Part 20

L. E. W., forty-nine years of age, farmer and lawyer by occupation, a man of strenuous disposition, broke down under stress and strain with severe but common symptoms of mental and physical fatigue modified and exaggerated by apprehensions of incurable illness. At the end of a year there developed scruples and jealous suspicions of his wife’s chastity, not persistent but recurring from time to time in attacks, and always awakened by a suggestion of some kind—an associated idea, a remark heard, an act of some kind on the part of the wife, etc. Between the attacks he was entirely free from such thoughts, but during the attack, which came on with the usual suddenness, these thoughts—always the same doubts, suspicions, reasonings, jealousy, and fear—were dominating, imperative, and painful. An open-minded, frank, intelligent man he fully realized that his scruples were entirely unfounded and even characterized them as “delusions.” It was interesting, so clear was he in this respect, to hear him discuss his attacks between times with his wife, as if they were recurrent appendicitis. The attacks would pass off in a short time after discussing his scruples with his wife, and then he became natural again; they involved great suffering and he feared, as people thus afflicted so often do, that they spelled impending insanity. And yet it was easy to determine that they were only _imperative recurrent memories_, conserved complexes emerging from the unconscious. He had been married twenty-two years. He was of a jealous nature, and before marriage it annoyed him to think that his wife had been courted by other men, that she wrote them letters, etc. He began to think of her as a flirt, that she was going to jilt him, and to have misgivings of her character. He grew jealous and suspicions of possible unchastity worried him, but reasoning with himself he would say, “O, pshaw! it is an abominable suspicion,” “an hallucination,” and put the thought out of his mind, as he said. But we know he really put the thought _into_ his mind to be conserved in the unconscious, as a complex of chastity scruples, and there undergo incubation and further development. Later he had had spells of jealousy during his married life but no true imperative ideas until he broke down in health, and then, as he himself expressed it, “the devil got the upper hand and said, ‘I’ve got you now.’”

The devil was the complex organized twenty-two years previously with the emotion of jealousy[142] centered about the idea of his wife and the whole neurographically conserved. The impulsive force of the emotion was constantly striving to awaken and give expression to the unconscious complex. He was able to hold it in check, to repress it, by the conflicting force of other sentiments until these became weakened by the development of the psychasthenic state. Then these latter controlling elements of personality were repressed in turn whenever the more powerful jealousy complex was awakened. The whole mechanism was undoubtedly more complicated than this, in that the jealousy complex had a setting in certain unsophisticated and puritanical ideas of conduct (brought to light in the analysis) which gave a peculiar meaning (for him) to his wife’s actions. So long as this setting persisted it would be next to impossible to modify the jealousy complex.

Whatever the mechanism, ideas with strong emotional tones (particularly fear, anger, jealousy, and disgust), no matter how absurd or repellent, or unjustified, and whether acceptable or unacceptable, tend to become organized and welded into a complex which is thereby conserved. The impulsive force of the incorporated emotion tends to awaken and give expression to the complex whenever stimulated. The recurrence of such an organized complex so far as it is reproduction is, of course, in principle, memory, and an imperative memory or _fixed idea_. Whether the complex shall be awakened as such a recurrent memory, or shall function as a dissociated subconscious process, producing other disturbances, or remain quiescent in the unconscious, depends upon other factors which we need not now consider.

3. Clinically the _periodic recurrence_ of such complexes is an _obsession_. An obsession _as met with_ is most likely to be characterized by fear not only because the instinct of fear is the most painful of the emotions, but for another reason. Although biologically fear is useful as a defense for the preservation of the individual, when perverted by useless associations it becomes harmful, in that it is not only painful but prevents the adjustment of the individual to his environment and thereby takes on a pathological taint. Complexes with other emotions are less likely to be harmful and therefore less frequently apply for relief. Yet imperative ideas with jealousy, anger, hatred, love, disgust, etc., centered about an object are exceedingly common though their possessors less often resort to a physician.

