The Nervous Child - Hector Charles Cameron

(b) The Suggestibility of the Child

We may pass from considering the imitativeness of the child to study a second and closely related quality, his suggestibility. His conception of himself as a separate individual, of his ego, only gradually emerges. It is profoundly modified by ideas derived from those around him. Because of his lack of acquired experience, there is in the child an extreme sensitiveness to impressions from outside. Take, for example, a matter that is sometimes one of great difficulty, the child's likes and dislikes for food. Many mothers make complaint that there are innumerable articles of diet which the child will not take: that he will not drink milk, or that he will not eat fat, or meat, or vegetables, or milk puddings. There are people who believe that these peculiarities of taste correspond with idiosyncrasies of digestion, and that children instinctively turn from what would do them harm. I do not believe that there is much truth in this contention. If we watch an infant after weaning, at the time when his diet is gradually being enlarged to include more solid food, with new and varied flavours, we may see his attention arrested by the strange sensations. With solid or crisp food there may be a good deal of hesitation and fumbling before he sets himself to masticate and swallow. With the unaccustomed flavour of gravy or fruit juice there may be seen on his face a look of hesitation or surprise. In the stolid and placid child these manifestations are as a rule but little marked, and pleasurable sensations clearly predominate. With children of more nervous temperament it is clear that sensations of taste are much more acute. Even in earliest infancy, children have a way of proclaiming their nervous inheritance by the repugnance which they show to even trifling changes in the taste or composition of their food. We see the same sensitiveness in their behaviour to medicines. The mixture which one child will swallow without resentment, and almost eagerly, provokes every expression of disgust from another, or is even vomited at once. In piloting the child through this phase, during which he starts nervously at all unaccustomed sensations and flavours, the attitude of mother and nurse is of supreme importance. It is unwise to attempt force; it is equally unwise, by excessive coaxing, cajoling, and entreaty, to concentrate the child's attention on the matter. If either is tried every meal is apt to become a signal for struggling and tears. The phase, whether it is short or long continued, must be accepted as in the natural order of things, and patience will see its end. The management of this symptom,—refusal of food and an apparently complete absence of desire for food,—which is almost the commonest neurosis of childhood, will be dealt with later. Here it is mentioned because I wish to emphasise that if too much is made of a passing hesitation over any one article of food, if it becomes the belief of the mother or nurse that a strong distaste is present, then if she is not careful her attitude in offering it, because she is apprehensive of refusal, will exert a powerful suggestion on the child's mind. Still worse, it may cause words to be used in the child's hearing referring to this peculiarity of his. By frequent repetition it becomes fixed in his mind that this is part of his own individuality. He sees himself—and takes great pleasure in the thought—as a strange child, who by these peculiarities creates considerable interest in the minds of the grown-up people around him. When the suggestion takes root it becomes fixed, and as likely as not it will persist for his lifetime. It may be habitually said of a child that, unlike his brothers and sisters, he will never eat bananas, and thereafter till the day of his death he may feel it almost a physical impossibility to gulp down a morsel of the offending fruit. So, too, there are people who can bolt their food with the best of us, who yet declare themselves incapable of swallowing a pill.

Another example of the force of suggestion, whether unconscious or openly exercised by speech, is given us in the matter of sleep. Among adults the act of going to bed serves as a powerful suggestion to induce sleep. Seldom do we seek rest so tired physically that we drop off to sleep from the irresistible force of sheer exhaustion. Yet as soon as the healthy man whose mind is at peace, whose nerves are not on edge, finds himself in bed, his eyes close almost with the force of a hypnotic suggestion, and he drops off to sleep. With some of us the suggestion is only powerful in our own bed, that on which it has acted on unnumbered nights. We cannot, as we say, sleep in a strange bed. It is suggestion, not direct will power, that acts. No one can absolutely will himself to sleep. In insomnia it is the attempt to replace the unconscious auto-suggestion by a conscious voluntary effort of will that causes the difficulty. A thousand times in the night we resolve that now we will sleep. If we could but cease to make these fruitless efforts, sleep might come of itself and the suggestion or habit be re-established.

In little children the suggestion of sleep, provoked by being placed in bed, sometimes acts very irregularly. Often it may succeed for a week or two, and then some untoward happening breaks the habit, and night after night, for a long time, sleep is refused. The wakeful child put to bed, resents the process, and cries and sobs miserably, to the infinite distress of his mother. It then becomes just as likely that the child will connect his bed in his mind, not with rest and sleep, but with sobbing and crying on his part, and mingled entreaties and scoldings from his nurse or mother. An important part in this perversion of the suggestion is played by the attitude of the person who puts the child to bed. Often the nurse is uniformly successful, while the mother, who is perhaps more distressed by the sobbing of the child, as consistently fails, because she has been unable to hide her apprehension from him, and has conveyed to his mind a sense of his own power.

Just in the same way, grown-up people, filled with anxiety because of the helplessness of the young child, unable to divest their minds of the fears of the hundred and one accidents that may befall, or that within their own experience have befallen, a little child at one time or another, unconsciously make unwise suggestions which fill his mind with apprehension and terror. They do not like their children to show fear of animals. Nor would they if it were not that their own apprehension that the child may be hurt communicates itself to him. The child is not of himself afraid to fall, it is they who suffer the anxiety and show it by treating the fall as a disaster. The child is not of himself afraid to be left alone in a room. It is they who sap his confidence in himself, because they do not venture to leave him out of their sight, from a nameless dread of what may happen. A little girl cut her finger and ran to her nurse, pleased and interested: "See," she said, seeing it bleed, "fingers all jammy." Only when the nurse grasped her with unwise expressions of horror did she break into cries of fear. A town-bred nurse, who is afraid of cows, will make every country walk an ordeal of fear for the children.

