Chapter 3
Similar instances can be adduced in all realms of sensation, both general and special. One person cannot bear the light, and wears blue glasses; another cannot breathe out-door air, and wears a respirator; another cannot bear to see a person rock or to hear a person drum.
If a family or circle of friends is so constituted that some are obsessed to _do_ certain things and others are obsessed _not to stand them_ the foundation is laid for a degree of irritability inconsistent with mental health. Mrs. X. simply cannot stand hearing Mr. X. tap the floor, and if he continues, her discomfort becomes acute; the sound so dominates her that she can think of nothing else and can accomplish nothing until the sound is stopped. She can stand _anything_ but _that_. The daughter, Miss X., hardly hears the tapping, and is irritated and impatient to the last degree on account of her mother's "silly" notion. What Miss X. simply cannot bear is hearing her brother continually clear his throat, and if he does not stop she must leave the room or "go wild." Unfortunately, meantime, Mr. X. is so obsessed to tap the floor that he cannot follow his task without it, and Master X. _must_ clear his throat every few moments with a peculiar note because he "has catarrh."
Here we have a common starting-point for family discomfort, and here we have a clue to the advice of the physician who advises isolation as a step toward the cure of the member of the family who first breaks down, not simply under the stress of occupation, but of occupation plus the wear and tear of minor but constant sources of irritation.
* * * * *
It is said that the victim of jiu jitsu, by breaking one hold, places himself in the greater danger from the next. Similarly, after having conquered a few obsessions, one is overwhelmed with the obsession to set every one straight. Soukanhoff was right in warning the obsessive to beware of pedantry.
The question here presents itself whether this line of thought does not foster, rather than lessen, the pedantry and the self-study which it is intended to combat. Why not simply drop the worry and the doubt without further argument? The difficulty is that the mental processes of the over-scrupulous person are such that he cannot summarily drop a habit of thought. He must reason himself out of it. There is no limit to his ability if properly directed; he can gradually modify all his faulty tendencies, and may even finally acquire the habit of automatically dismissing worry, but it would be too much to expect that he suddenly change his very nature at command.
Soukanhoff's description of obsessives is peculiarly apt: "over-scrupulous, disquieted over trifles, indecisive in action, and anxious about their affairs. They are given early to morbid introspection, and are easily worried about their own indispositions or the illnesses of their friends. They are often timorous and apprehensive, and prone to pedantism. The moral sentiments are pronounced in most cases, and if they are, as a rule, somewhat exigent and egotistic, they have a lively sense of their own defects."
A common obsession is the compulsion to dwell upon the past, to reproduce the circumstances, and painfully to retrace the steps which we took in coming to an erroneous decision which led to a foolish, unnecessary, or perhaps even a wrong decision. One of my earliest impressions in golf was the remark of a veteran who was good enough to make a round with me. "If I had only approached better, I should have made that hole in five," I remarked, after taking seven strokes for a hole.
"Perhaps not," he replied; "if you had _approached better_, perhaps you would have _putted worse_ and taken _eight_ strokes for the hole. At all events, that hole is ancient history now, and you will play this one better if you leave that one alone."
He little realized how many times his advice would recur to me elsewhere than on the links. Retrospective worry can be absolutely eliminated from the most obsessive mind by the practice of the veteran's philosophy.
Mercier says the greatest intellectual gift is the ability to forget.
The conscientious self-analyst spends too much time in weighing his ability or inability to perform some task. Between his fear, his worry over the past, and his indecision whether the task should be attempted, he starts with an overwhelming handicap. If he learns to say, "Other people fail; it will not matter if I do this time," he will find the task already half accomplished.
The Rev. Francis Tiffany has observed that if a ship could think, and should imagine itself submerged by all the waves between here and Europe, it would dread to leave its moorings; but in reality it has to meet but one wave at a time.
The tendency of the average American in this bustling age, whether he is obsessive or not, is to live at least several hours in advance. On the train he takes no comfort and makes no observations, for his mind is upon his destination rather than on his journey.
* * * * *
Though the immediate object of these chapters is the promotion of the mental, and indirectly the physical, health of the individual, I cannot forbear referring to the effect of this training on the position of the individual in society and his relation toward his surroundings.
The endeavor to overcome obsessions is likely to be ignored by two classes: the self-centered individuals who see no reason for learning what they do not want to learn, and the individuals who have no time for, or interest in, self-training because of absorption in subjects of wider relation, as art, or science, or reform. The philosophy of Haeckel applies to both:
"Man belongs to the social vertebrates, and has, therefore, like all social animals, two sets of duties--first to himself, and secondly to the society to which he belongs. The former are the behests of self-love, or egoism, the latter love for one's fellows, or altruism. The two sets of precepts are equally just, equally natural, and equally indispensable. If a man desires to have the advantage of living in an organized community, he has to consult not only his own fortune, but also that of the society, and of the 'neighbors' who form the society. He must realize that its prosperity is his own prosperity, and that it cannot suffer without his own injury."
