CHAPTER V

SEXUAL BASIS OF NERVOUS DISORDERS

Nervous disorders are so widely prevalent in the life of modern woman that any serious attempt to throw light upon the subject is of decided service to the cause of health.

Within comparatively recent years there has been a growing tendency in various therapeutic circles to emphasize the relationship of nervous disturbances to the sexual sphere. Freud, the Viennese psychoanalyst, is probably more responsible than any other individual for this trend. However, the policy of recognizing the sexual basis of nervous disorders is not now by any means restricted to the Freudians, or even the dissenting schools of psychoanalysis. All psychiatrists, neurologists, and the medical profession generally, are coming more and more to a realization of the potency of sex in starting off all sorts of nervous ills.

Of course, it is not contended by the present writer that every case of nervous disorder has its roots in sex; nor that there are not sometimes other contributing factors involved. The human organism is so complex, and the interrelations of its component parts are so marked, that it is often exceedingly difficult to find the precise cause of a given group of symptoms.

The conception of woman as a mysterious, sexually anesthetic being is now largely a thing of the past. As Dr. Phyllis Blanchard remarks in _The Adolescent Girl_: “One of the most tantalizing problems is woman, because she has remained a baffling mystery, as shown by the folklore and literature of every people at every level of culture, in spite of her intimate relationship to man and the commonplaceness of her existence. In the attempt man has made to fathom her soul, she has been deified or endowed with demonic powers as the case may be.”

Now that woman has jumped off the pedestal (which in theory only man had erected for her), and refuses to be classified as a demonic being in her contrary moments and moods, we are free to consider her case rationally and scientifically as that of a genuine human being.

SEX FACTORS IN ADOLESCENCE

The yearning and stress incident to the awakening of the sexual life of the girl at puberty have very far-reaching effects, although normally there is less concentration upon the genital zone than is the case with the boy. But on account of the very fact of the lack of this concentration, there is a wider distribution of the emotional reactions.

In general, the sexual impulse in the young girl manifests itself in the form of reverie, hazy sensations, with presentiments that are apt to lead to melancholy moods. If circumstances bring her in contact with sexually experienced female friends, or other ardently erotic stimuli, the sexual impulse may be transformed into a hectic flame.

Any sort of emotional outlet that lies at hand may be grasped at the time of this upwelling of strange and conflicting forces. In former times the objective emotional interests were found principally in religion, poetry, music and esthetics. The religious zeal of the young woman at the adolescent period was formerly a very commonplace thing. It was something to which rich and poor alike had recourse to; whereas the girl of poor family was denied the opportunity for finding an emotional outlet in music, esthetics or poetry (her drab, prosaic surroundings precluded the latter no less than music and beauty.)

Nowadays, young women are actively identified with every phase of life--commercial, industrial, and otherwise, that offer opportunities for emotional outlet that were formerly undreamed of. In addition to these, of course, there is also the great personal freedom which girls and young women now enjoy and naturally, sometimes abuse.

The love of early youth, Krafft-Ebing remarked, has a romantic, idealizing tendency. In its first manifestations it is platonic, and willingly exercises itself in poetry and history. But as the sensibility awakens, the danger arises that this passion with its idealizing power, will be transferred to persons of the opposite sex who in intellectual, physical and social relations are by no means all that could be wished, hence proceed misalliances, elopements and seductions, with the entire tragedy of impassioned love, which conflict with the dictates of morality and convention, and sometimes finds its bitter end in suicide or a double self-destruction. Love in which the senses play too prominent a part can never be a true and lasting love. For this reason, first-love is as a rule very transitory, since it is in most cases no more than the first flare of passion. Platonic love is a thing without existence, a self-deception, a false description of sexual sensations.

Bebel found that the number of suicides among women of the ages of sixteen to twenty-one years is an exceptionally large one, and he attributes this chiefly to unsatisfied sexual impulse, unfortunate love, secret pregnancy, and to betrayal by men.

