Neurotics sleep very little, and the more severe their case is, the less they sleep. Return of normal sleep generally coincides with a cure and has been by many credited with bringing about the cure. Hence the many “rest cures” suggested for the mentally disturbed patient.
The truth of the matter is that the absolutely insane person who lives all his absurd dreams in his waking life no longer needs the unconsciousness which the normal individual requires in order to escape from reality. The insane man who knows he is a combination of a Don Juan, a millionaire and a powerful ruler, need not dream of becoming all those characters. He has attained his goal and it is only the continued conflicts with reality which may reach his consciousness in his lucid moments which necessitate the unconsciousness of a few minutes or hours of sleep in which reality no longer intrudes into his absurd world.
Since insomniacs can rest without sleep and insomnia does not lead to insanity, there is no reason why narcotics should be administered. There is a very good reason on the other hand why they should never be administered except in case some harrowing pain has to be relieved and shock avoided.
For one thing, their effect is problematic and depends also to a great extent from the subject’s mental condition.
Kraepelin noticed that large doses of alcohol failed to produce the usual muscular lameness in subjects who were agitated. Bleuler makes the interesting suggestion that our central nervous system only “accepts” narcotics when they are “wanted” and keeps drugs, carried about in the blood stream, from being assimilated by the organism when the organism is not “willing” to submit to their influence.
But the most cogent reason why narcotics should never be resorted to in “nervous” sleeplessness is that they do not relax the organism but paralyse it by killing it partly. If they only dulled consciousness and freed the unconscious, they would accomplish some good but we do not know of any agent besides sleep, which accomplishes that successfully.
Narcotics partly kill both consciousness and unconscious. While their effect lasts, the very phenomenon which makes the neurotic a neurotic is exaggerated. In the neurotic’s waking state, unconscious complexes manage to free themselves, somewhat indirectly. In the stupor of drugged sleep, the repression is complete. Hence the horrible feeling which is often experienced when awakening from drug-induced sleep. Normal sleep is brother to life, but drug induced sleep is indeed akin to death.
Neither can hypnotic suggestion be recommended as a cure for sleeplessness, except of course, in emergencies.
About the end of the nineteenth century, a Swedish physician, Wetterstrand, inaugurated a method of treatment which was founded on a just estimate of the value of sleep, although Wetterstrand himself could not at the time have understood the psychology of it.
He had in Upsala a “house of sleep” furnished with innumerable divans and couches on which his patients were allowed to rest for hours in hypnotic sleep.