain fields of mental action. To make this clear, let me present an +outline of these different steps in tabular form. + + 1. Orientation tests on stutterers. + 2. Orientation tests on normal individuals. + 3. The research, its objects and methods. + 4. Final detailed results. + +Let us now pass to a minuter description of each of these procedures and a +tabulation of the data that resulted. + +1. PSYCHOLOGICAL ORIENTATION TESTS ON STUTTERERS: + +By orientation test I mean simply a vague try-out to see just where the +problem lies; an initial step to see what further steps are necessary; or in +other words enough of an investigation to know where to look next. + +The orientation tests consisted in requesting a series of twenty stuttering +cases to answer two questions. Following their answers an immediate +inspection was made of the content of their consciousness before, during, +and after speech. These two questions were as follows: + + 1. Where do you live? + 2. Say after me "The dog ran across the street." + +After these questions I asked the patients to state whether there was any +picture in the content of consciousness and how long it lasted; also whether +that was detailed, intense or weak. I noted the presence of stuttering in +relation to the presence or absence of this mental imagery; and also made a +note of any other unusual data that happened. The results of the tests +indicated above can be summarized as follows: + +Of the twenty stutterers examined, ten made no visualization of their homes, +some even after a residence of years; one of these twenty visualized home +very faintly; two others visualized home clearly but the picture vanished on +speaking; seven others visualized home clearly but these had been under +treatment. + +On repeating the dog statement, ten stutterers made no visualization +whatever; one visualized faintly; four visualized well but the picture +vanished on speaking; five others reported visualization, and four of these +had been under treatment. + +At first I did not know but what this was the norm of average visualization +methods; so I tried this same series upon a number of normal individuals for +comparison; by normal individuals, I mean, at this time, merely anyone who +is free from stuttering, and chosen in a haphazard way from the hospital +community; for example, one was our executive secretary, another a +typewriter, another a telephone operator and so on. + + + +2. PSYCHOLOGICAL ORIENTATION TESTS ON NORMAL INDIVIDUALS + +The results of these orientation tests upon normal individuals were as +follows: + +The normal individuals examined almost without exception visualized clearly +before and during speech. Sometimes this visualization was very marked in +detail and resulted in emotional responses, such as pleasures, etc. + +From the above two sets of figures were thus obtained a fair norm of +visualization for ordinary individuals; and in comparison a marked variation +from this in stutterers. This data therefore warranted the tentative +conclusion that stutterers have a loss or diminished power of visualization. +This assertion may seem a little more than is warranted by such meagre data +and perhaps would be better revised pending further data into the following: +As compared with the normal, stutterers show a weakness in visualization. + + + +3. THE RESEARCH, ITS OBJECTS AND METHODS: + +These general orientation tests for a norm and its pathological variation +were the basis upon which I proceeded on broader lines with a further and +more exhaustive investigation with the following points in view: + + +To what extent is visualization weak? + +Is it weaker in the worst cases? + +Is it less and less weak as cases appear less severe? + +Is it the same for past, present and future memories? + +Is visualization equally at fault in all sensory areas of the cortex? + +Do cases approach normal visualization processes in proportion as they +progress in their cure? and + +Lastly, numerous other minor queries presented themselves. + +All these questions were answered in the following research, which after +thus much orientation found a more complete and final form. + +In order to answer these questions I formulated the following series of +tests to the number of twenty-four in all, and asked them in series to +nineteen stutterers, making almost four hundred tests: + + 1. Speech: + Say, Today is sunny. + The dog ran across the street. + Submarines will sink all the steamers. + + 2. Motor: + Do you dance? + Did you ever skate? + Would you sew for a living? + + 3. General Sensory: + How does a pinch feel? + Did you ever get hurt? + What would you like to do if it was very hot next summer? + + 4. Hearing: (Eyes closed) + Do you hear anything? + Did you ever hear a rooster crow? + What sounds would you like to hear next summer? + + 5. Sight: (Eyes closed) + What do you see now? + What did you see yesterday? + What would you like to see next summer? + + 6. Smell: (Eyes closed) (Pen to nose) + Do you smell anything? + What have you told by smell? + What would you like to smell next summer? + + 7. Taste: (Eyes closed) + Do you taste anything? + What have you been able to tell by the taste? + What would you like to taste next summer? + + 8. Muscle Sense: (Eyes closed) + Put one arm up; the other like it. + Put one arm up, down; the other like it. + How would you hold a hand to read from it? + +This long series of questions with careful introspection tests upon the +content of consciousness constituted then my main research in the field of +stuttering. Perhaps further details in explanation of the questions chosen +is unnecessary. Three or more questions on introspection were asked at each +test. + +4. FINAL DETAILED RESULTS are found in the following conclusions as drawn +from 1440 answers. + +In our average conversation a visual picture is created before we begin +utterance. Severe stutterers never visualize at all. In direct proportion +that these cases become less severe, does visualization increase in +frequency, strength and continuation in consciousness before and during +utterance. + +When severe stutterers are free from spasms they visualize, and when they +stutter they do not visualize. + +When mild cases are free from spasms, they visualize, and when they stutter +they fail to visualize. + +In a word, when visualization is present stuttering is absent; when +visualization is absent stuttering is present. + +This is true not only of EACH UTTERANCE, in most cases, but is true of +severe as well as mild forms as a whole. + +Stutterers gain in visualization as they approach cure. + +For past, present and future memories: visualization is slightly more +frequent for past and future. + +Therefore stuttering is an indication of absent or weak visualization either +in isolated words, occasional stutterers, mild stutterers or the severest +type, either before or during speech, or both. + +The slump, then, in personality which I showed last year as the main thing +in stuttering as its cause and condition, is thus found by further +psychological analysis, to be a slump in the power to consciously visualize. + +By personality I mean as mentioned above the composite of collaborative +activities that lie between the low sensory repository areas and the low +motor expression areas. In other words, personality includes all those +collaborative processes that lie between the sensory intake areas and the +motor output areas; in a word, any unexpressed use the mind makes of its +intake. Conscious visualization is a part of personality processes, then. In +my last year's paper([1]) the whole matter was left vague. Here something +definite and constant is found. In other words the psychoanalytical method +revealed no conscious subconscious cause. Granted there is room here to +"interpret" (or create according to Freudian mechanisms) a definite +subconscious complex, a step which I could not feel justified in taking; I +leave this to better psychoanalysts than I. For me to twist stutter +phenomena to comply to a theoretical complex is unscientific to say the +least. But the psychological method--as represented by this paper--shows a +definite constant cause for all the phenomena of stuttering. + +FAULTY VISUALIZATION EXPLAINS ALL PHENOMENA: + +Upon this basis of an involved visualization all the intricate phenomena of +stuttering may be explained. Let us take some of these up in detail. + +THE START. Visualization processes are a matter of growth through exercise +and development and use from the sensory area mostly of the eye. If these +processes in their early start and evolution receive a setback through the +treatment of people in the environment, such as interruptions of their early +speech efforts, constant inattention of those to whom they speak, and +persistent refusal by older people to answer questions propounded or the +allowing of the little one to ask the same question without hopes of answer +for a great number of times, these visualization processes receive a +setback. This kind of treatment in the home is one of the chief causes of +the slump of visualization processes. Another cause is hearing other +stutterers interrupt their own visualization processes as they stutter; and +still other minor causes may be almost any psychic trauma; these traumata, +such as an operation, an accident or a severe illness, are sufficient to +bring to the surface or intensify a growing lack of visualization that has +been started by bad environment long before. + +THE DEVELOPMENT OF STUTTERING. When the habit of visualization is lessened, +the action upon speech is the same as the withdrawal of an inhibiting or +regulating reflex arc. + +It is thus that visualization processes act like reflex inhibition. When +visualization is present a higher inhibition arc is functioning and we have +a normal speech as a consequent reflex expression. When and in proportion as +visualization is absent this higher inhibition arc is not functioning; and +the speech thus uncontrolled flies away in spasms which we call stutter. It +should be called an exaggerated or uninhibited speech reflex. + +The stutter, then, is merely the externalization of an exaggerated reflex of +motor speech, exaggerated through the loss of the inhibitory action of a +more or less weakened visualization process. + +Not only does this explain the phenomena at large but seems to be a +satisfactory explanation for all its intricate, minute details. Some +examples may, perhaps, be welcome at this point. I say to two stutterers: +"Tell your first name." One of them stutters and the other one does not. +On furthering questioning, it is found that the one who did not stutter +visualized, and the one who did stutter did not visualize. + +CONCRETE: These conditions are also seen when stutterers talk about +concrete and abstract matters or when they promulgate some important plea +that cannot be visualized. On concrete matters that can be easily visualized +the stuttering is gone; and on abstract matters where visualization is hard, +the stuttering again appears. + +ANGER: In anger, when an intense visual picture is presented and occupies +the mind, there is then no stuttering, and also in other similar situations +there are periods when the individual is abandoned to some visual concept +which acts in the same manner. + +SINGING: We all know that stutterers can sing without stuttering. The +process here is a similar one; only that there is held up over the speech +before utterance an auditory image of a melody in place of the visual image +as held in normal speech. This auditory image may be more easily applicable +as supplying the needed inhibition reflex arc than the visual because it is +nearer to the speech area. + +PRAYER: For the same reason prayer is uttered without stuttering when there +is faith enough in a God to hold an image of Him during utterance. There may +also be other images held during prayer. + +FAMILIAR SIGHTS: Familiar sights are less stuttered upon than the detailing +of situations that are less familiar and therefore can be less well +visualized. This is also true of sights that have been recently seen or +that have been repeatedly seen, or that in some other way have been made +intense as pictures in the visual field. + +AS CURE PROCEEDS: In the process of recovery where visualization is seen to +increase as the stutter decreases, there is another illustration where this +visualization attitude explains the whole situation. I have taken a severe +stutterer and told him a story that could be well pictured, got him to work +up the pictures properly by several complicated processes (which we will not +consider now) and when he had them well in hand, I have seen him stand up +and relate the story from beginning to end with little or no stuttering If +at any point he would trip up, the inevitable confession would be that at +that point he dropped the picture, or, in other words, the visualization +could not be held over in its inhibitory action; and therefore the stutter +came. On further request to hold it over that point, the same passage would +be again expressed smoothly if he succeeded in holding the picture. + +This constancy, this presence and absence of the picture, its presence to +make smooth talk and its absence to cause stuttering, is so constant at +every turn of the situation, that I would offer it as a new interpretation +of all these phenomena. I know of no other interpretation that can EXPLAIN +EVERYTHING UNDER ONE HEAD as does this absence, weakness or interruption of +visualization processes. + +TERMINOLOGY. We have found in our orientation tests that in a vague way the +visualization was at fault. We have also found in normal individuals that a +marked visualization was an automatic process that preceded speech, and +lasted during utterance; and we have found in the long series of stutterers +that visualization is entirely absent in severe cases; that it is weak in +milder forms; that it is intermittent in most cases, and that on words that +are smooth it always appears, and in occasional stutter it is as +occasionally absent. + +We have also found that the form of visualization common in normal speech is +the visualization of eye sensations; that in unusual situations we may have +visualizations from other sense areas, such as the ear, taste or smell, but +these are the RARE EXCEPTION. + +From all this data it would naturally follow that some sort of term is +needed to designate this condition. Last year I probed to find such a term +without much success. + +At present I see no reason why it should not be called an Asthenia; it is +surely the weakening of a mental process that is strong in normal +individuals. The evidence here presented shows that. I doubt whether there +is any marked pathological change, since the individual may be educated out +of it; but this does not necessarily follow as proven with my dog in +Berlin.[2] As a general designation, then, I should consider Asthenia as +apropos. + +One objection to this is that the weakness is by this terminology lacking in +localization. Our data above has shown us that the location of the trouble +is visual; that is, it is situated about a centre of sensory registration +that deposits data from the eye; this must naturally then be located +somewhere in or near the cuneus. We could therefore add to the terminology +this idea of a minute localization and call it a Centre Asthenia. + +Some may prefer to carry the matter one step farther and add the name of the +centre in which this weakness is located, but I fear if I take this step and +complete my terminology by the word "Visual Centre Asthenia," it will, as +such, not cover quite all the cases, for I find that sometimes the +visualization is absent in other areas as well, and also the holding of an +emotion of pleasure or pain and of other dominating mental attitudes that +are sometimes visualized would not, therefore, be included. I would +therefore retract the broader claim in order to place the term on a +conservative basis and call the essence of the lesion simply no more or less +than a Centre Asthenia. As well as visual Asthenia, the following terms +might be considered as applicable: collaborative centre asthenia; +imaginative centre asthenia; visual creative centre asthenia; picture +producing centre asthenia. We say neurasthenia when the trouble is not in +the nerves as such, so much as it is in the collaborative centres. More of +this later. Here in stuttering the trouble is also collaborative, and we +can be still more definite than that and say the trouble is with the +collaboration of visualization. So if I were forced, however, to choose one +term from all these, my choice would be "Visual Centre Asthenia." This +indicates a new and rational treatment. But of this later. + +SUMMARY: Psychoanalysis reveals stuttering as some vague trouble in the +personality[1]. Psychological Analysis shows stuttering is an absent or weak +visualization at the time of speech. This new concept of stuttering as +faulty visualization may be called Visual Centre Asthenia. This lack or +weakness in visualization accounts for all the numerous phenomena of +stuttering in severe, medium, or mild cases. A new treatment is indicated. + + + +REFERENCES + +[1] Swift: Walter B, A Psychoanalysis of the Stutter Complex with Results +of Synthesis. + +[2] Swift Walter B., demonstration eines Hundes, dem beide Schafenlappen +xtirpiert worden Sind. Neurologisches Centralblatt, 1910, no 13. + + + +THE ORIGIN OF SUPERNATURAL EXPLANATIONS[*] + +[*] Read at the 7th Annual Meeting of the American Psychopathological +Association, New York, May, 1915. + +BY TOM A. WILLIAMS, M. B., C. M. (EDINBURGH) + +Corresponding Member Neurol. and Psychol. Societies of Paris, etc. +Neurologist to Freedmen's Hospital and Epiphany Dispensary, Lecturer on +Nervous and Mental Diseases, Howard University, Washington, D. C. + +THERE is a general impression that the explanations of natural phenomena, +including human destinies, to which the term superstitious is given are +usually attributable to the vestiges of traditional cosmogonies of our +tribal ancestors handed down to children at the knees of their parents or +guardians. This explanation however, is only true of a portion of the +beliefs which we call superstitions. The demand for superstitious +explanations depends upon psychophysiological tendencies of the human +organism, the root of which is comprised in the affect which we call +craving. This theorem I have tried to develop as follows:-- + +I + +Craving is a sign of physiological need. It is a sensory phenomenon, of +which, however, explicit awareness cannot always be discovered. It is +conspicuously noticed in cases of disturbance of the body secretions, such +as occurs in over-function of the thyroid gland. It is regarded as a crude +body-consciousness that something is the matter. In motorial organisms it +causes visible reaction: this expresses itself in what is termed +restlessness. But the unrest may show itself by a fixation more particularly +in the muscles of emotional expression, although the manifestation is not +confined to these; shallow respirations and restricted amplitude of movement +in limbs and trunk may be observed also. In cerebrate animals the reaction +of the individual is under the guidance of preceding impressions stored in +the pallium and known as memories; whereas in the animals without a pallium +all reaction is accomplished through stable mechanisms known as instincts. +Both of these types of reaction are tropisms merely; but the former are +labile, conditionable; whereas the latter cannot be modified. The science of +conditionable reactions of cerebrate animals is called psychology, and the +means by which the reactions are influenced are called psychogenetic, +whether these are healthy or diseased. It must not be forgotten, however, +that the genesis of a psychological disturbance may be purely somatic, +although the manner in which the reaction shows itself is contingent mainly +upon the features of the individual which have been derived from previous +sensory impressions and their resultant motor reactions commonly known as +experience. It is the influence of these upon the hereditary dispositions of +the individual which constitute what is known as "make-up" or character; and +it is this which determines the form which reaction to stimulus must take, +whether the stimulus is purely psychological or somatic. + +Now physiological discomfort is an experience universal at one time of life +or another; but the reaction to it is infinite in variety; and while part of +it depends upon the congenital dispositions which are the common property of +humanity, a larger part is contingent upon the psychogenetic factors which +have stamped the individual. + +II + +Now an influence which has been of great significance to every human being +since the traditional period, at least, has been the concept of the universe +regnant at the period of that individual's life. The insistence by its +protagonists upon this concept as the ultimate motive of human endeavour +made its acceptance almost universal at periods when it was the custom to +lean upon the dicta of authority for guidance in life even when blind +obedience was not the rule. Now in natural affairs, inconvenient +questionings and scepticisms towards dogmatisms would ultimately reach +truth. But as inaccessibleness to verification of what was called +supernatural made authority, rather than investigation, its criterion, +excommunication from the tribe would still all criticism.[1] Thus every act +of life became permeated by motives, originated in arbitrary interpretations +of a super-nature. + +[1] A dramatic study of this occurrence is presented by Grant Allen in "The +Story of Why-Why" in his book "The Wrong Paradise." + +These influences were specially conspicuous concerning the difficulties of +man's almost blind struggle against the uncomprehended astronomical and +geodetic phenomena marvelled at and fled from, as well as the pestilences +which ravaged him. In his sociological affairs too, every act or thought +became embued with relationship to an extraneous power. + +It is by these social and physical phenomena that the greatest appeal is +made to the states of feeling termed emotions and sentiments. So that it +became the custom to invoke, concerning ill states of feeling, the reference +to a supernatural influence. Thus, from the cradle up, the ordering of +social relationships was made dependent upon the simple expedient of the +supernatural extraneous agent, rather than upon the more difficult and +elaborate analysis and synthesis which would have been required for a proper +investigation of each perturbing circumstance in its relation to life as a +whole. The power of this influence was inversely proportional to the +resiliency and tenacity as well as the general well-being of the individual. + +But not only is reference to the supernatural favoured by traditional +cosmogony, but because of certain psychological features of the individual +himself there is a tendency towards supernatural explanations of the +introspective observations. The Occasions of introspection of this kind are +two, and I am not speaking of the inculcated introspection of the moralists. +One of these Occasions is the self-examination into his conduct which is a +normal character of a thinking being. This may give rise to supernatural +explanations even when the introspection is not determined by the tradition +of which I have already spoken. + +The second kind of Occasion demanding introspection, is the autochthonous +emanation of feeling of unaccustomed character. Such feelings occur at the +physiological epochs;--but at these times they are readily explained in a +familiar and simple way, and hence no supernatural agency is usually +invoked. A similar explanation is made readily enough in cases of evident +bodily disease, even where mental symptoms are prominent, for it is no +longer the custom to speak of demon-possession even in the acute deliria. +But even where no physiological epoch or clearly defined physical disease +stands forth, unusual feelings are no uncommon phenomenon, and they demand +explanation. Such occur conspicuously in the psychopathological syndrome so +completely described by Janet under the term psychasthenia. Persons thus +afflicted feeling an incapacity and an impediment to their free activity and +not recognizing that they are sick, endeavour to interpret their feelings. +Of course, the interpretation varies somewhat in accordance with the nature +of the feelings, and with the person's information about the world and his +psyche. But quite apart from modifications of this type, I have found it +very common for patients to declare "I feel as if there was another person +in me," or "I feel compelled as if by another agency to act thus." The +explanation of a supernatural agent weighing upon them becomes very easy. +For the purpose of this discussion, it is not important whether +psychasthenia arises purely from degeneration of structure, or from faults +in the chemistry of the plasma which bathes the nerve structures, or whether +it is a purely psychopathological condition to which the physical phenomena +are secondary, as some would have us believe. Our object is merely the +setting forth of the fact that it is a diseased condition which disposes its +victim towards metaphysical explanations. + +It is a sort of uneasiness which prevents comfort in the feelings of +certainty, in the operations of the intellect and decision of action. The +patient finding himself abulic, and perhaps too critical minded to accept +the mundane supports in his vicinity, seeks a solace in that which to him +seems powerful because incomprehensible, that is to say in something +supernatural. + +For this, it is not essential that the victim's mind be pervaded by the +infantine cosmogony which parades often as religious truth. Without anything +of the sort, there may arise naive interpretations, hardly even having +explicit reference to supernatural agents. For example, a patient may say +"If I begin on Friday, a certain undertaking will fail," "If I do not turn +my vest twice, misfortune will occur," "It is incumbent upon me to turn +round in my chair, or the negotiations will fail." The enumeration of +expedients would be useless. The above are from three different patients, +one a boy of fourteen now completely cured; the second from the son of a +prominent public man now quite restored to health; the third from a case +still under care. In none of these was the bodily state of importance, the +psychological reactions were the sole object of therapeutic effort, and +their ordination was accomplished by purely psychological means. + + + +DATA CONCERNING DELUSIONS OF PERSONALITY WITH NOTE ON THE ASSOCIATION OF +BRIGHT'S DISEASE AND UNPLEASANT DELUSIONS.[*] + +[*] Presented in abstract at the Sixth Annual Meeting of the American +Psychopathological Association, held in New York City, May 5, 1915. Being +Contributions of the State Board of Insanity, Whole Number 47 (1915. 13). +The material was derived from the Pathological Laboratory of the Danvers +State Hospital, Hathorne, Massachusetts, and the clinical notes were +collected by Dr. A. Warren Stearns, to whom I wish to express my +indebtedness but to whom no one should ascribe the somewhat speculative +character of the present conclusions. (Bibliographical Note.--The previous +contribution was State Board of Insanity Contribution, Whole Number 46 +(1915.12) by D. A. Thom and E. E. Southard entitled "An Anatomical Search +for Idiopathic Epilepsy: Being a First Note on Idiopathic Epilepsy at +Monson State Hospital, Massachusetts," accepted by Review of Neurology and +Psychiatry, 1915.) + +E. E. SOUTHARD, M. D. + +Pathologist, State Board of Insanity, Massachusetts; Director, Psychopathic +Hospital, Boston, Mass., and Bullard Professor of Neuropathology, Harvard +Medical School, Boston, Mass. + +ABSTRACT + +Previous work on somatic delusions. Suggestion that allopsychic delusions +are as a rule in some sense autopsychic. A genetic hint from general +paresis (frontal site of lesions in cases with autopsychic trend.) Mental +symptomatology of general paresis. Work on fifth-decade psychoses. +Statistical summary. Group with pleasant (or not unpleasant) delusions. +Three cases of senile dementia, delusions of grandeur, and frontal lobe +changes. Three cases with religious delusions. Remainder of +pleasant-delusion group. Group with unpleasant delusions. Nephrogenic +group. + +THE suggestions here put forward concerning personal (autopsychic) delusions +are based on material of the same sort as that previously analyzed for a +study of somatic and of environmental (allopsychic) delusions. Our +conclusions are also influenced by two analyses of the types of delusion +found in general paresis. Moreover, at a period subsequent to the analysis +presented here, some work on fifth-decade insanities had been completed, and +the delusional features constantly found in the functional cases of insanity +developing at the climacteric, entered to modify our general point of view. + +The situation may be summed up as follows: + +The accessibility to analysis of the clinical and anatomical data at the +Danvers State Hospital was such as to prompt the use of its card catalogues +for statistical work upon delusions. The more so, because in a period of +enthusiasm over the Wernickean trilogy (autopsyche, allopsyche, +somatopsyche) of conscious phenomena, the Danvers catalogue had attempted to +divide the delusions recorded into the three Wernickean groups. Putting +these clinical data side by side with the anatomical data, we were speedily +able to single out those cases with normal or normal-looking brains and thus +to secure a group approximately composed of functional cases of insanity. + +It shortly developed, as to the CONTENT of delusions, that somatic delusions +were exceedingly prone to parallel the conditions found in the trunk-viscera +and other non-nervous tissues of the subjects at autopsy.) A subsequent +study has confirmed this conclusion for the distressing hypochondriacal +delusions found in climacteric insanities, which delusions, however +distressing, are often far less so than the true conditions found at +autopsy. And it may be generally stated that the clinician can get very +valuable points concerning the somatic interiors of his patients by +reasoning back from the contents of their somatic delusions. + +But how far can we, as psychiatrists, reason back from the contents of +environmental delusions, e. g. those of persecution, to the actual +conditions of a given patient's environment? In a few cases it seemed that +something like a close correlation did exist between such allopsychic +delusions and the conditions which had surrounded the patient--the delusory +fears of insane merchants ran on commercial ruin, and certain women dealt in +their delusions largely with domestic debacles. But on the whole, we could +NOT say that, as the somatic delusions seemed to grow out of and somewhat +fairly represent the conditions of the some, so the environmental delusions +would appear to grow out of or fairly represent the environment. + +Thus, however brilliant an idea was Wernicke's in constructing the +allopsyche (or, as it were, social and environmental side of the mind) for +the purpose of classification, our own analysis promised to show that for +genetic purposes the allopsyche was much less valuable. These delusions +having a social content pointed far more often inwards at the personality of +the patient than outwards at the conditions of the world. And case after +case, having apparently an almost pure display of environmental delusions, +turned out to possess most obvious defects of intellect or of temperament +which would forbid their owners to react properly to the most favourable of +environments. Hence, we believe, it may be generally stated that the +clinician is far less likely to get valuable points as to the social +exteriors of his patients from the contents of their social delusions than +he proved to be able to get when reasoning from somatic delusions to somatic +interiors. Put briefly, the deluded patient is more apt to divine correctly +the diseases of his body than his devilments by society. + +Our statistical analysis, therefore, set us drifting toward disorder of +personality as the source of many delusions apparently derived ab extra and +tended to swell the group of autopsychic cases at the expense of the +allopsychic group, + +In the statistical analysis of a group of cases corresponding roughly with +the so-called functional group of diseases, we find false beliefs about the +some on a somewhat different plane from those about the patient's self and +his worldly fortunes. We can even discern through the ruins of the paretic's +reaction that his false beliefs concerning the body are often not so false +after all, and that his damaged brain of itself is not so apt to return +false ideas about his somatic interior as about his worldly importance and +plight. There then seems to be more reality about somatic than about +personal delusions: the contents of somatic delusions are rather more apt to +correspond with demonstrable realities than the contents of personal +delusions. Accordingly our analysis of delusional contents includes a hint +also as to genesis. Taken naively, the facts suggest a somatic genesis for +somatic delusions exactly in proportion as these delusions are not so much +false beliefs as partially true ones. + +What genetic hint have we for the delusions concerning personality? One +genetic hint was obtained from a correlation of delusions with lesions in +general paresis,[2] in which disease perhaps the most profound and +disastrous of all alterations of personality are found. Amidst the other +alterations of personality found in paresis, autopsychic delusions are +characteristic: indeed allopsychic delusions are conspicuously few in our +series. And, as above, the somatic delusions, fewer in number, can be +fairly easily correlated with somatic lesions, or else with lesions of the +receptor apparatus (thalamus) of the brain. + +Now it was precisely the cases with autopsychic delusions, as well as with +profound disorder of personality in general, that showed the brunt of the +destructive paretic process in the frontal region. The other +not-so-autopsychic cases did not show this frontal brunt, but were less +markedly diseased at death and had a more diffuse process. + +Our genetic hint from paresis, therefore, inclines us to the conception that +this disorder of the believing process is more frontal than parietal, more +of the anterior association area than of the posterior association area of +the brain. And if we can trust our intuitions so far, the perverted +believing process is thus more a motor than a sensory process, more a +disorder of expression than a disorder of impression, more a perversion of +the WILL TO BELIEVE than a matter of the rationality of a particular credo. + +Again we may appear to burst through from an undergrowth of statistics into +the clear field of truism. False beliefs are more practical than +theoretical, more a matter of practical conduct than of passive experience, +more a change of reagent than a reaction to change. The man on the street or +even many a leading neurologist would perhaps accept this formula as his +own. + +Certainly in general the least satisfactory of these chapters on the nature +of delusions was the chapter on environmental effects,[3] and this perhaps +because the results seemed so nearly negative. + +A further contribution to delusions of environmental nature was somewhat +unexpectedly derived from a piece of work on the general mental +symptomatology of general paresis.[4] Dichotomizing the paretics (all +autopsied cases) into a group with substantial, i. e., encephalitic, +atrophic or sclerotic lesions of the cortex and a group without such gross +lesions or else with merely a leptomeningitis, I found the latter (or +anatomically mild) group to be characterized by a set of symptoms which were +all "contra-environmental," whereas the former (or anatomically severe) did +not thus run counter to the environment. The conclusions of that paper, so +far as they concern us now, are as follows:-- + +The "mild" cases showed a group of symptoms which might be termed +contra-environmental, viz. allopsychic delusions, sicchasia (refusal of +food), resistiveness, violence, destructiveness. + +The "severe" cases showed a group of symptoms of a quite different order, +affecting personality either to a ruin of its mechanisms in confusion and +incoherence, or to mental quietus involved in euphoria, exaltation, or +expansiveness. + +The most positive results of this orienting study appear to be the +unlikelihood of euphoria and allied symptoms in the "mild" or non-atrophic +cases and the unlikelihood of certain symptoms, here termed +contra-environmental, in the severe or atrophic cases. Perhaps these +statistical facts may lay a foundation for a study of the pathogenesis of +these symptoms. Meantime the pathogenesis of such symptoms as amnesia and +dementia cannot be said to be nearer a structural resolution, as these +symptoms appear to be approximately as common in the "mild" as in the +"severe" groups. + +But in both papers dealing with paresis [2,4] we rest under the suspicion +that the delusions are possibly of cerebral manufacture. Of course, a lesion +somewhere outside the brain is not unlikely to be projected through the +diseased brain, and SOMATIC delusions in the paretic are rather likely to +represent something in the viscera. + +It was desirable to get back to normal-brain material, to learn how the +INTRINSICALLY NORMAL brain[5] could perhaps produce delusions from a +particular environment. Could a particularly "bad" environment actually +PRODUCE delusions? + +By chance, at about this stage in our studies of delusions, some work on +fifth-decade insanities[6] was completed. This work seemed to show that the +most characteristic (non-coarsely-organic) cases of involutional origin were +much given to delusions (each of 24 cases studied), somewhat more so than to +the hypochondria and melancholia which we commonly ascribe to the involution +period. But this result is equivocal as to the environmental (i. e. +allopsychogenic) power to produce delusions, since one could not rid oneself +of the suspicion that the delusions were due to the degenerating brain. + +To return to our former results with the normal-looking brain: + +Case after case of the quasi-environmental group proved to be more +essentially personal than environmental, until at last it almost seemed that +the environment could seldom be blamed for any important share in the +process of false belief. In short, we seemed to show that environment is +seldom responsible for the delusions of the insane. + +Be that as it may, we secured several lines of attack on the delusions of +personality by our study of quasi-environmental delusions. First, we were +irresistibly led to a consideration of the emotional (pleasant or +unpleasant) character of the delusions. We heaped up a large number of +unpleasant delusions in that (quasi-environmental, but actually) personal +group. It is interesting to inquire, accordingly, whether our more obviously +autopsychic cases will also be possessed of an unpleasant tone. Secondly, we +came upon the curious fact that cardiac and various subdiaphragmatic +diseases were correlated with unpleasant emotion as expressed in the +delusions. It was therefore important to inquire whether similar conditions +prevailed in the new group. Thirdly, we found ourselves inquiring whether +our patients were victims of what might be termed a spreading inwards of the +delusions (egocentripetal) or a spreading outwards thereof (egocentrifugal +delusions). But this difference in trend, clear as it often is from the +patient's point of view, remains to be defined from the outsider's point of +view. + +Again, it remains to determine, if possible, how far delusions are dominated +respectively by the intellect or the emotions, or even by the volitions. + +As before, I begin with a brief statistical analysis. + +SUMMARY + +Danvers autopsy series, unselected cases 1000 +Cases with little or no gross brain disease 306 +Cases listed as having autopsychic delusions 106 +Cases listed as having only autopsychic delusions 50 +Cases for various reasons improperly classified 13 +Cases of general paresis in which gross brain lesions were not observed 15 +Residue of autopsychic cases 22 + +The group of 22 cases thus sifted out can be studied from many points of +view. We may recall that our former study of allopsychic delusions proved +that a large proportion of delusions concerning the environment were in all +probability not essentially derived from the environment. Their contents +might relate to the environment, but their genesis could better be regarded +as autopsychic (intrapersonal). In fact we really found only 6 out of 58 +cases of pure allopsychic delusions, which could be safely taken as showing +so much coincidence between anamnesis and delusions that a correlation could +be risked. + +Following the method of our former work on somatic and on environmental +delusions, we sought in the first instance PURE cases of autopsychic +delusion-information. For a variety of reasons, more than half of the +original list, namely, 28 cases, had to be excluded. Many of these +exclusions were due to the strong suspicion that the cases were really cases +of general paresis, despite the normality of the brains in the gross. The +residue of 22 cases include, we are confident, no instance of exudative +disease of the syphilitic group, though general syphilization cannot safely +be ruled out in all cases. + +There are two groups of cases, a group of eleven cases with delusions of a +generally pleasant or not unpleasant character (in which group there is a +small sub-group of three cases of octogenarians with expansive delusions +reminding one of those of general paresis) and a group of eleven cases with +delusions of an unpleasant character. + +I. CASES HAVING DELUSIONS OF A NATURE PLEASING OR NOT UNPLEASING TO THE +BELIEVER + +The true emotional nature of the beliefs placed in this group cannot fairly +be stated to be pleasurable. But, if not pleasurable, they may perhaps be +stated to be complacent, expansive, or of air-castle type. The criteria of +their choice have been largely negative: the patients are not recorded as +expressing beliefs of a painful or displeasing character: in the absence of +which we may suppose the beliefs to be either indifferent or actually +pleasing in character. + +Of the 11 cases whose delusions were supposedly of an agreeable nature or at +least predominantly not unpleasant, there were 3 with delusions reminding +one of general paresis. The ages of these three were 80, 84, and 87 +respectively. They did not show any pathognomonic sign (e.g. plasma cells) +of general paresis. They all showed in common very marked lesions of the +cortex, including the frontal regions (in two instances the extent of the +frontal lesions was presaged by focal overlying pial changes) .999 was a +case of pseudoleukemia with marked cortical devastation but without brain +foci of lymphoid cells. Two of the cases showed cell-losses more marked in +suprastellate layers; in the third there was universal nerve cell +destruction, with active satellitosis caught in process. + +Condensed notes concerning the cases with pseudoparetic delusions follow. +Two of them, it will be noticed, yielded some delusions also of an +unpleasant nature. + +CASE I. (D. S. H. 10940, Path. 999) was a clever business man, Civil War +veteran, who began to lose ground at 75 and died at 84. He was given during +his disease to boasting and perpetual writing about elaborate real estate +schemes and said he owned a $100,000 concern for the purpose. + +The case was clinically unusual in that the picture of a pseudoleukemia was +presented, with demonstration at autopsy of great hyperplasia of +retroperitoneal lymph nodes and grossly visible islands of lymphoid +hyperplasia in liver and spleen. The brain weighed 1390 grams and showed +little or no gross lesion, if we except a pigmentation of the right +prefrontal region under an area of old pias hemorrhage. There was also a +chronic leptomeningitis, with numerous streaks and flecks along the sulci, +especially in the frontal region. There was little or no sclerosis visible +in the secondary arterial branches and but few patches in the larger +arteries. Microscopically the cortex proved to be far from normal: every +area examined showed cell-loss, perhaps more markedly in the suprastellate +layers than below. + +CASE 2. (D. S. H. 11980, Path. 1024) was a Civil War veteran who failed in +the grocery business, was alcoholic, was finally reduced to keeping a +boarding-house and grew gradually queer. Mental symptoms of a pronounced +character are said to have begun at 75. Death at 80. Delusions reminded one +of general paresis: worth $5,000,000 a month, 108 years old, was to build a +church: also, a woman was trying to poison him. + +Autopsy showed caseous nodules in lung, coronary and generalized +arteriosclerosis (including moderate basal cerebral), mitral and aortic +stenosis (the aortic valve also calcified). The frontal pia mater was +greatly thickened and, although no gross lesions were noted in the cortex, +the microscope brings out marked lesions in the shape of cell losses +(especially in suprastellate layers) in all areas examined. There were no +plasma cells in any area examined. + +CASE 3. (D. S. H. 12767, Path. 1185) was a widowed Irish woman, who died at +87. Previous history blank. Extravagant delusions of wealth were +associated with a fear of being killed. + +The autopsy showed little save chronic myocarditis with brown atrophy, +calcification of part of thyroid, non-united fracture of neck of left femur, +moderate coronary arteriosclerosis. The brain was abnormally soft (some of +the larger intracortical vessels showed plugs of leucocytes possibly +indicating an early encephalitis--Bacillus cold and a Gram-staining bacillus +were cultivated from the cerebrospinal fluid.) Though the convolutions were +neither flattened nor atrophied and absolutely no lesion was grossly +visible, the cortex cerebri and also the cerebellum were found undergoing an +active satellitosis with nerve-cell destruction in all areas examined. + +The following three cases (IV, V, VI) present a certain identity from their +delusions concerning messages from God (V thought he was God). It is very +doubtful whether VI should be placed in the present group of Pleasant or Not +Unpleasant Delusions, since the patient appears to have been "theomaniacal" +as the French say, in a rather passive and unpleasant manner (God occasioned +foolish actions!) Placed on general statistical grounds at first in the Not +Unpleasant group, Case VI should be transferred to the Unpleasant group. +Case V's delusion (identification with God, expression of atonement?) was in +any event episodic in a septicemia. Case IV ("happiest woman in the +world"), was phthisical (cf. VII) Notes follow: + +CASE 4. (D. S. H. 4019, Path. 218) Housewife, 37 years always cheerful, +became the happiest woman in the world, hearing God's voice and being +specially under God's direction. "Acute mania." Death from bilateral +phthisis with numerous cavities and bilateral pleuritis. There were no +other lesions except a small sacral bed-sore, a small fibromyoma of the +uterine fundus, small slightly cystic ovaries, a slight dural thickening, +and possibly a slight general cerebral atrophy. (wt. app. 1205 grams, +marked emaciation.) + +CASE V. (D. S. H. 11742, Path. 852) was a victim of streptococcus septicemia +(three weeks) who said he was God. Patient was a Protestant iron-worker of +59 years, who had lost an eye and had become unable to work about three +months before death. Aortic, cardiac, renal lesions at autopsy. Prostatic +hypertrophy. Dr. A. M. Barrett found few changes in nerve cells, except +fever changes. One area in left superior frontal gyrus showed superficial +gliosis. + +CASE VI. (D. S. H. 5345, Path. 867) was a "primary delusional insanity," a +salesman of 37 years, whose beliefs concerned impressions direct from God, +in consequence of which he habitually knelt and prayed. Yet many of the +actions which he felt he must perform were foolish actions. The patient +died of pneumococcus septicemia during a lobar pneumonia. The brain showed +a few changes suggestive of fever (A. M. Barrett). There were a few flecks +of atheroma in the aorta. There was an acute parenchymatous nephritis with +focal plasma cell infiltrations suggesting acute interstitial nephritis. +This case appears to have shown one of the most nearly normal brains in the +whole Danvers series. + +The remainder of the Pleasant or Not Unpleasant Group as originally +constituted consists of VII, a phthisical case (cf. IV), VIII, probably +feeble-minded romancer, not deluded in the sense of self-deception (probably +best excluded from present consideration); IX, probably not safely to be +assigned to the Pleasant or Not Unpleasant Group, feeling passive in +somewhat the same sense as Case VI (see above), suffering from auditory +hallucinosis (superior temporal atellitosis, data of the late W. L. +Worcester); X, delusion of birth to superior station, possibly the object of +mixed emotions, probably not pleasant; and XI, manic-depressive exaltation +with grandiose utterances, long prior to death (if there had been lung +tuberculosis at the basis of the ileac ulcers, it had long since healed). + +Notes follow (VII-XI) and at the end a brief summary of the entire group +(I-XI). + +CASE 7. (D. S. H. 8878, Path. 521) It is questionable whether the delusions +classified in this case entitle it to inclusion in the present study. e.g. +"I was baptized in the Catholic Church (patient a Protestant housewife) with +holy water, ink, and Florida water." Patient was variously designated, as +"dementia" and as "acute confusional insanity." Death in second attack at 26 +(first attack at 22). Father also insane. Death due to bilateral ptthisis +with tuberculosis of intestines and mesenteric glands, emaciation. It is +noteworthy that the brain weighed but 1038 grams. Dr. W. L. Worcester's +microscopic examination showed acute nerve cell changes probably of the type +of axonal reactions. + +CASE 8 (D. S. H. 8807, Path. 556) very probably a feeble-minded subject. At +all events patient had done no work in his life, had been given to spells of +restlessness and excitement, and had talked disconnectedly. Symptoms were +thought to have dated from the tenth year. It is questionable whether a +statement that he was managing the Electric Railway and Shipbuilding Company +can be regarded as delusional, that is, as believed by the patient. Death +was due to (perhaps septicemia from one abscess of jaw and to hypostatic +penumonia), the brain appeared normal but Dr. W. L. Worcester found, besides +certain acute changes, also satellitosis. The question remains open whether +the case should be regarded as defective or as belonging to the dementia +praecox group. + +CASE 9. (D. S. H. 8605, Path. 568) had an ill-defined attack of mental +disease and was in D. S. H. at 29. Thereafter, lived in Gloucester +Almshouse, but at 51 became excited and was returned to D. S. H. where she +died at 59. Possibly hallucinated: someone called her mother (single +woman). Delusion: the spirit is here (Protestant). Patient was given to a +stream of muttered, vulgar and incoherent talk. Possibly the case was +residual from hebephrenia. Dr. W. L. Worcester found cell changes in the +superior temporal gyri (finely granular stainable substance in practically +all nerve cells) and not elsewhere. The correlation is suggestive with the +probably auditory hallucinosis. The brain weighed 1190 grams. Death due to +bronchopneumonia. Heart and kidneys normal. + +CASE 10. (D. S. H. 10145, Path. 928) a Danish fisherman possibly +manic-depressive, victim of three attacks at 40, 50, and 69 years. The first +attack followed loss of wife, and delusions concerning being born again +developed. The last attack showed few well-defined delusions, as patient +was in a bewildered and incoherent state. One statement is characteristic: +if patient had remained in Denmark, he might have inherited the throne. The +autopsy showed most extensive arteriosclerosis, including basal cerebral. +Death from general anasarca and jaundice. (cholelithiasis). There was some +question of an acute encephalitic lesion in the tissues lining the posterior +half of the third ventricle. Various chronic lesions (splenitis, +endocarditis, diffuse nephritis), malnutrition. + +CASE 11. (D. S. H. 7767, Path. 792) was a case possibly of manic-depressive +type (previous attacks Hartford Retreat and Danvers State Hospital) who +worked as machinist between attacks and died at 70, having been in D. S. H. +8 years. Patient was greatly emaciated and anemic from chronic ulcers of +ileum. There was also cholelithiasis. There was a mild coronary atheroma +and slight mitral valve edge thickening. + +The delusions expressed were those of great wealth. Patient also thought he +was a great poet. No brain changes were found (A. M. Barrett). + +Having attempted on the basis of certain statistical tags to constitute a +group of cases having relatively normal brains and pleasant (or not +unpleasant) delusions, we are forced to reconstruct our group upon viewing +several cases more attentively. + +Case VIII should be excluded as probably not delusional. + +Case X might perhaps be transferred with propriety to the +unpleasant-delusion group. + +Certain cases of felt passivity under divine influence separate themselves +out from the group; indeed VI and IX probably belong in the +unpleasant-delusion group (see below). + +These subtractions leave seven cases to deal with. Three of these seven, +viz. I, II and III, are apparently best regarded as examples of frontal lobe +atrophy, and their grandiosity may resemble that of certain cases of general +paresis. + +Of the remaining four, two, Cases IV and VII, are phthisical; one, Case VI, +showed an episodic identification with God (incident in fatal septicemia), +and one, Case XI, uttered manic-depressive exalted statements about wealth +and poetical power. + +I turn to a consideration of the unpleasant-delusion group, which as first +constituted was to contain eleven cases (XII-XXII) but to which must be +added three more (VI, IX, X). + +Case XII should be at once excluded from present consideration on account of +its microscopy. + +CASE 12. (D. S. H. 12282, Path. 942) died in a second attack of depression +(manic-depressive insanity?). Catholic, always of a quiet and reserved +disposition, happy in married life. Delusional attitude concerning an +abortion which she said she had induced. "Soul lost," "I'll see hell." + +Autopsy: Death from gangrene of lung and acute fibrinous pericarditis. +Erosion of cervix uteri. The edema of the brain, irregular pink mottlings +of white substance, and an exudative lesion of one focus in the pia mater of +the right side suggested an encephalitis more marked on the right side. +Microscopically a few small vessels showed plugs of polynuclear leucocytes. +The nerve cells were affected by various acute changes. The visuo-psychic +portion of an occipital section (right) showed suprastellate cell-losses of +a somewhat focal character + +Of the remaining ten (XIII-XXII), one, Case XIII is another of mixed +emotions ("am Eve and have to suffer;" "in Purgatory;" etc) of a religious +type. It is the only case in the unpleasant group with phthisis pulmonalis, +(combined, however, with abdominal tuberculosis and nephritis). + +CASE 13. (D. S. H. 7361, Path. 499) was a somewhat defective Catholic woman +(mother insane) always of a melancholy and reserved temperament. She had +been ill-treated by husband, child had died, another had followed soon. She +developed a belief that she was Eve and had to suffer. At hospital decided +that she was in purgatory and expressed a variety of other religious +beliefs. She also thought she was ill-treated at hospital. Her head was +asymmetrical: skull thick and eburnated. Brain (1130 grams described as +normal). Chronic interstitial nephritis. Pulmonary and mesenteric +tuberculosis. + +Of the remaining nine (XIV-XXII) all had grossly evident kidney lesions +except two (XIV and XV). Of these two, XIV probably had renal +arteriosclerosis and was in any case very gravely arteriosclerotic in +general and suffered from cystitis. Case XV died apparently of starvation +with hepatic atrophy; it is a question whether "poverty" was or was not a +delusion. Notes of XIV and XV follow: + +CASE 14. (D. S. H. 8741, Path. 500) was a German teacher, college-bred, of +a reserved and melancholy turn of mind (mother insane). An attack at 39, +another at 70. "Both poor wife and son will starve." "Perhaps they should +be put out of reach of poverty," later felt he "had caused death of wife and +son on account of his expensive living." Autopsy: chronic internal +hydrocephalus, cerebral arteriosclerosis. Brain weight 1180 grams. Coronary +sclerosis with calcification throughout, aortic and pulmonary valvular +calcification hypertrophy of heart. Cystitis. + +CASE 15. (D. S. H. 4454, Path. 237) was presumably a manic-depressive case, +had in all four attacks, and died in the fourth attack (66 years). The day +he arrived at the hospital, having not eaten for several days at the end of +several months of delusions of poverty the case was called "acute +melancholia," and the cause of death assigned was starvation. The liver +weighed 1102 grams and was fatty. There was a diffuse thickening and +clouding of the pia mater, and the dura was firmly adherent everywhere to +the skull. + +Notes follow of seven cases (XVII-XXII) which show many lesions, are in a +number of instances cardiorenal and in all instances renal. If it is +permitted to count XIV also as renal, a list of eight cases out of the +original list of eleven unpleasant-delusion cases is obtained in which +nephritis of some type has been found. Case XIII, nephritis and phthisis, +belongs also in the renal group. + +CASE 16. (D. S. H. 4168, Path. 226) feared death and refused food on the +ground that she should not eat. Patient had always been of a despondent and +reserved nature (sister also insane) and, after her husband's death, when +she was 53, grew unable to carry on her house, dwelt constantly on griefs, +entered hospital at 61, and died at 64 ("chronic melancholia"). Death from +internal hemorrhagic pachymeningitis. The liver of this case weighed 1074 +grams and was fatty. There was chronic interstitial nephritis. + +CASE 17. (D. S. H. 4707, Path. 498) originally cheerful and frank, lost her +situation as companion, grew despondent at failure to get employment, had a +"hysterical" attack at 52. It is doubtful whether her beliefs were +delusional: "can never be better," "will not be taken care of," "no place +for her." "Subacute melancholia. "The autopsy showed gastric dilation (over +3000 cc.), and an atrophic liver and pancreas, and slightly contracted +kidneys. The heart was normal. Death from ileocolitis. Moderate chronic +internal hydrocephalus. Dr. W. L. Worcester's microscopic examination showed +rather unusual degrees of nerve cell pigmentation (precentral and +paracentral). + +CASE 18. (D. S. H. 8898, Path. 570) was an unmarried daughter of a fire +insurance company president. Both her mother and she developed mental +disease after the company failed (Boston and Chicago fires). Both mother and +father died, and patient was in several hospitals after 36, obscene, +denudative, onanist. Delusions concerning crimes committed. Satyriasis. +Could hear fire kindled to burn her. Diagnosis, "secondary dementia." + +Death at 54 from bilateral bronchopneumonia. Atrophic uterus. Cystic right +ovary with twisted pedicle: atrophic left ovary: contracted kidneys. The +brain was not abnormal in the gross-- but showed (Dr. W. L. Worcester) some +acute changes (also larger cells pigmented). + +CASE 19. (D. S. H. 10106, Path. 663) a cheerful Irish house-wife (mannerism +of drawling words) underwent a maniacal attack at 41, and another at 44. +Delusions: "sorry she had lived": "broken her religion" Given to self +recrimination. + +Autopsy: Death from hypostatic penumonia. Healed gastric ulcer. Moderate +arteriosclerosis, slight cardial hypertrophy. Granular cystic kidneys. +Mucous polyp and subperitoneal fibromyoma of uterus. The brain was +macroscopically normal, but showed superficial gliosis (frontal and +precentral) and thinning out of medullated fibers superficially (frontal). + +CASE 20. (D. S. H. 8963, Path. 679) an epileptic shoe-maker, 50 years, was +of the belief that he was sent to Hospital for hitting a boy and was to be +executed. + +Autopsy: Aortic and innominate aneurysm, hypertrophy and dilatation of +heart. Interstitial nephritis. The brain, normal macroscopically, proved +microscopically to show, in all areas examined, superficial gliosis. There +was gliosis in parts of the cornu ammonis, but no demonstrable nerve cell +loss (interesting in relation to the epilepsy). + +CASE 21. (D. S. H. 4584, Path. 861) cabinet-maker of melancholy +temperament, Civil War veteran. Said to have been feeble-minded after six +months in rebel prison. Violent at times for twenty years. Did no work, +thought "soul lost." + +Death from pneumococcus and streptococcus septicemia. Chronic diffuse +nephritis. The brain was described grossly as normal: but microscopically +there was marked superficial gliosis in all areas examined and considerable +cell loss in suprastellate layers of precentral cortex. The calcarine +sections show little or no cell-loss. But one section from the frontal +region is available (right superior frontal). This shows little cell-loss +except in the layer of medium-sized pyramids. + +CASE 22. (D. S. H. 8250, Path. 909) an unmarried woman without occupation, +two attacks of "melancholia" at 36, and 40. Always of a retiring and shy +disposition. Mental disease began after father's death. Delusions (if +such): has been selfish and wicked. Constant self condemnation. Suicidal. +Exophthalmic goiter. + +Autopsy: Thyroid glandular hyperplasia. Mitral sclerosis. Aortic sclerosis +with ulceration. Chronic endocarditis. Chronic diffuse nephritis. Scars of +both apices of lungs, with small abscess of left apex. Emaciation. Brain +weight 1050 grams. No gross lesions described; microscopically profound +alterations; extreme or maximal cell-losses in small and medium-sized +pyramids in both superior frontal regions. Smaller somewhat less marked +cell-losses elsewhere. + +Upon reviewing the unpleasant-delusion group, then, we exclude one (XII) +altogether. It is questionable whether XV actually exhibited delusions at +all. We then discover that eight (in all probability all) of our nine +remaining cases are renal in the sense of grossly evident lesions at +autopsy. + +But it will be remembered that we transferred three cases originally thought +to entertain "not-unpleasant" delusions to the unpleasant group, because +their constraint, although conceived to be of divine origin, seemed to be +unpleasant (VI, IX, X). Of these VI and X were renal cases; but IX is +expressly stated by a reliable observer (the late Dr. W. L. Worcester) to +have had normal kidneys as well as heart. In point of fact, however, Case IV +had hallucinations and religious delusions ("spirit is here") probably +derived therefrom, and Dr. Worcester found an isolated brain lesion +correlatable with the hallucinosis; and in any event the emotional state of +the patient is in grave doubt. + +Accordingly if we take the unpleasant-delusion group to be constituted of +Cases VI and X (transfers from the first group), XIII, XIV, and XIV to XXII, +that is eleven cases, we come upon the striking fact that virtually all of +them are renal cases. + +Of course, as (with Canavan) I have been at some expense of time to prove, +virtually ALL cases of psychosis (as autopsied) are in a microscopic sense +abnormal as to kidneys.