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The Psychology of Functional Neuroses. By H. L. HOLLINGWORTH. Appleton
and Co. New York and London. pp. 259, price $2.
There is a novelty in the plan of this book which arrests one's attention. Instead of attacking the problems of the neuroses by means of direct study of individual cases and individual symptoms, the author, who is a professional psychologist, has approached the subject in quite another way. His essential method is to apply a series of standard laboratory tests to a very large number of cases with the aim of ascertaining what generalisations may issue therefrom.
He begins by giving a very cursory review of the medical work in this field, his attitude towards which is decidedly superior and disparaging. In searching for a central concept that may serve to unify the various data he rapidly disposes of such ideas as are implied in the terms 'dissociation,' fixation,' 'conversion,'. 'general suggestibility,' "conditioned reaction,' pithiatism,' 'symbolism' and so on; the only one to which he gives even a conditional consideration is regression. Incidentally he quotes some interesting passages from Herbart's Text-book of Psychology, containing several anticipations of the Freudian conceptions, such as the rivalry of mental elements, the suppression of the weaker by the dominant, persistence of the suppressed element below the threshold of consciousness, its transformation in the effort to express itself, distinction between the conscious and the unconscious mind, and so on; the main difference here is that Herbart operated in terms of ideas, and not of those of more dynamic elements. It is historically untrue, however, to say that these conceptions were 'adopted bodily' by Freud from Herbart (p. 10). It may be imagined that the author will have nothing to say to Psycho-Analysis. He dismisses what he calls "this extravagant and analogical machinery” in the following words: “The intricate mazes, transformations, and epicycles of the psychoanalytic dogma in its present form resemble the familiar Ptolemaic astronomy, which waited long for a simple formulation that would place the observed facts on a basis of actual understanding” (p. 150).
The author finds his unifying concept in Hamilton's term redintegration, though he somewhat modifies the sense of this, defining it thus: “Redintegration is to be conceived as that type of process in which a part of a complex provokes the complete reaction that was previously made to the complex stimulus as a whole” (p. 19). Thus when a child has been frightened by a complex stimulation emanating from a dog, the entire fright reaction may subsequently be evoked by one part alone of the stimulus, e.g. a growl, even though this emanates from a parent hiding behind the door. He then discusses four types of faulty redintegration, those characteristics of the hypomanic, the feeble-minded, dementia praecox and the psychoneurotic respectively. The distinguishing feature of the last-named type he finds to be a tendency to react in redintegrative fashion to outstanding and often irrelevant items that are only an insignificant part of the total complex experience. This he traces to “faulty sagacity,' to use James' term. He is now confronted with the obvious problem of the cause or meaning of this particular mode of faulty response and it must be said that he evades this problem in a distinctly barefaced manner. “If it now be asked why some individuals show stronger inclination toward the redintegrative type of response to outstanding but
irrelevant details, it is perhaps most pertinent to point out that the same question should be asked of those whose descriptions of the psychoneurotic picture are in terms of symbolism, free-floating affect, conversion of libido, pithiatism, etc. In such cases no clear basis of individual differences, and hence no adequate etiological account is forthcoming. Hence even if we could offer no satisfactory reply concerning the causes of individual differences, the redintegrative mechanism would be in no greater predicament than are the other explanatory concepts” (p. 62). He then proceeds to translate his chosen concept into neurological terminology, though it is not clear what is gained thereby: “A special merit of the redintegrative concept is to be found in the ease with which it dispenses with this elaborate fiction of the efficacious unconscious” (p. 71), an idea which “flagrantly and naïvely ignores the familiar canons of demonstrations and proof” (p. 71).
