The "Bullying Method." Sometimes, to be sure, explanation is not enough. The brain paths between the a.s.sociated ideas are so deeply worn that no amount of persuasion avails. It is easy for the doubter to say: "Well, that sounds very well, but my case is different. I have tried over and over again and I know." With people of this sort, an ounce of demonstration is worth a pound of argument.
By way of ill.u.s.tration we might mention the man who couldn"t eat eggs. To be sure, he had tried many times but always had suffered the most intense cramps in his stomach, and no amount of talk could make him believe that an egg was not poison to him. I took the straight road of simply proving to him that he was mistaken, and had him eat an egg. After a time of apprehension and retching, he vomited the egg, thinking, of course, that he had proved his point. To his astonishment, I said, "Now, let"s go and eat another." With great consternation, he finally complied, evidently expecting to die on the spot; but as I immediately prescribed a game of tennis, he scarcely had time to think of the pain, which in fact failed to appear. However, as he thereafter insisted on eating four eggs a day,-with eggs at top-notch price I decided that the joke was on the doctor!
Enjoying the Right Things. In subst.i.tuting healthful complexes for unhealthful ones, psychotherapy not only changes ideas and emotions, but alters the feelings of pleasure or pain that are bound up with the ideas. Dr. Tom A. Williams writes: "The essence of psychotherapy and education is to a.s.sociate useful activities with agreeable feeling-tones and to dissociate from injurious acts the agreeable feeling-tones that may have been acquired." Right character consists not so much in enjoying things as in enjoying the right things.
Some people enjoy being martyrs. They love to tell about the terrible strain they have been under, the amount of work they have done, or the number of times they have collapsed. One of my patients gave every evidence of satisfaction as he told about his various breakdowns. "The last time I was ill," or "That time when I was in the sanatorium," were frequent phrases on his lips. Finally, after I had asked him if he would boast about the number of times he had awkwardly fallen down in the street, and had shown him that a neurosis is not really a matter to be proud of, he saw the point and stopped taking pleasure in his mistakes.
Such signs of pleasure in the wrong things are evidence of suppressed wishes which we do not acknowledge but try to gratify in indirect ways. [46] The pleasure which ought to be a.s.sociated with the idea of good work well done has somehow been switched over to the idea of being an invalid. The satisfaction which ought to go with a sense of power and ability to do things has attached itself to the idea of weakness and inability. The pleasurable feeling-tone which normally belongs to ministering to others, regresses in the nervous invalid to the infantile satisfaction of being ministered unto.
[46] For a further elaboration of this theme, see Holt: The Freudian Wish.
But these things are only a habit. A good look in the mirror soon makes one right about face and start in the other direction. Once started, a good habit is built up with surprising ease. It is really much more satisfying to cook a good dinner for the family"s comfort than to think about one"s ills; much pleasanter to enjoy a good meal than to insist on hot water and toast. Once we have satisfied our suppressed longings in more desirable ways, or by a process of self-training have initiated a new set of habits, we feel again the old zest in normal affairs, the old interest and pleasure in activities which add to the joy of life. Thus does re-education fit a man to take his place in the world"s work as a socially useful being, no longer a burden, but a contributor to the sum total of human happiness.
Summary
Knowing and Doing. Having set out to learn how to outwit our nerves, we are now ready to sum up conclusions and in the following chapters to apply them to the more common nervous symptoms. It has been shown that a nervous person is in great need of change,-not, indeed, a change in climate or in scene, in work or in diet, but a change in the hidden recesses of his own being. Outwitting nerves means first and foremost changing one"s mind, an inner and spiritual process very different from the kind of change which used to be prescribed for the nervous invalid.