[7] But only about a third exhibit GROSS interstitial +nephritis, arguing a certain severity of process. The above cases, it will +be observed, fall into the GROSS class in respect to renal lesions. + +Without laying too much stress on such results, it is worth while to say +that, whereas most workers might be willing to surmise that metabolic or +catabolic disorder must affect the sense of well-being, I must confess that +the discovery of so much gross kidney disease in a group selected on other +grounds filled me with a certain surprise. + +The literature is not without suggestions as to the possible correlation of +renal and mental disorder. Ziehen,[8] for example, remarks that nephritis +brings about mental disease in two ways,--through vascular changes which +very frequently accompany chronic nephritis and other uremic changes in the +blood. Inasmuch as we know that creatin, creatinin and potassium salts +irritate the animal cortex, Ziehen notes that psychopathic phenomena may +occur in man as a result of slight uremic changes. According to Ziehen, most +of these nephritic psychoses run the course of what he calls hallucinatory +paranoia (it may be remembered that Ziehen counts among paranoias a number +of acute diseases and even so-called Meynert's amentia). Chronic nephritis, +as well as acute diabetes and Addison's disease are thought by Ziehen to +produce certain chronic forms of mental defect which he terms autotoxic +dementia, but he regards most of these cases as really cases of +arteriosclerotic dementia. + +It does not appear that Wernicke[9] has considered renal correlations +systematically. + +Kraepelin[10] mentions the epileptiform convulsions of uremia as well as +delirious and comatose conditions, especially those in advanced pregnancy. +These uremic conditions may be both acute and chronic. But Kraepelin has +not been able to convince himself of the existence of a clearly defined +uremic insanity unless the delirious condition just mentioned may be +regarded as such + +Binswanger[11] states that the mental disorders occurring in acute and +chronic nephritis are either toxemic psychoses on uremic bases, or due to +arteriosclerosis. In the latter cases, he states that the disease pictures +are as a rule characterized by grave disturbances of emotions, chiefly of a +depressive character. He adds that these are all too frequently the +forerunners of arteriosclerotic brain degeneration. + +A brief mention of renal disease in the general etiology of mental disease +is made by Ballet.[12] Ballet states that Griesinger's opinion that renal +disease had little importance in the etiology of mental disease and that no +one would count the cerebral symptoms of Bright's disease as mental is no +longer held. Ballet enumerates a number of works upon so-called folie +brightique which tend to prove that acute or chronic Bright's disease gives +rise either to melancholic disorder or alternately to maniacal and +melancholic disorder. How the mental disease is produced is doubtful. +Ballet holds that all the various psychopathic disorders resulting from +Bright's disease are autotoxic. Renal disease like heart disease is only +capable of awakening a latent predisposition or liberating a constitutional +psychosis, unless it is merely effecting a species of intoxication. + +It cannot be doubted that the relation of kidney disorder to mental disorder +is worth intensive study, of which the present communication is merely a +fragment. Progress will be of course impeded by the fact that upon +microscopic examination, practically all cases of mental disease coming to +autopsy show renal disease of one or other degree; in fact, it is perhaps +possible to show a higher correlation of renal disease with mental disease +than of brain disease to mental disease. Perhaps something can be obtained +if we limit ourselves to a study of cases with pronounced somatic renal +symptoms and signs, cases with the renal facies and the like. + +As to the question of phthisis and mental disease, Ziehen remarks that the +tuberculous are often observed to be optimistic but that other cases show a +hypochondriacal depression with egocentric narrowing of interests. He +speaks of a sort of rudimentary delusional disorder looking in the direction +of jealousy in certain cases. Pronounced mental disorder occurs rarely in +tuberculosis, according to Ziehen, and leads either to melancholia or to +hallucinatory states of excitement, resembling the deliria of exhaustion or +inanition. Acute miliary tuberculosis may produce the impression of a +general paresis or of an amentia in Meynert's sense. The inanition delirium +of tuberculosis resembles that of carcinosis and malaria. + +Kraepelin regards tuberculosis as of very slight significance in the +causation of insanity, despite the fact that slight changes in mood and in +voluntary actions frequently accompany the course of the disease. +Irritability, depression and sensitiveness, incomprehensible confidence and +desire to undertake various tasks, pronounced selfishness, sexual excitement +and jealousy are the traits of mental disorder in tuberculosis. + +Kraepelin states that many cases of tuberculosis show traits of alcoholic +disease and says that the occurrence of polyneuritic forms of alcoholic +mental disorder is favored by the association of tuberculosis with +alcoholism. + +Wernicke does not systematically consider the topic. + +Binswanger states that tuberculosis, aside from miliary tuberculosis or +meningitis, produces no mental disorder except phenomena of the amentia of +exhaustion. + +Ballet states that there exists a peculiar mental state in the tuberculous. +It is compounded as rule of sadness, of looking on the dark side and of +profound egoism. This readily leads to mistrust and suspicion which may be +pronounced enough to constitute a sort of persecutory delusional state or a +state of melancholic depression (Clouston, Ball). More rarely there are +phenomena of excitation explained in part by fever. In its slightest degree +this phenomenon of excitation is characterized by a feeling of well-being, +of euphoria, which even at the point of death may give the patient the +illusion of a return to health, or there may be a more pronounced excitation +with impulsive sexual and alcoholic tendencies. Autointoxication may lead to +the usual train of confusional symptoms. + +If we compare the accounts in the literature of the two conditions here in +question, namely, nephritis and phthisis, we must be convinced, that aside +from so-called autotoxic phenomena, renal disorder seems to be marked by a +tendency to depressive emotions but that phthisis shows not only depressive +emotion but also euphoric and hyperkinetic phenomena. + +So far as these results thus hastily reviewed are concerned, they are +consistent with the appearances in the present group of cases. Both the +nephritic and phthisical groups need further intensive study. + +As to the question of the spreading inwards or outwards of delusions from +the standpoint of the patient, no analysis is here attempted. It is plain, +however, that the theopaths, as James calls them, or victims of theomania, +to use the French phrase, will be of importance in this analysis because of +the equivocal character of the emotions felt in cases of religious delusion. + +SUMMARY AND CONCLUSIONS + +The paper deals with delusions of a personal (autopsychic) nature and is one +of a series based upon certain statistics of Danvers State Hospital cases +(previous work published on somatic, environmental (allopsychic) delusions +and those characteristic of General Paresis). The previous work had +suggested that somatic delusions are perhaps more of the nature of illusions +in the sense that somatic bases for somatic false beliefs are as a rule +found. On the other hand, delusions respecting the environment (allopsychic +delusions) had appeared to be more related to essential disorder of +personality than to actual environmental factors. + +The fact that cases of paresis with delusions were found to have their +lesions in the frontal lobe, whereas non-delusional cases showed no such +marked lesions, is of interest in the light of the present paper because +three cases of senile psychosis were found to have delusions of grandeur +and, although they are demonstrably not paretic, they also show mild frontal +lobe changes supported by microscopic study. + +The Danvers autopsied series, containing 1000 unselected cases, was found to +show 306 instances with little or no gross brain disease. Of these, 106 had +autopsychic delusions and of these 106, 50 cases had delusions of no other +sort. 15 of these 50 cases appeared to have been cases of General Paresis +in which gross brain lesions were not observed at autopsy, and upon +investigation 13 other cases were found to be, for various reasons, +improperly classified. The residue of 22 cases was subject to analysis and +readily divides itself into two groups of 11 cases each, or two groups of +normal-looking brain cases having autopsychic delusions and these only are +cases which may be termed the "pleasant" and "unpleasant" groups, in the +sense that the delusions in the first group were either pleasant or not +unpleasant, whereas the delusions in the second group were of clearly +unpleasant character. + +Three of the "pleasant" delusion group were the three cases of grandeur and +delusions in the senium above mentioned. Three others were cases of +"theomania" in the sense that their delusions concerned messages from God. +It is not clear that these three religious cases should be regarded as +belonging in the group of "pleasant" delusions on account of the sense of +constraint felt by the patients. + +The remainder of the "pleasant group," as the delusions were originally +defined, turned out for the most part to show either doubtful delusions or +delusions involving a sense of constraint rather than of pleasure. + +An endeavor was made to learn the relations of pulmonary phthisis to the +emotional tone of the delusions. The few available cases in this series +seem consistent with the hypothesis of phthisical euphoria (IV, "happiest +woman in the world," hearing God's voice, VII and possibly XI). + +The problems of the "pleasant" delusion group, as superficially defined, +turned out to be a. the problem of a group of senile psychoses with +grandiose delusions and frontal lobe atrophy; b. the problem of felt +passivity under divine influence; c. the problem of phthisical euphoria. + +The group of "unpleasant" delusions in the normal-looking brain group should +be diminished by one on account of its positive microscopy (encephalitis). +One case (XIII) is a case of mixed emotions of religious type, showing +phthisis pulmonalis together with abdominal tuberculosis and nephritis. One +case (XV) is doubtful as to delusions; the remainder are subject to renal +disease, as a rule associated with cardiac lesions. + +Two cases which were transferred from the "pleasant" to the "unpleasant" +group on account of constraint feelings, were also renal cases,--VII and IX. +The only exception to the universality of renal lesions in this group is the +case in which religious delusions were probably based upon hallucinations +for which hallucinations an isolated brain lesion was found, very probably +correlatable with the hallucinosis. + +Virtually all of the eleven cases determined to belong in the "unpleasant" +group are cases with severe renal disease as studied at autopsy. + +Whether the unpleasant emotional tone in these cases of delusion formation +is in any sense nephrogenic and whether particular types of renal disease +have to do with the unpleasant emotion, must remain doubtful. A still more +doubtful claim may be made concerning the relation of euphoria to phthisis. +The renal correlation is much more striking as well as statistically better +based. A further communication will attack the problem from the side of the +kidneys in a larger series of cases. + +REFERENCES + +[1] Southard. On the Somatic Sources of Somatic Delusions. Journal of +Abnormal Psychology, December, 1912-January, 1913. + +[2] Southard and Tepper. The Possible Correlation between Delusions and +Cortex Lesions in General Paresis. Journal of Abnormal Psychology, +October-November 1913. + +[3] Southard and Stearns. How far is the Environment Responsible for +Delusions? Journal of Abnormal Psychology, June-July, 1913. + +[4] Southard. A Comparison of the Mental Symptoms Found in Cases of General +Paresis with and without Coarse Brain Atrophy. Submitted to Journal of +Nervous and Mental Disease, 1915. + +[5] Southard. A Series of Normal-Looking Brains in Psychopathic Subjects, +American Journal of Insanity, No. 4, April 1913. + +[6] Southard and Bond. Clinical and Anatomical Analysis of 25 Cases of +Mental Disease Arising in the Fifth Decade, with remarks on the Melancholia +Question and Further Observations on the Distribution of Cortical Pigments. + +[7] Southard and Canavan. On the Nature and Importance of Kidney Lesions in +Psychopathic Subjects: A Study of One Hundred Cases Autopsied at the Boston +State Hospital. Journal of Medical Research, No. 2, November, 1914. + +[8] Ziehen. Psychiatrie, Vierte Auflage, 1911. + +[9] Wernicke. Grundriss der Psychiatrie, 2 Auflage, 1906. + +[10] Kraepelin. Psychiatrie, Achte Auflage, I Band, 1909. + +[11] Binswanger. Lehrbuch der Psychiatrie, Dritte Auflage, 1911. + +[12] Ballet. Traite de Pathologie Mentale, 1903. + + + +SIXTH ANNUAL MEETING OF THE AMERICAN PSYCHOPATHOLOGICAL ASSOCIATION + +New York, N. Y., May 5, 1915 + +PROGRAM + +ADDRESS BY DR. ALFRED REGINALD ALLEN, President, Philadelphia, Pa. + +1. "The Necessity of Metaphysics," Dr. James J. Putnam, of Boston, Mass. + +2. "Anger as a primary Emotion, and the Application of Freudian Mechanisms +to its Phenomena," President G. Stanley Hall, of Worcester, Mass. + +3. "The Theory of 'Settings' and the Psychoneuroses," Dr. Morton Prince, of +Boston, Mass. + +4. "The Mechanisms of Essential Epilepsy," Dr. L. Pierce Clark, of New +York, N. Y. + +5. "Material Illustrative of the 'Principle of Primary Identification,' " +Dr. Trigant Burrow, of Baltimore, Md + +6. "Psychoneuroses Among Primitive Tribes," Dr. Isador H. Coriat, of +Boston, Mass. + +7. Data Concerning Delusions of Personality," Dr. E. E. Southard, of +Boston, Mass. + +8. "Dyslalia Viewed as a Centre-Asthenia." Dr. Walter B. Swift, of Boston, +Mass. + +9. "Constructive Delusions, " Dr. John T. MacCurdy and Dr. W. T. Treadway, +of New York, N. Y. + +10. "Narcissism," Dr. J. S. Van Teslaar, of Boston, Mass. + +11. "The Origin of Supernatural Explanations," Dr. Tom A. Williams, of +Washington, D. C. + +12. "The Psychoanalytic Treatment of Hystero-Epilepsy, " L. E. Emerson, Ph. +D., of Boston, Mass. + +The meeting was called to order by the President, Dr. Alfred Reginald Allen, +at 9:30 A. M., in Parlor E, Hotel McAlpin. + + + +Dr. Allen delivered The Presidential Address. + +Dr. James J. Putnam, of Boston, read a paper entitled, "The Necessity of +Metaphysics."[1] + +[1] Published in the June-July number, p. 88, of this Journal. + +DISCUSSION + +DR. MORTON PRINCE, Boston: I sympathize with Dr. Putnam in his interest in +philosophical problems, my only conflict with his point of view being with +what I conceive to be a mixing of problems. I suppose that if we want an +explanation of the universe it must be in terms of philosophy or +metaphysics. The only alternative is to accept it as a phenomenal universe, +as it is. You will remember that when it was reported to Carlisle that +Margaret Fuller said she "accepted the universe," he replied "Gad! I think +she had better!". So we have got either to explain the universe in terms of +philosophy or accept it as it is. + +I have no objection to introducing philosophical problems if we do not +confuse those problems with our psychological problems. They are entirely +distinct. This distinction between philosophy and science the physicists +and chemists clearly recognize. One of their problems is the ultimate nature +of matter, but it is not a problem of practical physics and chemistry. These +deal, let us say, with phenomenal atoms and molecules, with their +attractions and repulsions, etc. In dealing with the problem of the +ultimate nature of matter the chemist analyzes matter and finds that it can +be reduced to atoms, and then analyzes the atoms and finds them composed of +electrons flying about within the circumscribed space of an atom. Then he +analyzes the electron and reduces it to negative electricity, and when asked +what negative electricity is he says it is a form of the energy of the +universe, and stops there and says--"I don't know," when asked to explain +energy. + +Here the problem of the ultimate nature of matter becomes a question of +philosophy and metaphysics. It is a field of research by itself. The +chemist never confuses that problem with the specific problems of his +particular science. These deal with empirical atoms and molecules as he +finds them. No chemist would undertake to give the chemical formula of the +union of sulphuric acid and zinc by a formula which expressed the ultimate +nature of atoms or negative electricity. If he did so he would confuse his +problems. And so I think we confuse our problems when we attempt to explain +empirical psychological phenomena in philosophical or ultimate terms. We +must treat our psychological elements--ideas, wishes, emotions, etc,--as the +chemist treats atoms and molecules. But, just as the latter may take up +ultimate problems as a special field of investigation so may we do, if we +like, but we must not treat them as psychological problems. + +This confusion of problems is, I think, the fundamental error of Jung and +others in treating of the libido when he and they attempt to explain +specific phenomena as empirically observed. Jung undertakes to resolve +libido into the energy of the universe. Of course this is possible. All +forces can be ultimately so resolved, including the forces of mind and body. +Emotions such as anger and fear are forces and each of these forces, with +great probability, can be reduced in the ultimate analysis to a form of +energy. But this is not to admit that we are justified in explaining +specific concrete psychological phenomena, with which we are dealing, in +philosophical terms. We must explain them in terms of the phenomena +themselves. As a monist and pan-psychist, for example, I may believe that +conscious processes can be reduced to, or be identified with the ultimate +nature of matter, the thing-in-itself. And conversely atoms and electrons +may be reduced to a force which may be identified with psychic force, but I +would not attempt to explain psychological behaviour in terms of such a +philosophical concept but only through phenomenal psychological forces, let +us say, wishes. In other words, I would not undertake to introduce +pan-psychism into the problem at all as an explanation of a particular +phobia. I think, therefore, that when Jung and others attempt to explain +phobias and other psychological phenomena through a philosophical concept of +the libido as analyzed into an elan vitale or the energy of the universe, +they not only confuse their problems but introduce such a mixing up of terms +that the resulting explanation becomes little more than nonsense. The +libido, whatever it may be, must be treated as a psychophysiological force +just like any of the other emotions. Otherwise psychology ceases to be a +science. + +Now one word about conflicts. Undoubtedly conflicts play a most important +part in such psychological disturbances as we have to deal with in the +psycho-neuroses, but I cannot agree that psychological conflicts conform +only to, or are synonymous with ethical conflicts. Undoubtedly there are a +large number of conflicts between ideas and sentiments which we have all +agreed to label as ethical, but there are also a large number of conflicts +between sentiments which cannot be pigeon-holed as ethical. For example, the +mother whose child is threatened with danger and who herself would incur +danger in rescuing her child, undergoes a conflict between her fear +instinct, on the one hand, and her love on the other, exciting also her +anger emotion. The anger and love conflict with the fear, down and repress +it. There you have a conflict but I think it could not be classed as an +ethical conflict. It is a general law, whenever one instinct antagonizes +another instinct there is a conflict. It is a conflict which has its +prototype in the lower organic processes. Thus Sherrington's spinal +reflexes, that he has worked out so beautifully, involve conflicts between +opposing organic impulses. In the scratch reflex, for instance, the impulse +which excites the flexor muscles inhibits the excitation of the extensor +muscles. I believe this principle underlies the higher processes and upon it +is built up the whole of the psycho-physiological mechanisms. + +DR. TOM A. WILLIAMS, Washington, D. C.: I want Dr. Putnam to reply to two +objections to his position. One, the manifestations of functional +capacities which are themselves dependent upon structural differences. I am +not talking now of psychogenetic determinants, but alone of the trends of +which Dr. Putnam has spoken. Is he not assuming the contrary to Darwin when +he says that function precedes structure? Are not the potentials dependent +upon the variation which has determined this function? I am speaking now in +the broadest possible terms and not confining myself to the cerebrum. Do we +not find it in the tadpole who is prepared for breathing not because he +wants to breathe, but because he is going to have a new kind of breathing +apparatus and the duck who takes to the water because he has the mechanism +to swim? + +Two, in regard to Hegel and the appeal to the ethical as being of a +different type from the motive of biological satisfaction. Is not that +difficulty only apparent, and is it not answered by Dr. Putnam's own appeal +that these matters should be settled independently, and is not it the case +that the average sexual man would settle it very differently from Dr. Putnam +himself and most of us; and is not it true that, though the ethical +determinants of behaviour are not auspicious for the average sexual +satisfactions of man, yet are they not themselves forms of hedonistic +satisfactions? For a man who would behave unethically would be miserable in +doing so by the loss of his own self-respect. So that he already has a +hedonistic determinant for his own conduct which is in harmony with the +biological concepts of Aristotle. + +DR. JAMES J. PUTNAM, Boston: I should be very sorry to be taken as wishing +to put myself in the sort of adverse position which Dr. Prince and Dr. +Williams believe me to assume. I accept, of course, the proposition that +there are conflicts which are not ethical, and, as Dr. Williams says, the +average man would naturally come to different conclusions from those of the +trained man in ethical matters. I want to make a slight movement towards +restoring a balance which it seemed to me had become tipped too far one way. +Psychoanalysts, for example, actually deal with metaphysics and yet they do +not really study out what this involves. If we were nothing but scientific +men we could say, "very well, let metaphysics go." But we are not. We are +dealing with individuals who are thrilling with desires, hopes and fears, +the movements of which cannot be expressed in scientific formulae. Dr. +Williams speaks of Darwin. It can be asserted with justice, however, that +the genetic method of investigation which is exemplified by Darwin's study +of evolution is an imperfect method for discovering the aims of human +beings. I refer to the interesting book of Prince Kropotkin in which he +studies mutual aid as a factor in evolution, mutual aid being something not +adequately contemplated by Darwin, who considers conflict as the essential +influence in evolution. Prof. Judd showed in a paper a few years ago the +change which has taken place in the attitude of a good many students of +economics through the introduction of human intelligence and desires as +something quite distinct from the conflicts of interests, and similar +arguments have been brought forward by students of evolution. Among others +Prof. Cope, the distinguished Zoologist of Philadelphia and Prof. Hyatt of +Boston, showed very clearly how the course of evolution becomes materially +changed when desires and will become prominent as factors. I agree that, as +a partial motive, structure does limit and determine function. There is no +question about that. I merely want to say that logically function precedes +structure, inasmuch as the wish and desire to do a thing precedes the means +by which we secure for ourselves the power to do it. But of course all +energies must work through structural media. In regard to hedonism, one must +recognize that pleasure counts as a partial motive, but when it comes to +taking it as the final motive it fails utterly. Our lives contain +determinants which we cannot range under the category of pleasure. We act in +certain ways because our structure and our functions and our wills are what +they are, and not exclusively by our temporary wishes. Our "meanings," when +thoroughly studied are found to coincide with the meaning of the universe as +a whole. It is only through getting hold of the entire scheme that you have +something that you can use as a criteria. The nearest approach to this is +obtained through the study of the most broadly developed, public spirited +men, and such men do not work in accordance with hedonistic principles. +President G. Stanley Hall, of Worcester, Mass., read a paper entitled, "The +Application of Freudian Mechanisms to Other Emotions."[*] + +[*] Published in the June-July number, p. 81, of this Journal. + +DISCUSSION + +DR. JOHN T. MAC CURDY, New York City: I have been so interested in the +paper by Dr. Hall that I have been distinctly delighted by it and with your +permission I will refer to a point in Dr. Putnam's paper directly pertinent +to the issues raised by Dr. Hall. Dr. Putnam has spoken of the necessity +for metaphysics by which I presume he means the necessity for formulation. +Yesterday there was some antagonism in a discussion on formulation. We +cannot avoid formulating. Our advance in knowledge is purely empiric unless +it is directly dependent on formulation. We have not formulated enough. We +have stuck too much to our empiric data, have not made the necessary +deductions from it. What formulations there are have been based on +therapeutic data and explain the productions of symptoms. No attention has +been paid to the general psychoneurotic or psychotic Anlage. When this is +done I am sure that it will be found that there are just such primordial +reactions as President Hall has been talking about lying back of all the +sexual impulses. Sexual reactions have in the course of development come to +be the vehicle for more primitive ones. We know by observation that the +infant demonstrates anger in a much greater degree, and long before he gives +evidence of things sexual, in anything approaching the adult sense of that +term. The temporary formulation of psychoanalysts who attempt to explain +anger or temper by sadism are really ridiculous. President Hall rightly says +that sadism must be explained by anger. That is one of the primitive +emotions. Sex is merely a vehicle. The importance of this transference is +that the sex emotions are peculiarly adapted to repression and when once +unconscious, continue to operate all through the life of the individual. +This is less likely to occur in the sudden reaction of anger, which is much +more apt to be blown off at the time. + +DR. SMITH ELY JELLIFFE, New York, N. Y: I cannot quote the line, but in +Shaw's "Doctor's Dilemma," recently presented in New York, there is an +exchange of words during which the heroine tells the surgeon that she is +tempted to pass from loving him to hating him. He replied that one is +surprised after all what an amazing little difference there is between the +two different attitudes of mind. Dr. Jelliffe said he was quite in sympathy +with what Dr. MacCurdy had been saying, with reference to the need for +formulation: We all know how these formulations have grown and how they are +utilized practically. For instance, we formulate an attitude towards space. +We wish to handle space and say 3 ft. or 7 ft. in order to handle space +relations. In other words, to handle space we utilize a formulation which +we call a measure of space. In the same manner in order to handle time we +make a hypothetical unit to be pragmatic. In handling the phenomena of +electricity, we formulate other units. In my own mind there has grown up +therefore the analogy that in order to handle psychological phenomena we +have formulated the Oedipus by hypothesis. This hypothesis I would define as +the unconscious biological directing of the energy of the child towards the +parent of the opposite sex and away from that of the same sex. This is the +unconscious basis of what in consciousness we call love and hate. The boy +is unconsciously directed away from the parent of the same sex. He develops +according to the Oedipus hypothesis the desire to get away from the father +or the father image. All other men are patterned after the father image and +if this strong biological direction fails to take place, his interest not +being directed in an opposite direction, he fails to mate and thus fails in +his reproductive function. The reproductive function cannot go on without +this biological thrust towards the proper object. By Narcissism is meant the +formulation that a new development is taking place in the infantile Oedipus +fantasy. The child cannot hold on to the mother image. He passes it to +others nearer his own age. He does it first through his own identification +with the female. His bisexuality permits this. Similarly the infantile +father protest must be supplanted by an evolved brotherly love. The +competition with the father image must take a new form. It must be a mutual +competition with mutual productivity. Any contact between man and man that +does not ensue to the value of both in some degree, therefore, registers a +failure to sublimate the unconscious gather hatred of the infantile stage of +development. Sublimated hatred of the father image is brotherly love. +Sublimated love of the mother image is taking one's place in the world as a +father for the continuance of the race. In the unconscious the formula of +direction against same sex and towards opposite sex, means therefore that in +the unconscious love and hate are the same; one cannot give them these names +however. + +Thus I would enlarge the Oedipus formula and say that it is useful not only +in understanding the neurotic, but it can be used to measure up all +psychological situations. + +DR. JAMES J. PUTNAM, Boston: I deeply appreciated and enjoyed what Dr. Hall +said and I have no question whatever that we all who are so interested in +psychological work profit by arguments of this sort being brought before our +notice. I think it is an unfortunate thing that Adler, who was on that line +and did such good work in it, coupled his statements with a sort of +denunciation of Freud's views. It seems to me to have been entirely +unnecessary. One of the remarkable stories of O. Henry, who was a keen +observer of human nature, deals with a frontier army officer who exposed +continually himself to danger, desiring to work out in an indirect way this +feeling of conquering one person by another, only it was himself, his own +cowardice, that he wished eventually to conquer. I would ask Dr. Hall if +the notion of which Royce has made so much, namely, the social concept, is +not one which perhaps would act as the common denominator in these cases. We +cannot assert ourselves and get angry without virtually having reference to +other persons, neither can we have sex feelings without such reference. It +seems that the social instinct or imagination which is carried around by +every individual and which determines his acts is as natural and as +invariably present as the existence of a desire to live, not to speak of the +desire to conquer. + +DR. MORTON PRINCE, Boston: I feel extremely thankful to Dr. Hall for his +very interesting and satisfying presentation of the thesis which he has +given us. I remember an old gentleman once saying to me, in speaking of +another man with whom he had been conversing, "He is a very intelligent man. +He thinks just as I do." So I think Dr. Hall is a very intelligent man; he +thinks just as I do. I am entirely in accord with his views which he has so +well expressed. What he has said is in principle the basis of the paper +which I intended to present this morning but which, in view of the length of +our programme, I have decided to withdraw. + +The principle underlying the large number of concrete facts which he has +given is that besides the sexual instinct there are a large number of other +instincts--one of which is anger--which have a very important place and play +important parts in personality. Some of these instincts play not only as +important a part as the sexual instinct but even a more important part. +And, as Dr. Hall has said, the Freudian mechanisms can be applied to them +just as well and just as logically. If an analysis is fully carried out +along the directions of these instincts we find, according to my +observations, the same disturbances that we find from conflicts with the +sexual instinct and effected by the same mechanisms. Amongst these instincts +besides anger there is the parental instinct, containing, if we follow Mr. +McDougall's terminology, tender feeling or love. At any rate love is an +instinct entirely distinct from the sexual instinct. There are also the +instinct of self-assertion and, fully as important as any, that of +self-abasement. This last, according to my observations and interpretations +plays a very important part in many cases of psycho-neurosis and leads +through conflicts to the same disturbances of personality that one finds +brought about by conflicts between the other instincts. That love may be +something entirely separate and distinct from the sexual instinct is a view +which is generally recognized and accepted by psychological writers but +entirely ignored, as a rule, by Freudian writers. A criticism which I would +make of the work of the Freudians is that while they recognize these +instincts they do not give them their full value nor study them as +completely and thoroughly--nor do they carry their studies to the final +logical conclusion--as they do with the sexual instinct. So far as they may +do so they subordinate these instinctive emotions entirely to the sexual +instinct so that these latter simply make use of them. When the +psycho-neuroses are completely studied we will find the same repression of +the various instinctive dispositions and impulses to which I have referred +in the one case as in the other, and of ideas organized with these +disposition. We find the same conflicts and resulting disturbances. The +sexual instinct has no hegemony. To my mind each occupies precisely the +same position and may play the same part in personality. + +When you bear in mind that psychologically it is a fact, as I believe, that +sentiments are formed by the organization of emotional instincts with ideas, +with the memories of experiences, as Shand has pointed out, and when you +remember that it is through the force of emotional instincts thus organized +that an idea, i e., a sentiment, acquires its driving force which tends to +carry the idea to fulfilment, and when you bear in mind that sentiments thus +formed are derived from antecedent experiences sometimes dating back to +childhood and sometimes persisting through life, we can understand how +conflicts arise between antagonistic sentiments and the part which the +different instincts, through the force of their impulses, play in these +conflicts. + +Furthermore when we bear in mind that sentiments thus originating and +organized are conserved in the subconscious forming what I call the +"setting" which gives idea meaning, the meaning being the most important +component of any idea, and when we bear in mind that this subconscious +setting is an integral part of the total mechanism of thought--each +sentiment in the setting striving to carry itself to completion, and for +this purpose repressing every conflicting sentiment--I think we find a +satisfactory explanation of the disturbances due to conflict in the +psycho-neuroses. Such a mechanism gives full value to any one and all of the +emotional instincts without giving primacy to any one. + +DR. WALTER B. SWIFT, Boston: In regard to the origin of emotions: I +understood Dr. Hall to say that they were not instinct. Of late I have been +observing two young children develop certain emotions. The starting point of +that development has seemed to be in the imitation of motions seen in +others. It is plain to see that this is along the line of the James-Lange +hypothesis. So that before these motions were seen there was no emotion in +the child. If these motions were observed and imitated by the children then +the emotions developed. I would, therefore, like to ask President Hall +whether he would consider imitation of motion seen in another as the +starting point of the development of emotion. + +DR. TOM WILLIAMS, Washington, D. C.: The value of formulation we know. It +has been well illustrated by Dr. Hall's paper that he has by definite +concept followed out by investigation of this. The disadvantage of +formulation is very well shown by over-formulation by the scholastics in the +Middle Ages. I think Dr. Hall's wonderful contribution to our psychological +researches should be kept in mind by those who have excessively formulated +in a certain direction in order that some of us at least may apply to some +of the other emotions what others have attempted concerning libido. Dr. +Prince has long appealed for other methods than those which have been +applied so exclusively to the sexuality. In reference to the manifestation +of the anger trend, for instance, it may be not only a definitely conscious +manifestation, but it may perhaps produce a crisis even in dream-thought. I +am speaking of a case. A young boy at boarding school who was a musical +genius had been very much bullied. He suffered a great deal from this, but +did not retaliate until one night in the dormitory with eight boys while +asleep, he being badgered by neighbors, got up while asleep and attacked +these larger boys and discomfited them. It was the subject of conversation +in the dormitory, whether he was really asleep or not. The boy became so +terrible in his anger on future occasions and so successful as a fighter +that his bullying thereafter ceased, and his status in the school thereafter +was different. Whether this really occurred in a dream state or was mere +simulation I cannot say. + +DR. A. A. BRILL, New York City: I must say that the mechanisms described so +interestingly by Pres. Hall are found in our patients during analysis and I +believe that almost all of them belong to the love and hate principles. This +may not seem so on superficial examination, thus, I have on record nine +cases of women who were suffering from various forms of psychoneurosis, one +of whose symptoms was screaming. Every once in a while they had to scream. +It was an obsessive screaming. Questioning elicited that the screaming +always occurred when they were thinking of some terrible or painful thought. +For instance, one woman went through fancies of killing her husband and when +she came to the idea of shooting him, she began to scream. Here one might +think that it was an ethical struggle which had nothing to do with sex, but +if one considers that it was against her husband that her anger was +directed, that she wished to kill him because he abused her and that there +was another man in the case, it becomes quite clear that the anger had a +sexual motive. + +Concerning new formulations, I feel that there is nothing against +promulgating new attitudes and theories, provided one has sufficient cause +for doing so. Formulations based on insufficient data and hastily +constructed are dangerous, to say the least. Prof. Freud is most careful in +formulating new theories. He gathers his material for years before he puts +it forth in the form of tentative theories and does not hesitate to modify +them if occasion demands. Nor is it true that the Freudians ignore the work +done by others. Freud and his followers give due credit to other observers, +but as the Freudian mechanisms have opened up so many new fields for +investigation, we naturally give most of our time to this work. That does +not at all signify that we ignore everything else, as some believe. Freud +himself continually urges that the psychoanalytic problems should be taken +up by observers in other fields than medicine and I was, therefore, +extremely pleased to hear Prof. Hall's formulations of anger. I do not +believe, however, that his paper shows that we are overestimating the sexual +impulse. Basically, all his mechanisms come under the heading of "Sex," as +we understand it. + +DR. L. E. EMERSON, Boston, Mass: I wish to express my delight in President +Hall's paper. It seems to me what he has done has been to show the breadth +of the Freudian conception of sex. The word sex as the Freudians use it, +includes all personal relations and even personality; and it is apparently +in question only as to whether one is going to draw a line at one place and +say everything on this side is sex and the other side personality, or +whether one is going to enlarge the concept of sex to include personality. +That as I understand it, is what Dr. White has also said. It seems to me the +value of the sex conception lies in the fact that while it can be expanded, +and is illimitable, at the same time it focuses, it does come to a point. +Personalities as talked of ordinarily have no point, they are too vague. On +the other hand, a man who has a mind no bigger than a pinhole is too +circumscribed to be capable of understanding any very broad generalization. +If one can grasp a conception that does have a center, even though no +circumference, he has got hold of a very valuable generalization. + +DR. E. E. SOUTHARD, Boston: Dr. Jelliffe has just brought into ridicule +what he terms "pinhole psychiatry;" but as I remember it, there is a +technical method in psychology whereby things may be more clearly visible +through a pin-hole! + +The valuable thing about President Hall's communication is that the +fundamental distinction is brought out between two groups of workers in +psychopathology. I should be inclined to divide the people in this room +into what might be termed emotional monists and emotional pluralists. The +Freudian theory is in general a theory of emotional monism and therefore +fundamentally must satisfy a great many of the Hegelian tenets. Hence, +perhaps Dr. Putnam's adherence to both Hegel and Freud. Now as I understand +it, what Dr. Prince wants is an emotional pluralism such as might well be +founded upon the data in MacDougall's "Social Psychology" and in Shand's +work on "The Foundations of Character." This view of emotional pluralism is +one which I should myself be compelled to hold. We must remember, however, +that the work of Cannon on various types of emotion may possibly show that +different emotions which look vastly unlike (e. g. fear and rage) may be in +some sense equivalents. Fear may be equivalent to rage much as different +types of energy in the physical universe are equivalent to one another. The +emotions may be interchangeable in some sense so that it might be possible +that sex emotion and the emotion of fear are translatable. In this way there +might be constructed a fundamental monism of emotion in the same sense that +energetics is a science which unifies electricity, heat, magnetism, etc. It +would not seem to me, however, appropriate to identify all kinds of emotion +with the sexual. + +PRESIDENT HALL: It would take an encylopedia and an omniscient mind. and +many hours and days to exhaust such a topic as this. Dr. Southard has said +some of the things I would have said. I supposed this society was primarily +interested in pragmatic discussions. At any rate, I left the American +Philosophical Society some years ago and entered this to get rid of +metaphysics and arid abstractions. As to what Dr. Swift says, it seems to me +imitation plays a great but is by no means the sole role. It is of course +purely instinctive, and the social instinct comes in everywhere, so much so +that discussion on almost any topic is liable to raise the question of the +individual versus the social forces in the world. As to Dr. Jelliffe's +opinion whether after all hate and love are at bottom the same, he perhaps +bottoms on the recent discussions of what I might call the expanded theory +of ambivalence, as represented by Weissfeld. But I do not interpret this to +mean that there is any sense whatever that has any pragmatic value in the +statement that love and hate are the same. If you assume this, one is dizzy +and the world seems to spin around. Hegel showed a sense in which being and +not being are the same but that is a most abstract and purely methodological +statement. What in the world is more opposite than love and hate, from every +practical and truly psychological point of view? We must not be credulous +about the unconscious and ascribe to it absurdities, nor must we lose our +orientation for surely up and down, right and left, light and dark, do +differ. If the unconscious can be used to cause a darkness in which +everything loses its identity and fuses into a general menstrum, as Hegel +said all cows were black in the dark, it seems to me we can get nowhere. +Ought we not to start by admitting that there are certain immense +differences in the emotions, whether conscious or unconscious, and that the +tendency to find a common background or identify them is a matter largely of +speculative interest? + +DR. MORTON PRINCE, Boston, read by title a paper entitled "The Theory of +'Settings' and the Psychoneuroses." + +DR. L. PIERCE CLARK, New York, N. Y., read a paper entitled, 'The Mechanism +of Essential Epilepsy."