Chapter 20

VARIATIONS FROM NORMAL MENTAL PROCESSES

DISORDERS AND PERVERSIONS

Life would be a very simple proposition if the mental machinery always worked right. But this is peculiarly subject to damage both from without and from within. From without it may be damaged by the toxins of food, as in the acute toxic psychoses; by the poison of drink, as in the alcohol-produced psychoses, such as acute alcoholic hallucinosis; by lack of muscular exercise, resulting in a deficient supply of oxygen to burn up the accumulated toxins from energy-producing foods; by the infections, which may result in the infection-exhaustion psychoses; by wrong methods of education, and by surroundings which demand too severe a mental strain in the struggle toward adjustment. These damages from without we class roughly as environmental.

From within the mental workings may be injured by emotional dominance; by bad habits of thinking and feeling and doing--often the result of wrong methods of education; by defective heredity; by undeveloped will; by the insanities. These danger sources from within we might classify as self-produced and hereditary.

There may be disorders of any or every function of the intellect, disorders of feeling, and perversions of will. Some of the most commonly met we list below.

Disorders of the _Functions_ of _Intellect_.

/ Hyperesthesia (exaggeration of sensation) { as found in neurasthenia, or in mania. { Anesthesia (absence of sensation) { as in the numbness of hysteria; in sensory { paralysis. Disorders / Retardation of < as in dementia and melancholia. Sensation \ "Clouding" or dulness { as in simple depression. { Perversion { as in dementia and melancholia. Sweet may taste \ sour; fresh food may smell decayed.

/ Hyperesthesia (exaggeration) { as in neurasthenia or mania. { Anesthesia Disorders { as in hysteria or paralysis. of { Retardation Perception { as in dementia and melancholia. / "Clouding" or dulness (being < as in simple depression. dependent \ Illusion on sensation { found in normal mind--easily corrected; is always { found in many insanities. disturbed { Hallucinations with it). { frequently met in the infection-exhaustion psychoses, { in dementia, in paranoia, in acute \ hallucinosis of alcoholism.

/ Hypochondriasis { found in many of the hypersuggestible, frequent { in the mild depressions and in all victims of { self-attention. { Retardation { found in most depressions. { Deficiency { as in idiocy--the inability to form new concepts. { Acceleration { as in hypo-mania. { Poverty { as in the abnormally self-centered; { as in melancholia. { Rambling ideas { as in chronic insanity. { Flight of ideas { as in manias, hysterias, and acute deliriums. Disorders / Fixed ideas of < as in paranoia. Ideation \ Perversions (concepts change their meaning altogether) { as in dementia. { Ideogenous pains { as in hysteria. { Compulsive ideas { common in borderland states; { in psychasthenia, or hysteria. { Disorientation { { thing, { (wrong idea of { place, or { { person); { found in confused conditions; { in delirium from infections; { in insanities. { Confusion { as in the infection-exhaustion psychoses; \ in insanities.

/ Absent-mindedness. { Amnesia (morbid forgetfulness). { { temporary, Disorders / Aphasia { prolonged, of < {permanent (see later explanation). Memory \ Perversion { as fabrications, due to memory-confusion or { inaccuracy; also due to excessive ideation and \ defective judgment.

/ / Somatic { { as in hypochondriasis. { { Persecutory { { as in paranoia. { { Unworthiness { { as in simple depression or { { melancholia. { Delusions { Grandeur { Systematized / as in mania or paranoia. Disorders / Transient < Nihilistic of < Fixed \ often found in melancholia. Reason \ { Reference { { as in paranoia. { { Altered personality { { as in hysteria. { { Perverted personality { { (patient may believe he is a dog); { \ as in dementia. { Emotional thinking. { Shut-in personality { as seen in the deficient social capacity of potential \ dementia præcox.

/ Defective judgment { in all insanities; { in hysteria. { _Ex._: Patient who accepts mental suggestion { of disability as reality. { Perverted judgment Disorders / in severe dementias--as influenced by unreasonable of < fear, hatred, etc.; Judgment \ in all acute insanities--as manifested in inability { of patient to rid himself of his delusions. { Absence of judgment { in all acute insanities; { in later dementias. { Limitations \ in many so-called normal and in all the abnormal.

/ Suggestibility { in hysteria. { Excitement { in mania. { Depression { in melancholia. Disorders / Phobias of < as found in psychasthenia. Emotion \ Deficiency { as in the apathy of depression. { Perversion { in mania, in depression, in catatonia. { Deterioration { in dementia. { Sense of unreality \ found in all borderland cases.

/ Wilfulness { in many "normal." Very common in hypomania. { Willessness (aboulia or paralysis of will) { often found in psychasthenia; and in depressive { states. { Morbid inhibition { as in depressive states. { Indecision { as in psychasthenia; { as in simple depression. { Obsessions { found pre-eminently in psychasthenia. { Tics Disorders / in many borderland cases; of < in the hypersensitive as often the only expression Will \ of any neuropathic tendency. { Distractibility { as in hypomania and frequently in hysteria. { Negativism { as in catatonia. { Mutism { as in catatonia. { Compulsive acts { as in psychasthenia, hysteria, etc. { Psychomotor overactivity (volition unable to check) { as in mania. { Psychomotor retardation (volition unable to energize) \ as in depression.

From this limited survey of the mind's disorders we realize that every departure from the normal mental attitude tends to associate itself with one of the following five _states of mental disability_.

Depression, Exaltation, Perversion, Enfeeblement, Deficiency.