From another point of view abnormal complexes, represented by these examples, may be regarded as “_association psychoses_.” Sometimes the physiological bodily accompaniments form the greater part of the complex which is for the most part made up of physiological disturbances (vasomotor, cardiac, gastric, respiratory, secretory, muscular, etc.); almost pure association _neuroses_ they then become. Neuroses of this kind we shall consider in a later lecture.[143]

Sometimes, particularly in people of intensive temperaments, “imperative ideas” are formed by gradual evolution in consequence of the mind constantly dwelling with emotional intensity on certain phases of thought—i.e., through repetition. This we see in the development of religious complexes or faiths, but it is also obtrusive in other fields of thought, political, industrial, social, etc. Hence the evolution of _fanatics_. A. D. is a man of strong feeling and great imagination. As a child he was a constant witness of quarrels between his father and mother. His mind dwelt upon these experiences and there developed in him at an early date strong aversions toward marriage. Aversion means the instinct of repulsion or disgust. This instinct therefore became systematized with the idea of marriage as its object forming an intense sentiment of aversion. Even as a boy the aversion impelled him to determine never to marry and later he formed strong theoretical anti-matrimonial views which became almost a religion. For years he talked about his views, argued and preached about them like a fanatic to his friends. His aversion rose in successful conflict against every temptation to matrimony and his anti-matrimonial complex became an obsession. The consequences were what might have been expected when, later in life, he allowed himself in a moment of sympathetic weakness and owing to compromising situations to slip within the matrimonial noose. The complex then, like that of Voltaire’s orange rind, would not down at his own bidding, or at that of his devoted spouse for whom he had, in other respects, a strong affection mingled with personal admiration. The resulting situation can be imagined.

4. _Hysterical attacks._ It is of practical importance to note another part which emotional complexes may play in psychopathology. In certain pathological conditions in which there is limitation of the field of consciousness (involving a disappearance of a large part of the normal mental life) often all that persists of consciousness and represents the personal self is the obsessing complex which previously tormented the patient. In hysterical crises, psycholeptic attacks, trance, and certain types of epilepsy this is peculiarly the case. In these states the content of consciousness consists almost wholly, or at least largely, of a recurrent memory of an experience which originated in the normal life and which has been conserved in the unconscious. Here the obsessing ideas, which at one time were voluntarily entertained by the subject, or, as frequently happens, originated in some emotional experience, automatically recur, while the remainder of the conscious life becomes dissociated and suppressed; in other words the obsessing ideas emerge out of the unconscious (neurograms) and became substantially the whole conscious field. In hysterical attacks, particularly, the complex is accompanied by the same strong emotional tone—such as fear, anxiety, jealousy, or anger—which belonged to the original experience. In such pathological subjects, whenever the complex is awakened, the remainder of the conscious field tends to become dissociated and the psychological state to be reproduced. Hence, in such states, the ideas repeat themselves over and over again with the recurrence of the attacks. The subject lives over again as in a dream the original attack, which is a stereotyped revivification of the original experience. This peculiarity of the mental condition in attacks has been described by various writers. The dream of the hystero-epileptic is substantially always the same. Janet has accurately described the origin and rôle of the fixed ideas in the hysterical attack. “These ideas,” he says, “are not conceived, invented at the moment; they formulate themselves; they are only _repetitions_. Thus, the most important of the hallucinations which harassed Marcelle during her cloud-attack was but the exact reproduction of a scene which had taken place the previous year. The fixed ideas of dying, of not eating, are the reproduction of certain desperate resolutions taken some years ago. Formerly these ideas had some sense, were more or less well connected with a motive. A desperate love affair had been the cause of her attempts at suicide; she refused to eat in order to let herself die of hunger, etc. To-day these ideas are again reproduced, but without connection and without reason. She has, we convinced ourselves, completely forgotten her old despair, and has not the least wish to die. The idea of suicide comes to her to-day without any relation to her present situation, and she is in despair at the idea of this suicide which imposes itself on her as a relic of her past, so to say. She does not know why she refuses to eat; the ideas of suicide and refusal of food are dissociated. The one exists without the other. At one moment she hears the voice, ‘Do not eat,’ and yet she has no thought of death; at another, she thinks of killing herself and yet she accepts nourishment. We always find in fixed ideas this characteristic of automatic repetition of the past without connection, without actual logic.”[144]

When certain emotional and distressing ideas of wounded love are awakened in M. C., an hysteric, she is thrown into an hysterical attack in which these ideas recur over and over again and dominate consciousness. In P. M., another hysteric, ideas of loneliness and jealousy, which had previously been entertained but which had been thrust out of her mind again and again in a conscientious struggle with her moral nature, recur, emerge from the unconscious and dominate the field of consciousness in each hysterical attack which they induce.