[*] + +[*] Reserved for publication. + +DISCUSSION + +DR. E. E. SOUTHARD, Boston: Idiopathic epilepsy as found in Massachusetts +material and estimated from the appearances in the gross anatomy of the +brain occurs in about one of every three cases. There are accordingly more +idiopathic epilepsies than there are idiopathic or "functional" psychoses, +if the data of gross anatomy form a reliable index. + +It was a somewhat curious thing that in a series of cases investigated by +Dr. Thom and myself, that the more frequent the attacks of epilepsy the less +there seemed to be to show for them in the autopsied brains. In certain +cases with daily attacks the brains were strictly normal in gross +appearances. It was the frankly organic cases with large focal lesions that +had the occasional attacks. These frankly organic cases rarely had high +frequency attacks. + +DR. TOM A. WILLIAMS, Washington, D. C.: Will Dr. Clark explain the eccentric +convulsions such as when there is uraemia, on similar grounds? Also, if he +will postulate in such cases as recover with metabolic treatment. I have +published cases in which recurrent attacks of some years duration were +removed by means which considered only the metebolesia. (See Journal of +Neurology and Psychiatry, March, 1915.) + +DR. JOHN T. MACCURDY, New York: I have held the opinion for some years that +the study of epilepsy was going to be of greater psychiatric moment than +that of any other condition. I feel that this promise has been very largely +fulfilled by the work Dr. Clark has been doing for the last two years. We +have found, I think, from that work that we can really shell out what we may +term an epileptic reaction, which is really the most primitive of all +psychiatric reaction. It corresponds to a flight from reality. It is a +return to the subjective phase, which, in the psychoses, is no vague but a +very real thing. In epilepsy we get it in pure culture as a lapse of +consciousness, expressed either in completeness as in a grand mal attack or +partially when consciousness is merely clouded. Sleep probably represents an +analogous condition. We go to sleep to repair the body while psychologically +we are seeking that flight from reality which we all long for. The +convulsion may be a secondary affair, and a physiological sequel to the loss +of consciousness, which is psychologically determined. + +L. PIERCE CLARK: For the time being I am anxious to limit my remarks to the +mechanism of ESSENTIAL epilepsy, and, not to convulsive disorders in +general, however closely allied to idiopathic epilepsy. At some future time +I hope to take up the epileptoid convulsions and show their relationship and +variation from that of the mechanism of essential epilepsy. I may say, +however, that I have some data already at hand in which certain types of +epileptic phenomena connected with infantile cerebral hemiplegia would show +that the so-called epileptic constitution is much less marked in these +cases, but is present, however, to a certain degree. As has been well known +for a number of years and commented upon by such observers as Gowers, +Jackson and Binswanger, the so-called hemiplegic epilepsies sooner or later +develop the epileptic alteration in a character analogous to that seen in +idiopathic epilepsy. I hope to show that the main roots of the so-called +epileptic alteration in general necessarily lie in the primary make-up of +such individuals, and that the seizure phenomena of epilepsy only intensify +and make more marked the fundamental make-up when the disease has definitely +fastened itself upon the individual. My next paper on this whole subject +will attempt to show more conclusively that the epileptic seizures are but +an unfoldment of that which has already been existent in the biological +make-up of the individual epileptic. + +DR. TRIGANT BURROW, Baltimore, Md., read a paper entitled "Material +Illustrative of the 'principle of Primary Identification.' "[*] + +[*] Reserved for publication. + +DISCUSSION + +DR. JAMES J. PUTNAM, Boston: I am very much interested in Dr. Burrow's +paper and understand it as illustrating the argument brought forward by him +last night. As I remember the situation I do not quite see why this idea is +not essentially the same that has been endorsed by Freud and others. One's +interest in one's self is certainly in part the basis of homosexuality, and +this is intensified by the reflection from the mother. + +DR. JOHN T. MAC CURDY, New York: When Dr. Burrow first brought up this +subject last year it struck me as being the most original theory in +psychoanalysis that had been formulated in this country and one of the most +important of all the additions to our general psychoanalytic concepts. +Personally, I found that it immediately solved certain problems which had +been in my mind for some time. I had never been able to see how it came +about that the alcoholic had a strong latent homosexuality. The ordinary +interpretations of drinking as a fellatoristic substitute has always seemed +unlikely, for, if this were so any liquid would serve the purpose, so why +alcohol? Now it is manifest that the alcoholic is an individual who is +taking a drug which dulls his sensibility. That is a way of retiring from +reality, of getting away from objectivity, retiring from what Dr. Burrow +calls the subjective phase. Now we understand why the patient in an acute +alcoholic hallucinosis almost invariably hears voices making homosexual +accusations. The unreality complex is translated into sexual terms and he is +accused of unreal love. I have been struck in dream analysis by the almost +constant coincidence in dreams of Mutterleib symbols in the same dream that +on analysis proved to be homosexual in principle. I can quote one dream +that demonstrates dramatically every point which Dr. Burrow makes in his +thesis. This patient, a man who was being treated for homosexual tendencies +which worried him a great deal, on one of the first days brought this dream. +He was a hospital interne. Someone came to him and said a nurse had cut +herself. He ran up to the surgical amphitheatre where preparations were made +to fix her wound. He suddenly discovered that his was the cut and that it +was on the ventral surface of the penis corresponding to the primitive +subincision operation. He took up a needle, sewed it up and put on a +bandage. At the end of the dream he wondered what was going to happen, +whether the bandage would come off or not. Any psychoanalyst can imagine +what the incision indicated, that it led directly to the idea of a vagina, +also to the idea of castration which is combined with that. The bandage led +to swaddling clothes. Here we have the whole situation rehearsed. The +associations went to the mother. The mother changes into himself. At the +same time he represents himself with a vagina and gives birth to a child, +his own penis which he can fondle as his mother did him. + +DR. SMITH ELY JELLIFFE, New York: It seems to me the phrase identification +with the mother is very illuminating. I have no doubt that Dr. Burrow would +say that the failure to develop away from this primary identification lies +at the basis of what is called Narcissism. I have noted this identification +with the mother, i. e., with the female, in many patients. They are, in +ordinary life, after making a very hard fight with unconscious homosexual +trends and are managing themselves with great difficulty. This shows +particularly in the analysis of alcoholics especially of periodic types. +Self-fertilization is a frequent symbol in the unconscious. In males, +particularly, the identification with the mother is a frequent factor and +often explains the value of the instinctively sought relief through narcosis +and withdrawal from the conflict. Male hysterias also show it markedly. The +aggression towards the father is a frequent female symbolization in hysteria +as well. + +DR. TRIGANT BURROW, Baltimore: It seems to me that the President's +reference to this heterosexual instance need not necessarily be heterosexual +in a psychological sense. It is important to recognize that though the +object of the male in a particular case be a woman, yet psychologically this +need not be a heterosexual adaptation. In the case I have cited the +relation of the patient to his wife is psychologically a homosexual one. We +have seen in this case the presence of a profound neurosis and coexistent +with it an apparently normal sexual life. This we know from the Freudian +standpoint is impossible. The heterosexual adaptation is but apparent. + +DR. TRIGANT BURROW, Baltimore: In regard to Dr Putnam's comment that my +thesis contains what has been said already by Freud. Undoubtedly to a large +extent it has. There is, though, some modification here which seems to me of +importance, if only in the way of an extension of Freud's original +conception. One gets a very clear idea from Brill's excellent paper on +homosexuality of Freud's essential thesis. Here the idea of homosexuality is +that of a revulsion from the mother. The child is assumed to adapt itself +as the mother in order to get rid of the mother as object. This first +hypothesis related only to the male child. To explain homosexuality in the +female, either an analogous mechanism must be assumed, according to which +the female child adopts homosexuality to escape the father image, and +analysis does not bear out this explanation; or, assuming the same reaction +in respect to the mother in the female as in the male, the result would +entail not homosexuality but a heightened heterosexuality. I think the +formulation I have here advanced offers us a distinct advantage in placing +the causative factor in homosexuality in either sex upon an identical +genetic basis. + + + +AFTERNOON SESSION + +The meeting was called to order by the President at 2:15 P. M. + +Dr. E. E. Southard, Boston, read a paper entitled, "Data Concerning +Delusions of Personality."[*] + +[*] Published in this number of the Journal, p. 241. + +DISCUSSION + +DR. SMITH ELY JELLIFFE, New York: Dr. Southard has heretofore launched us +upon very large subjects. I can well recall in one of his previous +communications the fascinating correlations drawn between structural changes +and the character of the psychological signs. In dementia praecox +particularly, he has shown us how auditory symptoms group about temporal +atrophies and optical signs with the occipital and so forth and so on. He +now proposes to thrust us into a larger and much more intricate sphere of +activity as to the representation in the cortex of other changes which as he +has described are inframicroscopical or inframacroscopical. In other words, +there must be some type of correlation between the projection in the +cerebral structure of the organ itself which is cerebrally represented and +certain mental signs. If I see what Dr. Southard has been thinking about, +we are certainly engaged in a very fascinating topic. It is well known from +the standpoint of topographical cerebral correlation that the brain is +nothing but a series of body symbols, as it were. Adler has entered this +field and approaches the problem by saying that the inferior organ, liver, +kidney, or what not, is related to a similar defective cerebral +representation of the organ, thus introducing into the nemological mechanism +the task of compensating for the defective structure. Dr. Southard wishes to +try to map out these defects in the cerebral structures and thus reason +backwards to the somatic inferiority. I confess he lifts me into ideal +regions. Such stimuli are enjoyable and provocative of development. + +DR. TOM A. WILLIAMS, Washington, D. C: I conceive Dr. Southard's purpose +somewhat differently from Dr. Jelliffe whose thought seems to be somewhat +like that of Henry Head when he published his paper in reference to +hallucinations, corresponding to various head zones in correspondence with +different visceral areas and with special sense organs, eye, ear and so on. +I have conceived Dr. Southard as being a direct chemical in line with +Folius' pathology researches. If that is the case we have a great many +clinical cases which might be underlined with his central thought. + +PRESIDENT HALL: It is almost too good to be true if Dr. Southard has really +made connections between delusions of personality and the great topic of +character. It illustrates the old Hippocratic saw, "God-like is the man who +is also a philosopher." Character might almost be called a name for all the +mysteries of psychology, and from Mill's ethology and the old phrenologies +of temperament that Wundt adopts with slight modifications, we have really +made little progress. It seems to me very significant that Dr. Southard +should interest himself, as his paper leads one to judge he does, in such +problems as Shand's somewhat abstract work, and should seek correlations +with legal characterology like that of Roscoe Pound. It would be of great +interest to know whether Dr. Southard obtained his differentiations purely +from pathological cases or whether, accepting Shand or Pound or both, using +their distinctions as apperceptive organs, he unconsciously reads their +distinctions into his cases. His paper, at any rate, is a genuine +contribution as well as an encouragement to those who seek to correlate the +normal with the abnormal. + +DR. JAMES J. PUTNAM, Boston: I only want to express my warm sympathy with +Dr. Southard's scheme. This careful working out of correlations one would +say is a good method of scientific research and must lead to something. I +think Dr. Southard would rather avoid the suggestion of CAUSES for the +results that he found, but the METHOD appears safe and profitable. + +DR. JOHN T. MACCURDY, New York: As another psychoanalyst it gives me +pleasure to hear this paper. As a psychoanalyst, and one who has done most +of his work with the delusions. of the insane, I must say that I have felt +all along that psychoanalysis fails utterly when it tries to account for the +manifest content of a delusion. We can trace the psychological stages from +the manifest content in varying delusions back to a more or less constant +unconscious striving-- the latent content. The tendency of this latent +content to appear as delusions depends on a defect of adaptation, which must +have a physical basis probably of a general nature. The delusions, in many +cases, are symbols of the latent content. From a psycho-analytic standpoint, +the problem presented in Dr. Southard's paper is "Why is a certain symbol +chosen in one case and another in another individual?" It may well be that +specific organic factors operate here. One could imagine that the mechanism +is purely psychological. In a hepatic condition, for instance, the attention +of the patient may be directed to that part of the body which is affected by +the pathological process in the liver and that for this reason the ideas +which appear refer to generations in that region. At least we may hope for +definite and interesting results from elaboration of the method outlined by +Dr. Southard's statistics. + +DR. SOUTHARD: I am rather astonished and well pleased at the cordial +reception of my little statistical work on delusions and upon the elaborate +discussion. As to Dr. Hall's question whether my data were collected to +prove the a priori contention concerning the correlation of unpleasantness +with lesions below the diaphragm, I would say that I expressed a suspicion +of this correlation in my paper on "How Far is the Environment Responsible +for Delusions," (Journal of Abnormal Psychology, June-July, 1913). I was +stimulated to finish my article by the appearance of Shand's book on "The +Foundations of Character" and the articles on "Personality" by Prof. Roscoe +Pound which have been appearing in the Harvard Law Review. + +"Dyslalia Viewed as a Centre Asthenia" was the title of a paper read by Dr. +Walter B. Swift, Boston.[1] + +[1] Reserved for Publication. + +NO DISCUSSION + +DR. JOHN T. MACCURDY, New York, read a joint paper (with DR. W. T. TREADWAY) +entitled "Constructive Delusions."[2] + +[2] Published in the August-September number, p. 153, of this Journal. + +DISCUSSION. + +DR. WILLIAM A. WHITE, Washington, D. C., spoke of his interest in the paper +and his agreement with it. He suggested that it might be quite proper to +use the term "archaic" in speaking of this type of delusions. He also +commented on the recurrence of the excitement in the case of the last +patient quoted which, he suggested, might represent a physical periodicity +as the individual had a homosexual component in his make-up, so that it +might be reasonable to suppose that this was fundamentally sex periodicity. + +PRESIDENT HALL: Sex periodicity in males is very interesting. A student of +mine many years ago kept his own record for some years and published it +anonymously in my journal, as did another some ten years ago, and the +twenty-eight day cycle seemed very marked in the first and somewhat so in +the last of these papers. They are certainly interesting to the geneticist. +We now often speak of dreams as protectors of sleep. I am inclined to think +that a good many delusions are protectors of sanity in much the same way, +and I am not at all sure that we cannot say that we shall ere long see that +this is to a great extent true for the imagination. If this patient had a +less vivid fancy perhaps his delusions would have been kept less fluid and +his sanity would have been better protected. Is there not a relation between +floridness of fancy which passes easily over to delusions (just as creative +geniuses are allied to artists), but may there not be an inverse correlation +between great liveliness and activity of fancy and liability to fixed +delusions? At any rate, from the normal standpoint we are seeing more and +more that man lives on a genetic scale. This might be illustrated by the +many cases, some of them pretty well analyzed, of cat-phobias. The greatest +enemies of mankind were once the felidae, and the theory now is that this +type is made up of very definite elements, viz., sharp claws, stealthy +tread, eyes that shine in the dark, power to leap far and suddenly, a +uniquely developed voice, etc. Now the cat-phobiacs generally focus on some +one of these traits in consciousness, but analysis seems to show that the +rest of them reinforce the one that experience happens to thrust forward +into the center of the field of consciousness. In general it seems to me +that it is a great educational advantage to keep open the experiences that +connect us with the past of the race, and it may have a psychotherapeutic +value which we do not now dream. Years ago a New York paper investigated, +with the aid of many of its reporters, and found hundreds of people fishing +off the wharves of New York on Sunday, very few of whom caught any fish, and +many who did threw them back. They were reverting to the old piscatorial +stage, feeling again the old thrill of a nibble on the hook, and went home +refreshed, even if they had not had a bite, because they had been able to +drop back into an ancient stratum of the soul which was sound, so that they +came back to the hard reality of the next day refreshed. Play in general, +too, we now regard as reversionary, and I cannot but believe that many +delusions are precisely the same. + +DR. TOM A. WILLIAMS, Washington, D. C: Dr. Hall has cited the cat-phobia in +illustration that the belief that Dr. MacCurdy developed may be one in which +there may be philogenetic reasons for the phenomena. It seems to me that +before we use such data we need analyses more complete than has been given +for any of them. His citation brought to my mind a case I am working with +now, a cat-phobia. The cat does not represent sharp eyes and claws. The cat +is a definite symbol of definite sexual occurrences in childhood. I should +like to ask whether it would be here desired to draw philogenetic +conclusions. I think not without the further analysis which would be +necessary. I have a very strong distrust of the efforts which Jung and +Abrahams have made, followed by some of us, to draw analogy between the +morphological changes and the psychological experiences of the race as +reproductions in the life history of the individual. + +DR. E. E. SOUTHARD: I should be inclined to feel that much of the +disturbance in the constructive delusion group would be structurally founded +upon normal or abnormal conditions in the parietal lobe. At any rate cases +with hyperphantasia in my recent Dementia Praecox series (American Journal +of Insanity, 1914-15) appear to be correlated with parietal lobe anomalies +and atrophies. It is a curious thing that such subjects with +hyperphantastic delusions are very often good institutional workers. +Although a delusion of persecution by poison is an exceedingly simple +delusion, it is in a sense far more harmful to the organism and may be often +far more productive of motor results in a patient than an elaborate +psuedo-scientific theory such as constructed by Dr. MacCurdy's patient. It +is obvious that the degree of disease does not vary directly with the +simplicity of the delusion. + +It seems to me that Dr. MacCurdy's work has not only theoretical interest +but also practical importance from the standpoint of prognosis. + +DR. WALTER B. SWIFT, Boston: I often wonder if we are not a little inclined +to go too far back for explanations. In football it is recognized that the +men on the field have two sets of reflexes out of which they play under +different circumstances. One is a set that they have learned in the lower +schools; and the other is the reflex circle that they use after they have +been trained differently in college. When these men get tired it is a +psychological observation that they go back to those first learned reflex +mechanisms. That is, when tired, they play the football of the secondary +schools. Something similar occurs in stammering. When a case is trained to +have a higher reflex vocalization, and they learn to vocalize spontaneously, +it inhibits their stammering. But when they get tired they revert again. In +the subject under discussion are we not reaching too far back for sources? +Should we not go to infancy or early childhood (to the old reflex circle +there) rather than to ones we suppose are inherited? + +DR. TOM A. WILLIAMS, Washington, D. C.: My remarks do not apply to the +contents of the delusions, of course, but to the cerebral capacities merely +which were susceptible of the formation of such delusions. + +DR. SMITH ELY JELLIFFE, New York: Dr. MacCurdy's paper fascinated me a +great deal. There is so much material that one is in a maze. I am sorry, +moreover, that he had to mutilate his conclusions by being forced by lack of +time to condense them. It strikes me he gives us a very important +contribution to the mechanism of the cure of some psychoses. That mechanism +of cure, may be stated as follows: How can one take the split off libido +which results from the analytic technique and apply it to a better +constructive synthesis? It would seem that these constructive delusions +really correspond to interpretative schemes whereby a certain amount of the +split off libido becomes synthesized. In that sense these delusions are +constructive and are, therefore, helpful to the patient. They represent +partial curative processes. + +DR. JOHN T. MACCURDY, New York: I would like to refer briefly, first, to +the point made by Dr. White to the effect that these ideas were interesting +in so far as they were archaic. That is true and it is one of the +profoundest truths we have to offer. At the same time it is of psychological +and not strictly speaking of psychiatric value. The purpose of my paper was +essentially psychiatric, to point out that there is a prognostic value in +such delusion as I have tried to outline. Now one can get archaic delusions +in patients very much deteriorated. The point of this paper is rather to +show, as the discussion brought out, that it is the constructive tendency +operating in the insane as it has historically in the race. The second point +as to the cycle in his attacks, to follow the inference of Dr. White, I +presume he meant to imply that there may have been some organic swing +corresponding to the psychotic swing. That of course is quite possible. At +the same time the analysis of this case showed that purely psychic factors +had a great deal to do with it. His monthly attacks seemed to represent a +break in the balance. He was always in unstable equilibrium and the factor +that seemed to decide the issue finally between relative sanity and a +markedly deteriorated state, was a purely psychological one. When his father +died, when he was released from that bondage, the relief seemed just enough +to decide the issue. So the organic factors here seem to be the general, +underlying inability to adapt himself. One of the hardest situations to +adapt himself to was his relations with his father. If he could not free +himself he was going to be very insane. When that factor was removed he +became relatively insane. + +DR. TOM A. WILLIAMS, Washington, D. C., read a paper entitled, "The origin +of Supernatural Explanations."[*] + +[*] Published in this number of the Journal, p. 236. + +DISCUSSION + +DR. E. E. SOUTHARD, Boston: Are all these somatic explanations of +metaphysics? + +DR. WILLIAMS: Largely. + +DR. SMITH ELY JELLIFFE, New York: I recall a note in one of Dr. Jones' +papers in which he says "that in the future our reason will be used to +explain things. Heretofore it has been used to explain them away." + +DR. TOM A. WILLIAMS, Washington, D. C.: I am not prepared to make any +predictions about a thousand years from now, that is in the air. I mention +not the levels at all, nor do I speak of "decerebrate metaphysics." Nor do I +speak of metaphysics at all unless one would imply that what I have called +supernatural explanations needs must be metaphysical. I do not speak of +cerebral functions per se. I was simply speaking of states of feelings. +The source and origin I did not go into. I simply made an attempt to imply +that such states of feeling were responsible for the discomfort and feeling +of inadequacy of the patient, and as Dr. Jelliffe has well repeated that the +victim attempts to rationalize this in supernatural fashion and that this +may be not at all dependent upon the notion of the supernatural universe he +has imbibed as a child. It is a construing of natural means for getting out +of a difficulty. + +Dr. L. E. Emerson, Boston, read a paper entitled "The Psycho-Analytic +Treatment of Hystero-Epilepsy."[*] + +[*] Reserved for publication. + +DISCUSSION + +DR. JOHN T. MACCURDY, New York: I have been very much interested in this +paper by Dr. Emerson and the part that has interested me most in it has been +the therapeutic side. I cannot feel, however, that it adds a great deal to +our knowledge of epilepsy, that is, of idiopathic epilepsy. That, of course, +is a tremendously difficult problem to tackle. If we are to regard it as a +psychosis then we expect it to show other reactions, just as dementia +praecox shows manic depressive symptoms. If we are to find out what the +epileptic reaction is, we must study it in those who are typically epileptic +and nothing else. Or else we may examine those with transitional states +grading over into hysteria, for example, excluding from our formulations +everything in them that is hysteric. This last case which Dr. Emerson +brought forward seemed to me to represent what is essentially an hysteric +reaction. The convulsive movements this man went through were symbolic. It +is difficult to regard these movements in epilepsy as symbolic because in +the true epileptic there is as typical unconsciousness as we know. How can +anything going on in almost absolute unconsciousness represent something +symbolic to the individual? This is possible however, when the condition +grades off from the hysteric side into the epileptic. The fundamental +epileptic phenomenon is the disturbance of consciousness, and that is what +must be explained. + +DR. TOM A. WILLIAMS, Washington, D. C.: I don't know that we can say that +the fundamental differentiation of epilepsy is the unconsciousness. That is +a psychological division. The paper did not give any differential why they +were regarded as epileptics at all. There was no description of the +convulsion, except in so far as this formed the hysteric form of convulsion, +so I don't think we are in a position to discuss the paper without more +clear data of these instances. + +DR. WALTER B. SWIFT, Boston: I was interested in hearing about the case of +stammering. That will be explained in my own paper and I have also run up +against several who have done the same. I should like to ask Dr. Emerson if +he considers stammering as an expression of an orgasm. + +DR. L. E. EMERSON, Boston: Dr. MacCurdy well remarked that this adds +nothing to the understanding of epilepsy. In a certain sense this is true. +I do not feel that I could add anything to a deeper understanding of +epilepsy. The whole development of psycho-analytic theory, up to a certain +point, has been based on the actual recovery of patients, if you do not like +the use of the word cure, from particular symptoms. Then this has been +generalized. Now that has opened an enormous field for ratiocination. +Therefore, I am not at all sure that these conceptions will really apply to +essential epilepsies or to the real epilepsies. I do not know how far our +conceptions which originate in the therapeutic situation will apply to the +situation which appears to be absolutely beyond therapeutics. In regard to +what Dr. White said of starting from the known and going through +transitional stages to the unknown, you do get insight and it may be that +the condition as described in this broad way by Clark and by Stekel and +others may be true, but I am not perfectly sure. I am very grateful for Dr. +Allen's approval of this way of putting things because perhaps it is a +defence reaction on my own part that occasionally I feel it necessary to +report things I have seen with my own eyes and really experienced, instead +of following my natural tendency to go off into vague philosophizing. + + + +REVIEWS + +PSYCHOLOGY IN DAILY LIFE. By Carl Emil Seashore. 1914, XVIII plus 226 pp., +N. Y., D. Appleton & Co. + +This is the first volume of the "Conduct of Mind" series, the purpose of +which, as stated by its editor, Professor Joseph Jastrow, in his +introduction to the series, is "to provide readily intelligible surveys of +selected aspects of the study of mind and its applications." The present +work contains seven chapters, which were originally prepared as +"semi-popular addresses." As a consequence, the book lacks somewhat in +coherence, but, except in a few places, the emphasis is practical +throughout. It is perhaps not surprising that the most subtle and modern +part of the discussion, viz. the chapter on "Mental Law" should be the +least practical in its bearing. + +In the first chapter is discussed the practical importance of "Play," not +only in offering the opportunity for sensory, central, and motor development +in the child, but for releasing the broader life energies of the adult whose +mind is confined by specializing work. It is shown that the fundamental +motives of the play life are to be found in religion. + +The next three chapters, on "Serviceable Memory," "Mental Efficiency," and +"Mental Health," are full of sound practical advice. The first contains a +clear and attractive presentation of the principles of remembering, so +arranged as to exemplify the rules which it inculcates. The second +emphasizes the importance of the wave form of attention in all mental work, +the superiority of efferent to afferent response as an educational process, +and the acquirement of mastery by a transfer of control from higher to lower +mental levels. There is also good counsel with regard to the best time and +manner in which to rest, although the author's deductions from the +physiological "curve of sleep" appear somewhat hasty. "Mental Health" is +defined in terms of our mental "members" in the classical way, and the "Ten +Maxims of Wise Living," which are given, are selected from the history of +moral philosophy rather than from current psychotherapeutic results. + +The chapter on "Mental Law" is the most interesting one for the theoretical +psychologist, and discusses in a general but illuminating manner, principles +of perception and of perseveration which are of interest to the +psychological psychiatrist. The chapter on "Law in Illusion" seems +disproportionately long, but gives an interesting description and analysis +of three different types of illusions: those based on "units of direction," +the over-estimation of "cylinder height," and upon the "size-weight" error. +In connection with the second, the results of original investigations in the +author's laboratory are presented. It is shown that a knowledge of the +complex but definite principles underlying illusions can be made practically +serviceable, for example, in tests of mental normality. + +The final chapter deals with a specific illustrative problem in "Mental +Measurement," viz. the determination of a subject's fitness for a musical +career. A detailed analysis of the problem is offered, and it is shown that +the elemental questions involved can be answered by the methods of the +psychological laboratory, but that these answers require expert +interpretation before they can be made practically applicable. + +The author's style is engaging and clear. LEONARD THOMPSON TROLAND. + +AN OUTLINE OF PSYCHOBIOLOGY. By Knight Dunlap, Associate Professor of +Psychology in the Johns Hopkins University. Baltimore, The Johns Hopkins +Press, 1914. Pp. 121, octavo; illustrated. + +This volume even though brief will be highly appreciated by very many +students of normal and of abnormal psychology because it is the first book +to afford them just what, in an elementary way, they need concerning the +nervous system, the essential musculatures, and the epithelia, whose +manifold activities are in some certain mode concomitant to the succession +of compound mental events. Surely, and widely, those who a few years ago +"came to scoff" at the ever-rising scientific stream of mind-protoplasm +relationship will "remain to pray" to the rising and satisfying goddess of +the new philosophy. The body with its unimagined intricacies and beauties of +still unguessed adaptation and its marvels of Someone's ingenuity is surely +now at length coming into its own. And when, after the years, it has come +into its own in a reasonable measure, "the continuity of mind-and-energy" +and "the dynamic-spiritualism of the Cosmos" when they are mentioned will no +longer draw that quasi-withering smile of toleration to the face of the +orthodox psychologist with which some of us are familiar. + +This volume, happily devised by Professor Dunlap to meet this real need, at +first in his own pupils and later in a wider public, will materially help +this progress, for it has within it in fairly up-to-date and simple form +much of the structure and function, always of surpassing interest when +understood, of the human action-system. Seventy-seven excellently clear and +well-chosen illustrations make the well-printed text still more informing. +There is a good index; and short lists of books at the ends of the chapters. + +The present reviewer notes only one omission of substantial importance from +the neurologic part of the book, and that is the very recent, howbeit +important, matter of the functional opposition between the sympathetic +proper and the other, the cranio-sacral, portion of "the autonomic." The +work lacks also, in this first edition, a statement and discussion of the +important all-or-none principle which is now applicable to voluntary muscle, +probably, and to the neurones. And it is to be hoped too that the author +will take the bull by the horns and, in the next edition, show the nature of +protoplasm in general in an homologous way, as the basis, through its +uniquely complex kineticism, of the onward rush of the mental process. With +this addition the essential nature of irritability too might be set forth in +this already valuable (and inexpensive) treatise. GEORGE V. N. DEARBORN. +Sargent Normal School. + +PSYCHOLOGY, GENERAL AND APPLIED. Hugo Munsterberg New York and London: D. +Appleton and Co., 1914; Pp. xiv X487 1.75. + +In this volume, designed to serve the needs both of the general reader and +of the college student, Professor Munsterberg has represented in most +readable form the essentials of the entire range of his contributions to +psychology. The well-known differentiation of the "two psychologies" is the +core of the book; herewith is reintroduced the psychology of the soul, not +merely as being on a level with, but ultimately even superordinate to, the +descriptive psychology which had banished from so many systems all mention +of the soul or even of the self. For we are shown how all description and +explanation, whether of material objects or of conscious processes, is after +all but construction in the service of purposes, to apprehend, understand, +and realize which is the primary business, of life. + +This exposition of purposive psychology, surely the most novel feature of +the book, is what interests us most, and we discover with disappointment +that though theoretically every conscious state is subject-matter for either +type of psychology, i.e. may be either described in its causal relationships +or immediately grasped as an act of will, still Professor Munsterberg fills +five times as many pages with the usual descriptive psychology as with this +newer departure. We willingly conceded the importance of tradition in +textbook writing, but would urge upon Professor Munsterberg the impatience +with which we await more extended treatment of this topic. + +A second deviation for a book of this type,--if Professor Munsterberg may +rightly be said ever to write books typical of anything but his own +uniqueness,--is the inclusion of a section on social psychology. This too, +we are inclined to regard as in nature of a promise, representing the +germination of lines of thought which we are assured elsewhere[*] are later +to receive more elaborate formulation. + +[*] Munsterburg, H. "Grundzuge der Psychotechnik." Leipzig, 1914. Vorwort, +S. VIII. + +Thirdly, one of the main divisions of the book is devoted to applied +psychology, the presentation here being essentially an abstract of the +author's previous publications in the field of his acknowledged preeminence, +psychotechnics. + +Throughout the book discussion of general principles, whether of philosophy +or biology, takes precedence over the presentation of concrete facts; the +text contains no explicit references, though a brief bibliography of works +in English is appended. The consequent gain in readability is only one of +the many factors which insure this volume a very wide reading. R. M. +ELLIOTT. Harvard University. + + + +THE JOURNAL OF ABNORMAL PSYCHOLOGY + +THE SEX WORSHIP AND SYMBOLISM OF PRIMITIVE RACES + +BY SANGER BROWN II., M. D. + +Assistant Physician--Bloomingdale Hospital. + +PSYCHIATRY, during recent years, has found it to its advantage to turn to a +number of related sciences and allied branches of study for the explanation +of a number of the peculiar symptoms of abnormal mental states. Of these +related studies, none have been of greater value than those which throw +light on the mental development of either the individual or the race. In +primitive races we discover a number of inherent motives which are of +interest from the standpoint of mental development. These motives are +expressed in a very interesting symbolism. It is the duty of the +psychiatrist to see to what extent these primitive motives operate +subconsciously in abnormal mental conditions, and also to learn whether an +insight into the symbolism of mental diseases may be gained, through +comparison, by a study of the symbolism of primitive races. In the +following communication one particular motive with its accompanying +symbolism is dealt with. The application of these findings must be left with +the psychiatrist in his clinical studies. + +A great many of the institutions and usages of our present day civilization +originated at a very early period in the history of the race. Many of these +usages are carried on in modified form century after century, after they +have lost the meaning which they originally possessed; it must be +remembered, however, that in primitive races they were of importance, and +they arose because they served a useful end. From the study of these +remnants of former days, we are able to learn the trends of thought which +activated and inspired the minds of primitive people. When we clearly +understand these motives, we may then judge the extent of their influence on +our present day thought and tendencies. + +Now, in our present communication, we wish to deal with a motive which we +find expressed very generally in primitive religion; this is the worship of +sex. We not only find evidences of this worship in the records and +monuments of antiquity, but our knowledge of the customs and practices of +certain tribes, studied in comparatively modern times, indicates the +presence of this same primitive religion. We feel that in sex worship we are +dealing with an important motive in racial development, and our object at +present is to give an account of its various phases. + +Before we proceed, it is desirable to make reference to some of our sources +of information. There are plenty of books on the history of Egypt, the +antiquities of India or on the interpretation of Oriental customs, which +make scarcely any reference to the deification of sex. We have always been +told, for example, that Bacchus was the god of the harvest and that the +Greek Pan was the god of nature. We have not been told that these same gods +were representations of the male generative attribute, and that they were +worshipped as such; yet, anyone who has access to the statuettes or +engravings of these various deities of antiquity, whether they be of Egypt, +of India or of China, cannot fail to see that they were intended to +represent generative attributes. On account of the incompleteness of many +books which describe primitive races, a number of references are given +throughout these pages, and some Bibliographical references are added. + +SIMPLE SEX WORSHIP + +As will be presently shown, we have evidence from a number of sources to +show that sex was at one time frankly and openly worshipped by the primitive +races of mankind. This worship has been shown to be so general and so +widespread, that it is to be regarded as part of the general evolution of +the human mind; it seems to be indigenous with the race, rather than an +isolated or exceptional circumstance. + +The American Cyclopedia, under Phallic worship, reads as follows "In early +ages the sexual emblems were adored as most sacred objects, and in the +several polytheistic systems the act or principle of which the phallus was +the type was represented by a deity to whom it was consecrated: in Egypt by +Khem, in India by Siva, in Assyria by Vul, in primitive Greece by Pan, and +later by Priapus, in Italy by Mutinus or Priapus, among the Teutonic and +Scandinavian nations by Fricco, and in Spain by Hortanes. Phallic monuments +and sculptured emblems are found in all parts of the world." + +Rawlinson, in his history of Ancient Egypt, gives us the following +description of Khem: "A full Egyptian idea of Khem can scarcely be +presented to the modern reader, on account of the grossness of the forms +under which it was exhibited. Some modern Egyptologists endeavor to excuse +or palliate this grossness; but it seems scarcely possible that it should +not have been accompanied by indelicacy of thought or that it should have +failed to exercise a corrupting influence on life and morals. Khem, no +doubt, represented to the initiated merely the generative power in nature, +or that strange law by which living organisms, animal and vegetable, are +enabled to reproduce their like. But who shall say in what exact light he +presented himself to the vulgar, who had continually before their eyes the +indecent figures under which the painters and sculptors portrayed him? As +impure ideas and revolting practices clustered around the worship of Pan in +Greece and later Rome, so it is more than probable that in the worship of +Khem in Egypt were connected similar excesses. Besides his priapic or +"Ithyphallic" form, Khem's character was marked by the assignment to him of +the goat as his symbol, and by his ordinary title Ka-mutf, "The Bull of his +Mother," i.e., of nature." + +This paragraph clearly indicates that the sexual organs were worshipped +under the form of Khem by the Egyptians. The writer, however, has fallen +into a very common error in giving us to understand that this was a degraded +form of worship; from numerous other sources it is readily shown that such +is not the case. + +The following lines, from "Ancient Sex Worship," substantiate the above +remarks, and at the same time, they show the incompleteness of the writings +of many antiquarians. In this book we read: "Phallic emblems abounded at +Heliopolis and Syria and many other places, even in to modern times. The +following unfolds marvelous proof to our point. A brother physician, writing +to Dr. Inman, says: 'I was in Egypt last winter (1865-66), and there +certainly are numerous figures of gods and kings on the walls of the temple +at Thebes, depicted with the male genital erect. The great temple at Karnac +is, in particular, full of such figures and the temple of Danclesa, +likewise, although that is of much later date, and built merely in imitation +of old Egyptian art.' " The writer further states that this shows how +completely English Egyptologists have suppressed a portion of the facts in +the histories which they have given to the world. With all our descriptions +of the wonderful temple of Karnac, it is remarkable that all mention of its +association with sex worship should be omitted by many writers. + +A number of travellers in Africa, even in comparatively modern times, have +observed evidences of sex worship among the primitive races of that +continent. Captain Burton[1] speaks of this custom with the Dahome tribe +Small gods of clay are made in priapic attitudes before which the natives +worship. The god is often made as if contemplating its sexual organs. +Another traveler, a clergyman,[2] has described the same worship in this +tribe. He has observed idols in priapic attitudes, rudely carved in wood, +and others made of clay. On the lower Congo the same worship is described, +where both male and female figures with disproportionate genital organs are +used for purposes of worship. Phallic symbols and other offerings are made +to these simple deities. + +[1] Quoted by H. M. Westropp, Primitive Symbolism + +[2] J. W. Wood. The uncivilized Races. + +Definite examples of the sexual act having religious significance may be +cited. Richard Payne Knight[3] quotes a passage from Captain Cook's voyages +to one of the Southern Pacific Islands. The Missionaries of the expedition +on this occasion assembled the members of the party for religious ceremonies +in which the natives joined. The primitive natives observed the ceremony +with great respect and then with due solemnity enacted their form of sacred +worship. Quite to the astonishment of the white people, this ceremony +consisted of the open performance of the sexual act by a young Indian man +and woman. This was entirely a religious ceremony, and was fittingly +respected by all the natives present. + +[3] The symbolical language of ancient art and mythology. + +Hargrave Jennings[4] describes the same custom in India. An Indian woman of +designated caste and vocation is selected. Many incantations and strange +rites are gone through. A circle, or "Vacant Enchanted Place" is rendered +pure by certain rites and sprinkled with wine. Then secret charms are +whispered three times in the woman's ear. The sexual act is then +consummated, and the whole procedure before the altar is distinctly a form +of sacrifice and worship. + +[4] The Roseicrucians. + + +Hoddar M. Westropp in "Primitive Symbolism" has indicated the countries in +which sex worship has existed. He gives numerous instances in ancient +Egypt, Assyria, Greece and Rome. In India, as well as in China and Japan, +it forms the basis of early religions. This worship is described among the +early races of Greece, Italy, Spain, Scandinavia, and among the Mexicans and +Peruvians of America as well. In Borneo, Tasmania, and Australia phallic +emblems have been found. Many other localities have been mentioned by this +writer and one seems fairly justified in concluding that sex worship is +regularly found at one time in the development of primitive races. We shall +now pass to another form of this same worship, namely, sacred prostitution. + +SACRED PROSTITUTION + +There is abundant evidence to show that there was a time in the centuries +before Christ when prostitution was held as a most sacred vocation. We +learn of this practice from many sources. It appears that temples in a +number of ancient cities of the East, in Babylonia, Nineveh, Corinth and +throughout India, were erected for the worship of certain deities. This +worship consisted of the prostitution of women. The women were consecrated +to the support of the temple. They were chosen in much the same way as the +modern woman enters a sacred church order. The returns from their vocation +went to the support of the deity and the temple. The children born of such a +union were in no way held in disgrace, but on the contrary, they appeared to +have formed a separate and rather superior class. We are told that this +practice did not interfere with a woman's opportunities for subsequent +marriage. In India the practice was very general at one time. The women +were called the "Women of the Idol." Richard Payne Knight speaks of a +thousand sacred prostitutes living in each of the temples at Eryx and +Corinth. + +A custom which shows even more clearly that prostitution was held as a +sacred duty to women was that in Babylonia every woman, of high rank or low, +must at one time in her life prostitute herself to any stranger who offered +money. In "Ancient Sex Worship" we read: "There was a temple in Babylonia +where every female had to perform once in her life a (to us) strange act of +religion, namely, prostitution with a stranger. The name of it was +Bit-Shagatha, or 'The Temple,' the 'Place of Union.' " Moreover we learn +that once a woman entered the temple for such a sacred act she could not +leave until it was performed. + +The above accounts deal exclusively in the sacrifice made by women to the +deity of sex. Men did not escape this sacrifice and it appears that some +inflicted upon themselves an even worse one. Fraser[5] tells us of this +worship which was introduced from Assyria into Rome about two hundred years +before Christ. It was the worship of Cybele and Attis. These deities were +attended by emasculated priests and the priests in oriental costume paraded +Rome in religious ceremony. + +[5] Adonis, Attis and Osiris. + +On one occasion, namely, "the day of blood" in the Spring, the chief +ceremony was held. This, among other things, consisted in fastening an +effigy of the god to a pine tree, which was brought to the temple of the +Goddess Cybele. A most spectacular dance about the effigy then occurred in +which the priests slashed themselves with knives, the blood being offered as +sacrifice. As the excitement increased the sexual nature of the ceremony +became evident. To quote from Fraser; "For man after man, his veins +throbbing with the music, his eyes fascinated by the sight of streaming +blood, flung his garments from him, leaped forth with a shout, and seizing +one of the swords which stood ready for the service, castrated himself on +the spot. Then he ran through the city holding the bloody parts in his hands +and threw them into one of the houses which he passed in his mad career." + +We see that this act directly corresponds with the part played by the +female. The female prostituted herself, and the male presented his +generative powers to the deity. Both the sacred prostitutes and emasculated +priests were held in religious veneration. + +The above references are sufficient to show that a simple form of sex +worship has been quite generally found. It becomes apparent as we proceed +that the worship of sex not only plays a part, but a very prominent part, in +the developing mind of man. In the frank and open form of this worship it is +quite clear that we are dealing with a very simple type of mind. These +primitive people exhibit many of the qualities of the child. They are quite +without sex consciousness. Their motives are at once both simple and +direct, and they are doubtless sincere. Much misunderstanding has arisen by +judging such primitive people by the standards of our present day +civilization. Sex worship, while it held sway was probably quite as +seriously entertained as many other beliefs; it only became degraded during +a decadent age, when civilization had advanced beyond such simple +conceptions of a deity, but had not evolved a satisfactory substitute. + +We shall now pass to a less frank and open deification of sex, namely, +sexual symbolism. + +SYMBOLISM + +As civilization advanced, the deification of sex was no longer frank and +open. It came to be carried on by means of symbolism. This symbolism was an +effort on the part of its originators to express the worship of the +generative attributes under disguise, often understood only by the priests +or by those initiated into the religious mysteries. The mysteries so +frequently referred to in the religions of antiquity are often some +expression of sex worship. + +Sexual symbolism was very general at one time and remains of it are found in +most of the countries where any form of sex worship has existed. Such +remains have been found in Egypt, Greece, Italy, India, China, Japan, and +indeed in most countries the early history of which is known to man. + +One important kind of symbolism had to do with the FORM of the object +deified. Thus, it appears that certain objects,--particularly upright +objects,--stones, mounds, poles, trees, etc., were erected, or used as found +in nature, as typifying the male generative organ. Likewise certain round +or oval objects, discs, certain fruits and certain natural caves, were +worshipped as representing the female generative organ. (The yoni of India.) + +We also find that certain QUALITIES OF ANIMAL OR VEGETABLE nature were +equally venerated, not because of their form, but because they stood for +some quality desirable in the generation of mankind. Thus we find that some +animals--the bull because of its strength and aggressive nature, the snake, +perhaps because of its form or of its tenacity of life,--were male +representatives of phallic significance. Likewise the fish, the dolphin, and +a number of other aquatic creatures came to be female representatives. This +may be shown over and over again by reference to the antique emblems, coins, +and engravings of many nations. + +Another later symbolism, which was adopted by certain philosophies, was more +obscure but was none the less of distinct sexual significance. FIRE is made +to represent the male principle, and WATER, and much connected with it, the +female. Thus we have Venus, born of the Sea, and accompanied by numerous +fish representations. Fire worship was secondary to the universally found +sun worship. The sun is everywhere the male principle, standing for the +generative power in nature. At one time the symbolism is broad, and refers +to generative nature in general. At another time it refers solely to the +human generative organs. Thus, the Greek God Hermes, the God of Fecundity in +nature, is at times represented in unmistakable priapic attitudes. + +Still another symbolism was often used in India. This was the addition of a +number of members to the deity, possibly a number of arms or heads. This +was in order to express a number of qualities. Thus the deity was both +generator and destroyer, one face showing benevolence and kindness, the +other violence and rage. In many of the deities both male and female +principles were represented in one,--an Androgyne deity--which was an ideal +frequently attempted. The idea that these grotesque deities were merely the +expression of eccentricity or caprice on the part of their originator is not +to be entertained. Richard Payne Knight has pointed out that they occur +almost entirely on national coins and emblems, and so were the expression of +an established belief. + +We shall refer first to the simpler symbols, that is those in which an +object was deified because of its form. + +THE UPRIGHT + +It is perhaps not remarkable that upright objects should be selected because +of their form as the simplest expression of phallic ideas. The simple +upright for purposes of sex worship is universally found. An upright conical +stone is frequently mentioned. Many of the stone idols or pillars, the +worship of which was forbidden by the Bible, come under this group. +Likewise, the obelisk, found not only in Egypt, but in modified forms in +many other countries as well, embodies the same phallic principle. The usual +explanation of the obelisk is that it represented the rays of the sun +striking the earth: when we speak of sun worship later, we shall see that +this substantiates rather than refutes the phallic interpretation. The +mounds of religious significance, found in many countries, were associated +with sex worship. The Chinese pagodas are probably of phallic origin. +Indeed, there is evidence to show that the spires of our Churches owe their +existence to the uprights or obelisks outside the Temples of former ages. A +large volume has been written by O'Brien to show that the Round Towers of +Ireland (upright towers of pre-historic times) were erected as phallic +emblems. Higgins, in the Anacalipsis, has amassed a great wealth of +material with similar purport, and he shows that such "temples" as that of +Stonehenge and others were also phallic. The stone idols of Mexico and Peru, +the ancient pillar stones of Brittany, and in fact all similar upright +objects, erected for religious purposes the world over, are placed in this +same category. We shall presently give a number of references to show that +the May-pole was associated with phallic worship and that it originated at a +very remote period. + +We shall now quote from some of the authors who have contributed to our +knowledge of this form of symbolism, as thereby a clear idea of their +meaning may be set forth. These interpretations are not generally advanced, +and therefore we have added considerable corroborative evidence which we +have been able to obtain from independent sources. + +In an Essay on the Assyrian "Grove" and other Emblems, Mr. John Newton sums +up the basis of this symbolism as follows: "As civilization advanced, the +gross symbols of creative power were cast aside, and priestly ingenuity was +taxed to the utmost in inventing a crowd of less obvious emblems, which +should represent the ancient ideas in a decorous manner. The old belief was +retained, but in a mysterious or sublimated form. As symbols of the male, or +active element in creation, the sun, light, fire, a torch, the phallus or +lingam, an erect serpent, a tall straight tree, especially the palm or fir +or pine, were adapted. Equally useful for symbolism were a tall upright +stone (menhir), a cone, a pyramid, a thumb or finger pointed straight, a +mask, a rod, a trident, a narrow bottle or amphora, a bow, an arrow, a +lance, a horse, a bull, a lion, and many other animals conspicuous