Sexual emotion, tension or preparedness, as Dr. Frink has pointed out, is less dependent on external conditions than are the other normal emotions. We do not feel continual normal anger or fear unless we are continuously subject to an external danger. But sexual tension, or preparedness, may arise in the absence of any external stimulation, and tends to persist until temporarily relieved by some suitable action, of which coitus, in the adult, is normally the most satisfactory.

Thus, in the absence of actions adequate in quality or in frequency to discharge the tension, there may come about a state of organic sexual preparedness which is chronic--even though the individual is not continuously aware of sexual desire. In other words, a lack of adequate sexual outlet may result in the accumulation in the blood of abnormal quantities of thyroid secretion and perhaps, sugar, adrenin, and other substances which constitute also an important part of the state of preparedness for non-sexual exertion, such as attack or flight, and this very likely is accompanied by corresponding changes in the sympathetic nervous system.

DISORDERS DUE TO ABSTINENCE

Whereas in youth, abstinence is more easily borne by woman than man, at full maturity woman’s sexual urge, as unconsciously manifested, if not, indeed, consciously--when not adequately gratified--may be quite as insistent as in man.

Nystrom states that abstinence has often as severe an effect upon woman as upon man, although some difference occurs in the manifestations, because of the difference in the physiological organization of the two sexes.

The consequences of prolonged self-denial, especially in women whose sexual desire has been thoroughly aroused by erotic experience, are much the same as in men. They show the same symptoms of functional disturbance, embracing a wide range of disorders.

The most common disturbances due to abstinence are chlorosis (a form of anemia), “female diseases,” nervousness in its many phases, cramps, hysterics with a tendency to alternate laughing and crying, hilarity and sadness, insomnia, hallucinations, mental disorders, etc.

Professor Erb, who has made important investigations in this domain, is under the impression that the health of many young women of good breeding and exemplary morals has suffered from abstinence. He considers that undoubtedly innumerable older, single women of refinement and education become sick or ailing from abstinence.

A number of married women who had been neglected by their husbands, and widows, have told him that they suffered severely from their enforced continence, and most of them became neurasthenic and hysterical. Nerve specialists generally, who so often come across these cases, have reported the same experience.

Numerous young, healthy, normal women related to Erb how, from the mid-twenties, they have become ill from semi-conscious sexual desires and ungratified craving for love, have experienced sexual fancies and hallucinations, melancholy and “female diseases,” etc.

Of course, there is a considerable number of women who are sexually anesthetic, or frigid, and appear to have no primary sexual feeling whatever. In true cases of this kind, they never experience the sexual urge, even after having borne children. Their genital organs are so insensible to feeling that they do not respond to artificial irritation, such as electricity, etc.

It is generally believed by sexologists and gynecologists, however, that a considerable proportion of cases of so-called frigidity is not organic or constitutional, but are due to long-established repression, fear of pregnancy and false, prudish ideas of sex--considering it “nasty.” They are the victims of miseducation. Another not inconsiderable number has been improperly initiated by a blundering husband. Their first sexual experiences were rude, brutal awakenings which so revolted them that it established a chronic feeling of antipathy, or at best apathy, toward the sexual function. Some women never overcome this attitude, implanted by an ignorant or inconsiderate husband. In others, under the influence of love and kindness, and with the later acquisition of insight into sexual problems, there is gradually established the normal sexual feeling.

Dr. Hegerisch has written: “Although I agree with Malthus in appreciation of womanly virtue, I must as a physician express as my opinion that the chastity (abstinence) of woman nevertheless is a crime against nature, and often is followed by serious functional disturbances and symptoms of diseases.”

Practically all the leading authorities in this field have supplemented their general comments by citing numerous cases, showing specifically the results of abstinence in normal, sexually mature women.

Occasionally, of course, we find brilliant, intellectual women living an active, productive life without apparently suffering from sexual abstinence.

Then there is another type of woman, full of energy, some of which is possibly transferred from the sexual goal, who interests herself in, or more literally throws herself into, various movements and organized activities, sometimes with remarkable constructive and consistent results, and at other times merely as a means of “expressing herself,” without capacity for co-operation or tolerance for the ideas of others who show a dissenting opinion.

