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diff --git a/18843-h/18843-h.htm b/18843-h/18843-h.htm new file mode 100644 index 0000000..e528125 --- /dev/null +++ b/18843-h/18843-h.htm @@ -0,0 +1,5448 @@ +<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" + "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"> + +<html xmlns="http://www.w3.org/1999/xhtml"> + <head> + <meta http-equiv="Content-Type" content="text/html;charset=iso-8859-1" /> + <title> + The Project Gutenberg eBook of Applied Psychology, by Mary F. Porter. + </title> + <style type="text/css"> +/*<![CDATA[ XML blockout */ +<!-- +body{ margin-left: 10%; + margin-right: 10%; + } +p { margin-top: .75em; + margin-bottom: .75em; + text-align: justify; + line-height:1.3em; + } +body > p { text-indent:2em; + margin-top:0; margin-bottom:0;} +.pagenum { + position: absolute; + left: 92%; + font-size: 13px; /* same appearance for pagenums in <h> */ + font-weight: normal; /* regular <p> or in the index */ + font-variant:normal; + text-indent: 0em; text-align:right; + color: silver; + background-color: inherit; + } +span[title].pagenum:after { + content: "[" attr(title) "] "; + } +a[name] { position:absolute; } /* Fix Opera bug */ + +/* HEADINGS ETC */ +p.title {text-align:center; + font-weight:bold; + text-indent:0; + } +small { font-size:80%;} +h1,h2,h3,h4,h5 { + text-align: center; + clear: both; + } +h4 { font-variant: small-caps; + font-size:120%; + margin-bottom:0.5em; } +h5 { font-size:100%; + font-weight:normal; + margin-bottom:0; + } +div.titlepage {border:2px solid black;} +.titlepage h3 { margin-top:3em; margin-bottom: 3em; + } +hr.front {width:8em; + margin:0.5em auto 0.5em auto; + height:1px; + color:black; + background-color:black; + } +hr { margin-left: auto; margin-right: auto; + clear: both; + } +hr.major { width:75%; margin-top:2em; margin-bottom: 2em;} +hr.minor { width:30%; margin-top:0.5em; margin-bottom: 0.5em;} + +/* STYLES */ +.center { text-align: center; text-indent:0; + margin-right:auto; margin-left:auto; +} +.smcap {font-variant:small-caps;} +.allsc {text-transform:lowercase; font-variant:small-caps;} +.normal {font-variant:normal;} +.sf {font-family:sans-serif, serif;} +.ads {font-weight:bold; + text-align:center; text-indent:0; + line-height:1.5em; + margin:0.5em 25% 0.5em 25%; + } +/* TRANSNOTES */ +ins.correction { text-decoration:none; + border-bottom: thin dotted gray; } +.transnote {background-color: #E6E6FA; + color: black; + font-size:smaller; + padding:0.5em; + margin-bottom:5em; + font-family:sans-serif, serif; + } + +/* LISTS */ +ol, ul, dl {margin-top:0; } +ol { margin-bottom:0; + list-style-position:inside; margin-left:0; } +body > ul, ul.IX, td ul, .toc ul { list-style-type:none; + margin-bottom:0; } + body > ul.IX {margin-left:10%; + font-size:90%;} +li, dt { margin-top: 0; + line-height: 1.3em; } +dl.toc {margin-left:10%; width:80%; + position:relative; + } +.toc dt{font-variant:small-caps;} +.diagram dl {margin-left:2em; + margin-top:0;} +.diagram dd {text-indent:-2em; margin-left:4em;} +span.ralign { position: absolute; + right: 0; + top: auto; } +ul.adlist p {margin-left:2em; + font-size:smaller; + margin-top:0; + } +/* TABLES */ +body > table {margin-left: 2em;} +td { vertical-align:middle;} +body > table td {padding-top:0; padding-bottom:0; line-height:1.3; } +th { font-weight:normal; vertical-align:top;} +table.az { margin-left:15%; width:70%; + margin-bottom:2em; + border-collapse:collapse; + } +table.az td {text-align:center;} +.diagram table td {padding:0;} +table.spaced{ margin-top:0.5em;margin-bottom:0.5em; } +table.spaced td {padding-right:4em; + vertical-align:top; + font-size:90%; } +.tdc { text-align:center; } +.tdr { text-align:right; padding-right:0.5em;} + // --> + /* XML end ]]>*/ + </style> + </head> +<body> + + +<pre> + +Project Gutenberg's Applied Psychology for Nurses, by Mary F. Porter + +This eBook is for the use of anyone anywhere at no cost and with +almost no restrictions whatsoever. You may copy it, give it away or +re-use it under the terms of the Project Gutenberg License included +with this eBook or online at www.gutenberg.org + + +Title: Applied Psychology for Nurses + +Author: Mary F. Porter + +Release Date: July 16, 2006 [EBook #18843] + +Language: English + +Character set encoding: ISO-8859-1 + +*** START OF THIS PROJECT GUTENBERG EBOOK APPLIED PSYCHOLOGY FOR NURSES *** + + + + +Produced by Alicia Williams, Laura Wisewell and the Online +Distributed Proofreading Team at http://www.pgdp.net + + + + + + +</pre> + + +<div class="transnote"> +<p><b>Transcriber’s Note:</b> A number of printer errors have been corrected. These are marked with mouse-hovers <ins class="correction" title="A description of the error.">like this</ins>, and also listed <a href="#errors">at the end</a>. The two diagrams on pages <a href="#Page_50">50</a> and <a href="#Page_96">96</a> were originally rendered using very large curly brackets. In this version, nested lists have been used, but links to images from the original are provided.</p> +</div> + +<div class="titlepage"> +<h1><span class="pagenum" title="Page 1"> </span><a name="Page_1" id="Page_1"></a>Applied Psychology<br /> +for Nurses</h1> + +<h3>By +<br /> +Mary F. Porter, A. B. +<br /> +<small><i>Graduate Nurse; Teacher of Applied Psychology,<br /> +Highland Hospital, Asheville, N. C.</i></small></h3> +<p class="title"> +Philadelphia and London<br /> +W. B. Saunders Company<br /> +1921<br /> +</p> +</div> + + +<hr class="front" style="margin-top:4em;" /> +<p class="title"><span class="pagenum" title="Page 2"> </span><a name="Page_2" id="Page_2"></a>Copyright, 1921, by W. B. Saunders Company</p> +<hr class="front" /> +<hr class="front" style="margin-top:8em;" /> +<p class="title sf"> +PRINTED IN AMERICA</p> +<hr class="front" /> +<p class="title sf"> +PRESS OF<br /> +W. B. SAUNDERS COMPANY<br /> +PHILADELPHIA<br /> +</p> + + + + +<p class="title" style="margin:8em;"><span class="pagenum" title="Page 3"> </span><a name="Page_3" id="Page_3"></a> +TO THE MEMORY OF<br /> +MY FATHER<br /> +<span class="pagenum" title="Page 4"> </span><a name="Page_4" id="Page_4"></a></p> + + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 5"> </span><a name="Page_5" id="Page_5"></a>FOREWORD</h2> + + +<p>This little book is the outgrowth of a conviction, strengthened by some +years of experience with hundreds of supposedly normal young people in +schools and colleges, confirmed by my years of training in a +neurological hospital and months of work in a big city general hospital, +that it is of little value to help some people back to physical health +if they are to carry with them through a prolonged life the miseries of +a sick attitude. As nurses I believe it is our privilege and our duty to +work for health of body and health of mind as inseparable. Experience +has proved that too often the physically ill patient (hitherto nervously +well) returns from hospital care addicted to the illness-accepting +attitude for which the nurse must be held responsible.</p> + +<p>I conceive of it as possible that every well trained nurse in our +country shall consider it an essential to her professional success to +leave her patient imbued with the will to health and better equipped to +attain it because the sick attitude has been averted, or if already +present, has been treated as really and intelligently as the sick body. +To this end I have dealt with the simple principles of psychology only +as the nurse can immediately apply them.</p> + +<p><span class="pagenum" title="Page 6"> </span><a name="Page_6" id="Page_6"></a>The writer wishes to acknowledge her indebtedness for criticism of this +work and for several definitions better than her own, in the chapters +<i>The Normal Mind</i> and <i>Variations From Normal Mental Processes</i>, to +Dr. Robert S. Carroll, who through the years of hospital training helped +her to translate her collegiate psychology from fascinating abstract +principles into the sustaining bread of daily life.</p> + +<p style="text-align:right;"> +<span class="smcap">Mary F. Porter.</span></p> +<p style="text-indent:-1.5em; margin-left:3em;"><span class="smcap">Asheville, N. C.</span>,<br /> +<i>August, 1921</i>.<br /> +</p> + +<hr class="major" /> +<h2><span class="pagenum" title="Page 7"> </span><a name="Page_7" id="Page_7"></a><a name="CONTENTS" id="CONTENTS"></a>CONTENTS</h2> + + +<dl class="toc"><dt><span class="ralign allsc">PAGE</span></dt></dl> +<h5>CHAPTER I</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_I">What is Psychology?</a> <span class="ralign normal"><a href="#Page_11">11</a></span></dt> +</dl> + +<h5>CHAPTER II</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_II">Consciousness</a> <span class="ralign normal"><a href="#Page_20">20</a></span></dt> + +<dd><a href="#The_Unconscious">The Unconscious</a> <span class="ralign"><a href="#Page_23">23</a></span> </dd> +<dd><a href="#Consciousness_is_Complex">Consciousness is Complex</a> <span class="ralign"><a href="#Page_29">29</a></span> </dd> +<dd><a href="#Consciousness_in_Sleep">Consciousness in Sleep</a> <span class="ralign"><a href="#Page_31">31</a></span> </dd> +<dd><a href="#Consciousness_in_Delirium">Consciousness in Delirium</a> <span class="ralign"><a href="#Page_32">32</a></span> </dd> +</dl> + +<h5>CHAPTER III</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_III">Organs of Consciousness</a> <span class="ralign normal"><a href="#Page_34">34</a></span></dt> + +<dd><a href="#The_Central_and_Peripheral_Nervous_Systems_in_Action">The Central and Peripheral Nervous Systems in Action</a> <span class="ralign"><a href="#Page_35">35</a></span> </dd> +<dd><a href="#The_Sympathetic_Nervous_System">The Sympathetic Nervous System</a> <span class="ralign"><a href="#Page_37">37</a></span> </dd> +</dl> + +<h5>CHAPTER IV</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_IV">Relation of Mind and Body</a> <span class="ralign normal"><a href="#Page_40">40</a></span></dt> + +<dd><a href="#The_Cerebrum_or_Forebrain">The Cerebrum or Forebrain</a> <span class="ralign"><a href="#Page_43">43</a></span> </dd> +</dl> + +<h5>CHAPTER V</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_V">The Normal Mind</a> <span class="ralign normal"><a href="#Page_47">47</a></span></dt> +</dl> + +<h5>CHAPTER VI</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_VI">The Normal Mind (<span style="font-variant:normal;">Continued</span>)</a> <span class="ralign normal"><a href="#Page_59">59</a></span></dt> + +<dd><a href="#Instinct">Instinct</a> <span class="ralign"><a href="#Page_59">59</a></span> </dd> +<dd><a href="#Memory">Memory</a> <span class="ralign"><a href="#Page_62">62</a></span> </dd> +<dd><a href="#The_Place_of_Emotion">The Place of Emotion</a> <span class="ralign"><a href="#Page_67">67</a></span> </dd> +<dd><a href="#The_Beginning_of_Reason">The Beginning of Reason</a> <span class="ralign"><a href="#Page_69">69</a></span> </dd> +<dd><a href="#Development_of_Reason_and_Will">Development of Reason and Will</a> <span class="ralign"><a href="#Page_71">71</a></span> </dd> +<dd><a href="#Judgment">Judgment</a> <span class="ralign"><a href="#Page_72">72</a></span> </dd> +<dd><a href="#Reaction_Proportioned_to_Stimuli">Reaction Proportioned to Stimuli</a> <span class="ralign"><a href="#Page_75">75</a></span> </dd> +<dd><a href="#Normal_Emotional_Reactions">Normal Emotional Reactions</a> <span class="ralign"><a href="#Page_77">77</a></span> </dd> +<dd><a href="#The_Normal_Mind">The Normal Mind</a> <span class="ralign"><a href="#Page_77">77</a></span> </dd> +</dl> + + +<h5><span class="pagenum" title="Page 8"> </span><a name="Page_8" id="Page_8"></a>CHAPTER VII</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_VII">Psychology and Health</a> <span class="ralign normal"><a href="#Page_79">79</a></span></dt> + +<dd><a href="#Necessity_of_Adaptability">Necessity of Adaptability</a> <span class="ralign"><a href="#Page_80">80</a></span> </dd> +<dd><a href="#The_Power_of_Suggestion">The Power of Suggestion</a> <span class="ralign"><a href="#Page_84">84</a></span> </dd> +<dd><a href="#One_Thought_Can_Be_Replaced_by_Another">One Thought Can Be Replaced by Another</a> <span class="ralign"><a href="#Page_89">89</a></span> </dd> +<dd><a href="#Habit_is_a_Conserver_of_Effort">Habit is a Conserver of Effort</a> <span class="ralign"><a href="#Page_90">90</a></span> </dd> +<dd><a href="#The_Saving_Power_of_Will">The Saving Power of Will</a> <span class="ralign"><a href="#Page_93">93</a></span> </dd> +</dl> + +<h5>CHAPTER VIII</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_VIII">Variations from Normal Mental Processes</a> <span class="ralign normal"><a href="#Page_95">95</a></span></dt> + +<dd><a href="#Disorders_and_Perversions">Disorders and Perversions</a> <span class="ralign"><a href="#Page_95">95</a></span> </dd> +</dl> + +<h5>CHAPTER IX</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_IX">Variations from Normal Mental Processes (<span style="font-variant:normal;">Continued</span>)</a> <span class="ralign normal"><a href="#Page_101">101</a></span></dt> + +<dd><a href="#Factors_Causing_Variations_from_Normal_Mental_Processes">Factors Causing Variations from Normal Mental Processes</a> <span class="ralign"><a href="#Page_108">108</a></span> </dd> +<dd><ul> +<li><a href="#Heredity">Heredity</a> <span class="ralign"><a href="#Page_108">108</a></span></li> +<li><a href="#Environment">Environment</a> <span class="ralign"><a href="#Page_109">109</a></span></li> +<li><a href="#Personal_Reactions">Personal Reactions</a> <span class="ralign"><a href="#Page_110">110</a></span></li> +</ul> +</dd></dl> + +<h5>CHAPTER X</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_X">Attention the Root of Disease or Health Attitude</a> <span class="ralign normal"><a href="#Page_112">112</a></span></dt> + +<dd><a href="#The_Attention_of_Interest">The Attention of Interest</a> <span class="ralign"><a href="#Page_112">112</a></span> </dd> +<dd><a href="#The_Attention_of_Reason_and_Will">The Attention of Reason and Will</a> <span class="ralign"><a href="#Page_118">118</a></span> </dd> +</dl> + +<h5>CHAPTER XI</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_XI">Getting the Patient’s Point of View</a> <span class="ralign normal"><a href="#Page_124">124</a></span></dt> + +<dd><a href="#What_Determines_the_Point_of_View">What Determines the Point of View</a> <span class="ralign"><a href="#Page_124">124</a></span> </dd> +<dd><a href="#Getting_the_Other_Mans_Point_of_View">Getting the Other Man’s Point of View</a> <span class="ralign"><a href="#Page_126">126</a></span> </dd> +<dd><a href="#The_Deluded_Patient">The Deluded Patient</a> <span class="ralign"><a href="#Page_133">133</a></span> </dd> +<dd><a href="#Nursing_the_Deluded_Patient">Nursing the Deluded Patient</a> <span class="ralign"><a href="#Page_135">135</a></span> </dd> +<dd><a href="#The_Obsessed_Patient">The Obsessed Patient</a> <span class="ralign"><a href="#Page_136">136</a></span> </dd> +<dd><a href="#The_Mind_a_Prey_to_False_Associations">The Mind a Prey to False Associations</a> <span class="ralign"><a href="#Page_137">137</a></span> </dd> +</dl> + +<h5>CHAPTER XII</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_XII">The Psychology of the Nurse</a> <span class="ralign normal"><a href="#Page_139">139</a></span></dt> + +<dd><a href="#Accuracy_of_Perception">Accuracy of Perception</a> <span class="ralign"><a href="#Page_141">141</a></span> </dd> +<dd><a href="#Training_Perception">Training Perception</a> <span class="ralign"><a href="#Page_142">142</a></span> </dd> +<dd><a href="#Association_of_Ideas">Association of Ideas</a> <span class="ralign"><a href="#Page_143">143</a></span> </dd> +<dd><a href="#Concentration">Concentration</a> <span class="ralign"><a href="#Page_146">146</a></span> </dd> +<dd><a href="#Self-training_in_Memory">Self-training in Memory</a> <span class="ralign"><a href="#Page_150">150</a></span> </dd> +</dl> + + +<h5><span class="pagenum" title="Page 9"> </span><a name="Page_9" id="Page_9"></a>CHAPTER XIII</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_XIII">The Psychology of the Nurse (<span style="font-variant:normal;">Continued</span>)</a> <span class="ralign normal"><a href="#Page_152">152</a></span></dt> + +<dd><a href="#Emotional_Equilibrium">Emotional Equilibrium</a> <span class="ralign"><a href="#Page_152">152</a></span> </dd> +<dd><a href="#Self-correction">Self-correction</a> <span class="ralign"><a href="#Page_160">160</a></span> </dd> +<dd><a href="#Training_the_Will">Training the Will</a> <span class="ralign"><a href="#Page_161">161</a></span> </dd> +</dl> + +<h5>CHAPTER XIV</h5> +<dl class="toc"> +<dt><a href="#CHAPTER_XIV">The Nurse of the Future</a> <span class="ralign normal"><a href="#Page_164">164</a></span></dt> +</dl> + +<hr class="front" /> +<dl class="toc"> +<dt><a href="#INDEX">Index</a> <span class="ralign normal"><a href="#Page_169">169</a></span></dt> +</dl> + +<p><span class="pagenum" title="Page 10"> </span><a name="Page_10" id="Page_10"></a></p> + + +<hr class="major" /> +<h1><span class="pagenum" title="Page 11"> </span><a name="Page_11" id="Page_11"></a>Applied Psychology for Nurses</h1> +<hr class="major" /> + + +<h2><a name="CHAPTER_I" id="CHAPTER_I"></a>CHAPTER I +<br /> +WHAT IS PSYCHOLOGY?</h2> + + +<p>Wise men study the sciences which deal with the origins and development +of animal life, with the structure of the cells, with the effect of +various diseases upon the tissues and fluids of the body; they study the +causes of the reactions of the body cells to disease germs, and search +for the origin and means of extermination of these enemies to health. +They study the laws of physical well-being. They seek for the chemical +principles governing the reactions of digestive fluids to the foods they +must transform into heat and energy. So the doctor learns to combat +disease with science, and at the same time to apply scientific laws of +health that he may fortify the human body against the invasion of +harmful germs. Thus, eventually, he makes medicine itself less +necessary.</p> + +<p>But another science must walk hand in hand today with that of medicine; +for doctors and nurses are realizing as never before the power of mind +over body, and the hopelessness of trying to cure the one without<span class="pagenum" title="Page 12"> </span><a name="Page_12" id="Page_12"></a> +considering the other. Hence psychology has come into her own as a +recognized science of the mind, just as biology, histology, chemistry, +pathology, and medicine are recognized sciences governing the body. As +these are concerned with the “how” and “why” of life, and of the body +reactions, so psychology is concerned with the “how” and “why” of +conduct and of thinking. For as truly as every infectious disease is +caused by a definite germ, just as truly has every action of man its +adequate explanation, and every thought its definite origin. As we would +know the laws of the sciences governing man’s physical well-being that +we might have body health, so we would know the laws of the mind and of +its response to its world in order to attain and hold fast to mind +health. Experience with patients soon proves to us nurses that the weal +and woe of the one vitally affects the other.</p> + +<p>“Psychology is the science of mental life, both of its phenomena and +their conditions.”</p> + +<p>So William James took up the burden of proof some thirty years ago, and +assured a doubting world of men and women that there were laws in the +realm of mind as certain and dependable as those applying to the world +of matter—men and women who were not at all sure they had any right to +get near enough the center of things to see the wheels go round. But +today thousands of people are trying to find out something of the way +the mind is conceived, and to understand its workings.<span class="pagenum" title="Page 13"> </span><a name="Page_13" id="Page_13"></a> And many of us +have in our impatient, hasty investigation, self-analytically taken our +mental machines all to pieces and are trying effortfully to put them +together again. Some of us have made a pretty bad mess of it, for we +tore out the screws and pulled apart the adjustments so hastily and +carelessly that we cannot now find how they fit. And millions of other +machines are working wrong because the engineers do not know how to keep +them in order, put them in repair, or even what levers operate them. So +books must be written—books of directions.</p> + +<p>If you can glibly recite the definition above, know and explain the +meaning of “mental life,” describe “its phenomena and their conditions,” +illustrating from real life; if you can do this, and prove that +psychology is a science, <i>i. e.</i>, an organized system of knowledge on +the workings of the mind—not mere speculation or plausible theory—then +you are a psychologist, and can make your own definitions. Indeed, the +test of the value of a course such as this should be your ability, at +its end, to tell clearly, in a few words of your own, what psychology +is.</p> + +<p>The word <i>science</i> comes from a Latin root, <i>scir</i>, the infinitive form, +<i>scire</i>, meaning to know. So a science is simply the accumulated, tested +knowledge, the proved group of facts about a subject, all that is known +of that subject to date. Hence, if psychology is a <i>science</i>, it is no +longer a thing of guesses or theories, but is a group<span class="pagenum" title="Page 14"> </span><a name="Page_14" id="Page_14"></a>ing of confirmed +facts about the mind, facts proved in the psychology laboratory even as +chemical facts are demonstrated in the chemical laboratory. Wherein +psychology departs from facts which can be proved by actual experience +or by accurate tests, it becomes metaphysics, and is beyond the realm of +science; for metaphysics deals with the realities of the supermind, or +the soul, and its relations to life, and death, and God. Physics, +chemistry, biology have all in their day been merely speculative. They +were bodies of theory which might prove true or might not. When they +<i>worked</i>, by actually being tried out, they became bodies of accepted +facts, and are today called sciences. In the same way the laws of the +working of the mind have been tested, and a body of assured facts about +it has taken its place with other sciences.</p> + +<p>It must be admitted that no psychologist is willing to stop with the +<i>known</i> and <i>proved</i>, but, when he has presented that, dips into the +fascinations of the yet unknown, and works with promising theory, which +tomorrow may prove to be science also. But we will first find what they +have verified, and make that the safe foundation for our own +understanding of ourselves and others.</p> + +<p>What do we mean by “mental life”?—or, we might say, the science of the +life of the mind. And what is <i>mind</i>?</p> + +<p>But let us start our quest by asking first what reasons<span class="pagenum" title="Page 15"> </span><a name="Page_15" id="Page_15"></a> we have for +being sure mind exists. We find the proof of it in consciousness, +although we shall learn later that the activities of the mind may at +times be unconscious. So where consciousness is, we know there is mind; +but where consciousness is not, we must find whether it has been, and is +only temporarily withdrawn, before we say “Mind is not here.” And +<i>consciousness</i> we might call <i>awareness</i>, or our personal recognition +of being—awareness of me, and thee, and it. So we recognize <i>mind</i> by +its evidences of awareness, <i>i. e.</i>, by the body’s reaction to stimuli; +and we find mind at the very dawn of animal life.</p> + +<p>Consciousness is evidenced in the protozoön, the simplest form in which +animal life is known to exist, by what we call its response to stimuli. +The protozoön has a limited power of self-movement, and will accept or +reject certain environments. But while we see that mind expresses itself +in consciousness as vague, as dubious as that of the protozoön, we find +it also as clear, as definite, as far reaching as that of the statesman, +the chemist, the philosopher. Hence, the “phenomena of mental life” +embrace the entire realms of feeling, knowing, willing—not of man +alone, but of all creatures.</p> + +<p>In our study, however, we shall limit ourselves to the psychology of the +human mind, since that concerns us vitally as nurses. Animal psychology, +race psychology, comparative psychology are not within the realm of our +practical needs in hospital life. We would know the<span class="pagenum" title="Page 16"> </span><a name="Page_16" id="Page_16"></a> workings of man’s +mind in disease and health. What are the instinctive responses to fear, +as shown by babies and children and primitive races? What are the normal +expressions of joy, of anger, or desire? What external conditions call +forth these evidences? What are the acquired responses to the things +which originally caused fear, or joy, or anger? How do grown-ups differ +in their reactions to the same stimuli? Why do they differ? Why does one +man walk firmly, with stern, set face, to meet danger? Why does another +quake and run? Why does a third man approach it with a swagger, face it +with a confident, reckless smile of defiance?</p> + +<p>All these are legitimate questions for the psychologist. He will +approach the study of man’s mind by finding how his body acts—that is, +by watching the phenomena of mental life—under various conditions; then +he will seek for the “why” of the action. For we can only conclude what +is in the mind of another by interpreting his expression of his thinking +and feeling. We cannot see within his mind. But experience with +ourselves and others has taught us that certain attitudes of body, +certain shades of countenance, certain gestures, tones of voice, +spontaneous or willed actions, represent anger or joy, impatience or +irritability, stern control or poise of mind. We realize that the +average man has learned to conceal his mental reactions from the casual +observer at will. But if we see him at an unguarded moment, we can very +often get a fair idea of<span class="pagenum" title="Page 17"> </span><a name="Page_17" id="Page_17"></a> his mental attitude. Through these outward +expressions we are able to judge to some extent of the phenomena of his +mental life. But let us list them from our own minds as they occur to us +this work-a-day moment, then, later on, find what elements go to make up +the present consciousness.</p> + +<p>As I turn my thoughts inward at this instant I am aware of these mental +impressions passing in review:</p> + +<p>You nurses for whom I am writing.</p> + +<p>The hospitals you represent.</p> + +<p>What you already know or do not know along these lines.</p> + +<p>A child calling on the street some distance away.</p> + +<p>A brilliant sunshine bringing out the sheen of the green grass.</p> + +<p>The unmelodious call of a flicker in the pine-tree, and a towhee singing +in the distance.</p> + +<p>A whistling wind bending the pines.</p> + +<p>A desire to throw work aside and go for a long tramp.</p> + +<p>A patient moving about overhead (she is supposed to be out for her walk, +and I’m wondering why she is not).</p> + +<p>The face and voice of an old friend whom I was just now called from my +work to see.</p> + +<p>The plan and details of my writing.</p> + +<p>The face and gestures of my old psychology professor and the assembled +class engaged in a tangling metaphysic discussion.</p> + +<p><span class="pagenum" title="Page 18"> </span><a name="Page_18" id="Page_18"></a>A cramped position.</p> + +<p>Some loose hair about my face distracting me.</p> + +<p>An engagement at 7.30.</p> + +<p>A sharp resolve to stop wool-gathering and finish this chapter.</p> + +<p>And yet, until I stopped to examine my consciousness, I was keenly aware +<i>only</i> of the thoughts on psychology I was trying to put on paper.</p> + +<p>But how shall we classify these various contents?</p> + +<p>Some are <i>emotion</i>, <i>i. e.</i>, feelings; others are <i>intellect</i>, <i>i. e.</i>, +thoughts; still others represent <i>determination</i>, <i>i. e.</i>, volition or +will.</p> + +<p>There is nothing in this varied consciousness that will not be included +in one or another of these headings. Let us group the contents for +ourselves.</p> + +<p>The nurses for whom I am writing:</p> + +<p>A result of memory and of imagination (both intellect). A sense of +kinship and interest in them (emotion). A determination that they must +have my best (will, volition).</p> + +<p>And so of the hospitals:</p> + +<p>My memory of hospitals I have known, and my mental picture of yours made +up from piecing together the memories of various ones, the recollection +of the feelings I had in them, etc. (intellect).</p> + +<p>What you already know.</p> + +<p>Speculation (intellect), the speculation based on my knowledge of other +schools (memory which is intellect).<span class="pagenum" title="Page 19"> </span><a name="Page_19" id="Page_19"></a> A desire (emotion) that all nurses +should know psychology.</p> + +<p>Child calling on street.</p> + +<p>Recognition of sound (intellect) and pleasant perception of his voice +(emotion).</p> + +<p>Desire to throw work aside and go for a tramp on this gorgeous day.</p> + +<p>Emotion, restrained by stronger emotion of interest in work at hand, and +<i>intellect</i>, which tells me that this is a work hour—and <i>will</i>, which +orders me to pay attention to duties at hand.</p> + +<p>So all the phenomena of mental life are included in feelings, thoughts, +and volitions which accompany every minute of my waking life, and +probably invade secretly every second of my sleeping life.</p> + +<p>The conditions of mental life—what are they?</p> +<ol> +<li>In man and the higher animals the central nervous system, which, +anatomy teaches us, consists of the brain and spinal cord. (In the +lowest forms of animal life, a diffused nervous system located +throughout the protoplasm.)</li> + +<li>An external world.</li> + +<li>A peripheral nervous system connecting the central nervous system +with the outside world.</li> + +<li>The sympathetic nervous system, provided to assure automatic workings +of the vital functions of the body. These organs of the mind will be +discussed in a later chapter.</li> +</ol> + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 20"> </span><a name="Page_20" id="Page_20"></a><a name="CHAPTER_II" id="CHAPTER_II"></a>CHAPTER II +<br /> +CONSCIOUSNESS</h2> + + +<p>We took a glimpse at random into the mental life of an adult +consciousness, and found it very complicated, constantly changing. We +found it packed with shifting material, which, on the surface, seemed to +bear very little relation. We found reason, feeling, and will all +interacting. We found nothing to indicate that a consciousness as simple +as mere <i>awareness</i> might exist. We believe there might be such in the +newborn babe, perhaps even in the baby a month old; but can we prove it? +Let us look within again and see if there are not times of mere, bare +consciousness in our own experience that give us the proof we need.</p> + +<p>I have slept deeply all night. It is my usual waking time. Something +from within or from without forces an impression upon my mind, and I +stir, and slowly open my eyes. As yet I have really not seen anything. +With my eyes open my mind still sleeps—but in a few seconds comes a +possessing sense of well-being. Obeying some stimulus, not recognized by +the senses as yet, I begin to stretch and yawn, then close my eyes and +settle down into my pillows as for another nap. I am<span class="pagenum" title="Page 21"> </span><a name="Page_21" id="Page_21"></a> not aware that I +am I, that I am awake, that I have yawned and stretched. I have a +pleasant, half-dreamy feeling, but could not give it a name. For those +few seconds this is all my world—a pleasant drowsiness, a being +possessed by comfort. My consciousness is mere awareness—a pleasant +awareness of uncomplicated existence. In another moment or two it is a +consciousness of a day’s work or pleasure ahead, the necessity of +rising, dressing, planning the day, the alert reaction of pleasure or +displeasure to what it is to bring, the effort to recall the dreams of +sleep—the complicated consciousness of the mature man or woman. But I +started the day with a mental condition close to pure sensation, a vague +feeling of something different than what was just before.</p> + +<p>Or this bare consciousness may come in the moment of acute shock, when +the sense of suffering, quite disconnected from its cause, pervades my +entire being; or at the second when I am first “coming back” after a +faint, or at the first stepping out from an anesthetic. In these +experiences most of us can recall a very simple mental content, and can +prove to our own satisfaction that there is such a thing as mere +awareness, a consciousness probably close akin to that of the lower +levels of animal life, or to that of the newborn babe when he first +opens his eyes to life.</p> + +<p><i>Consciousness</i>, then, in its elements, is the simplest mental reaction +to what the senses bring.</p> + +<p><span class="pagenum" title="Page 22"> </span><a name="Page_22" id="Page_22"></a>How shall we determine when consciousness exists? What are its tests?</p> + +<p>The response of the mind to stimuli, made evident by the body’s +reaction, gives the proof of consciousness in man or lower animal.</p> + +<p>But what do we mean by a stimulus?</p> + +<p>Light stimulates me to close my eyes when first entering its glare from +a dark room, or to open them when it plays upon my eyelids as I sleep +and the morning sun reaches me. It is a stimulus from without.</p> + +<p>The fear-thought, which makes my body tremble, my pupils grow wide, and +whitens my cheeks, is a stimulus from within.</p> + +<p>An unexpected shot in the woods near-by, which changes the whole trend +of my thinking and startles me into investigating its cause, is a +stimulus from without causing a change within.</p> + +<p>A <i>stimulus</i>, then, is anything within or without the body that arouses +awareness; and this is usually evidenced by some physical change, +however slight—perhaps only by dilated pupils or an expression of +relief. When we see the reaction of the body to the stimulus we know +there is consciousness. On the other hand, we cannot say that +consciousness is always absent when the usual response does not occur; +for there may be injury to organs accounting for the lack of visible +reaction, while the mind itself may respond. But with due care, in even +such cases, some external symp<span class="pagenum" title="Page 23"> </span><a name="Page_23" id="Page_23"></a>toms of response can usually be found if +consciousness exists.</p> + +<p>We have already realized how complex, intricate, and changing is fully +developed consciousness.