for +masculine power. As symbols of the female, the passive though fruitful +element in creation, the crescent moon, the earth, darkness, water, and its +emblem, a triangle with the apex downward, "the yoni"--the shallow vessel or +cup for pouring fluid into (cetera), a ring or oval, a lozenge, any narrow +cleft, either natural or artificial, an arch or doorway, were employed. In +the same category of symbols came a boat or ship, a female date palm bearing +fruit, a cow with her calf by her side, a fish, fruits having many seeds, +such as the pomegranate, a shell, (concha), a cavern, a garden, a fountain, +a bower, a rose, a fig, and other things of suggestive form, etc. + +These two great classes of conventional symbols were often represented IN +CONJUNCTION with each other, and thus symbolized in the highest degree the +great source of life, ever originating, ever renewed . . . . . . . . . . "A +similar emblem is the lingam standing in the centre of the yoni, the +adoration of which is to this day characteristic of the leading dogma of +Hindu religion. There is scarcely a temple in India which has not its +lingam, and in numerous instances this symbol is the only form under which +the god Siva is worshipped." + +In "Ancient Sex Worship" we read, "As the male genital organs were held in +early times to exemplify the actual male creative power, various natural +objects were seized upon to express the theistic idea and at the same time +point to those points of the human form. Hence, a similitude is recognized +in a pillar, a heap of stones, a tree between two rocks, a club between two +pine cones, a trident, a thyrsus tied around with two ribbons with the ends +pendant, a thumb and two fingers. The caduceus again the conspicuous part +of the sacred Triad Ashur is symbolized by a single stone placed +upright,--the stump of a tree, a block, a tower, a spire, minaret, pole, +pine, poplar or pine tree." + +Hargrave Jennings, the author of several books on some aspects of religions +of antiquity, among them one on phallicism deals freely with the phallic +principles embodied in these religions. As do many other writers, he +identifies fire worship with sex worship, and the following short paragraph +shows his conception of their interrelationship, as well as the significance +of the upright of antiquity. In the Rosicrucians he says: "Obelisks, +spires, minarets, tall towers, upright stones, (menhirs), and architectural +perpendiculars of every description, and, generally speaking, all erections +conspicuous for height and slimness, were representations of the Sworded or +of the Pyramidal Fire. They bespoke, wherever found and in whatever age, +the idea of the First Principle or the male generative emblem." + +We might readily cite passages from the writings of a number of other +authors but the above paragraphs suffice to set forth the general principle +of this symbolism. As stated above, such interpretations have not been +generally advanced to explain such objects as sacred pillar stones, +obelisks, minarets, etc. It is readily seen how fully these views are +substantiated by observations from a number of independent sources. + +In a book of Travel[6] in India we are able from an independent source to +learn of the symbolism of that country. The traveller gives a description of +the caves of Elephanta, near Bombay. These are enormous caves cut in the +side of a mountain, for religious purposes to which pilgrimages are made and +where the usual festivities are held. The worship of generative attributes +is quite apparent. The numerous sculptured female figures, as remarked by +the traveller, are all represented with greatly exaggerated breasts, a +symbolism which is frequent throughout oriental countries for expressing +reproductive attributes. + +[6] Rousselet, India and its native princes. + +In an inner chamber is placed the symbol which is held in particular +veneration. Here is found an upright conical stone standing within a +circular one. The stone is sprinkled with water during the festival season. +The writer states that this stone, to the worshippers, represents the male +generative organ, and the worship of it is not considered an impropriety. In +this instance we feel that the symbolism is very definite, and doubtless the +stone pillars in the other temples of India and elsewhere are of the same +significance. + +A clergyman in the Chinese Review of 1876, under the title "Phallic Worship +in China," gives an account of the phallicism as he observed it at that +time. He states that the male sexual organ is symbolized by a simple mound +of earth and is so worshipped. Similarly, the female organ is represented +by a mound of different form and is worshipped as the former. The writer +states that at times these mounds are built in conjunction. He states this +worship is similar to that of Baal of Chaldea, etc., and that probably all +have a common origin. It appears to be a fundamental part of the Chinese +religion and the symbolism of the Chinese pagoda expresses the same idea. He +says that Kheen or Shang-te, the Chinese deities of sex, are also worshipped +in the form of serpents, of which the dragon of the Chinese is a +modification. This furnishes a concrete instance in which the mound of +earth is of phallic significance, and substantiates an interpretation of +serpent worship to which we shall presently refer. + +Hoddard M. Westropp has given us an excellent account of phallic worship and +includes in his description the observations of a traveller in Japan at as +late periods as 1864 and 1869. + +A temple near the ancient capital of Japan was visited by a traveller. In +this temple the main object of worship was a large upright, standing alone, +and the resemblance to the male generative organ was so striking as to leave +no doubt as to what it represented. This upright was worshipped especially +by women, who left votive offerings, among them small phalli, elaborately +wrought out of wood or other material. The traveller remarked that the +worship was most earnest and sincere. + +The same traveller observed that in some of the public roads of Japan are +small hedged recesses where similar stone pillars are found. These large +pillars unquestionably represent the male organ. The writer has observed +priests in procession carrying similar huge phalli, painted in color as +well. This procession called forth no particular comment and so was +probably not unusual. It is stated that this is a part of the ancient +"Shintoo" religion of Japan and China. There are frequent references to +certain of the gods of the Ancients being represented in priapic attitudes, +the phallus being the prominent and most important attribute. Thus Hermes, +in Greece, was placed at cross-roads, with phallus prominent. This was +comparable to the phallus on Japanese highways. In the festivals of Bacchus +high phalli were carried, the male organ being represented about the size of +the rest of the body. The Egyptians carried a gilt phallus, 150 cubits high, +at the festivals of Osiris. In Syria, at the entrance of the temple at +Hieropolis, was placed a human figure with a phallus 120 cubits high. A man +mounted this upright twice a year and remained seven days, offering prayers, +etc. + +In Peru in the Temple of the Sun an upright pillar has been described +covered with gold leaf, very similar to those existing elsewhere and to +which has been ascribed similar significance. + +A number of writers have expressed the belief that the May-pole is an emblem +of ancient phallic worship. We know that May-day festivals are of the most +remote antiquity. We are indebted to R. P. Knight for a description of what +May-day was like about four centuries ago in England. The festival started +the evening before. Men and women went out into the woods in search of a +tree and brought it back to the village in the early morning. The night was +spent in sexual excesses comparable to those of the Roman Bacchanalia. A +procession was formed, garlands were added to the May-pole, which was set up +in the village square. The Puritans referred to it as an idol, and they did +not approve of the festivities. Until comparatively recent years there was +a May-pole in one of the squares of London, and Samuel Pepys,[7] writing of +his time, speaks of seeing May-poles in the front yards of the prominent +citizens of Holland. A festival much the same as this was held in Ancient +Rome and also in India. The May-pole properly pierces a disc and thus +conforms with the lingam-yoni of India. We also know that the first of May +was a favorite time for all nature worship with the ancients. For a number +of interesting suggestions the reader is referred to R. P. Knight, Worship +of Priapus, and Hargrave Jennings, Indian Religions (Page 66.) + +[7] Pepys Diary. + +Tree worship is frequently mentioned in the religions of antiquity. We are +told that the mystic powers of the mistletoe comes from the fact that it +grows on the oak, a once sacred tree. The pine of the North, the palm and +the fig tree of the South, were sacred trees at one time. John Newton made a +study of tree worship, especially the Ancient Grove Worship of Assyria. He +shows that the object of veneration was a male date palm, which represented +the Assyrian god Baal. Sex was worshipped under this deity, and it is shown +that the tree of the Assyrian grove was a phallic symbol. Palm Sunday +appears to be a relic of this worship. In France, until comparatively +recent times, there was a festival, "La Fete des Pinnes," in which palms +were carried in procession, and with the palms were carried phalli of bread +which had been blessed by the priests. + +Richard Payne Knight tells us that Pan was worshipped by the Shepherds under +the form of the tall fir, and Bacchus "by sticking up the rude trunk of a +tree." It is shown throughout these pages that sexual attributes were +worshipped under both these deities. In reference to other symbols, the +writer continues,[8] "The spires and pinnacles with which our churches are +decorated come from these ancient symbols; and the weather cocks, with which +they are surmounted though now only employed to show the direction of the +wind, were originally emblems of the sun; for the cock is the natural herald +of the day, and therefore sacred to the fountain of light. In the +symbolical writings of the Chinese the sun is still represented by a cock in +the circle; and a modern Parsee would suffer death rather than be guilty of +the crime of killing one. It appears on many ancient coins, with some +symbol of the passive productive power on the reverse; and in other +instances it is united with priapic and other emblems and devices, +signifying other attributes combined." + +[8] Symbolic language of ancient art and mythology. + +Dr. Thomas Inman has made a study to show how this phallic symbolism found +its way into ancient art, and even into some designs of modern times. Thus, +many formal designs are studied in which the upright plays a part; likewise, +the oval and the circle receive a similar explanation. The architectural +ornaments spoken of as eggs and anchors, eggs and spear heads, the so-called +honey-suckle ornament of antiquity, and the origin of some church windows +and ornaments, are all studied by this writer, and his text is accompanied +by illustrations. Hargrave Jennings has also traced the origin of the +symbols of Heraldry, the emblems of Royalty and of some church orders with +similar explanations. + +We may add that the crux ansata of the Egyptians, the oval standing upon the +upright, or letter Tau, may be shown to be a sex symbol, the union of the +oval with the upright being of symbolic significance. The crux ansata is +found in the hand of most of the Egyptian deities. It is found in the +Assyrian temples and throughout the temples of India as well. Prehistoric +monuments of Ireland have the same design. Priests are portrayed in +adoration of the crux ansata before phallic monuments. This symbol, from +which our modern cross is doubtless derived, originated with the religions +of antiquity. Much additional evidence could readily be given to illustrate +this prehistoric origin. The present Christian symbol affords another +example of the adoption by a new religion of the symbols of the old. + +Some reflection will show that the origin of many church customs and +symbols, and indeed of a great number of obscure customs and usages, may +quite properly be traced to the religions and practices of primitive races. +Lafcadio Hearn has insisted upon this in the interpretation of the art and +customs of the Japanese. He says,[9] "Art in Japan is so intimately +associated with religion that any attempt to study it without extensive +knowledge of the beliefs which it reflects were mere waste of time. By art I +do not mean painting and sculpture but every kind of decoration, and most +kinds of pictorial representation--the image of a boy's kite or a girl's +battledore not less than the design upon a lacquered casquet or enameled +vase,--the figure upon a workman's trowel not less than the pattern of the +girdle of a princess,--the shape of the paper doll or wooden rattle bought +for a baby, not less than the forms of those colossal Ni-O who guard the +gateways of the Buddha's temples," etc. + +[9] Japan, an attempt at Interpretation. + +In the above pages, we have given an account of the views of a number of +writers upon certain forms and symbols, and at the same time we have offered +considerable evidence in substantiation from independent sources. These +origins, found associated especially in art and religious usages, have not +been generally understood. Yet when we reflect upon the fact that many +religious customs are of great antiquity; that when once a certain form or +custom becomes established, it is well nigh ineffaceable, although subject +to great change or disguise throughout the centuries; when we reflect upon +these conditions, and realize the fact that sex worship with its +accompanying symbolism is found throughout primitive religions, we may then +more readily appreciate the entire significance of the above +interpretations. + +It must, of course, be borne in mind that no one now gives these +interpretations to spires, minarets, and to the various monumental symbols +of which we have been speaking. We are here dealing exclusively with +pre-historic origins, not with present day meanings. The antiquity of +certain symbols is truly remarkable. The star and crescent, for example, a +well known conventionalized symbol, is found on Assyrian cylinders, +doubtless devised many centuries before Christ. + +The full force and meaning of these various symbols may be very readily +grasped by reference to a number of designs, ancient coins, bas-reliefs, +monuments, etc., which have been reproduced in plates and drawings by C. W. +King, Thomas Inman, R. P. Knight and others. To these we refer the reader. + +(TO BE CONCLUDED) + +REFERENCES.[10] + +[10] For a number of additional references consult New York Library under +Phallicism. + +Cox, Rev. G. W.: The Mythology of the Aryan Nations. + +Deiterich, A.: Mutter Erde. + +Fraser, J. G.: Adonis, Attis and Osiris; Balder, the Beautiful; Psyche's +Task. + +Grosse: The Beginnings of Art. + +Higgins, Godfrey: The Anacalypsis; Celtic Druids. + +Harrison, Miss Jane: Ancient Art and Ritual; Themis. + +Howitt, A. W.: The Native Tribes of South East Australia. + +Inman, Dr. Thomas: Ancient Faiths Embodied in Ancient Names; Ancient Pagan +and Modern Christian Symbolism. + +Jennings, Hargrave: The Rosicrucians; The Indian Religions. + +King, C. W: The Gnostics and their Remains; Hand-book of Engraved Gems. + +Knight, R. P.: The Symbolical Language of Ancient Art and Mythology; Two +Essays on the Worship of Priapus. + +Layard, A.: Babylon and Nineveh; Nineveh and its Remains. + +Murray, Gilbert: Hamlet and Orestes. + +Newton, John: Assyrian Grove Worship. + +O'Brien, Henry: The Round Towers of Ireland + +Rawlinson, G.: History of Ancient Egypt; Ancient Monarchies. + +Rhyn, Dr. Otto: Mysteria. + +Rocco, Sha: Ancient Sex Worship + +Spencer, B.: Native Tribes of the Northern Territory of Australia. + +Westropp, Hodder, M.: Primitive Symbolism. + +Wood, Rev. J. G.: The Uncivilized Races. + +ADDITIONAL REFERENCES (Primitive customs, religious usages, etc.) + +Bryant: System of Mythology. + +DeGubernatis, Angelo: Zoological Mythology. + +Judson: Myths and Legends of the Mississippi Valley and the Great Lakes. + +Langdon, S.: Tammuz and Ishtar. + +Perrot, and Chipiez: History of Art in Phrygia, Lidia, Caria and Lycia; +History of Art in Persia. + +Prescott: Conquest of Peru. + +Rousselet, Louis: India and Its Native Princes. + +Stevens, J.: Central America, Chiapez and Yucatan. + +Solas, W. J.: Ancient Hunters. + +Wood-Martin: Pagan Ireland. + + + +THE PSYCHOANALYTIC TREATMENT Of HYSTERO-EPILEPSY + +BY L. E. EMERSON, PH. D. + +Psychologist, Massachusetts General Hospital; Examiner in Psychotherapy, +Psychopathic Hospital, Boston, Massachusetts; Assistant in Neurology, +Graduate School of Medicine, Harvard University. + +WHEN a new method of working in any field of endeavor is devised, or a new +point of view is discovered, it is natural to turn to other similar fields +to see if the method will work there. This is what is done when one +approaches the study of Epilepsy from the point of view of psychoanalysis. + +It is not my purpose to undertake an exhaustive psychoanalytic study of +Epilepsy. Neither is it my purpose to enter into a discussion of the +problems of differential diagnosis. It has already been shown, in borderland +cases, that one cannot tell the difference between epilepsy and hysteria, +without a prolonged psychoanalysis, and even then one cannot be certain. +This suggests that the whole thing is more or less a matter of definition. +Into such questions I cannot enter. My aim is much more modest. The +immediate purpose of my paper is to study some of the problems of therapy, +from the psychoanalytic point of view, of that small class of patients on +the borderline between hysteria and epilepsy, or patients with epileptiform +attacks. + +The first publication of studies of this general nature was made by Dr. +James J. Putnam and Dr. George A. Waterman in the Boston Medical and +Surgical Journal for May, 1905, under the title "Certain Aspects of the +differential Diagnosis between Epilepsy and Hysteria." In this paper the +authors say, "No one, so far as we are aware, has as yet studied with +sufficient thoroughness the subconscious memories of epileptics, and for all +we now can say, closer resemblances may be found between these and the +subconscious states of the hysterics than we now imagine." p. 513. + +In this paper, however, therapy is only hinted at. + +A contribution to our insight as to the epileptic state of mind is made by +Jung, under the title, "Analyse der Assoziationen eines Epileptikers," in +his, "Diagnostische Assoziationsstudien. Beitrage zur experimentellen +Psychopathologie." p. 175 (1906). + +He found an extraordinary number of emotionally toned, egocentric relations. +There were some signs to suggest that the emotional tone in the epileptic +was unusually lasting. + +The first thing published on epilepsy avowedly from the psychoanalytic +view-point was by Maeder: "Sexualitat und Epilepsy." Jahrbuch BI HI, 1909. + +Maeder goes into the subject rather exhaustively, after characteristic +German fashion, but his conclusions are comparatively simple. He says, "The +sexuality of the epileptic is characterized by the prominence of auto- and +allo-erotism. It retains much of the infantile form, but has undergone, +nevertheless, a certain development, which I designate as 'sexual +polyvalence.' For some unknown reason the libido seems to have an abnormal +intensity." p. 154. + +This is an important contribution to our knowledge of the psychic state of +epileptics but it is notable that not a word is said as to therapy. + +Sadger published the same year, "Ein Fall von Pseudoepilepsia hysterica +psychoanalytisch erklart." (Wiener klein. Rundschau, p. 212, 1909.) But +neither does he have anything to say about therapy. + +Dr. Wilhelm Stekel, however, treats the problem from the therapeutic point +of view in, "Die psychische Behandlung der Epilepsie." (Zentralblatt fur +psychoanalyse p. 220 No. 5-6, Vol. 1). + +The essential kernel of Stekel's view is that the epileptic is a repressed +criminal. The convulsion is a substitute for the criminal act. He +announces categorically that pseudoepilepsy is curable by psychoanalytic +procedures. Of three cases which he completely analysed, two were cured. His +final conclusion is fourfold: (1) Epilepsy, more often than we have +hitherto thought, is of psychogenic origin. (2) In all cases there is a +strong tendency to criminality which is unbearable to consciousness. (3) +The attack is a substitute for an offense, hence, eventually a sexual +offense. (4) Pseudo-epilepsy is curable by psychoanalysis. + +Spratling calls attention "to the value of an occasional convulsion in +certain cases. In some patients the fit acts as a safety valve that +unquestionably permits escape from insanity. . . In many cases the +convulsion seems t o come as the termination of an obscure (auto-toxic) +cycle which varies in duration in different individuals and bears some +relationship to the ascending period of the folie circulaire of the French. +It seems that the specific cause of the fit in these cases is something that +permeates the entire organism; something that comes and goes; that grows +rapidly in intensity, exerting a pernicious influence on the patient by +making him act out of harmony with his normal state, until the limit is +reached and the mind loses its direction and control. The power of +inhibition being finally destroyed, the nervous storm breaks with great +force and violence." p. 361. + +Although Spratling had in mind a toxic agent, one cannot but be struck with +how completely his terms describe an emotional outburst. + +In a paper read in Boston last winter, Dr. L. Pierce Clark advanced the view +that the epilpetic seizure was the symbolical expression of the desire of +the patient to return to the mutterleib. The convulsive moments were such +reflect and random acts as one sees in infants or infers in the embryo. +Regard for social sanctions is lost. This, of course, suggests the first +step in criminality. Clark found that favorable cases were amenable to +psychic treatment and said that some cases had been very much helped by +psychoanalysis. I am not certain whether he claims to have cured any +particular case of pseudo-epilepsy or epileptiform attacks, by +psychoanalysis. In presenting some of my own cases let me begin with one +that certainly was not a complete success, but nevertheless was much helped +by psychoanalysis. + +This case is that of a young girl, aged 14, without known inherited +tendency. Her first attacks had occurred about a year previous in the form +of fainting spells. These were afterwards followed by convulsions. In +convulsions the patient thrashed about, kicking her legs and clawing at her +chest. These convulsive movements stopped after a while and were followed +by a deep sleep, after which the patient awoke without any memory of what +had happened. + +It was found that during the convulsion the patient imagined she was being +pursued by a black-faced figure with claw-like hands, of a peculiar shape +like her father's. + +Further investigation showed that her father got drunk and did chase her, +sometimes kicking her out of the house. She would undress her father +sometimes and put him to bed. Once when taking off his shoes he kicked her, +as she was bending over him, in the lower part of the abdomen. This was just +before the convulsions developed. The fainting spells occurred soon after +she had first seen her father naked. The image of his nakedness so +distressed her by continually coming before her mind that she made the most +desperate efforts to repress it, finally partially succeeding. Speaking of +her father she said, "Every time I think of him I feel like taking a fit. +Oh! It makes me feel terrible." + +Her father had kicked her in the chest, too, which perhaps partially +accounts for the clawing. + +In the light of this knowledge the convulsive movements become a little more +comprehensible. They are futile attempts to run away. They are the partial +movements of flight. + +The cries that sometimes initiated and accompanied the convulsions at first, +afterwards became sufficiently articulate to be understood as calls "Mama, +Mama, Mama." + +It was found that when her father would chase her about the house, in +drunken fury, she would call for her mother in frantic fear. Here, +apparently, is a meaning of the call preceding the convulsions. + +Under a very short psychoanalytic treatment the patient showed marked +improvement. Her attacks became much less violent and much farther apart. +She became able to control them to a great extent. Finally she became so +well that one might say she had practically recovered. + +Apparently there is no hint here of a repressed criminal complex. But a +little deeper analysis suggests it, however. The first attack, which was in +the form of a faint, occurred under the following circumstances. The patient +was at the funeral of the father of her best girl friend. As she looked at +the dead body of her friend's father the thought flashed through her mind, +"He was so good, and now he is dead, while my father who is so bad, still +lives. I wish he were dead." Shortly after she fainted. + +There were a number of reasons, seemingly adequate, for incomplete success +in this case. In the first place, the patient had been in this country only +a few years and spoke very broken English. She is a Russian Jew. Obviously +this was a very great barrier to understanding. In the next place it was +almost impossible to change conditions of home, although Social Service +worked wonders in this case. The father continued to get drunk, and one of +the last of her now infrequent attacks occurred on his return from jail. The +patient was dreadfully afraid lest her father find out that the knowledge of +his delinquency had been discovered through her. + +Not the least of the reasons militating against complete success was the +short time possible for psychoanalytic treatment. The patient was seen only +three weeks. As the time needed for a psychoanalysis is variable depending +on the particular patient, it is clear that this would be too short a time +to enable a young girl, only recently here from Russia, to understand, or to +overcome resistances. That the treatment was as nearly successful as it was +is perhaps encouraging to the hope that suitable cases under favorable +conditions might be cured. + +The next case is one where the diagnosis lay between hysteria and epilepsy. +The symptoms were as follows: The patient had attacks in which she became +unconscious, gasped, and spittle ran from her mouth. She also bit her +tongue. She becomes stiff, eyes stark, and is left tired and weak. These +attacks were first noticed about five years ago. Since then she has had +about five similar attacks, the last three coming within five months. The +last two were within a day of each other and frightened her so she came to +the hospital. At the age of eight or nine she said that she had flashes of +speechlessness, and a thought which she cannot define, as of a horse or a +man. She never became unconscious or bit her tongue. After her first +catamenial these flashes of speechlessness and thought came only at this +time. At the age of two the patient said that she had fallen down stairs +and hit her head. She said she was unconscious twenty-four hours. + +As a result of a psychoanalysis the following facts were learned. The +patient was a very sensitive child, exceedingly responsive to her +environment. She was also stubborn and self-willed, at times. She was +reserved and capable of great repression. When she was about three or four +she remembers seeing in the Bible a picture of the Devil on a white horse. +This used to make her shudder, but it also had a sort of irresistible +fascination. Later, when she was seven or eight, it would come into her +mind in school even and make her feel so badly she would lay her head on her +arms. But she never told anybody what it was that troubled her and she +would put it out of her mind. She thoroughly believed her mother when she +told her that the Devil would come and get her if she did wrong. + +At about the age of ten or eleven she began going with a girl much older +than herself. She used to visit this girl and spend the night with her, and +in turn have her at her own home. In this way they spent the night together +quite frequently. Soon the girl wanted to masturbate her and although she +repelled her advances at first she finally allowed it because she was told +she would be regarded as queer if she didn't as other girls did it and liked +it. She, however, never did get any pleasure out of the practice, and +remained perfectly passive. She thought if her friend enjoyed it and it +didn't hurt her she should let her have her pleasure. She never told of +this. + +The patient now began having what she called staring spells. These never +lasted more than a second or so and they were never observed. She carefully +concealed them. Just before the patient began to menstruate which was when +she was about fourteen, she noticed that the day after she had been with the +girl who masturbated her she had a terrific headache. Then she remembered +that for a long time it had been so though she had never connected the +headaches before with the masturbation. She stopped the practice immediately +and never allowed it to be resumed. + +After menstruation began the staring spells became grouped and came only +during her periods. But they were more numerous. She would have a number in +one day. They were not yet sufficiently observable to be noticed. At about +this time she had a terrible fright. She was kneeling at her mother's side +listening to a story when she thought she saw a woman's face looking at her +over her mother's shoulder. She was speechless with terror. This was not +noticed and she did not tell. Around this time too she had another fright. +She was studying one evening at the dining-room table when she saw a face +looking in at the window. She screamed, and kept on screaming, but finally +was able to tell that she had seen someone looking in at the window. Her +father took her out and showed that it couldn't be so because there were no +tracks in the snow which was on the ground. She wouldn't or couldn't stop +crying, however, and kept it up all night, she said. Just before +menstruation she did some sleep-walking. She got up one night and went to +her mother and said she had something to tell her. Her mother tried to get +her to say what it was but could not, and saw that her daughter was asleep. +She kept saying, "you know what it is." The mother did not dare to waken her +and finally got her quietly back into bed. The next morning she remembered +nothing of what had happened. + +When the patient was about sixteen she married. Her husband did not want +any children and practiced coitus interruptus, but she became pregnant +nevertheless and had an abortion performed. Although c.i. continued to be +practiced she became pregnant again and this time she had a daughter. Four +more years of c. i. followed. During all this time the patient had the +staring spells, but they were never noticed and she never told, not even her +mother. Then, like a thunder bolt out of a clear sky, came a tragedy. + +She was pregnant again, and visiting her mother, expecting her husband for +over Sunday, when she received a letter saying he had left her and had gone +off with another woman. When she read the letter she lost consciousness. + +Then followed a terrible time. In hate of her husband and on account of +fear lest she be unable to care for her baby she had another abortion +performed. This time she nearly died through not having proper medical +attendance afterwards, but she finally recovered and lived a life of +feverish activity and hate. + +During her marriage she had been entirely frigid with respect to the sexual +act. A friend told her she had been missing an essential experience of +marriage. About a year after her husband left her she met a man who +thrilled her through and through, and thought, "this is what my friend +meant." This man showed her some attention and she set out consciously to +seduce him. She soon succeeded and though he was wildly in love with her and +wanted to marry her, she steadfastly refused on the score of not loving him, +but was his mistress for two or three years. During this time her staring +spells seem to have been at a minimum, but I cannot assert that they +disappeared. + +Then she met the man who became her second husband. She had refused to marry +her lover because she did not "love" him. She now dropped him completely, +and getting a divorce from her husband on the ground of desertion, married. + +She was happy about a year and a half when her husband moved to a country +cross-road near a "hotel" (bar-room). Here he began drinking badly, and +consorting with prostitutes. For three years she fought her husband off, in +fear of infection. During this time she had no intercourse. At this time +began the attacks of unconsciousness. She was alone one night, while her +husband was off carousing, when she had a terrible fright on seeing a man +trying to get in at the window. This was probably hallucinatory as nothing +came of it. But from this time forth she was subject to attacks, in which +she lost consciousness, had convulsions, frothed at the mouth, and bit her +tongue badly. + +At the end of about three years, however, her patience broke, and she told +her husband that if he did not stop she should leave him. This threat +brought him to his senses apparently, and he completely reformed. But her +love for him was dead. And though she now permitted marital relations to be +resumed, she remained from this time on absolutely frigid. Her husband too, +now suffered from premature ejaculation. Thus from the point of view both +of "passion" and of "love" the patient was not satisfied. Her attacks +increased in number and violence, coming now at any time, not being confined +to the menstrual period as at first, and coming days as well as nights. + +In this patient we have represented the points of view both of Stekel and of +Clark. The patient showed conclusively her capacity for criminal action. +She also illustrates the craving for a return to the mother. The morning of +the day on which she had the first attack in which she bit her tongue, she +passed through the town where her mother was living and thought, "Oh, if I +could only go to my mother." But remembering she had promised her lawyer to +live a year with her husband, she went on. Of the sexual character of her +conflicts no further comment is necessary. + +Here then we have the natural history of what? Hysteria? or Epilepsy? This +question I shall not attempt to answer. But what has been the therapeutic +result of psychoanalysis? This question I can answer. + +In the six months during which the analysis has been in progress the patient +has had no attacks in which she has had convulsions, frothed at the mouth, +or bitten her tongue. She has had only three spells in which consciousness +was lost and these were mild. The last one was described by the daughter. +She said it was like a faint; that her mother was in it only a short time; +that she had none of the symptoms she used to have; and was all right soon +afterwards with no bad after-effects. She added that since her mother had +been coming to the hospital she had improved so much they never thought of +her now as being sick. The bad feelings have diminished so much in number +and intensity as to be almost negligible. Family relations have so improved +husband and wife are practically at one in their purposes. Social relations +have also improved to such an extent that the patient has been able to +prevent the wreck of the home of a friend, and in her church is an active +worker on a number of committees. She is now doing her best to get her +daughter started right in life. The patient regards herself as having +practically recovered. + +The next case I wish to present for your consideration is that of a young +man twenty-six years old. He was brought into the accident-room of the +hospital one night last Summer suffering from convulsions. He continued to +have convulsions throughout the night, and as many as five interns were +required to hold him quiet. These convulsions seemed to have enough purpose +in them to warrant the diagnosis of hysteria, so the next morning he was +referred to me. + +"Last Wednesday night," he said, "I was having dinner with a customer at the +Hotel Thorndike. I began to feel sick and went to the toilet and vomited. +Then I went back and got my friend and started for a drug store in Park +Square to get some quinine. But before I got very far I began to shiver and +shake and I knew that it took quinine two or three hours to work so I +started back to the hotel to get a room. No rooms were to be had, so I said +'get a taxi and take me to the hospital.' I lost the use of my legs on the +steps and they had to carry me. In this attack I was more or less conscious +all through it." What were you thinking of in the taxi, I asked. "I don't +know. I felt as if I wanted to jump at something and grab something." Can +you not remember what was in your mind, I continued. "Only what I've told +you," he answered. Will you lie down and close your eyes and imagine +yourself back in the taxi, I asked. Now tell me what you see. After a +moment he said, "I see flames." What else do you see? "Nothing, only +flames. I feel as if I wanted to jump into the fire." Did you see flames +in the taxi, I asked. "Yes, that was what I wanted to jump at." At this +moment the patient gave a start. What did you see then, I asked. "There is +something in the flames, an object, I don't know what it is. It might be a +thing or a person. I feel as if I wanted to grab the object." At this +instant the patient gave a violent jump into the air and then sank back +relaxed. What did you see, I asked. "This object. It seemed to be +attracting me." Can't you tell what it is, I said. "No. But it seems almost +like a person. It seems as if I could see an arm." What else do you see? +"The arms seem beckoning me." It is a person then? Is it a man or a woman? +"I don't know. I can't make out." Look. "It is a woman. I can see now." +Is it anybody you know? "No, I can't see any face." What do you see? "Just +a woman, standing in the flames, with outstretched arms, as if imploring me +to come. I feel a yearning, as if I must jump and grab her." The patient +stiffened slightly and gave a sort of spring up from the couch and then sank +back, breathing a little heavier. What did you see, I asked. "I thought she +beckoned me to come." Can you see who it is now? "No The face is blank." +Look again and see if you can't tell who it is. What do you see? "I can't +tell. I see several faces come and go." Do you recognize them? "Yes. The +first is my little girl's; then I see a former sweetheart of mine; then I +see my wife's face." + +Gradually the following story was elicited from the patient. His mother died +when he was seven and his father married again in less than a year. The +former sweetheart was his step-mother's half-sister who came to live at +their house because the schools were better. He became infatuated with this +girl and his step-mother did everything she could to encourage his feeling +as she thought it would be a good match. The vision of his sweetheart in the +flames was based on an actual occurrence. She was sitting in front of a +fireplace once when a log of burning wood fell out and he jumped to pull her +away and held her close in his arms for a moment. + +Finally, however, he broke off absolutely all relations with the girl. The +reason seems quite adequate. Why didn't you marry, I asked. He answered, +"we quarrelled and I left her. I didn't like her morals. She went with +other men and had connection with them. I saw her go into the woods one +night with another fellow, and once at Salisbury Beach I saw her go into a +hotel with a man and register as his wife." + +About a year after this the patient began going with another girl more in an +attempt to crowd the image of his former first love out of his mind than +because he had fallen in love again. A year later they married. From the +first his married life was not entirely happy. More or less unconsciously he +began to regret lost opportunities. He was a travelling man and soon after +marriage his route was enlarged necessitating his being away from home a +month at a time. On these trips he used to get exceedingly lonesome +especially as he steadily refused going with other travelling men and making +a night of it as they often did. One of his routes took him to Virginia and +he said that he had returned from New York on the way there just for the +sake of spending a night with his wife. Once, in New York, he was +unfaithful to his wife and on that occasion contracted gonorrhea. This, +however, was the only time he has ever had extra-marital sexual relations, +he said. + +Just before his attacks began, which was about four years ago, he was told +by his wife's doctor that it would be impossible for her to have any more +children as she was suffering from heart disease. To his mind this meant +giving up coitus. Then, unconsciously, he began to dream of Anna, his first +love. He regretted more than ever not taking advantage of his former +opportunities, and unconsciously dallied with the thought of deserting his +wife. Just at this time his attacks began. + +As the analysis progressed his attacks diminished and shortly disappeared. +Gradually the image of his wife took full possession of his mind and the +image of Anna disappeared. Towards the end of the analysis as he was lying +on the couch with his eyes shut, he saw Anna in the flames and felt the +yearning but not so strongly as to lead to any impulsive movements. What do +you think all this might mean, I asked. "I don't know," he answered, "it +might mean I still cared for Anna and that if I let myself go it would break +up my home." With his full realization of the meaning of this symbolization, +it was assumed that he was cured. + +Seven months later, in company with a colleague, I visited my former patient +and he told me that he had not had a moment's illness since I last saw him. +He told me that while occasionally the thought of Anna would come to his +mind, it never disturbed him, and never distracted his attention from other +things. He has prospered in his business, and I saw every evidence of a +happy home. + +This case merits consideration for a number of reasons. In the first place +the attacks were cured by psychoanalysis. No one who saw the association of +the symbolical imagery and the convulsive movements could fail to see that +there was a causal connection between them. The subsidence in violence and +frequency of the convulsive movements as the conscious grasp of the meaning +of the mental symbolical imagery increased was also completely convincing of +the therapeutic value of the analysis. The question of the permanence of the +recovery is of course open, because seven months is far too short a time to +carry complete conviction. + +The comparison of this case with the one immediately preceding raises a very +interesting question. Why is this patient apparently completely cured and +the other one not? Several reasons may be noted. The patient is much +younger. He had never been through anything like the same mental strains. +His trouble was of short duration. But above all as he was successful in +his business he was successful in his sublimation. Here is a sine qua non of +a successful psychoanalysis: the capacity and the opportunity for successful +sublimation. If these are present the prognosis is good. + +It is interesting also to compare this case in its results with the +contentions of Clark and of Stekel. It is hard to see any signs of a +definite criminal tendency. Inasmuch as the temptation to go back to his +early love is a sign of a tendency towards regression and erotism generally +the patient shows what Clark has spoken of as a desire to return to the +mother-body. This case is not very important, however, to the views of +either Clark or Stekel as the analysis is relatively superficial, and there +is no knowing what a more thorough analysis might reveal. From the point of +view of superficiality, however, the case is important as it emphasizes +Taylor's view of the value of a modified analysis. The patient was seen only +five times. + +On the basis of these, and a number of other similar cases, I should like to +suggest, from a descriptive point of view, that the epileptiform seizure is +of the nature of an orgasm. An orgasm is a sudden, explosive, discharge of +nervous energy, raised to the breaking point of nervous tension. I should +like to generalize the idea of orgasm. Ordinarily, of course, it is confined +to the sexual sphere. In the last case I reported it seems to me fairly +clear that the explosive actions, convulsive-like impulses, were closely +associated in the mind of the patient with sexual ideas. That they were +substitutes for the normal relief of sexual tension, seems to me also clear. +This idea is perhaps more convincing if I add the fact, as stated by the +patient, that his last attack started when he saw an attractive girl sitting +at a nearby table in the Thorndike Hotel, and who started him dreaming about +Anna, because she looked so much like her. + +The second case I reported seems also easily brought under this conception. +Here we know more about the earliest childhood of the patient and we can +easily imagine that there was an especial predisposition for the form the +symptoms took. This, however, does not militate against the descriptive +value of the above conception. That the epileptiform attacks did not take +place until after actual sexual orgasms had been experienced, lends weight +to the conception I am presenting here. The first case is not so clear. +This is partly due to the fact that it was impossible to make anything like +a complete analysis. But it shows nothing contradictory to the conception, +and indeed has some slight value as added evidence in favor of the +conception, in as much as the original trauma consisted of a kick in the +genitals, by her father. + +This conception does not contradict either Stekel's or Clark's ideas, but +rather supplements them. The essence of the criminal act lies in its +unrestrained aggressive character. From this point of view anything getting +in the way of the libido discharge has to take the consequences. This also +agrees with Clark, only his idea seems to me perhaps a little too passive to +describe fully the dynamic quality of the attack. + +Here, as in Hysteria, the therapeutic effect of an analysis depends on the +possibility of sublimation. The three cases I have given in some detail may +easily be arranged in order. The last case having the best chances for +sublimation shows the best results. + + + +ON THE GENESIS AND THE MEANING OF TICS + +BY MEYER SOLOMON, M. D. + +Associate in Neurology, Maimonides Hospital, Chicago + +THE problem of the genesis and meaning of the strange manifestations which +we find in that peculiar disorder which goes by the accepted name of tics is +indeed difficult of solution. The analytic and genetic standpoint only +comparatively recently assumed in the domain of neurology and psychiatry is +having an ever wider and wider application. The problems in neurology and +psychiatry which still cry loudly for solution and rational explanation are +indeed numerous. Some of these questions are so baffling that at times they +seem almost beyond the ken of the human mind. Nevertheless, with +persistence and the "Don't give up the ship" spirit keenly imbued into us, +and with that irrepressible spirit of investigation and of research born of +optimism and of curiosity, we may expect to see many of these problems which +now seem to us so hopelessly unsolvable gradually rescued from the uncertain +waters of speculation and theorization and brought to the more sound shores +and land of the knowable and the known. If our theories be but tinctured +with due admixture of that sound self-criticism that comes of prolonged and +serious reflection and deliberation, and if the results of observation and +investigation be brought forth in support of these theories, then we need +have no hesitancy in permitting freedom in theorization and speculation. Let +us also remember that unsound theories or standpoints do not come to stay, +but, after surviving for a certain time, give way before that which is more +sound, more tangible, more near the truth, which, to be sure, is always but +approximately attained. If, therefore, the theory which I intend to set +before you for consideration may seem on first thought far-fetched and +unsupported, I beg you to remember that in a field where but comparatively +little is known with absolute certainty, it behooves us to take notice of +all theories or conclusions which may be propounded, since, even though they +may not contain the whole truth, they may, perhaps, contain certain germs of +truth, which may contribute, in some measure, however slight, toward the +ultimate solution of the problem under consideration. + +With these brief prefatory remarks, I shall forthwith enter into the +discussion of the genesis and meaning of the tics. + +I may say at once that this is not merely a theoretical and purely academic +proposition which has no practical bearings in the way of prognosis and +treatment. On the other hand, a real understanding of the nature, origin, +and significance of the tics is of decided value in giving us proper +standpoints and orientation with respect to the prevention, prognosis and +cure of the condition. + +I need not enter into a description of the characteristics of tics in this +place. I may merely mention that tics have two aspects--a psychic and a +physical. It is, in other words, a psychoneurosis. The characteristic +mental state is one of doubt, of indecision, of inadequacy, of restlessness, +of tension, of discomfort and of dissatisfaction, which is more or less +unappeasable and irrepressible and uncontrollable until it finds vent in a +rather explosive series of motor expressions which, as it were, are the +safety valve for the peculiar feeling of tension and discomfort which the +individual has been experiencing and which is accompanied by a sense of +relief, satisfaction and a relative degree of comfort and mental rest. The +mental imperfection (Charcot) of the ticquer is a polymorphic psychic defect +(Brissaud, Meige and Feindel) characterized by mental infantilism; for +ticquers, like other psychoneurotics, are like big children. They have the +mind of children, in respect to the emotional make-up. + +The mental condition of ticquers is especially characterized by the +imperfection or weakness of volition, by a certain degree of mental +instability and lack of inhibitory control of the desires, tendencies, +activities and motor expressions of the individual, this defect laying the +groundwork for the impulsions and obsessions, as also for hysterical, +so-called neurasthenic, hypochondriacal, depressive and so-called dementia +praecox reactions. The tic movement is the symbol of the psychic defect or +degeneration or instability. + +The earlier investigators were responsible for the differentiation of the +tics from such other conditions as Sydenham's chorea, Huntington's chorea, +the spasms, the stereotypies, the habit movements, the myoclonias, and other +allied conditions. It is due to their pioneer work that tics were +recognized as a definite and distinct clinical entity. The process of +disintegration of these various movements and their differentiation one from +the other cannot be overvalued. Among those who have contributed most to +this subject may be mentioned Magnan and his pupils, especially Saury and +Legrain, Gilles de la Tourette, Letulle, Guinon Noir, Pitres, Cruchet, +Grasset, Trousseau, Charcot, Brissaud Meige and Feindel. Although Trousseau +recognized the the ticquer was mentally abnormal, it was Charcot who first +called definite attention to the psychic origin of the condition and to the +fact that tic was indeed a mental disorder, a psychoneurosis, a psychomotor +reaction. His lead was subsequently followed up by Brissaud, and by the +latter's pupils Meige and Feindel, the latter two authors giving us a +comprehensive discussion of the subject in their well-known classic. [1]More +recently the Freudian school has attempted to dig down into the roots of the +tree which ultimately sends forth its branches in the guise of tics. + +[1] Tics and their treatment. English translation by S. A. K. Wilson. New +York, 1907. This book contains an extended bibliography. + + + +VIEWS OF THE FRENCH SCHOOL + +The usual conception of tics, as laid down by Brissaud, Meige and +Feindel,[1] may be stated as follows: Tic movements are physiological acts +which were originally functional and purposeful in character, but which have +become habits, apparently purposeless and meaningless. The motor reaction is +the result of some external stimulus or idea (normal or abnormal) or both, +which originally was necessary for the production of the tic movement, which +latter eventually became habitual and automatic, and, owing to repetition, +was executed, even in the absence of the external stimulus or idea, without +apparent purpose or meaning. At first but little more than purposive habit +movements, they finally became irrepressible acts which sought for +expression, which were but little under the control of the will, which +occurred in attacks varying in frequency, duration and severity, which +decreased under distraction and generally ceased during sleep, which were +increased in frequency and duration and severity by fatigue, emotional +upset, mental unrest, conflict and strain, while the lack of inhibition and +will power, the lack of self-control was the dominant mental state, leading +to feelings of insufficiency, doubt, indecision and incapacity, and making +the ground work for the psychasthenic reactions in the form of morbid +impulses and obsessions, and for the hysterical, so-called neurasthenic and +other morbid psychic trends. + +The inherent or acquired neuropathic and psychopathic state is the basic +condition which prepares the subsoil. + +From a consideration of the motor symptom we may say that it is but a +pathological habit, which, however, is apt to lead to the tendency toward or +generation of an increasing number of such pathological habits. + +Characteristic of tics we may mention their being conscious before and after +but not during their execution, their being disordered functional acts, +their impetuous, irresistible demand for execution, the antecedent desire, +and the subsequent satisfaction. + +The etiology of tics, as laid down by Meige and Feindel, may be summed up by +stating that they occur most frequently in young subjects, less frequently +in savages and animals than in the civilized, there is a psychic +predisposition based on heredity (of a similar or dissimilar neuropathy or +psychopathy) upon which Charcot laid great stress, imitation (especially in +the young) plays a role, as also brain fatigue (emotion, mental upset and +worry) and indolence, with the frequent exciting cause of an external or +internal stimulus or an idea, which is the explanation of the origin, +source, situation and form of the tic or tics present in any particular +case. + +Scattered references to emotional shock acting as a possible exciting cause +of tics, as at times of obsessions, can be found in the literature. Dupre[2] +has made such reference. Meige and. Feindel[3] themselves make the +statement that "Fear may elicit a movement of defense, to persist as a tic +after the exciting cause has vanished." They also state that "in ticquers +the impulse to seek a sensation is common and also to repeat to excess a +functional act." + +[2] Soc. de Neur. de Paris, April 18, 1901, quoted by Meige and Feindel, +page 54, of the English translation (reference 1). + +[3] Loc. cit., p. 62. + +Bresler[4] has called attention to the fact that the movements are in the +nature of defensive and protective movements of expression and mimicry and +originally in reaction to some external irritant or as the result of some +idea, and he proposed the name "mimische Krampfneurose" for them. This is +somewhat allied to Breuer and Freud's theory of hysteria. + +[4] Quoted by Meige and Feindel, Loc. cit., p. 267. + +The object of tic is some imaginary end, the influence of the will always +being present in the beginning, although later it may be absent. Tics are of +cortical origin, being coordinated and synergic, clonic or at times tonic[*] +muscular movements, physiologically and not anatomically grouped, +premeditated, purposive, of abnormal intensity, apparently causeless and +inopportune. + +[*] Cruchet objects to calling these tonic reactions tics. + +Insufficiency of inhibition is the cause of the beginning and of the +persistence of bad habits and of tics. + +Tic is a sign of degeneration, in the biological and evolutionary sense, a +degenerative neuropathic and psychopathic basis, as mentioned previously, +being present, although often latent. + +The maladie des tics is but the extreme form. + +The onset is as a rule insidious, with a tendency to spread. + +Spontaneous cures may occur, while Gilles de la Tourette's disease is but +the extreme form of a condition in which antagonistic gestures are +frequently adopted by the patient to adapt himself and to get to a state of +rest. + +This, as I see the situation, is as far as the French students of this +subject (including Brissaud, Meige and Feindel, and even Janet) have +permitted themselves to go. And, in my opinion, their observations and +conclusions seem to be quite accurate. + + + +VIEWS OF THE FREUDIAN SCHOOL + +Recently the Freudian school has endeavored to penetrate more deeply to the +nucleus of the problem and to solve it. Freud has delimited what he calls +obsessional or compulsion neurosis (Zwangsneurosis), which is classed under +psychasthenia by the French and under neurasthenia by others. The Freudians +regard this as a distinct neurosis, sometimes complicated by neurasthenic or +hysterical symptoms. The characteristic symptom is a feeling of compulsion. +The symptoms may be motor (obsessional acts, impulsions), sensory +(obsessional hallucinations or sensations), ideational (obsessions), and +affective (obsessive emotions, particularly doubt and fear). In this +condition we find that there is an excessive psychical significance attached +to certain thoughts. Obsessions are characterized by dissociations from the +main personality. They thus exist in the unconsciousness. The original +unconscious mental processes have brought about, by displacement, an excess +of psychical significance to these thoughts. Ernest Jones[5] states that +Freud found, by his work in psychoanalysis, that obsessions represented, +symbolically, the return of self-reproaches of ancient, infantile and early +childhood origin, which had been repressed and buried until the obsession +made its appearance. "They always refer to active sexual performances or +tendencies;" and, as Jones further explains, "there occurs early in life an +exaggerated divorce between the instincts of hate and love, and the conflict +and antagonism between the two dominate the most important reactions of the +person. A fundamental state of doubt, an incapacity for decision, results +from this paralyzing doubt. The patient oscillates between the two +conditions of not being able to act (when he wants to), and of being obliged +to act (when he doesn't want to). The symptom symbolizes the conflicting +forces. These are not, as in hysteria, fused into a compromise-formation, +but come to separate and alternating expression; one set of manifestations, +therefore, symbolizes the repressed forces, another the repressing." + +[5] See his article on "The Treatment of the Psychoneuroses," White and +Jelliffe's Modern Treatment of Nervous and Mental Diseases, Vol I, pp. +408-409. + +To put the matter plainly, the Freudians contend that obsessions are +symbolical representations of the repressed sexual activities and tendencies +of infantile and early childhood origin. It must be remembered that the +Freudians employ the term sexual in a very broad sense, including under it +the most indirect and distant physical, mental and moral reverbations. +conscious or "unconscious," of the relations between the sexes. The sexual +impulse is here conceived of as having incestuous, bisexual and polymorphous +perverse sexual tendencies. The word sexual is not only used as synonymous +with love, but practically all emotional surgings, all feelings, all +affectivity, all sense-cravings and bodily heavings are classed by certain +members of the Freudian school as sexual. This latter interpretation and +extension of the connotation generally accorded by us to the term sexual we +surely have no right to give it. + +Clark, of New York City, is the author who has carried out the Freudian idea +to its ultimate conclusion. I refer to his series of three papers[6] in the +Medical Record, and call particular attention to his last (third) paper in +which he has fully elaborated his theory of the meaning of tics.