The main thesis of the whole book is that the essential feature of psychoneurotic redintegration is the “constitutional cortical inferiority (intellectual deficiency)” of the patients, their mental competence being just above that of the feeble-minded (p. 77). "If we have been justified in distinguishing between sagacity and learning, the psychoneurotic's chief difficulty is in the former function, and he may in a given case be pitifully weak in sagacity, yet relatively competent in general alertness. On the whole, however, the trait of sagacity is undoubtedly a component of that more general characteristic which we commonly call intelligence, and mental measurements of psychoneurotic soldiers show very clearly that these cases are inferior to the average citizen. They occupy, in fact, that region of the frequency curve lying just below the average intelligence rating and just above the highest grade of the feeble-minded. They occupy the region of stupidity. It is highly probable that the various character defects' so commonly ascribed to the hysteric-dependence, extreme suggestibility, naïveté, forgetfulness, credulity, deceitfulness, impulsiveness, volitional debility, etc.--portray simply the humble intelligence of these patients, rather than the presence of a peculiar 'hysteric make-up' or 'neurotic constitution'” (pp. 78, 79).
The second part of the book comprises a presentation of data intended to demonstrate the truth of this thesis. They are obtained from applying a series of modified Binet-Simon intelligence tests to 1200 cases of war shock cases at Plattsburg Barracks, New York State, where the author worked during the war. As tested in this way, the average mental age of the normal American soldier was known to be fourteen years, but that of the patients suffering from neurasthenia, psychasthenia, and other forms of neurosis, was found to be round about twelve years. It was found further that the average mental age in the cases of conversion hysteria, i.e. with physical symptoms, was no less than four years lower than that of patients suffering from psychical symptoms. The author correlates this last finding with the familiar observation in all countries that the former class of case occurred much more characteristically among the ranks and the latter among officers. He ascribes this, however, to the difference in average intelligence subsisting between the two classes of men, and not, as is usually done, to the difference in the psychical situation to which they were exposed (responsibility, motive, prestige, and so on).
A further sets of interesting data is furnished by the results of a questionnaire of 116 points, which was made just before and after the time of the armistice. The beneficial effect of this event is shown very clearly, and the author analyses in detail the respects in which the answers differed before and after it.
The fundamental criticism of the mode of approach in the work here presented, one which evidently has not occurred to the author, relates to the whole of the work now being carried out by means of the various intelligence tests. It is this; that no general conclusions drawn from them can be regarded as other than tentative until some serious study is made of the extraordinarily subtle way in which the individual responses are influenced by affective factors, especially by unconscious ones. The fallacious assumption, for instance, that the emotional disorders from which the author's subjects were suffering had no influence on their responses to the intelligence tests he applied vitiates his conclusions as to the intellectual difference between the neurotic and the healthy, and therefore those as to the nature of neurotic reactions.
NOTES ON RECENT PERIODICALS.
The International Journal of Psycho-Analysis, Vol. I, Part m, 1920. Perhaps the most interesting and useful portion of this number is that which is devoted to condensed translations of collective reviews dealing with the progress of Psycho-Analysis during the past six years. Theory of Instinct and Sexuality is dealt with by Ed. Hitschman; Special Pathology and Therapy of the Neuroses, by Karl Abraham; Psycho-Analytic Therapy, by Van Ophuijsen; General Theory of the Neuroses, by Š. Ferenczi; Child Psychology and Education, by H. Hug-Hellmuth.
Among the original articles the following may be noted: C. P. Oberndorf writes on “Reaction to Personal Names” and gives illustrations of the unconscious motives that may lead a person to change his name. Stärcke, writing on “The Reversal of the Libido-Sign in Delusions of Persecution,” and Van Ophuijsen, “On the Origin of the Feeling of Persecution,” both come to the conclusion that delusions of persecution are derived from an anal complex, and that the loved person who reappears as the persecutor has unconsciously been identified with the “Skybalum” which is “the primary (real) persecutor.” H. Flournoy gives an account of some “Dreams on the Symbolism of Water and Fire”; and Hanns Sachs relates a short history of a case in which he traces the origin of “The Wish to be a Man.” Ernest Jones, in “A Linguistic Factor in English Characterology," seeks to find an explanation of the “insistence on propriety” which all foreign observers consider to be a characteristic trait of the English people. He thinks this trait has been fostered by the peculiar nature of the English language which provides a duplication of its vocabulary owing to its twofold origin from the Saxon and the Norman. More feeling is developed when the mother tongue is used, and it is notorious that the words which are considered most ‘indelicate' or 'vulgar' are words of Saxon origin. The possibility of giving expression to forbidden ideas by using a foreign language is well known, and Dr Jones traces “English propriety" to the inhibition of feeling which accompanied the use of Norman-French and Latin words in the transition from Anglo-Saxon to Modern English.