</p> + + +<h4><a name="The_Unconscious" id="The_Unconscious"></a>The Unconscious</h4> + +<p>But the mind of man knows two distinct conditions of activity—the +conscious and the unconscious. Mind is not always wide awake. We +recognize what we call the <i>conscious</i> mind as the ruling force in our +lives. But how many things I do without conscious attention; how often I +find myself deep in an unexplainable mood; how the fragrance of a flower +will sometimes turn the tide of a day for me and make me square my +shoulders and go at my task with renewed vigor; or a casual glimpse of a +face in the street turn my attention away from my errand and settle my +mind into a brown study. Usually I am alert enough to control these +errant reactions, but I am keenly aware of their demands upon my mind, +and frequently it is only with conscious effort that I am kept upon my +way unswerved by them, though not unmoved.</p> + +<p>When we realize that nothing that has ever happened in our experience is +forgotten; that nothing once in consciousness altogether drops out, but +is stored away waiting to be used some day—waiting for a voice from the +conscious world to recall it from oblivion—then we grasp the fact that +the quality of present thought or<span class="pagenum" title="Page 24"> </span><a name="Page_24" id="Page_24"></a> reaction is largely determined by the +sum of all past thinking and acting. Just as my body is the result of +the heritage of many ancestors plus the food I give it and the use to +which I subject it, so my mind’s capacity is determined by my +inheritance plus the mental food I give it, plus everything to which I +have subjected it since the day I was born. For it forgets absolutely +nothing.</p> + +<p>“That is not true,” you say, “for I have tried desperately to remember +certain incidents, certain lessons learned—and they are <i>gone</i>. +Moreover, I cannot remember what happened back there in my babyhood.”</p> + +<p>Ah, but you are mistaken, my friend. For you react to your task today +differently because of the thing which you learned and have “forgotten.” +Your mind works differently because of what you disregarded then. “You” +have forgotten it, but your brain-cells, your nerve-cells have not; and +you are not quite the same person you would be without that forgotten +experience, or that pressing stimulus, which you never consciously +recognized, but allowed your subconsciousness to accept. Some night you +have a strange, incomprehensible dream. You cannot find its source, but +it is merely the re-enacting of some past sensation or experience of +your own, fantastically arrayed. Some day you stop short in your hurried +walk with a feeling of compulsion which you cannot resist. You know no +reason for it, but some association with this particular spot, or some +vague<span class="pagenum" title="Page 25"> </span><a name="Page_25" id="Page_25"></a> resemblance, haunts you. You cannot “place” it. One day you hit +the tennis-ball at a little different angle than you planned because a +queer thought came unbidden and directed your attention aside. Again, +under terrific stress, with sick body and aching nerves, you go on and +do your stint almost mechanically. You do not know where the strength or +the skill is derived. But your unconscious or subconscious—as you +will—has asserted itself, has usurped the place of the sick conscious, +and enabled you automatically to go on. For we react to the storehouse +of the unconscious even as we do to the conscious.</p> + +<p>Remember that the unconscious is simply the latent conscious—what once +was conscious and may be again, but is now buried out of sight.</p> + +<p>The mind may be likened to a great sea upon which there are visible a +few islands. The islands represent the conscious thoughts—that +consciousness we use to calculate, to map out our plans, to form our +judgments. This is the mind that for centuries was accepted as all the +mind. But we know that the islands are merely the tops of huge +mountain-ranges formed by the floor of the sea in mighty, permanent +upheaval; that as this sea-floor rises high above its customary level +and thrusts its bulk above the waters into the atmosphere, is the island +possible.</p> + +<p>Just so there can be no consciousness except as that which is already in +the mind—the vast subconscious<span class="pagenum" title="Page 26"> </span><a name="Page_26" id="Page_26"></a> material of all experience—rises into +view and relates itself through the senses to an outside world. We speak +very glibly of motion, of force, of power. We say “The car is moving +now.” But how do we know? Away back there in our babyhood there were +some things that always remained in the same place, while others changed +position. The <i>changing</i> gave our baby minds a queer sensation; it made +a definite impression; and sometimes we heard people say “move,” when +that impression came. Finally, we call the feeling of that change +“move,” or “movement,” or “motion.” The word thereafter always brings to +our minds a picture of a change from one place to another. The +process—the slow comprehending of the baby mind—was buried in +forgetfulness even at the time. But had not the subconscious been +imprinted with the incident and all its succeeding associations, that +particular phenomenon we could not name today. It would be an entirely +unique experience. So our recognition of the impression is merely the +rising into consciousness of the subconscious material in response to a +stimulus from the outside world which appeals through the sense of +sight. We can get no response whatever except as the stimulus asking our +attention is related by “like” or “not like” something already +experienced; that is, it must bear some relation to the known—and +perhaps forgotten—just as the island cannot be, except as, from far +down below, the sea-floor leaves its bed and raises itself through the +deeps.<span class="pagenum" title="Page 27"> </span><a name="Page_27" id="Page_27"></a> The visible island is but a symbol of the submarine mountain. +The present mental impression is but proof of a great bulk of past +experiences.</p> + +<p>And so we might carry on the figure and compare the birth of +consciousness to the instant of appearance of the mountain top above the +water’s surface. It is not a new bit of land. It is only emerging into a +new world.</p> + +<p>“But,” you ask, “do you mean to assert that the baby’s mind is a +finished product at birth; that coming into life is simply the last +stage of its growth? How unconvincing your theory is.”</p> + +<p>No, we only now have the soil for consciousness. The island and the +submarine mountain are different things. The sea-floor is transformed +when it enters into the new element. An entirely different vegetation +takes place on this visible island than took place on the floor of the +sea before it emerged. But the only new elements added to the hitherto +submerged land come from the new atmosphere, and the sea-floor +immediately begins to become a very different thing. Nevertheless, what +it is as an island is now, and forever will be due, primarily, to its +structure as a submarine mountain. In the new atmosphere the soil is +changed, new chemical elements enter in, seeds are brought to it by the +four winds—and it is changed. But it is still the sea-floor +transformed.</p> + +<p>Just so the baby brain, complete in parts and mechanism at birth, is a +different brain with every day of growth in its new environment, with +every contact with the<span class="pagenum" title="Page 28"> </span><a name="Page_28" id="Page_28"></a> external world. But it is, primarily and in its +elements, the brain evolved through thousands of centuries of pushing up +to man’s level through the sea of animal life, and hundreds of centuries +more of the development of man’s brain to its present complete mechanism +through experience with constantly changing environment.</p> + +<p>Hence, when the baby sees light and responds by tightly shutting his +eyes, then later by opening them to investigate, his sensation is what +it is because through the aëons of the past man has established a +certain relation to light through experiencing it. To go further than +this, and to find the very beginning, how the first created life came to +respond to environment at all, is to go beyond the realm of the actually +known. But that he did once <i>first</i> experience his environment, and +establish a reaction that is now racial, we know.</p> + +<p>So our baby soon shows certain “instinctive” reactions. He reaches out +to grasp. He sucks, he cries, he looks at light and bright objects in +preference to dark, he is carrying out the history of his race, but is +making it personal. He has evolved a new life, but all his ancestors +make its foundation. The personal element, added to his heritage, has +made him different from any and all of his forebears. But he can have no +consciousness except as a bit from the vast inherited accumulation of +the past of his ancestors, of all the race, steps forth to meet a new +environment.</p> + +<p><span class="pagenum" title="Page 29"> </span><a name="Page_29" id="Page_29"></a>And again you ask, “How came the first consciousness?”</p> + +<p>And again I answer, “It is as far back as the first created or evolved +organism which could respond in any way to a material world; and only +metaphysics and the God behind metaphysics can say.”</p> + +<p>We only know that careful laboratory work in psychology—experiments on +the unconscious—today prove that our conscious life is what it is, +because of: <i>first</i>, what is stored away in the unconscious (<i>i. e.</i>, +what all our past life and the past life of the race has put there); +<i>second</i>, because of what we have accepted from our environment; and +this comprises our material, intellectual, social, and spiritual +environment.</p> + + +<h4><a name="Consciousness_is_Complex" id="Consciousness_is_Complex"></a>Consciousness is Complex</h4> + +<p>The one fact we want at this stage of our inquiry is simply this: that +consciousness, awaking at birth, very soon becomes complex. However +single and simple in content immediate consciousness may be, it is so +intimately linked with all preceding experience that a pure sensation is +probably never known after the first second of life. As the sensation is +registered it becomes a basis for comparison. That first sensation, +perhaps, was just a feeling of <i>something</i>. The next is a feeling of +something that is the same, or is not the same, as the first. So +immediately perception is established. The baby consciousness recognizes +that the vague feeling is,<span class="pagenum" title="Page 30"> </span><a name="Page_30" id="Page_30"></a> or is not, <i>that same thing</i>. And from +perception to a complex consciousness of perceptions, of ideas, of +memories and relations, and judgments, is so short a step that we cannot +use our measuring rods to span it.</p> + +<p>Thus through the various stages of life, from infancy to maturity, the +conscious is passing into the unconscious, only to help form later a new +conscious thought. Hence the conscious thought is determined by the +great mass of the unconscious, plus the external world.</p> + +<p>But every thought, relegated to the unconscious, through its association +there—for it is plastic by nature—comes back to consciousness never +quite the same, and meets never quite the same stimulus. And as a result +a repeated mental experience is never twice exactly the same. So the +conscious becomes the unconscious and the unconscious the conscious, and +neither can be without the other.</p> + +<p>Our problem is to understand the workings of the mind as it exists +today, and to try to find some of its most constructive uses; and on +that we shall focus attention. To that end we must first examine the +various ways in which consciousness expresses itself.</p> + +<p>We have recognized two distinct mental states—the conscious and the +unconscious—and have found them constantly pressing each on the other’s +domain. Our study of consciousness reveals the normal in the aspects of +sleeping and waking, also various abnormal states. Consciousness may +become excited, depressed, confused,<span class="pagenum" title="Page 31"> </span><a name="Page_31" id="Page_31"></a> delirious, or insane. We shall +consider later some of the mental workings that account for these +abnormal expressions. At present let us examine the mind’s activities in +sleep and in delirium.</p> + + +<h4><a name="Consciousness_in_Sleep" id="Consciousness_in_Sleep"></a>Consciousness in Sleep</h4> + +<p>Sleep seldom, if ever, is a condition of utter unconsciousness. We so +frequently have at least a vague recollection, when we wake, of +dreaming—whether or not we remember the dream material—that we are +inclined to accept sleep as always a state of some kind of mental +activity, though waking so often wipes the slate clean. A new word which +serves our purpose well has come into common use these last years, and +we describe sleep as a state of rest of the conscious mind made possible +as weariness overpowers the <i>censor</i>, and this guard at the gate naps. +The censor is merely that mental activity which forces the mind to keen, +alert, constructive attention during our waking hours, a guard who +<i>censors</i> whatever enters the conscious mind and compares it with +reality, forcing back all that is not of immediate use, or that is +undesirable, or that contradicts established modes of life or thought. +In sleep we might say that the censor, wearied by long vigilance, +presses all the material—constantly surging from the unconscious into +consciousness, there to meet and establish relations with matter—back +into the unconscious realms, and locks the door, and lies and slumbers. +Then the half-<span class="pagenum" title="Page 32"> </span><a name="Page_32" id="Page_32"></a>thoughts, the disregarded material, the unfit, the +unexpressed longings or fears, the forbidden thoughts; in fact, the +whole accumulation of the disregarded or forgotten, good, bad, and +indifferent—for the unconscious has no moral sense—seize their +opportunity. The guard has refused to let them pass. He is now asleep. +And the more insistent of them pick the lock and slip by, masquerading +in false characters, and flit about the realms of the sleeping +consciousness as ghosts in the shelter of darkness. If the guard +half-wakes he sleepily sees only legitimate forms; for the dreams are +well disguised. His waking makes them scurry back, sometimes leaving no +trace of their lawless wanderings. So the unconscious thoughts of the +day have become sleep-consciousness by play acting.</p> + + +<h4><a name="Consciousness_in_Delirium" id="Consciousness_in_Delirium"></a>Consciousness in Delirium</h4> + +<p>At this time of our study it will suffice to say that in delirium and in +insanity, which we might very broadly call a prolonged delirium, the +toxic brain becomes a house in disorder. The censor is sick, and +sequence and coherence are lost as the thronging thoughts of the +unconscious mind press beyond the portals into consciousness, disordered +and confused. We shall later find, however, that this very disorder +falls into a sort of order of its own, and a dominant emotion of pain or +<ins class="correction" title="Transcriber’s note: Original read ‘ecstacy’.">ecstasy</ins>, of depression or fear, of exaltation or depreciation calls +steadily upon the stored away incidents and<span class="pagenum" title="Page 33"> </span><a name="Page_33" id="Page_33"></a> remembered, related +feelings of the past and interprets them as present reality. The censor +of the sick brain is stupefied by toxins, shock, or exhaustion, and the +citadel he is supposed to guard is thronged with besiegers from every +side. The strongest—<i>i. e.</i>, those equipped with most associations +pertinent to the emotional status at the time—win out, occupy the brain +by force, and demand recognition and expression from all the senses, +deluding them by their guise of the reality of external matter.</p> + +<p>We find consciousness, then, determined by all past experience, by an +external world, and by its organ of expression—the <i>brain</i>.</p> + +<p>Consequently, our psychology leads us into anatomy and physiology, +which, probably, we have already fairly mastered. In rapid review, only, +in the following chapter we shall consider the organs of man’s +consciousness, the brain, spinal cord, and the senses, and try to +establish some relation between the material body and its mighty +propelling force—the <i>mind</i>.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 34"> </span><a name="Page_34" id="Page_34"></a><a name="CHAPTER_III" id="CHAPTER_III"></a>CHAPTER III +<br /> +ORGANS OF CONSCIOUSNESS</h2> + + +<p>Nothing is known to us until it has been transmitted to the mind by the +senses. The nerves of special sense, of sight, hearing, smell, taste, +touch, the temperature sense (“hot or cold” sense), the muscular sense +(sense of weight and position), these, and the nerves controlling +voluntary motion, form the peripheral, or surface, nervous system. This +acts as a connecting medium between the outside world and the central +nervous system, which is composed of the brain and spinal cord. We might +liken the nerves, singly, to wires, and all of them together to a system +of wires. The things of the external world tap at the switchboard by +using the organs of special sense; the nerves, acting as wires, transmit +their messages; at the switchboard is the +operator—consciousness—accepting and interpreting the jangle of calls.</p> + +<p>The recognition by the brain of the appeals coming by way of the +transmitting sense, and its interpretation of these appeals, is the +mind’s function of consciousness, whether expressed by thinking, +feeling, or willing.</p> + +<h4><span class="pagenum" title="Page 35"> </span><a name="Page_35" id="Page_35"></a><a name="The_Central_and_Peripheral_Nervous_Systems_in_Action" id="The_Central_and_Peripheral_Nervous_Systems_in_Action"></a>The Central and Peripheral Nervous Systems in Action</h4> + +<p>I am passing the open door of a bake-shop, and a pervading odor fills +the air. I think “hot rolls,” because my organ of smell—the nose—has +received a stimulus which it transmits along my olfactory nerves to the +brain; and there the odor is given a name—“hot rolls.” The recognition +of the stimulus as an odor and of that odor as “hot rolls” is +consciousness in the form of thinking. But the odor arouses desire to +eat—hunger; and this is consciousness in the form of feeling. The +something which makes me walk into the shop and buy the rolls is +consciousness in the form of willing. The sensory appeal from the +outside world gained admission through the sense of smell; this +transmitted the message, and consciousness recognized the stimulus, +which immediately appealed to my hunger and incited action to satisfy +that hunger.</p> + +<p>The ear of the operator in the telegraph office, again, might illustrate +consciousness. It must be able to interpret mere clickings into terms of +sense. To the operator the sounds say words, and the words are the +expression of the object at the other end of the wire. The brain is the +receiving operator for all the senses, which bring their messages in +code, and which it interprets first as sound, vision, taste, touch, +feel, smell, temperature; then more accurately as words, trees, sweet, +soft, round, acrid, hot.</p> + +<p><span class="pagenum" title="Page 36"> </span><a name="Page_36" id="Page_36"></a>The mind can know nothing except as the stimulus is transmitted by +sense-channels over the nerves of sense, and received by a conscious +brain. A baby born without sight, hearing, taste, smell, or touch would +remain a mere bit of clay. He could have no awareness. But so long as +any one sense channel remains open the mind may acquire some knowledge.</p> + +<p>Suppose I am paralyzed, blind, and deaf, and you put a tennis-ball into +my hand. I cannot tell you what it is, not even what it is like. It +means nothing whatever to me, for the sense channels of touch, sight, +and hearing, through which alone it could be impressed upon my brain, +are gone. Suppose I am blind and deaf, but have my sense of touch +intact; that I never saw or touched or heard of a tennis-ball before, +but I know “apple” and “orange.” I can judge that the object is round, +that it is about the size of a small orange or apple. It is very light, +and has a feel of cloth. I know it to be something new in my experience. +You tell me in the language of touch that it is “tennis-ball”; and +thereafter I recognize it by its combination of size, feel, and weight, +and can soon name it as quickly as you, who see it.</p> + +<p>Suppose I am blind and my hands are paralyzed, but I have my hearing. +You tell me this is a tennis-ball, and if I have known “tennis-ball” in +the past, I can describe it to you. It has been impressed upon my brain +through my sense of hearing; and memory im<span class="pagenum" title="Page 37"> </span><a name="Page_37" id="Page_37"></a>mediately supplies the +qualities that go with “tennis-ball.”</p> + +<p>But if none of the senses has ever developed, my brain can receive no +impression whatever; it cannot have even the stimulus of memory. Hence +conscious mind cannot be, except as some sense-channel or channels have +been opened to carry thought material to the brain. So far as we know +today, in this world, mind is absolutely dependent upon the sense organs +and the brain—upon matter—for existence.</p> + + +<h4><a name="The_Sympathetic_Nervous_System" id="The_Sympathetic_Nervous_System"></a>The Sympathetic Nervous System</h4> + +<p>Associated with the central nervous system by connecting nerves—but +located outside of it in various parts of the body—are groups of +nerve-cells (gray matter) and their fibers, forming what we call the +<i>sympathetic nervous system</i>—the direct connecting link between mind +and body.</p> + +<p>The <i>central nervous system</i> is the director of all conscious action of +the body; the <i>sympathetic</i> orders all unconscious action.</p> + +<p>The beating of the heart, the contraction of the blood-vessels, hence +the flowing of the blood, the processes of digestion, the functioning of +the glands, are all directed by the sympathetic. In other words, the +<i>central nervous system</i> normally controls the movements of the +voluntary muscles; the <i>sympathetic</i> controls those of the involuntary +muscles.</p> + +<p><span class="pagenum" title="Page 38"> </span><a name="Page_38" id="Page_38"></a>The quick blush, the sudden paling of the cheeks, the start of fear, the +dilated pupils of fright are the direct result of the action of +involuntary muscles under control of the sympathetic system. The +stimulus is received by the central nervous system; the fibers +connecting the central and the sympathetic systems carry the message +quickly to the latter, which immediately respond by ordering contraction +or expansion of involuntary muscles. So tears flow, we breathe freely +again or we quake and tremble, our pupils widen or contract, the heart +beats suffocatingly, or seems almost to stop.</p> + +<p>The <i>sympathetic system</i>, as the name implies, is influenced by +suggestions from the emotions rather than from the intellect. We might +say that it is controlled by the “feeling mind” rather than the thinking +mind, for intellect cannot influence it in the least.</p> + +<p>The wise nurse, who knows something of the laws of the mind, soon +realizes that the <i>sympathetic nervous system</i>, rather than physical +disability, causes many indigestions, headaches, diarrheas, dry mouths, +chills; is responsible for much nausea, much “exhaustion,” etc. When she +has had wider experience she finds that almost any known physical +disorder can be unconsciously imitated by the suggestible patient, whose +sympathetic nervous system causes physical reactions to respond to the +feelings of a sick mind. Let the nurse remember, however, that is it not +for her to decide<span class="pagenum" title="Page 39"> </span><a name="Page_39" id="Page_39"></a> whether the disorders from which her patient suffers +are of physical or nervous origin. It is for her, on the other hand, to +study her patient’s mentality and reactions, and to become expert in +reporting symptoms of nervous as well as of physical significance.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 40"> </span><a name="Page_40" id="Page_40"></a><a name="CHAPTER_IV" id="CHAPTER_IV"></a>CHAPTER IV +<br /> +RELATION OF MIND AND BODY</h2> + + +<p>We have found that mind is entirely dependent upon the bodily organs for +its existence. Is the body in the same way dependent upon the mind? Can +the mind die and the body go on?</p> + +<p>Given a perfect body with unblocked sense channels, and put the mind to +sleep, paralyze the <i>central nervous system</i> with alcohol in sufficient +quantity so that the undamaged <i>peripheral nervous system</i>—the +senses—can obtain no response or recognition from it, and that perfect +body is as useless for the time as if dead. But here comes proof of the +remarkable hold of the body on life. The unconscious mind takes up the +burden of directing the sympathetic nerves to stimulate the muscles of +breathing. The unconscious sees to the beating of the heart. It directs +the contraction of the blood-carrying vessels. It maintains certain +vital processes of secretion. Thus automatically life goes on; the body +still reacts to a limited field of stimuli, and consciousness recognizes +it not. But when the unconscious mind ceases to function, then, indeed, +does the body die. Yet the conscious mind may “die” and the body live +on, so long as the unconscious continues its activity.</p> + +<p><span class="pagenum" title="Page 41"> </span><a name="Page_41" id="Page_41"></a>It is possible for the human body to live for years, utterly paralyzed, +with many of the senses gone, with no consciousness of being—if cared +for by other persons—a merely vegetable existence. The current of power +is broken; but the spark is still glowing, though utterly useless +because connected with nothing. And it may continue to glow for some +time while properly stimulated from outside sources.</p> + +<p>We might liken the mind to the boiler in which steam is generated, and +the body to the engine which the steam runs. If the boiler bursts, the +engine stops; but it may not be otherwise damaged. It simply cannot +carry out its main function of motion any longer. The fires under the +boiler are still burning and can be kept burning so long as fuel is +provided, but the connection is broken and the great bulk of iron is a +useless thing in that it can no longer fulfil its purpose.</p> + +<p>In just such a way may the mind be paralyzed; but the spark of life, +which has through all the years kindled the now lost mind to action, may +still remain—a useless thing, which would die away if not tended from +without by other bodies whose minds are still intact.</p> + +<p>But in the demented mind consciousness still remains, the awareness of +the young child or baby stage of life. The connection between the upper +or conscious brain centers and the body has been tampered with; it no +longer is direct, but breaks off into switch-lines. But the contact +still holds between the lower or unconscious<span class="pagenum" title="Page 42"> </span><a name="Page_42" id="Page_42"></a> mind and the body; so the +automatic body functions go on, directed as they were in babyhood before +the independent mind assumed control. Hence, when all acute +consciousness is finally gone, the unconscious mind, a perfect +automaton, may still carry out the simplest vegetative activities of +existence.</p> + +<p>When body is dead, mind, so far as its reactions to the world we know +are concerned, ceases to act. But when the conscious mind is “dead” the +body may yet live as a vegetable lives, with all its distinctively human +functions lost. Motionless, save for the beating of the heart and the +reaction of the lungs to air, the body may still be alive, though the +mind long since has ceased all earthly activity.</p> + +<p>So we discover that an organ of mind is an essential, here, to life of +mind, and that mind only can induce this organ to any action above the +vegetative stage. But, on the other hand, we find that life can exist +without conscious mind, even if untended by others, for a limited time.</p> + +<p>If the direct nerve connections between the brain and the hand, the +brain and the foot, or the brain and the trunk are cut off, the mind +henceforth realizes nothing of that part except as the sense of sight +reports upon it; for the optic nerves relate the hand and mind, through +this sense, as truly as the motor nerves which carry the mind’s message +for motion to the hand, and the sensory nerves which carry back to the +mind the hand’s pain.<span class="pagenum" title="Page 43"> </span><a name="Page_43" id="Page_43"></a> But let the optic nerve be inert, the sensory and +motor connections broken between brain and hand, or foot and trunk, or +brain and trunk, and the hand or foot may be amputated and the mind +never sense the fact; the trunk may be severely injured and the mind be +serenely unconscious. So the brain in man is “the one immediate bodily +condition of the mental operations.” Take away all the brain and man’s +body is a useless mass of protoplasm.</p> + +<p>The brain’s varied and intricate nerve connections with all parts of the +body, through nerves branching from the main trunks in the spinal cord, +we shall not discuss, for you know them through your study of anatomy. +For the purpose of our psychology we need consider only two of the main +divisions of the brain—the <i>cerebrum</i>, which includes what we call the +right and left hemispheres, and the <i>cerebellum</i>.</p> + + +<h4><a name="The_Cerebrum_or_Forebrain" id="The_Cerebrum_or_Forebrain"></a>The Cerebrum or Forebrain</h4> + +<p>For convenience the various lobes of the cerebrum are known as frontal, +temporal, parietal, and occipital, according to the parts of the brain +referred to: as forehead, temples, crown, or occiput. The cerebellum, or +hind brain, is also divided into two hemispheres, and is situated behind +and below the hemispheres of the cerebrum.</p> + +<p>A system of localization has been roughly mapped out, the result of +careful laboratory work on animals<span class="pagenum" title="Page 44"> </span><a name="Page_44" id="Page_44"></a> and of studying the loss of various +functions in human beings as related to the location of brain injuries.</p> + +<p>From these experiments it seems proved that consciousness belongs only +to the cortex or surface of the upper brain, and that the vast realm of +the unconscious belongs to the lower brain centers. Hence the cortex is +the organ of consciousness, and the lower centers are the repository of +the unconscious until it again becomes conscious.</p> + +<p>The motor zone of the cortex we now know to be situated in the +convolutions bordering the fissure of Rolando. Vision is evidently +excited from the occipital lobes, though not yet conclusively proved. +Smell, presumably, is located in the temporal lobes. Considered action +is directed from the upper hemispheres only. It is significant that the +hemispheres of the cerebrum are also accepted as the seat of memory for +man—that intellectual quality which makes him capable of acting from +absent stimuli, stimuli only present to memory; which makes it possible +for him to reason the present from the experiences of the past.</p> + +<p>But in all animal life, except the higher forms, the control of action +is from the lower brain centers, centers which respond only to present +objects. With them memory, as man knows it, is lacking; but the +reactions of the past are indelibly imprinted upon motor nerves and +muscles, so that when the present object presses the<span class="pagenum" title="Page 45"> </span><a name="Page_45" id="Page_45"></a> button, as it +were, calling forth the experience of the race, the animal instinctively +reacts.</p> + +<p>But of what use to man, then, are the lower brain centers?</p> + +<p>In man, as in lower animals, they care for the vegetative functions of +life, so that our blood continues to circulate, the air enters and +leaves our lungs, digestion is carried on, with no assistance from the +upper centers, the hemispheres of the cerebrum being thus left free for +concentration on the external world of matter, which it can transform +into a world of thought.</p> + +<p>It is the lower or vegetative brain that may still exist and keep life +intact when the functions of the cerebrum are destroyed. We can say, +then, of the brain as a whole that it is the organ of the mind, the +<i>sine qua non</i> of the mind, the apparatus for the registration of sense +impressions. The senses themselves are the rudiments of mind, are the +means by which stimuli alighting on sense organs enter consciousness; +for the nerves of special sense immediately carry the impetus to the +brain, where it is recognized as the “not me,” the <i>something</i> +definitely affecting the <i>me</i>, and demanding reaction from the <i>me</i>.</p> + +<p>The functions of the cerebrum we find grouping themselves in three +classes: <i>intellect</i>, <i>emotion</i>, and <i>volition</i>, more simply, thinking, +feeling, and willing; and we find no mental activity of the normal or +abnormal mind which will not fall into one of these groupings.<span class="pagenum" title="Page 46"> </span><a name="Page_46" id="Page_46"></a> This +does not mean that one part of the brain thinks, another part wills, +another part feels; for in the performance of any one of these functions +the mind acts as a whole. Our thinking or our willing may be permeated +with feeling, but the entire mind is simply reacting simultaneously upon +various stimuli.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 47"> </span><a name="Page_47" id="Page_47"></a><a name="CHAPTER_V" id="CHAPTER_V"></a>CHAPTER V +<br /> +THE NORMAL MIND</h2> + + +<p>Mind, we found, is born in the form of consciousness when the outside +world impresses itself upon the brain-cells by way of the senses. This +consciousness, observation and experiment prove, is first a feeling one, +later a feeling-thinking-willing one. The mind, then, is really the +activity of the brain as it feels, as it thinks, as it wills. We express +this in descriptive terms when we speak of mind as the <i>flow of +consciousness</i>, the sum of all mental associations, conscious and +unconscious. For mind is never a final thing. Looking within at our own +mental processes we find that always our thought is just becoming +something else. We reach a conclusion, but it is not a resting place, +only a starting place for another. My thought was <i>that</i> a moment ago, +but while it was <i>that</i> it was becoming <i>this</i>, and even now it is +becoming something else.