The room in which the patient was put into the subconscious state was quite dark, and accidentally the remark was dropped that the room was too dark to see anything; immediately the attack reappeared in all its violence. It was found later that it was sufficient to mention the words, “dark, damp, and cold” to bring on an attack even in the fully waking state. We could thus reproduce the attacks at will,—those magic words had the power to release the pent-up subconscious forces and throw the patient into convulsions of shakings and shiverings, with chattering of the teeth and intense fear.
Thus the apparent epileptiform seizures, the insistent psychomotor states of seemingly unaccountable origin, were traced to subconscious fear obsessions.
The following case is of similar nature. The study clearly shows the subconscious nature of such psycholeptic attacks:[10]
Mr. M., aged twenty-one years, was born in Russia, and came to this country four years previously. His family history, as far as can be ascertained, is good. There is no nervous trouble of any sort in the immediate or remote members of his family.
The patient himself has always enjoyed good health. He is a young man of good habits.
He was referred to me for epileptiform attacks and anaesthesia of the right half of his body. The attack is preceded by an aura consisting of headache and a general feeling of malaise. The aura lasts a few days and terminates in the attack which sets in about midnight, when the patient is fully awake. The attack consists of a series of spasms, rhythmic in character, and lasting about one or two minutes. After an interval of not more than thirty seconds the spasms set in again.
This condition continues uninterruptedly for a period of five or six days (a sort of status epilepticus), persisting during the time the patient is awake, and ceasing only during the short intervals, or rather moments, of sleep. Throughout the whole period of the attacks the patient is troubled with insomnia. He sleeps restlessly for only ten or fifteen minutes at a time. On one occasion he was observed to be in a state of delirium as found in post-epileptic insanity and the so-called Dämmerzustände of epilepsy. This delirium was observed but once in the course of five years.
The regular attack is not accompanied by any delirious states or Dämmerzustände. On the contrary, during the whole course of the attack the patient’s mind remains perfectly clear.