IV
The following valuable account given by an eminent physician brings out well the factors and principles of neurosis expounded in this volume:
“You ask me to write about my fears. I give you a brief account.
“As a child, as far as memory carries, I had a fear of ghosts, of giants, of monsters, and of all kinds of mysterious and diabolical agencies and witchcraft of which I had heard a number of tales and stories in my early childhood. I was afraid of thieves, of robbers, and of all forms of evil agencies. The fears were stronger at daytime, but more so at night. Strange noises, unexpected voices and sounds made a cold shiver run down my back.
“I was afraid to remain alone in a closed room, or in the dark, or in a strange place. It seemed to me as if I was left and abandoned by everybody, and that something awful was going to happen to me. When I happened to be left alone under such conditions I was often in a state of helplessness, paralyzing terror. Such states of fear sweep occasionally over me even at present. I find, however, that they are far more complicated with associations of a more developed personal life. I know that in some form or other the fears are present, but are inhibited by counteracting impulses and associations. I still feel a cold shiver running down my back, when I happen to go into a dark cellar in the dead of night, or happen to remain alone in a dark, empty house. Such fears date back to my fourth year, and possibly to an earlier time of my childhood.
“As a matter of contrast-inhibitions of such fears I may either brace myself and put myself in a state of courage and exaltation, or when this does not succeed, I let my mind dwell on other fears and troubles. I find that the last method is often far more effective in the inhibition of fear states which at the moment are present with me. All I need is to press the button, so to say, and awaken some other fears, the present fears diminish in intensity, and fade away for the time being. I actually favor, and welcome, and even look for disagreeable and painful experiences so as to overcome some of my present fears. The new fears are then treated in the same way.
“As I became older, about the age of eight, I began to fear disease and death. This may be due to the infectious diseases that attacked many members of our family, about this time. In fact, I have been present at the death bed of some of them, and the impression was one of terror, mysterious horror. I was afraid I might get diseases from which I might die. After my witnessing the last agonizing moment of death, my elders thought of removing me to a safer place; their fears and precautions still more impressed the fear of danger of disease and death. I may say that I really never freed myself from the fear of disease and death. The latter fear is always present with me in a vague form, always ready to crop up at any favorable opportunity. This fear, in so far as it is extending its tentacles in various directions, is often the bane of my life. Even at my best there is always a kind of vague fear of possible danger, lurking in various objects which may be infected or possibly poisonous.
“This fear has been spreading and has become quite extensive, involving my family, my children, my friends, my acquaintances, and my patients. Usually I ignore these fears, or get control over them by an effort of will. When, however, I happen to be fatigued, or worried over small things in the course of my work, or happen to be in low spirits by petty reversals of life, these fears may become aroused. Under such conditions I may become afraid, for instance, of drinking milk, because it may be tuberculous.
“This fear may spread and involve fear for my children and my patients; or again I may be afraid of eating oysters and other shell fish, because they may be infected with typhoid fever germs. I may refuse to eat mushrooms, because they may be poisonous. The other day I was actually taken sick with nausea and with disposition to vomiting after eating of otherwise good mushrooms. The fear seized on me that they all might be poisonous ‘toadstools.’ Such fears may extend to ever new reactions and to ever new associations, and are possibly the worst feature of the trouble.
“I have a fear of coming in contact with strangers, lest I get infected by them, giving me tuberculosis, influenza, scarlet fever, and so on. This mysophobia involves my children and my friends, inasmuch that I am afraid that strangers may communicate some contagious diseases. A similar fear I have in regard to animals, that they may possibly be infected with rabies, or with glanders, or with some other deadly, pathogenic micro-organism. I am afraid of mosquito bites, lest they give me malaria, or yellow fever. The fears, in the course of their extension, may become ever more intense and more insidious than the original states.
“As a child I had some bad experiences with dogs; I was attacked by dogs and badly bitten. Although this fear is no longer so intense as it was in my childhood, still I know it is present. My heart sometimes comes to a sudden standstill, when I happen to come on a strange dog. When the strange dog growls and barks, all my courage is lost, and I beat an inglorious retreat. It is only in the presence of other people that I can rise to the effort of walking along and apparently paying no attention to the dog. This is because I fear the opinion of others more even than I fear the growls of dogs. My social and moral fears are far greater than my purely physical fears.
“When I became older, about the age of eighteen to twenty, a new form of fear appeared, like a new sprout added to the main trunk, or possibly growing out of the main fear of disease and death, that is the fear of some vague, impending evil. The fear of some terrible accident to myself and more so to my family, or to any of the people of whom I happen to take care, is constantly present in the margin of my consciousness, or as you would put it, in my subconsciousness. Sometimes the fears leave me for a while, sometimes they are very mild, and sometimes again they flare up with an intensity that is truly alarming and uncontrollable. The energy with which those fears become insistent in consciousness, and the motor excitement to which they give rise are really extraordinary. The fear comes like a sudden flood. The energy with which those fears rise into consciousness is often overwhelming.