</p> + +<p>Thinking is mind. Feeling is mind. Willing is mind. But for the sake of +clearness we speak of feeling, thinking, and willing as being functions +of mind. Mind acts by using these powers. But to what end does it act? +What purpose does it serve? For these functions are not the reasons of +being for the mind, even as motion<span class="pagenum" title="Page 48"> </span><a name="Page_48" id="Page_48"></a>—while the immediate purpose of the +locomotive—is not its chief end. The steam engine may stand in the same +spot while its wheels revolve madly; it may move along the tracks alone, +and accomplish nothing; or it may transport a great train of loaded +cars. Unless it moves to some definite point and carries merchandise or +people there, it is a useless, indeed, a dangerous invention. We find, +in fact, that it functions to the very definite end of taking man and +his chattels to specified places.</p> + +<p>And so it is with the mind. If it is thinking and feeling and willing +only for the sake of exercising these mental powers, it might better not +be. But what end do we actually find these functions serving?</p> + +<p>Mind, with its powers of thinking, feeling, and willing, gives an +external world of matter; an internal world of thought, and so relates +them to each other as to make them serve man’s purposes. Thus these +functions exist for accomplishment.</p> + +<p>In the solving of a problem, for instance, the mind thinks, primarily; +in the enjoyment of music it feels, primarily, though its feeling may be +determined by the intellectual verdict on the music; in forcing its +owner to sit at the piano and practice in the face of strong desire to +attend the theater, it wills, primarily. Now one of its functions +predominates; now another. But the whole mind, not a feeling section, or +a thinking section, or a willing section, operates together to produce +action. When I play the piano it calls on all my mind.<span class="pagenum" title="Page 49"> </span><a name="Page_49" id="Page_49"></a> I think the +music. I feel it. I make my fingers play it. But the thinking, the +feeling, and the willing act together to result in the fingers playing.</p> + +<p>The mind, then, is an instrument of achievement. It fulfils its purpose +when it makes matter serve useful ends.</p> + +<p><i>Emotion</i> or <i>feeling</i> is the function of the mind which associates a +sense of pleasure or pain with every thought or act.</p> + +<p>Feeling is the affective state of mind. By this we mean that it has the +power to move us. And this emotion primarily does; for our feeling of +pleasure or pain moves us to action, as well as precedes and accompanies +and follows action. The word <i>emotion</i> is usually employed to denote an +acute feeling state, while the word <i>mood</i> denotes a prolonged feeling +condition, <i>i. e.</i>, a less acute emotional state. The word <i>feeling</i>, +however, is used to cover both; for in each case the sensational element +manifests itself in a definite physical affect, pleasurable or painful +in some degree.</p> + +<p><i>Thinking</i> is a conscious mental activity exercised to evolve ideas from +perceptions, and to combine and compare these ideas to form judgments.</p> + +<p>Intellection, or thinking, might be explained as the mental process +which converts sensation into percepts, groups percepts to form concepts +or ideas, stores away ideas and sensations for future use, and recalls +them when needed—the recalling being memory—and by reason combines, +compares, and associates ideas to form<span class="pagenum" title="Page 50"> </span><a name="Page_50" id="Page_50"></a> judgments, then compares +judgments to form new judgments. The process of intellect we name by +terms denoting activity, such as intellection, thinking, the <i>stream of +thought</i>, and the latter describes it most truly.</p> + +<p><i>Volition</i> or <i>will</i> is the function of the mind which compels the +expression of thought or feeling in action.</p> + +<p>For clarity we might indicate the mind and its functions in the +following diagram:</p> + +<h5><a href="images/diagram050.png" title="Image showing original layout of diagram.">Mind</a></h5> +<ul style="list-style-type:disc; margin-bottom:1em;"> + <li>Emotion + <ul style="list-style-type:circle;"> + <li>Pleasure</li> + <li>Pain</li> + </ul> + </li> + <li>Intellect, or the Stream of Thought + <ul style="list-style-type:circle;"> + <li>Sensation (impression on mind from sense organs) + <ul style="list-style-type:square;"> + <li>Eye</li> + <li>Ear</li> + <li>Nose</li> + <li>Mouth</li> + <li>Skin</li> + <li>Muscles</li> + <li>Viscera</li> + <li>General Sensation</li> + </ul> + </li> + <li>Perception (recognition of cause of sensation) + <ul style="list-style-type:square;"> + <li>of object</li> + <li>of quality</li> + </ul> + </li> + <li>Memory + <ul style="list-style-type:square;"> + <li>Self</li> + <li>Organic</li> + <li>Inorganic</li> + <li>Percept</li> + <li>Concept</li> + </ul> + </li> + <li>Ideation + <ul style="list-style-type:square;"> + <li>Abstract</li> + <li>Concrete</li> + <li>Imaginative + <ul style="list-style-type:disc;"> + <li>Fanciful</li> + <li>Constructive</li> + </ul> + </li> + </ul> + </li> + <li>Reason</li> + <li>Judgement</li> + </ul> + </li> + <li>Will</li> +</ul> + +<p><span class="pagenum" title="Page 51"> </span><a name="Page_51" id="Page_51"></a>The following terms are ones constantly used in psychology, and are +briefly defined that there may be no haziness in their application.</p> + +<p><i>Sensation</i> is the uninterpreted response of the mind to stimuli brought +by sense organs.</p> + +<table summary="Examples of sensations."> +<tr> +<td rowspan="3">Examples: Feeling of </td> +<td rowspan="3"><span style="font-size:300%; font-weight:lighter;">{</span></td> +<td>hot.</td> +</tr> +<tr><td>cold.</td></tr> +<tr><td>pain.</td></tr> +</table> + +<p>Sensation may arouse instinct and cause reflex action, or start a +feeling state, or a train of thought.</p> + +<p><i>Perception</i> is the conscious recognition of the cause of a given +sensation.</p> + +<table summary="Examples of perceptions."> +<tr> +<td rowspan="3">Example: </td> +<td rowspan="3"><span style="font-size:300%; font-weight:lighter;">{</span></td> +<td>fluid—water.</td> +</tr> +<tr><td>cold—snow.</td></tr> +<tr><td>pain—cut.</td></tr> +</table> + +<p><i>Percept</i> is a word often used to denote the mind’s immediate image of +the thing perceived.</p> + +<p>Percepts are of two kinds: object and quality.</p> + +<table summary="Examples of percepts."> +<tr> +<td rowspan="2">Example: </td> +<td rowspan="2"><span style="font-size:200%; font-weight:lighter;">{</span></td> +<td>object, as water.</td> +</tr> +<tr><td>quality, as fluid.</td></tr> +</table> + +<p><i>Memory</i> is the mind’s faculty of retaining, recognizing, and +reproducing sensations, percepts, and concepts.</p> + +<p><i>Organic memory</i> is the mind’s reproduction of past bodily sensations.</p> + +<p>Example: I recall the physical sensations of a chill, and live it over +in my mind, so that I can accurately describe how a chill feels to me, +though I can but surmise how one feels to you.</p> + +<p><span class="pagenum" title="Page 52"> </span><a name="Page_52" id="Page_52"></a><i>Inorganic memory</i> is the mind’s reproduction of its own reactions in +the past.</p> + +<p>Example: Myself having a chill, how I acted; what I thought and my +emotions during that chill.</p> + +<p><i>Ideation</i> is the mind’s grouping of percepts by the aid of memory, to +form concepts.</p> + +<p>Example: I perceive color, form, mouth, eyes, nose, chin, etc. These +percepts I combine as a result of past experience (memory) to form my +concept, <i>face</i>; and the process of combining is ideation.</p> + +<p><i>Concepts</i> are mental representations of things or qualities, +<ins class="correction" title="Transcriber’s note: Original omitted the first dot."><i>i. e.</i></ins>, of object or quality percepts.</p> + +<p>We might say that the percept is the mind’s immediate image of a thing +or quality, and the concept is the result of the storing up and grouping +and recombining of percepts. Thus a lasting mental picture is secured; +and my idea of horse, for instance, is so clear and definite a thing in +my mind that if I should never again see a particular horse, I should +yet always be able to think accurately of a horse.</p> + +<p>Concepts are of two kinds—concrete and abstract.</p> + +<p>A <i>concrete concept</i>, or concrete idea (for concept and idea are +interchangeably used), is an idea of a particular object or quality.</p> + +<table summary="Examples of concrete concepts."> +<tr><th rowspan="2">Examples: </th><td>This wine-sap apple (object concept).</td></tr> +<tr><td>This sweet orange (quality concept).</td></tr> +</table> + +<p>An <i>abstract concept</i>, or abstract idea, is a mental repro<span class="pagenum" title="Page 53"> </span><a name="Page_53" id="Page_53"></a>duction of a +quality or an object dissociated from any particular setting or +particular experience.</p> + +<p>Abstract ideas are of two kinds. We speak of them as <i>abstract object +concepts</i> and as <i>abstract quality concepts</i>. An <i>abstract object +concept</i> we might call a generalized idea, an idea comprehending all +objects having certain things in common.</p> + +<p>Example: My idea of animal includes many scores of very different +individual animals, but they all have bodies and heads and extremities. +They all have some kind of digestive apparatus; they breathe, and can +move.</p> + +<p>An <i>abstract quality concept</i> is easier to think than to explain. It is +as though the mind in considering a multitude of different objects found +a certain quality common to many of them, and it “abstracted,” <i>i. e.</i>, +drew this particular quality, and only this, from them all, and then +imagined it as a something in itself which it calls <i>redness</i>, or +<i>whiteness</i>, or <i>goodness</i>. Thereafter, whenever it finds something like +it anywhere else again it says, “That is like my redness.” So I call it +“red.” In other words, consciousness thereafter can determine in a newly +discovered object something it knows well merely because that something +corresponds to a representation which experience and memory have already +formed.</p> + +<p>These comprehensive concepts, or <i>universals</i>, as some psychologists +term them, the mind, having pieced together from experience and memory, +holds as independent realities, not primarily belonging to <i>this</i> or +<i>that</i>,<span class="pagenum" title="Page 54"> </span><a name="Page_54" id="Page_54"></a> but lending themselves to this or that. For example: My mind +says “white,” and sees white in some object. But I see the white only +because my mind has a quality concept, <i>whiteness</i>. This outside object +corresponds to my concept. I recognize the likeness and call it “white.”</p> + +<p>I speak of goodness, or purity, of benevolence; or of fulness, +emptiness, scantiness. There is no object or quality in the outside +world I can say is goodness, or fulness. But I do see things in the +external world through my ideas of goodness or fulness that correspond +to these ideas. They have some of the qualities the ideas embrace; and +so I point them out and say, “This represents purity; that, impurity”; +or, “This is full, that is empty.” One satisfies my concept of purity, +while the other does not. One fulfils my concept of fulness; the other +does not. And because we can never point out any one quality in the +outside world and say “This is purity, and all of purity; this is +goodness; or this good plus this good plus this makes all of goodness”; +because of this impossibility we speak of these concepts as having +reality somewhere. They are <i>absolutes</i>, <i>universals</i>, <i>abstract quality +concepts</i>—the unfound all of which the things we call pure and good are +but the part.</p> + +<p><i>Apperception</i> is the process of comparing the new with all that is in +the mind, and of classifying it by its likeness to something already +there.</p> + +<p>With an abstract idea of an object in mind we very<span class="pagenum" title="Page 55"> </span><a name="Page_55" id="Page_55"></a> deftly, through the +use of memory and constructive imagination, deduce the whole from the +part recognized as familiar.</p> + +<p>Example: In walking through the field, along the bank of the brook, I +glimpse under the low-hanging branches of the weeping willow a +restlessly moving hoof. I see a certain kind of hoof and only that. Or I +hear a lowing sound. And I say “cow.” I have not seen a cow, but only a +part which tells me a cow is there; for all the cows I ever saw had +hoofs of that general description, and so it fits into my concept <i>cow</i>, +and into no others. Or I have heard cows, only, give that lowing sound +before. From my perception, then, of hoof or sound I apperceive <i>cow</i>. +Memory relates that hoof or that lowing sound to a certain kind of +animal known in the past; and constructive imagination draws in all the +rest of the picture that belongs with it.</p> + +<p>Again, we may apperceive an object or quality from our recognition of +something which in our experience has been associated, under those +particular circumstances, with only that object or quality. I see smoke +on the ocean’s far horizon, and I decide instantly, “a steamer.” I have +not perceived any steamer, but only something that “goes with it,” as it +were. I see the ship with my mind, not with my eyes; for I know that a +cloud of smoke out there always has, in my past experience, represented +just that. I compare the newly appearing stimulus—smoke in that +particular loca<span class="pagenum" title="Page 56"> </span><a name="Page_56" id="Page_56"></a>tion—with all that is associated with it in my mind, +and classify it with the known. I apperceive “steamer.”</p> + +<p>In apperception, then, we construct from the known actually perceived by +the senses, the unknown. How does the child realize that the moving +speck on the distant hillside is his father? There is nothing to +indicate it except that it is black and moves in this direction. But +experience tells Johnny that father comes home that way just about this +time. Moreover, it says that father looks so when at that distance. When +Johnny is as sure it is his father as if he could see his face close +beside him he has apperceived him. The speck on the hill is the newly +arriving stimulus. Johnny compares it with what corresponds to it in his +mind’s experience and proclaims, as a fact, that he sees his father.</p> + +<p><i>Reason</i> is the mind’s comparison and grouping of concepts to form +judgments, and its association of judgments to form new judgments.</p> + +<p>Example: My concept <i>man</i> includes the eventual certainty of his death. +My concept mortal means “subject to death.” Therefore my judgment is, +“Man is mortal.” Reason has compared the concepts and found that the +second includes the first.</p> + +<p><i>Judgment</i> is the mind’s decision arrived at through comparing concepts +or other judgments.</p> + +<p>Example: <i>Man is mortal</i> is my decision after comparing the concepts +<i>man</i> and <i>mortal</i> and finding that<span class="pagenum" title="Page 57"> </span><a name="Page_57" id="Page_57"></a> the latter really includes the +former. Judgment at the same time says that “Mortals are men,” is not a +true conclusion. For in this case the first concept is not all included +in the second. Mortals are all life that is subject to death.</p> + +<p>We may assume personal consciousness even as we recognize an individual +body. Psychology does not deal with any awareness separated from a +person. It knows no central mind of which you partake or I partake, and +which is the same for us both. A universal consciousness would simply +mean one which is the sum of yours and mine and everybody’s who lives +today, or who has ever lived. So by <i>personal consciousness</i> the +psychologist means his consciousness, or yours, or mine. But they can +never be the same; for mine is determined by my entire past and by how +things and facts and qualities affect me; and yours, by your past, and +by things and facts and qualities, and by how they affect you.</p> + +<p><i>Personal consciousness</i> is the mind’s recognition of self; and as the +self changes with every added experience, so personal consciousness is +modified.</p> + +<p><i>Stream of thought</i> is a term <i>James</i> has brought into common usage to +illustrate the fact, already stressed, that thinking, as we know it, is +never static, is never one thing, one percept, one concept, one +judgment; but is a lot of these all together, just beginning to be or +just beginning to change into something else. We never know a concept, +for instance, except as it is a part of<span class="pagenum" title="Page 58"> </span><a name="Page_58" id="Page_58"></a> our entire consciousness, +related to all the rest; just as we do not know the drop of water in the +brook as it flows with the stream. We can take up one on our +finger-tips, however, and separate it from all the rest. But analyzed in +the laboratory, this drop will contain all the elements that a pint or +gallon or a barrel of the same water contains. The drop is what it is +because the stream has a certain composition. We only have a brook as +drops of rain combine to make it, but we also have only the drops as we +separate them from the steam.</p> + +<p><i>Imagination</i> is the combining by the mind, in a new way, things already +known.</p> + +<p>This may be either into fantastic groupings divorced from reality, or +into new, possible, rational groupings not yet experienced. So +imagination is of two kinds, the fantastic and the constructive. +Fantastic imagination, or fantasy, gives us gnomes, fairies, giants, and +flying horses, and all the delights of fairy tales. Constructive +imagination is the basis for invention, for literature, and the arts and +sciences.</p> + +<p>The word <i>thinking</i>, defined early in this chapter, is broadly used to +denote the sum of all the intellectual faculties. Thinking is really the +stream of thought.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 59"> </span><a name="Page_59" id="Page_59"></a><a name="CHAPTER_VI" id="CHAPTER_VI"></a>CHAPTER VI +<br /> +THE NORMAL MIND (Continued)</h2> + + +<h4><a name="Instinct" id="Instinct"></a>Instinct</h4> + +<p>We have found that the mind’s chief end is action, of itself, or of its +body. But what are its incentives to action?</p> + +<p>We see the very young baby giving evidences of an emotional life, living +in an affective, or feeling environment, leading a pleasure-pain +existence, from the first. He acts as desire indicates. But from the +very moment of his birth he performs actions with which he cannot as yet +have a sense-memory connection, because he is doing them for the first +time. How can he know how to respond to stimuli from the very beginning?</p> + +<p>No other possible explanation offers itself than that he is born with +certain tendencies to definite action. These we call instincts—man’s +provision to keep him going, as it were, till reason develops. Instincts +are handed down from all the past. Definite tendencies, they are, to +certain specific reflex actions in response to certain sensations. These +responses, from the very beginning of animal life, have been toward +avoiding<span class="pagenum" title="Page 60"> </span><a name="Page_60" id="Page_60"></a> pain, and toward receiving pleasure. It is as though the +stimulus presses the trigger—instinct—and the muscle responds +instantly with reflex action. This mechanism is the means of protection +and advancement, and takes largely the place of intelligence in all +animal life. It is what makes the baby suck and cry, clutch and pull, +until a sense memory is established. So instinct is really race memory. +We call instinctive those immediate, unthought reactions which are the +same with all mankind.</p> + +<p>The pugnacious instinct—the desire to fight—is the natural reaction of +every human being of sane mind to attack. The inner necessity of +avenging is so strong in the child or man of untrained mind or soul that +he acts before he thinks. He strikes back, or shoots, or plots against +his enemies. Only rare development of spirit or the cautious warning of +reason which foresees ill consequences, or a will trained to force +control, can later make the instinct inactive.</p> + +<p>Where instinct ends and sense memory, imitation, and desire step in is +difficult to determine. Later in life probably most of what we consider +instinctive action is simply so-called reflex action, depending on sense +memory, action learned so young that it is difficult to distinguish it +from the true reflex action, which is due only to race memory.</p> + +<p>James, in his <i>Talk to Teachers</i>, gives us a partial list of the +instincts. Thus:</p> + +<table class="spaced" summary="List of instincts."> +<tr><td><span class="pagenum" title="Page 61"> </span><a name="Page_61" id="Page_61"></a>Fear</td><td>Ownership</td><td>Shyness</td></tr> +<tr><td>Love</td><td>Constructiveness</td><td>Secretiveness</td></tr> +<tr style="vertical-align:top;"><td>Curiosity</td><td>Love of approbation</td><td>The ambitious impulses:<ul> +<li>Imitation,</li> +<li>Emulation,</li> +<li>Pride,</li> +<li>Ambition,</li> +<li>Pugnacity</li></ul> +</td></tr> +</table> + +<p>To this partial list we would add self-preservation, reproduction, etc.</p> + +<p>But instincts conflict with each other, and man carries about with him +in babyhood many of them which may have been very useful to his +prehistoric ancestors, but which only complicate things for him. Fear +and curiosity urge opposite lines of conduct. Love of approbation and +shyness are opposed. Love and pugnacity are apt to be at odds. So, +gradually, as intelligence increases, the child refuses to allow such +impulses to lead him to action. When fear-instinct and love-instinct are +at war, reason is provided to come to the rescue.</p> + +<p><i>Instincts</i> are racial tendencies of sensational or emotional states to +determine action.</p> + +<p>Instincts are the germs of habit, and when instinct would give rise to a +reaction no longer useful, reason, abetted by new habit formation, in +the normal mind, weakens instinct’s force; and the habit is discarded +and the instinct gradually declines.</p> + +<p>In prehistoric times when food was scarce, and man had not learned the +art of tilling the soil, hunger forced him to fight for what he got to +eat. As there was often<span class="pagenum" title="Page 62"> </span><a name="Page_62" id="Page_62"></a> not enough to go around, he maimed or killed +his fellow-man that he might have all he wanted, obeying the instinct to +survive. So, now, the baby instinctively clutches for all that appeals +to him. But an abundance of food for all, or the intelligent realization +that co-operation brings more to the individual than does fighting, and +a developed sense of responsibility toward others; or merely the fear of +the scorn of fellow beings, or the desire to be protected by the love of +his kind; perhaps a genuine love of people, acquired by spiritual +development, puts the primitive habit of food-grabbing into the discard. +Finally, the very instinct of self-preservation may be transformed into +desire to serve others. No better illustration of this can ever be +offered than the sacrifices of the World War.</p> + + +<h4><a name="Memory" id="Memory"></a>Memory</h4> + +<p>No mind retains consciously everything that has ever impressed it. It is +necessary that it put aside what ceases to be of importance or value and +make way for new impressions. We found early in our study that the +subconscious never forgets, but harbors the apparently forgotten +throughout the years, allowing it to modify our thinking, our reactions. +But the conscious mind cannot be cluttered with the things of little +importance when the more essential is clamoring. So there is a +forgetting that is very normal. We forget numberless incidents of our +childhood and youth; we may forget the<span class="pagenum" title="Page 63"> </span><a name="Page_63" id="Page_63"></a> details of much that we have +learned to do automatically; but the subconscious mind is attending to +them for us.</p> + +<p>Do you know how to skate? and if so, do you remember just how you did it +the first time? Probably all you recall is that you fell again and again +because your feet would slip away from where you meant them to be. When +you glide over the ice now it is as natural as walking, and as easy. You +cannot remember in detail at all how you first “struck out,” nor the +position of your feet and arms and legs, which you felt forced to +assume. At the time there was very real difficulty with every +stroke—each one was an accomplishment to be attempted circumspectly, in +a certain definite way. All you remember now is, vaguely, a tumble or +two, soreness, and lots of fun.</p> + +<p>We forget details we have intrusted to others as not a part of our +responsibility. We forget the things which in no way concern us, in +which we have no interest and about which we have no curiosity. And it +is well that we do so. If it were not for the ability to forget, our +minds would be like a room in which we have lived a lifetime, where we +have left everything that has been brought into it since our birth. It +would be piled ceiling high, with no room for us, and with difficulty +only could we find what we want. As we grow from babyhood to childhood, +from childhood to youth, from youth to maturity the room changes with<span class="pagenum" title="Page 64"> </span><a name="Page_64" id="Page_64"></a> +us. We put off childish things. They are stored away somewhere, in an +attic or basement, or destroyed. And day after day something new is +added, displacing something else. In the case of the mind all these +things are stored and cataloged in the subconscious, and forgotten, +until some need causes us to look into our catalog-index and see the +experience again, or some association calls it back, relating it to +something new. So our discussion of the subconscious involved also a +discussion of memory.</p> + +<p>But what of the things we must use frequently and cannot find in our +minds? What of absent-mindedness and faulty memory? In such cases our +minds might be compared to a cluttered room full of things we need and +want to use every day, but in confusion. We know where many of them are, +the ones we care most about; but we have to rummage wildly to find the +rest. We have no proper system of arrangement of our belongings. You +laid down that book somewhere, absent-mindedly, and now you cannot tell +where. You were thinking of something else at the time, and inattention +proves a most common cause of poor memory. Perhaps you simply have more +books than the room can hold in an orderly way, and so you crowded that +one in some corner, and now have no recollection of where you put it.</p> + +<p>Poor memory is the result of lack of attention, or divided attention at +the time the particular attention-stimulus knocked. You asked me to buy +a ribbon of a<span class="pagenum" title="Page 65"> </span><a name="Page_65" id="Page_65"></a> certain shade and a certain width when I went to town. I +was thinking of my dentist appointment. However, I heard your request, +answered it graciously, took the money you offered, still wondering if +the dentist would have to draw that tooth. And the chances are that I +forgot your ribbon. I was giving you only a passive and divided +attention.</p> + +<p>Or I have more to do than I can possibly accomplish in the next six +hours. You ask me to buy the ribbon. I attend accurately for the moment, +think distractedly, “How can I do it all?—but I will”—and crowd the +intention into an already overburdened corner of my mind, fail to +associate it with the other thoughts already there, and return six hours +later without the ribbon. My sense of hurry, of stress, of the more +important thing to be done, or a reaction of impatience at the request, +forced back the ribbon thought and allowed it to be hidden by others. I +was really giving you only partial attention, or an emotion interfered +with attention; and I forgot.</p> + +<p>Hence we find that a faulty memory may exist in an otherwise normal mind +when poor attention, or divided attention due to emotional stress or to +an overcrowded mind, which makes it impossible to properly assort its +material, interferes.</p> + +<p>Again, we forget many things because they are unpleasant to remember. We +have no desire, no emotional stimulus to make us remember; or because +some<span class="pagenum" title="Page 66"> </span><a name="Page_66" id="Page_66"></a> of the associations with the forgotten incident are undesirable. +We forget many things because if we remembered them we would feel called +upon to do some unpleasant duty. You forgot your tennis engagement with +B, perhaps, because you were so engrossed in a pleasure at hand, or in +your work, that anything which interrupted was, under the circumstances, +undesirable. You may have wanted very much to play with him, but some +more pressing desire—to care well for your patient, or to continue the +present amusement—was stronger. Or you forgot because you did not want +to play with him and had no excuse to offer at the time. You wished to +forget. Perhaps he does not play a good game, or you do not like him, or +at least you like some one else much more, and he happened along; so you +forgot B. The unconscious mind saw to it that something else was kept so +prominently before your attention that it could not return to the less +desired.</p> + +<p>Thus a forgetting may be purely the result of an emotional interference +which makes it, all in all, more pleasant to forget than to remember. If +we would help ourselves or our patients whose memories are faulty, and +who make them worse by their continual fretting over their disability, +we must train ourselves to be willing to forget all that does not in the +least concern our interests or those of the people about us, and does +not add anything desirable to our knowledge. Thus we may avoid +overcrowding the mind. But when we would<span class="pagenum" title="Page 67"> </span><a name="Page_67" id="Page_67"></a> remember let us give our whole +active attention at the moment of presentation of the new stimulus, and +immediately tie it up with something in past experience; let us +recognize what it is that we should remember, and call the reinforcement +of will, which demands that we remember whether we want to or not. +Sincere desire to remember will inspire early and frequent recalling, +with various associations, or hooks, until the impression becomes +permanent. The average patient’s poor memory is made worse by his +agitation and attention to it, and his conviction that he cannot +remember. The fear of forgetting often wastes mental energy which might +otherwise provide keenness of memory. If the nurse ties up some pleasant +association with the things she wants the sick man to remember, and +disregards his painful effort to recall other things, then—unless the +mind is disordered—he will often find normal memory reasserting itself.</p> + +<p>We shall consider this question of memory in more detail in a later +chapter of practical suggestions for the nurse.</p> + + +<h4><a name="The_Place_of_Emotion" id="The_Place_of_Emotion"></a>The Place of Emotion</h4> + +<p><i>Feeling Cannot Be Separated from Thinking.</i>—Emotion we found the +constant accompaniment of every other mental activity. It is first on +the stage of consciousness and, in the normal mind, last to withdraw.</p> + +<p>When I am working at a problem in doses or solutions, trying to learn my +<i>materia medica</i>, or wrestling<span class="pagenum" title="Page 68"> </span><a name="Page_68" id="Page_68"></a> with the causes of disease in my +<i>medical nursing</i>, or thinking how I can eke out my last ten dollars +till I get some more, I am pursued with some vague or well-defined +feeling of annoyance or satisfaction, of displeasure or pleasure. If all +goes well, the latter; if not, the former.</p> + +<p><i>Feeling Cannot Be Separated from Will.</i>—I cannot <i>will</i> without a +feeling accompaniment, pleasant or unpleasant. I may be using my will +only in carrying out what intellect advises. But we found that +intellect’s operations are always affective, <i>i. e.</i>, have some feeling +<ins class="correction" title="Transcriber’s note: Original read ‘or’.">of</ins> pleasure or pain. And the very act of will itself is a +pleasant one and much easier if it is making me do what I want to do; it +is a vaguely or actively unpleasant one if it is making me act against +desire. In the end, however, if I act against desire in pursuance of +reason or a sense of duty, the feeling of pleasure in the victory of my +better self is asserted. And feeling cannot be separated from will.</p> + +<p><i>Feeling Cannot Be Separated from Action.</i>—I cannot do anything without +a feeling of comfort or discomfort, happiness or unhappiness. Try it for +yourself when you are feeding a patient, making a bed, giving a bath or +massage, preparing a hypodermic. Other things being normal, if you are +performing the task perfectly, the feeling of satisfaction, of pleasure, +of the very ability to work effectively, with speed and accuracy and +nicety, comes with the doing. If you are bungling, there is a<span class="pagenum" title="Page 69"> </span><a name="Page_69" id="Page_69"></a> pervading +sense of dissatisfaction, of unpleasantness. In the automatic or +semi-automatic action a great economy of nature has conservatively put +feeling at the absolute minimum; but it has not eradicated it. As you +walk across the ward, though your predominating thought and feeling may +be elsewhere, there is a sense of pleasure or displeasure in the very +movement. If your body is fresh and you are of an energetic type and in +happy frame of mind, a pervasive feeling of satisfaction is experienced. +If tired or discouraged or sore from unaccustomed exercise, every step +registers protest.</p> + +<p>Thus we find by experiment that there is no thought we have, no single +conscious movement or action, nor any expression of the will, but is +accompanied with what the psychologist broadly terms <i>pleasure</i> or +<i>pain</i>. So <i>emotion</i>, the first expression of mentality, is never absent +from any mental or physical act. It permeates all we do, as well as all +we think and will, with the partial exception of automatic action, above +indicated.