As Putnam says, the slogan of the suggestion-school of psychotherapy has always been, "You can do better if you try"; while that of the psycho-a.n.a.lytic school is, "You can do better when you know." Refuting the old adage, "Where ignorance is bliss "tis folly to be wise," the best methods of psychotherapy insist that the first step in any thorough-going attempt to change oneself must be the great step of self-knowledge. As the conflicts which result in "nerves" are always far beyond those mental regions which are open to scrutiny, a real self-knowledge requires an examination of the half-conscious or wholly unconscious longings which are usually ignored. A real understanding of self comes only when one is willing, to a.n.a.lyze his motives until he sees the connection between them and his nervous symptoms, which are but the symbolic gratification of desires he dares not acknowledge.
Although these deeply buried complexes are the real force behind a nervous illness, the material out of which the symptoms are manufactured is taken largely from superficial misconceptions concerning the bodily functions. It is therefore a great help, also, to possess a fund of information,-not technical nor detailed but accurate as far as it goes,-about the more important workings of the bodily machinery. A little knowledge about the actual chemistry of fatigue and the way it is automatically cared for by the body is likely to do away with the idea of nervous exhaustion as resulting from acc.u.mulation of fatigue. A simple understanding of the biological and physiological facts concerning the a.s.similation of food and the elimination of waste material leaves the intelligent person less ready to convert his psychic discomfort into indigestion and constipation. Chapters IX to XIII in this book, which at first glance may seem to belong to a work on physiology rather than on psychology are designed to give just such needed insight.
But knowing the truth is only the first half of the way out. Every neurosis is a deliberate choice by a part of the personality. Self-discovery is helpful only when it leads to better ways of self-expression. The final aim of psychotherapy is the happy adjustment of the individual to the demands of society and the establishment of useful outlets for his energy. This phase of the subject will be discussed more fully in Chapter XVI.
The Future Hope. Much has been said about the cure of a neurosis. There are enough people already in the maze of nervousness to warrant the setting up of numerous signs reading, "This way out." But after all, is not a blocking of the way in of vastly more importance? As it is always easier to prevent than to cure, so it is easier to train than to reform. If re-education is the cure, why is not education the ounce of prevention which shall settle the problem for all time?
If the general public understood what "nerves" are, it is hardly conceivable that there could be so many breakdowns as there are at present. If a man"s family and friends, to say nothing of himself, understood what he is doing when he suddenly collapses and has to quit work, it is not likely that he would choose that way out of his difficulties.
Most important of all, when parents know that the foundation of nervousness is laid in childhood, they will see to it that their children are started right on the road to health. When fathers and mothers realize that an over-strong bond between parents and children is responsible for a large proportion of nervous troubles, most of them will make sure that such exaggeration is not allowed to develop.
And, finally, when parents are freed from their "conspiracy of silence" by a reverent att.i.tude toward the whole of life, their very saneness will impart to their children a wholesome respect for the reproductive instinct. There will then be found in the next generation fewer half-starved men and women carrying the burden of unnecessary repressions and the pain of unsatisfied yearnings.
Not that such a day will usher in the millennium. We are not suggesting a panacea for all the social ills. There is an inevitable conflict between the instinctive urge of the life-force and the demands of society, a conflict which makes men and women either finer or baser, according to the way they handle it. What is claimed is that the right kind of education-using the word in its largest, deepest sense-will remove the most fruitful cause of nervousness by taking away the extra burden of misconception and making it easier for people to be "content with being moral." [47]
[47] Frink: Morbid Fears and Compulsions.
CHAPTER IX
In which we discover new stores of energy and learn the truth about fatigue
THAT TIRED FEELING
Unfailing Resources
"They that wait upon the Lord shall renew their strength. They shall mount up with wings as eagles. They shall run and not be weary. They shall walk and not faint."
It is safe to say that many a person loves this promise of the prophet Isaiah without taking it in anything like a literal sense. The words are considered to be so figurative and so highly spiritualized that they seem scarcely to relate at all to this earthly life, much less to the possibilities of these physical bodies.
Besides the nervous folk who feel themselves so weary that they scarcely have strength to live, there are thousands upon thousands of men and women who are called normal but who have lost much of the joy of life because they feel their bodies inadequate to meet the demands of everyday living.