[*] + +[6] His three papers, which appeared in the Medical Record, New York, in the +issues of February 7 and 8, and March 8 1914, are entitled: (1) "Some +Observations upon the Etiology of Mental Torticollis," (2) "A Further Study +upon Mental Torticollis as a Psychoneurosis," and (3) "Remarks upon Mental +Infantilism in the Tic Neurosis." A fourth paper by Clark on tics appeared +in the Medical Record of January 30, 1915. + +[*] J. Sadger has also come to similar conclusions. + +Clark's conception of the meaning of tic movements and of the mental state +characteristic of ticquers must be here given. Although not denying the +basic neurotic constitution present in ticquers, Clark sums up by giving the +following definite and fully developed theory: + +"The ticquer has a strong sexual attachment; this is so strong that the love +instinct ineffectually sublimates the hate instinct and in the warring +conflict doubt and physical and psychic inadequacy arise. The situation +continues and generates mental, and physical infantilism, which in turn make +for increased feelings of tension. Motor and psychic restlessness succeed. +The motor expression manifests itself most often in habit movements of +disguised sexual significance (autoerogenous pleasures) a form of physical +stereotypy, in its broadest psychophysical meaning. The mental state often +pari passu takes up obsessive thinking and various physical acts and +thoughts are formed as defense mechanisms, born of conscious guilt. The +motor habits are usually inhibited or displaced in part, and the tic remains +as a motor symbol, usually in itself non-sexual, as a fragment of the former +complete habit movement. The mechanism of the completely evolved tic is +either a conversion (hysteric) or substitution (obsessive) mechanism or +both." + +By these who have studied Freudism this will, in a way, be understood. For +these who have not it may be more difficult of understanding without +somewhat further elaboration or explanation. In this connection I must again +mention that the Freudians include tics under their obsessive (obsessional) +neuroses. The theory of the mental mechanisms and evolution of these states +is given in the attached quotation, which is taken verbatim from Clark's +paper. + +"The affect of the painful idea does not become transformed into physical +symptoms, as in the conversion mechanism of hysteria, but affixes itself to +other ideas not in themselves unbearable, thus producing by this false +relationship a substitutive symptom or obsession. + +" . . . In all such obsessive neurotics the transformed reproaches which +have escaped repressions are always connected with some pleasurably +accomplished sexual act of childhood but may be almost entirely lost. The +obsessive acts really represent the conflict between impulses of opposite +instincts, love and hate, which are usually of equal value. The warring +conflict engendered makes for a curiosity to discover the meaning of life +forces (sexual largely) and the desire to know the end thereof. The +nuclear-complex of all this is a precociousness of emotional life and an +intensive fixation on one or the other parent or brother or sister. The +intensive love fixation waxes the stronger as the unconscious hate requires +increased barriers against its breaking through into the main or everyday +personality. As a result of these conflicts the will is partially weakened, +there is an incapacity for resolution, first in the realm of love alone; +then later succeeds a diffusion or displacement of the mechanism all over +the field of activity. A series of secondary defense mechanisms are now +brought in and these may enable the obsessive person to get square in a +limited way (as religious practices enable many to do). Some special +adaptation is required sooner or later, and the individual, having used up +all the helps, then falls back upon the different forms of obsessive acts +and thinking. Thus the obsessive neurosis is generated." + +Clark then proceeds to explain: + +"If one is not permitted to draw deductions from a few data as to the +further genesis of the tic disorders, we may still hold out a tentative +hypothesis, pieced together from many sources that a certain type of nervous +make-up is inherited. In such the emotional life is precocious much beyond +the intellectual faculties. The ticquer in infancy has the emotional +feelings of love and hate of an adult. Their very precociousness aids the +parental fixation and adhesion, and makes it the more difficult for the +libido to detach itself at the proper age. One should bear in mind that the +parental fixation in itself does not directly produce the mishaps of adult +life but this small fault in infancy generates wider and wider +maladaptations as development progresses. It is these latter glaring faults +and trends that make for the character defects, and these really break down +the final effort at adaptations and adjustments producing the tic or +obsessive disorder. But the essential nucleus of the defect is lack of +balance, precocious parental fixation, and continued attachment to the +parent-stem, that makes the adult defect possible. The very infantile +precociousness of the emotions argues for the hereditary transmission of +destructive temperamental qualities. Here, as elsewhere in tracing +hereditariness in so-called functional nervosities, one should take as the +unit character for study the mental traits or trends and exclude definite +disease entities applied to ancestral disorders. I believe it is not too +suppositious to think that many of these variant individuals are really +atavistic in makeup and have continued from one generation to another +special defective traits of emotional makeup which are fortunately denied +the average individual." + +The writer cannot understand how the theory which he has taken the trouble +to so fully present in the above quotations can be maintained. Jones and +Clark both assert that the tics or habit spasms as probably of the same +nature as the obsessions in general. Moreover, Jones agrees that "familiar +examples of compulsion in a slight degree are the obsessive impulses to +touch every other rail of an iron fence as one walks past, to step on the +cracks between the flagstones of the pavement, or not to step on them, and +so on." A little reflection will show us the impossibility and illogicality +of viewing all these conditions as being fundamentally of sexual origin. Let +us follow the argument. If tics are of sexual derivation, as the Freudians +here openly maintain, then it must follow that those familiar examples of +compulsion, such as the obsessive impulse to touch every other post, etc., +are likewise of sexual origin. This conclusion is forced upon us, since, +even according to Jones, the only difference between the marked tics and the +lesser manifestations is one of degree.[*] Now, these slighter impulsive +tendencies to which we have here referred are very frequent in all children +and by no means infrequent in grown-ups. They are habitual movements, which +may be of transient duration only or may, by repeated performance, develop +into more or less fixed habits. If, then, these habits are of sexual +significance, it must follow that all other habits, especially if associated +with a certain degree of consciousness or awareness, are in like manner +symbolical of the past infantile and early childhood sexual activities and +tendencies. This conclusion is, as is seen, inevitable, if we believe in +the Freudian theory of the pathogenesis of the tics. However, since this +leads us to a reductio ad absurdum, we must, of course, reject the +explanation which has been offered by the Freudian school. + +[*] The accompanying mental state characteristic of ticquers is absent in +habits. We can stop doing the latter when our attention is directed to +them; not so in tics Meige and Feindel have discussed these and other +differences. + +Perhaps I should also mention the fact that all of these symptoms or +tendencies which one finds in ticquers occur in other individuals who do not +present tics; and, furthermore, that all normal individuals possess these +qualities or tendencies in varying degrees of intensity and in varying +combinations, and that this applies to adults as well as to children, +although, of course, they are seen most characteristically in children. I +may further add that the difference between the mental infantilism which we +find present in the tic psychoneurosis and that which we observe in other +(normal and abnormal) conditions is one of degree rather than of kind. +Therefore, the most we can say of the mental condition in ticquers is that +there is an exaggeration of the mental infantilism or a fixation at or +tendency toward regression to this type of thinking or of reaction. And this +leads us to the further conclusion--and it is this point which I desire to +bring out in this connection--namely, that since the difference between the +mental infantilism in all of these conditions is relative, being one of +degree and of proportionate relationship or at any rate of genesis, +evolution and meaning, it naturally follows that what is in the conclusions +of Clark, as mentioned above, asserted to be an absolute and basic principle +or truth applicable to the tics, must consequently be true, but in different +degree, of all the other conditions of a similar or allied nature. Surely +the motive source is fundamentally the same in all of these conditions. + +Furthermore, tics occur in animals, especially in horses; and the whole +picture, physical and mental, of tics in horses resembles that which we find +in human beings, particularly idiots and imbeciles, with tics. And the +ultimate, fundamental meaning and motive source of tics in man is and must +be the same as that of tics in horses. + +To put Clark's idea in a nut-shell, it may be said that he believes that the +primary purpose of tics is not that of a protective, defense mechanism +against unpleasant situations in life but that of obtaining really +pleasurable gratifications to the psyche, these autopleasurable acts being +based on inherent defects and having a sexual significance in the sense in +which sexuality is conceived by Freud. The protective, defense mechanism +is, according to this view, but secondary to the primary and <p 340 > +fundamental purpose of obtaining the autopleasurable gratifications to the +psyche. + +Although approving of the analytic and genetic tendency displayed by Freud, +Clark and the Freudian school in general, it is regrettable to me that the +analytic tendency and reconstructive efforts of the Freudians in the field +of neurology and psychopathology have been seriously marred by their +insistence on forcing all observed physical and psychical phenomena and +reactions into line with their fixed sexual theories and their special +psychology, which is basically wrong in many fundamental and important +standpoints. + +The writer will agree with the Freudians that there must be a cause for the +appearance of these tics. This cause existed in the past. It has in the +course of time been forgotten, but still exists somewhere in the +subconsciousness or memory. This forgetting has been brought about by a +process of dissociation from the original exciting cause. But the writer +will not agree that this dissociation has been, of necessity, brought about +by psychic repression on the part of the individual, that by psychoanalysis +the condition can be traced back to the sexual activities or tendencies of +infantile or early childhood origin, or that the condition may be cured when +the original cause is made known to the patient through psychoanalysis, +without the training of the will so necessary in this condition. + +Thus the analytic tendency of the Freudian school is to be highly commended. +But this analysis should not be limited to sexual analysis, but should +include a consideration of all of man's instincts. Nor should the analysis +be limited to present-life psychic factors alone, but should be viewed from +a psychobiological standpoint. In this way only will all antecedent +causative factors--physical and mental--be included in our analytic +observation and speculation. + +To fully discuss or to prove the error of Clark in his conclusions would +necessarily lead me into a general discussion of Freudism, which I cannot do +in this place, since the ramifications are too numerous and the problems +involved would lead to lengthy and tiresome discussion, pro and con. I must, +however, mention the exclusively sexual standpoint assumed by the Freudian +school in their interpretations of physical and psychical activities, their +classifying of all activities characterized by a certain rhythmicity and +periodicity, and accompanied by a certain degree of satisfaction-- in other +words of all autopleasurable activities--as sexual (in the Freudian sense), +and the neglect of comparative and behavioristic psychology with proper +consideration for man's phylogeny and ontogeny or of his true genetic +history, from the racial and world history and not alone from the +individualistic psychological standpoint. As a matter of fact the +conception of sexuality assumed by Freud and his followers has undergone +many changes and is by no means definite and clean cut in its outlines. A +criticism of the conception of sexuality cannot be entered upon here. I may +merely state that what is an absolute and fixed law for the tics, what is +the fundamental and basic explanation or theory of the genesis and meaning +of the tics must apply also to all habit movements wherever and whenever +they occur, and, in like manner, to all habit formations of whatever nature. +And since our habits are but the prolongations of our instincts, the latter +also would be included within the purview of the same generalization. In +other words, if all tics have a sexual meaning, then all instincts, which +means the vital energy of man, has the same meaning. This question I have +discussed in another place[7] and cannot enter upon here. + +[7] A Critical Review of the Conception of Sexuality Assumed by the Freudian +School. Medical Record, March 27, 1915. + +Without furthur elaboration or discussion I am content to give the Freudian +conception to you as I have outlined it above and to let it stand for what +it is worth. + +I may say that in the physical aspect of tics we have a specific somatic +manifestation which, if explained, should, in a way, be the gateway toward +the understanding of the many somatic symptoms which we find in the +psychoneuroses and psychoses. + + + +THE EVOLUTIONARY, PHYLOGENETIC STANDPOINT + +A year or more before Clark's paper appeared, I had arrived at certain +general conclusions regarding the subject of tics. + +G. Stanley Hall has arrived at similar conclusions in his inspiring +Synthetic Genetic Study of Fear[8] and I wish here to acknowledge my +indebtedness to his paper for making my own ideas clearer to me, for having +given me broader standpoints and for clearly presenting a theory which shall +form the basis of the remainder of this paper. + +[8] In the American Journal of Psychology, Vol. XXV, in the July issue et +seq. + +Let us first take up the tic movements and see whether we can arrive at a +rational explanation for their appearance. + +The different varieties of tic movements embrace the entire field or range +of systematic, physiologically coordinated voluntary muscular activities. + +The main types of tics may be enumerated at this point: facial tics, which +are the most frequent and which may be tonic or clonic, are tics of mimicry +and express emotions; tics of the ear or auditory tics; nictitation and +vision tics, particularly of the eyelids; tics of sniffing; tics of sucking; +tics of licking; tics of biting and of mastication, and mental trismus; tics +of nodding, tossing, affirmation, negation, salutation and mental +torticollis; trunk, arm and shoulder tics; snatching tics; the professional +or occupational spasms, which are really a special atypical form of tics; +walking and leaping tics; tics of spitting, swallowing, vomiting, eructation +and wind sucking (aerophagia); tics of snoring, sniffing, blowing, +whistling, coughing, sobbing, hiccoughing; tics of speech, including all +sorts of sounds, stammering (in some cases), habit expressions, echolalia +and echopraxia. + +It is thus seen that we have here physiological and biological acts of +different manifestations and purposes. + +The tic movements have a certain significance at the time of their +performance. The physiological functions are definite. + +The Magnan school insisted that tics are not morbid entities but episodic +syndromes of mental degeneration. Charcot referred to tic as a sort of +hereditary aberration, which, I may add, is surely true when we view it from +the phylogenetic standpoint, as representing a resurrection of what was at +one time a normal tendency or reaction. Noir has called attention to the +fact that the movements found in the tics correspond to the infant's +spontaneous muscular play, which means the muscular play of all mankind. + +These authors were directing their efforts in the right direction. To +appreciate this we need but remember that the mechanisms or the +potentialities for the movements are inherited and have a phylogenetic +significance. At a lower psychic level, far back in our phylogenetic racial +history, all of these movements, perhaps then in a rudimentary form, had a +single, original meaning. This meaning was self-preservation, and it was +because of its value as a means of adaptation or reaction to the +environment, with the consequent maintenance of self-preservation; that the +movements or the mechanisms of the movements were selected for survival and +for hereditary transmission as inherent, unconscious, organic mechanisms, +processes or engrams. The original, phylogenetic significance attained at a +low cultural or psychic level, relatively unconscious, may or may not later +be consciously associated or dominate its subsequent functioning. But its +primary, biological significance, its real raison d'etre is to be found in +the phylogenetic, racial history of man. The present life history with its +varied experiences do but act as stimuli or as exciting factors to bring +once more into activity functions which have been preserved in the organic +structure of the nervous system. + +In our return to phylogenetic, ontogenetic, rudimentary, unconscious, +organic reactions, to atavistic, prehistoric, performed, embryonic, immature +methods of response, the vestigial remnants, revivals of long ago, which +have been submerged but which now reappear due to our reversionary +tendencies--uprooted by dissociation, disintegration or regression, with its +lapse or descent to low cultural or psychic levels--these old components +which reappear or rather fall apart and appear as independent activities, +are exaggerated, inflated, caricatured or excessively performed. In our +devolutionary tendency toward ancestral methods of reaction, the individual, +resolved, so to speak, into his proximate elements, permits or is compelled +by biological determinism to permit these split off tendencies to break +forth once more, albeit in exaggerated fashion, as if let loose from the +leash of control by the higher nervous centres, and reanimified, +intensified, and magnified, our infantile, archaic, instinctive, inherited, +hidden, phylogenetic tendencies or activities held sway. + +It seems to me that it is well worth while to quote at some length from G. +Stanley Hall, that great exponent of genetic psychology and all that it +stands for. His very stimulating and inspiring paper on fear, to which I +have already referred, is freely quoted in the following paragraphs. + +According to geneticism, Stanley Hall tells us, all responses to shock are +vestiges of once useful reactions. In fact, the shock neuroses and shock +psychoses, if analyzable psychogenetically, "would be found to be reversions +to, and also perhaps more often than we suspect, magnifications of acts and +psychic states that were at one time the fittest of which our forebears were +capable.[9] However, all the pathological phenomena of today are not mere +revivals of the acts and states of primitive man and his ancestors, but +"they are often, on the other hand, grotesque variants and intensifications +of phylogenetic originals that were more sane and simple if also more +generic. Shock symptoms may thus be symbols of long past racial experiences +which when we have learned to interpret them more fully will tell us much of +the early history of our phylum."[10] It is the outbreaks of emotion which +"mark the incursions of the race into the narrow life of the +individual."[11] + +[9] Loc. cit., pp. 178-179. + +[10] Loc. cit., p. 179. + +[11] Loc. cit., p. 183. + +Furthermore, "the central nervous system differs from all others in that it +is par excellence the organ of registration and of physiological memory. It +is there that the traces of ancestral experience are stored so that almost +nothing that was ever essential in the development of the phylum is ever +entirely lost. Hence suggestive as are many physical traits of our racial +history, the intangible psychophysic traits must be assumed to be both far +more numerous and more indelible. + +"While these faint tendencies often crop out in a behavioristic way, by far +the most of them need some stimulus of individual experiences to awaken +them, and still more exist only in the slight facilitization of impulses or +permeability of nervous centres, lability of molecular or neural tensions, +or as preferential re-enforcements, in one rather than in another direction +or manner."[12] + +[12] Loc. cit., p. 351-352. + +It is obvious that motor expressions of shock or motor methods of adaptation +or reaction are much older and far more prominent than psychic. But although +a changed environment made the old types of defense obsolete, they still +persist, "in a sthenic if somewhat now inco-ordinated way, and when they are +called into action now they evoke a faint phosphorescence of the old +primordial feeling."[13] + +[13] Loc. cit., p. 197. + +In brief it should be said that no matter how refined and how highly +cultured we are, we still fear and react to emotions "in the same terms of +the same old gross organs and functions as do the brutes."[14] + +[14] Loc. cit., p. 197. + + + +REGRESSION + +As I have stated in a previous paper,[15] the pathogenesis of tics and +allied conditions can best be appreciated by viewing the subject from an +evolutionary standpoint. In our reactions and adaptations to the varying +experiences with which we meet we respond by one or more of several methods +of motor reaction. These motor expressions are of increasing complexity as +we ascend the scale of evolution and development. One of the simplest kinds +of adaptation is by simple, reflex muscular action, the response being +anatomical and not physiological in its extent. Then come our simple +physiological reactions. A more complex reaction is by those +physiologically co-ordinated motor reactions or movements which go to +comprise our pantomimic movements. This is seen most characteristically in +our facial expressions, gestures, mimicry and dancing. Still higher up in +the scale we find our conduct and feelings as exemplified in our speech. And +finally, highest of all, we must place our conduct as shown in written or +printed language. This is a brief outline of our evolutionary and +developmental ascent and of the increasing complexity and refinement of our +social conduct. + +[15] Tics. Interstate Medical Journal, January and February, 1915. + +In our motor adaptations we respond in one or more of these ways. When for +some reason or another one outlet us denied us, we find avenues of +expression through one or more of the other paths. Now, the manner and +degree of our response is dependent on our stage in evolution and +development, on the development of our senses, on our instincts, feelings +and emotions, on our intellect and experiences. Unable to find expression by +means of writing or speech, we instinctively fall back upon and seek +expression by a less refined method, one earlier acquired and thus lower in +the scale of evolution. This has a more or less general application +throughout the scale of human (individual and social) conduct. It is an +application of the universal law of adaptation to existing conditions in the +best manner possible under the circumstances. We may thus lay down in a +general sort of way a conception which I like to call the theory of +psychophysical progression, fixation and regression along evolutionary and +developmental lines. In the case of tics the regressive or devolutionary +aspect comes in for special consideration. We may react mainly physically, +or mainly psychically. But as a rule we react by both physical and psychic +means, the manner and degree of our conduct being determined, as above +mentioned, by our stage in evolution and development. + +How does all this preliminary and general discussion apply to the problem of +the tics? The relation seems to me to be most intimate and most important. +The tics are methods of response or reaction to certain external irritations +or ideas, this response being the manner of adaptation. The response may be +mainly motor or mainly psychic, most frequently psychomotor. When the source +of irritation and the cause for action is known, our conduct is more +specific and is apt to be less diffuse, less inadequate, less indefinite. +In our reactive adaptations, which, as explained above, are greatly +dependent upon our psychophysical make-up or constitution, we protect +ourselves consciously or more or less unconsciously against disagreeable, +inimicable, unpleasant or irritating environmental factors, physical or +psychical, by bringing into activity certain psychical or physical or +psychophysical reactions or processes. The special defense reactions +brought into the foreground are those which follow the line of least +resistance, due to hereditary or environmental construction, or are those +which were most intensely stimulated or irritated and the most biologically +useful and adaptive at the particular moment or under the special +circumstances. The young child's reactions are preponderately motor, or at +any rate psychomotor and not purely psychic. When there are sources of +irritation or bodily or mental discomfort, there is a more or less general +bodily reaction, psychophysical in nature. When the irritation is definite +and clearly recognized by the child, the local motor response is also apt to +be definite. When, on the other hand, the irritation is but vaguely +perceived and not clearly appreciated or localized, we find that the child +may show a general diffuse reaction, or even, in some cases, a reaction +limited to certain regions as determined by the reaction taking place along +the line of least resistance. This is plainly seen in the conduct of the +physically sick child. Every pediatrician will find ample proof in support +of this statement in his observations of the defensive reactions of the ill +child. + +When this irritation along a certain nerve path is oft repeated or quite +constant, we have a consequent repetition of the defensive reaction, +whatever it may be. This performance may be so frequently repeated that the +idea of irritation or mental conflict or the anticipation or the expectation +of a repetition of same may be quite sufficient in itself to arouse this +reaction. It may become so habitual that, even though no such idea be in +the mind, there may be a repetition of the movement whenever the individual +is nervously excited or upset, whenever there is any mental stress, strain +or discomfort. And we may go even further and say that as a result of some +unusual mental struggle, some excessive mental strain, defense or adaptation +is brought about by regression or resort to a tic, this being conditioned by +the fact that for the particular individual under discussion this is the +easiest, most convenient or most immediate form of reactive response. The +discharge is, as is seen, along the line of least resistance. This line of +least resistance is determined by the organic nervous constitution and by +certain life-experiences or habit-formation factors. In some cases the +movement, once initiated, may be continued long after the disappearance or +cessation of the external irritation, because of the sense of relief or +satisfaction or pleasure[*] which is obtained by the performance of the tic. +In many instances the habit has become rather fixed, and, as a relief from +the struggle to do or not to do the movement, and because of fatigue in the +effort to inhibit or control the movement, the individual adopts the path of +least resistance, best for immediate relief from mental struggle; and as a +psychobiological effort at self-preservation and self-gratification, as +immediately as possible and at any cost to be paid in the future, he gives +vent, as it were, to the movement. + +[*] This is not, of course, of a sexual nature the Freudian school +notwithstanding. + +The psychic symptoms may come on at a later date than the motor symptoms or +simultaneously, although, of course, the early life history, in childhood +and puberty, for example, if we are dealing with an adult, may show, at +least in a certain proportion of cases, that the individual was of a +psychopathic type, perhaps somewhat shut-in or asocial. If the appearance of +the psychical symptoms be simultaneous with that of the physical symptoms, +we can understand at once how, like the motor symptoms, they may be repeated +time and again. In many instances, at least, the psychic symptoms arise +later, being added to the motor symptoms. These later psychic symptoms may +be a direct reaction to the source of irritation, or may be occasioned by +the dissatisfaction at being unable to control the movement in question. + +The degree of reaction, its duration and severity, depend upon the +hereditary and developmental make-up of the individual and the severity, +frequency and duration of the irritation, physical or psychical. The psychic +element is particularly apt to vary. The more neuropathic and psychopathic +the make-up the greater is the reaction. + +Where mental enfeeblement or mental disorder exist, the severity and +chronicity are apt to be still greater. + +There is thus a fixation, or rather a regression or reversion, oft repeated, +to a type of reaction of a very infantile, primitive sort, farther down in +the scale of evolution and development. + +This picture may be further complicated by so-called neurasthenic, +psychasthenic, hysterical or other reactions. Naturally one would expect to +find these conditions, especially the more aggravated forms, in individuals +of a neuropathic and psychopathic family strain, and who themselves are +neuropathic or psychopathic or both. + +It may be mentioned here, as is clearly appreciated from what has been said +before, that there is an interrelationship between the tics on the one hand +and the symptoms which we discover in the psychoneuroses, psychoses and the +mentally unstable on the other. + +In all of these conditions we find a cortical origin for the disturbance, +there is a lack of will power, of inhibition and of control of the lower +centres, there is a nervous and mental instability with a tendency toward +regression or dissociation, and the assumption of more or less independent, +almost automatic activity, this activity being characterized by its almost +(relatively) infantile, primitive, archaic makeup. + +Were I to take up any one of the tics as an illustration, this general idea +could be applied very nicely. But I shall not present any illustrative cases +in this paper. I shall leave it to the reader, however, to explain the +genesis and evolution of, for example, facial tics (which are so common) +from this standpoint. + +In passing I may say that the tic movements may have a special, individual, +psychological significance. But this is by no means necessarily so. +Frequently, I am inclined to believe usually, these movements result rather +merely because there has been effected a psychobiological reaction, +following the theory of psychophysical-progression, fixation and regression +with involvement of the nervous paths most seriously affected or most easily +disturbed. + +In the case of the tics, therefore, it is as if the various tic movements +are being used in reaction to or in adaptation to sources of internal or +external, physical or mental irritation, for the protection, defense or +self-preservation of this or that particular part of the nervous system--as +if the movements which we find in the tics and which are the expressions of +certain engrams, neurograms, mnemes or organic memories, are existing in and +for themselves, except that, in the tics, they are reacting with and for the +psychophysical organism, the organic make-up or personality. + +The individual, as a biological unit, is reacting to the particular +situation which presents itself by the tic mechanism. + +By granting the phylogenetic, racial significance we also give the basic, +psychophysical meaning of tics in all ticquers. + + + +EXCITING FACTORS + +How is it that these activities may come into play again? What brings them +to the surface once more? + +There are many factors which come in for consideration in this connection. +In the first place the basic cause is the instinctive, organic, +psychophysical make-up of the individual. Whether and which functions +re-exist as of old and respond as means of adaptation and self-preservation, +depends on the stability and the weaknesses or defects of the nervous +mechanism or system with its various parts, systems, functions or inherent +psychophysical dispositions on the one hand, and the life-experiences and +the immediate inciting factor on the other hand. + +A neuropathic or psychopathic or neuropsychopathic constitution with its +usual causes (germinal, intrauterine or extrauterine, usually of a toxic, +infectious or disturbed metabolic nature, and including particularly +alcohol, syphilis and nutritional disorders) may form the ground work. This +predisposition may be congenital--that is, present from the date of birth, +although not necessarily germinal in origin, or it may be acquired at some +period in life from physical or psychic causes. In this connection the +infantile and early childhood history are very important. Consequently the +diseases, training, example, education and opportunities in childhood and +infancy are of very great significance, the parental training and example +and the home conditions having a most intimate relationship to the +development of many of these tics. Imitation and mimicry here play a decided +role. Spoiled children, too quickly satisfied or over repressed, are apt to +develop tics. External somatic irritations may be the starting point in some +(not in all) cases. At other times an idea (normal or abnormal) may incite +the tic movements. Auto and hetero-suggestion, hypochondriacal ideas, +hysterical symptoms and obsessions may, particularly in adults, initiate +tics. Obsessions are especially apt to produce habits or tics, if they +produce any motor reaction. Tics may develop into obsessions and vice versa; +or both may co-exist simultaneously and be unrelated. The original ideas +which led to the movements vanish while the movements survive. In the insane +various sorts of delusions may be the groundwork on which a tic may later +develop. Habit movements, which represent purposive physiological acts +which have become automatic and not inhibited (hence showing weak will +power) and which seek strongly for expression, which the individual +struggles against and endeavors consciously to inhibit and overcome after +the tendency is fairly well developed, may eventually become impulsive and +irresistible with the ultimate evolution of the psychic state which is +characteristic of ticquers. Automatic habits and mannerisms or stereotyped +acts are of course not tics but the latter are but caricatures of the former +with an added characteristic mental state. Tics, as mentioned earlier in +this paper, are thus pathological habits. + +Tics may also be but the symbol for a vague feeling of tension, irritation +or stimulation, which seeks relief or expression by the performance of the +tic. + +Emotional stress and strain, fright, fear, excitement and mental shock can +arouse a tic. Mental conflict and unrest has not received that degree of +attention which it surely deserves. Clark and the Freudian school have +definitely called our attention to this aspect. Bresler refers to tic as a +motor reaction to original mental shock, so that it is in fact a psychic +defense reaction of expression. Dupre has stated that emotional shock may +act as a possible exciting cause of tics, as at times of obsessions. Meige +and Feindel have asserted that fear may excite a movement of defense, and +although the exciting cause has vanished, this movement may continue to +persist as a tic. They also mention that in ticquers we frequently find the +impulse to seek a sensation and to repeat to excess a functional act. + +That there is a weakness of will power in the ticquer, with a lack of +control or inhibition over the lower neurones normally regulated by the +higher co-ordinating centres, so that certain automatic activities become +dissociated and exist more or less independently, is generally acknowledged. + +In fact it must be said that tics are reactions of the organism, of the +organic make-up, the psychophysical personality, as a response to +irritation, excitation or stimulation, sensory, nervous or psychic! It is a +means of relief of tension, of organic reaction or adaptation, not +necessarily conscious but frequently unconscious and automatic, as in fear. +Starting in this way it may persist. In the tic we see a method by which +the individual or organic personality has met a certain difficult or +undesirable or disturbing situation. It is thus a constitutional, biological +defense reaction, psychophysical in nature, with a reversionary tendency +(when viewed from the evolutionary standpoint), and hence is indicative of +degeneration, this term being used in the racial, biological, phylogenetic +and ontogenetic sense. + +There is not such a far cry from the simplest tic to Gilles de la Tourette's +disease or maladie des tics with its more pronounced signs of psychophysical +deterioration and dissociation. The tendency is a degenerative one-- a +prolapse to ancestral methods of reaction, a dissociation or disintegration +of the personality, a lack of control over more elementary activities. We +should therefore appreciate the need of early recognition and treatment of +tics and fixed habit movements, especially since there is a tendency to +spread, for the tics to multiply, and for mental symptoms and reactions of a +hysterical and psychasthenic nature to appear, if they do not already exist +or have not existed before the onset of the tic. + +In brief, then, tics represent the emotional reactions and feelings of the +individual--the loves and the hates, the likes and the dislikes, the wishes +and the fears, the cravings and the dissatisfactions, the bodily and mental +tension, unrest, excitement, discomfort and disequilibration. In other words +the ticquer feels and speaks and acts by the tic. He lives by, in and for +his tic. He is attempting to meet certain situations of a disturbing nature +and to obtain equilibrium and equipoise by compensating for his feelings of +inefficiency and unrest by the tics. It is an organic, constitutional, +psychophysical, biological means of adaptation. + + + +PROGRESSIVE EVOLUTION OF THE CONDITION + +We now come to the progressive evolution of the motor manifestations and to +the mental aspect of this condition. + +Concerning the mental state characteristic of the ticquer it is generally +agreed that there is a polymorphic psychic defect or disorder which shows +itself particularly in a precocious or hyperemotional condition, in a lack +of will power and of inhibitory control, leading to a state and feeling of +doubt, indecision, incapacity, insufficiency and unreality, of inferiority +and self-depreciation, with a tendency towards morbid self-absorption, +egocentricity, self-observation, auto-and hetero-suggestion, with the +consequent development in many instances of so-called neurasthenic, +psychasthenic, hysteric and various psychotic reactions. I am not prepared +to say definitely how frequently the mental state, in lessened degree, +precedes the outbreak of the tic movements. This may be present in a certain +proportion of cases, but is by no means always present and it is even +questionable whether the predispositional mental condition is the ground +work in the majority of patients. + +Tics, it is true, are especially apt to develop in individuals with a +neuropathic or psychopathic history or heredity. In other cases this +history is not obtainable, the individual having been apparently perfectly +normal up to the time of the outcropping of the tic. In these cases shock +is apt to bring on the outbreaks and so one may say that the instability had +been latent and that a severe shock was sufficient to bring it to the +surface. We must remember, in all these cases, that the mental state which +we see in the ticquer is but an exaggeration of that which appears in many +children, and is similar to that which appears also in other psychoneurotic +states, and in fact the germs of this condition may occur transiently in any +of us. This psychic condition may frequently but does not always precede the +appearance of the tic movement. But it is only after the appearance of the +motor manifestations of tic that the mental state becomes prominent or +develops where it was not noticeable if not absent before. + +Be that as it may, or even granting that in most patients the characteristic +mental state or the neuropathic or psychopathic make-up exists in some +measure to an abnormal extent, we do know that once the tic movements have +made their appearance and begin to spread, so that the individual is thrown +into the struggle to perform or not to perform the movement, the development +of the psychic state which we find so patent in the more pronounced forms of +tic, thereafter more or less rapidly occurs, no matter what the mental +condition of the ticquer may have been previously. I am also not prepared to +discuss here at any length the phylogenetic or ontogenetic significance and +the biological genesis and meaning of the various mental trends of the +ticquer, but I may say that they too have been acquired in the course of +evolution, for certain very definite reasons which need not concern us here, +although it can be appreciated that the biological motive of +self-preservation played a most important role in their genesis and +fixation. + + + +APPLICATION OF ADLER'S THEORY OF THE NEUROTIC TO TICS + +The progressive spreading of the tic movement which so commonly occurs, as +well as the evolution of the mental aspect which develops subsequent to the +appearance of the tic movement, may be very nicely understood if we adopt, +for our present purposes the recent theories of Alfred Adler,[16] of Vienna, +concerning the makeup and development of the neurotic. This we may do +without committing ourselves, at this moment, one way or the other, with +regard to the correctness or incorrectness of Adler's views as applied in +toto to the neurotic. + +[16] Ueber den Nervosen Charakter, 1912. See also Adler's Studie uber +Minderwertigkeit von Organen, 1907. + +One should note that Meige and Feindel were, in a way, on the threshold of +this theory when they said that tic, like the other psychoneuroses, is due +to some congenital anomaly, an arrest or defect in the development of +cortical or subcortical association paths--unrecognized teratological +malformations. + +In a very few words Adler's theory may be given as follows: Adler assumes +that there is definite somatic inferiority (based on anatomical and +physiological changes) as the basis or foundation for the neurotic soil. +The neurotic consciously comes to realize the unconscious, organic, somatic +inferiority, and the endeavor to effect a psychic compensation or to make up +for these organic deficiencies by certain definite mechanisms, frequently +results in an overreaction or over-compensation. He thus overdoes himself in +efforts to make up for his inferiority, and in these endeavors he +necessarily makes use of unusual means and devices. It is this effort which +is the great motive force which dominates the life activities of the +individual and which compels him to seek as his ultimate object or final +goal a state which is best described as one of complete masculinity, of full +manhood, of self-maximization, of the will to live, to become powerful and +to seek supremacy or "the will to power" (Nietzsche). In following this goal +he goes to extremes and employs peculiar methods and devices, most of which +have for their object the concealment of his defects, and it is these +overcompensatory efforts and these peculiar devices resorted to, which go to +form the peculiarities or traits of the neurotic. According to Adler's +theory, the conscious efforts of the individual for psychic compensation or +overcompensation (for the unconscious, organic deficiencies) leads to a +resulting feeling of insufficiency, of incompleteness, of inferiority, of +unreality, of anxiety, of inability to face reality. Thus the mental +symptoms or characteristic mental state, being but the conscious recognition +of the unconscious inferiority, become especially pronounced when there is a +failure of compensation, or, in other words, when the individual is unable +to meet with or adapt to the situation which at the moment presents itself. +In these forced efforts at defense and compensation there is a resort or +regression to older, infantile, child-like, archaic types of reaction, of a +physical or mental nature, which are thus the protective defense mechanisms +or symbols. The struggle of the neurotic consists particularly in the +conscious appreciation of his goal and of his deficiencies of makeup and in +the attempt to reach his goal of full manhood and self-maximization in spite +of his handicapping deficiencies. + +Without discussing the exact status of this theory in the case of the +psychoneuroses and their related conditions in general, we may, as mentioned +previously, very conveniently use this theory in the elucidation and +understanding of the further development of the tic condition. + +Let us first consider the spreading of the tic movements. We know how in the +ticquer one tic movement may disappear only to give way to another, or one +after the other an increased number of tic movements and also of definite +compensatory movements not of a tic nature but of the nature of antagonistic +gestures and stratagems may make their appearance. The latter may in certain +instances become habit movements and eventually real tic movements. One +movement after the other may be resorted to, some perfectly consciously, +others more or less unconsciously, as reactions of the personality, of the +organic makeup or psychophysical constitution. These movements are adopted +by the patient, frequently more or less unconsciously, in order to attain a +state of equilibrium and rest, and in order to hide and make up for the +defect (the tic movements) of which he is aware. In these efforts he +overdoes himself and instead of hiding the movement he exaggerates it and +even resorts to further movements in his struggles to compensate, to adapt, +to conceal, and to flee from a state of mental disarrangement to a state of +psychophysical equilibrium. + +Now, most of our gross reactions are of a psychophysical nature, so that we +find that when the old types of defense or of activity are called forth (as +they are in the tics, as explained earlier in this paper, from the +evolutionary and phylogenetic standpoint), the resulting actions, now +reanimified, appear in exaggerated form, and also tend to "evoke a faint +phosphorescence of the old primordial feeling." This probably results in the +outcropping of the various psychic trends which appear in the ticquer and +which increase in degree and in number. The most common of the resurrected +psychic trends is the general tendency to dissociation or disruption of the +personality with the reanimification, in varying degrees, of certain mental +deficiencies and inferior types of reaction which are indicative of the +relative failure of the patient to measure up to and efficiently deal with +and adapt to the struggles of life as he must face and meet them. And so, +many undesirable and inferior kinds of mental trends come forth and hold +sway. The basis of their appearance is the lack of will power and of control +over these various trends which were previously more or less completely held +under control but which are now impulsively forcing their way to the surface +and being unravelled. These trends are characterized by their relative +immaturity, their infantile-like and archaic type. And so we have the states +of indecision, of doubt, of uncertainty, of inferiority, of depression, of +unrest, of self-depreciation, of self-observation, of auto and +heterosuggestion, of egocentricity, of self-criticism, of inhibition of the +expression of the personality along the broader, social lines of effort. +The groundwork for added states (hysteric, psychasthenic, and others) is +here very fertile. + +The law of psychic ambivalence and ambitendency, as so nicely developed by +Bleuler,[17] here shows itself in marked degree. There is both the positive +and the negative tendency toward the performance and execution of these +activities and reactions which are necessary for the living of a life of a +high or low degree of efficiency, so that the ticquer is obsessed by the +problem of "to do or not to do." This added factor leads to an exaggeration +of all the unfavorable psychic tendencies which have made their appearance, +and the intrapsychic struggle goes on with increased vigor. + +[17] The Theory of Schizophrenic Negativism. Translated by William A. +White. Nervous and Mental Disease. Monograph Series, No. II. + +The entire mental picture which we find in the most extreme forms of tic +could be beautifully elaborated along these general lines. For example, the +ticquer becomes asocial, seclusive and shuns society because of the +consciousness of the condition and the exaggerated sensitiveness. This +represents compensatory, defensive methods of concealment. Absentmindedness +and the inability to concentrate the attention are conditioned by the great +degree of attention devoted to the tic. The mental dissociation or +disintegration leads to an inflating of the emotional aspect of the +patient's mental life with a resulting increased nervous irritability and +reaction and a heightened degree of susceptibility to emotional +disequilibration and fatiguability of the mental faculties. The lack of +self-assertion, of confidence in himself, and the feeling of inferiority and +insufficiency are natural consequences of the general picture. The +inhibition of even, unhampered self-expression is always observed. + +In tics, it must be noted, there is regression to more inefficient and +inferior methods of response and adaptation, the types of activity being of +a somatic and psychic nature. Following the regression and owing to constant +repetition and habit formation there is a gradual fixation to certain +methods of response which become the lines of least resistance and this is +followed by progression and development of the general picture to other tics +and psychic symptoms. + +In general we note that the psychophysical reaction which we come upon in +the tics leads to the