NEURASTHENIA

Freud makes the astounding statement that in a normally constituted sex life no neurosis is possible.

This is based on a vast experience in the realm of nervous and mental disorders. It is not my purpose to defend this opinion _in toto_, but to offer it as the thoughtful observation of the world’s foremost medical psycho-neurologist.

If it has even a seventy-five per cent basis of fact to sustain it, it is still a remarkably striking recognition of the potency of sex in dominating our lives, even when we are not aware of the force that is tossing us hither and yon.

It must not be assumed that this statement of the influence of the sexual libido on the individual refers exclusively, or even in a major respect, to the present status of the person’s sex life. It includes the entire range of sexual history of the individual, meaning every sex impulse, thought, act and experience, either in relation to another or others, or purely autosexual acts and experiences.

If the individual sex history (from infancy) has been sound and healthy, if fate has interposed no deleterious experiences, and, of course, if heredity has been kind and generous, then there is the foundation for a healthy sexual constitution.

Assuming that this brings us up to the portal of adulthood, in the present case, _womanhood_--there follows the obligation to lead a sex life that is in harmony with the normal impulses and at the same time with the ideals.

If the ideals are irrational, or if difficulties intervene and prevent the living of a sane sex life, even then upon the good foundation of sexual health, there may develop neurasthenic flaws in the superstructure of sexual disharmony.

In his classification of the neurasthenic symptom-complex, Freud maintains that the cause of attacks of anxiety-neurosis is very frequently to be found in a number of injurious influences in the sphere of sexual life. In women, these anxiety-neuroses occur:

1. As virginal anxiety, or anxiety of adolescents. This authority has observed a number of unequivocal instances showing that a first encounter with the sexual problem, a rather sudden unveiling of what has hitherto been concealed, as, for instance, the sight of some sexual object or act, or something read or heard in conversation, may, in a girl at the time of puberty, give rise to an anxiety-neurosis, which is in a very typical manner combined with hysteria.

(This is an excellent argument for the proper enlightenment of young people regarding the nature of sex and what the continuance of the race implies. They have to find out sooner or later, and if the subject is treated by parents in a matter of fact manner, these vital facts of life are gradually and unobtrusively absorbed, without alarm, shock or stimulation.)

2. As anxiety of the newly married. Young wives who have been without sexual feeling in their first experience are not infrequently attacked by an anxiety-neurosis, which, however, disappears as soon as the sexual feeling becomes normal. Since, indeed, the majority of young women who lack sexual feeling in their first experience of sexual intercourse remain nevertheless quite healthy, it is evident that some other cause must co-operate in arousing the anxiety-neurosis.

3. An anxiety in married women whose husbands suffer from _ejaculatio praecox_ (premature ejaculation) or from great diminution of sexual potency, or

4. Whose husbands practice _coitus interruptus_, or _coitus reservatus_. Cases in these two classes are closely associated, since it is easy to ascertain from the analysis of a sufficiently large number of cases that the really important question is, whether during coitus the wife obtains or fails to obtain sexual satisfaction. In the latter event, the condition requisite to arouse the anxiety-neurosis is supplied.

5. As anxiety in the climacteric period, during the termination of the reproductive life, which frequently involves a flare-up of passion.

Various anomalies of the genital organs which give rise in the virgin to no trouble whatever, display their influence during maturity by unfavorably affecting the nervous system. Thus, in cases of malformation of the external organs of reproduction, imperforation of the vaginal canal, a rudimentary condition of the vagina, rigid hymen, or local disturbances in the vagina, it is only when sexual intercourse begins that neuroses or hystero-neurasthenic troubles ensue.

In a paper setting forth his views on the etiology of the neuroses, Freud states: “I was above all surprised in the frequency of coarse disturbances in the sexual life of patients. The more I was in quest of disturbances, during which I remembered that all men conceal the truth in things sexual, and the more skilful I became in continuing the examination despite the incipient negation, the more regularly such disease-forming moments were discovered in the sexual life, until it seemed to me that they were but little short of universal.”