The Journal of Neurology and Psychopathology, Vol. I, No. 4, Feb. 1921. The greater part of this number consists of Abstracts and Reviews. W. Johnson contributes a useful “Note on Intelligence Tests” and there is an excellent review by C. P. Symonds of some recent studies of animal behaviour and the bearing of these on “The Localisation of Function in the Central Nervous System.” In this review an account is given of the experimental work of Franz and Lashley in America. These investigators, in their work on the training of rats to acquire various habits of a more or less complex nature, were led to enquire into the relation of different cerebral areas to the acquisition or loss of such habits. As a result of their researches they concluded that in learning there is complete vicarious functioning of all parts of the cerebrum, although under normal conditions the various parts have specialised functions. Nevertheless, “this specialisation is only relative and is of such little practical consequence that learning may go on with equal speed in the presence or absence of the specialised areas.” The bearings of these results on Clinical Neurology are briefly discussed by Dr Symonds and he suggests that some of the success attendant on re-education in the treatment of the so-called hysterical element in organic nervous disease may be consequent upon a true re-learning ;-we may have here a true instance of vicarious functioning.
Alfred Carver contributes some “Notes on the Analysis of a case of Melancholia." His experience leads him to believe that “the underlying fact in melancholia is a failure of re-adaptation to an environment which, owing to a certain deprivation, has been rendered devoid of interest,” and that “of all the psychogenetic psychoses melancholia is the most amenable to treatment, though in view of the frequency of relapses one is not justified in speaking of a cure.”
The Psychoanalytic Review, Vol. viii, No. 1, Jan. 1921. The new volume opens with “A Psychologic Study of Abraham Lincoln” by L. Pierce Clark. The author believes that the true historical interpretation of any great epoch is not possible until we make a complete psychological study of the people of that particular period, especially of its great men and leaders. He attempts to find the origin of the periodic depression from which Lincoln suffered throughout his life. He bases his conclusions on reliable historic documents. From this study “it would seem that no small part of Lincoln's depression was due to certain deep, unconscious fixations or soul-attachment to the mother hindering the normal emotional life which in turn made it impossible in early life for him to assume the usual attitude of religious feeling and thought.” Towards the end of his life Lincoln "accepted a religious outlet, as a means for unconsciously solving or sublimating a large part of his regressive relations with life which had heretofore taken the form of intensive and prolonged depressions.”
A contribution by Dr Barnes, Professor of History at Clark University, entitled “Some Reflections on the Possible Service of Analytical Psychology to History” deals with the same topic as Dr Clark's paper. The lives of Alexander Hamilton and Thomas Jefferson are examined and the unconscious roots of their profoundly different characters are pointed out. “To a very large degree,” Dr Barnes says, “our strong federal government has been but a collective appropriation of the authority-loving and realityconquering personality of Alexander Hamilton.” Hamilton's contact with his father was very slight and he had no experience of male parental domination and the consequent development of an anti-authority complex such as underlay the freedomloving character of Jefferson. Thomas Jefferson was a slight and pallid youth whose father was “a gruff giant with a tremendous temper,” and the experiences of his boy. hood were such as were exactly suited to developing an abnormal anti-authority complex. “In a very real sense the Jeffersonian democracy can be regarded as an elaborate disguise and secondary rationalization of his innate revolt against authority and it is as accurate to say that American democracy may be traced back to the recoil of the pallid youth of Shadwell from his gigantic and formidable father as to hold that it derives its origin from the Teutonic folk-moot or opposition to the political and economic program of Hamilton.”
