At the base of every psycho-neurosis is an unhealthful suggestion. This is never the ultimate cause. There are other forces at work. But the suggestion is the material out of which those other forces weave the neurosis. Suggestibility is one of the earmarks of nervousness. A sensible and st.u.r.dy spirit, stable enough to maintain its equilibrium, is a fairly good antidote to attack. "As a man thinketh in his heart, so is he."
Why Feelings Count
The Emotions Again. It seems impossible to discuss any psychological principle without finally coming back to the subject of emotions. It truly seems that all roads lead to the instincts and to the emotions which drive them. And so, as we follow the trail of suggestion, we suddenly turn a corner and find ourselves back at our starting-point-the emotional life. Like all other ideas, suggestions get tied up with emotions to form complexes, of which the driving-power is the emotion.
If we look into our emotional life, we find, besides the true emotions, with which we have become familiar in Chapter III, a great number of feelings or feeling-tones which color either pleasurably or painfully our emotions and our ideas. On the one hand there are pleasure, joy, exaltation, courage, cheer, confidence, satisfaction; and on the other, pain, sorrow, depression, apprehension, gloom, distrust, and dissatisfaction. Every complex which is laid away in our subconscious is tinted, either slightly or intensely, with its specific feeling-tone.
Emotions-Tonic and Poisonous. All this is most important because of one vital fact; joyful emotions invigorate, and sorrowful emotions depress; pleasurable emotions stimulate, and painful emotions burden; satisfying emotions revitalize, and unsatisfying emotions sap the strength. In other words, our bodies are made for courage, confidence, and cheer. Any other atmosphere puts them out of their element, handicapped by abnormal conditions for which they were never fashioned. We were written in a major key, and when we try to change over into minor tones we get sadly out of tune.
There is another factor; painful emotions make us fall to pieces, while pleasant emotions bind us together. We can see why this is so when we remember that powerful emotions like fear and anger tend to dissociate all but themselves, to split up the mind into separate parts and to force out of consciousness everything but their own impulse. Morton Prince in his elaborate studies of the cases of multiple personality, Miss Beauchamp and B.C.A., found repeatedly that he had only to hypnotize the patient and replace painful, depressing complexes by healthy, happy ones to change her from a weak, worn-out person, complaining of fatigue, insomnia, and innumerable aches and pains, into a vigorous woman, for the time being completely well. On this point he says:
Exalting emotions have an intense synthesizing effect, while depressing emotions have a disintegrating effect. With the inrushing of depressive memories or ideas ... there is suddenly developed a condition of fatigue, ill-being and disintegration, followed after waking by a return or accentuation of all the neurasthenic symptoms. If on the other hand, exalting ideas and memories are introduced and brought into the limelight of attention, there is almost a magical reversal of processes. The patient feels strong and energetic, the neurasthenic symptoms disappear and he exhibits a capacity for sustained effort. He becomes re-vitalized, so to speak. [29]
[29] Prince: Psycho-therapeutics, Chap. I.
In cases like this the needed strength and energy are not lost; they are merely side-tracked, but the person feels as weak as though he were physically ill.
Bodily Response to Emotional States
Secretions. Let us look more carefully into some of the physiological processes involved in emotional changes. Among the most apparent of bodily responses are the various external secretions. Tears, the secretion of the lachrymal glands in response to an emotion, are too common a phenomenon to arouse comment. It is common knowledge that clammy hands and a dry mouth betray emotion. Every nursing mother knows that she dares not become too disturbed lest her milk should dry up or change in character. Most people have experienced an increase in urine in times of excitement; recently physiologists have discovered the presence of sugar in the urine of students at the time of athletic contests and difficult examinations. [30] We have seen what an important role the various internal secretions, such as the adrenal and thyroid secretions play in fitting the body for flight and combat, and how large a part fear and anger have in their production. Constant over-production of these secretions through chronic states of worry is responsible for many a distressing symptom.
[30] Cannon.
Most graphic evidence of the disturbance of secretions by emotion is found in the response of the salivary and gastric glands to painful or pleasurable thinking. As these are the secretions which play the largest part in the digestive processes, they lead us naturally to our next heading.
