Her verbal productions dealt with a rather limited range of topics which can be briefly summarized. As in the other cases, the reader will notice that the bulk of these ideas are of a kind not usually prominent in the typical stupor cases. Many of her thoughts seemed centered around her husband. She always knew him when he visited her, but in her thoughts there was a constant change as to his personality. She persistently confused him with the physicians, with her father, and with God, and one remark is typical, "I thought he was God, priest, doctor, lawyer—well, I wanted to go to Heaven; I thought he would still be my husband; I always hoped that I would be home in Heaven." Not unnaturally with this confusion there were doubts about her marriage. People said her marriage was wrong and her husband bad. Frequently she thought he was dead, or voices informed her that she was not married to him, or that he was the devil in Hell. In this connection she also said that people called her a
whore, or it seemed as if she were accused of not being married.
As prominently as appeared the ideas of the invalidity or impossibility of her marriage, to the same extent did her father assume an important rôle for her. As a rule he appeared in religious guise as God, but often he was the doctor—"I knew my father at home and my father in Heaven; which God do you mean? did you say God or father?" At times she spoke of being in Heaven and that God seemed to be God, doctor or priest. In this connection there were ideas of being under the power of some one, God, devil or father.
As is usually the case where strong interest is expressed in the father, ideas of the mother being dead occurred, although in the frankest form she reported them as dreams; for instance, one night she woke up screaming, said that she had dreamed that her mother was dead and her sister dying. That, in the psychoanalytic sense, this represented a removal of a rival, making union with her father easy, appeared in the statement that her father was dead but that she had dreamed he had come to life again for some one else. When asked what she meant, the question had to be repeated several times, then she said "My mother died, my father and mother had a quarrel." There is more than a suggestion here of a difference in the significance of death, in so far as it concerned the two parents. The mother dies and remains dead, that is, she is gotten rid of. The father dies but takes on a spiritual existence and comes to life again, a frequent method in psychoses for legitimizing the idea of union with the parent by elimination of the grossly physical.
There were strikingly few allusions to the plainly sexual. She spoke of being married to the doctor, and even went so far as to say that they belonged together in bed. On another occasion she called him "darling." Once she reported that it was said that she was going to have babies and babies and babies. These references were, however, quite isolated, so that the erotic formed a very small part of her productions.
Delusions of death, we have seen, are the most constant content of true stupors. In this case they were present but distinctly in the background. She spoke quite frequently of being in Heaven. She also talked of being crucified. Once she said "I
died but I came back again." This last utterance was rather significant in that frankly accepted ideas of death were unusual; for instance, she would say sometimes, "I think I am in Heaven, again not. It confuses me, but I know I am in Heaven."
In general, then, her ideas were, on the whole, not at all typical of stupor but much more like those met with in other manic-depressive conditions. Correlated with this was an unusual mood picture. Quietness and apparent apathy of the patient were interrupted by little bursts of emotion, and throughout the psychosis there was a coloring of perplexity. Not only was this last objectively noticeable, but she spoke very frequently of it and always in connection with the inconsistency of the ideas in her mind which puzzled her. For instance, in speaking to the doctor she said "I think of you as Bill (her husband's name) sometimes—I get confused thinking of Bill as God, doctor, lawyer, priest." Again, referring to her husband, she made these curious statements: "They seemed to speak of him as being in the wrong—the right—it seems that the right devil is the wrong one for me—they say he is not the right one for me; they say he went wrong from the time we were married." Again, she said that she did not know who her father was, and went on: "It puzzles me, this father business, I knew my father at home and my father in Heaven." Again, "Which God do you mean? Did you say God or father?" A hint as to how this subjective confusion made the environment seem uncertain comes from the statement, "You looked like the devil and yet you were God."
Distress and anxiety appeared not infrequently and always appropriately. The distress was usually occasioned by an idea of injury to others, as when she cried over the fancied accusation of drowning her husband and mother; or in connection with accusations of herself, such as when she reported "They called me a whore." As has been stated, there was never any frank elation, but an element of pleasurable expansive emotion was frequently present in connection with her religious utterances. This came particularly when she spoke of union with her father as God. She seemed to swell with ecstatic emotion. It was especially well marked once when she threw herself on the floor and when asked what she was trying to do replied, "I want to do what God wants me to do, drop dead or anything at all."
Perhaps the most unusual affective reaction was a blocking which occurred when certain topics appeared. This is a phenomenon quite unusual for stupor, where speech seems to stimulate and arouse the patient as a rule. One got the impression that ideas tended to come into this patient's mind which were painful enough to disturb her capacity for connected thought. A good example of this reaction was when she was speaking of her father having died and coming to life again. On being asked what she meant, she became quite blocked and the question had to be repeated several times, when finally the apparently unrelated statements appeared: "I dreamed my mother died—they had a quarrel." Who had a quarrel? she was asked, and replied "My mother and father." Apparently her thinking about her father coming to life for some one not her mother stimulated deeply unconscious ideas concerning the separation of her mother and father, and her taking the mother's place, and these ideas were sufficiently revolutionary to upset her capacity of speech for the time being.