Rationalizing Our Distress. Among other things, a nervous symptom furnishes a seemingly reasonable excuse for the sense of distress which is behind every breakdown. Something troubles us. We are not willing to acknowledge what it is. On the other hand, we must appear reasonable to ourselves, so we manufacture a reason. Perhaps at the time when the person first feels distress, he is on a railroad train. So he says to himself, "It is the train. I must not go near the railway"; and he develops a phobia for cars. Perhaps at the onset of the fear he happens to have a slight pain in the arm. He makes use of the pain to explain his distress. He thinks about it and holds on to it. It serves a purpose, and is on the whole less painful than the feeling of unexplained impending disaster which is attached to no particular idea. Perhaps he happens to be tired when the conflict first gets beyond control. So he seizes the idea of fatigue to explain his illness. He develops chronic fatigue and talks proudly of overwork. In every case the symptom serves a real purpose, and is, despite its discomfort, a relief to the distressed personality.
A neurosis is a subconscious effort at adjustment. Like a physical symptom, it is Nature"s way of trying to cure herself. It is an attempt to get equilibrium, but it is an awkward attempt and hardly the kind that we would choose when we see what we are doing.
Securing an Audience. Besides furnishing relief from too intense strain, a nervous breakdown brings secondary advantages that are at most only dimly recognized by the individual. One of the most intense cravings of the primitive part of the subconscious is for an audience; a nervous symptom always secures that audience. The invalid is the object of the solicitous care of the family, friends, physician, and specialist. Pomp and ceremony, so dear to the child-mind, make their appeal to the dissociated part of the personality. The repressed instincts, hungry for love and attention, delight in the petting and special care which an illness is sure to bring. Secretly and unconsciously, the neurotic takes a certain pleasure in all the various changes that are made for his benefit,-the dismantling of striking clocks, the m.u.f.fling of household noises, the banishing of crowing roosters, and the changes in menu which must be carefully planned for his stomach.
This characteristic of finding pleasure in personal ministrations is plainly a regression to the infantile phase of life. The baby demands and obtains the center of the stage. Later he has to learn to give it up, but the neurotic gets the center again and is often very loth to leave it for a more inconspicuous place.
Capitalizing an Illness. Then, too, a neurosis provides a way of escape from all sorts of disagreeable duties. It can be capitalized in innumerable ways,-ways that would horrify the invalid if he realized the truth. Much of the resentment manifested against the suggestion that the neurosis is psychic in origin is simply a resistance against giving up the unconsciously enjoyed advantages of the illness. An honest desire to get well is a long step toward cure.
The purposive character of a nervous illness is well ill.u.s.trated by two cases reported by Thaddeus Hoyt Ames. [39] A young woman, the drudge of the family, suddenly became hysterically blind, that is, she became blind despite the fact that her eyes and optic nerves proved to be unimpaired. She remained blind until it was proved to her that a part of her welcomed the blindness and had really produced it for the purpose of getting away from the monotony of her unappreciated life at home. She naturally resented the charge but finally accepted it and "turned on" her eyesight in an instant. The other patient, a man, became blind in order to avoid seeing his wife who had turned out to be not at all what he had hoped. When he realized what he was doing, he decided that there might be better ways of adjusting himself to his wife. He then switched on his seeing power, which had never been really lost, but only disconnected and dissociated from the rest of his mind.
[39] Thaddeus Hoyt Ames: Archives of Ophthalmology, Vol. XLIII, No. 4, 1914.
That the conscious mind has no part in the subterfuge is shown by the fact that both patients gave up their artificial haven as soon as they saw how they had been fooling themselves. The fact remains that every neurosis is the fulfilment of a wish,-a distorted, unrecognized, unsatisfactory fulfilment to be sure, but still an effort to satisfy desire. As Frink remarks, "A neurosis is a kind of behaviour." We always choose the conduct we like. It is a matter of choice. Does not this answer our question as to why some people always take unhealthy suggestions? If we take the bad one, it is because it serves the need of a part of our being.
Sign Language
Talking in Symbols. We have several times suggested that a nervous symptom is a disguised, indirect expression of subconscious impulses. It is the completeness of the disguise which makes it so hard for us to realize its true meaning. It takes a stretch of the imagination to believe that a pain in the body can mean a pain in the soul, or that a fear of contamination can signify a desire to bear a child. But in all this we must not forget the primitive, childlike nature of the instinctive life.