“Fear gets possession of me under circumstances in which my suspicions are, for some reason or other, aroused to activity, all the more so if the suspicions of possible impending evil are awakened suddenly. In other words, the fears arise with stimulations of associations of threatening danger to myself and to my family. I am afraid that something may happen to my children; I fear that they may fall sick suddenly; I fear that some terrible accident may happen to them; I fear that they may fall down from some place, and be maimed or be killed. I fear that my children and other members of my family may be poisoned by people who are not well disposed towards them. I am afraid that they may pick up some food that was infected, or that they may be infected in school by children who happen to suffer from some infectious maladies. I am afraid that my children may be overrun by some vehicles, by automobiles, or that they may be killed in an accident, that they may be killed by a street car, or even that the house may collapse. This latter event has actually taken place when I was a child. In fact, many, if not all of those fears have actually their origin in my experience.
“As I write you these lines, memories of such events come crowding upon my mind. Are they the noxious seeds that have been planted on the soil of fear? I am afraid sometimes that even the food I and my children as well as other people eat may give rise to toxic products and thus produce disease. Often in the dead of night, I may come to see my children in order to convince myself that they have no fever, and that they are not threatened by any terrible disease. The very words ‘sickness,’ ‘disease,’ ‘not feeling well,’ ‘death,’ arouse my feeling and sometimes throw me into a panic. I am afraid to use such words in connection with any of my children. I am afraid that the evil mentioned may actually happen.
“When a child I learned about testing and omens. If a test comes through in a certain way, it is an omen of good luck, otherwise it means bad luck. This superstitious testing and omens have remained with me, and that in spite of my liberal training and knowledge of the absurdity of such superstitions. I may test by opening the Bible at any page, or I may test by anything that might occur, according to my guesses. All of these fears I know have no meaning for me, they are senseless and absurd, but they are so rooted in my early childhood, they have been so often repeated, they have accumulated round them so much emotion of fear that they come to my mind with a force which is truly irresistible. Many of the fears have multiplied to such an extent that I cannot touch anything without rousing some slumbering fear.
“To continue with my fears; I am often afraid that the doors are not well locked, and I must try them over and over again; I go away and come back again, and try and try again, and once more. It is tiresome, but as the fear is constantly with me, and is born again and again, I cannot be satisfied, and must repeat the whole process over and over until I get tired, and give up the whole affair in sheer despair. In such cases a contrary and different fear comes in handy. One devil banishes another. I am afraid that the gas jet is left open, and I must try it over and over, and test the jets with matches. This process of testing may go on endlessly. The fear remains and the process must begin again until it is stopped by sheer effort of will as something meaningless, automatic, and absurd. The performance must be stopped and substituted by something else.
“Colds, or attacks of influenza of the mildest character have given rise to fears of pneumonia. Pain in the abdomen, or a little intestinal distress has awakened fears of possible appendicitis, or of tumor, or intestinal obstruction. The least suspicion of blood in the stools awakens the fear of possible cancer. Vomiting or even nausea brings fears of cancer of the stomach. There is no disease from which I have not suffered.
“The same fears have naturally been extended to my children, and to all those who are under my care. The least symptom is sufficient to arouse in me fears of possible terror and horrible consequences.
“I am afraid that suits may be brought against me, or that some of my own people, patients and even employees whom I discharged, may bring legal action against me in court, or blackmail me. When I leave home, I am afraid that something terrible has happened. The fear of impending evil is always with me. The fears have invaded every part of my being. It seems as if there is no resistance in my mind to those terrible fear states.
“Perhaps it may interest you to know that, although I am quite liberal, and even regarded as irreligious, still I am afraid to express any word against God, Christ, saints, martyrs of any church and denomination, be they Christian, Mohammedan, Buddhist, or pagan. I am afraid lest they may hear me and do me harm; I fear to say a word even against the devil or Satan. I am obsessed by fears. Fears pursue me as long as I am awake, and do not leave me alone in my sleep and dreams. Fears are the curse of my life, and yet I have control of them, none but you has any suspicion of them. I go about my work in a seemingly cheerful and happy way. The fears, however, are the bane of my life, and torture me by their continued presence.
“I tried to find whether or not those fears had any relation to my wishes or to my sexual experiences. I must say that I find they bear no relation whatever to wish or sex. My mental states grow on fear, take their origin in fear, and feed on fear. Fear is the seed and the soil of all those infinite individual phobias that keep on torturing me unless opposed by a supreme effort of my will.
“Truly the Biblical curse well applies to my life.
“‘The Lord will make thy plagues wonderful, and the plagues of thy seed, even great plagues, and of long continuance, and sore sickness, and of long continuance. Moreover, he will bring upon thee all the diseases of Egypt, which thou wast afraid of, and they shall cleave unto thee. And every sickness and every plague, which is not written in the book of this law, them will the law bring upon thee, until thou be destroyed. Thou shalt find no ease, neither shall the sole of thy foot have rest; but the Lord shall give thee a trembling heart, and failing of eyes, and sorrow of mind. And thy life shall hang in doubt before thee, and thou shalt fear day and night and shall have none assurance of thy life. In the morning thou shalt say, Would God it were even! and at even thou shalt say, Would God it were morning! for the fear of thine heart wherewith thou shalt fear....’
“I laid bare my soul before you. I permit you to do with this document whatever you may think fit.”