Digestion. Everybody knows that appetizing food makes the mouth water, but not everybody realizes that it makes the stomach water also. Nor do we often realize the vital place that this watering has in taking care of our food. "Well begun is half-done," is literally true of digestion. A good flow of saliva brings the food into contact with the taste-buds in the tongue. Taste sends messages to the nerve-centers in the medulla oblongata; these centers in turn flash signals to the stomach glands, which immediately "get busy" preparing the all-important gastric juice. It takes about five minutes for this juice to be made ready, and so it happens that in five minutes after the first taste, or even in some cases after the first smell, the stomach is pouring forth its "appet.i.te juice" which determines all the rest of the digestive process, in intestines as well as in stomach. Experiments on dogs and cats by Pawlow, Cannon, and others have shown what fear and anger and even mildly unpleasant emotions do to the whole digestive process. Cannon tells of a dog who produced 66.7 cubic centimeters of pure gastric juice in the twenty minutes following five minutes of sham feeding (feeding in which food is swallowed and then dropped out of an opening in the esophagus into a bucket instead of into the stomach). Although there was no food in the stomach, the juice was produced by the enjoyment of the taste and the thought of it. On another day, after this dog had been infuriated by a cat, and then pacified, the sham feeding was given again. This time, although the dog ate eagerly, he produced only 9 cubic centimeters of gastric juice, and this rich in mucus. Evidently a good appet.i.te and attractively served food are not more important than a cheerful mind. Spicy table talk, well mixed with laughter, is better than all the digestive tablets in the world. What is true of stomach secretions is equally true of stomach contractions. "The pleasurable taking of food" is a necessity if the required contractions of stomach and intestines are to go forward on schedule time. A little extra dose of adrenalin from a mild case of depression or worry is enough to stop all movements for many minutes. What a revelation on many a case of nervous dyspepsia! The person who dubbed it "Emotional Dyspepsia" had facts on his side.
Circulation. It is not the heart only that pumps the blood through the body. The tiny muscles of the smallest blood-vessels, by their elasticity are of the greatest importance in maintaining an even flow, and this is especially influenced by fear and depression. Blushing, pallor, cold hands and feet, are circulatory disturbances based largely on emotions. Better than a hot-water bottle or electric pads are courage and optimism. A patient of mine laughingly tells of an incident which she says happened a number of years ago, but which I have forgotten. She says that she asked me one night as she carried her hot-water bottle to bed, "Doctor, what makes cold feet?" and that I lightly answered "Cowardice!" Whereupon she threw away her beloved water-bag and has never needed it since.
There is a disturbance of the circulation which results in very marked swelling and redness of the affected part. This is known as angio-neurotic edema, or nervous swelling. I do not have to go farther than my own person for an example of this phenomenon. When I was a young woman I taught school and went home every day for luncheon. One day at luncheon, some one of the family criticized me severely. I went back to school very angry. Before I entered the school-room, the princ.i.p.al handed me some books which she had ordered for me. They were not at all the books I wanted, and that upset me still more. As I went into the schoolroom, I found that my face was swollen until my eyes were almost shut; it was a bright red and covered with purplish blotches. My fingers were swollen so that I could not bend the joints in the slightest degree. It was a day or two before the disturbance disappeared, and the whole of it was the result of anger.
We hear much to-day about high blood pressure. They say that a man is as old as his arteries, and now it is known that the health of the arteries depends largely on blood pressure. Since this is a matter that can be definitely measured at any minute, we have an easy way of noting the remarkable effect of shifting emotions. Sadler tells of an ex-convict with a blood pressure of 190 millimeters. It seems that he was worrying over possible rearrest. On being rea.s.sured on this point, his blood pressure began to drop within a few minutes, falling 20 mm. in three hours, and 35 mm. by the following day.
Muscular Tone. A force that affects circulation, blood pressure, respiration, nutrition of cells, secretion, and digestion, can hardly fail to have a marked effect on the tone of the muscles, internal as well as external. When we remember that heart, stomach, and intestines are made of muscular tissue, to say nothing of the skeletal muscles, we begin to realize how important is muscular tone for bodily health. Over and over again have I demonstrated that a courageous mind is the best tonic. Perhaps an example from my "flat-footed" patients will be to the point. One woman, the young mother of a family, came to me for a nervous trouble. Besides this, she had suffered for seven or eight years from severe pains in her feet and had been compelled to wear specially made shoes prescribed by a Chicago orthopedist. The shoes, however, did not seem to lessen the pain. After an ordinary day"s occupation, she could not even walk across the floor at dinner-time. A walk of two blocks would incapacitate her for many days. She was convinced that her feet could never be cured and came to me only on account of nervous trouble. On the day of her arrival she flung herself down on the couch, saying that she would like to go away from everybody, where the children would never bother her again. She was sure n.o.body loved her and she wanted to die. Within three weeks, in ordinary shoes, this woman tramped nine miles up Mount Wilson and the next day tramped down again. Her att.i.tude had changed from that of irritable fretfulness to one of buoyant joy, and with the moral change had come new strength in the muscles. The death of her husband has since made it necessary for her to support the family, and she is now on her feet from eight to fourteen hours a day, a constant source of inspiration to all about her, and no more weary than the average person.
