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Page 29
The two phenomena, agitation and depression, are almost always
associated in neuroses as well as in psychoses. It is likely that their
union depends upon some very general law, relating to the exhaustion of
psychological forces. It is probable that the superior phenomena exact
under a form of concentration, of particular tension, much more power
than acts of an inferior order, although the latter seem more violent
and more noisy. "When the force primitively destined to be spent for the
production of a certain superior phenomenon has become impossible,
derivations happen, that is to say, that this force is spent in
producing other useless and especially inferior phenomena."[17]
A very great number of phenomena observed in neuroses and psychoses are
in connection with depression and agitation. Convulsive attacks, diverse
fits of agitation, prove to us that before the fit there existed
disproportion between the quantity and the tension of the psychological
forces, and that the spending of forces during the fit re-establishes
the equilibrium. But at the same time, after this spending, one observes
a notable lowering of the mental level, a real psycholepsy. It is very
likely that studies of this kind will produce some day the key of the
epilepsy problem, for vertigos and certain epileptic fits are certainly
phenomena of relaxation, the meaning of which we do not comprehend
because we do not study sufficiently the state of psychological tension
before and after the accidents.
The difficulty of accomplishing superior acts, the exhaustion resulting
from their accomplishment, renders them fearful to the patient who has
the fear, the phobia of these acts, just as he has the terror of that
depression which gives the feeling of the diminution of life. The
shrinking of activity and conscience, phobias, negativisms, generally
take their starting point in this fear of exhaustion caused by some
difficult action. In other cases the patient feels incapable of
accomplishing correctly the reflected acts necessary to social and moral
life, and feeling no longer protected by reflection, he is afraid of
willing or believing something, as one is afraid of walking in a
dangerous path, when one cannot see. The vertigo of life produces itself
like the vertigo of heights, when one is not sure of oneself.
Depressed patients have felt, wrongly or rightly, a certain excitation
after a certain action. Through some curious mechanism, certain acts,
instead of exhausting them, have raised their psychological tension. The
need, the desire to raise themselves inspires them with the wish to
renew such acts, and we behold the impulsions to absorb poisons,
impulsions to command, to theft, to aggression, to extraordinary acts,
varied impulsions which play a great part in psychoses as well as in
neuroses.
I shall not insist any more on a very interesting phenomenon in
connection with the oscillations of the mind and which still plays a
great part in these diseases. I am speaking of the change of feeling
which may accompany the same action in the course of the oscillations of
the mind. At the level with the reflected action, more or less complete,
the thought of an action which appears important and of which one often
thinks, determines interrogations, doubts, scruples. If the individual
descends one degree, if he becomes quite incapable of reflecting and
therefore of doubting, the same action he continues to think about may
present itself under the form of an impulsion more or less irresistible.
There are patients who in the first stage have the fear and horror of
committing an act and who in the second stage are driven to accomplish
it. In other cases a subject may make use of an action as a means of
exciting and raising himself; he seeks it, and the thought of this
action is accompanied by love and desire. Let him become depressed and
he will no longer be able to accomplish this same action without
exhausting himself; he is then reduced to dread it and take an aversion
to it. That which was an object of love becomes an object of hatred.
Thence these turnings of mind that are so often to be observed in the
course of neuroses and psychoses. In a score of my observations the
frenzy of persecution and hatred presents itself as an evolution of
those obsessions of love and domination.
These are very curious facts that one observes in the oscillations of
the mind, in particular when the psychasthenic depression becomes more
serious and transforms itself in psychasthenic delirium, which is more
frequent than one generally imagines. As a rule the properly so-called
psychasthenic has only disorders of the reflection; he doubts but he
does not rave. But under different influences, his depression may
augment, and when he drops below reflection he has no longer the doubts,
the hesitations, he no longer shows manias of love and of direction, he
transforms his obsessions into deliriums and often his loves into
hatreds.
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