Every mother must be made to realise the ease with which these unconscious suggestions act upon the mind of the little child, and should school herself to be strong to make her child strong, and to see to it that all this suggestive force is utilised for good and not for evil.

It is upon this susceptibility to suggestion that a great part of his early education reposes. No one who is incapable of profiting by this natural disposition of the child can be successful in her management of him. Turn where you will in his daily life the influence of this force of suggestion is clearly apparent. The child does without questioning that which he is confidently expected to do. Thus he will eat what is given him, and sleep soundly when he is put to bed if only the appropriate suggestion and not the contrary is made to him. Again we have seen that a perversion of suggestion of this sort is a common source of constipation in early childhood. If the child's attention is directed towards the difficulty, if he is urged or ordered or appealed to to perform his part, if failure is looked upon as a serious misfortune, the bowels may remain obstinately unmoved. In children as in adults a too great concentration of attention inhibits the action of the bowels, and constipation, in many persons, is due to the attempt to substitute will power for the force of habitual suggestion. No matter what other treatment we adopt, the mother must be careful to hide from the child that his failure is distressing to her. A cheerful optimism which teaches him to regard himself as one who is conspicuously regular in his habits, and who has a reputation in this respect to live up to is sure to succeed. To talk before him of his habitual constipation, and to worry over the difficulty, is as surely to fail. In the same way unwise suggestion can interfere with the passing of water at regular and suitable intervals. There are children who constantly desire to pass water on any occasion, which is conspicuously inappropriate, because their attention has been concentrated on the sensations in the bladder. Often enough when at great inconvenience opportunity has been found, the desire has passed away, and all the trouble has proved needless. It is not too much to say that every occupation and every action of the day can be made delightful or hateful to the child, according to the suggestion with which it is presented and introduced. Dressing and undressing, eating and drinking, bathing, washing, the putting away of toys, even going to bed, can be made matters of enthralling interest or delight, or a subject for tears and opposition, according to the bias which is given to the child's mind by the words, attitude, and actions of nurses and mothers.

Here we approach very near to the heart of the subject. Stripped of all that is not essential we see the problem of the management of children reduced to the interplay between the adult mind and the mind of the receptive suggestible child. That which is thought of and feared for the child, that he rapidly becomes. Placid, comfortable people who do not worry about their children find their children sensible and easy to manage. Parents who take a pride in the daring and naughty pranks of their children unconsciously convey the suggestion to their minds that such conduct is characteristic of them. Nervous and apprehensive parents who are distressed when the child refuses to eat or to sleep, and who worry all day long over possible sources of danger to him, are forced to watch their child acquire a reputation for nervousness, which, as always, is passively accepted and consistently acted up to. Differences in type, determined by hereditary factors, no doubt, exist and are often strongly marked. Yet it is not untrue to say that variations in children, dependent upon heredity, show chiefly in the relative susceptibility or insusceptibility of the child to the influences of environment and management. It is no easy task to distinguish between the nervous child and the child of the nervous mother, between the child who inherits an unusually sensitive nervous system and the child who is nervous only because he breathes constantly an atmosphere charged with doubt and anxiety.

Let us study briefly a third quality of the child which, for want of a better name, I have called after the ruling passion of mankind, his love of power. Perhaps it would be better to call it his love of being in the centre of the picture. It is his constant desire to make his environment revolve around him and to attract all attention to himself. Somewhat later in life this desire to attract attention, at all costs, is well seen in the type of girl popularly regarded as hysterical. The impulse is then a morbid and debased impulse; in the child it is natural and, within limits, praiseworthy. A girl of this sort, who feels that she is not likely to attract attention because of any special gifts of beauty or intellect which she may possess, becomes conscious that she can always arouse interest by the severity of her bodily sufferings. The suggestion acts upon her unstable mind, and forthwith she becomes paralysed, or a cripple, or dumb, presenting a mimicry or travesty of some bodily ailment with which she is more or less familiar. "Hysterical" girls will even apply caustic to the skin in order to produce some strange eruption which, while it sorely puzzles us doctors, will excite widespread interest and commiseration. Now little children will seldom carry their desire to attract attention so far as to work upon the feelings of their parents by simulating disease. They have not the necessary knowledge to play the part, and even if they make the attempt, complaining of this or that symptom which they notice has aroused the interest of their elders, the simulation is not likely to be so successful as to deceive even a superficial observer. But within the limits of their own powers, children are past masters in attracting attention. The little child is unable to take part in any sustained conversation; most of his talking, indeed, is done when he is alone, and is addressed to no one in particular. But he knows well that by a given action he can produce a given reaction in his mother and nurse. A great part of what is said to him—too great a part by far—comes under the category of reproof or repression. He is forbidden to do this or that, coaxed, cajoled, threatened long before he is old enough to understand the meaning of the words spoken, although he knows the tone in which they are uttered and loves to produce it at will. How he enjoys it all! Watch him draw near the fire, the one place that is forbidden him. He does not mean to do himself harm. He knows that it is hot and would hurt him, but for the time being he is out of the picture and he is intent on producing the expected response, the reproof tone from his mother which he knows so well. He approaches it warily, often anticipating his mother's part and vigorously scolding himself. He desires nothing more than that his mother should repeat the reproof, forbidding him a dozen times. The mind of all little children tends easily to work in a groove. It delights in repetition and it evoking not the unexpected but the expected. If his sport is stopped by his mother losing patience and removing him bodily from the danger zone, his sense of impotence finds vent in passionate crying. But if his mother takes no notice, the sport soon loses its savour. He is conscious that somehow or other it has fallen flat, and he flits off to other employment.