6. In the _psycholeptic_, a variant of the hysteric, the same sensations, motor phenomena, and hallucinations, and the same bizarre ideas—whatever the symptomatic phenomena—characterize each attack. This could be shown experimentally in M——l.[145]

Of course the degree of dissociation of consciousness, the content of the fixed idea, and the physiological manifestations vary in individual cases, according to the nature of the case. Sometimes the disturbance of consciousness is slight and the physiological manifestations predominant.

From a consideration of all the facts we see that a conserved complex associated with strong feeling tones may play a disastrous and pathological part in certain individuals.

It is well to bear in mind here, as before, that in these statements we are only giving a literal description of the psychological events without attempt to form any theory of the mechanism of the processes, or the antecedent psychogenetic factors which lead to the development of the particular fixed ideas or complexes. About this there may be and is a difference of view.

=Systematized Complexes.= In contrast with the limited group of fixed ideas, organized with one or more emotions (i.e., instincts) I have been describing, are the large _systems_ of complexes or associated experiences which become organized and fairly distinctly differentiated in the course of the development of every one’s personality. In many, at least, of these systems there will be found a predominant emotion and certain instinctive tendencies, and a predominant feeling tone—of pleasure or pain, of exaltation or depression, etc. It is quite possible that careful investigation would disclose that it is this conflicting affective force which is responsible for the differentiation of one system from another with opposing affects and tendencies. The differentiation of such systematized complexes is of considerable practical importance for normal and abnormal personality. Among such systems may here be mentioned those which are related to certain _subjects_ or departments of human experience, or are related in _time_, or to certain dispositions or _moods_ of the individual. The first may be called _subject_ systems, the second _chronological_ systems, and the last _mood_ systems.

1. _Subject systems_: I find myself interested, for instance, in several fields of human knowledge; (a) abnormal psychology; (b) public franchises; (c) yachting; (d) local politics; (e) business affairs. To each of these I give a large amount of thought, accumulate many data belonging to each, and devote a considerable amount of active work to carrying into effect my ideas in each field. Five large systems are thus formed, each consisting of facts, opinions, memories, experiences, etc., distinct from those belonging to the others. To each there is an emotion and a feeling tone which have more or less distinctive qualities; these coming from the intellectual interest of abnormal psychology differing qualitatively from those of the “joy of battle” excited by a public contest with a railroad corporation or gas company, as it does from that of the exhilarating sport of a yacht race, or from the annoying and rather depressing care of business interests; and so on.

These five subject-complexes do not form independent automatisms or isolated systems which may intrude themselves in any conscious field, but comprise large associations, memories of experiences in a special field of thought. Within that field the ideas of the system are no more strongly organized than are ideas in general; but it can be recognized that the system as a whole with its affective tones is fairly well delimited from the other complexes of other spheres of thought. It is difficult, for certain individuals at least, to introduce the associations of one subject-complex into the focus of attention so long as another is invested with personal interest and occupies the attention of consciousness. They find it difficult to switch[146] their minds from one subject to another and back again. On the other hand, it is said of Napoleon that he had all the subjects of his experiences arranged in drawers of his mind, and that he could open each drawer at will, take out any subject he wished, and shut it up again as he wished. Ability of this kind involves remarkable control over the mind and is not given to all.

I have frequently made observations like the following on myself, showing the organization and differentiation of systems: I collect the various data belonging to one of the problems discussed in these lectures. I arrange all in an orderly fashion in my mind, work out the logical relations and the conclusions to which they lead, as well as their relations to other data and problems. The whole is then schematically arranged on paper to await proper elaboration the next morning, when it will be written out on waking, the preliminary mental arrangement having been done at night. A large complex has been created, the various details of which are luminously clear and the sequence of the ideas vividly conceived, the conclusions definite. There is, further, an affective tone of joy and exaltation which is apt to accompany the accomplishment of an intellectual problem and which produces a feeling of increased energy.

The next morning, as I awake and gradually return to full consciousness, another and very different kind of complex almost exclusively fills my mind, owing probably to the fatigue following the previous night’s work. All sorts of gloomy thoughts, memories of experiences better forgotten, course through the mind; and entirely different emotions (instincts), and a strong feeling of depression dominate the mental panorama. The whole—ideas, emotions, and feelings—makes a complex which has been experienced over and over again, and is recognized as such. The same old ideas, emotions, thoughts, and memories, conserved as neurograms, repeat themselves almost in stereotyped fashion. The mental complex has completely changed and the exuberant energy of the night before has given place to listless inertia.

All this is commonplace enough, merely morning depression you will say, due to fatigue; and so it is. But mark the sequel.

