The science of life : fully illustrated in tone and line and including many diagrams

HUMAN BEHAVIOUR AND THE HUMAN MIND

which higher education and public school training bring about helped to counteract the tendencies to segregation which a more naive and more rough-and-ready mental life encourage.

The neurasthenic patient grows thin, tired, and, above all, worried. He knows there is something gravely wrong with him, but has not the satisfaction of the hysterical patient of being able to show any definite symptoms which would justify his conviction of illness, and so he continues to reproach himself. The tradition of not giving in aggravates this feeling of self-reproach, and so does the prevalent belief, openly expressed or tacitly held by most laymen, that neurasthenia is really all the patient’s own fault (while smallpox or a cold in the head is not, even if you have contracted it by neglecting obvious precautions). Depression, even frequent dallying with the idea of suicide (though serious suicidal attempts are raré among neurasthenics), an awful conviction of sin or uselessness or inferiority, of difference from normal, healthy people, a wearisome difficulty in getting through one’s work, and especially in coming to a decision, a feeling that the mind is wearing thin and that the familiar self may fall through into a pit of mingled nothingness and hatefulness below, and with it all a longing to escape from the invisible prison in which the spirit finds itself, but a feeling of utter helplessness because the prison is one’s selfthese are some of the common symptoms of neurasthenia.

The neurasthenic is a living battle-ground. Two sides of his nature are in conflict ; but instead of his being able to separate the combatants by suppressing one altogether as in hysteria, the dog-fight goes on and on. Sometimes a change of circumstances, tonics and tangible hope may suffice to dispel the conflict, but more often an analysis of the issue and a new outlook is needed.

The War—cases of neurasthenia were usually simpler and more clear-cut than those of peace-time. The conflict often went on in the full daylight of consciousness, as in the earnest and religious young stretcherbearer who, in spite of constant prayer for strength, was seized with uncontrollable fear—not fear of death, for he came to desire death as his only solution ; but just Sear—at every shell-burst. He came to sleep less and less ; grew thinner ; became nervous and jumpy and distressed. The conflict continued—it became one between his religious convictions and this irrational fact of fear.

Much more frequently there is a perpetual but unavailing attempt to be rid altogether of one of the rival sets of impulses. The conscious self is repressing them, holding them down, but circumstances are always stimulating them, and they arise again, taxing the strength of the repressive ego ; and so the fight worries along at the boundary of Conscious and Unconscious. Often repression is successful during the day, but fails when the fatigued higher centres are asleep. That was the case with those numerous men in the War who repressed their fears and their fear-arousing memories of battle, only to have them rush up again during the night in the shape of nightmare battle-dreams.

A fact which throws a remarkable light upon the hidden springs of the mind is that severely-wounded soldiers very rarely showed any symptoms either of neurasthenia or hysteria. Why? Because the fact of being wounded relieved the Unconscious of all need to invent excuses for getting away from danger; because a wound, and especially a severe wound, brought to a sudden end the conflict between, on the one hand, repressed fear and worry over wife and children, and on the other, selfrespect, the honourable claims of duty and the grip of military discipline.

In peace-time, the problems that face men are neither so violent nor so crude as those of war; and when the neurasthenic state develops, it usually does so by a slow, creeping and complicated growth, with its roots in a hundred incidents of different periods of the past.

§ 11 Repression and the Complex

In our last two sections we have been speaking of hysteria and neurasthenia as if they were sharply distinct. So they are, when we are confronted with typical cases. But there are all gradations between the extremes and many cases that combine symptoms of both sorts.

This is what we should expect, since both kinds of disorder are the result of the same cause—namely, an unresolved conflict. Hysteria and neurasthenia are two symptomcomplexes, which differ from each other more because of a difference in the patients’ constitution and temperament than because of differences in the prime cause of the upset. In a similar way the same germ may cause no symptoms in one person, but may kill another.

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