The entire personality of most of the victims of trauma corresponds therefore to the child who is fretting, whimpering, unrestrained and naughty in consequence of a fright. The excessive importance which almost all the persons suffering from trauma attach to good food fits in with this picture. The slightest neglect in this respect may produce in them the most violent outbreaks of affect and even induce fits. Most of them are unwilling to work, they wish to be supported and provided for like a child.
It is here, therefore, not only a question, as Strümpell considers, of the production of illnesses on account of an actual gain (pension, compensation for injury, flight from the front) which are only secondary illness gains; the primary motive for the illness is the pleasure itself of remaining in the secure retreat of the childish situation once so unwillingly left behind. Both these narcissistic and apprehensive manifestations of illness have their atavistic prototype; it is even possible that the neurosis often reverts to methods of reaction which play no part at all in the individual development (feigning of death by animals, methods of progress and protection of the young of animals in the ancestral series). It is as though an over-strong affect could no longer be compensated along normal paths, but had to regress to previously abandoned but virtually existent mechanisms of reaction. I do not doubt that many other pathological reactions will yet be revealed as recapitulations of overcome methods of adaptation.
As symptoms of the traumatic neuroses which are less appreciated, I might mention the over-sensitiveness of all the senses (shunning of light, hyperacusis, extreme ticklishness) and the anxiety dreams. The real terrors that have been experienced, or things similar to them, are lived through again and again in these dreams. I am following a hint of Freud’s when I look upon these terrors and anxiety dreams, as well as the state of terror by day, as spontaneous attempts of cure on the part of the patient. They serve to bring piecemeal to conscious abreaction the shock, which in its totality was intolerable and unintelligible and was therefore converted into symptoms, and to contribute to the adjustment of the disturbed equilibrium in the psychical economy.
Ladies and gentlemen, I hope these few remarks of mine may serve as proof that the psycho-analytical conception discloses points of view where the rest of neurology leaves us in the lurch.
From the methodical psycho-analysis of many cases we ought to expect the full explanation of these morbid conditions and perhaps also their radical cure.
While this article was in the press, I read the interesting work of Prof. E. Moro, the childrens’ specialist of Heidelberg, on “the first Trimenon”, i. e. the peculiarities of the first three months of the infant’s life. He says: “If one lays a young infant on a pillow on a table and strikes the pillow on either side with the hands, then there results a peculiar reflex action. Both arms are thrown up symmetrically apart and then come together again in a curve with easy tonic movements. A similar movement is carried out simultaneously by the legs”. We would say: Moro has here artificially produced a little shock (or traumatic) neurosis. The remarkable thing in this action is that this reflex to the shock in the young infant of less than three months old shows signs of the natural reflexes of clasping, which characterise the “carried offspring”, i. e. the young of animals (monkeys) which are compelled with the help of a pronounced clasping reflex to hold fast with the fingers to the mother’s fur while she climbs about the trees. We would say: Atavistic reversion of the method of reaction in sudden terror[4].