I now remember that I have a task to perform and before rising take paper and pencil, lying ready at my side, to write out the theme previously arranged in skeleton. But to my surprise I find that it cannot be recalled. To be sure, I can, by effort of will, recall individual facts, but the facts have lost their associations and meaning, they remain comparatively isolated in memory; all their correlated ramifications, their associated ideas and relations, which the night before stood out in relief and crowded into consciousness, have gone. The emotional tone and impulses which energized the thoughts have also disappeared, and with them the system of complexes as a whole. It has been dissociated, inhibited, repressed, and there is _amnesia_ for it. With the fatigue depression a new system, with different emotions and feelings, now dominates the mind and the desired system cannot be switched in.

This amnesia is not one of conservation but one of reproduction; for later in the day the fatigue and depression disappear, a new energizing emotional tone arises and the sought-for system is switched in and returns in its entirety. With this change the depression system in turn disappears, and now it is difficult to recall it, excepting that as an intellectual fact I remember that such thoughts occupied my mind in the early morning hours. The two systems as a whole are distinctly differentiated from and alternate with one another.

All this is only expressing in somewhat technical language a common experience, as most people, I suppose, have such _alternations of complexes_. The facts are trite enough; but, because they are of common experience, it is well to formulate them and so, as far as possible, give precision to our conception of the psychological relations which have a distinct bearing on the principles of dissociated personality and other psychoses, on character and psycho-therapeutics. When, at a later time, we take up for study the subject of dissociated personality[147] we shall find that the dissociation of consciousness sometimes takes its lines of cleavage between systems of complexes of this kind.[148] And, above all, the formation of complexes _is the foundation stone of psycho-therapeutics_.

The methods of _education and therapeutic suggestion_ are variants of this mode of organizing mental processes. Both, in principle, are substantially the same, differing only in detail. They depend for their effect upon the implantation in the mind of ideational complexes organized by repetition, or by the impulsive force of their affective tones, or both. Every form of education necessarily involves the artificial formation of such complexes, whether in a pedagogical, religious, ethical, scientific, social, or professional field. So in psychotherapy by artfully directed suggestion, or education in the narrower sense, complexes may be similarly formed and organized. New points of view and “sentiments” may be inculcated, useful emotions and feelings excited, and the personality correspondingly modified. Roughly speaking, this is accomplished by suggesting ideas that will form _settings_ (associations) that give new and desired meanings to previously harmful ideas; and these ideas, as well as any others we desire to implant in the mind, are organized by suggestion with emotions (instincts) of a useful, pleasurable, and exalting kind to form desirable sentiments, and to carry the ideas to fulfilment. Thus sentiments of right, or of ambition, or of sympathy, or of altruism, or of disinterestedness in self are awakened; and, with all this, opposing emotions are aroused to conflict with and repress the distressing ones, and the whole welded into a complex which becomes conserved neurographically and thereby a part of the personality.

Under ordinary conditions of every-day mental life _social suggestion_ acts like therapeutic suggestion. But the suggestions of every-day life are so subtle and insidious that they are scarcely consciously recognized.

2. _Chronological systems_ (using complex in a rather extended sense) are those which embrace the experiences of certain epochs of our lives rather than the subject material included in them. In a general way events as they are successively experienced become associated together, and with other elements of personality, so that the later recollection of one event in the chain of an epoch recalls successively the others. Conversely a break in the chain of memory may occur at any point and the chain only be picked up at a more distant date, leaving between, as a hiatus, an epoch for which there is amnesia of reproduction. This normally common _amnesia affords confirmatory evidence_ of the associative relation of successive events. Involving as it does the unimportant and unemotional experiences as well as the important and emotional—though the former may be as well conserved as the latter—it is not easy to understand. The principle, however, plays an important part in abnormal amnesia particularly, but not necessarily, where there is a dissociation of personality.

The epoch may be of a few hours, or it may be of days, of months, or years. The simplest example is the frequent amnesia for the few hours preceding a physical injury to the head resulting in temporary unconsciousness. In other cases it is the result of extensive dissociation effected by suggestion (e. g., in hypnosis), or psychical trauma including therein emotional conflicts. Thus, to cite an experimental example: Miss B. is troubled by a distressing memory which constantly recurs to her mind during the twenty-four hours. To relieve her I suggest that she will completely forget the original experience. To my surprise, though the suggestion is limited to the experience alone, the whole twenty-four hours are completely wiped out of her memory. She cannot recall a single incident of that day. The whole epoch which had associations with the memory is dissociated.