</p> + + +<h4><a name="The_Beginning_of_Reason" id="The_Beginning_of_Reason"></a>The Beginning of Reason</h4> + +<p>We found feeling by far the strongest factor in producing action in +babyhood and childhood. Our instinctive doing, we learned, is the result +of a race impulse. Will acts chiefly at emotion’s bidding. But very +early the baby’s experience operates as a partial check to feeling’s +exclusive sway. It keeps him from touching the fire, no matter how its +brightness attracts. It may<span class="pagenum" title="Page 70"> </span><a name="Page_70" id="Page_70"></a> be merely the sense memory of <i>hurt</i> when +fingers and that bright thing came together; and one such impression +will probably prevent him from ever again touching it. Or it may be the +brain-cell’s retention of the painful feeling of slapped hands when the +fingers reaching out to the flame had not yet quite touched. These +punishment experiences are only effective in many children after more or +less repetition has set up an automatic prohibition from brain to motor +nerves; but right here intellect begins to assert itself in the form of +sense memory. The baby does not reason about the matter. His nerve-cells +simply remember pain, and that particular brightness and glow, and +finger touch—or that reaching out to the glow—and slapped hands, as +occurring together. In the same way he early connects pleasure with the +taste of certain forbidden things. He does not know they are sweet. He +only knows “I want.” Even here his desire to taste may be checked in +action by a vivid memory of what happened when he tasted that other +time, and was spanked or put in his little room all alone with only milk +and bread to eat for a long time.</p> + +<p>Later on the child may think, from cause to effect, thus: “Sweet, good, +want, taste, spank, hurt (or no dinner, all by self, lonely), spank hurt +more than sweets good. Not taste.” But long before he can work this out, +consciously, two distinct memories, one of pleasure and one of pain, are +aroused by the sight of the sweet. And what he will do with it depends +upon which mem<span class="pagenum" title="Page 71"> </span><a name="Page_71" id="Page_71"></a>ory is stronger. In other words, his action is governed +altogether by his feeling, though memory, which is an intellectual +factor, supplies the material for feeling.</p> + + +<h4><a name="Development_of_Reason_and_Will" id="Development_of_Reason_and_Will"></a>Development of Reason and Will</h4> + +<p>Later still, when the child is older, we may have somewhat the following +mechanism: “Sweets, good, want, taste; spank, hurt; don’t care, spank +not hurt much, maybe never found put, sweets very good.”</p> + +<p>Now the child is reasoning and choosing between two courses of action, +<i>don’t</i> and <i>do</i>. His decision will depend upon whether immediate +satisfaction of desire is stronger than the deferred satisfaction of +being good, and the fear of punishment. He probably prefers to take a +chance, and even if the worst comes, weighs it with the other worst, not +having the sweet—and takes the “bird in the hand.” He has reasoned, and +has chosen between two emotions the one which his judgment says is the +more desirable; and his will carries out the decision of his reasoning. +His chief end in life is still to get the most immediate pleasure. Still +later in child-life, much later, perhaps, his decision about the jam is +based on neither love of it nor fear of punishment, but—despite his +still sweet tooth—on a reasoned conclusion that if he eats jam now he +may be sick, or he may spoil his appetite for dinner; or on a +consideration that sweets between meals are not best on dietetic +principles; and <i>will</i> very readily backs up the<span class="pagenum" title="Page 72"> </span><a name="Page_72" id="Page_72"></a> result of his +reasoning. Though his determination is largely based upon feeling, +reason has chosen between feelings, between immediate desire to have, +and desire to avoid future discomfort. Reason is triumphant over present +desire.</p> + + +<h4><a name="Judgment" id="Judgment"></a>Judgment</h4> + +<p>The conclusion or decision that reason has reached we call a judgment. +The youth who decides against the sweet between meals, we say, has good +judgment. And we base our commendation on the proved fact that sweets +are real fuel, giving abundantly of heat and energy, and are not to be +eaten as mere <ins class="correction" title="Transcriber’s note: Original read ‘pasttime’.">pastime</ins> when the body is already fully supplied with +high calorie food not yet burned up; that if sweets are eaten at +irregular intervals and at the call of appetite, and not earned by an +adequate output of physical work, the digestive apparatus may become +clogged, and an overacid condition of the entire intestinal tract +threaten. We call judgment good, then, when it is the result of +reasoning with correct or logical premises which correspond with the +facts of life. We call it bad when it is the conclusion of incorrect or +partial or illogic premises.</p> + +<p>A <i>premise</i> “is a proposition laid down, proved, supposed, or assumed, +that serves as a ground for argument or for a conclusion; a judgment +leading to another judgment as a conclusion” (Standard Dictionary).</p> + +<p>Let us illustrate good and bad judgment by following out two lines of +reasoning, each quite accurate as such.</p> + +<p><span class="pagenum" title="Page 73"> </span><a name="Page_73" id="Page_73"></a>I want sweets. Sweets are good for people. They give heat and energy, +and I need that, for I am chilly and tired. People say “Don’t eat sweets +between meals.” But why? They contain just what I need and the sooner I +get them the better.</p> + +<p>So I have sweets when I want them. The judgment to take the sweets as +desire indicates is entirely logical if we accept all the premises as +correct. And they are, so far as they go; but they are partial; and so +cannot altogether correspond with the facts of life. Sweets are good for +people who expend much physical energy. They prove injurious in more +than limited amounts to the bed-ridden, the inactive, or the sluggish. +Hence this premise is partial and so far incorrect. Sweets do give heat +and energy, true. I am chilly and tired, also true. But why? Because I +am already toxic from the sweets and meats I have had throughout my +sedentary years. The question is, Do I need any more energy-producing +food when I am not burning up what I have? So again the premise is +partial. I do need heat and energy, but I already have the material for +it, and my mode of life has disorganized my system’s capacity to utilize +these foods normally. So now sweets have become a detriment to my +well-being. The judgment which determines me to the habit of eating +sweets between meals is the result of logic, but of logic spent on tying +up premises which do not fit the facts of the case.</p> + +<p><span class="pagenum" title="Page 74"> </span><a name="Page_74" id="Page_74"></a>One of the most prevalent defects of judgment is illustrated in this +common disability to select premises which fit the facts. Ignorance, +emotional reasoning, and a defective critical sense probably explain +most poor judgments.</p> + +<p>The other judgment illustrates the logic of correct, provable premises.</p> + +<p>“No, I shall wait until dinner-time. I have no need of so rich a food, +for I had an adequate meal at the usual time and have not worked hard +enough to justify adding this burden to my digestive apparatus; besides +only hard workers with their muscles can afford to eat many sweets. They +cause an overacid condition when taken in excess; and any except at +mealtimes would be excess for me, with my moderate physical exercise.”</p> + +<p>This judgment we call good. Its premises correspond to scientific facts.</p> + +<p>But much reasoning must always be done with probable premises, ones +which seem to correspond to the facts, but which have yet to be proved. +And our judgment from such suppositions cannot be final until we see if +it works.</p> + +<p>Some few centuries ago supposedly wise men called Christopher Columbus a +fool. Of course the world was flat. If it were round man would fall off. +It was all spread out and the oceans were its limits. If it should be +round, like a ball, as that mad man claimed, then the waters must reach +from Europe ’round the sphere<span class="pagenum" title="Page 75"> </span><a name="Page_75" id="Page_75"></a> and touch Asia; or there might be land +out there beyond the ocean’s curve. But it wasn’t round, and the idea of +finding a new way to Asia by sailing in the opposite direction was a +fool’s delusion.</p> + +<p>Their logic was perfect. If the earth was flat, and Asia lay east of +Europe, it was madness to sail west to reach it. But they argued from a +wrong premise, so their judgment was imperfect—for they did not yet +know the facts.</p> + +<p>The result of all reasoning is judgment. And judgment is good as the +materials of the reasoning process correspond to facts, or are in line +with the most probable of the yet unknown. It is poor as the reasoning +material fails to meet the facts, or is out of harmony with the most +probable of the yet unproved.</p> + +<p>It is of no avail, then, to attempt to improve our final judgments as +such. We must examine the materials we reason with, then learn to group +and compare them logically. And in the very separating of true premises +from false, we use and train the judgment we would improve. And this the +normal mind can do.</p> + + +<h4><a name="Reaction_Proportioned_to_Stimuli" id="Reaction_Proportioned_to_Stimuli"></a>Reaction Proportioned to Stimuli</h4> + +<p>In the normal mind the emotional or feeling accompaniment of thought and +action is proportionate and adequate to the circumstances, <i>i. e.</i>, +there is a certain feeling, of a certain strength, natural to every +thought and act; and when only that strength, not more or less,<span class="pagenum" title="Page 76"> </span><a name="Page_76" id="Page_76"></a> +accompanies the thought or the act, we say, “That man is emotionally +stable. His mind is normally balanced.”</p> + +<p>Joy naturally follows some stimuli; sorrow others. Disappointment or +loss, shock, failure, death of loved ones, illness in ourselves or +others, do not normally bring joy. A keen sense of suffering, +temporarily, perhaps, of numbness; the inability to grasp the calamity; +or flowing tears, an aching heart, or the <ins class="correction" title="Transcriber’s note: Original read ‘strees’.">stress</ins> of willed +endurance, are natural, and normal reactions to such stimuli.</p> + +<p>A developed will may refuse indulgence in the outward expression of the +normal feeling of shock, grief, and loss; and this may be normal. But +normal volition does not force us to laugh and dance and be wildly merry +in the face of grief and loss and pain. It only suggests the adequate, +reasonable acceptance of the facts that cannot be changed—the +acceptance of love, faith, and hope that sees in present suffering a +means of consecration to service; it does not convert the emotion of +sorrow and loss into a pleasurable one. Normal reason does not suggest +that <i>will</i> force the reactions to loss and suffering that belong by +nature to attainment and success.</p> + +<p>Nor does reason suggest the long face, the bitter tears, a storm of +anger, in response to comedy and farce, in the face of a good joke, or +to meet success; and normal will puts reason’s <ins class="correction" title="Transcriber’s note: Original reads ‘council’.">counsel</ins> into effect.</p> + +<h4><span class="pagenum" title="Page 77"> </span><a name="Page_77" id="Page_77"></a><a name="Normal_Emotional_Reactions" id="Normal_Emotional_Reactions"></a>Normal Emotional Reactions</h4> + +<p>Some emotions, that seem exaggerated at first thought, may be normal +under the circumstances. For no one can know the whole background for +emotional response in the life of another. After being long shut up in a +darkened room, with bandaged eyes and aching head and sick body, the +first visit to the bit of woods back of the house—when all the pains +have gone—may bring almost delirious joy. The green of the foliage, the +blue of the sky, the arousing tang of the air, the birds, the sense of +freedom—all go to the head like new wine. The abandon of joy is a +normal response under the circumstances, now. It would hardly be normal +to one whose habit it is to visit this same bit of woods every day, to +one who loved it, but for whom it had lost the force of newness.</p> + +<p>To the child, who has never in all his little life had a wish not +gratified, the denial of a desired stick of candy is as great a calamity +as is the loss of a fortune to the grown man. And the child reacts to +feeling equally intense. These are normal reactions to stimuli—normal, +under the circumstances.</p> + + +<h4><a name="The_Normal_Mind" id="The_Normal_Mind"></a>The Normal Mind</h4> + +<p>The normal mind reasons clearly with the best data at hand to results +that will stand the test of conformity to reality; the normal mind uses +reason and feeling,<span class="pagenum" title="Page 78"> </span><a name="Page_78" id="Page_78"></a> guided by reasonable attitude; in the normal mind +<i>reason</i> advises action and <i>will</i> brings it about; in the normal mind +<i>feeling</i> proportionate to the circumstances accompanies every thought +and every action. And in the well-balanced man or woman every function +of the mind leads to action as its final end.</p> + +<p>But man only approximates the normal. The perfectly balanced man or +woman is so rare as to be a marked person. The average intelligent +individual only in general approximates this standard. He goes beyond it +in spurts of untrammeled genius, to wrench lightning from the heavens, +and to send his trains through the air; or he allows his feelings to +dictate to his reason, and much of the time so exaggerates or +depreciates the simple facts of life that the results of his reasoning +no longer conform sufficiently to reality as to be thoroughly +dependable.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 79"> </span><a name="Page_79" id="Page_79"></a><a name="CHAPTER_VII" id="CHAPTER_VII"></a>CHAPTER VII +<br /> +PSYCHOLOGY AND HEALTH</h2> + + +<p>In the use of its functions the mind manifests certain powers and +certain modes of expression which can act as powerful allies or as +damaging enemies of health. We speak of man as adaptable, but also as a +being of habits. We speak of him as “feeling” when we wish to express +the fact that his emotions influence his body. We expect of the average +man a certain amount of suggestibility. We say that he is tremendously +affected by his environment, which simply means that his attention, +naturally centered chiefly on the things at hand, largely determines +what he is. But we recognize that a man of trained mind can choose and +will to substitute for his present surroundings thoughts upon more +constructive things from past experience, or from future possibilities, +or from within the mind’s own storehouse. His ability to largely modify +his life by his will, we recognize as man’s greatest power. +<i>Adaptability</i>, emotional response, <i>suggestibility</i>, <i>attention</i>, +<i>thought-substitution</i>, <i>habit-formation</i>, and <i>will</i> can minister +vitally to health, or can prove damaging avenues of disease.</p> + +<h4><span class="pagenum" title="Page 80"> </span><a name="Page_80" id="Page_80"></a><a name="Necessity_of_Adaptability" id="Necessity_of_Adaptability"></a>Necessity of Adaptability</h4> + +<p>Adaptability is as essential to life of mind as to life of body; and +health of mind as well as health of body is determined by the individual +ability to adjust himself to environment.</p> + +<p>There are dreamers who have lived in their ideal world so long that they +cannot meet the stern realities of life when they come. The shock is too +great for the mind that has accepted only the fantastic, the real as the +dreamer would have it; and he lets go altogether his hold on the actual, +accepting the would-be world as present fact. And we call him insane. +Other visionaries wakened rudely to life as it is, accept it as +unchangeable fate, lose all their true ideals and become cynical, or +victims of utter depression for whom life holds nothing that matters. +Still others go on through the years self-satisfied and serene because +they simply refuse to believe unpleasant truths; they “pretend” that +their wishes are realities, and acknowledge as facts only the pleasant +things of existence. The first two groups have failed to adapt self to +life as it is, and the mind is lost or so damaged as to no longer serve +its body properly. The “pretenders” have adjusted themselves, and so +long as they can remain happily self-deceived all goes well for them, +though they complicate living for others. However, they have made an +adaptation, a defective one, it is true, but one through which the mind +may survive. Some of this class, however, finally build up a more<span class="pagenum" title="Page 81"> </span><a name="Page_81" id="Page_81"></a> and +more elaborate system of self-deception until they, too, are insane.</p> + +<p>The practically adaptable man can dream dreams, but always recognizes +them as dreams, and can stop at will; can vision a beautiful ideal, but +comprehends that it is not yet reality, though it may some time become +so if he learns and fulfils the laws leading to its realization. The +adaptable man or woman recognizes the real as fact, desirable or +otherwise, the fantastic as unreal and only to be indulged in as a +pastime, and the ideal as the possible, a thing for which to work and +sacrifice. So perfect adaptability would mean perfect mental poise.</p> + +<p>It is for the nurse to realize that the greater number of her patients +do not belong to any of these classes absolutely, but that some of them +have tendencies leading in these various directions. And it is her +privilege to recognize the trend of her sick patient’s mental workings, +and to so deftly and unobtrusively encourage the recognition of facts as +things which are to be used—not as stumbling-blocks—that her mental +nursing, as her physical, shall be directed toward <ins class="correction" title="Transcriber’s note: Original had a comma instead of a full-stop.">health.</ins> She can +help her patient to accept illness and suffering as realities to be +faced, and treatment as a means, whether pleasant or not, of making it +possible for health to replace them. The understanding nurse can +actively help her charge one step at a time toward adaptation to the new +environment, remembering that many of the<span class="pagenum" title="Page 82"> </span><a name="Page_82" id="Page_82"></a> sick, particularly the +depressed, cannot be encouraged or incited to effort by having future +health held out to them. They are capable only of living in the present +and doubting all the future.</p> + +<p><i>There Can Be No Neurosis Without a Psychosis.</i>—If the brain is the +organ of the mind, then what affects the brain must perforce be at least +registered by mind. So every physical shock, accident, toxic condition, +infection—even the ordinary cold—rouses the mind at least to +awareness, usually to discomfort. For the nerve-cells and fibers—those +inseparable parts of the body mechanism—speedily report the fact that +they are being tampered with. In the toxicity of the infections these +very delicate tissues are nourished by toxic fluids; in accidents they +carry all the messages from the injured part. Then the brain—that +center of all man’s reactions and the organ of all his +consciousness—receives the report of the disturbance and translates it +into terms of more or less disability. The neurosis has become a +psychosis. The physical condition has become a mental discomfort. +Normally this ensuing mind state should be in accordance with the extent +of the injury to the nerve-cells and fibers. But under long-continued +discipline, or influenced by emotion, the conscious mind may not +recognize the neurosis; whereas, in the hypersuggestible, consciousness +will translate it into entirely disproportionate suffering.</p> + +<p>A great problem of nervous education is what the<span class="pagenum" title="Page 83"> </span><a name="Page_83" id="Page_83"></a> mind will do with +discomfort or pain. Will it put all its attention there and respond with +nervousness, irritability, demand for sympathy; or will it relegate all +the minor pains to their own little places, accepted as facts +but to be disregarded except in so far as actual treatment is needed? +Will it turn to attend to the host of other more desirable objects? Or +in case of acute suffering, will it take it as a challenge to endurance? +Will it use it as a means to strengthen volition, as a stepping-stone to +self-mastery?</p> + +<p>Realizing the force of the law—no neurosis without a psychosis—the +nurse will try to eliminate unnecessary irritations to physical comfort, +while she helps the patient to adjust himself to the ones which are +inevitable. It is the doctor’s problem rather than hers, except as she +carefully fulfils orders, to eliminate the toxic causes of psychosis. It +is hers to help the patient to meet adequately the effects of the +infections or toxins, and to prevent as far as possible the surrender to +uncontrolled nervousness. Her object is to have him face the psychosis +as one of the simple facts of science, then turn the sick mind’s +attention to more important things; she would encourage <i>will</i> to force +endurance; she would stimulate the feeling life to the forward look of +confidence and faith, or to acceptance of life’s suffering as a +challenge. The nurse knows that pains beyond the power of endurance the +doctor will lighten. And the patient’s reaction to discomfort and<span class="pagenum" title="Page 84"> </span><a name="Page_84" id="Page_84"></a> +suffering, the understanding nurse, without any preaching, can very +largely influence.</p> + + +<h4><a name="The_Power_of_Suggestion" id="The_Power_of_Suggestion"></a>The Power of Suggestion</h4> + +<p>One almost universal condition found in illness is +<i>hypersuggestability</i>. Here is the nurse’s despair and her hope. +Suggestion may come from without or from within. When from within, we +call it autosuggestion.</p> + +<p>Many of the sick are temporarily resting their reasoning faculties and +their judgment. The sick body is causing a feeling of “jangling nerves,” +and the mind, too, is strongly tempted to be sick. So every harsh sound, +every jolt, almost every sentence spoken in their hearing suggests +immediate nervous reactions. The mind does not wait to weigh them. The +nervous system reacts to them the second the impression is registered. +The whole self is oversensitive, and the very inflection of a voice has +enormous significance. Let the nurse remember that her way of giving a +treatment, her expression, or her very presence becomes a potent +stimulus on the second, one to which the patient’s mind responds like a +flash-light when the button is pressed.</p> + +<p>The nurse must comprehend the principle of the nervous effect on the +patient of all that is done and said, and realize her tremendous +privilege in making those stimuli wholesome. The nurse who has a +sympathetic insight, with unswerving loyalty to orders, can carry them +out with the average patient, unpleasant though<span class="pagenum" title="Page 85"> </span><a name="Page_85" id="Page_85"></a> they may be to him, in +such a way that his wholesome emotional response will be called forth, a +response of co-operation, or of faith or of good breeding, or of +“downing” the impulse to indulgence; or a response directed toward +holding the nurse’s interest and attention, and so keeping her in the +room; such a response as will gain some privilege, etc.</p> + +<p>But there are some patients in whose cases ordinary persuasion, +suggestion or requests fail. They are too nervously or mentally sick to +be moved by logic, or to respond with customary grace to a request which +their reason is not awake to answer. All usual suggestions may fail of +effect. And for these few, in order that health may be at all assured, +even the discipline of force may be necessary. But the nurse must use +this only as a last resort, of course, and in accordance with the +doctor’s orders, and then solely as treatment leading toward the ways of +health. Before turning to this final method she should clearly, firmly, +and kindly explain the principle of the discipline if the patient’s mind +is at all capable of grasping it. In any case, force should be used only +as the surgeon uses his knife. It hurts, but only to help and to save; +and it is not called upon when other methods can secure the needed +results. But force, thus limited in its application, may prove the only +suggestion which will bring about the action necessary to health on the +part of the patient. Force unwisely and unkindly used proves a damaging +suggestion, causing<span class="pagenum" title="Page 86"> </span><a name="Page_86" id="Page_86"></a> reactions of fear or anger; or it may lead to +delusions of persecution and to strengthened resistance.</p> + +<p>Many suggestions come to the patient from within. Discomfort in the +right side may suggest appendicitis. A slight indigestion, often purely +nervous, may be interpreted as inability to care for certain diet, etc. +The wise nurse will displace as many of these as she can by casual +suggestions on her own part. She will demand of herself that her very +presence be quieting, calming, happy; that her conversation with her +patient shall vibrate with a certain something that gives him courage +and strengthens the desire and the will to health; that her care of him +shall prove confidence-breeding. The patient’s attitude, when he is at +all suggestible, is largely in the nurse’s hands, and she can make his +illness a calamity by dishonest, fear-breeding, or suspicion-forming +suggestion. After all, the whole question here is one of the normality +of the nurse’s own outlook on life and people. The happier, truer, and +more wholesome it is, the more really can she help her patient to both +bodily and mental health. Of one thing let the overzealous nurse beware. +Do not irritate your patient by a patent, blatant, hollow cheerfulness +that any one of any sense knows is assumed for his benefit. Personally I +know of no more aggravating stimulus.</p> + +<p><i>What We Attend To Determines What We Are.</i>—This is one of the first +laws of education. If the child’s attention from birth could be +controlled, his future<span class="pagenum" title="Page 87"> </span><a name="Page_87" id="Page_87"></a> would be absolutely assured. But attention is a +thing of free will and cannot be forced by others. It can be won through +interest or self-directed by will. The child’s attention is entirely +determined by interest, interest in the morbid and painful as truly as +in the bright and happy. Punishment interests him tremendously because +it affects him, it interferes with his plan of life, it holds his entire +immediate attention to his injured self. But something more impelling +quickly makes him forget his hurt feelings and he is happy again. The +average sick person is emotionally very much like the child. His will at +the time, as we noted before, is tempted to take a rest, and his +interest is ready to follow bodily feeling unless something more +impelling is offered. The nurse who can direct attention to other +people, to analyzing the sounds of the street, to understanding +something of the new life of a hospital or sick room, to planning a +house, or choosing its furniture or equipping a library, or supplying a +store; to intelligent references to books or current events; or to +redecorating the room—all in his mind; to an appetizing tray, a dainty +flower, a bit of sunshine, a picture, etc., is fixing the patient’s +attention on something constructive, helping him to get well by +forgetting to think of himself.</p> + +<p>Thus the nurse, knowing the laws of attention, can keep herself alert to +divert and direct her patient’s thought to wholesome interests. Knowing +the possibility of thought substitution, she can open up new channels +of<span class="pagenum" title="Page 88"> </span><a name="Page_88" id="Page_88"></a> thinking. Knowing the power of the will to assist in health bringing +and health keeping, she can sometimes stimulate long-dormant +determination. Let her beware, however, of making the convalescent too +dependent upon help from without, but prick his pride to gradually +increasing doing for himself. Arouse his reasonable ambition, but let +him realize that life must be taken up again a step at a time; and that +he <i>can</i> do it. If limitations must be accepted, try to inspire the +feeling of pride in accomplishing the utmost possible within a +limitation, and an acceptance of the inevitable without bitterness.</p> + +<p>Attending to the unhappy, the painful, the boring without looking beyond +makes life unhappy, painful, and a bore. Not that the nurse should +ignore these realities, but she can accept them whole-souledly herself +as not the final things, as merely the rocks that can be used to stand +upon and get a view of the something better for everybody. When they are +thus used by the wholesome mind, facts, the very barest and meanest of +them, can be made useful as stepping-stones to the happier facts beyond +them.</p> + +<p>If the nurse can direct or tactfully lead the patient’s attention away +from himself and his illness, she has found a big reinforcement to his +treatment. This question is so vital in the care of patients that it +will be discussed at greater length later on.</p> + +<h4><span class="pagenum" title="Page 89"> </span><a name="Page_89" id="Page_89"></a><a name="One_Thought_Can_Be_Replaced_by_Another" id="One_Thought_Can_Be_Replaced_by_Another"></a>One Thought Can Be Replaced by Another</h4> + +<p>If we control attention we control thought, and with the suggestible +patient this principle depends upon the one just now considered. Hope +and courage-breeding thoughts can replace despairing and fearful ones, +but it will be only when attention is directed through interest or by +will to new material. There is no blank in waking consciousness. The +last thought or feeling or perception, through association of ideas, +brings up a related one, and so on indefinitely. We may start with a +pebble on the road and go on logically, smoothly, until in five minutes +we are thinking of the coronation of King George, with no sense of +anything at all unusual in the succession. It may be a very roundabout +process, from “pebble” through “rough way,” “ways that hurt,” “dangerous +ways,” “brigands,” “uncertainties of life.” “Uncertain lies the head +that wears a crown,” “King George and his crown,” “coronation.” But this +constant stream of thought can be broken into at any point by a spoken +word, a passing vehicle, which diverts the mind’s trend. So the nurse +can take advantage of the mind’s very suggestibility, and substitute for +the unhappy and sickness breeding by turning attention to anything else +of a happier color, and may divert the entire stream of thought in that +direction. She who knows these simple laws of the mind, and who at all +knows people, is a therapeutic agent of unlimited value.</p> + +<h4><span class="pagenum" title="Page 90"> </span><a name="Page_90" id="Page_90"></a><a name="Habit_is_a_Conserver_of_Effort" id="Habit_is_a_Conserver_of_Effort"></a>Habit is a Conserver of Effort</h4> + +<p>It is always easier to follow a beaten path than to break one’s way +through untrodden forests. It is easier to walk after we “learn how,” +and learning how is simply doing it over and over until the legs and +feet have acquired habits of motion and accommodation to distances and +to what is underfoot. It is easy to do anything after we have done it +again and again, so that it has become second-nature, and +“second-nature” is habit. The wise man early forms certain habits of +personal care, of eating, sleeping, exercising; of study, of meeting the +usual occurrences of life. The first day he spent at anything new was a +hard one. Nothing was done naturally. Active attention had to be keenly +held to each detail. He had to learn where things belonged, how to do +this and that for the first time, how to work with his associates.</p> + +<p>Do you remember the first hospital bed you ever made, the first bed-bath +you gave, the first massage? You had to be taught bit by bit, detail by +detail. You did not look upon the finished whole, but gave almost +painful attention to each step that led to the made bed, the completed +bath, or the given massage. Your fingers were probably all thumbs unless +you had experience in such things before you came to the hospital. Your +mind was tired from the strain of trying to remember each suggestion of +your instructor. The second time, or certainly the third or fourth time, +it went better. After<span class="pagenum" title="Page 91"> </span><a name="Page_91" id="Page_91"></a> a week of daily experience you gave the bath or +massage or made the bed with much less effort. A month later the work +was practically automatic and accomplished in a fraction of the time you +spent on it that first day. Now you can do it quickly and well with +little conscious thought; and at the same time carry on a brisk +conversation with your patient or think out your work for the day. Your +mind is free for other thoughts while you perform the task easily and +perfectly. Your method of doing the work has finally become a habit +which saves the effort of conscious attention. The details of your +routine work are directed by the subconscious. The habit will be energy +and time saving in proportion to the accuracy of your first conscious +efforts spent on the new undertaking. Thus, useful habit is the result +of active effort.</p> + +<p>We can acquire habits of thinking and habits of feeling as well as +habits of doing.</p> + +<p>But the other habits, the bad ones, are not acquired with effort. We +fall into them. Hazy thinking is easier than clear thinking. Suppose you +are by nature rather oversanguine or overdespondent, and you make no +genuine attempt to evolve that nature into poise. Directing <i>will</i> to do +what <i>desire</i> opposes is too difficult, and you go the way of least +resistance. So easily are the bad habits formed; but only with +tremendous effort of will and persistence in refusing their insistent +demands can they be broken or replaced by helpful ones.