The individual who is ruled by his obsessions not only paves the way for needless and ultimate breakdown, but is in danger of gradually narrowing his field of usefulness and pleasure until he is in little better case than Simeon Stylites, who spent nearly half a century on the top of a monument. Nor has he even Simeon's consolation that he could come down if he chose; for it seems that the authorities sent messengers demanding his return, with orders to let him stay if he showed willingness to come down--and he stayed.
VI.
THE DOUBTING FOLLY
_Jatgeir_. I needed sorrow; others there may be who need faith, or joy--or doubt--
_King Skule_. Doubt as well?
_Jatgeir_. Ay; but then must the doubter be strong and sound.
_King Skule_. And whom call you the unsound doubter?
_Jatgeir_. He who doubts of his own doubt.
_King Skule_ (slowly). That methinks were death.
_Jatgeir_. 'T is worse; 't is neither day nor night.
_King Skule_ (quickly, as if shaking off his thoughts). Where are my weapons? I will fight and act, not think.
IBSEN: _The Pretenders_, Act iv.
A gentleman once told me that he rarely passed another in the street without wondering if he had not accosted him in an improper manner. He knew very well that he had not, but the more he dwelt upon the possibility, the more doubtful he became, until the impulse to settle the question became so strong that he would retrace his steps and inquire. He asked if _nux vomica_ would help this trouble! I told him he needed mental training.
"I have tried that," he answered. "I keep saying to myself, 'I will not think of it,' but it is no use; my head becomes hot, my sight blurred, my thoughts confused, and the only relief I find is to settle the question."
I tried to point out the direction in which he was tending, and told him he must remind himself that even if he had accosted another improperly, it was a trifling matter compared to the injury to himself of giving way to this compulsion; moreover, the impression he would make upon the other by going back would be even worse than that of having so accosted him; and, finally, he must dwell upon the _probability_ that he had not offended the man, instead of the _possibility_ that he had. Having pursued this line of thought, he must force himself to think of something else until the besetting impulse was obliterated. I suggested that if a baseball player should become incapacitated for the game, he would not lessen his disappointment by reiterating, "I will not think of baseball," but if he persistently turned his thoughts and his practice to billiards he might in time forget baseball.
"I never played baseball," he replied, "and don't even know the rules."
This represents an extreme case of "doubting folly" a case in which the victim could no longer concentrate his thoughts on the simplest proposition outside the narrow circle to which his doubts had restricted him.
If we once allow ourselves to wonder whether we have turned off the water, enclosed the check, or mailed the letter, it is but a step to an uncomfortable frame of mind which can be relieved only by investigating the matter. This compulsion once acceded to, it becomes more and more easy to succumb. The next step is to blur, by constant repetition, the mental image of the act. In extreme cases the doubter, after turning the gas on and off a dozen times, is finally in doubt whether he can trust his own senses. A certain officer in a bank never succeeded in reaching home after closing hours without returning to try the door of the bank. Upon finding it locked, he would unlock it and disappear within, to open the vault, inspect the securities, and lock them up again. I once saw a victim of this form of doubt spend at least ten minutes in writing a check, and ten minutes more inspecting it, and, after all, he had spelled his own name wrong!
Constant supervision only impairs acts which should have become automatic. We have all heard of the centipede who could no longer proceed upon his journey when it occurred to him to question which foot he should next advance.
To other doubts are often added the doubt of one's own mental balance; but it is a long step from these faulty habits of mind to real mental unbalance, which involves an inability to plan and carry out a line of conduct consistent with one's station.
It took a young man at least fifteen minutes, in my presence, to button his waistcoat. He felt the lower button to reassure himself, then proceeded to the next. He then returned to the lower one, either distrusting his previous observation, or fearing it had become unbuttoned. He then held the lower two with one hand while he buttoned the third with the other. When this point was reached he called his sight to the aid of his feeling, and glued his eyes to the lower while he buttoned the upper, unbuttoning many meantime, to assure himself that he had buttoned them. This young man said he would sometimes stop on his way to the store in doubt whether he was on the right street, a doubt not quieted either by reading the sign or by asking a stranger, because the doubt would obtrude itself whether he could trust his sight and his hearing, indeed, whether he was really there or dreaming. Even this victim of extreme doubting folly conducted his business successfully so long as I knew him, and so comported himself in general as to attract no further comment than that he was "fussy."
