We must agree with the French psychologist, Ribot, when he comes to the conclusion that “every lowering of vitality, whether permanent or temporary, predisposes to fear; the physiological conditions which engender or accompany it, are all ready; in a weakened organism fear is always in a nascent condition.”
The fear instinct becomes morbid when the individual has to draw on his reserve energy, and finds he is unable to do it. The cure consists in the release of the reserve energy which has become inaccessible. This can be done by various methods, but the best is the method of induction of the hypnoidal state under the control of a competent psychopathologist. The whole process consists in the restitution of the levels of dynamic energy and the building up of the patient’s active personality.
From our point of view, fear is not necessarily due to pain previously experienced, it may be purely instinctive. The fear instinct may be aroused directly, such for instance is the fear of young children who have never before experienced a fall. In fact we claim that the fear instinct and the restlessness which expresses it antedate and precede pain. The fear of pain is but one of the forms under which the fear instinct is manifested. The fear instinct appears long before pain and pleasure come into existence. This holds true not only of the lower animal life, but also of the vague fear found in many a case of neurasthenia and functional neurosis and psychosis. Ribot also calls attention to pantophobia. “This is a state in which the patient fears everything, where anxiety instead of being riveted on one object, floats as a dream, and only becomes fixed for an instant at a time, passing from one object to another, as circumstances may determine.”
It is probably best to classify fears as antecedent and subsequent to experience, or fears as undifferentiated and differentiated.
When the dynamic energy is used up in the course of life adaptations, and reserve energy is drawn upon, there may be danger that the energy may be used up until the static energy is reached, and neuropathic conditions are manifested. These conditions are preceded by psychopathic disturbances. Associative life becomes disturbed, and emotional reactions become morbid. There is a degeneration or reversion to earlier and lower forms of mental activity, and to lower instinctive life. The primitive instincts, the impulse of self-preservation and the fear instinct, come to the foreground, giving rise to the various forms of psychopathic affections.
This process of degeneration and simplification is characteristic of all forms of psychopathic conditions, though it may be more prominent in some cases than in others. The type of mental life becomes lowered and there is a reversion, a sort of atavism, to simpler and more childish experiences, memories, reactions of earlier and less complex forms of mental life. I have laid special stress on this feature of psychopathic reactions in all my works on the subject. What I emphasize in my present work is the fact that psychopathic reactions are dominated by self and fear, which are laid bare by the process of degeneration.
The patient in psychopathic states is tortured by his fears, he is obsessed by wishes which are entirely due to his fear and deranged impulse of self-preservation.
As the static energy is reached, and with lack of functional energy of the dynamic character, the energy habitually used in the ordinary relations of life, the patient experiences a monotony, a void in his life activity. He has a feeling of distress, as if something is haunting him, and possibly something terrible is going to happen to him or his family. He may have a feeling of some depression, and may suffer from a constant unquenchable craving for new stimulations, run after new impressions and excitements which pale in a short time on his fagged mind. He is restless, demanding new amusements and distractions. He is distracted with fear, conscious and more often subconscious,—which he is unable to dispel or shake off. He seems to stand over a fearful precipice, and he is often ready to do anything to avoid this terrible gap in his life. Life is empty, devoid of all interest; he talks of ennui and even of suicide; he is of a pessimistic, gloomy disposition, his state of mind approaching a state of melancholia. He asks for new sensations, new pleasures, new enjoyments which soon tire him. He is in the condition of a leaking barrel which never can be filled.
Psychopathic individuals are in a state of the wicked “who are like the ocean which never rests.” This misery of ever forming wishes and attempting to assuage the inner suffering, this craving for new pleasures and excitements, in order to still uneasiness, distress, and the pangs of the fear instinct with its gnawing, agonizing anxieties, brings the patient to a state in which he is ready to drink and use narcotics. The patient seeks ways to relieve his misery. The patient has used up all his available dynamic energy, and being unable to reach the stores of reserve energy looks for a key or stimulant to release his locked up reserve energies. The patient is unable to respond to the stimuli of life, so he attempts then the use of his static energy. This can only result in producing psychopathic and neuropathic symptoms.
The patient needs to be lifted out of the misery of monotony and ennui of life, he needs to be raised from his low level of vitality, to be saved from the listlessness into which he has fallen. The low level of energy makes him feel like a physical, nervous, and mental bankrupt. This bankruptcy is unbearable to him. He is in a state of distraction, distracted with the agony of fear. Something must be done to free himself from the depression of low spirits and from the low level of energy which keeps him in a state devoid of all interest in life, accompanied by physical, mental and moral fatigue. He is like a prisoner doomed to a life long term.