</p> + +<p><span class="pagenum" title="Page 92"> </span><a name="Page_92" id="Page_92"></a>But habits can be learned; and bad habits can be broken when an +overpowering emotion is aroused against them, possesses the mind, and +controls the will; or when reason weighs them in the balance and +judgment finds them wanting, and volition directs the mind to displace +them by others.</p> + +<p>The nurse meets in her patients numberless habits which retard recovery +of body and make for an unwholesome mental attitude. Some patients have +the complaint habit, some the irritation habit, some the self-protection +habit, some the habit of impatience, some of reckless expression of +despair, some of loss of control, some of incessant self-attention. The +nurse who can arouse an incentive to habits of cheer expression when the +least cause of cheer appears, who can by reason, or if that is not +possible, by suggestion; by holding out incentives, or by making some +privilege depend upon control—this nurse can help her patient to +displace habits of an illness-accepting mind by habits of a +health-accepting one. Above all, let her beware of opening the way to +habits of invalidism. Some people acquire the “hospital habit” because +it is easier to give way to ill-feeling, however slight, and to be cared +for with comfort, than to encourage themselves to build up endurance by +giving little attention to minor ailments.</p> + +<h4><span class="pagenum" title="Page 93"> </span><a name="Page_93" id="Page_93"></a><a name="The_Saving_Power_of_Will" id="The_Saving_Power_of_Will"></a>The Saving Power of Will</h4> + +<p>It is not uncommon to hear a doctor say, “Nothing but his will pulled +him through that time.” It does not mean quite what it says, for the +patient’s will would have been helpless to cure him without the medicine +and the treatment. But it does mean that in some cases when life is +hovering on the brink, even the most skilful treatment cannot hold it +back if the <i>will to live</i> is gone. The chances may be half and half. +Lack of desire to live may drop the balance on the death side. +Determination and hope and confidence may overweigh the life side. For +the influence of will in refusing to surrender to depression may throw +the needed hair’s weight in favor of more normal circulation. Depression +and emotion may so effect the sympathetic nervous system as to cause a +lowered circulatory activity. Determination, based on volition, may +stimulate a response from the sympathetic system which will increase +heart activity. And certainly, when it is not a matter of life and +death, but a prolonged recovery, will is a saving grace. The patient who +sets all his sick energies to the task of winning health reaches his +goal quicker than the hopeless and depressed. Perhaps his will merely +brings utter relaxation for the time, forces acceptance of present +helplessness only for the sake of giving the body a better chance to +recuperate; but the very fact that it is acting to hopefully carry out +orders lightens by half the nurse’s task of getting him well;<span class="pagenum" title="Page 94"> </span><a name="Page_94" id="Page_94"></a> and she +can encourage this will to co-operate with the doctor’s efforts by +suggestion, by her directness and honesty, by the quiet assurance that +at least a reasonable degree of health is won by effort.</p> + +<p>We have touched upon only a few of the laws of the mind. The nurse can +help develop saving mental habits and wholesome attitudes while she +helps to strengthen sick bodies; she can make a cure a little more +certainly lasting who will remember that:</p> + + +<ol><li>Adaptability is essential to life and health.</li> +<li>There is no neurosis without a psychosis.</li> +<li>Suggestion may be a powerful factor for health.</li> +<li>What we attend to determines what we are.</li> +<li>Thought substitution is possible.</li> +<li>Habit is a conserver of effort.</li> +<li>Will is a saving power.</li> +</ol> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 95"> </span><a name="Page_95" id="Page_95"></a><a name="CHAPTER_VIII" id="CHAPTER_VIII"></a>CHAPTER VIII +<br /> +VARIATIONS FROM NORMAL MENTAL PROCESSES</h2> + + +<h4><a name="Disorders_and_Perversions" id="Disorders_and_Perversions"></a>Disorders and Perversions</h4> + +<p>Life would be a very simple proposition if the mental machinery always +worked right. But this is peculiarly subject to damage both from without +and from within. From without it may be damaged by the toxins of food, +as in the acute toxic psychoses; by the poison of drink, as in the +alcohol-produced psychoses, such as acute alcoholic hallucinosis; by +lack of muscular exercise, resulting in a deficient supply of oxygen to +burn up the accumulated toxins from energy-producing foods; by the +infections, which may result in the <ins class="correction" title="Transcriber’s note: Original joined this instance with an em-dash rather than a hyphen.">infection-exhaustion</ins> psychoses; +by wrong methods of education, and by surroundings which demand too +severe a mental strain in the struggle toward adjustment. These damages +from without we class roughly as environmental.</p> + +<p>From within the mental workings may be injured by emotional dominance; +by bad habits of thinking and feeling and doing—often the result of +wrong methods of education; by defective heredity; by undeveloped will;<span class="pagenum" title="Page 96"> </span><a name="Page_96" id="Page_96"></a> +by the insanities. These danger sources from within we might classify as +self-produced and hereditary.</p> + +<p>There may be disorders of any or every function of the intellect, +disorders of feeling, and perversions of will. Some of the most commonly +met we list below.</p> + +<div class="diagram"> +<h5><a href="images/diagram096.png" title="Image showing original layout of diagram.">Disorders of the <i>Functions</i> of <i>Intellect</i>.</a></h5> + +<ul> +<li>Disorders of Sensation + <dl> + <dt>Hyperesthesia (exaggeration of sensation)</dt> + <dd>as found in neurasthenia, or in mania.</dd> + <dt>Anesthesia (absence of sensation)</dt> + <dd>as in the numbness of hysteria; in sensory paralysis.</dd> + <dt>Retardation</dt> + <dd>as in dementia and melancholia.</dd> + <dt>“Clouding” or dulness</dt> + <dd>as in simple depression.</dd> + <dt>Perversion</dt> + <dd>as in dementia and melancholia. Sweet may taste sour; fresh + food may smell decayed.</dd> + </dl> +</li> +<li>Disorders of Perception (being dependent on sensation is always +disturbed with it). + <dl> + <dt>Hyperesthesia (exaggeration)</dt> + <dd>as in neurasthenia or mania.</dd> + <dt>Anesthesia</dt> + <dd>as in hysteria or paralysis.</dd> + <dt>Retardation</dt> + <dd>as in dementia and melancholia.</dd> + <dt>“Clouding” or dulness</dt> + <dd>as in simple depression.</dd> + <dt>Illusion</dt> + <dd>found in normal mind—easily corrected;</dd> + <dd>found in many insanities.</dd> + <dt>Hallucinations</dt> + <dd>frequently met in the infection-exhaustion psychoses, in + dementia, in paranoia, in acute hallucinosis of alcoholism.</dd> + </dl> +</li> +<li><span class="pagenum" title="Page 97"> </span><a name="Page_97" id="Page_97"></a>Disorders of Ideation + <dl> + <dt>Hypochondriasis</dt> + <dd>found in many of the hypersuggestible, frequent in the mild + depressions and in all victims of self-attention.</dd> + <dt>Retardation</dt> + <dd>found in most depressions.</dd> + <dt>Deficiency</dt> + <dd>as in idiocy—the inability to form new concepts.</dd> + <dt>Acceleration</dt> + <dd>as in hypo-mania.</dd> + <dt>Poverty</dt> + <dd>as in the abnormally self-centered;</dd> + <dd>as in melancholia.</dd> + <dt>Rambling ideas</dt> + <dd>as in chronic insanity.</dd> + <dt>Flight of ideas</dt> + <dd>as in manias, hysterias, and acute deliriums.</dd> + <dt>Fixed ideas</dt> + <dd>as in paranoia.</dd> + <dt>Perversions (concepts change their meaning altogether)</dt> + <dd>as in dementia.</dd> + <dt>Ideogenous pains</dt> + <dd>as in hysteria.</dd> + <dt>Compulsive ideas</dt> + <dd>common in borderland states;</dd> + <dd>in psychasthenia, or hysteria.</dd> + <dt>Disorientation</dt> + <dd style="text-indent:0; margin-left:1.5em;"> + <table style="margin:0 0 0 0; text-indent:0;" summary="Explanation of disorientation."> + <tr> + <td rowspan="3">(wrong idea of</td> + <td rowspan="3" style="padding-top:0.5em;"><span style= + "font-size:300%; font-weight:lighter;">{</span></td> + <td>thing,</td> + </tr> + <tr> + <td>place, or</td> + </tr> + <tr> + <td>person);</td> + </tr> + </table> + </dd> + <dd>found in confused conditions;</dd> + <dd>in delirium from infections;</dd> + <dd>in insanities.</dd> + <dt>Confusion</dt> + <dd>as in the infection-exhaustion psychoses;</dd> + <dd>in insanities.</dd> + </dl> +</li> +<li><span class="pagenum" title="Page 98"> </span><a name="Page_98" id="Page_98"></a>Disorders of Memory + <dl> + <dt>Absent-mindedness.</dt> + <dt>Amnesia (morbid forgetfulness).</dt> + <dd style="text-indent:0; margin-left:0;"> + <table style="margin:0 0 0 0;" summary="Aphasia and subtypes."> + <tr> + <td rowspan="3">Aphasia</td> + <td rowspan="3" style="padding-top:0.5em;"><span style= + "font-size:300%; font-weight:lighter;">{</span></td> + <td>temporary,</td> + </tr> + <tr> + <td>prolonged,</td> + </tr> + <tr> + <td>permanent (see later explanation).</td> + </tr> + </table> + </dd> + <dt>Perversion</dt> + <dd>as fabrications, due to memory-confusion or inaccuracy; also + due to excessive ideation and defective judgment.</dd> + </dl> +</li> +<li>Disorders of Reason + <dl> + <dt>Delusions<br /> + Systematized Transient Fixed</dt> + <dd style="text-indent:0; margin-left:0;"> + <dl style="margin-bottom:0;"> + <dt>Somatic</dt> + <dd>as in hypochondriasis.</dd> + <dt>Persecutory</dt> + <dd>as in paranoia.</dd> + <dt>Unworthiness</dt> + <dd>as in simple depression or melancholia</dd> + <dt>Grandeur</dt> + <dd>as in mania or paranoia.</dd> + <dt>Nihilistic</dt> + <dd>often found in melancholia.</dd> + <dt>Reference</dt> + <dd>as in paranoia.</dd> + <dt>Altered personality</dt> + <dd>as in hysteria.</dd> + <dt>Perverted personality</dt> + <dd>(patient may believe he is a dog);</dd> + <dd>as in dementia.</dd> + </dl> + </dd> + <dt>Emotional thinking.</dt> + <dt>Shut-in personality</dt> + <dd>as seen in the deficient social capacity of potential dementia + præcox.</dd> + </dl> +</li> +<li><span class="pagenum" title="Page 99"> </span><a name="Page_99" id="Page_99"></a>Disorders of Judgement + <dl> + <dt>Defective judgment</dt> + <dd>in all insanities;</dd> + <dd>in hysteria.</dd> + <dd><i>Ex.</i>: Patient who accepts mental suggestion of + disability as reality.</dd> + <dt>Perverted judgment</dt> + <dd>in severe dementias—as influenced by unreasonable fear, + hatred, etc.;</dd> + <dd>in all acute insanities—as manifested in inability of patient + to rid himself of his delusions.</dd> + <dt>Absence of judgment</dt> + <dd>in all acute insanities;</dd> + <dd>in later dementias.</dd> + <dt>Limitations</dt> + <dd>in many so-called normal and in all the abnormal.</dd> + </dl> +</li> +<li>Disorders of Emotion + <dl> + <dt>Suggestibility</dt> + <dd>in hysteria.</dd> + <dt>Excitement</dt> + <dd>in mania.</dd> + <dt>Depression</dt> + <dd>in melancholia.</dd> + <dt>Phobias</dt> + <dd>as found in psychasthenia.</dd> + <dt>Deficiency</dt> + <dd>as in the apathy of depression.</dd> + <dt>Perversion</dt> + <dd>in mania, in depression, in catatonia.</dd> + <dt>Deterioration</dt> + <dd>in dementia.</dd> + <dt>Sense of unreality</dt> + <dd>found in all borderland cases.</dd> + </dl> +</li> +<li><span class="pagenum" title="Page 100"> </span><a name="Page_100" id="Page_100"></a>Disorders of Will + <dl> + <dt>Wilfulness</dt> + <dd>in many “normal.” Very common in hypomania.</dd> + <dt>Willessness (aboulia or paralysis of will)</dt> + <dd>often found in psychasthenia; and in depressive states.</dd> + <dt>Morbid inhibition</dt> + <dd>as in depressive states.</dd> + <dt>Indecision</dt> + <dd>as in psychasthenia;</dd> + <dd>as in simple depression.</dd> + <dt>Obsessions</dt> + <dd>found pre-eminently in psychasthenia.</dd> + <dt>Tics</dt> + <dd>in many borderland cases;</dd> + <dd>in the hypersensitive as often the only expression of any + neuropathic tendency.</dd> + <dt>Distractibility</dt> + <dd>as in hypomania and frequently in hysteria.</dd> + <dt>Negativism</dt> + <dd>as in catatonia.</dd> + <dt>Mutism</dt> + <dd>as in catatonia.</dd> + <dt>Compulsive acts</dt> + <dd>as in psychasthenia, hysteria, etc.</dd> + <dt>Psychomotor overactivity (volition unable to check)</dt> + <dd>as in mania.</dd> + <dt>Psychomotor retardation (volition unable to energize)</dt> + <dd>as in depression.</dd> + </dl> +</li> +</ul> +</div> + +<p>From this limited survey of the mind’s disorders we realize that every +departure from the normal mental attitude tends to associate itself with +one of the following five <i>states of mental disability</i>.</p> + + +<ul><li>Depression,</li> +<li>Exaltation,</li> +<li>Perversion,</li> +<li>Enfeeblement,</li> +<li>Deficiency.</li> +</ul> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 101"> </span><a name="Page_101" id="Page_101"></a><a name="CHAPTER_IX" id="CHAPTER_IX"></a>CHAPTER IX +<br /> +VARIATIONS FROM NORMAL MENTAL PROCESSES (Continued)</h2> + + +<p><i>Hyperesthesia</i> is abnormal sensitiveness to stimulation.</p> + +<p><i>Anesthesia</i> is loss, either temporary or permanent, of any of the +senses.</p> + +<p><i>Perversion</i> is morbid alteration of function which may occur in +emotional, intellectual, or volitional fields.</p> + +<p>Example: The odor of a rose causing an acute sense of physical pain.</p> + +<p>An <i>illusion</i> is a false interpretation of a perception.</p> + +<p>The normal mind is quite subject to illusions, either due to a faulty +sense organ, or to a preconceived state of mind which so strongly +expects or presages something else than reality as to misinterpret what +the senses bring.</p> + +<table summary="Examples of illusions."> +<tr><th rowspan="4">Examples: </th><td>The crooked stick as a snake.</td></tr> +<tr><td>A ghost created from shadow.</td></tr> +<tr><td>An ordinary ringing in the ears as sleigh-bells.</td></tr> +<tr><td>Milk tasting like blood.</td></tr> +</table> + +<p>An <i>hallucination</i> is a perception without an object.</p> + +<p>The hallucinated individual projects, as it were, the things of his +mind’s creation into the outer world, and<span class="pagenum" title="Page 102"> </span><a name="Page_102" id="Page_102"></a> accepts them as reality. He +sees snakes where there is nothing to suggest them; sees a ghost where +there is no shadow; believes that the taste of blood is constantly in +his mouth.</p> + +<p>There are possible hallucinations of every sense. Nonexistent objects +are seen, touched, tasted, heard, or smelled.</p> + +<p><i>Hypochondriasis</i> is a state characterized by persistent ideas of +non-existent physical disabilities.</p> + +<p>The hypochondriac has every known symptom of indigestion, or of heart +disease, or is threatened with tuberculosis—all in his mind; and +whatever the disorder he seizes upon, his attention hovers there, while +the ideas of that particular disability persist and strengthen.</p> + +<p>A <i>flight of ideas</i> is an abnormal rapidity of the <i>stream of thought</i>.</p> + +<p>Every perception so immediately is linked with some association of +experience that expression is swift and often incoherent. One word will +follow another with amazing rapidity, words suggested by sound +association, usually, rather than by that of meaning.</p> + +<p>Example: “Made a rhyme, had a dime, did a crime, got the time, bring +some lime.” This association by rhyme is quite common. But the +associations of meaning are not uncommon.</p> + +<p>Example: “Made a rhyme. Mary was a poet. Mary had a little lamb. Where’s +Mary?—Mary!—No Jim—Jim, all my children—calling, calling, calling,” +etc.</p> + +<p><span class="pagenum" title="Page 103"> </span><a name="Page_103" id="Page_103"></a>A <i>fixed idea</i> is one which morbidly stays in the mind and cannot be +changed by reason.</p> + +<p>Example: In <ins class="correction" title="Transcriber’s note: Original read ‘hypochondrasis’.">hypochondriasis</ins>, as given above.</p> + +<p><i>Ideogenous pains</i> are either pains born of an erroneous idea, or mental +reproductions of pains now having no physical cause.</p> + +<p>A suggestible person, learning that his grandfather died of an organic +heart, conceives the idea that he has inherited the trouble, and begins +to suffer cardiac pains; and as long as the idea persists the pain is +felt.</p> + +<p><i>Compulsive ideas</i> are ideas which intrude, recur, and persist despite +reason and will.</p> + +<p>Example: The compulsive idea of contamination may lead its victim to +wash and rewash his hands at every contact with matter, until finally, +though they are raw and sore, he is incapable of resisting the act.</p> + +<p><i>Disorientation</i> is a state of mental confusion as to time, place, or +identity.</p> + +<p><i>Amnesia</i> is pathologic forgetfulness.</p> + +<p>Example: As sometimes found in the infection-exhaustion psychoses, when +the entire past of the patient may be wiped out for the time. Cases of +permanent amnesia are known.</p> + +<p><i>Aphasia</i> is a defect in the interpretation or production of language.</p> + +<p>There may be motor aphasia, auditory aphasia, vocal aphasia, sight +aphasia; and with disability to produce words, they may yet be +recognized when seen; or when<span class="pagenum" title="Page 104"> </span><a name="Page_104" id="Page_104"></a> they can be spoken they may not be +recognized when heard; or with inability to speak them, they are +accurately sensed by hearing; or though understood when heard, they are +incomprehensible when read.</p> + +<p>A <i>delusion</i> is a false belief which cannot be corrected by reason.</p> + +<p>A <i>somatic delusion</i> is one centering upon alterations in the organs or +their functions.</p> + +<p>Example: Absence of a stomach, inability to swallow.</p> + +<p>A <i>nihilistic delusion</i> is one which denies existence in whole or part.</p> + +<p>Example: Mother denies the existence of her child.</p> + +<p>A <i>delusion of reference</i> is one in which the deluded individual +believes himself an object of written, spoken, or implied comment.</p> + +<p>Example: The actors on the stage are directing their remarks directly +against the victim in the box.</p> + +<p>A <i>shut-in personality</i> is one that habitually responds inadequately to +normal social appeal.</p> + +<p><i>Sense of unreality</i> is one of the commonest psychic alterations through +which customary sensation states are displaced by unnatural and usually +distressing ones.</p> + +<table summary="Examples of a sense of unreality."> +<tr><th rowspan="2">Examples: </th><td>The breakfast table appears undefinably altered.</td></tr> +<tr><td>Laughter is accompanied by strange, rather than by normal, sensations.</td></tr> +</table> + +<p><i>Morbid inhibition</i> is an abnormal, negative activity of the will.</p> + +<p><span class="pagenum" title="Page 105"> </span><a name="Page_105" id="Page_105"></a>Sometimes a patient will try pitifully to express some thought or +feeling; the desire to explain is there, but will is blocked in action. +Or the patient attempts to dress, makes repeated new beginnings, but +cannot succeed. We say, “He is inhibited.”</p> + +<p>An <i>obsession</i> is an idea which morbidly dominates the mind, constantly +suggesting irrational action.</p> + +<p>Obsessed patients may consistently step in such a way as to avoid the +juncture of the flagstones on the pavement; may insist on removing their +shoes in church; may hail each person met on the street and tap him on +the arm; may refuse to ever leave the house without an open umbrella; or +may try to attack every man they see, not because they want to hurt or +kill, but because they are obsessed to the performance of the action.</p> + +<p>A <i>tic</i> is a useless, habitual spasm of a muscle imitating a once +purposeful action.</p> + +<p>Motor tics, such as habitual jerking of the arms, shrugging the +shoulder, contorting the face, shaking or nodding the head, snapping the +fingers, etc., are very common among nervous children, and even in many +otherwise normal grown-ups.</p> + +<p><i>Distractibility</i> is an abnormal variation of attention.</p> + +<p>The common inability of the hypomanic patient to hold his attention to +any subject when another is open, is very like the distractibility of +the child who turns to every new interest as it is presented.</p> + +<p><span class="pagenum" title="Page 106"> </span><a name="Page_106" id="Page_106"></a><i>Negativism</i> is a state of persistent compulsion to contrary response to +suggestion.</p> + +<p>It is with these patients as though not only initiative were lost but +also the power to follow another’s lead. But their independence asserts +itself in opposing every suggestion and in acting so far as possible +contrary to it.</p> + +<p><i>Mutism</i>, as used in psychiatry, is an abnormal inhibition to speech.</p> + +<p>Patients sometimes speak no word in many months. To all appearance they +are true mutes. Then suddenly something may remove the mental blockade +and they talk.</p> + +<p><i>Compulsive acts</i> are acts contrary to reason, which the will cannot +prevent.</p> + +<p>A seemingly quite normal patient will sometimes grab a vase from a stand +in passing, and dash it to the floor. Something “urged” him to do it, +and he could not resist. Others will tear their clothes to shreds, not +in anger, but because they “could not help it.”</p> + +<p><i>Psychomotor overactivity</i> is abnormal activity of both mind and body, +contrary to reason and uncontrolled by will.</p> + +<p><i>Psychomotor retardation</i> is an underactivity of both mind and body in +which consciousness is dulled and the body sluggish.</p> + +<p>A <i>neurosis</i> is a disorder of the nerves, which may be functional or +organic.</p> + +<p><i>Nervousness</i> is properly termed a <i>psychoneurosis</i>—for<span class="pagenum" title="Page 107"> </span><a name="Page_107" id="Page_107"></a> we have +learned that there can be no neurosis without an accompanying psychosis.</p> + +<p><i>Psychosis</i> is the technical synonym for insanity.</p> + +<p><i>Borderland</i> disorders constitute a group in which mental perversions do +not yet so dominate reactions as to make them irrational.</p> + +<p>Twilight is neither night nor day; the feelings of the hysteric are not +insane, but the actions may be.</p> + +<p><i>Insanity</i> is a prolonged departure from the individual’s normal +standard of thinking, feeling, and acting.</p> + +<p><i>Mania</i> is insane excitement.</p> + +<p><i>Melancholia</i> is the inability of the mind to react to any stimulus with +other than gloom and depression.</p> + +<p>Melancholia may be of the intellectual type or of the emotional type. +The patient who tells you constantly that he has murdered all his +children, that he is a criminal beyond the power of God to redeem, who +seems chained to his delusions, yet shows no adequate feeling reaction, +no genuine sorrow, we call a case of the intellectual type of +melancholia. Another patient misinterprets every normal reason for +happiness until it becomes a cause of settled foreboding. The mother, +whose son fought safely through the war and is now returning to her, +feels that his coming forecasts calamity for him. He had better have +died in France. She is of the emotional type of melancholia.</p> + +<p><i>Hysteria</i> is a nervous disorder based upon suggestibility, and capable +of imitating most known diseases.</p> + +<p><span class="pagenum" title="Page 108"> </span><a name="Page_108" id="Page_108"></a><i>Insane impulses</i> are morbid demands for reckless action beyond the +control of the will.</p> + +<p>Example: The impulse to kill, quite regardless of who may be the victim.</p> + +<p><i>Psychopathic personality</i> is a term much used today to designate an +hereditary tendency on the part of the individual to mental disorder.</p> + +<p>The <i>neuropath</i> is the individual with an inborn tendency to the +neurosis.</p> + +<p><i>Neurotic</i> is a term broadly employed for the nervous in whom emotions +predominate over reason.</p> + +<p><i>Neurasthenia</i> is a nervous disorder characterized by undue +fatiguability.</p> + +<p><i>Psychasthenia</i> is a nervous disorder characterized by a sense of +unreality, weakness of will, self-accusation, and usually by phobias and +obsessions, all subject to temporary correction by reason or influence +from without.</p> + +<p><i>Hypochondriasis</i> is a disorder characterized by morbid attention to +bodily sensations, and insistent ideas of bodily disorder.</p> + +<p><i>Phobia</i> is a morbid fear or dread.</p> + + +<h3><a name="Factors_Causing_Variations_from_Normal_Mental_Processes" id="Factors_Causing_Variations_from_Normal_Mental_Processes"></a>FACTORS CAUSING VARIATIONS FROM NORMAL MENTAL PROCESSES</h3> + +<h4><a name="Heredity" id="Heredity"></a>Heredity</h4> + +<p>When we consider the accumulated possibilities for disorder which the +family tree of almost any one of us<span class="pagenum" title="Page 109"> </span><a name="Page_109" id="Page_109"></a> can show, the wonder is not that +there are so many nervous or insane, but rather that any come within +hailing distance of the normal. For multitudes are born of parents whose +bodies were food poisoned or alcohol or drug poisoned, and whose nervous +systems were tense and irritable, oversensitive, and suffering from the +effect of these same toxins on the brain. Others are of manic-depressive +parentage; some are possibly even of paranoic or dementia præcox +lineage; while many of our finest and best had psychopathic or +neuropathic heredity. Syphilis, itself, and the underpower bodies of +tuberculosis are heritages of many.</p> + +<p>When we realize, too, that we are born with certain inherent tendencies +of temperament, which are too often of the melancholic or overcholeric +type, our wonder grows that we are not doomed to defeat at birth. Were +it not for the possibilities in the germ-plasm of choosing the much of +good also in our heredity, often enough to overbalance the bad, and for +the proved power of environment and training to modify or even +altogether overcome the harmful parts of our birthright, there would be +little hope for many.</p> + + +<h4><a name="Environment" id="Environment"></a>Environment</h4> + +<p>While environment may prove the saving grace from poor heredity, it may +itself add heavily to the debit side. With the very best of health +backgrounds, environment may damage body and mind beyond repair.<span class="pagenum" title="Page 110"> </span><a name="Page_110" id="Page_110"></a> Under +environment we include everything that touches life from +without—people, things, work, play, home, school, social life, business +life, college-life, etc. Among factors of environment damaging to mental +health are overemotional family life, overstrict home discipline or the +lack of needed discipline; overfeeding, underfeeding, wrong diet, lack +of proper exercise, stimulants, drugs, overstimulation, overprotection, +too much hardship and privation, loneliness, poor educational methods, +immorality, etc.</p> + + +<h4><a name="Personal_Reactions" id="Personal_Reactions"></a>Personal Reactions</h4> + +<p>What will decide whether a human being can resist, <ins class="correction" title="Transcriber’s note: Original read ‘successfuly’.">successfully</ins>, bad +tendencies in heredity, or in environment, or in both, and keep a +reasonably balanced mind? It demands insight, ambition, will; and if +these remain the body can be forced to saving ways of health, and body +and mind can largely make their own environment. But with heavy +handicaps of heredity or environment, or both, and poor insight, or lack +of desire, or weak will, nothing can save the mind from neurotic taint +or worse—nothing but obedience to some one strong enough to control the +habits of that life, until self-control is born. And there is a hope +that it <i>can</i> be born in the most neurotic or neurasthenic, so long as +the mind is sane.</p> + +<p>But after all, a large number of people whose mental processes are not +normal, have only themselves, their<span class="pagenum" title="Page 111"> </span><a name="Page_111" id="Page_111"></a> poor emotions, their lazy wills, +their hazy thinking to blame. We except what are called the heredity +insanities—<i>dementia præcox</i> and the other dementias and the +<i>manic-depressive</i> groups and <i>paranoia</i> and <i>psychasthenia</i>—for in +these cases, possibly with the exception of the <i>manic depressives</i>, +even the most perfect environment could probably not prevent the +disorder from asserting itself. Many neurotics, neurasthenics, and +hysterics are curable if they will seriously undertake to fulfil the +laws of physical and mental health—simple laws, but ones which demand a +strengthened will to carry out.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 112"> </span><a name="Page_112" id="Page_112"></a><a name="CHAPTER_X" id="CHAPTER_X"></a>CHAPTER X +<br /> +ATTENTION THE ROOT OF DISEASE OR HEALTH ATTITUDE</h2> + + +<h4><a name="The_Attention_of_Interest" id="The_Attention_of_Interest"></a>The Attention of Interest</h4> + +<p>Attention naturally follows interest. It can, however, be held by will +to the unappealing, with the usual result of transforming it into a +thing of interest.</p> + +<p>One of the laws of the mind we have already stressed is that what we +attend to largely determines what we are, or shall be. The interests +which secure our consideration may be the passive result of emotional +life, the things which naturally appeal, which give us sensations that +the mind normally heeds; or they may be the active result of our will +which has forced application upon the things which reason advised as +worth acquiring.</p> + +<p>We found that the beginning of health of mind consists in the directing +of thought toward the health-bringing attitude. We have seen how quickly +the normal mind can be diverted from the undesirable by a new or +stronger emotional stimulus. We found that the sole appeal to attention +in the baby-life is through the emotions, and that it is natural +throughout life for the<span class="pagenum" title="Page 113"> </span><a name="Page_113" id="Page_113"></a> mind to heed and follow the interesting; which +is only another way of saying that thinking follows where emotion leads, +unless volition steps in to prevent. The supreme test of the will’s +power is its ability to hold the train of thought in the line that +reason directs, when feeling would draw it elsewhere. This ability marks +the man who does big things; while the inability to ever turn attention +away from the interests proposed by feeling assures weakness.</p> + +<p>Some of the most charming people we shall ever know are those +temperamental children of happiness whose interests are naturally +wholesome and externalized, whose natures are spontaneous and joyous, +and who live as they feel, seemingly never knowing the stress of forced +concentration. With them attention follows feeling, feeling is sweet and +true, and volition simply carries out what feeling dictates. And life +may not be complicated.</p> + +<p>But there is another class whose attention also follows in the ways of +least resistance; and life for them is a wallowing in the morbid and +unwholesome. In them feeling is perverted, they seem to see life +habitually through dark glasses; they passively attend to the sad, the +distressing, sometimes the gruesome and the horrible with a sort of +pallid joy in their own discolored images. The first group puts joy in +all they see, because they are brimming full of joy themselves. These +others find only the unwholesome in life because their minds are<span class="pagenum" title="Page 114"> </span><a name="Page_114" id="Page_114"></a> +storehouses of it. We say that each type has projected himself, that is, +has thrust himself out into the external world, and is standing back, +looking at his own nature and calling that the universe.</p> + +<p>But neither of these two groups can long withstand the stress of a world +they only feel and have never attempted to comprehend. The irresponsibly +happy ones are too often crushed and broken when life proves to bring +loss and failure and disappointment; the morbid probably will cease some +day to enjoy their melancholic moods, and be unable to find their way +out of them. If both had learned to control attention, they might have +been saved. The happy, care-free child of the light is at desperate loss +when the sun he loves is obscured, if he has not learned to look upon +the far side of the clouds to find that there they glow golden with the +rays temporarily shut from him. Because clouds were not interesting to +him he never attended to them—and now he cannot. If the pessimistic, +morbid one had looked away from the shadow to the sun it hid he, too, in +the end might have seen with sane eyes and lived so wholesomely as to +find all the good there was in life. Willed attention, rather than +spineless feeling distractibility, might have saved him.</p> + +<p>When thinking can be forced to follow where trained reason directs, and +can be kept in that direction, the greatest problem of physical and +nervous well being is solved. To the nurse there is no other principle +of<span class="pagenum" title="Page 115"> </span><a name="Page_115" id="Page_115"></a> psychology so important. But no child ever had his attention +diverted by reasoning alone. The object at which you wish him to look +must be made more impelling than the one he already sees, or he must +want much to please you, else he only with his eyes will follow your +command while his mind returns to his real interest; and the second you +cease to command that eye service, he looks back to the thing that was +holding him before. The beginning of all education is in arousing a +<i>want to know</i>; in turning desire in the direction of knowledge.</p> + +<p>I am an undisciplined child and I want only candy for my lunch. It is +not good for me. Milk is what I should have. I don’t want it. You may +deprive me of the candy and force me to drink the milk, and I can do +nothing but submit. But I rebel within, and I am only more convinced +that I “hate” it and want candy, and that you are my natural enemy +because you force the one upon me and deprive me of the other. If I were +insane and so, of course, could not be reasoned with, this might be +inevitable. But it would be unfortunate. In that case, if possible, do +not let me see the candy; let only the food it is best for me to have be +put before me, and perhaps eventually I shall come to want the more +wholesome thing—for it is better than the hunger.