To such men and women the Biblical promise, "As thy day, so shall thy strength be," comes now as the message of modern science. Nature is not stingy. She has not given the human race a meager inheritance. She did not blunder when she made the human body, nor did she allow the spirit of man to develop a civilization to whose demand his body is not equal. After its long process of development through the survival of the fittest, the human body, unless definitely diseased, is a perfectly adequate instrument, as abundantly able to cope with the complex demands of modern society as with the simpler but more strenuous life of the stone age. The body has stored within its cells enough energy in the shape of protein, carbohydrate and fat to meet and more than meet any drains that are likely to be made upon it, either through the monotony of the daily grind or the excitement of sudden emergency. Nature never runs on a narrow margin. Her motto seems everywhere to be, "Provide for the emergency, enough and to spare, good measure, pressed down, running over." She does not start her engines out with insufficient steam to complete the journey. On the contrary, she has in most instances reserve boilers which are almost never touched. As a rule the trouble is not so much a lack of steam as the ignorance of the engineer who is unacquainted with his engine and afraid to "let her out."
"The Energies of Men." Perhaps nothing has done so much to reveal the hidden powers of mankind as that remarkable essay of Professor William James, "The Energies of Men." [48] Listen to his introductory paragraph as he opens up to us new "levels of energy" which are usually "untapped":
[48] James: On Vital Reserves.
Every one knows what it is to start a piece of work, either intellectual or muscular, feeling stale-or cold, as an Adirondack guide once put it to me. And everybody knows what it is to "warm up to his job." The process of warming up gets particularly striking in the phenomenon known as the "second wind." On usual occasions we make a practice of stopping an occupation as soon as we meet the first effective layer (so to call it) of fatigue. We have then walked, played or worked "enough," so we desist. That amount of fatigue is an efficacious obstruction on this side of which our usual life is cast. But if an unusual necessity forces us to press onward, a surprising thing occurs. The fatigue gets worse up to a certain critical point, when gradually or suddenly it pa.s.ses away, and we are fresher than before. We have evidently tapped a level of new energy, masked until then by the fatigue-obstacle usually obeyed. There may be layer after layer of this experience. A third and fourth "wind" may supervene. Mental activity shows the phenomenon as well as physical, and in exceptional cases we may find, beyond the very extremity of fatigue-distress, amounts of ease and power that we never dreamed ourselves to own, sources of strength habitually not taxed at all, because habitually we never push through the obstruction, never pa.s.s those early critical points.
Again Professor James says:
Of course there are limits; the trees don"t grow into the sky. But the plain fact remains that men the world over possess amounts of resource which only very exceptional individuals push to their extremes of use. But the very same individual, pushing his energies to their extreme, may in a vast number of cases keep the pace up day after day, and find no "reaction" of a bad sort, so long as decent hygienic conditions are preserved. His more active rate of energizing does not wreck him; for the organism adapts itself, and as the rate of waste augments, augments correspondingly the rate of repair. [49]
[49] Ibid., pp. 6-7.
Another psychologist, Boris Sidis, writes: "But a very small fraction of the total amount of energy possessed by the organism is used in its relation with the ordinary stimuli of its environment." [50] These men-Professor James and Dr. Sidis-represent not young enthusiasts who ignorantly fancy that every one shares their own abundant strength, but careful men of science who have repeatedly been able to unearth unsuspected supplies of energy in "worn out" men and women, supposed to be at the end of their resources. Every successful physician and every leader of men knows the truth of these statements. What would have happened in the great war if Marshal Foch had not known that his men possessed powers far beyond their ken, and had not had sublime faith in the "second wind"?
[50] Sidis: P. 112 of the composite volume Pychotherapeutics.
