But time will not permit me to follow this tempting lead, which has been introduced for another purpose—the proposal of a remedy.
Worries either are or are not groundless. Of those that have a basis, many are exaggerated. It has occurred to me to utilize as an antidote an appeal to the same great law that originally excited the instinctive involuntary reaction known as fear— the law of self-preservation.
I have found that if an intelligent patient who is suffering from fear can be made to see so plainly as to become firmly convinced that his brain, his various organs, indeed his whole being, could be physically damaged by fear, that this same instinct of self-preservation will, to the extent of his conviction, banish fear. It is hurling a threatened active militant danger, whose injurious influences are both certain and known, against an uncertain, perhaps a fancied, one. In other words, fear itself is an injury which when recognized is instinctively avoided. In a similar manner anger may be softened or banished by an appeal to the stronger self-preserving instinct aroused by the fear of physical damage, such as the physical injury of brain-cells. This playing of one primitive instinct against another is comparable to the effect produced upon two men who are quarreling when a more powerful enemy of both comes threateningly on the scene.
The acute fear of a surgical operation may be banished by the use of certain drugs that depress the associational power of the brain and so minimize the effect of the preparations that usually inspire fear. If, in addition, the entire field of operation is blocked by local anesthesia so that the associational centers are not awakened, the patient will pass through the operation unscathed.
The phylogenetic origin of fear is injury, hence injury and fear cause the same phenomena. In their quality and in their phenomena psychic shock and traumatic shock are the same. The perception of danger by the special senses in the sound of the opening gun of a battle, or in the sight of a venomous snake, is phylogenetically the same and causes the same effects upon the entire body as an operation under anesthesia or a physical combat in that each drives the motor mechanism. The use of local anesthetics in the operative field prevents nerve-currents from the seat of injury from reaching the brain and there integrating the entire body for a self-defensive struggle. The result, even though a part of the brain is asleep and the muscles paralyzed, is the same as that produced by the interception of the terrifying sound of the gun, or of the sight of the dangerous reptile, since the stimulation of the motor mechanism is prevented.
By both the positive and the negative evidence we are forced to believe that the emotions are primitive instinctive reactions which represent ancestral acts; and that they therefore utilize the complicated motor mechanism which has been developed by the forces of evolution as that best adapted to fit the individual for his struggle with his environment or for procreation.
The mechanism by which the motor acts are performed and the mechanism by which the emotions are expressed are one and the same. These acts in their infinite complexity are suggested by association— phylogenetic association. When our progenitors came in contact with any exciting element in their environment, action ensued then and there. There was much action—little restraint or emotion. Civilized man is really in auto-captivity. He is subjected to innumerable stimulations, but custom and convention frequently prevent physical action. When these stimulations are sufficiently strong but no action ensues, the reaction constitutes an emotion. A phylogenetic fight is anger; a phylogenetic flight is fear; a phylogenetic copulation is sexual love, and so one finds in this conception an underlying principle which may be the key to an understanding of the emotions and of certain diseases.
PAIN, LAUGHTER, AND CRYING[*]
[*] Address delivered before the John Ashhurst, Jr.. Surgical Society of the University of Pennsylvania, May 3, 1912.