unearthing of various psychophysical types of +reaction, this unearthing consisting of disintegration or regression or +dissociation, the repressed, hidden, unconscious, phylo and ontogenetic, +archaic and relatively infantile-like activities, tendencies and +possibilities coming to the fore and unfolding themselves. + +It is here seen that this broad genetic standpoint is one of the greatest +contributions to psychopathology and is of infinite aid to us in the +understanding of the problems which confront us in the domain of +psychopathology and psychiatry. + +Comparative and animal psychology and the study of the reactions of +children, of primitive races, and of the mentally disordered give us a +splendid opportunity for studying it and unravelling the meaning of the many +somatic and psychic manifestations which are exhibited to us in the +psychoneuroses and psychoses and in tracing out the racial history of man. +Is it not plain that an understanding of the genesis and meaning of tics +opens the gateway to the elucidation of the origin and significance of the +psychoneuroses and functional psychoses--of reaction types of various kinds? + + + +REVIEWS + +THE INDIVIDUAL DELINQUENT. By William Healy, A. B., M. D. (Little, Brown & +Co., Boston, 1915.) + +It is a rare and pleasant experience to meet a book on such a general topic +as delinquency, which has not as its raison d'etre the exploitation of some +over-worked hypothesis. The Director of the Psychopathic Institute of the +Juvenile Court in Chicago has, however, not only avoided this danger but has +given psychologists, jurists, and penologists such a report of his five +years work as not one of them can afford to overlook. As the title of the +work implies, the material is drawn from the individual study of the +delinquent. He presents the results of the unbiased investigation of the +discoverable factors in the production of criminality in 1000 recidivists, +who were mostly, though far from exclusively, adolescents-- the period when +factors, both internal and external, are most easily determined and +modified. + +A careful perusal of the introductory chapter on methods reveals both the +thoroughness and open-mindedness of the author. He demonstrates that no +satisfaction was gained by the finding of any special mental or physical +abnormality, unless a more direct relation could be shown with the crime +committed than is established by mere coincidence. It is particularly +satisfying to note the precautions taken in the application of set tests, +how careful Dr. Healy and his assistants have been to determine the +completeness of cooperation on the part of the subject and to weigh this +factor in evaluating the results. One soon reaches the conclusion that the +author's own series of tests are much more likely to lead to reliable +diagnosis than the series of Binet, which demands so much of the rather +specialized capacity of abstract formulation. Healy's tests, on the other +hand, deal fairly with the primitive, untaught mind and that which has an +unequal and deceptive development of language ability. In connection with +these tests, it is interesting to note, by the way, that he finds +irregularity in results (or cooperation) to be so often associated with +epilepsy and depletion from sex over-indulgence that it may be taken as a +suggestive diagnostic feature. + +The value for the reader in discovering the eclectic view-point and critical +conservatism of an investigator lies in the confidence which these qualities +beget in the reliability of results. One can read most of "The Individual +Delinquent" to learn facts without the distraction of critical uncertainty. +With this in mind, therefore, a few of his conclusions, picked mostly at +random, may be quoted. An important factor in the production of delinquency +he finds to lie in the premature appearance of adult sex development--a +precocity which he regards as dangerous because it seems to be correlated +with a stimulation of sex instinct before adult inhibitions appear. In girls +(not in boys) he finds a distinct tendency to general physical +over-development as compared with the norm of the same age. In this +connection it is striking to find how many of his cases, which seem to +exhibit ingrained criminal tendencies, are delinquents only during the +period of adolescent instability. The various statistics are naturally also +of extreme interest, particularly since they are the result of examination +of 1,000 cases, chosen for this purpose only when there were sufficient data +secured to make the individual study relatively complete, and since they are +so at variance with the publications of others who have approached criminal +statistics to prove a theory rather than to learn facts. He finds alcoholism +in one or both parents in 311 cases. He cannot determine any direct +inheritance of criminal tendencies as such, but regards them as indirectly +of great importance as there were 61% who showed distinct defects in the +family antecedents. He thinks that stigmata of degeneration are probably +better correlated with mental defect and also with nutritional or +environmental conditions than with criminalism as such. Followers of +Lombroso will be disappointed to read that he found only 83 epileptics, or +possible epileptics, among his 1,000 cases. A full two-thirds of the cases +presented no symptoms of mental abnormality while only one tenth were +definitely feeble-minded. These are but scattered data; no digest, which +might be taken as substitute for the book itself, would be advisable. + +It is to be expected, of course, that psychologists (and particularly those +interested in dynamic psychology) will find mixed pleasure in reading this +work. The section on "Mental Conflicts" must appeal to all with its +practical demonstration of what can be done by psychological analysis to +abolish anti-social tendencies in many puzzling cases. There will +undoubtedly be disappointment in his failure to make general psychological +formulations, but, as the critics would differ amongst themselves as to what +these formulations should be, Dr. Healy's silence is here probably a wise +conservatism. At the same time there is certainly exhibited a tendency to be +rather too individual and give too few generalizations. This is evidenced by +his failure to regard as a factor in one case what has been admitted as such +in a slightly more obvious instance. To cite one example: On page 192, he +speaks of the inheritance of hypersexual tendencies; on page 166, we find: +". . . immodest behavior and use of obscene language on the part of a +parent, which we have so frequently found to be one of the main causes of a +girl going wrong . . . " Somewhat similar results are thus ascribed once to +heredity and again to environment. At this stage of our knowledge it would, +of course, be foolish to eliminate any specific inheritance as a factor, but +it is surprising that in the former case he does not consider environment as +a factor, although he elsewhere gives striking evidence of unconscious +influence proceeding from one individual to another via sex initiation. + +It is possible that this lack of a broad psychological view point-- this +example chosen is far from isolated--is connected with a specific, and most +definitely serious, defect in the book. The treatment of the psychoses is +distinctly unsatisfactory. Apparently the author has had to rely on the +literature for his preparatory experience and has been fortunate only in +some cases, if we may judge by his references. The most satisfactory group +he describes is that of the traumatic psychoses and there he follows Meyer's +admirable study. On the other hand, in introducing the Dementia praecox +group, he makes no specific mention of any one of the cardinal symptoms of +disassociation or shallowness of affect, scattering of thought, and +delusions or hallucinations. His nearest approach is when he says: +"Variations in the way of excitement, with dullness and paranoidal +excitement are seen during the course of the disease." This is followed by +the description of a case which he says contains the symptoms typical of the +psychosis but in which no pathognomic abnormality is mentioned except +negativism-- a vague term whose meaning varies with the observer. + +Not unnaturally with such unfamiliarity, the psychosis is a "dispensation of +Providence." There is no evidence that to him psychiatry is as much a +problem of every day life as it is of institutional care of the insane. We +can, therefore, find such a statement as this: + +"The mental findings and the conduct determined the fact of aberration and +that is all that should be necessary for immediate court purposes. Further +business of diagnosis should be left to a psychopathic hospital." + +It is true that responsibility may and should be evaded when the psychosis +is full-blown; but how about the innumerable cases of incipient psychotic +disturbance which grade over into the "mental conflicts?" + +In harmony with this diffidence is the repeated hope for aid from the +Abderhalden. or some similar reaction. For instance: + +"The newer methods of diagnosis of Dementia praecox we look forward to for +help in one place where discrimination is important." + +But surely a psychologist cannot hope to predict conduct by physical +findings! If Dementia praecox postulated criminality, the situation might +be different, but, as it stands, the reaction would only be of value in the +doubtful cases-- cases which are so many of them non-institutional. + +With this vague conception of the psychoses it is not surprising to find +that diagnosis used faute de mieux. For instance, in describing Case 169, +of "pathological lying," he says: + +"We could not in any way find evidence of mental peculiarity but we did +question his story because of intrinsic improbability." Rather conflicting +statements! Later on, he explains, the case was diagnosed as one of +"epileptic psychosis" because the subject developed convulsions, although +there is no evidence, or even claim, presented that the lying was an +equivalent, or in any way correlated with the epilepsy except as a +coincidence! + +Such faults in a book of this sort are serious but only in so far as the +work is theoretical. The main object of the book is to present facts in an +unbiased way and for the first time we have them in anything like +completeness. The importance of Dr. Healy's labors cannot, then, be +overestimated. His publication will be eagerly welcomed by the army of +workers who see a few cases at various stages of delinquency and who long to +know authoritatively what the types are, how they develop, what the outlook +is, and how that may be modified by appropriate treatment. We owe him much. +JOHN T. MACCURDY. + + + +HUMAN MOTIVES. By James Jackson Putnam, M. D. Professor Emeritus, Diseases +of the Nervous System, Harvard University. Boston. Little, Brown & Co., +1915; 12mo. Price $1. + +According to the publishers' announcement this is a study in the psychology +and philosophy of human conduct, based largely on the author's use of the +Freudian psychoanalytic method of mental diagnosis. The editorial +introduction by Dr. Bruce consists in a brief outline of the subconscious +mind. The author's preface, aside from anticipating the main features of the +book, makes the announcement that the latter is based very largely on the +personal experience of the last two years. The author gives one the +impression that this period represents to him one in which he has to his own +satisfaction mastered the relationship between psychoanalysis on the one +hand and our current conception of moral philosophy, ethics and religion on +the other. During this period he has "studied motives at close range." + +The work consists of six chapters and of these the first two deal with the +philosophic method of viewing man, while the others are devoted to +psychoanalysis. In the last chapter the author makes suggestions as to the +possibility of synthesizing the two methods. + +Human motives are either constructive or adaptive. The former are +associated with conscious reasoning and will, the latter with emotional +repressions. The former represent aspirations and are much higher than they +seem, since every man has an ideal--"getting out the best that is in +himself." He is a "lover of the best" and will die for and live for mere +ideas and abstractions like patriotism. He is assumed to be free because he +voluntarily creates, and is as free as anything in the Universe; and he is +free because he can choose. But where there is freedom there must be +clashing and compromise and repression. Among repressed subjects are +prejudices and superstitions, which, while irrational, unconsciously affect +our conscious motives. + +Man has feelings of humanity and brotherhood but has also the feeling of +separate individuality which comes from the egoism of the young child. The +instincts also come into play in the conflict between duty to others and +love of self. No one, however good, can escape this conflict. + +The old teaching as exemplified in philosophy and religion is based on a +study of man at his best, man in the abstract. This is incomplete because it +cannot promote such feelings as sympathy and understanding among men. +Something has always been needed to supplement it and this is found in +psychoanalysis in which conditions are reversed. + +Religion the author regards as an existence which is in harmony with that of +the "universe-personality." If we have the attributes we give to the Deity +as reason, love (disinterested) and will, we should seek this harmony. The +"world of sense" is antagonistic to this conception, in that it leads us to +reject all other than sense knowledge. Our notions of love, honor, power, +justice cannot spring from the sense-world. We must look beyond the +latter--a mere illusion--to find the true, immutable. Mind cannot be +evolved from life but must pre-exist. God and man must be conceived in the +same way--both represent a totality of expressions of world will, both +create and persist in their creations. Man must be regarded as creating his +thoughts and acts, even his own body. Every portion of the universe is +responsible for every other portion. Man, though ever changing, represents a +"self consciously unified person" and therefore feels responsible for all he +has ever done or ever will do. Freud himself, as the author states, never +cared to generalize on the subject of psychoanalysis. + +The book proceeds with a general outline of psychoanalysis which need not be +reproduced here. The subject of sexual repression, so far from being +exaggerated by Freud, is completely borne out by centuries of teaching by +the Church that all sexual matters must be repressed, because they proceed +solely from the flesh, the material world. As we have seen, however, the +author with others--both Freudians and non-Freudians--makes the libido a +form of creative energy, which attitude lifts it above the purely material +plane. Complete suppression of anything which will not down is regarded as +unwise hygiene of the soul, and the results of psychoanalysis, both as to +cause and cure of neurotic disturbances, amply sustain this view. A man's +unbidden thoughts are part of him and must be acknowledged. + +Psychoanalysis cannot be employed upon a number of subjects at once. It lies +between physician and patient, teacher and pupil. The unconscious but active +motive must be brought under the conscious will. The fantastic world of +childhood must be re-created. The teacher, dealing with childhood has an +advantage over the physician who applies his analysis to adults. + +The child should be encouraged to show all that is in him, and at the same +time must learn to regard himself less as an individual and more as a social +unit. He should do things which divert him from himself. + +In psychoanalysis an act is nothing, a tendency everything. The latter must +be changed. In analysis of one's self one must avoid all tendency to self +depreciation, since all must make mistakes. One should also distrust in +himself whatever savors of emotional excess. + +There is no radical difference between the neurotic and sound subject in +respect to the presence of unreasonable fears, compulsions and obsessions. +Stress of circumstances causes even the normal man to show objectionable +traits. Mental disease-phenomena, like physical, indicate natural +reactions, or "attempts at repair" such as are found in the organic and even +inorganic worlds. + +Treatment by psychoanalysis represents an education--the removal of +inhibitions which are fixations or arrests. + +The fifth chapter is in a way a resume of what the author had previously +said. He also seeks to reduce his teachings to a tabulation. The +rationalisation or adaptation of life progresses in proportion as the +individual is mature, but here maturity is by no means equivalent to age. +The process also is active in the immature child. + +A subject is usually quite unaware of his fixations and explains the results +of his internal conflicts by false reasoning. Rationalisation in this +connection becomes a bad habit. + +All motives are creative. The act is not the result of the immediate motive +but of all those which preceded it. The final act throws no light on the +original motives. + +In speaking of certain adults as children who never grew up, we are +referring to a much larger class than is commonly understood. All who attain +mature years with fixations are to be regarded as children. All +individualists belong here unless their individualism is merely a stepping +stone to altruism. Indeed, we see in all men a desire to place themselves +on a pinnacle. This craving seeks expression in a thousand acts. Even if +outgrown it may assert itself in times of stress. It is of benefit at times +when individuals espouse just but unpopular causes. What we ordinarily call +courage involves self assertion but a higher courage is involved in +refraining from certain things. + +All individuals also have occasional cravings to get away from +responsibility and back to rest and pleasure. We long to get back to a +theoretical state of childhood, as the infant longs to return to his +mother's body. + +For a number of reasons this not a work to be criticized. The author does +not mean to be dogmatic. His dicta, while they may have the ipse dixit +flavor, are not meant to be axioms. The creative energy of the mind can +formulate these dicta and they must clash with the convictions of others. It +is easy to deride the method as a method, but we must judge it by its +results. In Emerson's hands it became a profound stimulus to thought to +people of quite dissimilar mental makeup. In like manner the author's work +will prove of the highest suggestive value to the reader, and especially the +materialistic reader. But aside from the general character of the book we +must not forget that it has a very definite object, to wit, to elevate +psychoanalysis to the highest planes of philosophical speculation and to +remove the prejudices of those who profess to go to the other extreme and +see in it only the slime of the pit. The author's attempt to bring it in +unison with the eternal verities is deserving of the highest commendation +and illustrates his deep faith in the nobility of this new resource for +understanding the spiritual side of man. L. PIERCE CLARK, M. D. + + + +EDUCATIONAL PSYCHOLOGY: VOL. I, THE ORIGINAL NATURE OF MAN VOL. II, THE +PSYCHOLOGY OF LEARNING. By Edward L. Thorndike. Published by Teachers +College, Columbia University, New York, 1913. + +In the first three chapters of Vol. I Professor Thorndike introduces what he +calls the 'original tendencies' of man. These are the simpler and what have +often been called the 'instinctive', or 'innate' forms of behaviour. And +they are here taken as innate, in contradistinction to learned; as the +inherited dispositions on which the character of the adult is built. In +Chapters IV to X, inclusive, these original tendencies are enumerated and +described. This is a valuable, although somewhat unordered, inventory of +the more elementary human activities. A wholesome step is taken in +replacing the terms 'pleasure' and 'pain' (subjective categories supposed +from time immemorial to account for many sorts of reaction and to be the +basis of the learning process) by the more objective terms 'satisfiers' and +'annoyers'. The author inclines away from the common idea that very young +individuals exhibit random or diffuse activities + +A curiously baffling and admirably sceptical chapter on the Emotions (XI) is +followed by a largely destructive chapter on Consciousness, Learning, and +Remembering, in which Prof. Thorndike is in point of literary style almost +at his worst; and in some cases incoherent (e.g. p. 185, middle). The +chapters on the Anatomy and Physiology, on the Source, on the Order and +Dates of Appearance and Disappearance, and on the Value and Use of Original +Tendencies seem to the reviewer inconclusive and uninspired. There are +shrewd and interesting remarks here and there, particularly those of a +destructive intent, which the older reader will appreciate; while on the +whole he will wonder whether the author has, in these last four chapters, +any other than the whimsical aim of producing bedlam in the minds of his +younger readers. + +Vol. II is a long treatise of 452 pages on the faculty of Learning. The +author would probably reject the suggestion that he is dealing with his +subject in the spirit of the faculty psychology. Learning, he would say, is +an empirical fact, which he is simply describing. So also, however, the +'faculties' are empirical phenomena--attention, memory, and all the rest. +The question is, do Prof. Thorndike and others like minded analyze the +phenomena in a way that reveals their mechanism, or in the unfruitful manner +of the faculty psychology? Is, for instance, the mind an aggregate of the +following "functions that have been, or might be, studied:--Ability to spell +cat, ability to spell, knowledge that Rt 289 equals 17, ability to read +English, knowledge of telegraphy,. . . . ability to give the opposites of +good, up, day, and night, . . . . fear and avoidance of snakes, misery at +being scorned," etc., etc. (p. 59)? To the reviewer it appears that these +'functions' are cross-sections of the mental life which reveal NOTHING of +the mind's real mechanism. This way, surely, lie the maximum of pedantry +and the minimum of scientific insight. The volume as a whole may be +recommended to those who wish to ascertain to what extent academic +psychology of to-day is still dominated by the spirit of faculty psychology. +E. B. HOLT. + + + +SLEEP AND SLEEPLESSNESS. By H. Addington Bruce. Little, Brown & Co. +Boston, 1915. Pp. vii, 219. + +This book constitutes the third volume of the "Mind and Health" Series. In +it the author has given an admirable and clear summary of the recent +psycho-pathological work on sleep and sleeplessness. He begins by a +discussion of the nature of sleep and considering the difficulties involved +in making such a discussion clear to the average reader, the author has done +remarkably well in summarizing the technical work along this line. He then +passes to the problem of dreams and the part played by the unconscious +mechanism involved in dreaming, laying particular and justifiable stress +upon the point, that when problems are solved or adjusted in dreams, they +have always been previously solved by a kind of unconscious incubation +during the waking moments. The chapters on the disorders of sleep and the +causes of sleeplessness are brief but comprehensive, while in the discussion +of sleeplessness important stress is laid on the mental elements involved in +every case of insomnia. A strong plea is made for the psycho-therapeutic +rather than the pharmacologica, treatment of the disorders of sleep. On the +whole the book is clearly written and can be recommended to those who wish a +brief and at the same time comprehensive account of the modern theories of +sleep and its disorders. ISADOR H. CORIAT. + + + +A CORRECTION. +To the Editor of the Journal of Abnormal Psychology. + +I wish to call your attention to the fact that the quotation attributed to +me on p. 135 in the June-July issue of your Journal is a misrepresentation +of what I actually said. Due to an oversight on the part of the publishers +of the A. M. A. Journal, the stenographer's notes of the A. M. A. meeting +were not submitted to the members of the Section for examination and +correction. The Editor of the A. M. A Journal regretted this fact and the +discussion of my paper "The Conception of Homosexuality," from which this +quotation was taken, was published in corrected form in the Transactions of +the Section of Nervous and Mental Diseases (1913) of the A. M. A. A. A. +BRILL + + + +BOOKS RECEIVED + +PATHOLOGICAL LYING, ACCUSATION AND SWINDLING. By William Healy and Mary +Tenney Healy. Pp. 278 Plus x and Indexes. Little, Brown & Co., 1915. + +THE CRIMINAL IMBECILE. By Henry Herbert Goddard. Pp. 154 Plus vii & Index. +The MacMillan Co., 1915. $1.50. + +CHARACTER AND TEMPERAMENT. By Joseph Jastrow. Pp. 596 Plus xviii. D. +Appleton & Co., 1915. $2.50 net. + +A SURGEON'S PHILOSOPHY. By Robert T. Morris, M. D. Pp. 575 Doubleday, Page +& Co. $2.00 net. + +BACKWARD CHILDREN. By Arthur Holmes. Pp. 247. Bobbs, Merrill. $1.00 net. + +A MECHANISTIC VIEW OF WAR AND PEACE. By George W. Crile. Pp. 105 Plus xii. +The MacMillan Co. $1.25. + + + +THE JOURNAL OF ABNORMAL PSYCHOLOGY + +SCIENTIFIC METHOD IN THE INTERPRETATION OF DREAMS[*] + +WITH A THEORY TO EXPLAIN THE DREAM-PROCESS AS APPERCEPTIVE TRIAL-AND-ERROR. + +[*] A paper read at Columbia University, April 19, 1915, at a Joint Meeting +of the New York Branch of the American Psychological Association and the New +York Academy of Sciences, Section of Anthropology and Psychology. + +Copyright 1916, by Richard G. Badger. All Rights Reserved. + +LYDIARD H. HORTON + +HISTORICALLY speaking, dreams have always been credited with meanings; but, +in a given case, the psychologist must ask, how far does the accredited +meaning represent the mere fancy of the interpreted and how far does it +mirror actual conditions in the dreamer's mind. To seek aught beyond these +is but idle divination. For of all dreams it is true, in the words of Ralph +Waldo Emerson, "that the reason for them is always latent in the +individual." "Things are significant enough, Heaven knows;" he exclaims, +"but the seer of the sign,--where is he?"[1] + +Not till the last year of the nineteenth century, did an answer come; it was +Sigmund Freud's work, "The Interpretation of Dreams," which said, in effect, +"Here am I, in Vienna."[2] + + + +THE FREUDIAN PRETENSIONS + +"In the following pages," he begins, "I shall prove that there exists a +psychological technique by which dreams may be interpreted and that upon the +application of this method every dream will show itself to be a senseful +psychological structure which may be introduced into an assignable place in +the psychic activities of the waking state." + +The sweeping character of this pretension has not been justified. The +demonstration has succeeded only with that large class of dreams in which +there happens to be a trend of infantile reminiscence and of disguised +sexual phantasy. It fails to reveal the inner nature of other kinds of +dreams or the modus operandi of dreaming as a process of thinking. And while +it is asserted by the publishers of the English[3] edition that the main +contentions of his book have never been refuted, the fact is that his thesis +has not been accepted by the representatives of scientific psychology, as a +solution of the problem. + +The exponents of Freudian interpretations today are medical men associated +with the practice of so-called "Psychoanalysis;" which means that they are +more concerned to apply Freud's ideas for the treatment of nervous ailments +than to cultivate pure psychology. An examination of the methods they +exemplify in individual practice and in the large literature of the +psycho-analytic movement shows sufficient reason, in my view, why the +psycho-analytic theory of dreams should still be greeted with skepticism. +Psycho-analysts tell us that repugnance for the subject-matter has delayed +acceptance of their essentially sexual interpretations. But there is also a +resistance based on sound logical criticism. Judged by this standard, +Freud's theory appears dangerously inaccurate and needs revision. + + + +THE TWO SCHOOLS OF PSYCHO-ANALYSIS + +Dr. C. G. Jung, formerly a pupil and literal follower of Freud, is +attempting to reform psycho-analytic doctrine from within the fold.[4] +Incidentally, he tells us that there is nothing essentially novel about the +technique of investigating the dream in Psycho-analysis. It copies the +methods of historical and literary criticism and consists in collecting all +the data possible about each item of the dream. These are then called the +dream material. What seems to me novel and characteristic is the +psycho-analytic method of working up this material into an interpretation by +a process of inference. Freud and Jung are today no longer in agreement as +to the details of this process.[6] Speaking of the interpretations of these +authorities, on the basis of extended investigations of dreams on my own +part, I must say that their methods do not seem to be as rigorous, as is +required today in the investigation of literary and historical problems, nor +capable of bearing comparison with experimental psychology. + +It must be acknowledged, however, that Freud has infinitely refined the +guesses of earlier generations of thinkers as to the relationship of +sleep-fancies to the waking life. He has conferred startling precision upon +the general proposition of Goethe "that these whimsical pictures, inasmuch +as they originate from us, may well have an analogy with our whole life and +fate." And he has certainly vindicated in practice that dictum of Emerson: +"A skilful man reads dreams for his self-knowledge."[1] But he has +formulated no open-sesame, as psycho-analysts proclaim. + +When it comes to the use of symbols, the Viennese professor parts company +with the Concord philosopher. The latter, as we know, decried the mystical +conception of fixed symbolism in any domain. But Freud, although +theoretically agreed, falls victim in practice to the fascinations of the +dream-book cipher method which he has condemned. The adjective Freudian is +now justly a by-word, among psychopathologists, for a stereotyped habit of +reducing each item of a dream to some cryptic allusion or roundabout +reference to the primitive demands of the infantile and sexual life. Freud's +fertility in such interpretations has led one of our best-known experimental +psychologists to say, in mingled admiration and impatience: "His utterances +are those of a poet, not of a scientist." + + + +JUNG'S COURAGEOUS RECANTATION + +As spokesman of the Zurich group of psycho-analysts, Dr. Jung has lately +protested against these arbitrary translations, which he calls Freud's +"reductive method."[6] In formulating a more scientific method of his own, +which he calls the "constructive method," Jung reveals a change of views so +extensive as to suggest, on several points, almost a conversion to the ideas +that Dr. Morton Prince expressed in 1910, as to the insecurity of the +psycho-analytic ideas of symbolism.[7] At that time, Jung valiantly defended +the Freudian preference for stereotyped meanings as against the Principian +idea of highly variable meanings.[8] Now, in going to the other extreme from +Freud's cipher-like method, Jung has succumbed to the attractions of that +other popular method, equally decried by his former master: the symbolical +method of Joseph and Daniel.[9] But at least he has bravely called in +question views which he once espoused with exaggerated positiveness. + +Jung's principal amendment to the Freudian dream-analysis consists in +subjecting the literal implications of the established Freudian symbols, +such as snakes and staircases, to a further, more allegorical mode of +treatment in which the sexual meaning is greatly altered. The evidence, +which Freudians continually find in dreams, for a pre-occupation concerning +infantile and sexual needs[10] is explained away, as merely incidental +reviewing of past experiences, in the attempt to solve problems of the +future by analogy with the past. In other ways also Jung alters his views, +notably by following Prince in explaining the dream on a broad biological +foundation, viewing it as part and parcel of the individual's life-struggle. +Yet it is difficult to see wherein the so-called constructive method really +applies, to the concrete dream, those biological conceptions of which it +makes ostentation. The practical consideration of telling the patient what +is good for him, and of keeping sexuality in the background seems to +dominate the technique.[6] The interpretations are no more accurate than +before. There is not much to choose between the reductive and the +constructive method from the standpoint of the application of logic. + + + +THE SUPPOSED LANGUAGE OF DREAMS + +These reductions and constructions of the psychoanalytic schools appear to +be rather favorite ways of guessing than rival scientific methods. +Unquestionably, they must achieve a gratifying number of hits under the +easygoing conditions of the psycho-analytic seance. This is obviously +satisfactory to medical practice; but the danger to psychological theory +lies in the temptation to overvalue the particular technique that seems to +bring about such successes. For instance, Freud and Jung, finding it +convenient to assume that the dreamer is attempting to express his latent +thoughts by the use of metaphors and figures of speech, have unfortunately +come to regard the behavior of the Unconscious Mind as if it were employing +a secret archaic code or language of dreams. According to Freud, its symbols +have very concrete meanings; Jung, more liberal, says they are only very +general. But both authors seem to abuse the language-analogy as a guidance +in dream interpretation. That is why psycho-analytic method today suggests +not only the free play of poetic invention, but the license of mystical +speculation. + +If there is any present point in Emerson's remark that "Mysticism consists +in the mistake of an accidental and occasional symbol for an universal one," +then, in speaking to the psycho-analyst, the psychologist should echo +Emerson further, and say: "Let us have a little algebra instead of this +trite rhetoric-- universal signs instead of these village symbols--and we +shall both be gainers."[11] + +The reason we shall need a little algebra, as it were, is that many +psycho-analysts have fallen into confused ways of regarding their signs and +significations. + +Consider, for example, the reputed signs of the birth-phantasy, as listed by +Freud:[12] + +"A large number of dreams, often full of fear, which are concerned with +passing through narrow spaces or with staying in the water, are based upon +fancies about the embryonic life, about the sojourn in the mother's womb and +about the act of birth." . . . Again, "There are dreams about landscapes and +localities in which the emphasis is laid upon the assurance, 'I have been +there before.' In this case the locality is always the genital organ of the +mother; it can be asserted with such certainty of no other locality that one +has 'been there before.' " + +(What we should infer from the waking illusion of familiarity, which, +Emerson said "almost every person confesses"--on this basis--is too absurd +to contemplate.) + +Statements like these, though far from syllogistic in form, are virtually +general propositions or laws to the effect that all dreams having the +designated earmarks or manifest content, possess additionally and +necessarily certain specified qualities in the latent content--in this case, +the meaning of birth-phantasy.[13] + +Freud and Jung have stood sponsors for many such seemingly far-fetched +interpretations. How do they come to be so sure of their ground? + + + +EXAMINATION OF THE LANGUAGE-ANALOGY[14] + +Let A represent the idea in the latent content and C the corresponding +"symbol" in the manifest content. Suppose that in a number of cases a +correlation is observed between A, the antecedent latent idea, and C, its +consequent or sequential manifestation in the dream-consciousness. +Thereafter, the observer comes to interpret the re-appearance of C in a +dream narrative as a sign of the presence of the affiliated idea A, in the +latent content. And, as Thomas Hobbes phrased the matter in 1651, the +oftener they have been observed in like connection, the less uncertain is +the sign.[15] Now this is precisely the way we come to recognize the verbal +signs of our mother-tongue. And our confidence that a given speech C' is +significant of a meaning A', in the speaker's intent, is arrived at by +relying upon, if not consciously formulating, just such a causal connection. +Where an existing language is concerned, this is a perfectly legitimate +tooling of thought. But in applying such inferences to a supposititious +language of dreams, psycho-analysts are begging the question, as well as +running into other kinds of fallacy as to the powers of the Unconscious. + +The meanings and significations of dream-items are not so simply made out as +in language. For one cannot readily make sure that the relationship or +affiliation between A and C has been observed in its purity; there is an +uncertainty coming from the possible interposition of a variable factor, +which may have vitiated the observation, as Alfred Sidgwick points out in +his "Application of Logic."[10] So let us well consider the basis of any +inference of meaning in dreams, and how far the language-analogy applies. + + + +THE SOURCES OF MEANING + +Fundamentally, every dream, yours or mine, consists of certain more or less +clearly remembered images or ideas; and these are secondarily derived from +some mental disposition previously or coetaneously acting in the background, +as it were: i. e., persisting through its residual subliminal nervous +dispositions. This anterior phenomenon is properly called the primary idea +or image; the other, which appears (supraliminally) in the dream is called +the secondary image or idea. The dream is thus made up of collocations and +combinations of secondary images, to which is usually added a filling-in of +fancy which may be called tertiary ideas: required, to find the primary +ideas and so, the relation of one idea to another--which is the measure of +"meaning." + +Each secondary or tertiary image, in the absence of any immediate stimulus +to account for it, may usually be traced back into a primary train of +thought left unfinished during the day. This is the conception of the +perseveration of the unadjusted, stated in 1891 by Delage, in giving his +theory of dreams.[17] Its history runs back to Thomas Hobbes; and it has +been amplified lately by Professor Woodworth, to whom I am indebted for +unusually clean-cut illustrations of the applicability of the theory to +dream-life. The principle is a most important contribution to the study of +meaning in dreams. + +More specifically, Prince, through his text-book on "The Unconscious," is +the exponent of the idea that the elements of meaning reside in the primary +ideas and must be sought there by highly specific investigations in the +given case: "the meaning is in the fringe of thought." The meaning of a +supraliminal image must be discovered in its relation to the subliminal +ideas clustering around it. This implies studying by association-tests what +James called the psychic overtones, and what Prince has, in his teaching, +called the unconscious settings-of-ideas, which determine meaning.[18] Care +must be taken to find the real determinants, and to set aside spurious dream +material--which is not always facilitated by the psycho-analytic methods. + +In order to show that one should not assume meanings by rule of thumb, +without investigations of this kind, Prince has demonstrated a case in which +typical phallic symbols, in a phobia of bells and towers, had acquired their +emotional meanings, not through sexual analogies, as Freudians would +suppose, but through actual contiguity-experience with church bells and +belfry, quite apart from sexual matters.[18] Similarly, snakes, sticks, +circles do not necessarily carry the sexual meanings assumed by +psycho-analysts, who are over-influenced by the language-analogy. + + + +DECISIVE VALUE OF CONTEXT AND APPERCEPTION MASS + +To Freudians such statements seem paradoxical, to say the least; but the +simple fact is that never is it correct to assume, as they do, a +transcendental connection between a symbol C and a signification A, as if +the Unconscious Mind disposed of ready-made symbols of its own. Barring +words used in their proper sense, and similar borrowings from waking habit, +the so-called symbols in dreams are essentially impromptu fabrications, in +which the association is not a direct causal connection between A and C, but +a mediate association involving a third element, which psycho-analysts +usually leave out of account. + +An element of this kind, overlooked in the formulation of a supposedly +simple connection between cause A and effect C, is labeled Hidden Z, by +Alfred Sedgwick. The Hidden Z in this case is what James calls the +topic-of-thought, Ebbinghaus the set-of-the-mind, and others +apperception-mass. In rhetoric it is familiar as context. It has an +important place in thought and speech. For example, when I utter the +phrase--Pas de lieu Rhone qne nous--the idea obtained is different according +to whether your language apperception-mass is set for French or for English. +It may have happened that while I was uttering the French nonsense phrase +you were hearing it as the English saying. Similarly, the traveler in Egypt +may correctly apperceive the meaning of architectural forms of temples as +phallic; whereas it would be manifestly out of context to do so in +connection with churchly edifices of the Gothic type, which do not represent +the generative powers of nature, as do the former. + +Conversely, the Freudian disciple may apperceive, in error, a sexual meaning +in a dream, when the dreamer's mind contained no reference to this topic. +Hence, the interpreter must make sure that his own apperception-mass is +attuned to that of the dreamer in the given case. That is, one must be free +from apperceptive bias. One must reject all hastily formed causal laws to +the effect that C is the sign of A in every case. Otherwise absurd +conclusions must result, as in Freud's theory of the birth-phantasies. For +the same "symbol" may proceed from entirely different significations +according to the set-of-the-mind or apperception-mass. The following analogy +of Ebbinghaus puts the matter clearly: "When a train enters a large station +there are many paths over which it might pass; but its actual path depends +on the position which was given to the switches immediately before the +train's arrival."[19] That is why one needs to detect, experimentally, the +dream material that really represents the set-of-the-mind, and thence the +significant relations called MEANING. + +In this connection, I published a year ago the dream of a child of six, +containing seemingly typical phallic symbols.[20] Not one of them could be +correlated with a sexual context; but every one was concretely shown to have +reached its position in the dream through the influence of an entirely +different set-of-the-mind. It is, therefore, not safe to assume stereotyped +meanings in dreams. + + + +METAPHYSICAL CONCEPTIONS IN PSYCHO-ANALYSIS + +There are three reasons why psycho-analysts do not more often encounter this +variable element, this Hidden Z. First, such dreams as they elect to deal +with, are mostly sexual. Second, they do not apply the methods of +individual differences which have been made so familiar and so useful by +Professor Cattell in this country.[*] Thirdly, their type of culture leads +them to study the dream extensively rather than intensively and all the +while in apparent disregard of those conceptions of physiological psychology +which we now associate with the work of Wundt, of Ladd and of Woodworth, and +with the psychopathology of Prince. + +[*] The writer's present psychophysiological theory of dreams was first +broached in public, at a series of meetings on the subject of Individual +Differences, held in honor of Professor Cattell, at Columbia University, in +the Department of Psychology, in April, 1914. + +To be sure, Jung's recent utterances before the Psycho-Medical Society of +London, demonstrate his dissatisfaction with the Freudian conception of the +dream; but he is still far from those studies of specific mental and nervous +dispositions to which psychology has slowly come, and for which we now have +a tool in the shape of Prince's conception of the neurogram. In +psycho-analytic work a more vague use of "dream material" is preferred and +it is only by good luck that the real settings-of-ideas come into account. +Jung, no less than Freud, has forgotten that philosophy has become +mechanistic since Descartes'[21] famous year of 1637, and Jung would throw +us back to the early seventeenth century, with his energic conception of the +Libido, or the Ur-libido, now called Horme and sometimes merely elan vital. +And this, fifty years after Herbert Spencer's tremendous emphasis on +specific studies in reflex-action![22] + +Fontenelle, the wittiest of Cartesians, writing in 1686, gives us a classic +tableau of this sort of speculative temper. [23] He pictures worthies like +Pythagoras, Heraclitus; Empedocles, as being invited to witness Lulli's +opera "Phaeton," at the Paris Odeon. In characteristic fashion, each in +turn tries to explain the spectacular aerial flight of the actor in the +title-role, from the floor of the stage to the ceiling. One says, that +Phaeton is able to fly by the potency of certain numbers of which he is +composed; another, that a secret virtue carries him aloft; still another, +that Phaeton travels through the air because he abhors to leave a vacuum in +the upper corner of the stage; and so on, with a hundred and one +speculations which, as Fontenelle remarks, should have ruined the reputation +of antiquity. Finally, he pictures Descartes coming along and saying: "This +actor is able to rise from the floor because he hangs by a cord, at the +other end of which is a counterpoise, heavier than he, which is descending." +This is mechanistic . . . If Freud and Jung had been of the party, can it be +doubted that the one would have ascribed Phaeton's aviation to a +wish-fulfilment of the flying-dream type, derived from a reminiscence of +erotic motion-pleasure[24] in childhood, or that Jung, for his part, would +have said Phaeton was levitated by the energic force of a sublimation of the +Ur-Libido, alias elan vital, alias Horme! + +* * * + +VARIETIES OF DREAM INTERPRETATIONS + +Let me illustrate these points of criticism of the psychoanalytic methods, +by the analysis of a sample dream; speaking first as the dreamer giving the +simple narrative; next as Freud applying the reductive method; then as Jung +employing the constructive method; and finally explaining the dream, as I +would myself prefer, by the use of what I may call the reconstitutive +method. The dream itself, for reasons, that will be obvious, I call the +"Scratch-Reflex Dream." + +"I was looking down upon a microscope from the right side of the lens-tube, +and could see, laid upon the stage, a glass slide. Under the cover-glass, in +place of an ordinary specimen, there was supposed to be a new reflex,--one +of those discovered by my friend the neurologist, Dr. X., whose scrawly +handwriting I recognized on the label. I was anxiously trying to decipher +what he had written, and was having the same trouble with it that I had +experienced in real life with the record of some of his dreams, which I had +interpreted successfully. The handwriting on the label, as I gazed, appeared +less and less like script and more like disconnected, scratchy lines or +hachures, owing to the formation of lacunae in the inky traces. It became +scratchier and scratchier as I wakened. On coming to my senses . . . " + +"That is enough," we hear Dr. Freud saying, "It is obvious what kind of +reflex-action you have in mind! The word 'slide' is of a punning nature, +and in conjunction with the easy moveability of the microscope-barrel +suggests a meaning akin to that of dreams of skating and sliding, which are +usually sexual. From the standpoint of symbolics, the geometric forms and +relative positions of cover-glass and microscope suggest allusions to the +generative powers of nature--like the phallicism of the ancient Egyptian +religion, whose sacred emblems of sexual objects still confront the explorer +and the tourist. Here, the 'stage' of the microscope refers obviously to +the theatre, so often the scene of exhibitionistic activities. Your dream +represents the male and the female principles in such a manner that it must +mean a survival of infantile curiosity related to the mystery of parenthood. +Sir, this proves your Libido to have been fixated at the 'voyeur' +level."[25] + +"Not so fast," says Dr. Jung, while the dreamer remains nonplussed at the +foregoing example of the reductive method. "It is not good for the health +to overvalue the past, as my colleague does. Nous avons change tout cela, +in Zurich. Your curiosity, according to the constructive method, is a +demand for satisfaction in new and better ways than those of infancy. I will +prove this to be so, by an investigation of the dream material. This Dr. X., +what of him and his handwriting?" + +The dreamer then explains that Dr. X. had consented to have his dreams +analyzed, and that the outcome had been the uncovering of his secret +intention to be married; the dreamer also states that Dr. X. had written +some very original papers on periosteal reflexes. + +"Ah," says Dr. Jung, as it were, making quotations from his own writings, +(as indicated in italics) "one has only to hear this dream material in order +to understand at once that the dream is not so much the fulfilment of +infantile desires as it is the expression of biological duties hitherto +neglected because of . . . infantilism.([6]) To be sure these are sexual +objects that you are looking at in the dream, as Freud would have it. But +your interest in them is not so primitive as it would seem. For do you not, +symbolically speaking, 'look down upon' them in your fancy. And moreover, +since you are looking at these emblems of parental union 'from the right +side,' does it not therefore mean that you are contemplating something +legitimate; namely, marriage on your own account-- not exhibitionism on the +part of others. One infers you wish to put away childish sex-curiosity and +fulfil your destiny as a parent. In this case symbolical value, not concrete +value must be attached to the sexual phantasy." + +At this point, the dreamer makes free to admit that he is a bachelor, and +that he would not be averse to marriage if he could manage to take a wife +and at the same time keep up his research work. + +"Precisely," Dr. Jung might say, rapidly turning these clues to account, +"your interest in future advancement is clearly reflected in your anxiety to +decipher the handwriting of Dr. X., with whom you have identified yourself. +You desire to emulate his scientific achievements; his published work on +reflexes excites your ambition. The handwriting on the label, which +perplexes you, is an allusion not only to his authorship but to the +difficulties in the way of your own contribution to the science of dream +interpretation. By imitating Dr. X's triumph you wish to make your marriage +possible. Your Horme or elan vital is pushing you to evolve new and higher +forms of the Libido. You are sublimating!"[26] + + + +THE RECONSTITUTIVE METHOD + +"No, gentlemen," the dreamer replies at last, "your reductions and your +constructions are too easy-going, too conjectural, too much dominated by +prepossessions and the 'will to interpret.' The alleged sources or +determinants for this dream may or may not have played the parts you assign +to them; the mystery of the matter must remain inscrutable. But what your +methods, so plausible in effect, certainly do show is how easy it may be to +confabulate an explanation that goes no deeper than a phrenological reading +of cranial bumps or than a seance in the cabinet of a palmist. Let us turn +away from all this and consider what really happened, as by the grace of +luck I can bear witness. Permit me to reconstitute the dream as an actual +event, by the employment of certain clues which I was about to give when the +ready-made symbolism of Dr. Freud was interposed." + + + +OUTLINE OF THE RECONSTITUTION + +Inasmuch as the dream is one of my own, I may be permitted to testify that +it was unmistakably connected with a scratching sensation at my ear, as I +distinctly perceived on awaking. This stimulation proceeded obviously from a +mouse, which I had time to observe in close proximity, as it remained +perched on the bedclothes, until my own startled movements put it to flight. +Tracing the stimulation from this external source, I shall try to maintain +the following interpretation:-- + +First, that the dream is an associative reaction to the sensation of +scratching, in the form of evocations of imagery related in experience to +this sensory element; and that the dream-process was a part of the +perception, or recognition or apperception of the stimulus. + +Second, that this reaction--let us name it apperception of the stimulus-- +took place slowly and imperfectly, owing to the state of sleep, so that the +reaction was, to begin with, only remotely relevant to the stimulus, but +improved in relevancy with successive evocations, until the mental +representation closely approximated the character of the stimulus. + +Third, that in and among the secondary images[27] so evoked, incidental +processes of thought, tertiary compoundings of these images, were +immediately set up; the selection and re-arrangement of these secondary and +tertiary features, constituting the revelation of a significant state of +mind which had preceded the dream. + +Specifically, in addition to the mental response to the external stimulus, +there was a phantasy representing an imaginary wish-fulfilment: namely the +desire to forsake the study of histology, with the eye-straining search +through the microscope, in favor of the study of reflex-action or +reflexology. + +My contention is that this blended response[28] to a physical and to a +psychic cue arose very naturally and simply out of a single context, +prepared by events of the night before; and I would show that by comparing +the phantasy with this context, it is possible to reconstitute the dream in +a way that amounts to a refutation of the two other interpretations, which I +have essayed in accordance with the methods of Freud and of Jung, +respectively. + + + +THE REAL CONTEXT OF THE DREAM + +Our constant consideration should be for the fact, emphasized by William +James, that there is "no recall without a cue."[29] Here we have a +scratching sensation provoked by a mouse as the immediate and demonstrated +cue. The images that followed in serial response, proved upon investigation +to have been wholly derived from a certain conversation with Dr. X., the +night before. The subject had been reflex-action and especially the +scratch-reflex of the guinea-pig[30] as investigated by Sherrington; we had +discussed also the attempts of other authors to explain the higher mental +functions in terms of reflex-action.