Mental Short-Circuit.—The minds of these people must do something, and since there is nothing really occupying for them to do, in a very expressive modern phrase, they are doing their possessors. As we suggest elsewhere, the nearest simile is that of the short-circuiting of a dynamo. Mental energy is exerted harmfully within the machine instead of in doing work.
See what happens in these cases when by some chance the women, or the men, who complain almost constantly are suddenly deprived of the means which enabled them to live an aimless life. The physician often has patients who have been in affluence but after a financial panic are in straitened circumstances. It is interesting to note what an excellent tonic effect, in younger people always, in older people very often, the change of life has on these chronic valetudinarians. Sometimes this is attributed to the simpler life which they lead when poorer, occasionally to the lack of responsibility, or other similar reason. Nearly always it is easy to see that the real cause of the improvement in health is the occupation of mind with serious interests outside of self.
Regulation of Life.—In the matter of occupation, and especially occupation of mind, the formation of habits and the training of the will are extremely important. In his book on "The Education of the Will," which was so popular that it went through over thirty editions in France, M. Jules Payot [Footnote 25] emphasizes the necessity for deliberately arranging the details of life so that time shall not hang heavily on the hands, he reverts to certain rules of life of the old religious orders, and to the habits advised by spiritual directors. He counsels that every one should make an examination of the day's happenings at the end of it, in order to see just where the failures lay and in what accomplishment was made. At the end of this old-fashioned examination of conscience, he counsels that a set of resolutions for the next day be made and an arrangement of work for various times, so that even more may be accomplished.
[Footnote 25: English translation by Dr. Smith Ely Jelliffe. New York, 1909.]
M. Payot further suggests that a certain time be given up to reflection, or as he calls it, meditation, on the significance of life and on the consideration whether something valuable is being made of it. Without this he insists that it is easy to let one's self slip into habits of life in which absolutely nothing is accomplished for self or others. If there is no real accomplishment, then pleasure soon palls, because pleasure has a place only as an interval in the midst of labor and as a relief from effort. These reversions to the old modes of life and thought of the monastic communities show how little of real advance there is in life, and what excellent conclusions serious men came to even in the distant past. Certainly for many of the leisure class in modern times only the use of periods of reflection and the examination of [{221}] results obtained will serve to prevent that utter waste of time which leads to the intense dissatisfaction that is often reflected in the general health.
Thought for Others.—After forgetfulness of self, the most important factor in psychotherapeutics is thoughtfulness for others. Ordinary diversions are quite insufficient to occupy most people. One must have a serious occupation that appeals deeply, and then diversions of mind will be useful for purposes of recreation. Pleasure, so-called, if pursued not as an interruption from work but for its own sake and without serious occupation, palls, and after a time its votaries find life is scarcely worth living. The pursuit of pleasure as the sole interest of life is one of the most fruitful resources of depression, discouragement and neurotic symptoms with which modern physicians are brought in contact. The only way to be sure of having compelling interests is to be so much occupied with other people that one forgets self.
Yet mere flippant excitement and superficial entertainment is nothing but a cheap counterfeit of what is needed. Voluntary effort is needed, and this is the field where the psychotherapist must put in his most intelligent effort. There is no one for whom there is not a chance for work in our social fabric. The prescription of work has not only to be adjusted to the abilities, the knowledge, and social conditions, but has to be chosen in such a way that it is full of associations and ultimately of joyful emotions. Useless work can never confer the greatest benefits; mere physical exercises are therefore psychophysically not as valuable as real sport, while physically, of course, the regulated exercises may be far superior to the haphazard work in sport. To solve picture puzzles, even if they absorb the attention for a week, can never have the same effect as a real interest in a human puzzle. There is a chance for social work for every woman and every man, work which can well be chosen in full adjustment to the personal preference and likings. Not everybody is fit for charity work, and those who are may be entirely unfitted for work in the interest of the beautification of the town. Only it has to be work; mere automobiling to charity places or talking in meetings on problems which have not been studied will, of course, be merely another form of the disorganizing superficiality. The hysterical lady on Fifth Avenue and the psychasthenic old maid in the New England country town both simply have to learn to do useful work with a concentrated effort and a high purpose. From a long experience I have to confess that I have seen that this unsentimental remedy is the safest and most important prescription in the prescription book of the psychotherapist.
Care of Children.—Probably the most important therapeutic factor in the cure of the ills which come to unoccupied women is the finding of some occupation that will absorb their hearts as well as their intellects, that is, satisfy their feelings as well as appeal to their intelligence. That very acute observer and kenner of her sex, Mrs. St. Leger Harrison, who is Charles Kingsley's daughter and writes under the pseudonym of "Lucas Malet," said in "Sir Richard Calmady": "Feed their hearts and the rest of the mechanism runs easy. I have known disease to develop in a perfectly healthy woman simply because the heart was starved." For most women the only thing that will entirely satisfy the heart or keep it from hunger is children. Fortunately an interest in other people's children can, under certain circumstances, be almost as satisfying as in one's own.
Interest in Others.—Probably the best possible occupation that a childless woman can have is the care of others. Charity in one form or another satisfies the emotions as well as creates interest and gives varied occupations. Even the frequent disillusions that are encountered in charity work only add variety [{222}] to the experience, and do not discourage those who have the real charity instinct. For women particularly, as we have said, some charity that brings them much in contact with children is the surest preventive of over-occupation with themselves and over-emphasis on their feelings and sufferings. Many a woman in our large cities owes her freedom from the neurotic symptoms to which her sisters are subject, to her interest in tuberculous children. There is just enough of suffering to arouse all the pity of the visitor, without so much of anguish as would deter the more delicate from being interested in the work.
Touch with Real Suffering,—For patients who think they have much to suffer, yet whose complaints are all of subjective feelings of oppression and depression, there is no better remedy than to come in touch with real suffering. I have known not a few neurotic young women, who were preparing for themselves years of suffering by over-attention to little pains and aches, saved to a life of usefulness and even happiness by having to nurse near relatives through the last stages of fatal cancer. When these neurotic persons are brought intimately in touch with real suffering, have their sympathies aroused, and see how well human nature can bear pain when it has to, and yet not be impatient, nor wish to end it all, then a renewed life comes over them and they cease to be preoccupied with themselves.