網頁圖片
PDF
ePub 版

social continuity of interpretation dependent upon the social sense perceptions shared among the observers in question.

As a result of the group analysis with which I have in the last years been constantly occupied, it has been my experience that only the authority of a social consensus of receptive sense impressions is adequate for the unbiased observation of complexes in which we are all socially participants. The private interpretation of the individual psychiatrist or analyst is not competent to envisage the private position on which the individual neurosis bases its support. This private basis of outlook represents but the casual and uncodified mood-interpretation based upon social images that involve the physician no less than the patient. In the subjective involvement of each within this habitual image-sphere there is absent the condition of observation requisite to scientific inquiry. In the failure of psychiatry or of psychoanalysis to recognize its own involvement in a social mood-consensus, there is precluded the possibility of a thought-consensus such as may place this social mood-reaction among the materials of objective investigation. We are deceived in thinking that we can escape this habitual mood-involvement in the absence of an analytic challenge of our own social mood. Under our present social system of mood-evaluations the dilemma of the neurotic patient lies in the circumstance that his individual unconscious finds ready support in an equally unconscious social mood which the psychiatrist shares with him. When through the analysis of this social moodinvolvement psychiatrists shall present a consensus of impressions based upon a consensually codified experience, psychiatry need no longer be the interpreter of private hearsay and report but the observer of actual material based upon a social agreement of organic sense perceptions. In this common consensual viewpoint the data of psychiatry will take their rightful place among the materials of an objective science.

There is the definite need of a psychiatric laboratory for the investigation of our human processes. In the modest beginnings of such an attempt on the part of my associates and myself there is clearly the promise of a saner basis of outlook not only for the individual patient but for the students of mental disorders whose function it is to relieve these sick and oppressed mental states as they occur both in the individual and in the social system of which our students and ourselves are also a part.

SOME CLINICAL ASPECTS OF CERTAIN EMOTIONS

BY DONALD E. CORE

The object of the present paper is in the main twofold; to endeavour to correlate certain psychical phenomena with groups of clinical symptoms and, to assess as far as may be possible the biological value of the functional nervous disorders.

Since the time of Charcot investigation into these disorders has been concerned largely with the different emotions presumed to be operative in their formation; Dejerine laid the necessary stress on the importance of the emotions in this connexion and the majority of modern work has been directed to the different tones and their relative values. A certain degree of divergence of opinion has resulted and this has reflected upon current ideas of treatment and, of necessity, upon their classification also.

An emotional tone, being an integral part of an instinctive activity, may be considered as an index of the reaction of an organism to its surroundings. Two possibilities arise for consideration out of this relationship; the organism may either be in harmony with its surroundings or it may not; it

may be in a state of discord. We should then at the very outset be justified in assuming that emotionalism, however amenable it may

be to further and more detailed subdivisions, will be apparent as a characteristic of an animal in one or other of these states. Also, whereas an animal is occasionally terrified, occasionally angry, occasionally parental, it is always either in accordance with its environment or at variance with it, and this fact would appear to have an important bearing in the genesis of certain clinical states. The detailed subdivision of the different emotional tones has a positive value as far as social science is concerned, but from the clinical point of view it probably has no such value; whereas the recognition of the dual aspect of emotionalism has a clinical importance that is difficult to overestimate.

Quite apart from clinical medicine this duality is obvious and it is emphasised by a very superficial study of an animal under the influence of representative emotions. It is almost unnecessary to dwell upon well recognised facts in a paper of this description, but for the sake of completeness it may be pointed out, that, if we take as types the affective states associated on the one hand with behaviour proper to reproduction and on the other that which subserves flight, there is an acute difference between the two according as to whether they are considered from such widely divergent standpoints as:

(1) Inception. With regard to the emotion of tenderness the rise into consciousness is never sudden and the period of maximum intensity is maintained for a considerable time. There is no diminution of intensity immediately after inception; there may, indeed, be an increase. The duration of the emotional tone is liable to be lengthy. The emotion of fear on the other hand is always of sudden incidence; its maximum intensity is attained immediately and provided the animal be given freedom of appropriate behaviour the intensity of the tone rapidly declines. With suitable treatment the maximum is capable of being reproduced at any period during this decline, differing acutely in this respect from the tender emotion, the intensity of which, once it has begun to decline, can never be reinforced for the specific object in the ordinary course of events. For the re-induction of the tender emotion the preliminary body changes associated with reproduction must be passed through. (A case illustrating this fact is the following. One of the laboratory cats kittened and the survivor of the litter was brought up by its mother in the usual way and in the usual way parental solicitude was replaced by indifference and to a certain extent by irritability. In the course of time the mother cat again kittened and the whole litter was destroyed; at once the mother demonstrated maternal solicitude and affection for the now grown cat of the former litter; its affectionateness, being adapted for younger kittens, was somewhat out of place in its new role.)