The savage and the child do not think as civilized man thinks. Savage or child thinks in pictures; he acts his feelings; he groups things according to superficial resemblances, he expresses an idea by its opposite; he talks in symbols. We still use these devices in poetic speech and in everyday thought. A wedding-ring stands for the marriage bond; the flag for a nation; a greyhound for fleetness; a wild beast for ferocity; sunrise for youth; and sunset for old age. "The essence of language consists in the statement of resemblance. The expression of human thought is an expression of a.s.sociation." [40]
[40] Trigant Burrow: Journal of American Medical a.s.sociation, Vol. LXVI, No. II, 1916.
The a.s.sociation may be so accidental and superficial as to seem absurd to another person, or it may be so fundamental as to express the universal thought of man from the beginning of time. Many of the signs and symbols which crop out in neurotic symptoms and in normal dreams are the same as those which appear in myths, fairy tales and folk-lore and in the art of the earlier races.
A Secret Code. When the denied instincts of a man"s repressed life insist on expression, and when the shocked proprieties of his repressing life demand conformity to social standards, the subconscious, held back from free speech, strikes a compromise by making use of figurative language. As Trigant Burrow says, if the moral repugnance is very strong, the disguise must be more elaborate, the symbols more far-fetched. The symbols of nervous symptoms and of dreams are a "secret code," understood by the sender but meaningless to the censoring conscience, which pa.s.ses them as harmless.
The Right Kind of Symbolism. Sublimation itself is merely a symbolic expression of basic impulses. It follows the line of our make-up, which naturally and fundamentally is wont to let one thing stand for another and to express itself in indirect ways. Sublimation says: "If I cannot recreate myself in the person of a child, I will recreate myself in making a bridge, or a picture, or a social settlement,-or a pudding." It says: "If I cannot have my own child to love, I will adopt an orphan-asylum, or I will work for a child-labor law." It merely lets one thing stand for another and transfers all the pa.s.sions that belong to the one on to the other, which is the same thing as saying that it gives vent to its original desire by means of symbolic expression.
The Wrong Kind of Symbolism. A nervous disorder is an unfortunate choice of symbols. Instead of spiritualizing an innate impulse, it merely disguises it. The disguise takes a number of forms. One of the commonest ways is to act out in the body what is taking place in the soul. The woman with nausea converted her moral disgust into a physical nausea, which expressed her distress while it hid its meaning. The girl who was tired of seeing her work, and the man who wanted to avoid seeing his wife chose a way out which physically symbolized their real desire. A dentist once came to me with a paralyzed right arm. He had given up his office and believed that he would never work again. It turned out that his only son had just died and that he was dramatizing his soul-pain by means of his body. His subconscious mind was saying, "My good right arm is gone," and saying it in its own way. Within a week the arm was playing tennis, and ever since it has been busy filling teeth. There were, of course, other factors leading up to the trouble, but the factor which determined its form was the sense of loss which acted itself out through the body.
Sometimes, as we have seen, the disguise takes another form. Instead of conversion into a physical symptom, it lets one idea stand for another and displaces the impulse or the emotion to the subst.i.tute idea. The girl with the impulse to take drugs fooled her conscience by letting the drug-taking idea stand for the idea of conception. The girl with the fear of contamination carried the disguise still farther by changing the desire into fear,-a very common subterfuge.
The Case of Mrs. Y. There came to me a short time ago a little woman whose face showed intense fright. For several months she had spent much of the time walking the floor and wringing her hands in an agony of terror. In the night she would waken from her sleep, shaking with fear; soon she would be retching and vomiting, although she herself recognized the fact that there was nothing the matter with her stomach.
Part of the time her fear was a general terror of some unknown thing, and part of the time it was a specialized fear of great intensity. She was afraid she would choke her son, to whom she was pa.s.sionately devoted. During the course of the treatment, which followed the lines of psycho-a.n.a.lysis to be described in the next chapter, I found that this fear had arisen one evening when she was lying reading by the side of her sleeping child. Suddenly, without warning, she had a sort of mental picture of her own hands reaching out and choking the boy. Naturally she was terrified. She jumped out of bed, decided that she was losing her mind and went into a hysterical state which her husband had great trouble in dispelling. After that she was afraid to be left alone with her children lest she should kill them.
