For a few days I remained A and then owing, I think, to a lessening of nervous tension, I changed again to B [personality] and remained in that state for two or three weeks during which time I was physically well and happy again. At the end of this time, as a result of another realization of the actual situation, A reappeared and was the only personality for some weeks. These changes were due to successive emotional shocks.

The following passage which continues A’s viewpoint accurately describes her state of mind when she came under my observation.

When you first saw me I was A at my worst. I had no amnesia for the events of the preceding months when, as B, I had been filled with the joy of living. There was no thought on my part of any “change of personality”—I had never heard of such a thing—but I was like one slowly awakening from a dream. I was equally aghast at what I (B) had done for pleasure, and at what I (A), had done from a sense of duty; one seemed as unbelievable as the other.[[296]]

One of the most shocking things to me, as A, was the fact that I had enjoyed myself as B. Had I committed the most dreadful crimes I could not have felt greater anguish, regret, and remorse. I had been dominated by the fixed ideas and obsessions of B; I had felt that I must respond to any call for help made by this person [the drug-addict] even though it was against my inclination and judgment to do so; there seemed no choice for me in the matter—I had to;[[297]] I could see no point of view but my own. To do what seemed my plain duty I was willing to sacrifice myself in every way, but could not see that I (A) was now causing as much anxiety to my family as I had previously done as B; that I was sacrificing them also, and that my idea of duty was entirely mistaken. A, it would seem, was the emotional and idealistic part of my nature magnified a thousand times. My emotions and ideals as A were not different in kind from those of my normal self, but were so exaggerated as to be morbid.

As A I was full of metaphysical doubts and fears, full of scruples. I did not attend church because I felt that I could no longer honestly say the Creed and the prayers. The service had lost all meaning to me and so it seemed hypocritical to take part in it. I felt that I had utterly failed in the performance of every duty, and tortured myself with the remembrance of every act of omission and commission. I accused myself of selfishness, neglect, in fact, of nearly all the crimes in the calendar including, in an indirect way, that of murder.[[298]] My conversation was always of the most serious character,—religion (I believed in nothing), life after death (of which I found no hope), and I dwelt much upon the fact that no one should be judged by their deeds alone, that no one could tell what hidden motive had prompted any given act. This was because I had (as B) done so many things which (as A) I wholly disapproved of and felt might be misunderstood. I did not understand them myself but knew that my motive had been good. I was frightened, bewildered, shocked, agonized—concentrated anguish and remorse. During these weeks I suffered more than it ought to be possible for any one ever to suffer for anything, and always, over and over in my mind went the same old thoughts,—“Why did I do as I did? How could I have done it? Why did it seem right? What would my friends think if they knew? I was mad! I was not myself.” Finally I decided to end it all—I could not live under such a weight of humiliation and self-reproach. I am sure, Dr. Prince, that you must remember how impossible it was to reason with me as A, for it was at this time and in this state that I was sent to you and you first saw me.

Summing up this statement a new personality had come to the fore—a personality that was the antithesis of B. The traits which characterized A had been left entirely out of B while those which had characterized B were left entirely out of A. Both sets of traits were to be found in C though less accentuated and less freely manifested. The gaiety, love and pleasure and joy of life, the absence of all thought of responsibility and care belonging to B had given place to seriousness, a sense of responsibility and duty, a feeling of apprehension, to doubts and fears and self-reproaches. Depression and sorrow had taken the place of exaltation and joy. The neurasthenic state had replaced buoyant health.

Now it should be noted that these latter were the traits of the subject C during the preceding four-year period of stress and strain, and the succeeding neurasthenic period, and represented a side of her character which was developed, systematized and intensified by the circumstances of her life. In accordance with these traits, habits of thought had been established and by constant repetition complexes had been built. It is of importance to note that it was against these very A traits that the “B complex” at that time had rebelled—that very complex which was to become the chief component of the “B personality,” and which was the other side of the original self. It was during the neurasthenic state that the A traits had become abnormally developed and belonged to the neurasthenic condition. When the personality changed to B these A traits became dissociated but still remained conserved as unconscious systematized neurograms; now the A traits were awakened once more, there was a conflict and the B traits, the lighter side of her character, were repressed, dissociated and subsided into the unconscious. A was, therefore, a dissociated personality. She was the original C, if you please, but now so shattered and shorn as to be but an abstract and wreck of her former self. The normal C possessing both sets of traits had been, and now, resynthesized to health, is able to compare, to weigh, to modify, to balance the judgments obtained from the point of view of the B system with those of the A system and thus keep a fairly equitable poise of mind. The one counteracted the other fairly well. The A and B phases being respectively deprived of the characteristics of the other, each exhibited its own traits in a highly intensified degree, and manifested excessive reactions to the environment. The dissociated state A was plainly a reversion to the stress-and-strain and neurasthenic period. The awakening of A was the awakening of a system of thoughts which had lain dormant during the B state. Now the repressed B state was dormant.

It is of great significance for an understanding of neurasthenic disturbances that the awakening of the A system brought back all the neurasthenic symptoms that had as physical reactions accompanied this system at the time when it was dominant in C. The A system of thoughts, emotions, instincts, innate dispositions, etc., and the physical symptoms necessarily went together, for the latter are the expression or reaction of a dissociated personality that is deprived of its sthenic and exalting emotions. The moment the sthenic emotions were brought back (in C or A) the physical symptoms disappeared. The disappearance of the neurasthenia even in A when certain emotions were temporarily restored by suggestion was remarkable.

II

What caused the awakening of the A system? We have seen that the awakening of the rebellious B personality was an emotional trauma which was the same in kind as that which originally gave rise to the primitive “rebellion” as a reaction to the emotion. A similar trauma later awakened the same rebellion but one grown to the large proportions of the “B complex.” So in like fashion the new trauma to B awakened the A system as a reaction and associative phenomenon. What was the new trauma?