What about Being Tired? If all these things are true, why do people need to be told? If man"s equipment is so adequate and his reserves are so ample, why after all these centuries of living does the human race need to learn from science the truth about its own powers? The average man is very likely to say that it is all very well for a scientist sitting in his laboratory to tell him about hidden resources, but that he knows what it is to be tired. Is not the crux of the whole question summed up in that word "tired"? If we do not need to rest, why should fatigue exist? If the purpose of fatigue seems to be to slow down our efforts, why should we disregard it or seek to evade its warnings? The whole question resolves itself into this: What is fatigue? In view of the hampering effect of misconception on this point, it is evident that the question is not academic, but intensely practical. We shall find that fatigue is of two kinds,-true and false, or physical and moral, or physiological and nervous,-and that while the two kinds feel very much alike, their origin and behavior are quite different.
Physiological Fatigue
Fatigue, not Exhaustion. In the first place, then, fatigue very seldom means a lack of strength or an exhaustion of energy. The average man in the course of a lifetime probably never knows what it is to be truly exhausted. If he should become so tired that he could in no circ.u.mstances run for his life, no matter how many wild beasts were after him, then it might seem that he had drained himself of all his store of energy. But even in that case, a large part of his fatigue would be the result of another cause.
A Matter of Chemistry. True fatigue is a chemical affair. It is the result of recent effort,-physical, mental, or emotional,-and is the sum of sensations arising from the presence of waste material in the muscles and the blood. The whole picture becomes clear if we think of the body as a factory whose fires continuously burn, yielding heat and energy, together with certain waste material,-carbon dioxide and ash. Within man"s body the fuel, instead of being the carbon of coal is the carbon of glycogen or animal starch, taken in as food and stored away within the cells of the muscles and the liver. The oxygen for combustion is continuously supplied by the lungs. So far the factory is well equipped to maintain its fires. Nor does it fail when it comes to carrying away waste products. Like all factories, the body has its endless chain arrangement, the blood stream, which automatically picks up the debris in its tiny buckets-the blood-cells and serum-and carries it away to the several dumping-grounds in lungs, kidneys, intestines, and skin.
Besides the products of combustion, there are always to be washed away some broken-down particles from the tissues themselves, which, like all machinery, are being continuously worn out and repaired. By chemical tests in the laboratory, the physiologist finds that a muscle which has recently been in violent exercise contains among other things carbon dioxid, urea, creatin, and sarco-lactic acid, none of which are found in a rested muscle. Since all this debris is acid in reaction and since we are "marine animals," at home only in salt water or alkaline solution, the cells must be quickly washed of the fatigue products, which, if allowed to acc.u.mulate, would very soon poison the body and put out the fires.
No Back Debts. The human machine is regulated to carry away its fatigue products as fast as they are made, with but slight lagging behind that is made good in the hours of sleep, when bodily activities are lessened and time is allowed for repair. Unless the body is definitely diseased, it virtually never carries over its fatigue from one day to another. In the matter of fatigue, there are no old debts to pay. Nature renews herself in cycles, and her cycle is twenty-four hours,-not nine or ten months as many school-teachers seem to imagine, or eleven months as some business men suppose. In order to make a.s.surance doubly sure, many set apart every seventh day for a rest day, for change of occupation and thought, and for catching up any slight arrears which might exist. But the point is that a healthy body never gets far behind.
If through some flaw in the machine, waste products do pile up, they destroy the machine. If the heart leaks or the blood-cells fail in their carrying-power, or if lungs, kidneys or skin are out of repair, there is sometimes an acc.u.mulation of fatigue products which poisons the whole system and ends in death. But the person with tuberculosis or heart trouble does not usually allow this to happen. The body incapacitated by disease limits its activities as closely as possible within the range of its power to take care of waste matter. Even the sick body does not carry about its old toxins. The man who had not eliminated the poisons of a month-old effort would not be a tired man. He would be a dead man.
A Sliding Scale. If all this be true, real fatigue can only be the result of recent effort. If one is still alive, the results of earlier effort must long since have disappeared. The tissue-cells retain not the slightest trace of its effects. Fatigue cannot possibly last, because it either kills us or cures itself. Up to a certain point, far beyond our usual high-water mark, the more a person does the more he can do. As Professor James has pointed out, the rate of repair increases with the rate of combustion. Under unusual stress, the rate of the whole machine is increased: the heart-pump speeds up, respirations deepen and quicken, the blood flows faster, the endless chain of filling and emptying buckets hurries the interchange of oxygen and carbon dioxid, until the extreme capacity is reached and the organism refuses to do more without a period of rest.