</p> + +<p>But as it happens I am a perfectly normal person, only I am sick. I am +tired of bed, and want to sit up—and it does seem that I should have my +desire. The<span class="pagenum" title="Page 116"> </span><a name="Page_116" id="Page_116"></a> nurse, wise in her knowledge of sick “grown-ups,” who are, +after all, very like children, will find a way to divert my mind from +the immediate “I want” to something which I also can be led to want. I +may agree that I want more the better feeling an hour from now. Perhaps +her humorous picture of the effects of too early freedom on my +condition, or of my body’s urgent demand for rest, regardless of my +mind’s wish; perhaps only a joke which diverts me; perchance the +“take-for-granted you want to help us out” air; mayhap the story to be +read or told; or simply the poise and quiet assurance of the nurse who +never questions my reasonableness and acquiescence; perhaps her +confidence that this will serve as a means to the end I covet—will +result in my gladly taking her advice, and my perfect willingness to +wait for new orders, while I indulge in beautiful plans I shall carry +out when they finally arrive.</p> + +<p>In other words, with the sick as with children, attention naturally +follows interest. And the good nurse realizes that it is not wise to +force co-operation when she can secure it by diverting her patient’s +thoughts to another interest than the one now holding him. Very often, +merely by chatting quietly about something she has learned has an +appeal, she can make the patient forget his weariness and boredom, or +his resistance to details of treatment. The very milk he is refusing to +drink may be down before he realizes it. But right here lies a hidden +reef which may cause wreckage in the<span class="pagenum" title="Page 117"> </span><a name="Page_117" id="Page_117"></a> future. It is good therapy to +divert attention by appealing to another interest when the patient is +too sick or too stubborn or not clear enough mentally to be reasoned +with. But if this becomes a principle, and his reason and active +co-operation are never secured to make him choose the way of health for +himself, the hour he is out of the nurse’s hands he reverts to the +things that now happen to appeal to him. Then unless some wise friend is +near to continue her method of making the reasonable interesting, the +advice of reason can “go to smash.”</p> + +<p>There has been a very constant illustration throughout the past of the +unwisdom of relying upon diverted attention alone as an effective +therapeutic agent. We hope this will not illustrate our point so clearly +in the future. The drunkard, who is just recovering from a big spree, +and feels sick and disgusted with himself, and sore and ashamed, is +appealed to in glowing terms of the wellness and strength and buoyancy +of the man who never drinks. He has no “mornings after.” The Lord is +just waiting to save this dejected victim of alcohol from his hateful +enemy who has made him what he is at this hour, and will forgive all his +sottishness, his sins. He will be respected; he can command the love of +his family again. He will no longer be a slave, but a free man. Right +now, respect of the world and love of family and friends, and cleanness, +and the forgiveness of a good God are infinitely more interesting than +this splitting headache, this horrible sick feeling. And<span class="pagenum" title="Page 118"> </span><a name="Page_118" id="Page_118"></a> attention may +be very readily diverted. This promised new life is more attractive than +the present. It is easy to keep attention there. And he reforms. He +swears off “for keeps.” He is a happy man, a free man. For a few days or +weeks, perhaps even longer, he glories in his new self-respect. It is a +strange and enticing sensation. Then one day something goes wrong. He +loses some money, or he is awfully tired, or the wife and children bore +him, and all of a sudden the one greatest interest in the world is a +drink. And because his thinking can always be led by his feeling; +because he has never learned to force it to go elsewhere, he has his +drink. Appealing to his emotions did not and cannot save him unless that +appeal is followed at the right moment by awakened reason, which will +look at the whole proposition when the mind is at its normal best, and +choose to follow where rational feeling directs. Nor will reason save +unless volition comes to its support and strongly backs it up and +enforces what it advises.</p> + + +<h4><a name="The_Attention_of_Reason_and_Will" id="The_Attention_of_Reason_and_Will"></a>The Attention of Reason and Will</h4> + +<p>So the good nurse will not consider her work done when she has diverted +mental processes into channels of co-operation. When the patient, who is +capable of reasoning, knows the why of his treatment, and realizes that +he can only keep well as he himself takes over the job and puts his mind +on things out<span class="pagenum" title="Page 119"> </span><a name="Page_119" id="Page_119"></a>side of his feelings, and carries out the doctor’s +instructions for the sake of securing a certain end—then he has been +under a good nurse. This wise helper never “preaches,” but makes the +healthy goal very desirable, stirs up an ambition to attain it, and +prods the will to keep on after it despite anything feeling may say.</p> + +<p>This attitude on the part of the nurse presupposes that her own +attention, while with her patient, is upon him and upon securing his +health, and not upon her tiredness, or boredom, or headache, or the +party tonight, or the man who has asked her to go to the theater with +him tomorrow. She, surely, must learn to direct her thoughts where +reason suggests, and to gain new interests through willed attention, or +as a nurse she is less than second rate. Nor can she get the best +results until she can turn with a single mind to the patient at hand as +the immediate problem to be solved. And probably neither nurse nor +doctor does any better service, except in saving life itself, than in +keeping the patient from thinking constantly of himself and his ills. +For it seems of little use to have made some people physically well, if +they are to carry through prolonged years the curse of constant +self-attention, self-centeredness, an ingrowing ego.</p> + +<p>There are a few simple laws of the mind hinging upon attention which are +today being impressed upon teachers in every department, in +kindergarten, public school, college, and university. And they are as +necessary to<span class="pagenum" title="Page 120"> </span><a name="Page_120" id="Page_120"></a> the nurse as to the teacher. Three of them we have already +discussed:</p> +<ol> +<li>Attention naturally follows interest.</li> + +<li>Attention may be held by will where reason directs.</li> + +<li>New interests grow out of willed attention. + +<p style="margin-top:0; margin-bottom:0;">A fourth we shall stress before considering the use the nurse can make of them:</p></li> + +<li>The thing to which our chief attention is given becomes the most +important thing.</li> +</ol> +<p>Do not contradict this too quickly. Don’t say that nursing gets your +chief consideration because it is, of necessity, your profession; but +that you love your music infinitely more, and look forward to that +through all your hours on duty. If this merely proves that music is +distracting your attention, you are doing your nursing as a means, and +not as an end; you give it probably all the attention necessary for good +work, but your real desire is music. Your chief attention is directed +toward that goal. Hence music is to you the most important thing. If +your will is sufficiently trained to keep you from consciously thinking +of it, still you are dreaming of it and working for it. You may make a +very good nurse, but you will never be as excellent a one as the woman +from whom nursing demands first and chief attention.</p> + +<p>We sometimes speak of one woman as a born nurse, and say of another, +“She’s a good nurse, thoroughly conscientious, but not a natural one +like Miss X.” It<span class="pagenum" title="Page 121"> </span><a name="Page_121" id="Page_121"></a> only means that Miss X’s main purpose in life has +always been caring for the sick, while Miss Y’s secondary concern is +that. There is a third, however, who may be sidetracked into nursing, +but whose chiefest interest and attention in life has not been so much a +certain profession or accomplishment, but a passion for people, with an +ability to enter into their lives understandingly. She may not care for +nursing in itself. It is only accidental that her thoughts were turned +to it. But her liking for people makes it easier for her to concentrate +attention on the details of nursing, as thereby she is fulfilling her +life’s ambition in studying and serving human beings. She may be a real +success if she can only convince herself that this is her forte. If not, +and she dreams of other fields of service, her concentration on the +thing at hand is not perfect enough for her to compete successfully with +the “born nurse.”</p> + +<p>Whatever it is, the thing that gets our chief attention is the most +important to us. It may be lack of appetite, or pain in the side, +indigestion, general disability, discomfort, the mistreatment we once +received, the mistake we once made, or the sin we committed—whatever it +is that holds our attention, it is the most absorbing and interesting +thing in the universe, though it may be an utterly morbid interest, an +unhappy attention. But it blots out for the time the rest of the world. +A big hint for the nurse exists therein. Let her try in every lawful way +to divert her patient’s attention from<span class="pagenum" title="Page 122"> </span><a name="Page_122" id="Page_122"></a> the disease-breeding stimuli +toward the happy and wholesome ones.</p> + +<p>For the nurse herself in the care of patients let us draw some +conclusions from these laws of the mind’s working:</p> +<ol> +<li>Have a goal in view for the patient’s health of both body and mind.</li> + +<li>Work toward instilling in your patient a health ambition—a pride in +health.</li> + +<li>Remember that overcrowding the mind defeats your purpose of making +one clear impression.</li> + +<li>Win interest by any legitimate means to the next step toward the +goal, and only the next.</li> + +<li>Work for attention to hopeful, courageous, and happy things.</li> +</ol> +<p>Let us as nurses remember always that it is for the patient’s sake and +not for our own that certain results must be obtained. Our work is +usually in helping the doctor to get the best possibilities out of the +material at hand, and we cannot hope to change the fabric. But we can +help to repair it; we can sometimes influence the color and suggest some +details of the pattern, or assist in the “making over” process; and when +the fabric is substantial and beautiful we may assist in preventing its +marring. So we may help to evolve a body-health and mind-health attitude +from what seemed the wreckage of a disease-accepting mind; or we may +have the great privilege of warding off the disease-accepting<span class="pagenum" title="Page 123"> </span><a name="Page_123" id="Page_123"></a> attitude. +But always, in all our care of patients, let us not neglect or fail to +use wisely this central fact of psychology; that anything that gains +attention, even for a moment, leaves its impress on the mind; that the +direction of attention determines our general reaction to life.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 124"> </span><a name="Page_124" id="Page_124"></a><a name="CHAPTER_XI" id="CHAPTER_XI"></a>CHAPTER XI +<br /> +GETTING THE PATIENT’S POINT OF VIEW</h2> + + +<h4><a name="What_Determines_the_Point_of_View" id="What_Determines_the_Point_of_View"></a>What Determines the Point of View</h4> + +<p>The point of view of any individual depends upon temperament, present +conditions—mental and physical—and the aim of the life. That is, it +depends upon his inherited tendencies plus a unique personal something, +plus all the facts of his environment and experience, plus what he lives +for.</p> + +<p>Richard and Jim both live in Philadelphia, Richard on Walnut Street and +Jim on Sansom Street. Richard’s father is of the best Quaker stock, with +hundreds of years of gentle and aristocratic ancestry behind him. He +followed his father and his grandfather into the profession of medicine, +and is a well-known specialist, alert, keen, expert, and deservedly +honored. He is at home in Greek and Latin, French, and the sciences. He +selects at a glance only the conservative best in art and music and +literature. His world is a gentleman’s world, a scholar’s world, and the +world of a scientist and a humanitarian. And Richard, his son, is true +to type.</p> + +<p><span class="pagenum" title="Page 125"> </span><a name="Page_125" id="Page_125"></a>Jim’s father is the ash man. His world is in the alleys and basements. +His pastime, cheap movies, and the park on Sundays. When he is not +working he is too “dead tired” for anything heavier than the Sunday +Supplement or perhaps the socialist club-rooms, where he talks about the +down-trodden working man and learns to hate the “idle” rich. He spends +his money on food and cheap shows and showy clothes. He talks loudly, +eats ravenously, works hard, is honest, and wants something better for +his children than he and the “old woman” have had. His music is the +street-organ, the movie piano, and the band—some of it excellent +too—but none of your dreamy stuff—good and lively. And his son, Jim, +is true to type.</p> + +<p>After the Armistice Jim and Richard, who have fought for months side by +side, go to Paris together. Richard may “have a fling” at Jim’s +amusements for the sake of playing the game and “seeing how the other +half lives” and all that—but before long we shall find him in the +high-class theaters and restaurants, visiting the wonderful art +collections and libraries, riding in luxurious automobiles, and staying +in the best hotels he can find. And even though Jim may have saved +Richard’s life and Richard is eternally grateful, and loves Jim as a +“dandy good scout,” their ways will inevitably drift apart when the one +big common interest of fighting together for a free world is over. They +will always remember each other. Jim will decide that<span class="pagenum" title="Page 126"> </span><a name="Page_126" id="Page_126"></a> a “highbrow” can +be a real man, and Richard will ever after have a fellow-feeling for the +“other half” and think of them now as “folks.” But Jim is not at home in +Richard’s neighborhood and circle; and Richard is a fish out of water in +Jim’s. The point of view of each has been largely determined by his +heredity and his environment.</p> + +<p>But suppose Jim isn’t true to type. From the time he was a mere +youngster the ash-man life did not appeal to him. In school he liked the +highbrow crowd; he “took to” Latin and literature. He has a feeling of +vague disgust when he sees a vulgar picture, a shudder when the +street-organ grinds. There is something in Jim different. He isn’t in +tune with either his immediate heredity or his environment. The +contribution from some remote ancestor has overbalanced the rest, and +Jim becomes a professional man.</p> + +<p>Or perhaps Richard breaks his father’s heart. Instead of following the +trail already made, he cuts loose, frequents vulgar resorts, hates his +school work, becomes a loafer and a bum—and, finally, a second-rate day +laborer. Again, what he is himself, his “vital spark” has been stronger +than immediate heredity and environment, and has broken through.</p> + + +<h4><a name="Getting_the_Other_Mans_Point_of_View" id="Getting_the_Other_Mans_Point_of_View"></a>Getting the Other Man’s Point of View</h4> + +<p>Our points of view are very frequently merely hereditary or acquired +prejudices, hence altogether emotional<span class="pagenum" title="Page 127"> </span><a name="Page_127" id="Page_127"></a> rather than rational. We only +with great difficulty see things through another man’s eyes. It +necessitates comprehending his background fully, and standing exactly +where he stands, so mind and eyes can both look out from the same +conditions that confront him. And this is only possible for the man or +woman possessed of a vicarious imagination. Such an imagination, +however, can be cultivated.</p> + +<p>You hate my father. He injured yours—unjustly, to your mind, of course, +for yours can do no wrong. From my point of view this father of mine is +a great, good man. From your point of view he is wicked and cruel. We +are both honest in our emotion-directed opinions. Until you can know my +father as I know him, and I can know yours as you know him, we shall +never agree about them. But I <i>can</i> learn to understand <i>why</i> you feel +as you do, and you <i>can</i> learn to understand <i>why</i> I feel as I do. I can +put myself, in imagination, in your place, and see that other man as my +father, and pretty well grasp your point of view, and you can likewise +get mine.</p> + +<p>After all, the law is very simple. Each man is the result of the things +he puts his attention chiefly upon; and he puts it naturally upon the +things which his forebears and his surroundings have held before him. +The rare person and the trained person can assert the “vital spark” of +his own personality and tear attention away from the easy direction and +force, and hold it<span class="pagenum" title="Page 128"> </span><a name="Page_128" id="Page_128"></a> somewhere else. So he can change his points of view +by learning that there are other vantage grounds which direct to better +results. With some one else to lead the way and give a bit of help, or +with the urge of desire to understand the new viewpoint, or by the drive +of his will, he can change his own.</p> + +<p>Let us not forget that what we see depends on whether or not our eyes +are normal, on where we look, or on what kind of spectacles we wear. Two +things we can change—where we look, and the spectacles. If our eyes +were made wrong we probably cannot change that, but we can often correct +poor vision by right artificial lenses. There are people doomed to live +in most unattractive, crowded surroundings who make a flower-garden of +charm and sweetness there, or, without grounds, keep a window-box of +fragrance. The normal person can pretty largely either make the most +impossible environment serve his ends or get into a better one. So we +can usually look to something constructive, helpful, attractive, or +beautiful; and we can refuse to wear blue spectacles.</p> + +<p>We nurses soon realize that there are just about as many points of view +as there are people, and that if we would help cure attitudes as well as +bodies, and so lessen the tendency to sickness, it behooves us to learn +to see what the other man sees through his eyes or by the use of his +glasses, from where he stands.</p> + +<p>Let us try just a few experiments. Hold your pain<span class="pagenum" title="Page 129"> </span><a name="Page_129" id="Page_129"></a> and suffering from +your appendix operation, and disappointment because you can’t be +bridesmaid at your chum’s wedding, up close to your eyes, and you cannot +see anything else. They crowd the whole field of vision. Look at the +world from the eyes of a spoiled woman of wealth who for twenty years +has had husband, friends, and servants obedient to her every whim. She +has grown selfish and demanding. What she has asked for, hitherto, has +been immediately forthcoming. Now she is ill, and she naturally +considers the doctors and nurses mere agents to secure her relief from +discomfort. She is willing to pay any price for that—and still she is +allowed to suffer. From her point of view it is utterly unreasonable, +inexcusable. What are hospitals and nurses for, anyway? And she is +carping, critical, and disagreeable. Her attitude is as sick as her +body. How could it be otherwise?</p> + +<p>Look about you from an aching mind and body, after days of suffering and +sleeplessness, and unless you are a rare person and have a soul that +sees the sunshine back of everything—you will find the world a place of +torture. Look out from despair and loss of the ones you love best, or +from failure of will to meet disaster, and everybody may be involved in +bringing about your suffering, or in effecting your disgrace.</p> + +<p>Look out on the world from the eyes of the immigrant who has lost all +his illusions of the land where dollars grow on the street and where +everyone has an<span class="pagenum" title="Page 130"> </span><a name="Page_130" id="Page_130"></a> equal chance to be president, and if you do not cringe +in abject humility, you are not unlikely to be insufferably +self-asserting, considering that the world has robbed you and that now +it is your turn to get all that is coming to you. So you make loud +demands in a rude, ordering voice. The nurse is there to wait upon +you—and finally you will have your innings.</p> + +<p>Look out from the resentful eyes and smarting mind of the negro who is +just beginning in a northern city to realize that his boasted “equality” +is a farce, and you will try to prove to the white nurse that you are as +good as anybody. You are impossible; but back of all your bravado and +swagger and rudeness and complaint of neglect because of your color, you +realize that you cannot measure up. You know you belong to a different +race, most of whose members are daily giving evidences of inferiority; +and you are sure that the nurse is thinking that.</p> + +<p>Look from the eyes of the “new rich,” or the very economical, and you +are going to get your money’s worth out of your nurses.</p> + +<p>The nurse who can get back of her patient’s forehead and put her mind +there and let it work from the patient’s point of view, will learn a +saving sense of humor, will be strict without antagonizing, will clear +away a lot of mental clouds and help to make permanent the cure the +treatment brings.</p> + +<p>One can often judge very truly a patient’s real char<span class="pagenum" title="Page 131"> </span><a name="Page_131" id="Page_131"></a>acter by his +reaction to his sickness. On the other hand, frequently it only +indicates that he has not yet properly adapted himself to a new +experience and a trying one. We hear so often, “Why, she’s a different +person these days, since she’s feeling better. It’s a joy to do things +for her.” She was the same person a while back, but had not learned to +accept discomfort. Any of the following list of adjectives we hear +applied to our patient again and again by the nurses:</p> + +<table class="spaced" summary="List of negative adjectives applied to patients by nurses."> +<tr><td>unreasonable</td><td>stubborn</td><td>lazy</td><td>deluded</td></tr> +<tr><td>cranky</td><td>resistive</td><td>unco-operative</td><td>will-less</td></tr> +<tr><td>hipped</td><td>obsessed</td><td>hypocritical</td><td>of mean disposition</td></tr> +<tr><td>excitable</td><td>fearful</td><td>exacting</td><td>dissatisfied</td></tr> +<tr><td>undecided</td><td>wilful</td><td>self-centered</td><td>morbid</td></tr> +<tr><td>doubtful</td><td>demanding</td><td>retarded</td><td>abusive</td></tr> +<tr><td>depressed</td><td>spineless</td><td>self-satisfied</td></tr> +</table> + +<p>Unpleasant terms they are, and condemning ones if accepted as final. +When the nurse realizes that under the same conditions she would +probably merit them herself, she becomes more anxious to remove the +conditions, and less bent upon blame.</p> + +<p>We must admit that the highest type person, when sick of any physical +illness, does not deserve such descriptive terms as these. But they are +the rare folks, few and far between; while the great mass of us have not +acquired more than enough self-control and thoughtfulness for the +ordinary routine of life. We are weakly upset by the unexpected. If it +is a pleasant unex<span class="pagenum" title="Page 132"> </span><a name="Page_132" id="Page_132"></a>pected, we are plus in our enthusiasm, and people +applaud; if the unpleasant unexpected, we fall short, and people deplore +our weakness. If we learn our lesson of self-control and adaptability, +and gain in beauty of character through experience, it has served a +purpose. But the nurse deals with the average of human nature, and she +finds their reaction faulty. Very often, if she is observant, she will +discover that a patient responds in a very different way to some other +nurse, who somehow finds that “trying” sick woman charming or +thoughtful, likable or sweet. Of course, it may be because the other +nurse weakens discipline and caters to the patient’s whims; but it is +just as likely to be because she has tempered her care and her +strictness with understanding. She has grasped the patient’s point of +view; and with that start, the chances are 50 per cent. more in favor of +the patient grasping and acceding to the wise nurse’s point of view.</p> + +<p>Shall we not remember that our trying, cranky, stubborn patient is a +sick person, and learn to treat that <ins class="correction" title="Transcriber’s note: Original read ‘stubborness’.">stubbornness</ins> or crankiness as a +symptom indicating her need, just as we would a rising temperature?</p> + +<p>When we can meet her attitude with comprehension, and, if necessary, +with quietly firm disregard, then we are beginning to be good nurses.</p> + +<p>Some of the most common of these sick reactions with which the nurse +must deal are enhanced suggestibility, repression, oversensitiveness, +stubbornness, fear, de<span class="pagenum" title="Page 133"> </span><a name="Page_133" id="Page_133"></a>pression, and irritability. And each one demands +a different method of approach if real help is to be given.</p> + +<p>Old Isaac Walton wrote a book many, many years ago called “The Complete +Angler.” He was a famous amateur fisherman, and he says there are only +three rules to be observed and they will bring sure success:</p> + +<ol> +<li>Study your fish.</li> +<li>Study your fish.</li> +<li>Study your fish.</li> +</ol> + +<p>If the angler follows these directions, he is not apt to offer the wrong +bait. When he knows all their little peculiarities, he will know how to +catch his fish. The “complete angler” has an unlimited patience and an +infinite sense of repose and calm. He never hurries the fish, lest they +become suspicious of his bait. And he proves that these three rules +work.</p> + +<p>The nurse who accepts every patient as like every other, and treats him +accordingly, will never be a great success. The nurse who “studies her +fish” and learns their psychology, will be a therapeutic force. She will +know the <i>why</i> of the way that patient acts.</p> + + +<h4><a name="The_Deluded_Patient" id="The_Deluded_Patient"></a>The Deluded Patient</h4> + +<p>If the patient’s mind is temporarily clouded through infection or +suffering, he may be reacting to a delusion, an obsession, a fixed idea +of disability, a terrifying fear. Sometimes he persistently refuses +food, and gives no reason for it. The unthinking nurse is tried, +puzzled,<span class="pagenum" title="Page 134"> </span><a name="Page_134" id="Page_134"></a> and irritated. In other ways, perhaps, the patient seems quite +normal. But, after all, the explanation is very simple. He probably is +as confident that the food is poisoned as you are that it is as it +should be. No arguing would convince him, for, to his mind, the nurse is +either a complete dupe or an agent of the people whom he knows are +plotting his death. And urging him only strengthens his conviction.</p> + +<p>The writer recalls one such case of a patient who had to be tube fed +through many months, though a tray was set before her three times a +day—and as regularly refused. Then one day she was seen slipping food +from off another patient’s tray and eating it greedily, not knowing she +was observed. When questioned, though she had never before given a +reason for refusing food served to her, she said that “they” had nothing +against Mrs. B., so wouldn’t try to poison her. Her reasoning was +excellent when one accepted her premises. She had bitter enemies. They +were not enemies of Mrs. B. and would not harm Mrs. B. Therefore she +dare not touch her own food, but could eat Mrs. B.’s if no one knew.</p> + +<p>These deluded patients live in a world we often do not sense, a world +whose reality we do not appreciate. The nurse, after much experience, +finds that there is a key to every resistance, to every lack of +co-operation, to abnormal attitudes and actions. She realizes that a +powerful emotion of desire or fear, of love or hate, of ambition or +self-depreciation, of hope or despair, of<span class="pagenum" title="Page 135"> </span><a name="Page_135" id="Page_135"></a> faith or distrust, unchecked +by reason or judgment through the years, has provided a soil upon which +emotional thinking alone can grow. The patient is a mere puppet of the +suggestions of emotions which may not be at all pertinent to the facts.</p> + + +<h4><a name="Nursing_the_Deluded_Patient" id="Nursing_the_Deluded_Patient"></a>Nursing the Deluded Patient</h4> + +<p>The nurse soon realizes the uselessness of attempting to argue a patient +out of his delusions, of trying to convince him that the things he sees +and hears and perhaps tastes and feels, are but hallucinations. Her very +insistence only fastens his attention more firmly upon the false +conclusion or makes him more convinced that his mind is giving him a +true report from the senses of sight and hearing and taste and feeling. +But often a quiet disregard of the delusions while the nurse goes on her +way and holds her patient to his routine, consistently and confidently, +as she would in case they were not true, will eventually cause him to +question their reality just because no calamity results. The nurse acts +as if these delusions and hallucinations were non-existent in reality, +and when the occasion arises, through the patient’s questioning, she +urges him to exert his will to act also as if they were not true; to try +it and see what happens. Arguing, also, she finds, usually antagonizes +or makes the patient stubborn. He cannot prove by her logic his point, +but he “knows” from inner experience that he sees what he sees, hears +what he<span class="pagenum" title="Page 136"> </span><a name="Page_136" id="Page_136"></a> hears, and knows what he knows. The fact that the nurse does +not is merely annoying evidence that she is blind, deaf, or stupid to +these things of his reality. He knows he is lost and damned, or tainted; +that he is King George, Cæsar, or the Lord, as the case may be; or that +his internal organs are all wrong. He “feels” it and the nurse +can’t—therefore, he alone has true knowledge of it. In the end, the +wise nurse who never disputes with him, but leads him on to action which +utterly disregards these things, may bring about a gradual conviction in +the patient’s mind that a man couldn’t do what he does if all these +things were true; and the delusion slowly may lose its force or the +hallucination fade away. Many patients drop them from their lives +entirely. Many others in whom dementia is not indicated, or in whose +cases it is indefinitely delayed, can come to an intellectual +realization that all these things are fantasies, and do not represent +reality; that despite their continued, frequent, or occasional demands +upon feeling life, they can be consistently ignored. These psychopathic +individuals may act as they would if the delusions never came henceforth +to their consciousness, and so be enabled to live a comparatively normal +life.</p> + + +<h4><a name="The_Obsessed_Patient" id="The_Obsessed_Patient"></a>The Obsessed Patient</h4> + +<p>A patient who is suffering from obsessions must carry out certain +abnormal actions, or be wretched. She cannot do otherwise. It is as +though she were forced by<span class="pagenum" title="Page 137"> </span><a name="Page_137" id="Page_137"></a> some outside agent, though the forcing is +actually from within. When the nurse realizes this, and the more +essential fact—that many patients, who have not true obsessions, yet +have a tendency toward obsessed ways of thinking and doing—when she +comprehends it almost as she would if she were the victim, then she is +ready to help the patient by gently making the action impossible, and at +the same time diverting attention.</p> + + +<h4><a name="The_Mind_a_Prey_to_False_Associations" id="The_Mind_a_Prey_to_False_Associations"></a>The Mind a Prey to False Associations</h4> + +<p>Sometimes a nurse reminds a patient of some one in the past who has +complicated her life in an unhappy way, so she distrusts or dreads her +or is made constantly uncomfortable in her presence. In such a case, if +the nurse reports her patient as resistive, or fearful or cringing, or +distrustful, she is really misrepresenting her; for under another’s care +that patient may show an entirely opposite reaction.</p> + +<p>The nurse can only sense the strength of the influence of heredity and +environment and habit of thought, which would give the explanation of +many things in her patient’s attitude. Nor can she realize just what +shade of meaning certain phrases and words have for her charge. To the +nervously overwrought person the most innocent reference—father, +sister, wife, home—may bring concepts that are unbearable. The +association of the word may make for deep unhappiness, of which the +nurse knows nothing. But she <i>can</i> learn that<span class="pagenum" title="Page 138"> </span><a name="Page_138" id="Page_138"></a> all these things <i>do</i> +influence attitude, can appreciate the difficulty of her patient’s +effort at adjustment, and do all in her power to make that adjustment +possible. If the patient is reasonable she can appeal to her reason. If +she is too sick for that, the nurse can use happy suggestions. If the +mind is deluded and obsessed she can use firm kindness. She can learn +what loss of privileges will affect the rude and unco-operative patient, +and may be allowed to try that. She can sometimes help the patient to +self-control by making her realize that after each outburst she will be +constructively ignored.</p> + +<p>But the point we wish to make is this: There are some sick reactions +which the nurse, if she recognizes as such, can help the patient to +transform into wholesome ones. At the very least the wise nurse can +learn to simplify her own difficulties by accepting the unpleasant +patient as possibly the result of her illness, and refusing to allow her +trying attitude to get on her nerves. The patient may be reacting +normally to the stimulus her untrained and toxic brain received. And +when the nurse can see into the other’s mental workings, get her point +of view, she is ready to give fundamental help.