During the a.n.a.lysis it was discovered that what she had been reading on that first night was the thirteenth verse of the ninety-first Psalm. "Thou shalt tread upon the lion and the adder. The young lion and the dragon thou shalt trample under foot." To her the adder meant the snake, the tempter in the Garden of Eden, and hence s.e.x. What she wanted to choke was her own insistent s.e.x urge of which the child was the symbol and the result. On later occasions she had the same sort of hallucinations in connection with another child and on sight of a brutish kind of man who symbolized to the subconscious mind the s.e.x-urge, of which she was afraid. Not so much by what her mother had said as by what she had avoided saying, and by her expression whenever the subject was mentioned, had she given her little daughter a fundamentally wrong idea of the reproductive instinct. Later when the girl was woman grown she still clung to the old conception, deploring the s.e.x-part of the marriage relation and feeling herself too refined to be moved by any such sensual urge. But the strong s.e.x-instinct within her would not be downed. It was so insistent as to be an object of terror to her repressing instinct, which could not bring itself to acknowledge its presence. The fear that came to the surface was merely a disguised and symbolic representation of this real fear which was turning her life into a nightmare.
The nausea and vomiting in this woman seemed to be symbolic of the disgust which she felt subconsciously at the thought of her own s.e.x-desires, but sometimes the physical disturbances which accompany such phobias are the natural physical reactions to the constant fear state. Indigestion, palpitation, and tremors are not in themselves symbolic of the inner trouble but may be the result of an overdose of the adrenal and thyroid secretions and the other accompaniments of fear. In such cases the real symptom is the fear, and the physical disturbance an incidental by-product of the emotional state. In any case a nervous symptom is always the sign of something else-a hieroglyph which must be deciphered before its real meaning can be discovered.
Summary
Three Kinds of People. Absurd as it sounds, "nerves" turn out to be a question of morals; a neurosis, an affair of conscience; a nervous symptom an unsettled ethical struggle. The ethical struggle is not unusual; it is a normal part of man"s life, the natural result of his desire to change into a more civilized being. The people in the world may be divided into three cla.s.ses, according to the way they decide the conflict.
The Primitive. The first cla.s.s merely capitulate to their primitive desires. They may not be nervous, but it is safe to say that they are rarely happy. The voice of conscience is hard to drown, even when it is not strong enough to control conduct. Happily it often succeeds in making us miserable, when we desert the ways that have proved best for our kind. The "immoral" person has not yet "arrived"; he simply disregards the collective wisdom of society and gives the victory to the primitive forces which try to keep man back on his old level. We cannot break the ideals by which man lives, and still be happy.
The Salt of the Earth. The second cla.s.s of people decide the conflict in a way that satisfies both themselves and society. They give the victory to the higher trends and at the same time make a lasting peace by winning over the energy of the undesirable impulses. By sublimation they divert the threatening force to useful work and turn it out into real life, using its steam to make the world"s wheels go round. Their love-force, unhampered by childish habits, is free to give itself to adult relationships or to express itself symbolically in socially helpful ways.
Nervous People. To the third cla.s.s belong the people who have not finished the fight. These are the folk with "nerves," the people in whom the conflict is fiercest because both sides are too strong. The victory goes to neither side; the tug of war ends in a tie. Since the energy of the nervous person is divided between the effort to repress and the effort to gain expression, there is little left for the external world. There is plenty of energy wasted on emotion, physical symptoms, phantasy, or useless acts symbolizing the struggle.
A neurotic is a normal person, "only more so." His impulses are the same impulses as those of every other person; his complexes are the same kind of complexes, only more intense. He is an exaggerated human being. He may be only slightly exaggerated, showing merely a little character-weakness or a slight physical symptom, or he may be so intensified as to make life miserable for himself and everybody near him. It is quant.i.ty, not quality, that ails him, for he differs from his steady-going neighbor not in kind but in degree. More of him is repressed and a larger part of him is fixed in a childish mold.
Tricking Ourselves. A neurosis is a confidence game that we play on ourselves. It is an attempt to get stolen fruit and to look pious at the same time,-not in order to fool somebody else but to fool ourselves.
No nervous symptom is what it seems to be. It is an arch pretender. It pretends to be afraid of something it does not fear at all, or to ignore something that interests it intensely. It pretends to be a physical disease, when primarily it has nothing to do with the body; and the person most deluded is the one who "owns" the symptom. Its purpose is to avoid the pain of disillusionment and to furnish relief to a distracted soul which dares not face itself.