The whole arrangement ill.u.s.trates the wonderful provisions of Nature. Although each individual is continuously manufacturing enough carbonic-acid gas to kill himself in a very few minutes, he need not be alarmed for fear that he may forget to expel his own poisons. n.o.body can hold his breath for more than a few minutes. The naughty baby sometimes tries, but when he begins to get black in the face, he takes a breath in spite of himself. The presence of carbonic-acid gas in the circulation automatically regulates breathing, and the greater the amount of gas the deeper the breath. The faster we burn the faster we blow. As with breathing, so with all the rest of elimination and repair. The body dares not get behind.
"Second Wind." A city man frequently sets out on a mountain tramp without any muscular preparation for the trip. He walks ten or fifteen miles when his average is not over one or two. Sometimes after a few hours he feels himself exhausted, but a glorious view opens out before him and he goes on with new zest. He has merely increased his rate of repair and drawn on a new stock of energy. That night he is tired, and the next day he is likely to be stiff and sore. There is a little fatigue left in him, but it takes only a day or two for the body to be wholly refreshed, especially if he hastens the process by another good walk. Up to a certain point, far beyond our usual limit, the more we do, the more we can do.
One day after a long walk my little daughter said that she could go no farther and waited to be carried. But she soon spied a dog on ahead and ran off after him with new zest. She followed the dog back and forth, running more than a mile before she reached home, and then in the exuberance of her spirits, ran around the house three times.
The Emotions Again. What is the key that unlocks new stores of energy and drives away fatigue? What is it in the amateur mountain-climbers that helps the body maintain its new standard? What keeps indefatigable workers on the job long after the ordinary man has tired? Is it not always an invigorating emotion,-the zest of pursuit, the joy of battle, intense interest in work, or a new enthusiasm? All great military commanders know the importance of morale. They know that troops can stand more while they are going forward than while running away, that the more contented and hopeful they are, the better fighters they make; discouragement, lack of interest, the fighting of a losing game, dearth of appreciation, futility of effort, monotony of task, all conspire in soldier or civilian to use up and to lock up energy which might have been available for real work. Approaching the matter from a new angle, we find once more that the difference between strength and weakness is in many cases merely a difference in the emotions and feeling-tones which habitually control.
Fatigue is a safety-device of nature to keep us within safe limits, but it is a device toward which we must not become too sensitive. As a rule it makes us stop long before the danger point is reached. If we fall into the habit of watching its first signals, they may easily become so insistent that they monopolize attention. Attention increases any sensation, especially if colored by fear. Fear adds to the waste matter of fatigue little driblets of adrenalin and other secretions which must somehow be eliminated before equilibrium is reestablished. This creates a vicious circle. We are tired, hence we are discouraged. We are discouraged, hence we are more tired. This kind of "tire" is a chemical condition, but it is produced not by work but by an emotion. He who learns to take his fatigue philosophically, as a natural and harmless phenomenon which will soon disappear if ignored, is likely to find himself possessed of exceptional strength. We can stand almost any amount of work, provided we do not multiply it by worry. We can even stand a good deal of real anxiety provided it is not turned in on ourselves and directed toward our own health.
"Decent Hygienic Conditions." If fatigue products cannot pile up, why is extra rest ever needed? Because there is a limit to the supply of fuel. If the fat-supply stored away for such emergencies finally becomes low, we may need an extra dose of sleeping and eating in order to let the reservoirs fill again. But this never takes very long. The body soon fills in its reserves if it has anything like common-sense care. The doctrine of reserve energy does not warrant a careless burning of the candle at both ends. It presupposes "decent hygienic conditions,"-eight hours in bed, three square meals a day, and a fair amount of fresh air and exercise.