These doubts lead to chronic indecision. How often, in deciding which of two tasks to take up, we waste the time which would have sufficed for the accomplishment of one, if not both.
The doubt and the indecision result directly from over-conscientiousness. It is because of an undue anxiety to do the right thing, even in trivial matters, that the doubter ponders indefinitely over the proper sequence of two equally important (or unimportant) tasks. In the majority of instances it is the right thing for _him_ to pounce upon _either_. If he pounces upon the wrong one, and completes it without misgiving, he has at least accomplished something in the way of mental training. The chances are, moreover, that the harm done by doing the wrong thing first was not to be compared to the harm of giving way to his doubt, and either drifting into a state of ineffective revery or fretting himself into a frenzy of anxious uncertainty.
A gentleman once told me that after mailing a letter he would often linger about the box until the postman arrived, and ask permission to inspect his letter, ostensibly to see if he had put on the stamp, but in fact to reassure himself that he had really mailed the missive, although he knew perfectly well that he had done so. The life of the chronic doubter is full of these small deceits, though in most matters such persons are exceptionally conscientious.
This form of over-solicitude is peculiarly liable to attack those in whose hands are important affairs affecting the finances, the lives, or the health of others. I have known more than one case of the abandonment of a chosen occupation on account of the constant anxiety entailed by doubts of this nature. Nor are these doubts limited to the question whether one has done or left undone some particular act. An equally insistent doubt is that regarding one's general fitness for the undertaking. _The doubter may spend upon this question more time than it would take to acquire the needed facility and experience_.
Some one has said there are two things that no one should worry about: first, the thing that can't be helped; second, the thing that can. This is peculiarly true of the former.
Reflection upon the past is wise; solicitude concerning it is an anachronism. Suppose one has accepted a certain position and finds himself in doubt of his fitness for that position. Nothing can be more important than for him to decide upon his next line of conduct. Shall he resign or continue? Is he fit for the position, or, if not, can he acquire the fitness without detriment to the office? These are legitimate doubts. But the doubter who finds himself in this predicament adds to these legitimate doubts the question, "Ought I to have accepted the office?" This is the doubt he must learn to eliminate. He must remind himself that he has accepted the position, whether rightly or wrongly, and that the acceptance is ancient history. The question what shall he do next is sufficiently weighty to occupy all his attention without loading his mind with anxious doubts regarding the irrevocable past.
Suppose, in fact, the doubter has made a mistake; how shall he banish the worry? By reminding himself that others have made mistakes, why should not he, and that it is somewhat egotistic on his part to insist that, whatever others may do, _he_ must do everything right. If this line of reasoning fails to console him, let him think of the greater mistakes he might have made. A financial magnate was once asked how he succeeded in keeping his mind free from worry. He replied, by contemplating the two worst things that could happen to him: losing all his property and going to jail. He had learned the lesson that _one thought can be driven out only by another_.
With regard to immediate doubts. If the over-scrupulous business or professional man, worn out after an exacting day's work, will stop and reflect, he will realize that much of his exhaustion is due to his having filled the day with such doubts as whether he is doing the wrong thing, or the right thing at the wrong time, whether he or someone else will miss an appointment or fail to meet obligations, and whether he or his assistants may make blunders.
Let him resolve some morning that he will proceed that day from task to task without allowing such thoughts to intrude. If he does so he will find that he has succeeded in his work at least as well as usual, and that he is comparatively fresh in the evening.
Why not try this every day?
* * * * *
So far we have only considered the most obvious and simple among the evidences of doubting folly. A still more obstinate tendency of the doubter is the insistent habit interminably to argue over the simplest proposition, particularly regarding matters pertaining to the health, comfort, and life of the individual himself. A certain patient, of this type, attempts to describe to his physician a peculiar, hitherto undescribed, and even now indescribable sensation "through his right lung." He traces this sensation to what he believes to have been the absorption of a poison some years ago. His line of reasoning is somewhat as follows: 1. The drug was a poison. 2. If he absorbed it he must have been poisoned. 3. If he was poisoned then, he is poisoned now. 4. There is no proof that such a poison cannot produce such a sensation. 5. He has the sensation. Conclusion: He is suffering from poison. In support of this proposition he will spend hours with anyone who will listen. The physician who allows himself to be drawn into the controversy speedily finds himself, instead of giving advice to listening ears, involved in a battle of wits in which he is quite likely to come off second best. He assures the patient, for example, that, as far as scientific methods can establish the fact, the lung is sound.
"But has science established everything? And if it had, is such negative evidence to be weighed against the positive evidence of the sensation in my lung?"
"But the sensation may not be in your lung."
"Can you prove that it is _not_ in my lung?" Folly scores!
