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self-assertive and the submissive tendencies and led to alternating undue dominance of each in turn. His unfortunate marriage intensified the conflict and rendered impossible a due cooperation of the two tendencies; hence his oscillation between exaltation and depression.
One or two more points may be made in support of the theory of manic-depressive insanity here suggested. In no other form of disorder do we observe an alternating predominance of two different affects. This alternation in this common disorder shows that these two affects are somehow functionally related in an intimate manner and that the disorder is the consequence of disturbance of the normal balanced relation between them; now, it is the sentiment of self-regard alone which everywhere in all persons involves such an intimate combination of two distinct and opposed tendencies; and it is this sentiment which constitutes the very core or rather crown of the personality, the keystone of character, the balance wheel of conduct. Again, in some insanities the intercurrence of some acute physical disorder sometimes abolishes the mental symptoms for the period of its duration. This effect, one of the most mysterious in the whole range of medicine, is in itself strong evidence of the functional nature of the insanity; no such abeyance of symptoms occurs or could be expected in an insanity arising from gross cerebral disease, such as general paresis. My limited experience does not enable me to say whether the manic excitement is peculiarly susceptible to such influence; but I venture to suggest that, when such abeyance occurs in the course of mania, it may be explained in terms of the hypothesis, as follows: we have seen that a state of bodily well-being favours the predominance of the self-assertive impulse; while bodily weakness and ill-health favours that of the submissive impulse;' and it may be that hormones play a specific rôle in the matter. If then a manic patient falls sick of a physical disease, may it not be that the physical depression suffices to restore for the time being the due balance between the opposed tendencies of the self regarding sentiment, re-establishing a due docility? We may see an analogy to the process suggested in some young children. An undisciplined infant of strongly self-assertive tendency and great physical vigour, who makes life hard for all his obedient slaves, is sometimes suddenly reduced to docility and 'goodness' by some mild physical disorder that sends up his temperature some two or three degrees.
A last point in favour of the hypothesis we may see in the fact that although manic-depressive disorder seems to be distinctly a functional disorder, recovery from which with little or no impairment of mental
Med. Psych. v
powers is the rule, yet it does not seem to be susceptible to any form of analytic treatment. I do not know of any case in which it is claimed that psychological treatment, beyond simple tactful humouring and management, has materially contributed to cure. This implies that the root of the disorder is not to be found in any repression or in any dissociated system of memories. And it is consistent with this view that the manic patient commonly can, when the excitement has subsided, remember pretty well the incidents and experiences of the exalted period. Whereas during intermissions of, or on recovery from, some other acute insanities (more especially attacks of dementia praecox, in which repressions seem to play the leading rôle) the patient, if he can remember anything of the acute period, remembers it vaguely only, as a dim dream-like experience.
Dr E. Kretschmer's Physique and Character contains a careful study of the cyclo-thymic or cycloid temperament. All that he says of it seems to fit with the hypothesis sketched in this article. I append a few excerpts to illustrate the fact. He distinguishes among cycloids two classes, those who incline to excitement, whom he calls the hypomanic cycloids, and those who incline to depression, the melancholic or depressive cycloids. Both classes are liable to manic-depressive disorder; in such disorder the manic phases predominate in the former class, the depressive in the latter. Of the one class he writes:
The hypomaniac is 'hot-headed,' he is a man of a quick temper, who flares up all of a sudden, and is soon good again. He cannot halt behind a mountain; when anything gets in his way, he sees red at once, and tries to get what he wants by making a row.... They do not know what it is to be tired, neither have they the brooding inner feeling of agitation and tension of the nervous man. Again:
What one calls hypomanic egoism has something childlike and naïve about it.... This hypomanic self-feeling is not an abrupt setting up of the individual's own personality against an outside world, which is regarded with hatred or indifference, but a "live and let live,” an evenly balanced swimming in comfort for oneself and the world, and an almost ludicrous conviction of the value of one's own personality.... Only in rare cases do we find strong ambition in a cycloid. Hypomanics rather, on the whole, display a dashing impulse to work, and a satisfied self-feeling and self-sufficiency, than a burning thirst after a high-placed end. He speaks also of the hypomanic's “tendency to superficiality, tactlessness, over-estimation of himself and recklessness.” He cites as a typical hypomanic remark: “I am a valuable chap; a man of feeling. My wife hasn't the least idea what she got hold of when she got hold of me."