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 139"> </span><a name="Page_139" id="Page_139"></a><a name="CHAPTER_XII" id="CHAPTER_XII"></a>CHAPTER XII +<br /> +THE PSYCHOLOGY OF THE NURSE</h2> + + +<p>The mind can be as definitely developed and strengthened as the body. +The man who has suffered for years an organic disease will never have +the same force as he who has never been seriously ill; but his +constitution can be built up and made as efficient as possible within +its limitations. Many a man or woman who has an organic heart disorder, +through treatment and the proper exercises gradually increased, can very +often approximate through many years the output of a normally strong +person. The individual weakened by a tuberculous infection can +frequently, by following a prescribed regimen for a time, by wise, +scientific diet and rest treatment and the help of the out-of-doors, +then by carefully increased physical activity, finally live the useful, +average life. But it takes scientific care to evolve the weak body into +a strong one; and in some cases, at best, it can never stand the same +strain that the uninjured one carries with ease. However, even damaged +bodies can be made very productive within their limited spheres. Also +the naturally perfect physique can quickly become unfit through neglect +or infections or misuse.</p> + +<p><span class="pagenum" title="Page 140"> </span><a name="Page_140" id="Page_140"></a>In the same way, and just as definitely, can the mind be developed and +strengthened. Some are by nature keen, alert, brilliant. They may +develop into masterfulness; or they, too, may degenerate, through abuse, +or from the effect of body infections, into uselessness. The germ-plasm +has foreordained some individuals to psychic disorders; but training and +mode of life can modify many of these defects. And the average mind, +like the average physical organs, can be made more efficient through +partaking of the proper mental food, through careful training and wise +use.</p> + +<p>No more urgent necessity faces the professional woman than this of +training her mind to its highest productiveness. Argument is not needed +to convince intelligent people today that the accomplishment of life +depends upon mentality.</p> + +<p>Let us look into the very A, B, C’s of mind development, and as nurses +undertake to equip ourselves to master our profession from the ground +up. The first essential is ability to think clearly.</p> + +<p><i>Steps to Clear Thinking</i>:</p> +<ol> +<li>Accurate perception, with attention to the thing that reason chooses.</li> + +<li>Association of ideas.</li> + +<li>Concentration, acquired by the help of emotion and will.</li> + +<li>Emotional equilibrium, which refuses to allow feeling to obscure +judgment by leading reason astray.</li> + +<li><span class="pagenum" title="Page 141"> </span><a name="Page_141" id="Page_141"></a>Self-correction.</li> + +<li>Automatic habits, which free the mind of all unnecessary crowding.</li> +</ol> + +<h4><a name="Accuracy_of_Perception" id="Accuracy_of_Perception"></a>Accuracy of Perception</h4> + +<p>The beginning of learning is perception. Keen, accurate perception at +the time of first introduction of a new fact or thought, and the linking +up of that new material with something already in consciousness, insures +in the normal mind the ability to remember and use that fact or thought +again. The things casually perceived and not definitely tied up with +something else are soon forgotten by the conscious mind.</p> + +<p>You pass a florist shop where a score of different flowers and plants +are displayed. If your thoughts are intently on your errand you may +glance in, see flowers, color, perhaps a riot of colors only—and +beauty; and you feel a glow of pleasure from the sight. But a moment +later you cannot name the blooms in the window. Perhaps roses come to +mind because you have very special feeling for them; or carnations, or +sweet peas. But the window as a whole you perceive only as flowers, and +color, and beauty. You cannot describe it in detail, for you gave it +only passive attention.</p> + +<p>But if you went to that window to know its contents; to find out what +the florist had in his shop, because you are very interested in all +flowers and plants, then you can tell minutely what is there. You had a<span class="pagenum" title="Page 142"> </span><a name="Page_142" id="Page_142"></a> +purpose in perceiving the window; your will held attention upon each +object in turn; and your love of flowers (an emotion) eased the effort +of volition when it might have tired.</p> + +<p>Perception, then, is of three kinds: passive, incited by interest, and +directed by will. And the perception which is the basis of accurate +knowledge is one of keen interest, or of will, or of interest plus will.</p> + + +<h4><a name="Training_Perception" id="Training_Perception"></a>Training Perception</h4> + +<p>The nurse who demands of herself that she perceive accurately paves the +way for accurate, deft service in her profession. There are constant +means at hand for training in the art. Suppose you try to get so +definite a picture of each ward or room you enter, in a swift but +attentive examination of its furnishings and their locations, and of the +patients, that you can reproduce it to yourself or a friend some days +later.</p> + +<p>You come into a large ward, with a row of beds on either side of the +door, and a wide central space between. How many beds in each row? There +is a table at the far end of the room, opposite the door, and a nurse in +white is writing there. Why does she wear white? What is her name? To +your right is a closet-like room opening from the ward. That is a +medicine-room, you are told. How many windows has the ward? You glance +from bed to bed with a rapid passing in review of the patients. Which +ones seem to you very<span class="pagenum" title="Page 143"> </span><a name="Page_143" id="Page_143"></a> ill? There is a large white screen about one. You +are told that when treatments are given the screen is put there, or that +when a patient is dying the bed is screened. You look for the +ventilators, and see how many are open and how they work. You see a +room-thermometer, and ask at what temperature it is kept. The nurse +explains that a certain degree is ordered, and that, so far as possible, +the ventilators are operated to insure that.</p> + +<p>If your attention has followed all these details with careful, accurate +perception; if you have grasped them clearly, one by one, at the time, +you will be able to answer quickly next day when some one asks how many +patients the wards accommodate, and how many beds are vacant. You can +describe the lighting and ventilation, the room temperature, etc. And +later on you will quickly see to it that a screen is properly placed +when you know treatments are to be given.</p> + + +<h4><a name="Association_of_Ideas" id="Association_of_Ideas"></a>Association of Ideas</h4> + +<p>After the first few years of life practically nothing enters +consciousness that cannot by some likeness or contrast or kinship be +connected with something already there. Were it not for this saving +economy memory would be helpless. So the nurse who is in earnest and +eager to master her new work will not only perceive carefully each +detail of arrangement, but in two or three days at most will know each +patient there; she will have worked out a system of associations, +remem<span class="pagenum" title="Page 144"> </span><a name="Page_144" id="Page_144"></a>bering not a meaningless name, but an individual with certain +characteristics which she ties up with her name, and so gives it a +definite personality. She thereafter recalls not merely a patient, but a +very special patient; and as she comes to mind she brings a title with +her, which is her symbol. Likewise when her name is spoken or thought, +she herself comes into the nurse’s immediate consciousness. A bed in a +certain part of the room will be no longer merely a bed, but +Mrs. Brown’s bed. Remembering can be made easy by using some such method +as this:</p> + +<p>The first bed to the right as you enter is Mrs. Meade’s. She is the +woman with the broken hip. The next is Mrs. Blake’s, that blonde, big +woman who wants more attention than any one else. The third is +Mrs. Bunting’s. She has wonderful, curling black hair, and a nice +response to everything done for her. The next beyond is Mrs. O’Neil’s. +She looks as Irish as her name sounds, and you will remember her by +that. So each bed comes to mean a certain patient, and each patient +comes to suggest the ones on either side of her—her neighbors. +Blondeness and bigness together call Mrs. Blake to mind. Broken hip +means Mrs. Meade, etc. Each individual on that side of the ward becomes +associated with a name which stands for definite characteristics.</p> + +<p>Then you begin at the left bed nearest the door and follow the occupants +back on that side. You may re<span class="pagenum" title="Page 145"> </span><a name="Page_145" id="Page_145"></a>member better by jotting them down in +order of the beds, with names and a brief comment on each patient. Keep +that list on a small card in your pocket for reference for a day or two, +then depend on memory entirely. I have personally found this an +excellent method.</p> + +<p>You are expected to be able to turn quickly to any medicines needed in +emergency, and you soon learn to remember them and where they are placed +by the arrangement into classes or kinds, which most hospitals require. +Cathartics are together, hypnotics together, etc. So when you want +<i>cascara</i> you associate it with cathartic and turn to that shelf. You +learn very soon that poison medicines are kept apart from the others, +and quickly associate the <i>poison</i> label with danger to patients, +necessity of locking safely away and hiding the key from any but those +responsible for the care of the sick.</p> + +<p>Learning to look closely at the patient’s face, instead of casually +glancing at her when you care for her, makes it possible for you to note +changes of expression, heightened color, dilated pupils, a trace of +strain, etc. Then try to find the exact word that will express what you +see. Such experiments in perception and attention, association and +memory, repeatedly demanded of yourself—<i>i. e.</i>, the being able to +recall and describe in detail the room- or ward-arrangements and to +place the patients accurately, as we have just described—will prove +invaluable practice, helping you to attend to every change<span class="pagenum" title="Page 146"> </span><a name="Page_146" id="Page_146"></a> in your +patient’s demeanor and expression, which may prove significant symptoms. +And remember that while the mind can only contain so many isolated +facts, yet there is no limit to its possibilities when the power of +association of ideas is employed.</p> + +<p>Your first step to clear thinking is accuracy of perception, with +attention to the thing reason chooses; your second is association of the +things perceived, a grouping of them to fit in with each other, and with +what is already in the mind. And both imply the third—concentration, +aided by emotion and will. For passive attention and haphazard +associations assure the opposite of clear thinking.</p> + + +<h4><a name="Concentration" id="Concentration"></a>Concentration</h4> + +<p><i>How to Study.</i>—You learn sooner or later from experience that the +quickest and best way to learn anything new is to give it your undivided +attention at the moment; to perceive one thing at a time and to perceive +it as something that is definite, or as some quality that is unblurred. +One of you will spend three hours on an anatomy lesson, another two +hours, while a third nurse may give it a half-hour of concentrated study +and know it better than either of you, if you have been day-dreaming, or +talking, or rebelling at the “luck” which keeps you indoors learning +about bones, when the tennis-court is so inviting. True, some minds have +better natural equipment and some have better previous<span class="pagenum" title="Page 147"> </span><a name="Page_147" id="Page_147"></a> training than +others. But the average mind could learn a lesson well in much less time +than is spent upon learning it poorly. Few people hold their attention +strictly to the task at hand if something more interesting beckons, or +if they feel tired, or “blue.” But you can learn to do it.</p> + +<p>Put aside a certain amount of time today for study; hold your undivided +attention on your lesson, regardless of how many pleasanter things +appeal. When your eyes or your thoughts wander from your note-book, +bring them back forcibly, if need be. Your first task is to keep your +eyes there, instead of letting them follow your roommate’s movements, or +resting them by watching the street below. But it is easier to do this +than to make your mind grasp the meaning of the things you see. You may +read two or three pages, and not receive one idea, not even be able to +recall any words from the context. Your eyes are obeying your will and +seeing the words, but your mind is “wool-gathering.” Now take yourself +in hand firmly. If you are really a bit fagged, try some deep-breathing +exercises before the open window, bathe your face in cold water. Then +read a paragraph, close your book, and write, if you are not alone, or +repeat to yourself aloud, if your roommate is out, what that paragraph +says—its meaning. If you cannot do it, read it again with that end in +view. Repeat the process, and hold yourself to it day after day, if +necessary, until finally will has won the battle, or,<span class="pagenum" title="Page 148"> </span><a name="Page_148" id="Page_148"></a> better still, +your will to learn has been reinforced by an interest in the very +competition with yourself, if not yet in the contest. Then, as you learn +some facts from your notes, use your imagination to apply them in real +life.</p> + +<p>The triceps muscle. What is it for? Your notes inform you, and then it +is really interesting to see how it performs its function. What origins +and attachments must the triceps have to make it extend the arm? Your +notes say that a muscle tends to draw the part to which it is attached +toward its origin. This triceps muscle straightens the arm. In that case +it must oppose the flexion at the elbow. How is that likely to be done? +The triceps must start somewhere above the elbow, and quite far above, +too, to be able to make a straight angle of an acute one; it must start +toward the back in order to draw back the forearm; and be attached to +the back of the bone below. Also it must be quite a long muscle. So much +reason tells you. Now let me see how it is done, in fact. And you find +that the triceps has three origins high above its one attachment as a +tendon, to give it a good strong pull. These are in the outside of the +humerus and in the scapula. That is logical, and you will remember it.</p> + +<p>Now how does the arm bend? What pulls against the triceps? And you are +interested before you know it.</p> + +<p>There is nothing, good, bad, or indifferent, but has some points of +interest if the mind turns its entire atten<span class="pagenum" title="Page 149"> </span><a name="Page_149" id="Page_149"></a>tion to it. But our tendency +is to grow tired of calling back our wandering thoughts again and again +to the thing that is hard, dry, or stupid. And we need more incentive +than just the doing of the duty because it is to be done. We need a +compelling interest in the goal to encourage our wills to concentration +on the less interesting. Let us first think out the <i>why</i> of knowing +anatomy if we are to be nurses. And if the profession of nursing is the +goal, let anatomy become just the next stretch of the road that leads to +it.</p> + +<p>Concentration can be acquired. It may require three hours at first to +learn your lesson; but later on you will do it in two, then in one, and +perhaps in less. And when you can sit down with your notes and learn +them with voices about you—perhaps; with some one else in the room; +with a party an hour ahead; when you can disregard all but the work at +hand, then you can concentrate, and the big battle of your life as a +student is won. Study is no longer drudgery. Lessons occupy much less of +your time and leave you more free hours. Because you give them your +whole mind you learn them in a fraction of the hours hitherto wasted +upon them, when you studied with divided attention. When you are doing +clear thinking on the thing at hand, satisfactory results are assured.</p> + +<h4><span class="pagenum" title="Page 150"> </span><a name="Page_150" id="Page_150"></a><a name="Self-training_in_Memory" id="Self-training_in_Memory"></a>Self-training in Memory</h4> + +<p>Hand in hand with clear thinking goes reliable memory. But so many of us +have it not, and feel its need so strongly that we shall consider for a +moment some means of training it.</p> + +<p>William James holds that brain-paths cannot be deepened; that memory is +not strengthened in that way. There is a natural retentiveness with +which some of us are born—the men of colossal intellect—and they +remember and are able to use infinitely more things acquired in the +past, because they have a brain substance of greater tenacity in holding +impressions than others possess. James compares some brains to wax in +which the mark left by the seal is permanent; and others he compares to +jelly which vibrates at every touch, but retains no dent made in it. +From our study of the subconscious we know that the dent did leave an +impression on the brain; but it was in the subconscious. So we beg to +change the figure and liken, in all mankind, that part of the brain that +handles the subconscious to wax, while granting that in some rare cases +parts handling the conscious material also hold impressions, as does the +wax.</p> + +<p>Consequently, according to this theory, we do not strengthen our +memories by repetition of facts, lines, or phrases. We cannot grave any +deeper the memory paths which nature has provided at birth. But the +attention to the thing to be remembered, which repetition<span class="pagenum" title="Page 151"> </span><a name="Page_151" id="Page_151"></a> has required, +has made a larger number of connections of the words with each other, of +thought with thought, and of the new with the old. So we have tied the +new together with the old by that many more strings, as it were; and any +bit of the new tugs at other bits; and the old to which it is tied +brings the new with it when it comes to the fore. In other words, +careful attention, at the time, to the new stimulus, and its association +with the already known, together with repetition, will form a whole +system of relations in the mind, and the newly entered material soon +become so well-known that it will be difficult to disregard it.</p> + +<p>When, in spite of determined effort to remember, the thing is forgotten, +especially in the nurse’s case, it is usually because the emotional +reaction to weariness or to some like obstacle has interfered with +proper attention. James advises us if we would improve memory, to +improve our thinking processes; to pay more and keener attention, so +that we will link things closely together. This in itself will help to +arouse interest in the thing to be remembered; and keen interest alone, +or careful attention at the time of introduction of the new, and +repetition of the thing to be retained, with a will which holds the +attention fast, will assure a good, workable memory in any normal mind.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 152"> </span><a name="Page_152" id="Page_152"></a><a name="CHAPTER_XIII" id="CHAPTER_XIII"></a>CHAPTER XIII +<br /> +THE PSYCHOLOGY OF THE NURSE (Continued)</h2> + + +<h4><a name="Emotional_Equilibrium" id="Emotional_Equilibrium"></a>Emotional Equilibrium</h4> + +<p>Suppose that when you first enter the ward you are wishing with all your +heart you had never decided to become a probationer. Perhaps the white +screen and its possible meaning has so frightened you that your thoughts +refuse to go beyond it. Suppose the very sight of so much sickness has +agitated you instead of strengthening your determination to help nurse +it. That is, suppose your emotions, your feelings, so fill your mind +that perception is necessarily inaccurate and blurred. Then tomorrow +your account of the ward will be hazy, and your desire will probably be +against returning to a place where so many unpleasant feelings were +aroused.</p> + +<p>The emotional balance which refuses to allow feelings to obscure +judgment by leading reason astray is a necessary safeguard for the work +of the nurse. There is little place in the profession for the woman who +is “all sentiment,” but perhaps there is less for the one without +sentiment.</p> + +<p><span class="pagenum" title="Page 153"> </span><a name="Page_153" id="Page_153"></a>Feeling, we found, is the first expression of mind—feeling which in the +early months is entirely selfish. The happiest baby you know is not +sweet and winning to please you, but because he feels comfortable and +happy and cannot keep from expressing it. His universe is his own little +self and you exist only in your relation to him. If you give him +pleasure he likes you; if pain, he does not want you. His mother often +fails to please him, but satisfies him so much more frequently than +anybody else that he loves her best. Then comes nurse or father—if he +proves the satisfactory kind of father, or she a nurse he can love. To +the baby whatever he happens to want is good. What is not desirable is +bad. And such emotional responses are altogether normal in early months, +yes, even until the child is old enough to use reason to choose between +two desires the one that will in the end prove more satisfying. But they +are defects in adult life.</p> + +<p>The nurse who would always act as her first feeling dictates would not +be in training many days. Unpleasant sights and sounds, the fear of +making a mistake which might harm a patient, the undesirability of long +hours of hard work in caring for patients who frequently only find fault +with her best efforts, would early decide her in favor of another +life-work. Comparatively few so-called “grown-ups” are guided only by +feeling; and most of those are in institutions that are well +safeguarded. But a great many mature men and women<span class="pagenum" title="Page 154"> </span><a name="Page_154" id="Page_154"></a> allow feeling to +unduly influence their thinking. The sentimental nurse, for instance, +may find it very difficult to give an ordered hypodermic. The patient +dreads the pain and the nurse fears hurting her. Suppose she were to +fail to give it on such grounds. This is an almost unthinkable case. But +the very nurse who agrees that such an emotional weakling should not be +allowed to train, will help her patient, even when recuperating nicely, +to grow inexcusably self-centered, by sympathizing with every complaint, +warning her at every turn, by allowing her and even encouraging her, +perhaps, to discuss her illness and suffering in the minutest detail. +This nurse is more damaging than the sentimentalist who fails to give +the hypodermic; for that slip is easily discovered, and the transgressor +must immediately reform and obey orders, or be dismissed. But the second +nurse may take perfect care of the sick body, and the doctor never +realize that she is developing the sickness idea in her patient’s mind.</p> + +<p>In both of these instances reason has followed the leadings of feeling. +It is unpleasant to hurt the patient, and she is disagreeable, too, when +you insist on carrying out the orders. It is easier to agree with her +ideas and sympathize with her troubles, much easier than to find some +other avenue for her thinking, or to search for feeling substitutes. It +is pleasanter right now to allow her mind to slip unmolested into sick +reactions than to lead her, unwilling as she is, into the ways of<span class="pagenum" title="Page 155"> </span><a name="Page_155" id="Page_155"></a> +health. Reason follows feeling’s logic, which suggests that it is much +better for the patient to talk of her ills than to keep them pent up +inside; and judgment is sadly obscured.</p> + +<p>The emotionally balanced nurse hears the story once, that she may have +the material for helping the need. Feeling, perhaps deep and genuine +sympathy with a real trouble, is aroused, and rightly. But this brings a +keen desire to help the situation. Reason insists that talking of +sufferings, real or fancied, only makes them more insistently felt; that +there must be some better way to meet them. It suggests various methods +to divert the patient’s attention, to change the train of thought until +she is able herself to direct it into healthful channels; judgment +weighs the propositions and decides upon the one which will lead toward +establishing a health attitude.</p> + +<p>The nurse is continually meeting the necessity of acting contrary to +fear and discouragement and weariness of spirit. How can she secure +emotional equilibrium for herself?</p> + +<p>Keep in mind the fact that most sick people are very suggestible; that +you have a definite responsibility to make your suggestions to your +patient wholesome; and that your mood is a constant suggestion to him. +Remember that he needs your best. Then, if your own trouble seems too +great to bear, determine that, so long as you remain on duty, you will +not let it show. Try<span class="pagenum" title="Page 156"> </span><a name="Page_156" id="Page_156"></a> an experiment. See if you can go through the day +carrying your load of sorrow, or disappointment or chagrin, with so +serene a face that the sick for whom you are caring will not suspect +that you have a burden at all. That is a triumph worth the striving. +Then—if you can let it make you a little more comprehending of others’ +pain, a little more gentle with the sickest ones, a bit more patient +with the trying ones, more kindly firm with the unco-operative, +realizing that each one of them all has his burden too—you have not +choked feeling, but you have fulfilled reason’s counsel: that sick +people are not the ones to help you in your stress; that a good nurse +should rise above personal trouble to the duty at hand. Your judgment +has compared your reasons, and decided that you should act before your +patients as you would if all were well. And <i>will</i> holds you to +emotional equilibrium. Such a thing can be done in a very large measure; +and no better opportunity for emotional control will ever be offered +than the necessity of being calm and serene before your patients, no +matter how you feel.</p> + +<p>But, while reason and judgment teach us to control the expression of +certain feelings, they urge that this control be exercised in +transforming those feelings into helpful ones and giving them an +adequate outlet. Such a substitution has been suggested above. Let us +not forget that nothing in existence is of personal value until it gives +some one an emotion; that feeling is the<span class="pagenum" title="Page 157"> </span><a name="Page_157" id="Page_157"></a> beauty of life; that living, +without the happy, wholesome affective glow, would not be worth the +effort; that beauty and strength and sweetness of feeling make for a +worthy self. Remember, too, that feeling is the curse of life. It is +feeling that would make us give up the whole struggle; and ugliness and +weakness and bitterness of feeling make for a despicable self.</p> + +<p>Hope lies for us all in the realization that we can choose our feelings, +our responses. We can be utterly discouraged, and bitter and depressed +at failure; or we can recognize it as a sign-board telling us that the +other way than the one we just followed leads to the goal. And we can +follow its pointing finger with faith in a new attempt because, now, we +know at least how <i>not</i> to go. We can learn despair from all the bitter +and the hateful and the mean; or we can learn that they never could be +called so if there were not the sweet, the lovable, and the generous +with which to compare them. You can learn to search as with a microscope +for all the undesirable traits of your patients, or you can calmly +accept all that assert themselves as undeniable facts, but use your +microscope to find their desirable characteristics which offer +possibilities of being brought to the foreground.</p> + +<p>You cannot constructively help yourself or your patient by denying the +existence of the less worthy traits; but you can resolve to call out the +something better. And if you do not find it, as may rarely be the<span class="pagenum" title="Page 158"> </span><a name="Page_158" id="Page_158"></a> case, +you can refuse to let it make you skeptical of finding it in others. Let +us remember always that, “It is not things or conditions or people that +harm us; it is only the way we respond to them that can hurt.” This one +great truth, if really believed and made a part of all our thinking, +would save scores of people from nervous wreckage. It is a favorite +saying of a wise man who has helped a great many people to endure and +take new courage when life seemed too hard to meet.</p> + +<p>That big, broken-arm case on the ward cursed you yesterday because you +would not loosen his splints. And you rushed from the room angry and +humiliated, wishing you could quit nursing forever, and asked to be +moved because you had been insulted. But that man cannot harm you. He +has never known a real lady in his life before. His training from +childhood has been to regard women as chattels to do man’s bidding; his +experience in life is that they usually do what he asks—women of his +kind. Moreover, he has never had a serious pain before, and it is not to +be endured.</p> + +<p>Of course, the man must be dealt with and made to realize the +distinction between his new surroundings and the old. Probably the +intern or the doctor is the one to do it. Also he must be brought to +apologize, or leave the hospital, perhaps. But he did not hurt you. Your +own reaction did that. For outside things or people cannot damage what +we are in ourselves. The way we respond to them does the harm. When you +can<span class="pagenum" title="Page 159"> </span><a name="Page_159" id="Page_159"></a> control your expression of anger and humiliation, and substitute +for your intense feeling a desire that such a patient may learn that +pain is often the gateway to healing; that some respect for women may be +kindled in him, so that eventually such an outburst in the ward may be +impossible for him or for anyone who heard it; then you are choosing +between emotions the one of helpfulness, for the one of justified +indignation; and feeling has followed reason, rather than leading reason +astray. The judgment which decides you to try methods which will shame +or inspire some manliness into the patient was one influenced by a +well-balanced emotional life.</p> + +<p>If we would really acquire emotional poise, there are a few practical, +proved methods we might adopt for ourselves.</p> + +<p>When we can hold back the expression of the almost overpowering impulse +or passion of anger and resentment and hurt; absolutely shut tight our +lips until we can think; then wait until we can think without the strain +of intense feeling, we will not only keep ourselves out of trouble, but +will be able to calmly state our position, right the wrong done us if +wrong there was, or recognize that we ourselves were wrong. For we +seldom analyze the situation properly under the influence of strong +feeling. If we want to accomplish anything with our words, let us wait +until we can speak them without having to choke down our sobs or cram +back our<span class="pagenum" title="Page 160"> </span><a name="Page_160" id="Page_160"></a> hot anger, or forcibly restrain ourselves from tearing things +or slamming doors. After all that “wild fire” of emotion is gone, +judgment will lead us to wisely reasoned action.</p> + + +<h4><a name="Self-correction" id="Self-correction"></a>Self-correction</h4> + +<p>Accuracy in work, a primary essential to the nurse, can become automatic +if she will demand of herself accuracy of perception, and concentrate on +learning and doing until details almost take care of themselves; if she +will correct her own work by the standards taught her, and recognize +just why and wherein she falls short. Not that she can always do things +with the nicety in which they were taught. She cannot give eighteen ward +patients in eight hours the same detailed care her private patients +would receive if she had only two of them for the same length of time. +In such a case she must often sacrifice refinements of detail in +service; but there is no excuse for sacrificing accuracy in the +necessary treatments of her charges. The nurse merely chooses between +the multitude of things which can be done for her ward, the important +ones which must be done. Because she is rushed is no excuse for giving a +poor hypodermic injection or a careless bed-bath. Accuracy in doing the +essential things should be so automatic that it takes not a whit more +time than inaccurate doing; and such accuracy is chiefly dependent on +constant self-correction when the task is still new,<span class="pagenum" title="Page 161"> </span><a name="Page_161" id="Page_161"></a> and on never +letting up in practice until the details of the doing become practically +automatic.</p> + + +<h4><a name="Training_the_Will" id="Training_the_Will"></a>Training the Will</h4> + +<p>There is no better opportunity for will-training than the hospital +affords the nurse. The constant necessity of acting against desire, of +doing tasks which in themselves cannot be agreeable, calls for a +developed will, while it gives it constant exercise. Moods of +discouragement and depression cannot be indulged. The nurse must do her +work no matter how tired or blue or “frazzled” she feels, if she is not +too sick to be on duty; for all time lost, she knows, is to be made up +to the hospital before training is completed.</p> + +<p>Can this <i>will to do</i>, despite strong desire to the contrary, this mood +control and the ability to disregard physical discomfort, be acquired; +and if so, how?