Handicaps of Childhood

by H. Addington Bruce

Please, however, understand clearly that she was really a sick girl when her mother took her to my neurological friend. It was not simply a question of dealing with a "naughty" girl. The depression, the tears, the attacks of irritability were not deliberately put on to excite sympathy and to play on the mother's affections. This assuredly was their basic purpose, but they were the product of subconscious, not conscious, mental action. They were the resultant of an emotional stress, the responsibility for which rested not with the girl herself but with her mother's unwise treatment of her. If she had become neurotic, it was because her mother had made her so. What she needed, and all she needed, was psychic re-education, and this she obtained through the neurologist's common-sense method of cure.

The fact that such cases are indicative, not of mere naughtiness, but of the action of an inner force operating independently of the victim's conscious volition, will become more apparent when I add that sometimes the symptoms causing medical aid to be invoked are physical instead of mental. In one typical case of this sort a neurologist was summoned to examine a small boy who had been attacked by a peculiar weakness of the legs. To all appearance, he was in perfect bodily health, but when he attempted to walk his legs gave way, and he would fall, unless quickly supported. The most careful testing failed to reveal any organic cause for this condition, and a diagnosis of juvenile hysteria was made. It was learned that the boy's trouble began soon after he had met in the street a badly crippled, semi-paralysed man, whose appearance had evidently made a deep impression on his mind, as he spoke of it, when he got home, in terms partly of astonishment and partly of fear. There could be no doubt that the sight of this man had acted as a "suggestion" to cause the development of a somewhat similar condition in the boy himself. The question remained, why should the mere seeing of a crippled man have sufficient suggestive force to bring on an hysterical crippling? For undoubtedly the boy must have had not a few equally distressing experiences long before this one.

On investigation it turned out that at the time he saw the cripple he was under considerable mental strain. A petted, spoiled child, he had rebelled against being sent to school. He would much rather stay home and play by himself or with his mother. His parents' desires in the matter were as nothing to him: it was what he wanted that was the important thing. For once, though, the parents insisted on being obeyed by their thoroughly selfish boy. He had to go to school, and go to school he did, until the hysterical paralysis set in. This paralysis, of course, was somewhat inconvenient, since it limited his opportunities for play, but it at least had the advantage of keeping him from attending the school that he detested. The boy himself was not in the slightest conscious of the part thus played by selfish wishing in the development of his diseased condition. He was really frightened at finding himself unable to stand and walk. Nevertheless, so strong was his antipathy against school that it was some time before the suggestion of paralysis was broken down by appropriate psychotherapeutic treatment.

Other cases even more extraordinary are recorded in medical annals. One "spoiled child," a little girl not five years old, had a series of convulsive attacks, following the unexpected refusal of her parents to grant a request that involved risk to her if they granted it. After the convulsions she was paralysed in her lower limbs, and the parents, terrified, called in an eminent specialist in nervous diseases. Fortunately, the specialist recognised almost at once that it was a case of hysterical paralysis, brought on by lack of discipline and lack of training in emotional control, and he obtained the parents' permission to isolate the little girl and treat her as he deemed best. His treatment was harsh, but exceedingly effective. For two days he starved the child, then put a bowl of bread and milk some distance from her bed. The suggestion of food was too strong for the suggestion of paralysis. Without further ado, she skipped nimbly out of bed and secured the bowl. But the specialist did not reproach her for being a naughty girl. His reproaches were for the parents, to whom he gave some greatly needed advice as to her future upbringing.

Hysterical pains, contractures, swellings, even hysterical blindness, have been observed in children who, after having been unduly indulged, feel that their father or mother, as the case may be, is no longer as attentive to and lenient with them as they would like. More frequently, under such conditions, the symptoms of nervousness are chiefly mental, or, if physical, are confined to muscular twitchings, slight involuntary movements of the face, head, hands, and similar manifestations. Unhappily, the true significance of these is often overlooked. They are thought to be defects which the child will "outgrow," and in many cases they certainly are outgrown, to all appearance. But, if the moral weaknesses underlying them—the self-centredness, the deficiency in emotional control—are not in the meantime corrected, at any crisis in adult life there is likely to result a nervous breakdown or a serious attack of hysteria. Indeed, in not a few cases of adult hysteria, the causal agency of selfishness is unmistakably in evidence to those accustomed to interpreting nervous symptoms. There are plenty of men and women whose chronic neuroticism is motivated by a subconscious craving to be the centre of attraction, or to be perpetually dominant in the family life. There are other unfortunates who, when their will is seriously crossed, take refuge, like the boys and girls just mentioned, in various forms of nervous disease. The curious experience of a New England physician, Doctor A. Myerson, for some time connected with the Boston Psychopathic Hospital, is by no means as unique as might be thought.

This physician was summoned to attend a woman suffering from what was supposed to be a cerebral hemorrhage. She no longer was able to move her right arm, right leg, or the right side of her face, and had entirely lost the power of speech. For many months previous to the onset of this deplorable condition she had been troubled at irregular intervals by headaches, nausea, and fainting spells. The patient herself and her friends had little doubt that she was in so serious a condition that recovery could not be expected. But Doctor Myerson, making use of the most up-to-date methods of neurological diagnosis, soon was able to reach a reassuring verdict. It was a case, he found, not of organic, but of functional paralysis—in fine, a case of hysteria. And, in the end, by employing what is technically known as the method of "indirect suggestion," he actually re-educated the paralyzed woman both to walk and to talk.

Meantime, he made a searching inquiry to ascertain just why she had been stricken by hysterical paralysis. He discovered, for one thing, that the patient's fainting and vomiting spells and her headaches had usually followed bitter quarrels with her husband—and usually had the effect of placing victory on her side. There was one point, nevertheless, on which the husband was immovable. He was a poor man and could not grant his wife's insistent demand to move to a more expensive neighbourhood. He would not have granted it if he could, for in the particular neighbourhood to which she wished to move she had friends whom he regarded as undesirable. It appeared that the attack of paralysis and speechlessness had been preceded by an exceptionally bitter quarrel over this question of moving—"a quarrel which," to quote from Doctor Myerson's report, "had lasted for a whole day and into the night of the attack."

Thus, the attack itself could be correctly interpreted as the supreme effort of a self-centred, neurotic personality to gain a desired end. But, while making this interpretation, Doctor Myerson was quick to add, in his report on the case, that the attack had not by any means been brought on through the patient's "conscious purpose or volition." It was all an affair of her subconsciousness, working in a blind, abnormal, irrational way to help attain the object of her conscious desire. That her subconsciousness should work so abnormally and so disastrously was chiefly due, beyond any doubt, to the absence of adequate training in self-control and emotional restraint.

But it is not only as a strange, irrational mode of fulfilling a wish that hysteria and other nervous disorders may become manifest in selfish people. Without this element of wishing entering in at all, nervousness is particularly likely to attack the selfish. Many nervous conditions are directly brought on by conscious or subconscious fixing of the thoughts on the bodily processes. We are so constituted that our internal organs work best when we pay no attention to them—or, more strictly, when we pay no attention to the physical sensations to which they give rise while working. If, for any reason, our attention is turned to and held on these sensations, they at once become exaggerated, and the organs giving rise to them tend to function badly. In this way any bodily organ may be disturbed in its action, and general symptoms of nervousness result through nothing but over-attention.