Of the depressive cycloids Kretschmer writes as follows:
1 London, 1925. I should say that this article had been written before I had the opportunity to read Dr Kretschmer's book.
In difficult, responsible positions, when there is any danger, in thorny, exasperating situations, and in a sudden precarious crisis in business, they are not nervous, irritated, or agitated, like the average man, and particularly like a great many schizophrenes. But they are unhappy. They cannot see any distance ahead, everything stands like a mountain in front of them....Patients and their relations are apt to describe slight cyclo-thymic depression euphemistically and inaccurately as nervousness. If one enquires further, one does not come upon what the doctor understands by nervousness...but an indefinite depressive discomfort with feelings of psychic inhibition and inferiority. He writes also of their “well-marked good-natured unassumingness, which makes the melancholic cycloid so pleasant in personal relations." Also they, “in spite of their conscientiousness, have a tendency to give in and make a fair compromise.” And they can raise themselves from the bottom rung, through their assiduity, conscientiousness, and dependableness, their quiet, practical outlook, and, last but not least, through their goodness of heart, their affable friendliness and personal fidelity, to the position of a kind of revered, indispensable, old factotum, beloved of all.... If they are suddenly thrown into violent, unaccustomed, responsible situations, then they easily lose their courage, their wits and their energy, indeed, they get a typical repressed depression.... Among the more depressive temperaments, we often find religious men. Their piety, just like their personality, is soft, very emotional, heartfelt, rousing deep feelings combined with conscientious belief, but without pedantry and bigotry, unassuming and broad-minded towards those who think otherwise, without sentimentality or a pharisaic or sharply moralistic accent....A certain anxiousness and shyness is found with many cycloid-depressive natures...this anxiety and shyness seems to be closely connected with the lack of self-assertion, and the tendency to a feeling of inferiority, and are psychologically determined by them.
I have put into italics the phrases in these passages which seem to me to indicate clearly that in these two types of the cycloid we have to do, on the one hand in the hypomanic, with persons in whom the selfassertive impulse is insufficiently checked by the submissive; and, on the other hand in the depressives, with persons relatively lacking in the self-assertive impulse.
The Journal of Abnormal Psychology, vol. xix, January-March, 1925.
JAMES DREVER: 'Conscious' and 'Unconscious' in Psychology. Consciousness is not an entity but a character belonging to certain processes or events in the universe, and though incapable of definition may be figuratively described as a “psychical integration' or as an “inside view of an event; consciousness for the psychologist is a primary fact. The conscious process is conditioned by inner processes or 'dispositions' (interests, prejudices and sentiments) but the character of consciousness does not belong to these determinants, they are ‘unconscious. The individual is not aware of them to be sure, but are they not to be classified under the head of conscious processes? Drever attributes them to the 'structural unconscious.' The terms “subconscious' and 'extra personal confuse terminology. What of the processes, which determine dreams for instance-processes that can never become conscious? These are ‘endopsychic' processes and are of two types: (1) those involved in the operation of associations, and (2) those involved in the interaction of dispositional elements, e.g. in conflict. The first type illustrates the functional or dynamic' unconscious, the second the structural unconscious. Just as the cells of the body cannot act independently neither can the 'cell wishes' (the psychic energy manifesting itself in the activity of each cell) seek their own ends but are forced into an equilibrium by reciprocal inhibition. Each ‘cell wish' acting under the Pleasure Principle seeks its own end but “because of the Reality Principle resident in the life of the organism as an organism there must necessarily be repression of trends and partial trends," repressed trends remain active in the ‘unconscious,' i.e. within the cell life. He adds that this interpretation of Freudian psychology has not yet been attempted but he believes it is useful and fruitful. As an example he takes the state of love in which not merely behaviour but the whole attitude of the individual towards the object is modified. Anger may be inhibited and may not be conscious at all in relation to the object, here is conflict but yet the lover is not conscious of it. It is possible that the process is physiological