</p> + +<p>It is a law of the mind and of the body that any task becomes easier by +repetition. We found that automatic habit eases much of the strain of +action. What seemed repulsive service to the probationer on her first +day in the hospital, she forced herself to do because she wanted to be a +nurse. She may go on through her three years unreconciled to these +particular duties, yet holding herself to them because she likes other +features of her work, or because she must earn her living and this seems +the best avenue open to her, or because her will to become a nurse is +strong enough to make her act<span class="pagenum" title="Page 162"> </span><a name="Page_162" id="Page_162"></a> continually against desire. And finally, +for almost every nurse, the interest in the end to be attained +overshadows the unpleasant incidents in its way. The tasks are actually +easier by their constant repetition, and her feeling of repugnance +becomes only a mild dislike. She has strengthened her will by continuing +to act against desire. But there is a better way to the same goal.</p> + +<p>The woman who has thought out the reasons for and against taking +training; who has considered it carefully as a profession, and has +chosen to put up with any obstacles in the way of becoming a graduate +nurse, can find a happy adjustment to the disagreeable incidents it +involves. Realizing that the paths of learning are seldom thoroughly +smooth, she can resolve to use their very roughness for firmer +footholds, as a means to self-control, as a fitting for the sterner +hardships of self-support, of nursing the dangerously ill, alone, of +meeting suffering and death in her patients with quiet courage and +faith. In other words, she can meet the thousand and one personal +services which in themselves might be disagreeable and prove pure +drudgery, not merely with the stern will to do them because they are a +necessary part of obtaining a desired end, but also for the sake of +adding to the comfort and well-being of each patient in her care. The +emotion of interest and kindly desire will ease the strain which will +undergoes in demanding that she not shirk the disagreeable. For there is +little stress in doing what we wish to do.</p> + +<p><span class="pagenum" title="Page 163"> </span><a name="Page_163" id="Page_163"></a>It is psychologically possible to find genuine pleasure in the meanest +tasks if the doing is backed up by a strong desire to make life count as +much for others as possible. The nurse who comes to realize the waste +involved in carrying out against desire what <i>reason</i> proposes and +volition dictates, will try to secure the co-operation of desire, and +save will-force for more worthy accomplishment.</p> + +<p>A constant opportunity for will-strengthening comes to many a nurse +during the early weeks and months of training in the necessity of going +on despite the sheer tiredness, the weary backs and swollen, tender, +aching feet. The one who means to “see it through” disregards them as +far as possible on duty, gets all the out-of-doors her time permits, +takes special exercises to strengthen weak spots, and relaxes her body +while she reads or studies or visits in her off-duty time. In the end, +not only does her body adjust itself to the new work, but her will has +become a better ally for the next demands upon it; her endurance is +remarkably increased.</p> + +<p>When she can accept hardship, drudgery, weariness of mind and body and +perhaps of soul, the nagging of unco-operative patients, and the demands +on her sympathies of the suffering; when she can meet these as +challenges to develop a strong will—a will not only to endure, but to +find happiness and give service through it all—then the nurse has +learned the art of making every circumstance a stepping-stone to mastery +and achievement.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 164"> </span><a name="Page_164" id="Page_164"></a><a name="CHAPTER_XIV" id="CHAPTER_XIV"></a>CHAPTER XIV +<br /> +THE NURSE OF THE FUTURE</h2> + + +<p>The student of life and of the sciences which deal with the origin and +development of the human race, and with the relations of man to man and +nation to nation—such sciences as biology and anthropology, sociology +and ethics and history—comes to the conclusion that life exists for the +development of mind. And mind is not merely intellect, but the only +gateway we know to character, to soul. The deepest students of human +science see no reason for life except as it “evolves” a perfect +mind—man’s goal, his ideal. And this visioned perfect mind <ins class="correction" title="Transcriber’s note: Original read ‘in’.">is</ins> one +which adjusts itself without friction to the body, making it fulfil the +laws of health that it may help and not hinder mind’s progress; one +which adjusts itself to people and things, co-operating with other minds +to develop manners and customs and laws of the most satisfactory +community living; one which forces things to be servants of its will; +one which makes harmony of life by fulfilling the laws of the soul as +well as of the intellect and of the body.</p> + +<p>If we believe that life exists for the development of mind into a force +of intellect and character and soul,<span class="pagenum" title="Page 165"> </span><a name="Page_165" id="Page_165"></a> then we need not ask why a nurse +should know something of the laws of mind. She does not ask why she +should know anatomy or pathology. Her work is dependent upon such +knowledge. But if the center of life, the thing which makes the body a +living, moving, acting agent instead of a clod, is mind; if the one +thing which makes a difference between animal life and mineral and +vegetable life is consciousness, <i>i. e.</i>, mind; and if everything that +affects that body, its organ, affects mind also—then surely no nurse +can afford to learn only the rules of repair or of keeping in order the +instrument of consciousness, without knowing what effect her efforts +have on the mind itself. It is as though an ignorant maid accepted a +piano as merely a piece of furniture to be kept clean and shining, and +in her zeal to that end scrubbed the keyboard with soap and water which, +dripping down into the body of the instrument, swells and damages its +felts, rusts and corrodes its keys, and ruins its notes. When she knows +that she may thus make impossible the beautiful sounds she has heard it +give, and that the more carefully the keyboard is handled the more sure +is the beauty resulting, her care is to keep it as free as possible of +dust, to see that the top is down and the keyboard covered when she +sweeps—and to clean it hereafter in such a way as to never injure its +tone.</p> + +<p>The nurse has a much greater function than merely to help in saving the +body and keeping its machinery in<span class="pagenum" title="Page 166"> </span><a name="Page_166" id="Page_166"></a> order. If the aim of life is the +strengthening and perfecting of the mind—that “urge” of life, then +surely the nurse’s big aim will be to help establish such health of body +as leads toward health of mind. In the average man or woman this vital +urge becomes temporarily blocked by the very weakness of the body it +urges. The body <i>must</i> give the life-flame some fuel, or it dies out; +but with very little fuel it flickers on, waiting, hoping for the more +that it may burn strongly again. In the cases the nurse handles very +often the “vital spark” has been poorly fed by the disabled body, and so +discouragement or depression, or “loss of grip” results, or the flame +continues to shine brightly with whatever little sustenance it receives, +and so encourages the body to greater effort for it; or sinks into +embers, glowing steadily though dully; or it burns wildly, +recklessly—it becomes what we call “wild fire,” that has no direction +and no purpose save to burn up everything it can find.</p> + +<p>In other words, the nurse deals with those in whom the “urge” is +weakened—the depressed and discouraged; with those whose spirits never +flag in their steady shining—those brave souls we could almost worship; +and those others who hold grimly on with quiet grit and courage, but +with no cheer; and with the unstable ones of neuropathic or psychopathic +tendency who become hysteric or maniacal.</p> + +<p>What will the nurse do for them all? Will not an understanding of how to +recall the ambition to live, the<span class="pagenum" title="Page 167"> </span><a name="Page_167" id="Page_167"></a> will to get well, and the grit to see +the thing through, be an incalculable asset.</p> + + +<h4><a name="The_Nurse_of_the_Future" id="The_Nurse_of_the_Future"></a>The Nurse of the Future</h4> + +<p>The nurse of the future will not be merely a handmaiden to care for the +sick body by deftly carrying out the doctor’s orders. She will do this +almost automatically as a matter of course, and skilfully; but it will +be the merest beginning of her mission. That mission itself will be to +eliminate the causes of disease; to teach the ways of health, to +supervise the sanitary conditions of city, town, and country. Practical +ways and the wise means to this end will be taught in her hospital, +which will become a community center with clinics, teaching through its +doctors and nurses the way to health, instead of merely treating and +advising the cases as they come. But the greatest contribution of the +nurse of the future will be a wide-spread <i>desire for health</i> and <i>will +to health</i>, rather than a desire and will to avoid discomfort and pain +and danger of death. This <i>will to health</i> will doom in the sane mind +the disease-accepting attitude. It will do all that common sense and +applied medical science can do to strengthen the body; then it will take +what life brings in the way of unavoidable disease and <ins class="correction" title="Transcriber’s note: Original read ‘weakenss’.">weakness</ins> and +inability, with an uncringing mind. It will hold the mind’s attitude to +serenity and poise and accomplishment within the necessary limits of its +disordered body. It will be<span class="pagenum" title="Page 168"> </span><a name="Page_168" id="Page_168"></a> master of its dwelling and make the most of +the little the body can give, and force all bearable weakness and pain +to be stepping-stones to endurance and will-strength and cheer. It will +not accept physical limitations as final things. If life must be lived +in a prison-house it will be its own jailer, and fill the rooms with +flowers, music, friends, and happiness.</p> + +<p>No nurse is competent to help her patient to overcome any curable +physical weakness, and keep the mind serene in the face of the +incurable, until she herself has learned that the will to health is +capable of transforming disease of body, from disaster, into health of +mind and soul.</p> + +<p>The nurse of the future will know the laws of mind as she knows the +course of disease; she will be dedicated to such wise care of existing +disease as will lead to prevention of future disease; and she will be a +sworn, trained ally of the health-accepting mind.</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 169"> </span><a name="Page_169" id="Page_169"></a><a name="INDEX" id="INDEX"></a>INDEX</h2> + +<table class="az" border="1" summary="Alphabetic jump-table for the index"> + <tr> + <td><a href="#IX_A">A</a></td> + <td><a href="#IX_B">B</a></td> + <td><a href="#IX_C">C</a></td> + <td><a href="#IX_D">D</a></td> + <td><a href="#IX_E">E</a></td> + <td><a href="#IX_F">F</a></td> + <td><a href="#IX_G">G</a></td> + <td><a href="#IX_H">H</a></td> + <td><a href="#IX_I">I</a></td> + <td><a href="#IX_J">J</a></td> + <td>K</td> + <td><a href="#IX_L">L</a></td> + <td><a href="#IX_M">M</a></td> + </tr> + <tr> + <td><a href="#IX_N">N</a></td> + <td><a href="#IX_O">O</a></td> + <td><a href="#IX_P">P</a></td> + <td>Q</td> + <td><a href="#IX_R">R</a></td> + <td><a href="#IX_S">S</a></td> + <td><a href="#IX_T">T</a></td> + <td><a href="#IX_U">U</a></td> + <td><a href="#IX_V">V</a></td> + <td><a href="#IX_W">W</a></td> + <td>X</td> + <td>Y</td> + <td>Z</td> + </tr> +</table> + +<ul class="IX"> +<li><a name="IX_A" id="IX_A"></a>Absent-mindedness, <a href="#Page_64">64</a></li> +<li>Absolutes, <a href="#Page_54">54</a></li> +<li>Abstract concept, <a href="#Page_52">52</a> +<ul class="IX"> +<li>object concepts, <a href="#Page_53">53</a></li> +<li>quality concepts, <a href="#Page_53">53</a></li></ul></li> +<li>Accuracy of perception, <a href="#Page_141">141</a></li> +<li>Action cannot be separated from feeling, <a href="#Page_68">68</a></li> +<li>Acts, compulsive, <a href="#Page_106">106</a></li> +<li>Adaptability, <a href="#Page_79">79</a> +<ul class="IX"> +<li>necessity of, <a href="#Page_80">80</a></li></ul></li> +<li>Amnesia, <a href="#Page_103">103</a></li> +<li>Anesthesia, <a href="#Page_101">101</a></li> +<li>Aphasia, <a href="#Page_103">103</a></li> +<li>Apperception, <a href="#Page_54">54</a></li> +<li>Association of ideas, <a href="#Page_143">143</a></li> +<li>Attention, <a href="#Page_79">79</a> +<ul class="IX"> +<li>of interest, <a href="#Page_112">112</a></li> +<li>of reason and will, <a href="#Page_118">118</a></li> +<li>root of disease or health attitude, <a href="#Page_112">112</a></li></ul></li> +<li>Autosuggestion, <a href="#Page_84">84</a></li> +<li>Awareness, <a href="#Page_15">15</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_B" id="IX_B"></a>Bad habits, <a href="#Page_91">91</a></li> +<li>Beginning of reason, <a href="#Page_69">69</a></li> +<li>Body and mind, relation of, <a href="#Page_40">40</a></li> +<li>Borderland disorders, <a href="#Page_107">107</a></li> +<li>Brain, <a href="#Page_33">33</a> +<ul class="IX"> +<li>hind, <a href="#Page_43">43</a></li></ul></li> +</ul> + +<ul class="IX"> +<li><a name="IX_C" id="IX_C"></a>Censor, <a href="#Page_31">31</a></li> +<li>Central and peripheral nervous systems in action, <a href="#Page_35">35</a></li> +<li>Cerebellum, <a href="#Page_43">43</a></li> +<li>Cerebrum, <a href="#Page_43">43</a> +<ul class="IX"> +<li>functions of, <a href="#Page_45">45</a></li></ul></li> +<li>Clear thinking, steps to, <a href="#Page_140">140</a></li> +<li>Compulsive acts, <a href="#Page_106">106</a> +<ul class="IX"> +<li>ideas, <a href="#Page_103">103</a></li></ul></li> +<li>Concentration, <a href="#Page_146">146</a></li> +<li>Concepts, <a href="#Page_52">52</a> +<ul class="IX"> +<li>abstract, <a href="#Page_52">52</a></li> +<li>object, <a href="#Page_53">53</a></li> +<li>quality, <a href="#Page_53">53</a></li> +<li>concrete, <a href="#Page_52">52</a></li></ul></li> +<li>Concrete concepts, <a href="#Page_52">52</a></li> +<li>Consciousness, <a href="#Page_15">15</a>, <a href="#Page_20">20</a>, <a href="#Page_21">21</a> +<ul class="IX"> +<li>definition, <a href="#Page_15">15</a></li> +<li>flow of, <a href="#Page_47">47</a></li> +<li>in delirium, <a href="#Page_32">32</a></li> +<li>in sleep, <a href="#Page_31">31</a></li> +<li>is complex, <a href="#Page_29">29</a></li> +<li>organs of, <a href="#Page_34">34</a></li> +<li>personal, <a href="#Page_57">57</a></li></ul></li> +</ul> + +<ul class="IX"> +<li><a name="IX_D" id="IX_D"></a>Delirium, consciousness in, <a href="#Page_32">32</a></li> +<li>Deluded patient, <a href="#Page_133">133</a> +<ul class="IX"> +<li>nursing of, <a href="#Page_135">135</a></li></ul></li> +<li>Delusion, <a href="#Page_104">104</a> +<ul class="IX"> +<li>nihilistic, <a href="#Page_104">104</a></li> +<li>of reference, <a href="#Page_104">104</a></li> +<li>somatic, <a href="#Page_104">104</a></li></ul></li> +<li>Determination, <a href="#Page_18">18</a></li> +<li>Development of reason and will, <a href="#Page_71">71</a></li> +<li>Disease attitude, attention, root of, <a href="#Page_112">112</a></li> +<li><span class="pagenum" title="Page 170"> </span><a name="Page_170" id="Page_170"></a>Disorders, <a href="#Page_95">95</a> +<ul class="IX"> +<li>borderland, <a href="#Page_107">107</a></li> +<li>of emotion, <a href="#Page_99">99</a></li> +<li>of functions of intellect, <a href="#Page_96">96</a></li> +<li>of ideation, <a href="#Page_97">97</a></li> +<li>of judgment, <a href="#Page_99">99</a></li> +<li>of memory, <a href="#Page_98">98</a></li> +<li>of perception, <a href="#Page_96">96</a></li> +<li>of reason, <a href="#Page_98">98</a></li> +<li>of sensation, <a href="#Page_96">96</a></li> +<li>of will, <a href="#Page_99">99</a></li></ul></li> +<li>Disorientation, <a href="#Page_103">103</a></li> +<li>Distractibility, <a href="#Page_105">105</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_E" id="IX_E"></a>Effort, habit a conserver of, <a href="#Page_90">90</a></li> +<li>Emotion, <a href="#Page_18">18</a>, <a href="#Page_45">45</a>, <a href="#Page_49">49</a> +<ul class="IX"> +<li>disorders of, <a href="#Page_99">99</a></li> +<li>the place of, <a href="#Page_67">67</a></li></ul></li> +<li>Emotional equilibrium, <a href="#Page_152">152</a> +<ul class="IX"> +<li>reaction, normal, <a href="#Page_77">77</a></li></ul></li> +<li>Environment as cause of variation from normal mental processes, <a href="#Page_109">109</a></li> +<li>Equilibrium, emotional, <a href="#Page_152">152</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_F" id="IX_F"></a>False associations, mind a prey to, <a href="#Page_137">137</a></li> +<li>Feeling, <a href="#Page_49">49</a> +<ul class="IX"> +<li>cannot be separated from action, <a href="#Page_68">68</a></li> +<li>from thinking, <a href="#Page_67">67</a></li> +<li>from will, <a href="#Page_68">68</a></li></ul></li> +<li>Fixed idea, <a href="#Page_103">103</a></li> +<li>Flight of ideas, <a href="#Page_102">102</a></li> +<li>Forebrain, <a href="#Page_43">43</a></li> +<li>Future, the nurse of the, <a href="#Page_164">164</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_G" id="IX_G"></a>Getting other man’s point of view, <a href="#Page_126">126</a> +<ul class="IX"> +<li>patient’s point of view, <a href="#Page_124">124</a></li></ul></li> +</ul> + +<ul class="IX"> +<li><a name="IX_H" id="IX_H"></a>Habit a conserver of effort, <a href="#Page_90">90</a> +<ul class="IX"> +<li>bad, <a href="#Page_91">91</a></li> +<li>hospital, <a href="#Page_92">92</a></li></ul></li> +<li>Habit-formation, <a href="#Page_79">79</a></li> +<li>Hallucination, <a href="#Page_101">101</a></li> +<li>Health and psychology, <a href="#Page_79">79</a> +<ul class="IX"> +<li>attitude, attention, root of, <a href="#Page_112">112</a></li></ul></li> +<li>Heredity as course of variation from normal mental processes, <a href="#Page_108">108</a></li> +<li>Hind brain, <a href="#Page_43">43</a></li> +<li>Hospital habit, <a href="#Page_92">92</a></li> +<li>How to study, <a href="#Page_146">146</a></li> +<li>Hurt, <a href="#Page_70">70</a></li> +<li>Hyperesthesia, <a href="#Page_101">101</a></li> +<li>Hypersuggestability, <a href="#Page_84">84</a></li> +<li>Hypochondriasis, <a href="#Page_102">102</a>, <a href="#Page_108">108</a></li> +<li>Hysteria, <a href="#Page_107">107</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_I" id="IX_I"></a>Idea, compulsive, <a href="#Page_103">103</a> +<ul class="IX"> +<li>fixed, <a href="#Page_103">103</a></li></ul></li> +<li>Ideas, association of, <a href="#Page_143">143</a> +<ul class="IX"> +<li>flight of, <a href="#Page_102">102</a></li></ul></li> +<li>Ideation, <a href="#Page_52">52</a> +<ul class="IX"> +<li>disorders of, <a href="#Page_97">97</a></li></ul></li> +<li>Ideogenous pains, <a href="#Page_103">103</a></li> +<li>Illusion, <a href="#Page_101">101</a></li> +<li>Imagination, <a href="#Page_58">58</a></li> +<li>Impulses, insane, <a href="#Page_108">108</a></li> +<li>Inhibition, morbid, <a href="#Page_104">104</a></li> +<li>Inorganic memory, <a href="#Page_52">52</a></li> +<li>Insane impulses, <a href="#Page_108">108</a></li> +<li>Insanity, <a href="#Page_107">107</a></li> +<li>Instinct, <a href="#Page_59">59</a></li> +<li>Instincts, list of, <a href="#Page_61">61</a></li> +<li>Intellect, <a href="#Page_18">18</a>, <a href="#Page_45">45</a> +<ul class="IX"> +<li>functions of, disorders of, <a href="#Page_96">96</a></li></ul></li> +<li>Interest, attention of, <a href="#Page_112">112</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_J" id="IX_J"></a>Judgment, <a href="#Page_56">56</a>, <a href="#Page_72">72</a> +<ul class="IX"> +<li>disorders of, <a href="#Page_99">99</a></li></ul></li> +</ul> + +<ul class="IX"> +<li><a name="IX_L" id="IX_L"></a><span class="pagenum" title="Page 171"> </span><a name="Page_171" id="Page_171"></a>Life, mental, <a href="#Page_14">14</a> +<ul class="IX"> +<li>conditions of, <a href="#Page_19">19</a></li> +<li>phenomena of, <a href="#Page_15">15</a></li></ul></li> +</ul> + +<ul class="IX"> +<li><a name="IX_M" id="IX_M"></a>Mania, <a href="#Page_107">107</a></li> +<li>Melancholia, <a href="#Page_107">107</a></li> +<li>Memory, <a href="#Page_51">51</a>, <a href="#Page_62">62</a> +<ul class="IX"> +<li>disorders of, <a href="#Page_98">98</a></li> +<li>inorganic, <a href="#Page_52">52</a></li> +<li>organic, <a href="#Page_51">51</a></li> +<li>self-training in, <a href="#Page_150">150</a></li></ul></li> +<li>Mental disability, states of, <a href="#Page_100">100</a> +<ul class="IX"> +<li>life, <a href="#Page_14">14</a></li> +<li>conditions of, <a href="#Page_19">19</a></li> +<li>phenomena of, <a href="#Page_15">15</a></li> +<li>processes, normal, variations from, <a href="#Page_95">95</a>, <a href="#Page_101">101</a></li> +<li>factors causing, <a href="#Page_108">108</a></li></ul></li> +<li>Mind, <a href="#Page_14">14</a>, <a href="#Page_33">33</a> +<ul class="IX"> +<li>a prey to false associations, <a href="#Page_137">137</a></li> +<li>and body, relation of, <a href="#Page_40">40</a></li> +<li>functions of, <a href="#Page_50">50</a></li> +<li>normal, <a href="#Page_47">47</a>, <a href="#Page_77">77</a></li></ul></li> +<li>Mood, <a href="#Page_49">49</a></li> +<li>Morbid inhibition, <a href="#Page_104">104</a></li> +<li>Motion, <a href="#Page_26">26</a></li> +<li>Movement, <a href="#Page_26">26</a></li> +<li>Mutism, <a href="#Page_106">106</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_N" id="IX_N"></a>Necessity of adaptability, <a href="#Page_80">80</a></li> +<li>Negativism, <a href="#Page_106">106</a></li> +<li>Nervous systems, central and peripheral, in action, <a href="#Page_35">35</a> +<ul class="IX"> +<li>sympathetic, <a href="#Page_37">37</a></li></ul></li> +<li>Nervousness, <a href="#Page_106">106</a></li> +<li>Neurasthenia, <a href="#Page_108">108</a></li> +<li>Neuropath, <a href="#Page_108">108</a></li> +<li>Neurosis, <a href="#Page_106">106</a> +<ul class="IX"> +<li>from psychosis, <a href="#Page_82">82</a></li></ul></li> +<li>Neurotic, <a href="#Page_108">108</a></li> +<li>Nihilistic delusion, <a href="#Page_104">104</a></li> +<li>Normal emotional reactions, <a href="#Page_77">77</a></li> +<li>Normal mental processes, variations from, <a href="#Page_95">95</a>, <a href="#Page_101">101</a> +<ul class="IX"> +<li>factors causing, <a href="#Page_108">108</a></li> +<li>mind, <a href="#Page_47">47</a>, <a href="#Page_77">77</a></li></ul></li> +<li>Nurse of the future, <a href="#Page_164">164</a> +<ul class="IX"> +<li>psychology of, <a href="#Page_139">139</a></li></ul></li> +<li>Nursing deluded patient, <a href="#Page_135">135</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_O" id="IX_O"></a>Obsessed patient, <a href="#Page_136">136</a></li> +<li>Obsession, <a href="#Page_105">105</a></li> +<li>One thought replaced by another, <a href="#Page_89">89</a></li> +<li>Organic memory, <a href="#Page_51">51</a></li> +<li>Organs of consciousness, <a href="#Page_34">34</a></li> +<li>Overactivity, psychomotor, <a href="#Page_106">106</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_P" id="IX_P"></a>Pain, <a href="#Page_69">69</a> +<ul class="IX"> +<li>ideogenous, <a href="#Page_103">103</a></li></ul></li> +<li>Patient, deluded, <a href="#Page_133">133</a> +<ul class="IX"> +<li>nursing of, <a href="#Page_135">135</a></li> +<li>obsessed, <a href="#Page_136">136</a></li></ul></li> +<li>Patient’s point of view, getting, <a href="#Page_124">124</a> +<ul class="IX"> +<li>what determines it, <a href="#Page_124">124</a></li></ul></li> +<li>Percept, <a href="#Page_51">51</a>, <a href="#Page_52">52</a></li> +<li>Perception, <a href="#Page_51">51</a> +<ul class="IX"> +<li>accuracy of, <a href="#Page_141">141</a></li> +<li>disorders of, <a href="#Page_96">96</a></li> +<li>training of, <a href="#Page_142">142</a></li></ul></li> +<li>Peripheral and central nervous systems in action, <a href="#Page_35">35</a></li> +<li>Personal consciousness, <a href="#Page_57">57</a> +<ul class="IX"> +<li>reactions as cause of variation from normal mental processes, <a href="#Page_110">110</a></li></ul></li> +<li>Personality, psychopathic, <a href="#Page_108">108</a> +<ul class="IX"> +<li>shut-in, <a href="#Page_104">104</a></li></ul></li> +<li>Perversions, <a href="#Page_95">95</a>, <a href="#Page_101">101</a></li> +<li>Phenomena of mental life, <a href="#Page_15">15</a></li> +<li>Phobia, <a href="#Page_108">108</a></li> +<li>Place of emotion, <a href="#Page_67">67</a></li> +<li>Pleasure, <a href="#Page_69">69</a></li> +<li><span class="pagenum" title="Page 172"> </span><a name="Page_172" id="Page_172"></a>Point of view, getting other man’s, <a href="#Page_126">126</a> +<ul class="IX"> +<li>patient’s, getting, <a href="#Page_124">124</a></li> +<li>what determines it, <a href="#Page_124">124</a></li></ul></li> +<li>Poor memory, <a href="#Page_64">64</a></li> +<li>Power of suggestion, <a href="#Page_84">84</a></li> +<li>Premise, <a href="#Page_72">72</a></li> +<li>Protozoön, consciousness in, <a href="#Page_15">15</a></li> +<li>Psychasthenia, <a href="#Page_108">108</a></li> +<li>Psychology and health, <a href="#Page_79">79</a> +<ul class="IX"> +<li>definition, <a href="#Page_12">12</a></li> +<li>of the nurse, <a href="#Page_139">139</a></li></ul></li> +<li>Psychomotor overactivity, <a href="#Page_106">106</a> +<ul class="IX"> +<li>retardation, <a href="#Page_106">106</a></li></ul></li> +<li>Psychoneurosis, <a href="#Page_106">106</a></li> +<li>Psychopathic personality, <a href="#Page_108">108</a></li> +<li>Psychosis, <a href="#Page_107">107</a> +<ul class="IX"> +<li>neurosis from, <a href="#Page_82">82</a></li></ul></li> +<li>Pugnacious instinct, <a href="#Page_60">60</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_R" id="IX_R"></a>Reactions, normal emotional, <a href="#Page_77">77</a> +<ul class="IX"> +<li>proportioned to stimuli, <a href="#Page_75">75</a></li></ul></li> +<li>Reason, <a href="#Page_56">56</a> +<ul class="IX"> +<li>and will, attention of, <a href="#Page_118">118</a></li> +<li>development of, <a href="#Page_71">71</a></li> +<li>beginning of, <a href="#Page_69">69</a></li> +<li>disorders of, <a href="#Page_98">98</a></li></ul></li> +<li>Reference, delusion of, <a href="#Page_104">104</a></li> +<li>Relation of mind and body, <a href="#Page_40">40</a></li> +<li>Retardation, psychomotor, <a href="#Page_106">106</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_S" id="IX_S"></a>Saving power of will, <a href="#Page_93">93</a></li> +<li>Science, <a href="#Page_13">13</a></li> +<li>Second-nature, <a href="#Page_90">90</a></li> +<li>Self-correction, <a href="#Page_160">160</a></li> +<li>Self-training in memory, <a href="#Page_150">150</a></li> +<li>Sensation, <a href="#Page_51">51</a> +<ul class="IX"> +<li>disorders of, <a href="#Page_96">96</a></li></ul></li> +<li>Sense of unreality, <a href="#Page_104">104</a></li> +<li>Shut-in personality, <a href="#Page_104">104</a></li> +<li>Sleep, consciousness in, <a href="#Page_31">31</a></li> +<li>Somatic delusion, <a href="#Page_104">104</a></li> +<li>Steps to clear thinking, <a href="#Page_140">140</a></li> +<li>Stimuli, reaction proportioned to, <a href="#Page_75">75</a></li> +<li>Stimulus, definition, <a href="#Page_22">22</a></li> +<li>Stream of thought, <a href="#Page_50">50</a>, <a href="#Page_57">57</a></li> +<li>Study, how to, <a href="#Page_146">146</a></li> +<li>Suggestibility, <a href="#Page_79">79</a></li> +<li>Suggestion, power of, <a href="#Page_84">84</a></li> +<li>Sympathetic nervous system, <a href="#Page_37">37</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_T" id="IX_T"></a>The unconscious, <a href="#Page_23">23</a></li> +<li>Thinking, <a href="#Page_49">49</a>, <a href="#Page_58">58</a> +<ul class="IX"> +<li>cannot be separated from feeling, <a href="#Page_67">67</a></li> +<li>clear, steps to, <a href="#Page_140">140</a></li></ul></li> +<li>Thought, stream of, <a href="#Page_50">50</a>, <a href="#Page_57">57</a></li> +<li>Thought-substitution, <a href="#Page_79">79</a></li> +<li>Tic, <a href="#Page_105">105</a></li> +<li>Training perception, <a href="#Page_142">142</a> +<ul class="IX"> +<li>the will, <a href="#Page_161">161</a></li></ul></li> +</ul> + +<ul class="IX"> +<li><a name="IX_U" id="IX_U"></a>Unconscious, the, <a href="#Page_23">23</a></li> +<li>Universals, <a href="#Page_53">53</a></li> +<li>Unreality, sense of, <a href="#Page_104">104</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_V" id="IX_V"></a>Variations from normal mental processes, <a href="#Page_95">95</a>, <a href="#Page_101">101</a> +<ul class="IX"> +<li>factors causing, <a href="#Page_108">108</a></li></ul></li> +<li>Volition, <a href="#Page_45">45</a>, <a href="#Page_50">50</a></li> +</ul> + +<ul class="IX"> +<li><a name="IX_W" id="IX_W"></a>What determines patient’s point of view, <a href="#Page_124">124</a> +<ul class="IX"> +<li>we attend to determines what we are, <a href="#Page_86">86</a></li></ul></li> +<li>Will, <a href="#Page_50">50</a>, <a href="#Page_79">79</a> +<ul class="IX"> +<li>and reason, attention of, <a href="#Page_118">118</a></li> +<li>development of, <a href="#Page_71">71</a></li> +<li>cannot be separated from feeling, <a href="#Page_68">68</a></li> +<li>disorders of, <a href="#Page_100">100</a></li> +<li>saving power of, <a href="#Page_93">93</a></li> +<li>training of, <a href="#Page_161">161</a></li> +</ul></li></ul> + +<hr class="major" /> +<h2><span class="pagenum" title="Page 173"> </span><a name="Page_173" id="Page_173"></a><big>A Short History of Nursing</big> +<br /> +<small>From the Earliest Times to the Present Day</small></h2> + +<p class="title">By +<br /> +<big>Lavinia L. Dock, R.N.</big> +<br /> +<small>Secretary, International Council of Nurses</small> +<br /><br /> +In Collaboration with +<br /> +<big>Isabel Maitland Stewart, A.M., R.N.</big> +<br /> +<small>Assistant Professor, Department of Nursing and Health, Teachers College, +Columbia University, New York</small></p> + +<p class="center">12<sup>o</sup>. <i>Price, $3.00</i></p> + +<p class="ads">This New Volume Has Been Prepared Especially for the Use of Student +Nurses</p> + +<p>It is, in effect, a condensation of the four volumes of the larger +<i>History of Nursing</i>, prepared by Miss Dock in collaboration with +Miss Nutting, a work which has been considered standard on the subject, +but which, by its very nature, was too elaborate for class use. This +condition has now been overcome by condensation into this single, +comprehensive, inexpensive volume of all the salient facts of the larger +work.</p> + +<p>It is generally believed that the best place in the nursing curriculum +for the History of Nursing is in the early part of the first year, when +the student is just beginning to form her conception of nursing, and is +being initiated into its traditions.</p> + +<p class="ads">The Many Excellent Features of this <i>Short History of Nursing</i></p> + +<p style="text-indent:0;">will inevitably bring it into use in a very great number of Hospital +Training Schools; it should, of course, be in the library of every +Hospital which does not maintain a Training School. It is believed that +it will be found to be</p> + +<p class="ads">The Best Volume on This Important Subject</p> + +<p style="text-align:right;">(<i>Over</i>)</p> + + + +<hr class="major" /> +<h2><span class="pagenum" title="Page 174"> </span><a name="Page_174" id="Page_174"></a><small>Some of the</small> +<br /> +<big>Putnam Nursing Books</big></h2> + +<ul class="adlist"> +<li><b>Maxwell and Pope’s Practical Nursing</b> +<p> +Price $2.50.</p></li> + + +<li><b>Cadmus’ Manual of Obstetrical Nursing</b> +<p> +Approximate price $1.50.</p></li> + + +<li><b>Dock’s Materia Medica for Nurses</b> +<p> +Price $2.25.</p></li> + + +<li><b>Higgins’ Psychology of Nursing</b> +<p> +Price $2.50.</p></li> + + +<li><b>Pope’s Manual of Nursing Procedure</b> +<p> +Price $2.40.</p></li> + + +<li><b>Pope’s Essentials of Anatomy and Physiology for Nurses</b> +<p> +600 pages. Price $2.90.</p></li> + + +<li><b>Pope’s Quiz Book for Nurses</b> +<p> +485 pages. Price $2.50.</p></li> + + +<li><b>Dock and Nutting’s History of Nursing</b> +<p> +In four volumes. Illustrated volumes 1 and 2, price $7.50. Volumes 3 and +4, price $7.50.</p></li> + + +<li><b>Dock and Stewart’s Short History of Nursing</b> +<p> +One volume, 400 pages. Price $3.00.</p></li> + + +<li><b>Pope’s Physics and Chemistry for Nurses</b> +<p> +450 pages. Price $2.50.</p></li> +</ul> +<p class="title"><big>Arthur W. Isca</big><br /> +Medical and Nurse Books<br /> +Besse Building<br /> +Minneapolis, Minnesota +</p> + +<div class="transnote" style="margin-top:2em;"> +<p><a name="errors" id="errors"></a><b>Transcriber's List of Errors</b></p> +<table summary="List of printer errors corrected."> +<tr><td class="tdr"><a href="#Page_32">32</a></td><td>ecstacy</td><td>changed to </td><td>ecstasy</td></tr> +<tr><td class="tdr"><a href="#Page_52">52</a></td><td><i>i e.</i></td><td class="tdc">"</td><td><i>i. e.</i></td></tr> +<tr><td class="tdr"><a href="#Page_68">68</a></td><td>or</td><td class="tdc">"</td><td>of</td></tr> +<tr><td class="tdr"><a href="#Page_72">72</a></td><td>pasttime</td><td class="tdc">"</td><td>pastime</td></tr> +<tr><td class="tdr"><a href="#Page_76">76</a></td><td>strees</td><td class="tdc">"</td><td>stress</td></tr> +<tr><td class="tdr"><a href="#Page_76">76</a></td><td>council</td><td class="tdc">"</td><td>counsel</td></tr> +<tr><td class="tdr"><a href="#Page_81">81</a></td><td>,</td><td class="tdc">"</td><td>.</td></tr> +<tr><td class="tdr"><a href="#Page_95">95</a></td><td>em-dash</td><td class="tdc">"</td><td>hyphen</td></tr> +<tr><td class="tdr"><a href="#Page_103">103</a></td><td>hypochondrasis</td><td class="tdc">"</td><td>hypochondriasis</td></tr> +<tr><td class="tdr"><a href="#Page_110">110</a></td><td>successfuly</td><td class="tdc">"</td><td>successfully</td></tr> +<tr><td class="tdr"><a href="#Page_132">132</a></td><td>stubborness</td><td class="tdc">"</td><td>stubbornness</td></tr> +<tr><td class="tdr"><a href="#Page_164">164</a></td><td>in</td><td class="tdc">"</td><td>is</td></tr> +<tr><td class="tdr"><a href="#Page_167">167</a></td><td>weakenss</td><td class="tdc">"</td><td>weakness</td></tr> +</table> +<p>The inconsistent hyphenation of hypo-mania is as in the original.</p> +</div> + + + + + + + + +<pre> + + + + + +End of Project Gutenberg's Applied Psychology for Nurses, by Mary F. 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