Flabbiness in the muscles often causes this trouble with the feet. "The arches of the foot are maintained by ligaments between the bones, supported by muscle tendons which prevent undue stretching of the ligaments and are a protection against flat-foot." [31] Muscle tissue has an abundant blood supply, while ligaments have very little and soon lose their resiliency if unsupported. Any lack of tone in the calf-muscles throws the weight on the less resistant ligaments and on the cartilages placed as cushions between the bony structures of the arch. This is what causes the pain. [32]
[31] Grey"s Anatomy-"The Articulations."
[32] Actual loss of the arch by downward displacement of the bones cannot be overcome by restoring muscle-tone. The majority of so-called cases of flatfoot are, however, in the stage amenable to psychic measures.
Flat-footedness is only one result of weak muscles. Eye-strain is another; ptosis, or falling of the organs, is another. In a majority of cases the best treatment for any of these troubles is an understanding attempt to go to the root of the matter by bracing up the whole mental tone. The most scientific oculists do not try to correct eye trouble due to muscular insufficiency by any special prisms or gla.s.ses. They know that the eyes will right themselves when the general health and the general spirits improve. I have found by repeated experience with nervous patients that it takes only a short time for people who have been unable to read for months or years to regain their old faculty. So remarkable is the power of mind.
Summary
We have found that the gap between the body and the mind is not so wide as it seems, and that it is bridged by the subconscious mind, which is at once the master of the body and the servant of consciousness. In recording the physical effects of suggestion and emotion, we have not taken time to describe the galvanometers, the weighing-machines and all the other apparatus used in the various laboratory tests; but enough has been said to show that when doctors and psychologists speak of the effect of mind on body, they are dealing with definite facts and with laws capable of scientific proof.
We have emphasized the fact that downcast and fearful moods have an immediate effect on the body; but after all, most people know this already. What they do not know is the real cause of the mood. When a nervous person finds out why he worries, he is well on the way toward recovery. An understanding of the cause is among the most vital discoveries of modern science.
The discussion, so far, has merely prepared us to plunge into the heart of the question: What is it that in the last a.n.a.lysis makes a person nervous, and how may he find his way out? This question the next two chapters will try to answer.
CHAPTER VII
In which we go to the root of the matter
THE REAL TROUBLE
Pioneers
Following the Gleam. Kipling"s Elephant-child with the ""satiable curiosity" finally asked a question which seemed simple enough but which sent him on a long journey into unknown parts. In the same way man"s modest and simple question, "What makes people nervous?" has sent him far-adventuring to find the answer. For centuries he has followed false trails, ending in blind alleys, and only lately does he seem to have found the road that shall lead him to his journey"s end.
We may be thankful that we are following a band of pioneers whose fearless courage and pa.s.sion for truth would not let them turn back even when the trail led through fields. .h.i.therto forbidden. The leader of this band of pioneers was a young doctor named Freud.
The Search for Truth
Early Beginnings. In 1882, when Freud was the a.s.sistant to Dr. Breuer of Vienna, there was brought to them for treatment a young woman afflicted with various hysterical pains and paralyses. This young woman"s case marked an epoch in medical history; for out of the effort to cure her came some surprising discoveries of great significance to the open-minded young student.
It was found that each of this girl"s symptoms was related to some forgotten experience, and that in every case the forgetting seemed to be the result of the painfulness of the experience. In other words, the symptoms were not visitations from without, but expressions from within; they were a part of the mental life of the patient; they had a history and a meaning, and the meaning seemed in some way to be connected with the patient"s previous att.i.tude of mind which made the experience too painful to be tolerated in consciousness. These previous ideas were largely subconscious and had been acquired during early childhood. When by means of hypnosis a great ma.s.s of forgotten material was brought to the surface and later made plain to her consciousness, the symptoms disappeared as if by magic.
