X. OCCUPATION NEUROSIS
Be not ashamed, to be helped; for it is thy business to do thy duty like a soldier in the assault on a town. How, then, if being lame thou canst not mount up on the battlement alone, but with the help of another it is possible?
Marcus Aurelius.
The insistent and over-conscientious habit of mind plays so large a part in the so-called occupation neuroses that a brief discussion of their nature may here be in place.
The best-known form of this distressing malady is "writer's cramp." Upon this subject the proverbially dangerous little knowledge has been already acquired; a fuller knowledge may give comfort rather than alarm, and may even lead to the avoidance of this and allied nervous disorders.
The term "writer's cramp" has unduly emphasized a feature, namely, the cramp, which is neither the most common nor the most troublesome among the symptoms resulting from over-use of a part. In occupation neuroses, other than those produced by the use of the pen, pain, weakness, and numbness are at least equally prominent, and even in writer's cramp the "neuralgic" form is common.
The fact is generally realized that this type of disorder is particularly frequent among persons of nervous temperament. The reason is twofold, first, the resistance of such individuals is less than the average, second, the insistent habit of mind leads them to overdo. It is against the latter factor that our efforts may to advantage be directed.
I have in mind the case of a lady who complained of severe pain in the right arm with no apparent physical cause. The pain, at first appearing only when the arm was placed in a certain position, finally became almost constant. She denied excessive use of the arm, but her husband stated that she plied the needle to such an extent that it caused the family distress. This she indignantly denied, and fortified her position by the statement that she only took short stitches! Further inquiry elicited the acknowledgment that she did so because she could no longer take long ones. This is a fair example of an occupation neurosis.
Some time ago, after long continued and over-conscientious effort to satisfy the requirements of an athletic instructor, I acquired what is known as a "golf arm." Efforts at its relief were unavailing. A vigorous course of massage only increased the pain. I finally asked a friend what they did in England when a golf player suffered this annoyance. He replied that no golf player ever did so; when it occurred among others the arm was placed in wool for three months, at the end of which time a single movement of swinging the club was made; if this movement caused pain the treatment was renewed for another three months. I did not suppose he intended the advice to be taken literally, but followed it, except as regarded the wool, and I verily believe that I should otherwise have been experimenting with the treatment of golf arm to-day.