Handicaps of Childhood

by H. Addington Bruce

Evidently, then, physical conditions do not of themselves account for nightmares and night terrors. One must look elsewhere for their ultimate cause. This is what the medical psychologists have done, and, doing this, they have discovered that the children who are troubled by night terrors are always children of a sensitive nervous organisation who have been subjected to emotional stress. A child may be nervously highstrung, yet entirely escape night terrors, provided his mind be kept free from emotional upheavals. But let anything occur to disturb him emotionally in an excessive degree and he at once becomes likely to suffer, not only from night terrors, but also—as it has been a prime purpose of this book to impress convincingly on every reader—from nervous affections of a more serious kind. He may even have "day terrors," seeing imaginary and terrifying objects as vividly as the child who wakes in panic from a distressing dream.

For example, a boy of eight was sent to the Washington neurologist, Doctor T. A. Williams, to be treated for general nervousness, and, in particular, for a tendency "to see things where there is really nothing to be seen." Doctor Williams found the boy to be so nervous that it was hard for him to sit still and to keep from wriggling excitedly about in his chair. Questioned as to his hallucinations, he said that these were mostly of a snake. He could not describe the imaginary snake, except to say that its head was like an eel's. It seemed to come from nowhere, and presented itself to his astonished gaze with a suddenness that caused him to scream and run. His father gave Doctor Williams the additional information that these hallucinations were experienced only when the boy was alone, and that, though his day terrors were not followed by night terrors, he would not go to bed unless some one were in the room with him.

Questioning his little patient more closely, Doctor Williams next learned that he had a veritable horror of being alone at any time. As long as somebody was in sight, he could enjoy his games, and would readily run errands. Left alone, the imaginary snake, or some hallucinatory wild beast, was almost at once seen by him. Further inquiry brought out the significant fact that this fear of solitude had actually been implanted in the boy by over-anxiety on his mother's part.

His horror of being alone was paralleled by her dread of having him out of her sight. She was continually thinking, and talking, of risks he would incur if he were allowed to be by himself. In this way she had unconsciously infected him with a "fixed idea" that something dreadful was sure to happen to him unless older persons were at hand to protect him. This fixed idea preying on his unusually impressionable mind, and keeping him in a constant state of emotional strain, was the decisive factor in the production of his day terrors. In proof whereof it need only be added that his hallucinations and general nervousness ceased to trouble him soon after corrective training was begun, supplemented by treatment by "suggestion" to rid him of the abnormal fear of being alone.

Fortunately, though I might detail a number of other cases of day terrors, this affliction is of rare occurrence, compared with night terrors. And, from the point of view of the medical psychologist, it is only to be expected that such should be the case. As explained by Doctor Williams, in a passage which gives a clear idea of the mechanism of night terrors:

"If I say to a small boy that a bear will eat him up, the effect upon his emotions entirely differs, whether I make the remark with portentous gravity and horror, or whether I say it with bubbling joviality as, evidently, a huge joke. In the first eventuality, the boy will rush to my side in terror and try to be saved from the bear, and a phobia is in course of construction; with the latter proceeding, the boy will laugh consumedly, and it would not take much to make him enter the cage and strike the bear. But, even when terrified, a child feels a refuge in the protection of his elders during the day, when they are rarely absent....

"At night, however, the child is alone, and his little consciousness cannot find the support of others. Before the kaleidoscope of his dreams pass the various images and accompanying emotions of his waking life, so that if any of these images has become linked with fear it is certain to bring with it terror, as it surges into dream in the night, and the child jumps up, awakened, in panic, finding no one near, upon whom to lean."[17]

In many a case of night terrors, no great psychological skill is required to detect the influence of emotional stress as the prime factor in causing the alarming attacks. In one instance that has come to my knowledge, a seven-year-old girl was brought to a physician, with a history of both night and day terrors. She was subject, her mother said, to attacks of loud screaming, during which she seemed dazed and in an agony of fear. The attacks sometimes lasted ten minutes, and immediately afterwards the girl generally fell into a heavy sleep. Her night terrors were of the usual sort, except that on the occasion of the first attack she was in such a panic that she opened her bedroom window and threw herself out of it. Luckily, it was early evening, and her mother, walking in the garden beneath her window, was able to catch her and save her from harm.

"She had gone to bed as usual," the mother said, in detailing this episode, "and seemed to be quite well, though I remember I thought she looked a little wild about the eyes. For an hour she slept quietly. Then, as I later learned, she woke up moaning, jumped out of bed, and made for the window."

"And," asked the physician to whom the child had been taken, "had anything out of the way occurred to her that day?"