The Tendency for Insanity to increase on Account of the Stress of Life.
That there is a tendency for insanity to increase on account of the stress of competition and all the complexities of modern civilisation few will deny. The burden of taxation upon the nerve tissues and the drain upon their stores of energy must necessarily go on increasing as the uses for the physical mechanism of the body and limbs diminish and become replaced by the more complex nervous activities essential to brain and mental avocations. The influences of rural and urban life, trades and occupations, &c., as favouring the occurrence of insanity, have been dealt with in an exhaustive manner in various reports, treatises, and innumerable papers, and the result has been to apprise us of the fact that the percentage of individuals who are incapable by reason of mental perversion or defect from taking active and useful parts as citizens far exceeds our previous conceptions as to the extent of the degeneration in our midst.
It is well-nigh impossible to obtain a complete census of the physical and mental states of the people. Statistics furnish us with so many fallacies that for present purposes I prefer to omit them, and deal only with broad issues which seem to have direct bearings upon the mental health of the community.
It is now an accepted fact that civilisation, with its tendencies towards the aggregation of individuals into dense communities, favours the occurrence in those communities of overcrowding, pauperism, crime, and degeneration. For those designed by habit and heredity to rural life, migration to cities where the struggle for life is continued under totally different circumstances is disastrous, and for them the step from country to town is but one of the commonest of all the steps towards mental and physical deterioration, the accidents of civilisation finding in them merely the readiest victims.
The necessity of this migration, as determined by the state of agriculture, makes it none the less an evil, and it is a symptom in the evolution of an essentially agricultural race which is fraught with extreme danger to the maintenance of its nervous and mental stability.
The problem, however, has a different aspect for those who by habit and heredity are trained for city life, and certain it is that increased facilities for travelling are tending to decentralise our cities and thereby render the city dwellers healthier and more fit to cope with the drain upon their nervous energies. As a physician, it would appear to the writer that the problem of Sunday observances in town and country have different bearings on the health and physical fitness of the people. There is no doubt that periodic decentralisation of town dwellers is essential to the maintenance of bodily health, and it is also true that physical exercise and change from mental to physical functioning and vice versa is essential to all—i.e. if the balance between the mental and physical powers is to be adequately maintained. It is, of course, to be understood that to a physician the preservation of this balance is his first care, and to him is entrusted the function of aiding in the proper observance of all that is in agreement with biological and, therefore, natural laws. To him there is a great difference between ‘observance’ and ‘belief’; and he sees in them either mutually co-operative or mutually destructive factors for good or ill respectively.
If religious observances, under determined conditions, are found to be useful and essential for the sane in mind and body, they are also likely to be so, under conditions otherwise determined and arranged, for the insane. Many insane patients are totally incapable of attending any religious function. Some must be prohibited; others may be encouraged. As an asylum physician the writer may state that a generic case of religious excitement or enthusiasm may most advisedly even be restrained from religious functions until at least the acute symptoms have subsided. There can be little doubt that no religious officer would be likely to succeed in accomplishing much for patients without an accurate knowledge of insanity and the mental experiences of those whom he seeks to influence. The fact that mental aberration forms a special study and phase of life increases his difficulties and limits his possibilities. Where there is apparent failure both inside asylums and without, such failures may very possibly be attributed to the deficiencies of the doctrine, the discipline of the religion itself, the organisations peculiar to it, or the functionaries associated with it in our day. If the Christian religion is a true philosophy, it is the duty of all who profess Christianity to assist in the practical application of its precepts, where such can be judiciously and safely applied, taking religious things perforce as they find them, and utilising their own special knowledge to the best possible advantage, according to the conditions they find.
Is a person with deep religious conviction better equipped to face the stress of life than an unbeliever? An answer to this question was given by the writer in a paper read at the annual meeting of the British Medical Association held at Leicester in 1905. In stating that ‘a true and philosophical religion raises the mind above a mere incidental emotionalism’ he used the word ‘religion’ in its literal sense, as derived from re and lego, to gather and consider, as opposed to negligens. He in no way extended its connotation so as to include demonstrations of incidental emotionalism, superstition, or fanaticism. Religion and moral obligation he considered to be almost convertible terms, both equally compatible with intuitionalism, utilitarianism, or any other ‘ism’ derived from the study of the laws of life and mind. Moral laws are generally principles of thought and action, which an intelligent being must apply for himself in the guidance of his conduct, and the translation of such general principles (expressed either in general abstract form or in the form of a command) into particular actions. Conformity with such precepts of morality may with reason be regarded as a safeguard against the ‘lusts of the flesh.’
Religious enthusiasm in itself cannot justly be termed an evil. Rather does it embody the most healthy and preservative development of our social forces. Like many other tendencies of the mind, it is subject to exaggeration, misapplication, and a predominance of the emotions over the intellect. The typical cases of religious insanity directly developable from sectarian and even undenominational religious enthusiasm, from religious meditations, exercises, devotions, or superstitions, are by no means so common as they are supposed to be by the uninitiated observer. The true point lies in this, that very many mental cases bear a strongly marked religious or at least moral aspect. The psychology of the subject will show, for example, that acute depression—a predominant phase of abnormal emotional life—leads almost necessarily to a religious interpretation. And this is even more the case with many actual sense perversions. Such, I mean, as have ever been associated with the ideas of the supernatural.
These are not necessarily caused by religious over-excitement or enthusiasm. They may assume the appearance of it, because, being the deepest and most real feelings, desires, and convictions of the perverted organic life or of the moral reaction which accompanies it, they cannot well be expressed or described except in strong moral terms. Over and over again does this appear, and often among those least likely to be suspected of any religious predisposition. That these feelings should be clothed according to the prevailing ideas and creed of the patient is an essential reproduction of the mind. But, after all, this only relates to the form of their appearance, and there are many things which lie deeper.