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Page 23
But however absurd her statement regarding her being touched by a
"blackbird" and all her vitality removed might appear to superficial
observation, it must be admitted that when we know the mental content of
that patient, we cannot but see that at any rate it was not so
irrational. And not only was this recognized by the doctor, but, and
this is much more important, by the patient herself.
It is, therefore, the mental content which must be discovered before
doctor or patient can understand the disability and before any common
ground between the two can be found. And when the mental content is
known it will be easy to recognize the affective condition of the
patient to be a normal response. It will also be specific and if intense
will dominate the patient. "Why is it I can never feel joy as I used to
do?" was the pathetic inquiry of the patient dominated by a feeling of
misery and fear. Was it not for the reason that being dominated by
misery and fear, joy could find no place? The emotion of misery because
of its intensity could more or less inhibit the feeling of joy, but joy
could not inhibit the misery.
No repetition of the memory of the unpleasant experiences with their
associated emotion of misery and fear led to the formation of a habit of
mind and feeling. And when once such a habit of mind is established it
is remarkable by what a host of stimuli received in ordinary daily life
the cause of the disturbance can be recalled.
This question of stimuli deserves further notice. It is not so difficult
to realize the mechanism by which a stimulus which clearly crosses the
threshold of consciousness can lead to a given reaction. But it is
perhaps difficult to imagine how so many stimuli which do not cross the
threshold of consciousness or which, if they do, are not recognized by
the patient at the time as having any reference whatever to the special
memory can yet set the memory mechanism into action. The result may not
be seen till after the relapse of some considerable period of time, as
in the case of a man who for years had been disturbed by terrific
nightmares, based on the idea of snakes coming out of the ground and
attacking him. He complained one day that he was much worse, that three
nights before he had had the worst nightmare of his life. On being
questioned as to what could have suggested snakes to him he could not
tell. A few minutes later he said: "I think I know the cause now. I
spent the evening before I had that nightmare with a sergeant who had
returned from the service in India." This friend amongst other things
had mentioned that whenever they were about to bivouac they had to
search every hole under a stone and every tuft of grass to see that
there were no snakes there. This, which had been received as an ordinary
item of information, had been the stimulus which had set his memory
mechanism into action and the nightmare between two and three o'clock in
the morning had been the result.
The result in many instances is evidenced by an emotional state alone
and the actual memory of the original experience may not come into
consciousness. Many examples of this might be given. The sound of a
trolley wheel on a tram wire in one case gave rise to terror instead of
its normal reaction, viz., that of satisfaction at getting to the
destination quickly and without effort. This terror was produced because
the sound on the wire resembled that of a shell which came over, blew in
a dugout, killed three men, and buried the patient. No memory of this
incident came into consciousness, only a terror similar to that
experienced at the time of the original incident was experienced. Or,
the time four o'clock in the afternoon could act as a stimulus to arouse
an emotional state of misery similar to that experienced at the same
time of day during an illness some years previously. Or, passing the
house of a doctor when on a bus could produce a sudden outburst of
anxiety, giddiness, and confusion; the patient had been taken into that
house at the time of an epileptic attack. Or, showing photographs of the
front could lead to an epileptic attack which was based on the memory of
the time when the patient was wounded in the head; this has occurred on
two separate occasions separated by an interval of some months. Or,
noticing a familiar critical tone in a remark made at a dinner-table
could lead to an acute change of feeling so that the subject who,
before dinner, had felt she would like to play a new composition on the
piano so as to obtain the opinion of the guest who had exhibited the
critical tone, after dinner felt incapable of doing so. Her feelings had
been hurt on many former occasions by critical remarks made by him in
that tone. The critical remarks were not called to memory but there
arose the feeling that under no circumstances could she play that piece
to him.
Of special importance also are the experiences of childhood. An unhappy
home or unjust treatment as a child may warp the development of the
personality, lead to a lack of self-confidence, to the predominance of
one emotional tendency, and so prevent that balanced equilibrium which
will allow a rapid and suitable emotional reaction such as we may
consider normal. This may lead to a failure of development or a loss of
the sense of value, because the existence of one dominating emotional
tendency so often produces a prejudiced view which may render a just
appreciation of our general experience almost impossible and may
seriously disturb our mental activity.
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