(2) Mental State of the Animal under the Influence of the Emotion. In the case of the emotion of fear, this is characteristically one of confusion, and when the emotion is present in very great intensity it may approach a condition of semi-coma. In the case of the tender emotion on the other hand the essential mental state is one of concentration on a specific object, and this does not prevent concentration being manifested for other objects in the environment.

(3) Associated Somatic Manifestations. In the case of the emotion of fear, these only occur at the time of incidence of the affect and are concerned entirely with efficiency of the motor mechanism necessary for escape. Such manifestations are liable to be transient and the sympathetic nervous system would appear to be intimately concerned in their production (Cannon). The actual muscular energy demonstrated by animals when under the influence of the emotion of fear in great intensity may be very great indeed, and it is instructive to compare this with the conspicuous absence of the psychical (pictorial memorisation) activity which obtains at the time. We may I think recognise it as a fact, that promptness and forcefulness of motor behaviour are inversely proportionate to the consciousness of the animal (as represented by its pictorial memorisation power) prevailing at the time. In the case of the tender emotion special body changes precede the incidence of the tone and in many cases they are elaborate and of the nature of gross structural alterations. The interval of time necessary for their development may be one of weeks and months.

(4) Re-inducibility of the Emotion. In the case of the emotion of fear, this is possible at any time and there is no tendency for the intensity of the emotion produced to fade with the frequency of re-induction. In the case of the tender emotion this is not the case; once it has begun to fade for the specific object it can never again be revived for that object unless the whole gamut of preceding somatic changes has been reexperienced.

(5) State of the Animal in the Intervals. The animal is essentially normal in the intervals of its being terrified; as far as the tender emotion is concerned a considerable period of the interval is taken up with the anticipation of the coming emotional exacerbation.

The foregoing differentiating features are obvious on a comparatively casual study of the animal; in other respects also the resolution of emotionalism into its two aspects may be recognised.

For example; the value to the animal of emotional control differs in the two groups. (By “emotional control' is meant the faculty possessed by some animals of modifying the specific conative behaviour biologically associated with a primary emotional tone in accordance with experience and pictorial memory.) As far as the tones which directly subserve reproduction are concerned it is probable that their control serves no useful purpose and may indeed be harmful; even in very highly evolved animals such control is liable to have an unsatisfactory result. In the case however of emotions of the other group, fear and repugnance, their value to the animal is reinforced by control; animals under such circumstances being rendered all the more secure in situations of potential danger. Of still greater importance is the fact that the amenability of the fear emotion to control bears with it the implication of added security of the race.

Again, the end-results in the psychology of an animal differ acutely according as to whether an emotion such as that of parental tenderness be considered, or one such as fear. In the former case the specific object of the emotion is ultimately de-emotionalised and a state of familiarity is developed for that object. In the case of fear, familiarity is never an end-result; its place is taken by the formation of habitual action and the increasing perfection of somatic performance by experience.

(It is of interest in this connection to consider the affectionateness of the human parent for its offspring. The human differs from the nonhuman animal, among other things, in the great extension of its associational powers. The development of the child is accompanied in the psychology of the parent by a progressive growth of specific associations for it, associations constantly in activation through objective experience and constantly giving rise to the emotional tone initially operative. There is, so to speak, psychical growth on the part of the parent keeping pace with the physical development of the child and in the course of time the intense instinctive tenderness manifested originally on the part of the parent for the child is replaced by the secondarily induced emotion arising out of the constant reactivation of these associations. In the event of the child being brought up away from its parent, associations in the psychology of the latter are still liable to be formed and their re-activation tends to reproduce the tone at work in their formation.)

Apart from obvious objective differentiation of emotional tones and apart from their end-results, it may be suggested that these representative emotions differ from each other in another respect, and that is, their liability or otherwise to psychical dissociation. It would seem probable that emotional tones of the parental tenderness type are not so liable whereas those of the fear group essentially are.

Psychical dissociation is of great importance to the clinical psychologist. Its effects perhaps appear to have been more closely studied than the underlying mechanism operative, and it is possible that it has, unjustifiably, been made accountable for psychical phenomena, superficially similar, but in reality differing widely from each other when viewed from the standpoint of their genesis.

The operation of psychical dissociation is accompanied by an amnesia for the specific experience dissociated and, leaving on one side the mechanism at work in the formation of this amnesia, it is obvious that, were emotional tones of the fear order to be accompanied characteristically by such dissociation and those of the parental tenderness group never to be so accompanied, many, if not all, of the differentiating features enumerated above would of necessity arise.

For example; a terrifying experience subjected to amnesia is always

« 上一頁繼續 »