but to assume this is as easy as it is baseless. J. W. BRIDGES: A Reconciliation of Current Theories of Emotion. Introspectionists, behaviourists, functionalists, structuralists, psycho-analysts, ‘and what not' waste so much time in dispute; they should be brought into co-operation. If the fact of consciousness and the fact of behaviour are both accepted and the assumption is made that instinctive consciousness invariably accompanies instinctive bodily response—then most of the current theories of emotion are compatible. W. Î. Root: The Psychology of Radicalism. Liberalism is an attitude of the mind, the conservative attaches sacredness to tradition, radicalism is ‘social relativity' (p. 342), and there are emotional and intellectual radicals, the former have a low emotional breaking point, anything sets them off into hysterical or paranoiac tantrums... Billy Sunday... the functional neurosis of radicalism...commercial radicalism (p. 356). JAMES H. LEUBA: The Sex Impulse in Christian Mysticism. We must surrender to the evidence: the virgins and unsatisfied wives who undergo the repeated 'love assaults of God' suffer from intense erotomania induced by organic need
and worship of the God of Love. [There is no analysis of ecstasy in terms of repressed alloerotic impulses or allusion to the ontogenetic origin of God.] LEO KANNER: A Psychiatric Study of Ibsen's 'Peer Gynt.' He was the son of an alcoholic father and a feeble-minded mother, a pathological liar, a day dreamer, full of illusions and delusions, with visual, auditory and somatic hallucinations, self-satisfied, egotistical, emotionally indifferent and immoral, with no inhibitions, no insight and no judgment-psychiatric diagnosis: dementia praecox, “intrapsychic ataxia’ and splitting of the psyche. Then why do people go to the play? Out of pity for the hero or fear for themselves (Aristotle)? The author thinks no one could pity the braggart though they might well pity his mother, one has compassion for Solveig too, but one is not afraid of going insane. No. We go to the play to watch a noble mind o'er-thrown, just as we go to an asylum to feel the incomprehensible inexpressible mysteriousness of the situation when the partition between genius and insanity is torn away! SARAH E. MARSH and F. A. C. PERRIN: An Experimental Study of the Rating Scale Technique. Size of head, physical attractiveness, intelligence and leadership, etc. are rated. ROLAND C. Travis: The Measurement of Fundamental Character Traits by a New Diagnostic Test. Fifty psychological and psychoanalytical terms are chosen to represent a number of sets or personal attitudes, 200 sentences grouped into sets of ten are given to the subject to number in order of preference. If the sentence “Find out for yourself” is given first choice a sly character trait is revealed; “Be your brother's keeper's keeper" indicates a religious set; the cases were analysed' and a remarkable correlation found: often 90 per cent. agreements between analysis and test. No details of the method of analysis are given.
Vol. xx, April, 1925. EDITORIAL. $5000-reward to anyone who will demonstrate supernormal material phenomena under rigid laboratory conditions. Intelligence Testing and Personality Rating for Vocational Guidance in Colleges is advocated. GEORGE HUMPHREY: Is the Conditioned Reflex the Unit of Habit? It differs from habit in being less robust and self-subsistent, it is a simplified type of habit rather than a unit. IRVING C. WHITTEMORE: The Competitive Consciousness. WILLIAM MCDOUGALL: A Great Advance of the Freudian Psychology. In “Beyond the pleasure Principle” Freud abandons the attempt to interpret the war neuroses in terms of Freudian theory. McDougall regards the original Freudian theory’as a strange mixture of three irreconcilables, a mechanistic determinism, psychological hedonism and the hormic principle which sees instinctive urges at the root of all thought and action. The modification introduced by the book above quoted is based on a recognition that instinctive urges work within us in relative independence of pleasure and pain, a recognition that was foreshadowed by the profoundly obscure term 'the reality principle,' and acknowledged in the concept of “repetition-compulsion.' McDougall thinks the last notion unnecessary because the phenomena ascribed to it can be explained by the hormic principle according to which "every instinctive tendency is a tendency towards a goal of a particular kind, and however it be brought into play it tends towards that goal. Hence repetition is of the essential nature of instinctive activity.” Accordingly the death instinct is regarded as extravagant speculation. If Freud had taken to heart the lessons contained in McDougall's Social Psychology in 1907 a great deal of misdirected energy would have been saved, the false dogma of the alldominance of the pleasure-principle would not have been put forward and