Although the true meaning of a symptom is hidden, there is fortunately a clue by which it can be traced. Sometimes it takes the art of a psychic detective to follow the clues down, down through the different layers of the subconscious mind, until the troublesome impulses and complexes are found and dragged forth,-not to be punished for breaking the peace but to be led toward reconciliation. But "that is another story," and belongs to another chapter. We are approaching THE WAY OUT.
PART III-THE MASTERY OF "NERVES"
CHAPTER VIII
In which we pick up the clue
THE WAY OUT
The Science of Re-education
There is a story of an Irishman at the World"s Fair in Chicago. Although his funds were getting low, he made up his mind that he would not go home without a ride on a camel. For several minutes he stood before a sign reading: "First ride 25, second ride 15, third ride 10." Then, scratching his head, he exclaimed, "Faith, and I"ll take the third ride!" Should there by any chance be a reader who, eager to find the way out without paying the price of knowledge, is tempted to say to himself "Faith, and I"ll begin with Part III," we give him fair warning that if he does so, he will in all probability end by putting down the book in a confused and skeptical frame of mind.
It is difficult to find our way out of a maze without some faint idea of the path by which we got in. He who brings to this chapter the popular notion that nervousness is the result of worn-out nerve-cells, can hardly be expected to understand how it can be cured by a process of mental adjustment. Suggestion to that effect can scarcely fail to appear to him faddish and unpractical. But once a person has grasped the idea that "nerves" are merely a slip in the cog of hidden mental machinery, and has acquired at least a working-knowledge of "the way the wheels go round," he can scarcely fail to understand that the only logical cure must consist in some kind of readjustment of this underground machinery. If "nerves" were physical, then only physical measures could cure, but as they are psychic, the only effective measures must be psychic.
Gross Misconceptions. Nervousness is caused by a lack of adjustment to the world as it is; therefore the only possible cure must be some sort of readjustment between the person"s inner forces and the demands of the social world. As this lack of adjustment is concerned chiefly with the repressed instinct of reproduction, it is only natural that there should be people who believe that "the way out" lies in some form of physical satisfaction of the s.e.x-impulse-in marriage, in changing or ignoring the social code, in h.o.m.o-s.e.xual relations or in the practice of masturbation. But we have only to look about us to see that this prescription does not cure. Freud navely asks whether he would be likely to take three years to uncover and loosen the psychic resistances of his patients, if the simple prescription of s.e.x-license would give relief.
Since there are as many married neurotics as single, it is evident that even marriage is not a sure preventive of nervousness. License, on the other hand, can satisfy only a part of the individual"s craving. Freud insists that the s.e.x-instinct has a psychic component as well as a physical one, and that it is this psychic part which is most often repressed. He maintains that for complete satisfaction there must be psychic union between mates, and that gratification of the physical component of s.e.x when dissociated from psychic satisfaction, results in an acc.u.mulation of tension that reacts badly on the whole organism.
The psychic tension acc.u.mulating in adult s.e.x-relations has its inception in the mistaken att.i.tude on the part of the wife, who remains true to her childhood training that any pleasure in s.e.x is vulgar; or on the part of the man, who reacts to the mood of the wife, or is held by his own unbroken mother-son complex; or on the part of both the tension piles up because of society"s taboo upon rearing large families. As the first two factors in this lack of adjustment grew largely out of some kind of faulty education or from faulty reaction to early experiences, the only effective way to secure a better adaptation must be through a re-education which reaches down to that part of the personality that bears the stamp of the unfortunate early factors.
Remaking Ourselves. As a matter of fact, the science of psychotherapy or mental treatment is simply the science of re-education,-a process designed to break up old unhealthy complexes which disrupt the forces of the individual, and to build up healthy complexes which adjust him to the social world and enable him to use his energy in useful ways.
Fortunately, minds can be changed. It is easier to make over an unhealthy complex than to make over a weak heart, to straighten out a warped idea than to straighten a bent back. Remarkable indeed have been some of the transformations in people who are supposed to have pa.s.sed the plastic period in life. While it is true that some persons become "set" in middle life, and almost impervious to new ideas, it is also true that a person at fifty has more richness of experience upon which to draw, more appreciation of the value of the good, than has a person at twenty. If he really wants to change himself, he can do wonderful things by re-education.