A Startling Discovery. For a time Breuer and Freud worked together, finding that their investigations with other patients served to corroborate their former conclusions. When it became apparent that in every case the painful experience bore some relation to the love-life of the patient, both doctors were startled. Along with most of the rest of the world, they had been taught to look askance at the reproductive instinct and to shrink from realizing the vital place which s.e.x holds in human life.
Breuer dropped the work, and after an interval Freud went on alone. He was resolved to know the truth, and to tell what he saw. When he reported to the world that out of all his hundreds of patients, he had been unable, after the most careful a.n.a.lysis, to find one whose illness did not grow from some lack of adjustment of the s.e.x-life, he was met by a storm of protest from all quarters. No amount of evidence seemed to make any difference. People were determined that no such libel should be heaped on human nature. s.e.x-urge was not respectable and nervous people were to be respected.
Despite public disapproval, the scorn of other scientists, and the resistance of his own inner prejudices, Freud kept on. He was forced to acknowledge the validity of the facts which invariably presented themselves to view. Like Luther under equal duress, he cried: "Here I stand. I can do no other."
Freudian Principles. Gradually, as he worked, he gathered together a number of outstanding facts about man"s mental life and about the psycho-neuroses. These facts he formulated into certain principles, which may be summed up in the following way.
1 There is no chance in mental life; every mental phenomenon-hence every nervous phenomenon-has a cause and meaning.
2 Infantile mental life is of tremendous importance in the direction of adult processes.
3 Much of what is called forgetting is rather a repression into the subconscious, of impulses which were painful to the personality as a whole.
4 Mental processes are dynamic, insisting on discharge, either in reality or in phantasy.
5 An emotion may become detached from the idea to which it belongs and be displaced on other ideas.
6 s.e.x-interests dominate much of the mental life where their influence is unrecognized. The disturbance in a psycho-neurosis is always in this domain of s.e.x-life. "In a normal s.e.xual life, no neurosis." If a shock is the precipitating cause of the trouble, it is only because the ground was already prepared by the s.e.x-disturbance.
Freud was perhaps unfortunate in his choice of the word "s.e.x," which has so many evil connotations; but as he found no other word to cover the field, he chose the old one and stretched its meaning to include all the psychic and physical phenomena which spring directly and indirectly from the great processes of reproduction and parental care, and which ultimately include all and more than our word "love." [33]
[33] Freud and his followers have always said that they saw no theoretical reason why any other repressed instinct should not form the basis of a neurosis, but that, as a matter of fact, they never had found this to be the case, probably because no other instinct comes into such bitter and persistent conflict with the dictates of society. Now, however, the Great War seems to have changed conditions. Under the strain and danger of life at the front there has developed a kind of nervous breakdown called sh.e.l.lshock or war-neurosis, which seems in some cases to be based not on the repression of the instinct of race-preservation but on the unusual necessity for repression of the instinct of self-preservation. Army surgeons report that wounded men almost never suffer from sh.e.l.l-shock. The wound is enough to secure the unconsciously desired removal to the rear. But in the absence of wounds, a desire for safety may at the same time be so intense and so severely repressed that it seizes upon the neurosis as the only possible means of escape from the unbearable situation. In time of peace, however, the instinct of reproduction seems to be the only impulse which is severely enough repressed to be responsible for a nervous breakdown.
Later Developments. Little by little, the scientific world came to see that this wild theorizer had facts on his side; that not only had he formulated a theory, but he had discovered a cure, and that he was able to free people from obsessions, fears, and physical symptoms before which other methods were powerless. One by one the open-minded men of science were converted by the overpowering logic of the evidence, until to-day we find not only a "Freudian school," counting among its members many of the eminent scientists of the day, but we find in medical schools and universities courses based on Freudian principles, with text-books by acknowledged authorities in medicine and psychology. We find magazines devoted entirely to psycho-a.n.a.lytic subjects, [34] besides articles in medical journals and even numerous articles in popular magazines. Not only is the treatment of nervous disorders revolutionized by these principles but floods of light are thrown on such widely different fields of study as ancient myths and folk lore, the theory of wit, methods of child training, and the little slips of the tongue and everyday "breaks" that have until recently been considered the meaningless results of chance.