On being urged to direct his attention to some other part of his body, he promptly inquires,
"How can I direct my thoughts elsewhere, when the sensation is there to occupy my attention?" Obviously he can not without changing his mental attitude, so folly scores again.
He is assured that if the poison had been absorbed the effects would have passed away long before this time.
"But do the effects of poison _always_ pass away? And can you _prove_ that they have passed away in my case? Is not the sensation positive evidence, since you have allowed that you cannot prove that the sensation does _not_ come from the poison?"
Folly scores again, but the victory is an empty one. The vicious circle continues: Attention magnifies sensation--sensation produces fear--fear increases attention; and throughout runs the insistent thought that his sensations shall conform to his ideal.
If the discussion of such comparatively tangible matters can occupy a large part of one's attention, imagine the result of the insistent desire, on the part of the doubter, to solve such problems as "What is thought?" "What is existence?"
If the windings of this intellectual labyrinth have not too far involved us, we have only to recognize the futility of such arguments, and exercise our will-power in the right direction. If we can bring ourselves to take the initiative, it is as easy to step out of the vicious circle, as for the squirrel to leave his wheel. But unless we grasp the logic of the situation, and take this initiative, no amount of abuse, persuasion, or ridicule will effect our freedom.
* * * * *
A word may be in place regarding the anthropological status of the doubting folly and allied mental states. Men of genius have suffered from them all. A long list may be found in Lombroso's "Man of Genius." Under _folie du doute_ we find, for example, Tolstoi, Manzoni, Flaubert and Amiel.
Lombroso regards genius as degenerative, and places among the signs of degeneration, deviations from the average normal, whether physical or mental. This plan has been quite generally followed. The nomenclature seems to me unfortunate and hardly justified by the facts. I can think of no more potent objection to such inclusive use of the term degenerate, than the fact that Lombroso includes, under the signs of degeneration, the enormous development of the cerebral speech-area in the case of an accomplished orator. If such evolutional spurts are to be deemed degenerative, the fate of the four-leaved clover is sealed.
The application of the term degeneration may be, and should be, it seems to me, limited to the signs, whether physical or mental, which indicate an obviously downward tendency. I have elsewhere suggested, and the suggestion has already found some acceptance, that when the variation is not definitely downward, _deviation_ and _deviate_ be substituted for the unnecessarily opprobrious and often inappropriate terms, _degeneration_ and _degenerate_.
VII.
HYPOCHONDRIA
Il marche, dort, mange et boit comme tous les autres; mais cela n'empeche pas qu'il soit fort malade.
MOLIERE: _Le Malade imaginaire_.
The victim of hypochondria may present the picture of health, or may have some real ill regarding which he is unduly anxious. His consultation with a physician is likely to be preceded by letters explaining his exact condition, naming his various consultants and describing the various remedies he has taken. At the time of his visit notes are consulted, lest some detail be omitted. In his description anatomical terms abound; thus, he has pain in his lungs, heart, or kidney, not in his chest or back. Demonstration by the physician of the soundness of these organs is met by argument, at which the hypochondriac is generally adept.
The suggestion that the hypochondriac devotes undue attention to his own condition is met by him with indignant denial. Proposals that he should exercise, travel, engage in games, or otherwise occupy himself, fall on deaf ears, but he is always ready to try a new drug. If a medicine is found with whose ingredients the patient is not already familiar, its use is likely to produce a beneficial effect for a few days, after which the old complaint returns.
The case has come to my attention of a young man who, for fear of taking cold, remains in bed, with the windows of the room tightly closed and a fire constantly burning. He has allowed his hair to grow until it reaches his waist, he is covered with several blankets, wears underclothing under his nightshirt, and refuses to extend his wrist from under the bed-clothes to have his pulse taken.
Such faulty mental habits in minor degree are common. There are those who will not drink from a bottle without first inspecting its mouth for flakes of glass; some will not smoke a cigar which has been touched by another since leaving the factory; some will not shake hands if it can possibly be avoided; another pads his clothing lest he injure himself in falling. Many decline to share the occupations and pleasures of others through fear of possible wet feet, drafts of air, exhaustion, or other calamity. Such tendencies, though falling short of hypochondria, pave the way for it, and, in any event, gradually narrow the sphere of usefulness and pleasure.
No part of the body is exempt from the fears of the hypochondriac, but he is prone to centre his attention upon the obscure and inaccessible organs. The anecdote is told of a physician who had a patient of this type--a robust woman who was never without a long list of ailments. The last time she sent for the doctor, he lost patience with her. As she was telling him how she was suffering from rheumatism, sore throat, nervous indigestion, heart-burn, pains in the back of the head, and what not, he interrupted her:
"Ah," he said in an admiring tone, "what splendid health you must have in order to be able to stand all these complaints!"