Outwitting Our Nerves: A Primer of Psychotherapy

by Josephine A. Jackson; Helen M. Salisbury

So long as the bowel-content is in the region of automatic control, there is very little likelihood of trouble. An occasional case of organic trouble—appendicitis, lead-colic, mechanical obstruction, new growths or spinal-cord disease—may cause a real blockade, but in ninety-nine cases out of every hundred there is little trouble so long as the involuntary muscles, working automatically under the direction of the subconscious mind, are in control. By slow or rapid stages, on time or behind time, the bowel-content reaches the upper

part of the rectum and passes through a little valve into the lower pouch. Here is where the trouble begins.

Meddlesome Interference. In the natural state the little human, like the other animals, empties his bowel whenever the fecal mass enters the lower portion of the rectum. The presence of the mass in the rectum constitutes a call to stool which is responded to as unthinkingly as is the desire for air in the taking of a breath. But the tiny child soon has to learn to control some of his natural functions. At the lower end of the rectum there is a purse-string muscle called the Sphincter-ani, an involuntary muscle which may with training be brought partly under voluntary control. Under the demands of civilization, the baby learns to tighten up this muscle until the proper time for evacuation. Then, if he be normal, he lets go, the muscles higher up contract and the bowel empties itself automatically, as it always did before civilization began.

There is, however, a possibility of trouble whenever the conscious mind tries to assume control of functions which are meant to be automatic. Under certain conditions necessary control becomes meddlesome interference. If the child for one reason or another takes too much interest in the function of elimination; if he likes too much the sense-gratification from stimulation of the rectal nerves and learns to increase this gratification

by holding back the fecal mass; if he gets the idea that the function is "not nice" and takes the interest that one naturally feels in subjects that are taboo; or if he catches from his elders the suggestion that the bowel movement is a highly important process and that something disastrous is likely to happen unless it is successfully performed every day; then his very interest in the matter tends to interfere with automatic regulation, and to cause trouble.

Just as people often find it hard to let go the bladder muscle and urinate when in a hurry or under observation, and just as an apprehensive woman in childbirth tightens up the purse-string muscle of the womb, so the little child, or the grown up who catches the suggestion of difficulty in the bowel movement, loses the trick of letting go. Instead of merely exercising control by temporarily inhibiting the function, he tries to carry through the process itself by voluntary control—and fails. Constipation is a perfect example of the power of suggestion, and of the troublesome effect of a fear-idea in the realm of automatic functions.

Food and Constipation

Since the waste matter from all foods finally reaches the rectum, and since constipation is merely a difficulty in the forces of expulsion, it is hard to see how any normal food in the quantities usually eaten could have

the slightest effect on the problem. When we remember that it takes food from twelve to twenty-four hours to reach the rectum, and that it has during all that time been subjected to the action of the powerful chemicals of the digestive tract, it is hard to imagine a piece of cheese, of whatever variety, strong enough to stop the contraction of the muscles of the upper rectum or to tie the sphincter-muscle into a knot. It would be difficult to find a food which could pass without effect through twenty-seven feet of intestinal tubing only to become suddenly effective on the wall of the rectum. If the wrong kind of food is the cause of constipation, why does the rectum prove to be the most refractory portion of the tube? On what principle could a piece of chocolate inhibit the call to stool or contract the sphincter muscle? On the other hand, even if it should be conceded that constipation were the result of lack of lubricating secretions in the colon, how could two tablespoonfuls of mineral oil be a sufficient lubricant after being mixed with liquid and solid food through many feet of the intestinal tract?

An Adaptable Apparatus. The lining of the intestines has plenty of secretions to take care of its function. It is as well adapted to the vicissitudes of life as are the other parts of the body. The muscular coat is no more liable to paralysis or spasm than are the voluntary muscles. As the skin adapts itself to all