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

BOOK 8

of their former selves ; until finally a large proportion of the patients sink into an apparent stupor—‘“ those cold lifeless ruins,” as Kretschmer calls them, “who glimmer dimly in the corners of asylums dull-witted as cows.’ Minds can degenerate through disuse even more radically than muscles or tendons. But even in these unfortunates, there seems always to be a nucleus of inner life, atrophied by disuse, but still revolving round a trace of some self-centred idea.

We can follow a series of stages in this downward and inward progress. Over there is one of Kretschmer’s “‘ cow-like ” casesfor ever silent and apathetic. Here is a second, who lives only to repeat endlessly all day : ‘‘ Will that be all right if I walk up to the door and back again ? Will that be all right if I walk up to the door and back again? Will that be all right. ..?” There is a third, in whom not speech but action is repeated and stereotyped; she stands for hours together in one spot, gesticulating with outstretched right hand.

This patient has inner life so divorced from outer that he lets his limbs stay in the position the doctor cares to put them. And another shows the same phenomenon in speech ; asked a question, he repeats it, often just altering the pronoun. “ How are you to-day?” says the doctor. “* How am I to-day?” answers the patient. His interest is focused on his hidden thoughts, and the outwardly directed part of himself acts like an automaton. In other less striking cases the patient will do what he is asked, but in a stupid and repetitive way. It you put a dustpan and brush in this woman’s hands and tell her to clean the floor, she will begin to do so, but will go on brushing the same little bit of carpet for hours. More frequently the reverse is the case and the patient is entirely ‘‘ negativist ’—he does exactly the opposite of what is suggested or commanded. Here is an extreme case. The doctor makes as if to touch the patient’s hand ; it withdraws. It moves about like one magnet repelled by another, as the doctor moves his own hand. But if the doctor pretends that he is anxious to avoid being touched, his hand is followed about by the patient’s, as if the sign of the magnetism had changed. Here it seems probable that the strong wish of the Unconscious, not yet fully gratified, to cut itself off from the outer world, expresses itself in this symbolic reversal of all the suggestions which the outer world continues to inflict upon it. Sometimes ‘the resistance is violent; this other patient needs three attendants to dress

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THE SCIENCE OF LIFE

CHAPTER 7

and undress him, must be taken by force to his dinner and to exercise, and will try to tear up every new suit of clothes.

There are many other stages and varieties, but all have in common this inward preoccupation. As a result they are in a real sense living a dream. It is a waking dream and they cannot wholly prevent the outer world from obtruding upon it, but it is a dream, and often their thinking is typical of dream-thought, where symbols and wishes take the place of ideas and rational will.

Sometimes inwardly-directed thoughts become focused, not on a personal desire or simple wish, but on some more impersonal construction of the mind. This happens when the man has an intellectual bent ; and the result is the crop of “men of one idea’? who believe that their idea is to save or revolutionize the world. When they and their ideas happen to be in harmony with reality and to fit in with accidental circumstance they become the great prophets, reformers, and creators of history. When their notions are less in touch with reality and the spirit of the times, we call them faddists, cranks, unpractical fanatics; they found sects, develop new theories of the universe without worrying too much about facts or verifications, preach at street-corners, or promulgate new “-isms.” If their ideas are too flagrantly unreal, we say they are insane and shut them up. Don Quixote is the immortal embodiment of a borderland case of this type ; and every asylum contains his like, though each will be focused on his own peculiar craziness.

Conflict followed by the triumph of wish and the repression of reality is the most frequent symptom of insanity, and sometimes its cause. But it is not always accomplished by a turning away of the self from the outer world. This woman here, for instance, has become insane through her repressed wishes bursting through, so to speak, and justifying themselves against reality by an elaborate set of delusions. She announces firmly that she is a descendant of Queen Elizabeth, and, therefore, the rightful monarch of England. She already boasts a title—** Rule Britannia,’ she calls herselfand has armies at her disposal which she is preparing to launch against various European nations. Unfortunately her plans are always being hampered by the rival claimant, who happens to be in possession ;_ she will not accord him the title of king, she refers to him as “‘ Mr. Guelph.’’ It is he who has frustrated her schemes and _ eventually, alas, got her shut up! Even so he is not