([31]) My own preference for such +studies as applied to the explanation of dreams had been touched upon. This +preference had in turn been contrasted with the fact that I was at the time +of the dream called upon to spend much time studying histological specimens +through the microscope. Incidentally, I told him that this was bad for my +eyes, and likewise, I had complained that his dreams were not written out +clearly enough to suit my purpose to study them carefully. Such interest had +been aroused in the subject of reflexology, that Dr. X. and I had stayed up +late that night discussing it. + +A study of the dream in the light of these facts will show how perfectly the +dreaming mind appears to have "taken advantage of" them--in reality +following cues along the lines of least resistance. + + + +THE DREAM AS A RESPONSE TO A CUE + +The Scratch-Reflex dream is then to be reconstituted first of all as a +memory-reaction determined by factors of recency, frequency and intensity in +the dreamer's experience. The operation of these factors determines the +evocation of a specific context or apperception-mass, namely the +conversation in question, whose affinity with the external stimulus +(scratching) is now made evident. The course of events can be followed so +concretely as to permit the logical exclusion of other supposed +determinants; confining the explanation as stated. The principle of the +parsimony of causes is here applied. I contend that the dream is neither an +infantile nor a sexual wish-fulfilment, all plausible analogies to the +contrary notwithstanding. Should anyone wish to urge the more remote +interpretations which I first manufactured, then the burden of proof rests +with him. And no proof is conclusive that rests on mere precedent or on mere +reasoning by analogy. The only psychological proof of an interpretation is +fundamentally the ability of the interpreter to reconstitute the dream +beyond peradventure. This I propose to accomplish more in detail, showing +the dream to be a reaction to specific cues, through a process of +trial-and-error, and to a limited degree, of trial and success. + + + +TRIAL PERCEPTS + +Consider the sequence of events: the dream pictures are all related, at +least individually, to the conversation in question: microscope, slide, +reflex and "scratchiness" are all so many pictures jig-sawed out from this +very context or apperception-mass. The scratching sensation, we must +suppose, evoked these pictures serially, in the order stated. If these +images were what the psychologist calls "trial percepts," we would expect +from them just what we do find, namely, an increasing degree of +correspondence (relevancy) between the stimulus-idea and the images, as they +appear.[33] Precisely so, the images of microscope, slide, reflex and +scratchy handwriting, as they successively come into focus, conform more and +more to the nature of the stimulus, until the approximation ends in the idea +of an all-absorbing interest in "scratchy" marks. This visual image hardly +reaches precision before it becomes translated and transposed to the tactile +field of my ear; smoothly, as if it were one magic lantern view dissolving +into another. In fine, the presentation of each image in the dream amounts +to a groping effort of the dreamer's nervous system to find a proper +experiential EQUIVALENT for the arriving stimulus. It is a trial-and-error +method of perceiving or apperceiving a stimulus by marshelling associated +ideas; in this case they are serially evoked; (what might be called "oniric +echelon"); in other cases the trial apperceptions are blended smoothly +(oniric fusion) or heaped together in rough-and-tumble fashion, a kind of +confusion (conveniently called "oniric entassement") which testifies +sufficiently to the failures of the Unconscious t o dispose smoothly of +arriving excitations, and so emphasizes; the theory of trial-and-error, as +applied to dreams. + + + +APPERCEPTIVE DELAY IN TRIAL-AND-ERROR PROCESS + +The delay in arriving at the correct apperception of the stimulus may be +referred to as "finding-time" or simply as apperceptive delay. It represents +time occupied with the reproduction of erroneous apperceptive +images--apperceptive errors. Meanwhile the stimulus-idea, that mental +element most closely connected with the original stimulus, is operating +somewhere in the brain, determining the evocation of the secondary images +that appear in the dream.[33] This wire-pulling is done in the dark; the +primary stimulus-idea is not itself imaged, at first; neither is the context +or apperception-mass which meets it half-way, that is, becomes conjoined +with the stimulus-idea. Indeed, the images that come into the dream are only +emerging peaks of a submerged island of memory. What shall emerge is +determined by the interplay of stimulus-idea and apperception-mass, below +the level of consciousness. (A and Z are working together.) + +The particular "island of memory" in this case, was an impression of the +talk with Dr. X., about histology, reflexology and dream interpretation; it +remained subliminal, evidently, except so far as portions of it were raised +above the threshold by the reproductive energy of the stimulus of +scratching. Necessarily, a process of imageless thought had taken place, +whereby the conversation was brought into play as a sub-excited +apperception-mass or setting-of-ideas for the stimulus-idea. Furthermore, +another process of imageless thought must have taken place whereby the +secondary images being raised into consciousness attained to their +arrangement as a wish-phantasy, without that preliminary tuning-up which the +principal cue (scratching) called forth, on its own account. This remains to +be explained. + + + +THE INCIDENTAL WISH-FULFILMENT + +The dream, viewed as a mere wish-fulfilment, is plainly a successful +allegory. While the action of the principal cue or immediate stimulus had +served to evoke the apperception-mass or context out of which this +wish-phantasy was constructed, at the same moment, there was an ulterior +influence at work, dictating a process of re-arrangement of the secondary +images, so as to give expression to my preference for reflexology as against +histology. Besides, the ground appears to have already been so well +prepared that we can readily explain the absence of evident signs of +trial-and-error. For in dreaming that I look away from the microscope and +turn with intensive interest to the reflex, I was still only giving effect +to a preference which had already attached the emotions of liking and +dislike, to these two objects of thought, respectively. The creative fancy +in this instance, what Hobbes[34] called the FICTION of the mind, has a very +simple task to work upon: achieving the imaginary satisfaction of unadjusted +feelings regarding the mental conflict between histology and reflexology. +The MICROSCOPE is accordingly reproduced naively with an "endeavor fromward" +attached to it, and likewise the REFLEX, with an "endeavor toward" it.[*] +Thus is the expression completed of a wish which had been partially +outspoken in the conversation with Dr. X. + +[*] Hobbes, "Leviathan," Cap. VI: "These small beginnings of motion, within +the body of man, before they appear in walking, speaking, striking, and +other visible actions, are commonly called ENDEAVOUR. This endeavour,. when +it is toward something which causes it, is called APPETITE, or DESIRE; . . . +And when the endeavour is fromward something, it is generally called +AVERSTON. These words appetite and aversion, we have from the Latins, and +they both of them signify the motions, one of approaching, the other of +retiring. So do also the Greek words for the same, which are Horme and +Aphorme." + +In this connection, I beg leave to suggest that these Greek terms are more +usefully applied to dreams and to the passions in general, in their +uncomplicated primitive sense, rather than in the new way that Dr. C. G. +Jung is suggesting for Horme, as a companion word for Libido or for elan +vital. For several years, I have found it useful to employ the coined +adjectives hormetic and aphormetic to characterize the tendencies fromward +or toward, as exhibited in the association of ideas. For example, in the +Scratch Reflex dream, there is shown an aphormetic tendency regarding the +microscope and a hormetic tendency regarding the reflex. + +While the external physical stimulus (scratching) must be thought of as +being represented dynamically somewhere in the arrival platforms of the +brain, it is necessary to think of the internal psychic stimulus (or wish) +as existing in the form of facilitations, or ready-made connections of ideas +and motives, as it were awaiting, in a state of mobilization, the proper +signal to discharge into consciousness. The expression of the wish thus +became accessory to the apperception of the principal cue. The accessory +wish-cue wrought its effect coetaneously, during the apperceptive delay. + +Granted the correctness of this explanation, does it not clearly conform to +the statement of Emerson that "dreams are the maturation often of opinions +not consciously carried out to statements, but whereof we already possessed +the elements."[*] + +[*] Emerson, R. W., "Lectures and Biographical Sketches," Vol. X, Complete +Works, p. 8; Houghton, Mifflin & Company, 1904. + + + +THE PERSEVERATION OF THE UNADJUSTED + +In the foregoing words of Emerson, there is brought to bear on dreams an +energic conception of mind-action similar to that which Hobbes had developed +in his Leviathan in 1651. The latter, by analogy with conceptions of +mechanical inertia new in his time, had compared the persevering effect of +nervous stimuli to the continued agitation of waves of the sea after a +storm: "When a body is once in motion, it moveth, unless something else +hinder it, eternally; and whatsoever hindreth it, cannot in an instant, but +in time, quite extinguish it; and as we see in water, though the wind cease, +the waves give not over rolling for a long time after: so also it happeneth +in that motion, which is made in the internal parts of man, then, when he +sees, dreams, et cetera." (Cap. II) + +The Delage-Woodworth conception that dreams are due to persevering effects +of unadjusted mental elements is not, therefore, entirely novel; but is +itself a maturing of opinions which have been more or less loosely +entertained by writers on dreams since Hobbes first formulated the modern +doctrine of the association of ideas,--not to go back any further. The +fertility of the conception of the "perseveration of the unadjusted" has +been emphasized in my mind by illustrations obtained by an extended study of +the dreams of normal people, and notably, by the agreement of my conclusions +with those of Professor Woodworth and of Dr. Morton Prince. And I am led to +believe that a development of this conception should harmonize with accepted +principles of psychology, normal and abnormal, as formulated in Ladd and +Woodworth's text-book, and in Prince's "The Unconscious." + +Greater precision must be conferred upon this conception by showing +specifically in what ways, and by what associative mechanisms, the +persevering and unadjusted stimuli evoke the dream-images. Granting that +unadjusted stimuli persist in their effects upon dream life, or in other +terms, that primary stimulus-ideas may evoke secondary dream-images, and so +on unto the third and fourth "generations;" then, in what manner does the +process go on or come to an end? The answer to this question is an eminently +practical one, to which Psycho-analysis has already brought the complication +of its own still immature formulation of Ab-reaction and of Catharsis.[35] +The matter still requires further study. In particular, it is necessary to +formulate, through specific examples, a conception which shall be the +pendant or complement of the theory of the perseveration of the unadjusted, +and which I will call the "resolution of the unadjusted." + +Already, I have taken the preliminary steps in this direction by adopting +the physiological conception of trial percepts and applying it to dream +interpretation. As a result, I have come to regard the successive +evocations of imagery in the dream and even their reciprocal adaptations +under the influence of creative fancy, as being trial apperceptions or +attempted responses to one or more cues, either sensory or psychic. + + + +RESOLUTION OF THE UNADJUSTED + +The operation of any cue, waking or sleeping, implies the endeavor of the +organism to provide a channel of escapement for the nervous excitation +emanating from the stimulus. The best channels, of course, are furnished by +those neurograms, or vestiges of previous experience, originally +constellated with the stimulus-idea. Indeed, as in the Scratch-Reflex dream, +we find that the stimulus does immediately tend to pass into such channels. +But the same example shows that it takes time for the excitation to raise +into consciousness the image most closely related to, or agglutinated with, +the stimulus; this being, no doubt, due to the passive inertia in the +corresponding neurogram. Meantime, during the apperceptive delay, the energy +spills over into less appropriate neurograms, albeit they are more quickly +mobilized, with the result of evoking bizarre imagery; what I have called +trial apperceptions.[36] Sometimes, too, this is adequate to meet the +situation; for the resolution of the unadjusted is complete so soon as the +stimulus is drained off, re-distributed and dynamically absorbed, as in the +case of mechanical "lost motion." A useful and intelligent solution is by no +means requisite: mere rambling often suffices. + +Yet in sleep the process of trial-and-error may often result in highly +constructive resolutions, as in what the French call reve utile. This is +especially true in case the unadjusted cues are highly persistent psychic +stimuli. Here, the excitation rises instead of seeming to wear down and can +be followed in its working up, through trial-and-error, to the elaboration +of a more or less logical response to the demands of the mental +situation;--after which, the excitation appears to trouble the sleeper no +further. Unfortunately, time does not permit my giving the examples I would +like of the varieties of resolutions in dreams--with their every degree of +relevancy and irrelevancy, of a propos and bizarrerie. Instead, I will +briefly dwell on a suggestive example of mental adjustment to specific cues, +in the waking state. + +A Japanese poetess is asked to combine into one word-picture the ideas of a +triangle, of a square and of a circle. After a short pause, taken up (as we +may believe) by what Ernst Mach calls the conflict of ideas, and which I +think of as imageless trials and errors, the poetess evolves the following +phantasy: "Detaching one corner of the mosquito netting, lo, I behold the +moon." This resolution left nothing to be desired. + +All resolutions of problems, of riddles, of charades, and, according to my +experience, most dreams if not all, represent a trial-and-error method of +working out a reconciliation among unadjusted mental tendencies, the goal of +which is illustrated by the case of the Japanese poetess. Dreams, however, +usually exhibit only the preliminary efforts. Those are hidden in this +example, which stands midway between the severe reasoning of Euclid and the +free-play of a dreamer's response to the reproductive tendencies playing +upon his memory. + +As to the theory of the resolution of the unadjusted, I must resist the +temptation to dwell on its many attractive phases, in bringing this +discussion to a close. One of its neglected aspects, however, may be +indicated within the present context, by remarking upon the feeling of +incompleteness that would at this stage, be left in the mind of the hearer, +if I should make an end, abruptly, like a phonograph stopped in the middle +of a tune. My discourse would inevitably be left at loose ends, owing to +the persistency of a number of questions which have been raised, agitated, +but not fully set at rest. These would continue to act as so many persisting +and unadjusted stimulus-ideas. These are embodied in the feeling we now +have, that a summary should be made of what has gone before concerning the +Scratch-Reflex dream and the various methods of interpreting it. Thus, our +"unfinished feeling" represents in itself an obscure demand for a resolution +of the unadjusted; it corresponds to that inner compulsion which operates +upon the imperfect consciousness of the dreamer, or upon the mentality of +any person seeking the solution of a problem or "perplex," either asleep, or +awake--as I trust you all still remain. The present demand for the +resolution of the unadjusted must be met without going deeper into the +theory of the matter.[37] + + + +THE RECONSTITUTION SUMMARIZED + +Accordingly, I will now point out the fact that the analysis of the +Scratch-Reflex dream has been carried to the stage where the dream stands +reconstituted as follows:-- + +It is an attempt of the nervous mechanism to resolve a specific sensory +stimulus-idea (A) by the discharge of nervous energy into a previously +prepared or "facilitated" set-of-the-mind or context (Hidden Z). This, in +the premises, happened to possess associative affinity for the stimulus, and +was therefore, by the same token, chosen, i. e., brought into play, as a +spillway for the stimulus. The secondary images (C) in the dream, evoked by +the derivation of excitement through the channels of the given context +(conversation with Dr. X.) are explained as forming--in the order of their +appearance-- a chain of apperceptive pictures, or trial-and-error series, +whose links or steps approximate gradually to the characteristic features of +the primary stimulus-idea (scratching sensation). But while regarding this +immediate influence as the principal cue to memory (calling it A), we must +admit an ulterior influence or motive-power, itself in the nature of an +accessory cue, namely a wish (B), revived along with the memory of the +conversation. This wish (to substitute reflexology for histology) +contributes a special configuration or phantastic, wishful arrangement to +the group of successive trial apperceptions called forth by the physical +stimulus (A). The corresponding motives of desire and of aversion, +(concisely pictured as positive interest in the reflex and disinterest in +the microscope), although seeming to spring out of the system of memories +(Z), which form the context, are none the less separate from it as +self-acting sources of stimulus, as a wish apart from the mere brute memory +of the talk about reflexes. The wish is thus an accessory cue (B) operating +in conjunction with the external stimulus, although revived by the energy of +the latter. In this case, the imaginary wish-fulfilment achieves an +immediate, though limited, success. Correspondingly, it does not exhibit on +its own account the feature of trial-and-error which we have learnt to +recognize in the working of the unadjusted sensory stimulus (scratching). + +While this dream does not exemplify trial-and-error processes in response to +a psychic cue, it is proper to state that the same mechanism can be +demonstrated in the more purely psychic dreams, as well as in this one, +wherein we have followed the trial apperceptions of a stimulus, from their +incipience, to the point of awaking to a conscious recognition of the source +of excitation. Moreover, by a more delicate and intricate use of the +reconstitutive method it is possible to discover the stimulus-ideas in those +cases where the dreamer is not able to testify to their character, as I was +in this simple instance; purposely chosen, I may add, to outline the method +in its simplest aspect. + +According to the reconstitutive method, a dream is sufficiently interpreted +and explained by having formulated the operation of the several specific +factors, as in the foregoing example; that is, no preconceptions as to +content or meaning or transcendental symbols are imported into this sort of +purely mechanistic interpretation. + + + +THE PSYCHO-ANALYTIC DILEMMA + +Unfortunately, the psycho-analyst, if he applies the current conceptions of +symbolism, may well doubt whether the reconstitution has gone far enough, +and whether ALL the stimulus-ideas, or all the wish-factors have been found. +This is because he does not make it a rule to check up his guesses as to +meaning, by specific investigations of the settings-of-ideas, by +auscultating the so-called "fringe of thought," or by laying out crucial +tests for his own hypothesis in the given case. Such methods, which belong +no less to general psychopathology than to the reconstitutive method, do not +leave one free to argue from analogy; a privilege which most psycho-analysts +enjoy, and have been known to abuse, as Freud and Jung themselves have done. + +It follows that one might properly expect the psychoanalyst to dwell +especially upon the seemingly phallic "symbols" in the Scratch-Reflex dream, +which could be made out in the geometrical features of the microscope and +cover-glass. He would thus, as I have shown, be led to unearth a sexual +motive--which might be a mare's nest. This searching for sexual symbolism on +a purely a priori basis, when no evidence internal or external, and no real +clues to a sex idea exist, may become a mere obsession, a habit of +interpretation which is not scientific at all. Unable to distinguish the +subconscious operation of a non-sexual context, from that of the more +familiar sexual context, the interpreter is at the mercy of superficial +resemblances between the properties of the dream-objects and those of the +well-known sexual symbols. The ambiguity which has resulted from this +condition of affairs, maintains the Psychoanalytic Dilemma: that of not +knowing when to stop in apperceiving sexual allusions. Indeed, it is part of +the interpretative policy of psycho-analysts not to exclude sexual meanings, +in case of doubt; but rather to take the sexual sense for granted. + +How far this policy has been carried may perhaps be suggested by the +following instance: A well-known physiological psychologist, attempting to +show the absurdity of extreme sexual interpretations, remarked to a +well-known psycho-analyst that even the geometry of Euclid would, according +to the methods under criticism, be open to the imputation of sexual motive. +To this the psycho-analyst replied that he did not feel at all sure that +Euclid might not have been inspired to write his Geometry by the sexual +ideas which men have, from time immemorial, embodied in circles and +triangles and diameters.--This instance, be it said, implies no criticism of +Psycho-analysis beyond the fact that its conception of symbols in dreams and +elsewhere is transcendental and historical rather than truly psychological +as it purports to be; a state of opinion which the use of the reconstitutive +method is calculated to correct. + +The difference between the psycho-analytic methods and the reconstitutive +method, in a given case, is that the former assume the validity of sexual +symbolism unless it can positively be proved absent, which is rarely +attempted; whereas, the reconstitutive method assumes no symbolism and no +meaning to be present in the mind of the dreamer except as the probability +can be demonstrated by specific investigations and inferences as to the +interplay of CUES and CONTEXTS or apperception-masses. Moreover, a special +technique is used to study the "fringe."[1] + +Reverting for a moment to the sexual interpretations of the Scratch-Reflex +dream that I manufactured by applying the Freudian ready-made symbolism, +and, again, by imitating the constructive fancy of Jung; they must both be +judged as having no merit beyond, perhaps, that of coinciding with inherent +probabilities in the premises. That is, what they purport to reveal might be +made out of whole cloth to fit almost any unmarried man, barring a few +individual adaptations, to suit the known circumstances of the dreamer. As +these interpretations stand, they do not fit the psychogenesis of the dream. +They are rank confabulations on my part; yet they appear to hold water, +psychoanalytically. + +Enough has been said to suggest, I think, that while Dr. Freud may be +honored as the father of dream analysis, with Dr. Jung as its foster-father, +yet, to neither of these gentlemen of psycho-analytic fame should be +conceded the right to bring up the "child!" That is a task for the +psychologist, because he can afford to go deeper into normal processes than +has so far been possible in psycho-analytic practice. But he must take +pains to employ those scientific methods which comport the rigorous +application of logic even to the vagaries of dreams, and the rejection of +the argument from mere authority. Of such methods, the exemplars are to be +found only among those writers who today are worthily carrying forward the +mechanistic traditions originated by Descartes. In so far as +psycho-analysts depart from these traditions and, relying on the authority +of their leaders, follow them into metaphysical speculations about the +Libido, and transcendental notions of symbolism, they are wandering on +ground full of pitfalls to common sense. + + + +SUMMARY + +The question here considered is whether dream interpretations shall +represent the state of the dreamer's mind or the mere fancy of the +interpreter. Criticism is directed at the aprioristic and oftentimes +hit-or-miss practices of the Vienna and Zurich schools of Psycho-analysis. + +For illustration, a simple dream is interpreted by the current methods of +Psycho-analysis: first, according to the "reductive method" of Freud, it is +made out as symbolizing an infantile and sexual wish-fulfilment, expressing +a "voyeur" component of the Libido. Secondly, the dream is re-interpreted +by Jung's "constructive method" so as to gloss over the gross Freudian +phallicism. It is now made to mean that the dreamer is impelled to higher +biological duties, namely marriage and professional success. + +The plausibility of these interpretations once shown, they are next proved +to be wide of the mark, by the fact that the dream can be more adequately +accounted for in another way, i. e., by a proposed "reconstitutive method." +This method aims to "reconstitute" the dream-thought (both imaged and +imageless) by tracing the wave of nervous excitation from its origin in +primary stimulus-ideas (sensory or psychic) through a specific +apperception-mass into a consequently derived system of secondary images, +which form the manifest dream content. The derivation of the secondary +images must be concretely followed through the authenticated channels of +association--not assumed on the basis of "fixed symbolism," or any other a +priori conception. + +The reconstitution of this particular dream illustrates the reductio ad +absurdum of the two previous psycho-analytic "solutions." The fact that +either of them would apparently have satisfied the demands of the problem, +is characterized as an artifact evolved through the interpreter's deliberate +confabulation and forcing of analogy; thus causing the scant data of the +dream to fall into artificial agreement with the preconceived notions of the +Vienna and Zurich schools, respectively. As a guarantee of scientific +accuracy, it is urged that the interpreter trace the process of imageless +thought (Woodworth) back of the dream, and, in particular, seek the meaning +in the Unconscious Settings-of-Ideas (Prince). The reconstitutive method is +the extension of these two formulations from normal and abnormal psychology +into the field of dream analysis, through the study of Individual +Differences (Cattell) and the Application of Logic (Alfred Sidgwick). + +It is not denied that Freud's dream theories serve very well to interpret a +considerable proportion of common dreams; but the psycho-analytic technique +embodies a fallacious assumption that there is a transcendental symbolizing +activity in the Unconscious, as it were a language of dreams. This gives +rise to a biased "will to interpret." The alleged meaning may thus often be +the work of the interpreter's mind although not that in the dreamer's mind. + +The reconstitutive method brings into relief the trial-and-error character +of the dreaming process: the organism as attempting the physiological +resolution of persisting and unadjusted stimulus-ideas. Psychologically +speaking, the images evoked in the dream are called trial percepts or trial +apperceptions of the stimulus-ideas, corresponding more or less closely to +the latter; not through analogy necessarily, but through mere contiguity, as +the case may be. + +In certain cases, the erroneous apperceptions are observed to form a series +of approximations to the correct apprehension of one of the stimulus-ideas +at a time. In other cases, the apperceptive errors may take the form of a +blended reaction to two or more cues, more or less perfectly achieved. + +These mechanisms, when they go wrong, as they often do, produce the +incoherency and bizarrerie of the dream; but they do not preclude a +significant reconstitution of the process of which the dream is a +by-product. Such reconstitutions require to be validated by specific tests +and inferences, of such logical character as to bear comparison with the +methodology of other sciences. The psychoanalytic arguments from analogy, +from precedent and from authority are alike to be rejected. + + + +REFERENCES AND NOTES + +1. Emerson, R. W., "Demonology," 1839; Vol. X, Complete Works, 1904; +Houghton, Mifflin & Company, Boston. + +2. Freud, Sigmund, "Die Traumdeutung;" Three editions, 1900, 1909, 1911; +Franz Deutike, Leipzig und Wien. + +3. Same work, A. A. Brill trans., "The Interpretation of Dreams," 1914; The +Macmillan Company, New York. + +4. Jung, C. G., "Studies in Psychoanalysis," Psychoanalytic Review and +Monograph, 1914; Journal of Nervous and Mental Diseases Company, New York. + +5. Internationale Zeitschrift fur Aerztliche Psychoanalyse, Officielles +Organ der Internat. Psychoanalitischen Vereinigung; first number, 1913; +Heller pub., Leipzig und Wien. + +6. Jung, C. G., "Psychoanalysis," An address before the Psycho-Medical +Society of London, 1913, August; Transactions of the Society. + +7. Prince, M., "The Mechanism and Interpretation of Dreams"--A Reply to Dr. +Jones; Journal of Abnormal Psychology, 1910; See especially pp. 248 et seq. + +8. Jung, C. G., "Morton Prince, M. D.: 'The Mechanism. etc.,'--A Critical +Treatment;" Jahrbuch fur Psychoanalytischen Forshungen, 1910-11. + +9. Freud; See (3) page 81, on symbolical method. + +10. Freud, "Ueber den Traum;" translator M. E. Eder, "On Dreams," 1914, +Rebman Co., New York; compare views in (6) with Chapter XII, esp. page 105. +cf. p. 106, "unconscious thinking." + +11. Emerson, R. W., "The Poet," Complete Works, Vol. III pp. 34-5. + +12. Freud, "Interpretation of Dreams," p. 243. + +13. Russell, Bertrand: Lowell Lectures, 1914; Cf. Lect. VIII, pp. 219, +sec. 2, 222, sec. 2; Title, "Scientific Method in Philosophy," Open Court +Publishing Company, Chicago, London. + +14. James, William, "Principles . . . .," I, 270; Algebra-analogy; see also +"Fringe," p. 258. + +15. Hobbes, Thomas, "Leviathan," Chapt. III. + +16. Sidgwick, Alfred, "The Application of Logic," 1910; The Macmillan Co.; +especially pp. 93-94. + +17. Delage, Ives, "Une Theorie de Reves," Revue Scientifique, II, July, +1891. + +18. Prince, "The Unconscious," 1914; The Macmillan Co.; (a) "The Meaning of +Ideas as Determined by Unconscious Settings;" (b) Role of same in phobia: +especially p. 389, footnotes pp. 392-3, 408. Also, Journ. Ab. Psychology; +(a) Oct.-Nov., 1912; (b) Oct.-Nov., 1913. + +19. Ebbinghaus, "Abriss der Psychologie;" Max Meyer's version, Cf. pp. +94-5; "Ebbinghaus's Psychology," 1908; D. C. Heath & Co., Boston. + +20. "Inventorial Record Forms of Use in the Analysis of Dreams," Jour. Ab. +Psychology, Feb.-Mar., 1914. + +21. Descartes, Rene, "Discours de la Methode pour bien conduire sa raison +et chercher la verite dans les sciences;" Leyde, 1637. + +22. Spencer, Herbert, "The Physiology of Laughter," 1860; in Essays. + +23. Fontenelle, B. le B. de, "Entretiens sur la Pluralite des Mondes," +1686. + +24. Freud, "Interpretation of Dreams," pp. 237-9. + +25. Freud, "Drei Abhandlungen . . . ," trans.: "Three Contributions to the +Sexual Theory," Monograph, Journ. Nerv. and Mental Dis. Co., New York, +1909. + +26. Jones, Ernest, "Papers on Psycho-Analysis," Chapter XX; W. Wood & Co., +1913. + +27. Prince, "The Unconscious;" doctrine of secondary images. + +28. Galton, Francis, "Inquiries into Human Faculty," 1883; Macmillan; see +essays on association, doctrine of blends. + +29. James, William, "Principles . . . ;" The Mental Cue, II, 497, 518; for +phrase, "Talks to Teachers," p. ix--118, 1900; Henry Holt & Co., New York. + +30. Sherrington, C. S., "Integrative Action of the Nervous System," 1906; +Scribners, New York. + +31. Bechterew, W. von, "Objective Psychologie oder Psychoreflexologie," +1913; from the Russian, B. G. Teubner, Leipzig and Berlin. + +Pavlow, "Study of the Higher Mental Functions," British Medical Journal, +October, 1913. + +32. Ladd & Woodworth, "Elements of Physiological Psychology," 1911; p. 594; +Charles Scribner's Sons, New York. + +33. Woodworth, R. S., "A Revision of Imageless Thought," in Psychological +Review, January, 1915; Presidential Address, American Psychological +Association, Philadelphia, 1914, December. See esp. pp. 26-27. + +34. Hobbes, "Leviathan," Chapter II; cf. Compound imagination. + +35. Freud, "Selected Papers on Hysteria and other Psychoneuroses;" trans. +A. A. Brill, Monograph, Journ. Nerv. and Ment. Dis. Co., 1909, New York; pp. +5, and 177. + +36. Spencer's conception of the escapement of nervous excitation is +fundamental in connection with the dream theory here sketched: see the +essays on Laughter and on Music, also many passages in the Synthetic +Philosophy (Biology, Psychology). This conception is not to be confused with +Janet's idea of "derivation," as stated in "Obsessions et Psychasthenie." +The present formulation of the meaning of "apperceptive delay" in dreaming +is based on the neurographic hypothesis, ("The Unconscious," Chapt. V.), and +may be more precisely stated as follows:-- + +In the given instance, the original or primary neurogram possessed a certain +passive inertia in responding to the stimulus, and it took a relatively long +time for the excitation to raise the neurogic tonus of this primary +neurogram so as to attain the level requisite for conscious imagination. But +it was otherwise with the secondary or sequential neurograms, whose inertia +had already been overcome by the facilitation (Bahnung) of the recent +conversation about scratch-reflexes. For these neurograms to flash their +imaged (conscious) equivalents into the dream-thought, it was enough that +there should be a slight spill-over of excitation from the original +neurogram. + +Many examples could be cited from dreams, drowsy states and lapses of +thought, showing the ways in which sequential neurograms produce trial +apperceptions, pending the final revelation, through consciousness, of the +original neurogram. The phenomenon of mental groping, here alluded to, is +familiar in certain aspects; but, as an explanation of cryptic dreams, has +not received the recognition that it deserves. Hence, the trial-and-error +theory of dreams. + +37. "Perplex," neologism of the writer; used to indicate a phenomenon +frequent in both normal and psychopathic subjects; to wit, a group of +delimitable stimulus-ideas, persisting as such, and unadjusted--a complex of +persisting and unadjusted stimulus-ideas, demanding resolution; not the same +as "complex" in Psycho-analysis. Cf. Prince's definitions of the varieties +of complexes ("The Unconscious"). + + + +A CASE OF POSSESSION + +BY DONALD FRASER, M. D., GLASGOW + +THE Demonaic possession of the middle ages and of times nearer to our own +was largely hysterical in character, and generally occurred in Epidemics. + +It was associated with the more superstitious and emotional side of +religious beliefs, where a real Hell fire and a personal Devil with +attendant Angels or Demons were believed in, and feared, much more intensely +and widely than they are today even amongst the ignorant and superstitious, +while suggestion and contagion played a large part in its spread, as it did +in that other and more hateful form of it known as witchcraft. + +Esquirol who wrote clearly about it in his "Maladies Mentales" under the +heading of "Demonomania,"[1] spoke of it as being propagated "by contagion, +and by the force of imitation." This was illustrated in the Epidemic of +Loudun, amongst others referred to by him. This epidemic spread to +neighbouring towns menaced all the high Languedoc, but was arrested by the +wisdom of a Bishop, who did this by depriving the movement of its marvellous +elements. In this epidemic form it was in its bodily and mental +manifestations really hysteria with characteristic stigmata and convulsions. +An excellent example of this religious hysteria was presented as recently as +1857 in an epidemic at Morzines in upper Savoy. It began with two little +girls, pious and precocious, who had convulsive attacks. It spread to other +children and then to adults. Amongst the younger of those affected, +ecstasy, catalepsy, and somnambulism were seen, and later, convulsions only; +convulsive attacks returned several times a day. An attack usually began +with yawning, restless movements, the aspects of fear passing into fury with +violent and impulsive movements, with vociferations and cries that they were +lost souls in hell, the mouth-piece of the devil, etc. These attacks would +last from ten minutes to half an hour. A feature of this epidemic was the +absence of coarse and erotic speech or gestures. Between the convulsions +the victims were restless, idle and inattentive, being altered in character +for the worse. In our day such epidemics are represented, though in tamer +fashion, by Revivalism in its more noisy and extravagant eruptions. At all +times, even when such manifestations are not much if at all out of harmony +with ordinary religious feeling and action, there is a tendency to +pathological conditions. Often its subjects, in the words of Professor +James[2] "carry away a feeling of its being a miracle rather than a natural +process, voices are often heard, lights seen, or visions witnessed; +automatic motor phenomena occur; and it always seems after the surrender of +the personal will as if an extraneous higher power had flooded in and taken +possession." These are some of the more striking phenomena of mysticism, and +are also largely pathological being amongst the major symptoms of hysteria. +The history and course of our case illustrated very well this mixed +condition. It has been pointed out that the ecstasies, trances, etc., of +the mystic, while essentially pathological, have the evil effects of such +morbid manifestations modified or largely neutralized by the idealism behind +them, by that measure of true religious faith and feeling which dominates +the whole process in the case at least of the higher mystics. The ore may be +rough and very mixed, but the precious metal is there also, as it was in our +patient, though the divine influence for which she craved was perverted into +that of the "Evil one." In the individual cases described by Esquirol we +recognize a more profound mental disturbance than is shown in the epidemic +or hysterical variety. We indeed see many similar cases in our asylums +though we generally speak of them as Religious Melancholics rather than as +Demonomaniacs. In such cases recovery is slow or may not occur, the patient +passing into a state of chronic mania, or of Dementia. There are other +cases where the religious emotions and ideals are completely subordinated to +or become identified with feelings of fear or remorse, the result of fixed +ideas of a shameful, distressing or frightsome character. A good example of +this condition though essentially hysterical in its nature, is detailed by +Pierre Janet.[3] The patient, a neurotic, respectable business man +thirty-three years of age, a good husband and father, on his return from a +business journey of some weeks' duration is found to have become depressed +and taciturn, and as the days pass his melancholy deepens. At first he would +not speak, but soon when he wished to speak could not, making vain attempts +at articulation. Under the influence of medical ideas suggested to him his +symptoms simulate first Diabetes next Heart disease and his prostration +becomes profound. By and bye he passes into a state only to be described as +acute Demonomania marked by maniacal outbreaks in which he cried out and +blasphemed, lamenting in quieter intervals his powerlessness to resist the +Devil who was, he believed, actually not figuratively within him, who spoke +and blasphemed through him, prevented him sleeping, etc. After some months +he was sent to the Salpetriere where he came under the observation of +Charcot and Pierre Janet. He was cured by means of suggestion by the +latter, who also ascertained by his methods that the illness was the result +of remorse for an offence committed during the business journey which +preceded the outbreak. + +[1] For a detailed account of it see the "Dictionary of Psychological +Medicine" under the heading "Demonomania." + +[2] The Varieties of Religious Experience; William James p. 228. + +[3] "Nevroses et Idees Fixes" Vol. I, p. 377. + + + +In many ways our case differs from cases of this type. An important +difference was in the intermittent character of the symptoms. For a period +of two years the patient alternated between a condition of acute misery from +the delusion that the evil one had entered into her body, and one of +apparent sanity. At the end of two years she was dismissed cured, and has +remained well for several years. She differed also in the absence of +blasphemous, extravagant or obscene speech or action. The Devil never at any +time used her as the mouthpiece for devilish words or thoughts. He was +there, and as she insisted, in bodily form within her, making her intensely +miserable by his presence, and with the feeling that she was cast away from +"grace" and the privileges of the religious life. Nor were there, as in the +case above referred to shameful or remorseful complexes at the root of her +mental condition. In presenting the facts of the case, names and special +marks of identification have been altered. + +Mrs. A., a widow, aged fifty-two years, was admitted to the Paisley District +Asylum in 1910 with a history of having suffered for a month previously from +mental depression said to be due to distressing delusions of a religious +character such as that she was lost, was past forgiveness and dominating and +originating all such thoughts was the belief that she was possessed by Satan +or an evil spirit, who was in bodily form within her. This delusion caused +her acute misery, and so absorbed her thoughts that she had ceased to take +any interest in her household affairs, and had even talked of suicide. + +Her condition on admission and for two years subsequently was that of +recurring states of this acute mental distress, when she would rock to and +fro, moaning and crying out, often with tears over her lost and dreadful +state, and the presence in her inside of Satan or the "Evil one" whom she +said she felt within her, and who made her "repulsive." This condition was +varied with intervals of usually from one to three days of apparently +complete sanity, when though quiet and somewhat reserved in manner, she was +quite cheerful. When questioned at such times as to her delusion, she would +admit its absurdity, but refer to an uneasy sensation in the region of the +left hypochondrium, which, as she put it, surely meant that there was +something wrong there. She would be occasionally normal in this way for a +week or more, and on more than one occasion was so well as to be allowed out +on parole, but had often to be brought back next day as depressed and +delusive as ever. She was always worse in the mornings, and often improved +as the day went on. She was a stout, pleasant featured and intelligent +woman, somewhat anaemic, and with a slight bluish tinge of lips, though +beyond a lack of tone in sounds, the heart was normal. Her anaemic condition +was accounted for by her having suffered from menorrhagia for the greater +part of two years, which only stopped a few months before her admission to +the Asylum. It had during its continuance brought on breathlessness on +exertion, and what she called spasms or "grippings at the heart," no doubt +the basis of her uneasy feelings in left hypochondrium. There was a slight +enlargement of the thyroid gland, but no symptoms referable to it. None of +these physical conditions beyond the "grippings at the heart" it maybe, +appeared to have any appreciable influence on her mental condition, which as +has been noted above was normal until a month before her admission. An +interesting feature of the case was the relation between her blood pressure +and her varying mental states. Her blood pressure was taken with a Riva +Rocci Sphygmomanometer morning and evening, sometimes oftener, during the +greater part of 1912-13, and it was noted that her depressed or delusional +states were marked by a low pressure, while a high or relatively high +pressure marked her sane and cheerful states, contrary to what is usually +observed in melancholia, though similar to what is seen in agitated +melancholia and mania.[4] Thus at a pressure of 130" HGs, she was generally +very well; at or about 120" HGs she was often well; at 110" HGs or 100" HGs +she was always ill. When recovering, and few weeks before dismissal there +was a fairly steady pressure of 118" HGs to 120" HGs day after day. It had +been also noted throughout, that during a continuous period of depression, +or of well-being, the pressure kept steadily high or low day after day +according to the mental condition. There was obviously then a constant and +close relationship between her blood pressure and her mental states. At +first sight it looked as though those states were directly affected by the +varying pressure as it may have influenced the nutrition and therefore the +functions of the brain, and on physiological grounds it is difficult to +exclude such an influence altogether, even though we come to the conclusion +as we did that the variations followed the emotional conditions, and did not +precede or cause them. The broad general statement has been made that "each +pleasurable emotion raises the general blood pressure and increases the +blood flow through the brain and each painful emotion: brings about the +opposite result."[5] It cannot be said, however, that increased blood +pressure will give pleasurable emotion. The splanchnic area can be acted on +so as to raise the blood pressure without influencing the emotions. We know +also that when it is raised in melancholia the increased pressure is +associated with the reverse of pleasurable emotion. Still on therapeutical +as well as on other grounds it appeared to us important to determine what, +if any, influence the raising of her blood pressure by drugs or otherwise +would have on her mental state. We did this by baths, by abdominal pressure +by means of a large sand-bag laid over the abdomen, and by such drugs as +adrenalin and pituitrin. The results were disappointing so far as therapy +was concerned though of interest otherwise. The pressure was raised by all +these measures without any improvement following such as occurred when it +rose naturally. The rise by abdominal pressure was marked and occurred +quickly, but without any apparent effect on her mental condition. When it +was raised to 140"HGs under the influence of pituitrin there was marked +depression as is shown in the chart for July, 1912. Pituitrin given in m. +v. hypodermically three times a day, and after some days in larger doses by +the mouth, kept the pressure between 125" HGs and 130" HGs, but with no +corresponding mental improvement. For some days after the pituitrin was +stopped its influence seemed to persist as the pressure kept high while the +mental condition was low. One of her longest spells of continuous mental +depression which lasted for twenty-seven days, occurred while her pressure +was high under the influence of adrenalin. Digitalis, by the way, had no +influence in any way on either her blood pressure or her mental condition. +The only drug we found of any value was tinctopii in moderate doses three +times a day, but it gradually ceased to do any good. + +[4] Maurice Craig, Lancet June 25, 1898. + +[5] Leonard Hill, "Cerebral Circulation" p. 74. + +Four charts from a very large number are given which illustrate the above +points. + +It must be understood that these experiments while accurate so far as they +go, and carefully conducted under my supervision by a competent assistant, +were not made in a well appointed laboratory, but were clinical observations +made in the crowded ward of a hospital for the insane. The central +disturbance here was the result of shock from sudden and excessive fear +acting on a highly sensitive subject as will appear later. It has been +shown by Cannon[6] that such major emotions as fear, rage, or pain acting +upon the adrenal glands through the autonomic nervous system are accompanied +by an increased discharge of adrenalin into the blood, and by a passing of +stored glycogen from the liver for circulation through the body as dextrose, +the object of which is the increasing and liberation of muscular energy for +the animal's successful flight or fight. This discharge takes place very +quickly, and we are told that fright exhausts the adrenal glands, a somewhat +puzzling statement at first sight, but borne out by the experience of our +case where a fall of pressure occurred under the paralyzing effect of +extreme fear and distress continued not merely for minutes but for hours at +a time. By and bye as her distress lessened and her expression of it became +more and more automatic, there was a return to the normal adrenal discharge +and consequent normal rise in pressure. It is possible, of course, that +there may be another explanation in the inhibition of metabolism caused by +fear. Most of us have experienced the arrest of salivation and digestion +under the influence of fear or rage. This inhibition would affect the +products upon which the adrenal secretion depends, but the more likely cause +is where this fear, in this case really a recurring representation of the +original shock, acts through the autonomic nervous system on the adrenal +glands. The emotional disturbance here then was primarily of central origin, +and was certainly not originated by circulatory or visceral changes which +were secondary to it, and the facts do not support the James, Lange theory +of the emotions as it is generally understood. In this connection we may +refer very briefly to the laboratory experiments of Sherrington[7] and +Bechterew.[8] The former by spinal and vagal transection in a dog removed +"completely the sensation of the viscera, of all the skin and muscle behind +the shoulder. The procedure at the same time cuts from connection with the +organs of consciousness the whole of the circulatory apparatus of the body. +Yet the dog exhibited rage, fear, disgust, etc., under appropriate stimuli +as a normal dog might do." The conclusion reached after admitting possible +objections to them is that, "the vasomotor theory of the production of +emotion becomes, I think untenable, also that visceral presentations are +necessary to emotion." Bechterew, discussing this question as to whether the +vascular changes are anterior to the other processes, which determine the +alterations of the neuropsychic tone according to the James, Lange theory, +states that the experiments in his laboratory by Dr. Serenewsky, appear to +lead to an opposite conclusion having shown that under the effects of fear +the alteration of the neuropsychic tone is produced before the appearance of +the cardiovascular phenomena. There are no doubt objections to accepting +laboratory experiments upon inferior animals as conclusive where the psychic +part of the process in question is after all the dominant one, nor must we +forget that biochemical changes may be as important as the integrity of +nerves. We have however referred to these experiments because of their +bearing on the conclusions to be drawn from the above described clinical +facts which so far as the initiation of the emotional process is concerned +confirm them; though we feel that the bodily concomitants of the emotion are +essential to its full development, and that we owe much to James's +presentation of his theory even admitting its "slap dash"[9] character to +use his own phrase. It was to be expected that the artificially raised blood +pressure would have had some effect in improving the patient's mental +condition, and in the case of adrenalin, at any rate, some such effect +should have occurred if we are to accept the recently published conclusions +of Crilel[10] to the effect that "adrenalin causes increased brain action," +"that brain and adrenalin action go hand in hand, that is, that the adrenal +secretion activates the brain, and that the brain activates the adrenals." +More in harmony with the clinical experiences here is the fact according to +Biedl[11] "that the adrenalin affects the intracranial and the pulmonary +vessels only slightly if at all." We presume that what is true of adrenalin +in this respect will be true of all drugs which increase blood pressure. And +while the rise of the arterial pressure generally will accelerate the flow +of blood through the brain, yet we know that the cerebral circulation is in +"all physiological conditions, but slightly variable."