Type C: In this type the affect is linked with an idea as its object in consciousness but without meaning, so that whenever this idea is awakened it is accompanied by the affect alone. Some of the phobias are the most common pathological exemplars. Nor is there anything in the content of consciousness which gives meaning to the idea as something that should occasion anxiety. The subject, in other words, does not know why he is afraid of the given object. In such cases the restoration of dormant memories will disclose antecedent experiences in which the idea is set and which explains the origin and meaning of the fear. Here again we have the principle shown in a clear cut way in conditions of alternating personality. For instance take the case of Miss B. An emotion, apparently paradoxical, would be aroused in BIV in connection with a strange person or place, or in consequence of a reference by some one to an unknown event. BIV, without apparent reason, would feel an intense emotion in connection with something or other which she did not remember to have ever heard or seen before. A face, a name, a particular locality where she happened to find herself would arouse a strong emotional effect without her knowing the reason. The memories of the experiences to which these emotions belonged were a part of BI’s life and could easily be recalled by her when the personalities again alternated and BI came into existence. When BIV came again these experiences, of course, would be forgotten and become dormant, but the emotions associated with the visual, auditory, and other images of a given person or place, or whatever it might be, would be liable to be aroused in her by the perception, in spite of the amnesia, whenever the given person or place, as it might be, came into her daily life. Here the conscious content of the psychosis consists of perception plus affect without meaning.
I formerly was inclined to interpret such paradoxical emotions on the principle of the simple linking of an affect to a perception. But when we consider that, on the reversion of the personality to BI the perception, meaning, and affect still remained organized as a conscious psychic whole, it is much more probable that the meaning took part as a subconscious process in the mechanism of BIV’s emotional psychosis and was responsible for the paradox. In the case of recurrent fears the antecedent experiences which contain their meaning are conserved as unconscious complexes. The psychosis differs clinically from types A and B only in that another conscious element has been added,—viz.: the idea of an object of the fear. It is consistent therefore to infer that the unconscious complexes are a submerged part of the mechanism by which the affect is maintained in association with the object. The conscious and the subconscious form a psychic whole.
As an instance let us take the following case of phobia. It was ostensibly one of church-steeples and towers of any kind. The patient, a woman about forty years of age, dreaded and tried in consequence to avoid the sight of one. When she passed by such a tower she was very strongly affected emotionally, experiencing always a feeling of terror or anguish accompanied by the usual marked physical symptoms. Sometimes even speaking of a tower would at once awaken this emotional complex which expressed itself outwardly in her face, as I myself observed on several occasions. Considering the frequency with which church and schoolhouse towers are met with in everyday life, one can easily imagine the discomfort arising from such a phobia. Before the mystery was unraveled she was unable to give any explanation of the origin or meaning of this phobia, and could not connect it with any episode in her life, or even state how far back in her life it had existed. Vaguely she thought it existed when she was about fifteen years of age and that it might have existed before that. Now it should be noted that an idea of a tower with bells had in her mind no meaning whatsoever that explained the fear. It had no more meaning than it would have in anybody’s mind. In the content of consciousness there was only the perception plus emotion and no corresponding meaning. Accordingly I sought to discover the origin and meaning of the phobia by the so-called psycho-analytic method.
When I attempted to recover the associated memories by this method, the mere mention of bells in a tower threw her into a panic in which anxiety, “thrills,” and perspiration were prominent. Before making the analysis I had constructed a theory in my mind to the effect that a phobia for bells in a tower was a sexual symbolism, being led to this partly by the suggestiveness of the object and partly by the fact that I had found symbolisms of a sexual kind in her dreams.[[183]]
Analysis was conducted at great length and memories covering a wide field of experiences were elicited. When asked to think of bells in a tower, or each of these objects separately, there was at first a complete blocking of thought in that her mind became a blank. Later, memories which to a large extent, but not wholly, played in various relations around her mother (who is dead) as the central object came into the field of consciousness. Nothing, however, was awakened that gave the slightest meaning to the phobia even on the wildest interpretation. The patient, who had been frequently hypnotized by another physician, tended during the analysis to go into a condition of unusually deep abstraction, to such a degree that on breaking off the analysis she failed to remember, save very imperfectly, the memories elicited. Such an abstraction is hypnosis.
Finally, after all endeavors to discover the genesis of the phobia by analysis were in vain, I tried another method. While she was in hypnosis I put a pencil in her hand with the object of obtaining the desired information through automatic writing. While she was narrating some irrelevant memories of her mother, the hand rapidly wrote as follows: “G.... M.... church and my father took my mother to Bi.... where she died and we went to Br.... and they cut my mother. I prayed and cried all the time that she would live and the church bells were always ringing and I hated them.”
When she began to write the latter part of this script she became depressed, sad, indeed anguished; tears flowed down her cheeks and she seemed to be almost heartbroken. In other words, it appeared as if she were subconsciously living over again the period described in the script. I say subconsciously for she did not know what her hand had written or why she was anguished. During the writing of the first part of the script she was verbally describing other memories; during the latter part she ceased speaking.
After awakening from hypnosis and when she had become composed in her mind she narrated, at my request, the events referred to in the script. She remembered them clearly as they happened when she was about fifteen years of age. It appeared that she was staying at that time in G.... M...., a town in England. Her mother, who was seriously ill, was taken to a great surgeon to be operated upon. She herself suffered great anxiety and anguish lest her mother should not recover. She went twice a day to the church to pray for her mother’s recovery and in her anguish declared that if her mother did not recover she would no longer believe in God. The chimes in the tower of the church, which was close to her hotel, sounded every quarter hour; they got on her nerves; she hated them; she could not bear to hear them, and while she was praying they added to her anguish. Ever since this time the ringing of bells has continued to cause a feeling of anguish. This narrative was not accompanied by emotion as was the automatic script.
It now transpired that it was the ringing of the church bells, or the anticipated ringing of bells, that caused the fear, and not the perception of a tower itself. When she saw a tower she feared lest bells should ring. This was the object of the phobia.[[184]] She could not explain why she had never before connected her phobia with the episode she described. This failure of association as we know is not uncommon, and in this case was apparently related to a determination to put out of mind an unbearable episode associated with so much anguish. There had been for years a more or less constant mental conflict with her phobia. The subject had striven not to think of or look at belfries, churches, schoolhouses, or any towers, or to hear the ringing of their bells, or to talk about them. She had endeavored to protect herself by keeping such ideas out of her mind. Before further analyzing the case there are two points which are well worth calling attention to:
1. When the subject subconsciously described the original childhood experience by automatic script there was intense emotion—fear—which emerged into consciousness without her knowing the reason thereof. When, on the other hand, she later from her conscious memories described the same experience there was no such emotion. In other words it was only when the conserved residua of the experience functioned consciously and autonomously as a dissociated, independent process that emotion was manifested. So long as the memories were described from the view-point of the matured adult personal consciousness there was no emotion. As a subconscious process they were unmodified by this later viewpoint. This suggests at least that when the phobia was excited by the sight or idea of a tower it was due likewise to a subconscious process and that this was one and the same as that which induced the experimental phobia.