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Page 24
And if, as Bianchi suggests, all mental activity depends on a series of
reflex actions, or, as Bechterew and Pavlov have insisted, a series of
conditioned reflexes becomes established, it will assist us to
understand how such stimuli can give rise to mental disturbances, to
mental illnesses. We shall see that there may be something of real
importance underlying such remarks as "I felt I was a changed child"; or
"It is because of the treatment I received from my father that I have
taken life so seriously." "I have never imagined that what I went
through in my childhood could so influence me now"; or "I have never had
confidence in myself and often when I have appeared vivacious and
interested I have had an awful feeling of incapacity and dread within
myself."
The outward and obvious manifestations, therefore, are not necessarily a
true index of our mental and emotional conditions. This is true of all
mental illnesses, even the most severe.
One patient who had been in an asylum more than ten years illustrated
this in a most striking manner. His outward manifestations led one to
feel that he thought he possessed the institution in which he was
confined and also the surrounding property and that the authorities were
a set of usurpers and thieves who kept him incarcerated in order that
they might enjoy what was really his money and his property. On one
occasion I said to him, "George, what is that incident in your life
which you cannot forget and which has troubled you so seriously?" The
reply was a flood of abuse. I put the question to him several times
without getting any further answer, but when I came to leave the ward,
George came up behind me and whispered over my shoulder, "Who told you
about it?" No abuse, no shouting as usually occurred, but a whisper,
"Who told you about it?" Was not George running away from a memory with
its emotion which was unbearable to an idea which allowed him to be
angry with others instead of with himself? Many examples of this might
be given and really might be found by us in our own experience. It is
the mental content which is important, a mental content which can be
recalled by various stimuli, and which will be more persistently with us
the more intense is the emotion associated with it.
But the basis of the condition is not completely understood when we have
apparently arrived at the psychic cause of the disturbance.
It is recognized that the emotions are accompanied by physical changes,
changes which are specific for each emotional state. The physical
changes which normally are associated with fear differ from those of joy
or anger. This has been appreciated for a long time but recent
researches have recalled other reactions to us. Reactions in the
internal glands which further knowledge will probably prove to be of
great importance, in fact to form an integral part of the sum of
activities, connect with mental processes. The secretions of the glands
exert an influence on the sensibility and reaction of the organs
connected with psychic phenomena and their functions themselves are
affected by reactions occurring in the nervous system. Revival of a
memory may thus affect the functions of these glands, and the changes
produced in them may react on the sensibility and reactivity of the
nervous mechanisms. If this be so, it will be evident that the organism
works as a whole, that a disturbance of one organ may interfere with the
function of another and that in the repetition of all these influences
we may find an explanation of the chronicity of many of these illnesses.
A study of the activities and interactivities of all the organs of the
body is therefore essential and must be made before we shall understand
the biological significance of mental illness.
FOOTNOTES:
[Footnote 13: See Appendix III, p. 200.]
ADDRESS BY
DR. PIERRE JANET
_The Chairman_: Our country may be hesitating a little--I hope it will
not be for long--in joining a league of nations to prevent war, but
there can be no doubt of our immediate readiness to co-operate
internationally to prevent and reduce disease. Our distinguished guest
from gallant France, Dr. Pierre Janet, professor in the College of
France, evidently feels confident of our sympathy and willingness to
collaborate in this latter respect, for he has ventured across the
ocean, with Madame Janet, in response to our urgent invitation. His
introduction to an audience of American psychiatrists would be quite out
of place. His fame as a pathological psychologist has circled the world.
In the science of medicine he is a modern Titan. For to-day's address he
has chosen as a subject, "THE RELATION OF THE NEUROSES TO THE
PSYCHOSES."
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