Jackson Edmund Towne, in “A Psycho-Analytic Study of Shakespeare's Coriolanus” shows that “the story of a bold warrior losing his triumph because so ‘bound to's mother' is clearly but a variation of the most essentially tragic of all myths, that of Oedipus."
In a paper on “Religion in the Light of Psycho-Analysis” Cavendish Moxon gives an account of the Freudian view of the part played by religion in the lives of individuals and of the results to society which follow widespread addiction to religious practices. “By turning men's love towards imaginary objects, religion robs society of the vast sum of energy that is used in prayer and ascetic self-mortification.” “The man who has the power and opportunity to love and live with all his might needs no religious consolation."
“A Psychoanalytic Study of Manic-Depressive Psychoses” is the title of a paper by Lucille Dooley which is continued in the next number of the Review. This study contains much interesting case-material and some probable results of analysis are referred to; but as the author pertinently says, “Because of the irregularities in the manifestations of this disease no one can be sure of the efficacy of any form of treatment until many cases have been studied through a life-time.”
The Psychoanalytic Review, Vol. VIII, No. 2, April 1921. “The Rudiments of Character,” by David Forsyth, a paper read before the British Psycho-Analytical Society, is given the first place in the April number. Dr Forsyth endeavours to establish the main facts of infant psychology and the relation of these to character in adult life. He says there is no break in the psychology of the child immediately before and after birth; yet he considers the mind of the new-born child to be a blank as far as intelligence goes and to be lacking in all experience gained through its bodily senses. In birth the child passes from a state of Nirvana-like contentment to one of intense physical distress accompanied by fear. “This most dreadful experience marks the division of an infant's emotions into these two kinds." The intrauterine state is termed the “vegetive state” and its affective concomitant “vegetive emotion.” In this state all wants are supplied without effort and psychic life has not begun. Only with birth do needs arise which require for their satisfaction the activity of the nutritive and secretory functions. These are associated with four highly sensitive aşeas—the oral zone, the urethral zone, the anal zone and the respiratory zone. Through these zones pleasure is experienced when the tension due to deprivation is relieved by the appropriate stimulus.
The two emotions first to find special expression are love and hate. Love is the feeling bestowed on an object which can satisfy a bodily want. The original objects between which the infant's love is distributed are milk, urine, faeces and breath. “Experience shows that children in whose emotional life the associated zones come to fill too large a share are the most difficult to train and present the most serious anomalies of temperament in adult life.
Lucille Dooley's “Study of Manic-Depressive Psychoses” is concluded in this number. She found the therapeutic results of Psycho-Analysis to be meagre and doubtful. Her failure she ascribes partly to faulty technique, partly to the material worked upon and the handicaps of the surroundings.
Edward W. Lazell writes hopefully of “The Group Treatment of Dementia Praecox." This apparently consists of the delivery of lectures, in which the explanations of the causes and symptoms of dementia praecox are given, to selected groups of patients. As a result of his experience of the method Lazell says: "Taking into consideration the enthusiasm of the writer, and admitting that the results were not likely to have been underestimated by him, there still remains a large factor that cannot be ascribed to the tendency to so-called spontaneous recovery so often seen in praecox.”
The number concludes with two interesting notes on literary subjects. Dr J. S. Van Teslaar shows how the Christian tradition of the death of Pan, as a historic occurrence of incontrovertible veracity, may have originated through a misinterpretation of words heard, and Margaret K. Strong gives "A New Reading of Tennyson's The Lotos Eaters.” “By the device of balanced stanzas, Tennyson presents in the Choric Song the antithesis of a dissociated personality, unreconciled; indulgence versus struggle, sensuality versus rationalism.'