It was Freud’s particular experience in this field, even comparatively early in life which led him to the conclusion that “in a normal sex life no neurosis is possible.”

Years after he originally made this statement, he was confirmed in its correctness, although he had passed a good way beyond his former point of view in his opinions concerning the relation of sexual traumas to health in general. This gave him a deeper insight into the problems of sex in their universal application.

For instance, by chance his former material furnished him with a great number of cases of infantile histories in which sexual seduction by grown-up persons or older children played the main role. He therefore over-emphasized the frequency of these occurrences (otherwise not to be doubted), the more so because he was then in no position to distinguish definitely the _deceptive memories_ of hysterical patients, whereas he subsequently learned to explain many a seduction fancy as a defense against the reminiscence of the patient’s own sexual activity (infantile masturbation).

“The emphasis laid on the ‘traumatic’ (wounding) element of the infantile sexual experience disappeared with this explanation, and it remained obvious that the infantile sexual activities (be they spontaneous or provoked), _dictated the course of the later sexual life after maturity_.”

Of course, there is an almost immeasurably wide range of variations in the psychic and nervous constitution of individuals--ranging for our present purpose--from the ultra-sensitive to those of extremely low sensibility. Those persons of the former type, being most _impressionable_, are more readily influenced by psychic traumas or soul wounds at any time of life.

The opposite types (the “tough-minded” of William James’ classification), are less susceptible to psychic wounds and hurts, and therefore do not so readily become victims of the various neuroses.

No group of human beings, however, is exempt from the possibility of neurasthenic troubles, if conditions are favorable for their development.

And no ground is so propitious a breeding place for these disturbances as the fertile soil of sex under the highly artificial development of modern civilization, and the confusing ideas that prevail upon the vital question of sex ethics.

Transcriber’s Note:

Text that was in italics is enclosed by underscores (_italics_).

Text that was in bold is enclosed by equals sins (=bold=).

- Inconsistencies in hyphenation have been standardized.

- Minor punctuation errors have been changed without notice.

- The “table for calculating the date of confinement” originally spanned across pp. 26-27 horizontally. This could not be recreated in the .txt file, so it was split between two pages and moved to the end of the paragraph.

- Spelling was retained as in the original except for the following changes:

Page 4: “presence of abnormal erotism” to “presence of abnormal eroticism” Page 5: “over the calibre or” to “over the calibre of” Page 8: “lost in the magnificant” to “lost in the magnificent” Page 10: “Deutschlands litt und rel. Verhaltn in Reformations zeit” to “Deutschlands lit. u. relig. Verhältnisse im Reformationszeitalter” Page 18: “the first menstruation occuring” to “the first menstruation occurring” Page 25: “days, one way of the other” to “days, one way or the other” Page 25: “demands of the embyro” to “demands of the embryo” Page 27: “22 22 24” under “Jan.” to “22 23 24” Page 30: “Indian book of _Susruta_” to “Indian book of _Suśruta_” Page 31: “and in the rigid” to “and in the frigid” Page 32: “well-to-do, whose modes” to “well-to-do, whose mode” Page 37: “the head, epileptic paroxyms” to “the head, epileptic paroxysms” Page 39: “of the household, Clauston” to “of the household, Clouston” Page 42: “and of the metabulism” to “and of the metabolism” Page 42: “after effects of childb-irth” to “after effects of childbirth” Page 45: “has been, the moral” to “has been, the more” Page 47: “researches of Andral and Gavaret” to “researches of Andral and Gavarret” Page 49: “at late as 57” to “as late as 57” Page 50: “this condition. Edgar Selwin’s” to “this condition. Edgar Selwyn’s” Page 51: “concurred. Her husband has” to “concurred. Her husband had” Page 51: “brightly as in the heydey” to “brightly as in the heyday” Page 56: “proceed misalliances, elopments” to “proceed misalliances, elopements” Page 62: “suffer from _ejaculatio precox_” to “suffer from _ejaculatio praecox_”