Outwitting Our Nerves: A Primer of Psychotherapy

by Josephine A. Jackson; Helen M. Salisbury

Feeling His Legs. Mr. R. suffered from such severe and distressing pains in his legs that he believed himself on the verge of paralysis. He was also bothered by a chronic emotional state which made him look like a "weepy" woman. His eyes were always full of tears and his chin a-quiver, and he had, as he said, a perpetual lump in his throat. Under re-education both lump and paralysis disappeared completely and Mr. R. took his wife across the continent,

driving his machine with his own hands—and feet.

A Subconscious Association. Mr. D.'s case admirably illustrates the return of symptoms through an unconscious association. He was a lawyer, prominent in public affairs of the Middle West, who had been my patient for several weeks and who had gone home cured of many striking disabilities. Before he came to me, he had given up his public work and was believed by all his associates to be afflicted with softening of the brain, and "out of the game" for good. From being one of the ablest men of his State, he had fallen into such a condition that he could neither read a letter nor write one. He could not stand the least sunshine on his head, and to walk half a mile was an impossibility. He was completely "down and out" and expected to be an invalid for the rest of his life.

But these symptoms had one by one disappeared during his five-weeks stay with me. He had done good stiff work in the garden, carried a heavy sack of grapefruit a mile in the hot sun, and was generally his old self again. Now he was back in the harness, hard at work as of old. Suddenly, as he sat reading in his home one evening, all his old symptoms swept over him,—the pains in his head and legs, the pounding of the heart, the "all-gone" sensations as though he were going to die on the spot. He became almost completely dissociated, but through it all he clung to the idea which

he had learned,—namely that this experience was not really physical as it seemed but was the result of some idea, and would pass. He did not tell any one of the attack, ignored it as much as possible, and waited. In a few minutes he was himself again. Then he looked for the cause and realized that the article he was reading was one he had read several months previous, when suffering most severely from the whole train of symptoms. When the familiar words had again gone into his mind, they had pressed the button for the whole physiological experience which had once before been associated with them. This is the same mechanism as that involved in Prince's case, Miss Beauchamp, who became completely dissociated at one time when a breeze swept across her face. When Dr. Prince looked for the cause, he found that once before she had experienced certain distressing emotions while a breeze was fanning her cheek. The recurrence of the physical stimulation had been sufficient to bring back in its entirety the former emotional complex.

Another Kind of Association. One of my women patients illustrates another kind of association-mechanism, based not on proximity in time but proximity of position in the body. This woman had complained for years of "bladder trouble" although no physical examination had been able to reveal any organic difficulty. She referred to a constant distress in the region of the

bladder and was never without a certain red blanket which she wrapped around her every time she sat down. During psycho-analysis she recounted an experience of years before which she had never mentioned to anybody. During a professional consultation her physician, a married man, had suddenly seized her and exclaimed, "I love you! I love you!" In spite of herself, the woman felt a certain appeal, followed by a great sense of guilt. In the conflict between the physiological reflex and her moral repugnance, she had shunted out of consciousness the real sex-sensation and had replaced it with a sensation which had become associated in her subconscious mind with the original temptation. Since the nerves from the genital region and from the bladder connect with the same segment of the spinal cord, she had unconsciously chosen to mix her messages, and to cling to the substitute sensation without being in the least Conscious of the cause. As soon as she had described the scene to me and had discerned its connection with her symptoms, the bladder trouble disappeared.

Afraid of the Cold. Patients who are sensitive to cold are very numerous. Mr. G.—he of the prunes and bran biscuits—was so afraid of a draft that he could detect the air current if a window was opened a few inches anywhere in a two-story house. He always wore two suits of underwear, but despite his precautions

he had a swollen red throat much of the time. His prescription was a cold bath every morning, a source of delight to the other men patients, who made him stay in the water while they counted five. He was required to dress and live like other folks and of course his sensitiveness and his sore throat disappeared.

Dr. B——, when he came to me, was the most wrapped-up man I had ever met. He had on two suits of underwear, a sweater, a vest and suit coat, an overcoat, a bear-skin coat and a Jaeger scarf—all in Pasadena in May!