Handicaps of Childhood

by H. Addington Bruce

IX
"NIGHT TERRORS"

REFERENCE has already been made more than once, though only in an incidental way, to the childhood malady of pavor nocturnus, or "night terrors." In any book like the present one the subject of night terrors is deserving of detailed discussion. Not only do night terrors constitute a real handicap of childhood, but also they constitute a handicap, the seriousness of which is not yet appreciated by many people, and the true nature of which is as yet known to exceedingly few. In some quarters, indeed, there has been a disposition to minimise this malady, because it usually is "outgrown" by the eighth or ninth year. But, in reality, its effects—or, rather, the effects of the condition of which it is a sign—may, and often do, continue through life. Fortunately, the new knowledge that psychology has gained concerning it enables parents to frustrate its evil consequences and, in most cases, to prevent its occurrence.

At bottom, night terrors are almost identical with the nightmares of adult years. They are, to put it precisely, juvenile nightmares, with the added feature of profound disturbance in the waking state. The one real point of difference between night terrors and nightmares is that the former indicate a greater degree of nervous strain. The child who is a victim of night terrors generally has an hour or so of quiet sleep after going to bed. Then he wakes, shrieking for his mother. When the parents, alarmed, rush to his room, they are likely to find him out of bed, crouching behind a chair, or in the corner. His eyes are staring and full of horror. He seems not to recognise his parents, though he will eagerly clutch at them for protection. After a few minutes the attack passes off, he quiets down, returns to bed, and sleeps soundly until morning, when, as a rule, he has no conscious remembrance of his fears of the night before.

While the night terror is at its height the child may have ghastly hallucinations, representing a continuance in the waking state of the dream-images that have distressed him. Also, instead of leaping out of bed, he may merely sit up, or may find it impossible to move at all, as is the case with many adults when coming out of a nightmare. A Chicago physician, describing his experiences as a child, relates:

"When I was five years of age, and during the sixth year, I suffered from nightmare. I sat up in bed and fancied I saw a monkey come down the chimney and fasten itself to my shoulder and bite me, and terrify me so that I would scream out. My older sister would then come, wake me up thoroughly, and satisfy me that it was but a vision.

"Other nights I would feel a sense of oppression, ringing in ears, a sensation of perceiving something very small, which, gradually at first, and then rapidly, assumed enormous proportions and vast whirling speed, and which, I imagined, whirled me off with it—a buzzing in my ears, probably. Then would I feel that animals—rats—would creep over me and press heavily upon me, and I could neither move hand nor foot, nor speak."

The reference to the buzzing in the ears is typical of the attitude that until lately has been taken by almost all physicians in respect both to adult and to juvenile nightmares. For that matter, it still is the attitude of those physicians who are not familiar with the findings of medical psychology. Nightmare to them, whether in the old or in the young, is altogether a question of physical causation. As they see it, one need not look beyond bodily conditions of some sort to understand the nightmares of adults and the night terrors of children. Accordingly, treatment by sedatives, dieting, and hygienic measures has been the rule. Unfortunately, this by no means always succeeds in bringing about the desired result, although such measures undoubtedly do benefit the general health.

Seemingly, to be sure, they are especially successful in the case of night terrors. But it is significant that, even if left untreated, night terrors seldom persist beyond the period of childhood. Then, however, those who have had them show a tendency, in many cases, to be troubled by unpleasant dreams, often taking on the character of most distressing nightmares. The frequency of these may, or may not, be diminished by the usual treatment of a dietetic sort. On the other hand, observation has shown that many persons afflicted with the indigestion and other physical conditions commonly held responsible for nightmares are not troubled by nightmare at all. As one observer puts it, even a person whose stomach is half destroyed by cancer may commit all sorts of dietary indiscretions and not suffer from nightmare in the slightest.