[12] Besides, while +that increased flow must necessarily lead to increased cerebral activity, +that activity may be pathological as well as physiological, as in our +patient, who was quite uninfluenced mentally by the rise of blood pressure +which followed the administration of those drugs. The nature and genesis of +the emotional disturbance in this case may be understood from the following +history and observations. + +[6] The interrelations of emotion as suggested by W. B. Cannon. Recent +physiological researches, The American Journal of Psychology, April, 1914. + +[7] The Integration of the Nervous System--Sherrington. + +[8] Bechterew "La psychologic objective," p. 312. + +[9] Psychological Review, Vol. I, where Prof. James admits the defective +presentation of his theory and uses the above words to express it. He gives +all due importance to the associated memories, and ideas to which are +related the incoming currents as well as all pleasure and pain tone +connected with them, etc. + +[10] S. W. Crile, "The Origin and Nature of the Emotions," 1915. + +[11] Biedl innere secretion--Quoted by Cannon, 2 ed. 1913. + +[12] Leonard Hill--The Cerebral Circulation. + +She had married happily at the age of nineteen years, had a family of eight +children, but had been a widow for about twenty years. Her husband died +suddenly abroad, where she had lived with her family for two years after his +death, and acting on the advice of her friends, she came back to this +country bringing all her children with her. This involved her in years of +struggle and anxiety to bring them up creditably, which she managed to do. +During all these years of widowhood and stress she was mentally well, and +latterly she described her life as a happy one surrounded as she was by an +affectionate and well doing family. She had been brought up in a puritan +household. Her father and her husband had been deeply and consistently +religious though strict in their belief and observance of the letter. This +upbringing favoured a natural tendency towards religious mysticism which was +also promoted by the creed of the church to which she latterly belonged, and +of which she was a deaconess. In this church the "gift of tongues" and of +"prophesying" was recognized as a part of its heritage, and as she informed +me in one of her normal times, she occasionally spoke or prophesied in the +public assemblies of the congregation. I gathered that her utterances were +generally but a word or two of exhortation or pious aspiration, given +expression to in a moment of exaltation. From her description of her state +at such times, she was carried out of herself, was oblivious for the moment +of the presence and actions of those about her, was in short in a state of +ecstasy when she "prophesied." A natural tendency to self-depreciation, and +to ideas of unworthiness asserted themselves outside of those periods of +exaltation, which were generally followed by doubts as to her fitness to +take part in such work, and by the feeling as she expressed it "that she had +presumed as she was unworthy," and that God would be angry with her for her +presumption. Throughout her religious life she had been always lacking in +"assurance." Latterly this feeling had grown in her and was evidently part +of a deeper feeling of mental depression, as she began to think often, and +with a feeling of dread that she had been surely too happy these later years +which stood in such contrast to the poverty, struggles and disappointments +of the early years of her widowhood. This was her mental condition for some +little time before her attack of acute mental disturbance which began one +night a month before admission to the asylum. She went to bed feeling ill +and shivering as if from a chill. In the middle of the night she woke up in +a fright from a vivid dream the contents of which merged in a strong +sensation as of a hand being pressed on her shoulder. She described the +sensation as being that of a positive feeling of pressure, and with it came +a feeling of dread, and the conviction that it was the hand of Satan, so +that she cried out aloud to him to go out of the house, as it was blessed, +referring to the fact, as is the custom in her church that the minister had +blessed the house when she went to live in it. She thought of calling to +her daughter who was asleep near her, but did not, and after a time fell +asleep again being "comforted by the feeling that the Lord would take care +of her." Next morning the effects of the "chill" had passed off, but there +was left a more or less constant feeling of vague dread and fear of death, +and with this a haunting idea born of this strongly felt hallucination of +external touch that Satan was within her. The feelings of dread and fear +grew steadily and became too strong for her faith in the Lord taking care of +her, and very quickly her obsession as to possession by Satan, became the +definite delusion it was on admission to the asylum. Hallucinations of what +might be termed internal touch leading to this idea of possession, are not +unknown in the annals of mysticism of the more morbid types of it. Indeed +the more ecstatic the mystic becomes, the more he merges himself in his +feelings and tends to develop hallucinatory sensations. He is possessed, and +desires to be possessed, fortunately for him, by the Divine and not the evil +spirit. Hallucinations of external touch are as might be expected more +rare, though not uncommon we understand in the more abnormal types, and +occur in people supposed to be normal. Havelock Ellis tells of a "Farmer's +daughter who dreamt that she saw a brother, dead some years, with blood +streaming from his fingers. She awoke in a fright and was comforting herself +with the thought that it was only a dream when she felt a hand grip her +shoulder three times in succession. There was no one in the room, the door +was locked and no explanation seemed possible to her. She was very +frightened, got up at once, dressed, and spent the rest of that night +downstairs working. She was so convinced that a real hand had touched her, +that although it seemed impossible, she asked her brothers if they had not +been playing a trick on her. The nervous shock was considerable, and she was +unable to sleep well for some weeks afterwards." The writer's[13] +explanation is:--"it is well recognized that involuntary muscular twitches +may occur in the shoulder, especially after it has become subject to +pressure, and that in some cases such contractions may simulate a touch." In +illustration of this he quotes from the Psychical Society's Report on the +"Census of Hallucination" the case of an overworked, and overworried man +who, a few minutes after leaving a car, had the vivid feeling that someone +had touched him on the shoulder, though on turning round he had found no one +near. He then remembered that on the car he had been leaning on an iron +bolt, and therefore what he had experienced was doubtless a spontaneous +muscular contraction excited by the pressure. Touches felt on awakening in +correspondence with a dream are not so very uncommon. We think as to this +likely enough explanation, that whatever the local sensation may have been, +or however slight, as it probably was, it could only give rise to an +hallucination of having been touched by some external personality when it +was absorbed into, and became a part of a considerable emotional disturbance +as in the case of the girl above referred to, and of my patient, in both +cases associated with a frightsome dream. The illness of the latter began +with a dream, and its continuance was in our opinion, largely due to dreams +of a painful character. During the whole period of her residence it was +noted that she dreamt a great deal, and that they were terrifying or +alarming dreams, and that her bad days were generally preceded by a bad +dream. Notes of her dreams were regularly made, at one time for ten +consecutive nights, and only three of them were so far as she remembered +free from dreams. All of her dreams she described as "awful." Many of them +were of being mixed up with objectionable people who behaved roughly and +used profane language, but, and of this she was very certain, who never +talked or acted obscenely. She frequently dreamt of being on high +precipitous places from which she was either falling, or could not get away +from. She described one vivid dream during which she suffered great misery, +and awoke from in great distress. She dreamt that she was listening to a +preacher with open Bible in his hand, that he spoke about Peter whom he was +accusing of disobedience; a number of people were present but she saw +particularly only one man who looked very happy; the sermon ended, and she +awoke in "agony," this feeling being due, she said, to the conviction +present with her, that the sermon, and the man's happiness were intended to +show her how much she had lost since she was cut off from "grace" by Satan +dwelling in her body. Again she dreamt of a near relative whom she heard +singing, "And they all speak in tongues to magnify the Lord." This brought +sorrow to her of which she was conscious during the dream and after she +awoke as she thought Satan was putting this before her to show her what she +had lost. In another dream she saw three unpleasant looking men talking +together. The worst looking of them of Jewish appearance, came close to her +face, and argued with her about the evil spirit. She said "he was in her +body," and he answered "away with him." She fell asleep and dreamt the same +dream again. These dreams were obviously governed by her dread and fear as +to her religious position. The following one is somewhat different:--"A big +brown beast came up to her and pressed against her face; she slept again and +dreamt she was in a big ship sailing in black and dirty water; that she +tried hard to get out of the ship, but could not, and awoke in great +distress." We presume Freudians would find in the latent content of all +these dreams, particularly in this last one, evidence in favour of their +positions, though to us they reveal only, in the blurred and broken way +dreams do, the prevailing trend of thoughts governed by morbid religious +fears and garbed in the phraseology and symbolism of a judaic faith. The +sameness of their ending and meaning to her being obviously due to their +relation to the dream which ushered in her illness to which indeed most of +them were closely related in geneses and content. No doubt Freudian +psychoanalysis would be able to carry her memory back into the region of +long forgotten infantile or early sex memories where, as in every normal +human being they lie, the shadowy outlines of instinctive feelings whose +roots are in a far away, phylogenetic past, having apart from suggestion no +role as factors in the production of morbid fears or fancies. The +fantastical and too often repulsive dream interpretations of this school +forcibly remind us of the words of Lord Bacon, "With regard to the +interpretation of natural dreams it is a thing that has been laboriously +handled by many writers, but it is full of follies." All kinds of trivial +incidents of childhood and early youth are stored up by all of us, and are +recalled in sudden and unexpected ways, but not because of any relaxation of +a supposed "censor," nor necessarily because of any content of a sex nature, +but because they are more often than not associated with fear, chief of the +coarser emotions, and a more primitive and more enduring emotion than any of +those connected with reproduction, and more alien to the organism than sex +memories even of a perverse order, their resurrection being due to some +subtle association between the present and the past, generally a sensory +one, visual or auditory most frequently. In our own case the earliest +recollections of childhood are so associated and recollected. Sunshine +amongst trees, and birds singing bring back to us at very long intervals a +country scene where as a child we were frightened by threats of a "bogie +man." The only childish incidents which unexpectedly recur with us were +associated with childish fears and disappointments of a usual and ordinary +character never with morbid elements or emotional complexes which were +repressed or censored in the Freudian sense, and in this we are not +singular. + +[13]"The World of Dreams," p. 182. + +Again and again, association tests, as prescribed by Jung, and repeated +examinations of a psychological character were made without our being able +to obtain the slightest indication of their being erotic or similar +influences of the slightest value as factors in the causation of her mental +disturbance. The chief value of Jung's Tests we have found to be the +suggestion of lines of inquiry or the confirmation of evidence obtained in +other ways. The results here were negative and in that confirmed what we +knew from the history and character of our patient as a pure minded woman of +blameless life. She was constitutionally timid, and all her life liable to +doubts and fears of a morbid type. As an instance of this she told us that +when twelve years of age while influenced by the death of her step-mother, +which had just taken place, one morning early her father went out to his +work leaving her in bed, and alone in the house. Immediately after he left +she heard or more likely thought she heard, someone lift the latch of the +door, as if to come in, but though no one came in she was left in a state of +great fear, so marked that for long afterwards she dreaded being left alone, +and still remembers vividly her feelings during that experience. This +temperament she carried into her religious life which as we have seen was +marked by fears and doubts. "No one will deny that fear is the type of +asthenic manifestations. Yet is it not the mother of phantoms of numberless +superstitions, of altogether irrational and chimerical religious +practices."[14] The strength and character of her beliefs as well as the +religious teachings and influences to which she had been subjected from her +earliest years, all tended to develop the mystical in a temperament ready +for the dissociation necessary to enable the mystic to attain to that +ecstasy or absorption in something outside and beyond the self which is the +essence of that state. Why the ecstasy which she knew and desired should +pass into its opposite is not difficult to understand when the above history +is considered. + +[14] Ribot "The Creative Imagination." p. 34. + +The shock which originated the attack gave form and reality to fears and +doubts which had been assailing her for some time, and to the influence of +which she was specially liable at this time by the lowered physiological +tension, the result of her previous menorrhagia, and by the fact that the +comparative ease and comfort of her later life had given her opportunities +for introspection absent during her previous life of struggle for and +interest in others. She was then scrupulous, timid and superstitious, a +mystical, a psychopathic temperament, taking her place all the same with +John Bunyan and other chief of sinners whose self-depreciation and +absorption in the struggle for salvation from sin and the power of the +Devil, though morbid in character was not pathological. But when Satan +became not merely a spirit influencing her, but had entered bodily into her, +the border was crossed, and she was to herself literally possessed, and +became filled with fear, a fear pathological in action, dominating her +mentally and physically during her dissociated states. Once initiated it is +not difficult to see how these dissociated states which recurred so +regularly and persisted so long were kept up by her temperament, and her +constantly recurring dreams of a terrifying or depressing character, which +were, as we have already indicated, but representations of the original +shock. The following quotation applies closely to her case. "On this view an +intense, sudden painful experience, especially if the significance of it can +be dimly felt, but not understood, may persist long and latently +unassimilated by the central consciousness and without fusion with it, +almost as if it were a foreign body in the psychic system."[15] Professor +James has termed the pathological emotion an objectless emotion, but as +Professor Dewey puts it "from its own standpoint it is not objectless; it +goes on at once to supply itself with an object, with a rational excuse for +being."[16] Here the sensations in the left hypochondrium which she had +described as "grippings at the heart," became the object which, under the +influence of the initial shock with its unusual and alarming sensations and +feelings, she interpreted as she did. + +[15] Stanley Hall on Fear--The American Journal of Psychology, April 1914. + +[16] Psychological Review, Vol. I, page 562. + +Her recovery was very gradual and marked by many relapses. In her treatment +as in our ideas as to the causation of the disorder, we put the accent on +the psychic rather than on the physical factors. We did not however +underrate the latter but constantly sought to improve her bodily health and +condition. When at her worst in 1911 her weight, taken monthly, was round +about one hundred and sixty pounds. In 1912 it went up from one hundred and +sixty-six to one hundred and eighty-eight pounds and averaged one hundred +and seventy-six pounds. But as in the case of her blood pressure, the rise +was due largely to her mental improvement. It may be of interest to note +here that during and after a somewhat severe attack of diarrhoea with +hemorrhage from the bowels, her mental condition was better than usual, as +might even have been expected considering the mental distraction the attack +involved. + +We were satisfied that we could have shortened materially the duration of +her illness--two years,--by hypnotic suggestion, but unfortunately her +friends objected to this mode of treatment. Suggestion in the waking state +had been abundantly used, but with little apparent effect of an immediate +kind. + + + +THE SEX WORSHIP AND SYMBOLISM OF PRIMITIVE RACES + +(CONCLUSION) + +BY SANGER BROWN II., M. D. + +Assistant Physician--Bloomingdale Hospital + +PLANT AND FLOWER SYMBOLISM + +A number of plant and flower symbols have a different significance from that +which is generally given to them. We are all quite familiar with the grape +vine of Bacchus and the association of that deity with grapes. According to +R. P. Knight, this too, symbolizes a sexual attribute. Speaking of Bacchus, +he writes, "The vine was a favorite symbol of the deity, which seems to have +been generally employed to signify the generative or preserving attribute; +intoxicating liquors were stimulative, and therefore held to be aphrodisiac. +The vase is often employed in its stead to express the same idea and is +often accompanied by the same accessory symbol." + +We have often seen in sculptures and paintings, heads of barley associated +with the God of the Harvest. This symbol would appear to be self +explanatory; yet we are told by more than one writer that it contains +another symbolic meaning as well. H. M. Westropp, speaking of this says, +"The kites or female organ, as the symbol of the passive or productive power +of nature, generally occurs on ancient Roman Monuments as the Concha +Veneris, a fig, barley corn, and the letter Delta." We are told that the +grain of barley, because of its form, was a symbol of the vulva. + +A great many other female symbols might be mentioned. The pomegranate is +constantly seen in the hands of Proserpine. The fig-cone is carried by the +Assyrian Baal, and the fig in numerous processions has a similar +significance. When we add to these the various forms of tree worship +described above, we see to what an extent the products of nature were used +as symbols in the worship of sex. + +Among flower symbols there is one which recurs constantly throughout the art +and mythology of India, Egypt, China, and many other Eastern countries. This +is the lotus, of which the Easter lily is the modern representative. The +lotus appears in a number of forms in the records of antiquity. We have +symbolic pictures of the lion carrying the lotus in its mouth, doubtless a +male and female symbol. The deities of India are depicted standing on the +lotus, or are spoken of as being "born of the Lotus." "The Chinese,"[1] +says the author of Rites and Ceremonies, "worship a Goddess whom they call +Puzza, and of whom their priests give the following account;--they say that +'three nymphs came down from heaven to wash themselves in the river, but +scarce had they gotten in the water before the herb lotus appeared on one of +their garments, with its coral fruit upon it. They were surprised to think +whence it could proceed; and the nymph upon whose garment it was could not +resist the temptation of indulging herself in tasting it. But by thus eating +some of it she became pregnant, and was delivered of a boy, whom she brought +up, and then returned to heaven. He afterwards became a great man, a +conqueror and legislator, and the nymph was afterwards worshipped under the +name of Puzza.' " Puzza corresponds to the Indian Buddha. + +[1] O'Brien: The Round Towers of Ireland. + +In Egyptian architecture the lotus is a fundamental form, and indeed it is +said to he the main motive of the architecture of that civilization. The +capitals of the column are modelled after one form or other of this plant. +That of the Doric column is the seed vessel pressed flat. Earlier capitals +are simple copies of the bell or seed vessel. The columns consisted of +stalks of the plant grouped together. In other cases the leaves are used as +ornaments. These orders were copied by the Greeks, and subsequently by +western countries. + +We may ask ourselves, what is the meaning of this mystic lotus which was +held in sufficient veneration to be incorporated in all the temples of +religion, as well as in myths of the deity. This, too, refers to the +deification of sex. O'Brien, in the "Round Towers of Ireland" states, "The +lotus was the most sacred plant of the Ancients, and typified the two +principles of the earth fecundation,--the germ standing for the lingam; the +filaments and petals for the yoni." + +R. P. Knight states, "We find it (the lotus) employed in every part of the +Northern Hemisphere where symbolical worship does or ever did prevail. The +sacred images of the Tarters, Japanese or Indians, are all placed upon it +and it is still sacred in Tibet and China. The upper part of the base of +the lingam also consists of the flower of it blended with the most +distinctive characteristics of the female sex; in which that of the male is +placed, in order to complete this mystic symbol of the ancient religion of +the Brahmans; who, in their sacred writings, speak of Brahma sitting upon +his lotus throne." + +Alexander Wilder,[2] states that the term "Nymphe" and its derivations was +used to designate young women, brides, the marriage chamber, the lotus +flower, oracular temples and the labiae minores of the human female. + +[2] The Symbolical Language of Ancient Art and Mythology. + +The lotus then, which is found throughout antiquity, in art as well as in +religion, was a sexual symbol, representing to the ancients the combination +of male and female sexual organs. It is another expression of the sex +worship of that period. + +Our present conventional symbols of art are very easily traced to ancient +symbols of religion. We may expect these to be phallic in their meaning, to +just the extent that phallicism was fundamental in the religions where these +symbols originated. From the designs of some of the ornamental friezes of +Nineveh, we find these principles illustrated. On those bas-reliefs is +found the earliest form of art, really the dawn of art upon early +civilization. Here is the beginning of certain designs which were destined +to be carried to the later civilizations of Greece, Rome and probably of +Egypt. These friezes show the pine cone alternating with a modified form of +the lotus: the significance of which symbols we have explained. There are +also shown animal representations before the sacred tree or grove, a phallic +symbol. From these forms and others were designed a number of conventional +symbols which were used throughout a much later civilization. (See "Nineveh +and Its Remains." A. Layard.) + + + +ANIMAL SYMBOLISM + +One sees in the religions of antiquity, especially those of India, Assyria, +Greece and Egypt, a great number of sacred animal representations. The Bull +was sacred to Osiris in Egypt, and one special animal was attended with all +the pomp of a god. At one time in Assyria the god was always associated with +a sacred animal, often the goat, which was supposed to possess the qualities +for which the god was worshipped. Out of this developed the ideal animal +creations, of which the animal body and the human head and the winged bulls +of Nineveh are examples. The mystic centaurs and satyrs originated from this +source. At a later time the whole was humanized, merely the horns, ears or +hoofs remaining as relics of the animal form. + +We learn that in these religions the animal was not merely worshipped as +such. It was a certain quality which was deified. The Assyrian goat +attendant upon the deity, was in some bas-reliefs, not only represented in +priapic attitudes, but a female sexual symbol was so placed as to signify +sexual union. We shall show later that certain male and female symbolic +animals were so placed on coins as to symbolically indicate sexual union. + +An animal symbol which has probably been of universal use is that of the +snake or serpent. Serpent worship has been described in almost every +country of which we have records or legends. In Egypt, we find the serpent +on the headdress of many of the Gods. In Africa the snake is still sacred +with many tribes. The worship of the hooded snake was probably carried from +India to Egypt. The dragon on the flag and porcelain of China is also a +serpent symbol. In Central America were found enormous stone serpents +carved in various forms. In Scandinavia divine honors were paid to serpents, +and the druids of Britain carried on a similar worship. + +Serpent worship has been shown by many writers to be a form of sex worship. +It is often phallic, and we are told by Hargrave Jennings that the serpent +possibly was added to the male and female symbols to represent desire. Thus, +the Hindu women carried the lingam in procession between two serpents; and +in the sacred procession of Bacchus the Greeks carried in a sacred casket +the phallus, the egg, and a serpent. + +The Greeks also had a composite or ideal figure. Rays were added to the +head of a serpent thereby bringing it into relation with the sun god Apollo; +or the crest or comb of a cock was added with similar meaning. + +Many reasons have been offered to explain why the serpent has been used to +represent the male generative attribute. Some have called attention to its +tenacity of life; others have spoken of its supposed mystic power of +regeneration by casting its skin. Again, it seems probable that the form is +of symbolic significance. However this may be, we find that this universal +serpent worship of primitive man was a form of phallicism so prevalent in +former times. + +Many other animals may be mentioned. The sacred bull, so frequently met +with in Egypt, Assyria and Greece, was a form under which Bacchus was +worshipped. R. P. Knight speaks as follows; "The mystic Bacchus, or +generative power was represented under this form, not only upon coins but +upon the temples of the Greeks; sometimes simply as a bull; at other times +as a human face; and at others entirely human except the horns and ears." + +We would probably be in error to interpret all these animal symbols as +exclusively phallic although many were definitely so. Thus, while Hermes was +a priapic deity, he was also a deity of the fields and the harvests; so the +bull may have been chosen for its strength as well as its sexual attributes. + +There are many animals which were symbolic of the female generative power. +The cow is frequently so employed. The Hindus have the image of a cow in +nearly every temple, the deity corresponding to the Grecian Venus. In the +temple of Philae in Egypt, Isis is represented with the horns and ears of a +cow joined to a beautiful woman. The cow is still sacred in many parts of +Africa. The fish symbol was a very frequent representative of woman, the +goddess of the Phoenicians being represented by the head and body of a woman +terminating below in a fish. The head of Proserpine is frequently surrounded +by dolphins. Indeed, the female principle is regularly shown by some +representative of water; fire and water respectively being regarded as male +and female principles. + +Male and female attributes are often combined on coins for purposes of +sexual symbolism. R. P. Knight explains these symbols as follows; "It +appears therefore that the asterisk, bull, or minotaur, in the centre of a +square or labyrinth equally mean the same as the Indian lingam,--that is the +male personification of the productive attribute placed in the female, or +heat acting upon humidity. Sometimes the bull is placed between two +dolphins, and sometimes upon a dolphin or another fish; and in other +instances the goat or the ram occupy the same situation. Which are all +different modes of expressing different modifications of the same meaning in +symbolical or mystical writings. The female personifications frequently +occupy the same place; in which case the male personification is always upon +the reverse of the coin, of which numerous instances occur in those of +Syracuse, Naples, Tarentum, and other cities." By the asterisk above +mentioned the writer refers to a circle surrounded by rays, a sun symbol of +male significance. The square or labyrinth is the lozenge shaped symbol or +yoni of India. + +The above interpretations throw much light on the obscurity of the animal +worship of antiquity. This explains the partly humanized types, and the +final appearance of a human deity with only animal horns remaining, as +representing the form under which the deity was once worshipped. The satyrs, +centaurs, and other animal forms are all part of these same representations +and are similarly explained. + +Our main object in giving the above account of these various symbols has +been to illustrate the wide prevalence of sex worship among primitive races. +Another end as well has been served; our study gives us a certain insight +into the type of mind which evolves symbolism, and so a few remarks on the +use of symbolism as here illustrated are not inappropriate. + +We feel that while this symbolism may indicate a high degree of mechanical +skill in execution, it does not follow that it expresses either deep or +complicated intellectual processes. In fact, we are inclined to regard such +symbolism as the indication of a comparatively simple intellect. It appears +obscure and involved to us, because we do not understand the symbols. From +those which we do understand, the meaning is graphically but simply +expressed. + +On coins, bas-reliefs and monuments; we find the majority of these simple +emblems. If the desire is to express the union of male and female +principles, a male symbolic animal is simply placed upon the corresponding +female symbol. Thus, a goat or bull may be placed upon the back of a +dolphin or other fish. This is a graphic presentation but certainly one of a +most simple nature. Sometimes the male symbol is on one side of the coin +and then the female is always on the reverse. Unions are made which do not +occur in nature, and the representation is not a subtle one. + +In India, if there was a desire to express a number of attributes of the +deity, another head or face is added or additional arms are added to hold up +additional symbols. In Greece, when the desire was to express the androgyne +qualities of the deity, a beard was added to the female face, or one half of +the statuette represented the male form, the other the female. Such +representations do not indicate great ingenuity, however skillfully they may +be executed. + + + +SUN WORSHIP AND SUN MYTHS + +As is generally known, traces of sun worship are found in almost every +country of which we have a record. In Egypt Ra was the supreme sun god +where there was very elaborate worship conducted in his honor. In Greece +Apollo was attended with similar festivities. In the Norse mythology, many +of the myths deal with the worship of the sun in one form or another. In +England, Stonehenge and the entire system of the Druids had to do with solar +worship. In Central America and Peru, temples to the sun were of amazing +splendor, furnished as they were with wonderful displays of gold and silver. +The North American Indians have many legends relating to sun worship and +sacrifices to the sun, and China and Japan give numerous instances of the +same religion. Sun worship is so readily shown to be fundamental with +primitive races that we will not discuss it in detail at this time, but +rather will give the conclusions of certain writers who have explained its +meaning. + +At the present day, the sun is regularly regarded as a male being, the earth +a female. We speak of Mother Earth, etc.; in former times, the ancients +depicted the maternal characteristics of the earth in a much more material +way. Likewise the sun was a male deity, being often the war god, vigorous +and all powerful. We readily see to what an extent the male sun god was +portrayed in mythology as a human being. In many myths, the god dies during +the winter, reappears in the Spring, is lamented in the Fall, etc., all in +keeping with the changes in the activity of the sun during the different +seasons. + +The moon was associated with the female deity of the ancients. Isis is +accompanied by the moon on most coins and emblems. Venus has the same +symbols. Indeed, the star and crescent of our modern times, of the Turkish +flag and elsewhere, are in reality the sun and crescent of antiquity, male +and female symbols in conjunction. Lunar ornaments of pre-historic times +have been found throughout England and Ireland, and doubtless explain the +superstitions about the moon in those countries. The same prehistoric +ornaments are found in Italy. In the legends of the North American Indians, +Moon is Sun's wife. + +The full extent of these beliefs is pointed out by Mr. John Newton in +"Assyrian Grove Worship." Here we see that the ancient Hindus gave a much +more literary relationship between the sun and earth than we are accustomed +to express in modern times. He states, "This representative of the union of +the sexes typifies the divine Sakti, or productive energy, in union with the +pro-creative or generative power as seen throughout nature. The earth was +the primitive pudendum or yoni which is fecundated by the solar heat, the +sun, the primitive linga, to whose vivifying rays man and animals, plants +and the fruits of the earth, owe their being and continued existence." + +It is not possible to discuss Sun worship at any length without at the same +time discussing phallicism and serpent worship. Hargrave Jennings, who has +made careful study of these worships, points out their general identity in +the following paragraph. He states: "The three most celebrated emblems +carried in the Greek mysteries were the phallus, the egg, and the serpent; +or otherwise the phallus, the yoni or umbilicus, and the serpent. The first +in each case is the emblem of the sun or of fire, as the male or active +generative power. The second denotes the passive nature or female principle +or the emblem of water. The third symbol indicates the destroyer, the +reformer or the renewer, (the uniter of the two) and thus the preserver or +perpetuater eternally renewing itself. The universality of serpentine +worship (or Phallic adoration) is attested by emblematic sculptures or +architecture all the world over." + +The author of the "Round Towers of Ireland" in discussing the symbols of sun +worship, serpent worship and phallicism, found on the same tablet, +practically reiterates these statements. He says: "I have before me the +sameness of design which belonged indifferently to solar worship and to +phallic. I shall, ere long, prove that the same characteristic extends +equally to ophiolatreia; and if they all three be identical, as it thus +necessarily follows, where is the occasion for surprise at our meeting the +sun, phallus and serpent, the constitutent symbols of each, embossed upon +the same table and grouped under the same architrave?" + +By a number of references, we could readily show the identity of all these +worships. The preceding paragraphs give, in summary form, the conclusions +of those writers who have made such religions their special study. We shall +not exemplify this further, but will now point out the general relationship +of sun worship to the religious festivals and mythology of the Ancients. +This relationship becomes important when it is appreciated that the sun +worship expressed in the mysteries is also a part of phallicism. On some of +these festive occasions the phallus was carried in the front of the +procession and at other times the egg, the phallus and the serpent were +carried in the secret casket. + + + +ANCIENT FESTIVALS AND MYSTERIES + +The Ancients expressed their religious beliefs in a dramatic way on a number +of occasions throughout the year. The festivities were held in the Spring, +Autumn, or Winter. These were to commemorate the activities of the sun, his +renewed activity in the Spring calling forth rejoicing and his decline in +the Fall being the cause of sorrow and lamentation. As well as the +festivities, there were the various mysteries, such as the Eleusinia, the +Dionysia and the Bacchanalia. These were conducted by the priests who +moulded religious beliefs and guarded their secrets. The mysteries were of +the utmost importance and the most sacred of religious conceptions were here +dramatized. + +Mythology also gave expression to the religious ideas of the time and we +find that the most important myths, dramatically produced at the religious +festivals, were sun myths. + +The annual festivities and mysteries will be discussed together because both +were intended to dramatize the same beliefs. Both were under priestly +control and so were national institutions. The festivals were for the common +people but the mysteries were fully understood only to the initiated. + +While no very clear account of the mysteries has been given, a certain theme +seems to run through them all, and this is found in the myths as well. A +drama is enacted, in which the god is lost, is lamented, and is found or +returns amid great rejoicing.[3] This was enacted in Egypt where the +mourning was for Osiris; and in Greece for Adonis, and later for Bacchus. +All these are, of course, sun gods, and the whole dramatization or myth is +in keeping with the activities of the sun. + +[3] The Enactment and Rebirth. + +On these occasions, the main object seems to have been to restore the lost +god, or to insure his reappearance. The women took the leading part and +mourned for Osiris, Adonis or Bacchus. They wandered about the country at +night in the most frenzied fashion, avoided all men and sought the god. At +times, during the winter festival, the quest would be fruitless. In the +Spring, when they indulged themselves in all sorts of orgies and +extravagances, Adonis was found. + +The underlying motive appears to have been to enact a drama in which the +deity was supposed to exercise his procreative function by sexual union with +the women. This was an ideal which they wished to express dramatically. In +order to realize this ideal obstacles were introduced that they might be +overcome; in the old myth, Adonis was emasculated under a pine tree, and in +Egypt Osiris was similarly mutilated, his sex organs being lost. But at the +festivals it was portrayed that Adonis was found, and in the myth, Osiris +was restored to Isis in the form of Horus (the morning sun). In a number of +myths, the god is said to have visited the earth to cohabitate with the +women, an occurrence which was doubtless desired, in order that the deistic +attributes might be continued in the race. Thus, judging from what we have +been able to learn of this subject, the worship expressed in the mysteries +revolved about sexual union, the desire being to dramatize the continued +activity of deistic qualities. + +This character of many of the festivals and mysteries is very evident. In +the Eleusinian mysteries the rape of Persephone by Pluto, the winter god, is +portrayed. The mother, Demeter, mourns for her daughter. Her mourning is +dramatically carried out by a large procession, and this enactment requires +several days. Finally Persephone is restored. The earlier part of the +festival was for dramatic interest, and the real object was the union of +Persephone with Bacchus. "The union of Persephone with Bacchus, i.e., with +the sun god, whose work is to promote fruitfulness, is an idea special to +the mysteries and means the union of humanity with the godhead, the +consummation aimed at in the mystic rites. Hence, in all probability the +central teaching of the mysteries was Personal Immortality, analogue of the +return of the bloom to plants in Spring."[4] + +[4] Dr. Otto Rhyn, Mysteria. + +The mysteries of Samothrace were probably simpler. Here the phallus was +carried in procession as the emblem of Hermes. In the Dionysian mysteries +which were held in mid-winter, the quest of the women was unsuccessful and +the festival was repeated in the Spring. The Roman mysteries of Bacchus +were of much later development, and consequently became very debased. Men as +well as women eventually came to take part in the ceremony, and the whole +affair degenerated into the grossest of sexual excesses and perversions. + +We have stated what appears to us to have been the underlying motives of the +religious festivals and mysteries; namely, the enactment of a drama in which +the reproductive qualities of the deity were portrayed. The phallus was +carried in procession for this purpose and the women dramatized the motive +as searching for the god. Our account can be regarded as little more than an +outline, but it is sufficient for our present purposes. It indicates that +the mysteries give an expression of phallic worship, just as do the various +monuments of art and religion to which we have referred. It may also be +said that this same worship is represented in what may be termed early +literature, for much of the early mythology deals with the same subject. The +study of origins in mythology, however, cannot be dealt with adequately in +our present communication. + + + +CONCLUSION + +We have now traced the worship of sex, as recorded by the monuments of +antiquity, through its various phases. In its simplest form, the generative +organs are worshipped without disguise; the sexual act also forms a part of +religious ceremonies. Later, a rude symbolism develops. As the race becomes +more advanced, this becomes more elaborate, until finally a considerable +degree of ingenuity and skill are evidenced. The worship of sex is not only +expressed in religious usages, but comes to dominate early art as well; it +is also expressed in mythology, and so we find the same symbolical and +allegorical expressions in early literature. In fact, the deepest thoughts +of primitive races, as expressed in their religion, eventually dominate most +of the customs and usages of every day life. + +We may appropriately ask, why did primitive people deify the sexual organs? +This question may be answered when we understand the religious ceremonies of +primitive tribes. The earliest objects worshipped were those which were of +known benefit to man. The Aborigines of Australia have very elaborate +ceremonies which superficially seem meaningless but when understood have a +very definite meaning. This aim is to ensure some certain product of the +earth. If it is a Yam[5] ceremony, an elaborate procedure is carried out +which is supposed to make yams grow. There is a secret ceremonial object +which is a symbol of the yam and which bears to it more or less resemblance. +Other ceremonies are carried out for similar purposes. The meaning of all +these semi-religious performances, as clearly shown by Spencer Baldwin, is +to ensure the benfits which nature gives. This, in brief, explains nature +worship, and were it our object at present, it would be most interesting to +show the peculiar resemblance of these ceremonies to those carried on in sex +worship. + +[5] A kind of sweet potato. + +As the early races advanced in knowledge, they came to know that the +perpetuation of the race depended upon generative attributes. For this +reason human generative attributes were deified and appropriate ceremonies +were held, just as in the case of nature worship. These are not "lewd +practices," as they are not infrequently called. It is indeed regrettable +that the subject of sex worship has been disregarded by many historians, as +thereby erroneous impressions are given. The facts of nature worship have +always been much better understood and its importance has been realized; +those of sex worship have been less carefully recorded. + +The literature and philosophy which we are accustomed to associate with +Greek thought are of a later date. Once such abstract reasoning is possible, +sex worship is no longer seriously entertained. The symbolism remains, but +is, associated now, not so much with religion as with art. Likewise in +India, the early Buddhism, which was sex worship, has changed to the present +day Buddhistic Philosophy, the symbols alone remaining. + +From all this we are inclined to believe that in sex worship we are dealing +with important motives in the development of the race. We make no presence +of having exhausted the subject in this communication. The decadence of this +religion, as observed in the early Christian period, and in fact well +through the middle ages, forms a very interesting history. It is not our +purpose, however, to deal with it at present. Likewise, it should be +understood that the motives which we have been discussing are not +necessarily the earliest manifested in racial development; we have a record +of a time in the history of man when the worship of sex had not yet made its +appearance but this period also is not a part of our present topic. + +The influence of early racial motives upon present day civilization is a +topic of great interest. Its importance is, in fact, the main object of +studies of this kind. However, we wish our account to be mainly an +historical one, and so will not at present make reference to a number of +applications which arise. We have also refrained from making use of the +modern writings on matters of sex, as we thereby avoid criticism to the +effect that our findings have been drawn from biased sources. We feel that +while the reader may disagree in certain details as here set forth, the +universal appearance of sex worship at a certain stage of racial development +is scarcely to be denied. The writers whom we have cited are all of a former +generation, and they were searching for origins in religion, not in sexual +life; inadvertently they found the latter, in fact could not avoid it, and +so their conclusions are all the more valuable to us. + +REFERENCES.[6] + +[6] For a number of additional references consult New York Library under +Phallicism. + +Cox, Rev. G. W.: The Mythology of the Aryan Nations. + +Deiterich, A.: Mutter Erde. + +Fraser, J. G.: Adonis, Attis and Osiris; Balder, the Beautiful; Psyche's +Task. + +Grosse: The Beginnings of Art. + +Higgins, Godfrey: The Anacalypsis; Celtic Druids. + +Harrison, Miss Jane: Ancient Art and Ritual; Themis. + +Howitt, A. W.: The Native Tribes of South East Australia. + +Inman, Dr. Thomas: Ancient Faiths Embodied in Ancient Names; Ancient Pagan +and Modern Christian Symbolism. + +Jennings, Hargrave: The Rosicrucians; The Indian Religions. + +King, C. W: The Gnostics and their Remains; Hand-book of Engraved Gems. + +Knight, R. P.: The Symbolical Language of Ancient Art and Mythology; Two +Essays on the Worship of Priapus. + +Layard, A.: Babylon and Nineveh; Nineveh and its Remains. + +Murray, Gilbert: Hamlet and Orestes. + +Newton, John: Assyrian Grove Worship. + +O'Brien, Henry: The Round Towers of Ireland. + +Rawlinson, G.: History of Ancient Egypt; Ancient Monarchies. + +Rhyn, Dr. Otto: Mysteria. + +Rocco, Sha: Ancient Sex Worship. + +Spencer, B.: Native Tribes of the Northern Territory of Australia. + +Westropp, Hodder M.: Primitive Symbolism. + +Wood, Rev. J. G.: The Uncivilized Races. + + + +ADDITIONAL REFERENCES + +(Primitive customs, religious usages, etc.) + +Bryant: System of Mythology. + +DeGubernatis, Angelo: Zoological Mythology. + +Judson: Myths and Legends of the Mississippi Valley and the Great Lakes.. + +Langdon, S.: Tammuz and Ishtar. + +Perrot, and Chipiez: History of Art in Phrygia, Lidia, Caria and Lycia; +History of Art in Persia. + +Prescott: Conquest of Peru. + +Rousselet, Louis: India and Its Native Princes. + +Stevens, J.: Central America, Chiapez and Yucatan. + +Solas, W. J.: Ancient Hunters. + +Wood-Martin: Pagan Ireland. + + + +REVIEWS + +THE MEANING OF DREAMS. By Isador H. Coriat. Little, Brown and Company, +Boston, 1915, Pages xiv plus 194. + +This concise and well written little book hardly needs reviewing for the +readers of the Journal of Abnormal Psychology as all who have followed Dr. +Coriat's writings for the last few years will know at once the nature of the +book and what it contains. His purpose is evidently to give a simple clear +statement of the position of the Freudian school and he accomplishes this +with more than ordinary success. He is lavish in his praises of Freud and +seemingly accepts unquestionably the whole mass of Freudian doctrines. One +searches in vain for the least question or the slightest suggestion that +some of the Freudian concepts might possibly be wrong. Everywhere the words +of Freud and the beliefs of the author are given as absolute, eternal and +unquestionable. He incorporates some of the recent additions to the +Freudian teachings, such as Brill's treatment of the "artificial dream," but +concerning the fundamentals he leaves the original doctrines without +noticeable modification. In discussing the mechanisms of dreams he adds a +fifth to the original four, calling his addition "reinforcement." +Reinforcement is the mechanism by which "the prominent or primary wish of +the dream is reinforced, expressed anew for the purpose of emphasis by means +of a second dream following the first, really a dream within a dream." With +this exception he leaves the original Freudian teachings intact and +unchanged. He says that a dream is the fulfilment of a wish and no +modifications of the statement follow that could possibly make one think he +meant anything else. His definite position is stated as follows: "The term +'wish' in psycho-analysis is very comprehensive and connotes in a broad +sense all our desires, ambitions or strivings." He illustrates his points +by numerous dreams which he has himself analyzed. He will probably meet some +objection from those who are not ardent Freudians concerning some of these +dreams as the interpretation is not always "perfectly clear" as he says it +is to him. Some may say that at least a dozen other interpretations might +just as well and just as logically have been given, but this is the +objection that is raised concerning all Freudian literature. The best +characterization of the book is to say that it is typically Freudian. + +(As a side issue, it is interesting to notice how many of the dreams given +relate to the European War. Some one has said that America shows her +concern over the war by the way Americans dream.) + +There are two characteristics of the book which are worthy of special +mention and for which Dr. Coriat needs special praise. One of these is that +it is so simply written that the general public can read it and understand +it. No other Freudian publication which the reviewer has seen can boast of +the same simplicity. The other point is that absolutely everything +concerning sex which could possibly be objectionable has been ruled out. +There is not a word or a sentence in the book that a precise maiden lady +need hesitate to read to her Sunday School class or at a pink tea. In doing +this Dr. Coriat has indeed achieved the impossible as all will readily +agree. This book is probably too elementary for the majority of the readers +of the Journal of Abnormal Psychology but it is destined to fill a place +which no previous Freudian publication could ever fill; it is a book for the +general public and the beginner in psychology and for this purpose it is +truly a little gem. RAYMOND BELLAMY. Emory and Henry College. + + + +THE PSYCHONEUROSES AND THEIR TREATMENT BY PSYCHOTHERAPY. By Professor J. +Dejerine and Dr. E. Gauckler. Authorized Translation by Smith Ely Jelliffe, +M.D., Ph. D. J. B. Lippincott Co., Philadelphia, Pa. + +This book is another instance of the lack of a common nomenclature in +psychopathology. Psychological mechanisms are penetratingly discussed; and +important syntheses are made regarding categories which many American +psychopathologists name differently not to speak of the nomenclature of the +repressionist of Vienna. It seems to the reviewer indeed, that what the +authors call neurasthenia is merely a somewhat complex elaboration of the +psychosis by induction to which Babinski has restricted the name hysteria. +It is true that certain manifestations of this, especially a false +gastropathy, may lead to an increased fatigue, and to this the name +neurasthenic might appropriately be given. But still more often one sees the +appearance of increased fatigue on account of the patient's faulty notion; +and to this the name neurasthenic should certainly not be given. + +To place in the same rubric a simple somatic hysteria like a paralysis and +the complications of what are comprised in psychological neurasthenia as so +lucidly described in this book, seems at first sight irrational; but so at +first appeared the placing together of clinical pictures as unlike as +cervical struma, phthisis pulmonalis and ossious caries under the rubric of +tuberculosis, and in a nearer field the synthesis of catatonia, hebephrenia +and cementing paranoia into the rubric of dementia precox. So, recognizing +the accuracy of the beautiful analysis of Professor Dejerine of what he +calls neurasthenia, we venture to assimilate it with the equally true +analysis which Babinski has made of the immediate mechanism of what he +wishes to call pithiatism. It is the condition which we personally term +hysteria, and the mechanism of which we have more especially studied in the +traumatic neuroses and the occupational dyskinesias and some other disorders +incident to the exercise of trade or profession. Indeed, the authors +say:--"One can see that the helmet headache, the pain in the nape of the +neck, and the pain in the spine are frequent among cultivated people and +educated neurasthenics, but much rarer among the others" and he explains +this by saying that these disturbances "are due to the diffusion of the +attention towards obsessions or preoccupations;" and he gives as an example +the reply of a patient "I think of my illness or such vicissitude by which +it was brought about." Indeed, in one place, Professor Dejerine goes so far +as to permit himself to say that the hypochondriac preoccupation itself +constitutes originally a purely intellectual conception, a propos of which, +but secondarily to it the patient really may work up an emotion, but which +is really NOT OF EMOTIONAL ORIGIN, a position first taken and long insisted +upon by the reviewer. + +What is this when traced to its source but the mechanism of suggestion? The +portion of the book describing the functional manifestations of the +digestive system is charged with most illuminating instances of +associational mechanism typifying the induction of morbid reactions by +suggestion. No one perusing them can fail to perceive that the psychological +process at work does not differ in principle from that found in the somatic +hysterias, from which therefore their separation seems unjustifiable, and at +the hands of so eminent an author is likely to maintain rather than diminish +present psychological misunderstanding. + +The dissimilarity of terms and resemblances of ideas has another +illustration in the reference to energy and the will; here it is clearly +pointed out that the apparent aboulia of the "neurasthenic" is not a lack, +but an unfruitful directing of the will while the Viennese school imply the +same idea in their doctrine of sublimation. + +The authors believe that neurasthenia differs from the psychasthenia of +Janet in that the latter is constitutional, and that the obsessions are +secondary, when analysed profoundly, to some pain-bearing contingency which +by the mechanism of association has pervaded the mind and which henceforth +distorts it with subsequent realities. And yet when Dejerine lays stress +upon the fact that badly organized moral hygiene conduces to the emotional +preoccupations which lead to obsessions and which he regards as the +essential characteristics of the neurasthenic constitution, he leaves no +apparent distinction from the psychasthenia of Janet. + +"The fundamental distinction of neurasthenia is causation by emotion," but +the authors have not extricated this factor from the role played by +induction either of idea or its secondary emotion. In such a fundamental +matter as anaesthesia for instance, they say: "In our opinion there exist +three classes of hysterical anesthesia. In the first series of facts one may +place the cases due to simulation. In the second group of cases we shall +range the patients in whom the disturbances of sensibility are directly due +to suggestion. Finally there remains a third class of patients in whom the +disturbances of sensibility seem to us to be residual emotional phenomena." + +"Emotion is able to suppress sensibility entirely by producing absolute +side-tracking, and that under such circumstances it was really a question of +total anesthesia and not purely psychoanesthesia. When the state has passed +and the emotional cause has disappeared the sensibility may return, but +anesthesia which is preserved may also persist, either by auto-suggestion or +as in the case of the individual who remarks that he felt none of the +various injuries which he has experienced, or it is a question of simple +residual phenomenon independent of all suggestion." And yet, further on, the +authors say that the phenomena of auto-suggestion cannot be separated from +the emotion. All this lacks clarity; and except in the instances of failure +of perception or of auto-suggestion, the mechanism is not intelligibly set +forth. + +The authors, however, although under the deplorable classification of +neurasthenia or hysteria, depart from the usual therapeutic methods and seek +the cause of the patient's disease outside of the objective symptoms and +declare that the "element of diagnosis lies chiefly in the origin of the +symptoms." + +They make much of the assertion that Dr. Weir Mitchell's method of treatment +is based practically upon isolation, rest in bed, over-feeding, douches, +massage and electricity, in fact on purely physical measures and Professor +Dejerine adds: "I was not long in discovering that unless the patient's +state of mind improved, the therapeutic results were far from satisfactory;" +and he gives examples. + +But in spite of the objections to the nosology and psychopathological theory +of the authors, there remains nothing but the highest praise for the +presentation of the clinical facts and of the sound advice regarding the +therapy of various functional manifestations, and concerning the role of the +physician in the prophylaxis of the psychogenic neuroses. It is most +desirable that every physician should be aware of the clinical facts which +Professor Dejerine has accumulated in his vast experience. In gynaecology, +gastroenterology, cardiology. and genitounary disease the psychogenetic +affections are ignored by most physicians. + +This book will give a better understanding of what every practitioner of +those specialities should be familiar with. TOM A. WILLIAMS. + + + + + +End of The Project Gutenberg Etext of The Journal of Abnormal Psychology +Volume 10 + |