Not for a moment could she fix her attention on anything but herself, eating, drinking, sleeping, and feeling. Nothing interested her but herself. She avoided work, however short and easy. She could, however, talk of herself, of her achievements, of her moral, intellectual qualities by the hour and by the day. Even games did not interest her, nothing but herself, and self. This was so evident that one of the attendants noticed this characteristic psychopathic trait, and described her as “egomaniac.” She was the “Great I am.” “The Ego-person is the reflection of the Ego-god.” ...
Whenever one spoke of a great man, she was sure to have her opinion of him. She was at any rate superior to him. She could give her opinion on any conceivable subject in literature, economics, and politics.
She was as cunning as a savage, and as treacherous as a wild brute, and yet she was to all appearances a veritable saint, full of suffering for the sins of humanity, and for the faults of her husband who was “boyish and foolish, whom she had to manage,” and whom she did control and handle with an iron rod.
There is no doubt, however, that she herself was driven by her intense, uncontrollable impulse of self-preservation and by the instinct of fear. What especially terrorized her was the slow but sure extension of the fear instinct to more and more objects and acts. The fear instinct kept on creeping on her, slowly choking the life sources of her being. To call the patient “egocentric” is a mild descriptive term,—“tigress,” “satan,” “fiend,” would be more appropriate appellations. In her terror of self-preservation she tormented herself and others. She was a firebrand from hell, a firebrand fanned by the furies of self and fear.
F. W. Age 47; female, married; has no children. The patient claims to have been an invalid from childhood; that she was of extremely delicate health; she always had to take care of her health, and had to go through all kinds of diseases, especially gastro-intestinal troubles. At the age of eighteen she got married and then her family felicity began. She began to complain of all kinds of infirmities. The gynecologist humored her with operations and treatments. The fear disease became strengthened, and finally she cultivated a typical pathophobia; she was in terror of some fearful malady that might possibly take possession of her.
The patient always wanted to have someone near her. This fear of remaining alone dated from childhood, when at the least discomfort, she asked and screamed in terror for help. A companion, or nurse had to be with her day and night, so as to protect her from any impending evil.
Occasionally, to relieve her feelings, in the middle of a conversation, whether for the sake of impressing her family, her husband or her physicians with the gravity of her disease, or as a vent for the rising instinct of fear, she emitted a scream, wild and weird, reminding one of the howling of a timber wolf, or of a wild whoop of an Indian. This was a habit she kept up from childhood. It was a reaction of her fears, and a protection, it was a call for help which was sure to attract attention. The family could not refuse help at hearing such an unearthly call. Later on, it was consciously and unconsciously utilized by the patient as a rod to rule the family and especially her husband, when the latter happened to become refractory. The fear reaction was thus used as a protection and as a weapon of defense.
Things had to run according to her pleasure, or else she was put in a state of nervous excitement and fear with its awful yell of which the family and the husband were in perfect terror; they yielded unconditionally. The patient literally subjugated her husband by her spells of fear, especially by the fearful acoustic performance, the aura, the harbinger of a psychopathic attack.
The patient was always discontented and grumpy. Nothing could satisfy her, nothing was good enough for her. Everybody was criticized. No matter how one tried to please her, she always found fault with the person. In fact, the fault-finding was in proportion to the eagerness one tried to serve and oblige her. The nurses are not good, the servants intolerable, and people in general are bad, mean, stupid, and vulgar. She claims she comes from an “old New England family, from good stock.” Her grandfather was a fisherman, and her father a petty tradesman. The patient makes pretensions to education, poetry, art, and drawing. In reality, she is quite dull and ignorant.
G. A. Female, age 63; the patient was obsessed with pathophobia for over thirty-five years. She has been to a number of physicians, and to many sanitariums, looking for health everywhere, not finding it anywhere. The fears date to her early childhood. She was regarded as a delicate child, the fear of disease was strongly impressed on her. She went through a number of children’s diseases. Although she had several sisters and brothers, the child’s supposed delicate constitution was the fear and worry of the parents. This fear was communicated to the child, who for the rest of her life became a psychopathic patient with the characteristic developed impulse of self-preservation and intense fear of disease. She could not think of anybody but herself, everything had to be arranged for her,—for her food, for her sleep, and for her rest. She kept on complaining at the slightest change either in herself, in others, about the arrangements of the house, or about the weather. Everything had to be arranged just as she demanded, otherwise she was sick, or was going to become dangerously ill.