DR. ROY VAN WART
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Nervous and Mental Disease Monograph Series No. 8
WILLIAM A. OPHITE, fl.D.
Nervous and Mental Disease
Monograph Series will consist of
short monographs, translations,
and minor text-books, on subjects
related to these specialties It is
purposed to issue them from time to time
as the material becomes available The
editors will be pleased to consider the avail-
ability of manuscripts for the series.
Nervous and Mental Disease Monograph Series
SMITH ELY JELLIFFE, M.D.
WM. A. WHITE, M.D.
No. i. Outlines of Psychiatry. (Third Edition, 191 1.) Price,$2.5o
By WM. A. WHITE, M.D.
No. 2. Studies in Paranoia Price, $1.00
By Drs. N. GIERLICH and M. FRIEDMANW
No. 3. Psychology of Dementia Praecox. . Price, $2.00
By C. JUNG, M.D.
No. 4. Selected Papers on Hysteria and Other Psycho-
neuroses Price, $2.00
By PROF. SIGMUND FREUD, M.D.
No. 5. The Wassermann Serum Reaction in Psychiatry Price, $2.00
By FELIX PLATJT, M.D.
No. 6. Epidemic Poliomyelitis Price, $3. 00
New York Epidemic 1907.
No. 7. Three Contributions to Sexual Theory Price, $2.00
By PROF. SIGMUND FREUD.
No, 8. Mental Mechanisms . ............. .Price, $2.00
By WM. A. WHITE, M.D.
Address all communications to JOURNAL OF NERVOUS AND MENTAL
DISEASE, 64 West Fifty-Sixth Street, New York.
Nervous and Mental Disease Monograph Series No. s
WILLIAM A. WHITE, M.D.
AUTHOR OF "OUTLINES OF PSYCHIATRY"
SUPERINTENDENT GOVERNMENT HOSPITAL FOR THE INSANE, WASHINGTON, D. C; FIRST
LIEUTENANT, MEDICAL RESERVE CORPS, UNITED STATES ARMY; PROFESSOR OF
NERVOUS AND MENTAL DISEASES, GEORGETOWN UNIVERSITY, WASHINGTON,
D. C; PROFESSOR OF NERVOUS AND MENTAL DISEASES, GEORGE WASHING-
TON UNIVERSITY, WASHINGTON, D. C; AND LECTURER ON INSANITY,
U. S. ARMY AND U. S. NAVY MEDICAL SCHOOLS
THE JOURNAL OF NERVOUS AND MENTAL DISEASE
NERVOUS AND MENTAL DISEASE
Drs. SMITH ELY JELLIFFE and WM. A. WHITE
i. Outlines of Psychiatry. By Wm. A. White, M.D.
2. Studies in Paranoia.
By Drs. N. Gierlich and M. Friedman
3. The Psychology of Dementia Praecox.
By Dr. C. G. Jung.
4. Selected Papers on Hysteria and other Psychoneuroses .
By Prof. Sigmund Freud.
5. The Wassermann Serum Diagnosis in Psychiatry.
By Dr. Felix Plaut.
6. Epidemic Poliomyelitis. New York Epidemic, 1907.
7. Three Contributions to Sexual Theory.
By Prof. Sigmund Freud.
8. Mental Mechanisms.
By Wm. A. White, M.D.
By William A. White
T::e New era Printing Compant
Some Considerations on the Constitution! of Consciousness — Rela-
tion of Mental and Physical i
Types of Reaction — Defense and Compensation 19
The Content of Consciousness — Dreams — Symbolism — The Psy-
choses — Folk-Lore 32
The Complex — Types of " Complex " Reactions — Modes of Expres-
sion — General Considerations 49
Current Conceptions of Hysteria — Psychological, Physiological,
Biological and Clinical Theories 71
The Psychological Approach to the Problem of Art 90
The Theory, Methods and Psychotherapeutic Value of Psycho-
Preventive Principles in the Field of Mental Medicine 136
The teacher becomes naturally the writer of books. Every man
who tries to teach a subject inevitably comes to express himself
in a way different from other teachers of the same subject, and
different from the text-books. He is sure, sooner or later, to feel
the need of a book as a medium of his own individual manner of
expression. As the "Outlines of Psychiatry" (No. I of this
series) came into existence as the result of a need which grew out ^
of my teaching in the medical colleges, so this work is the result
of a need growing out of my efforts to present certain principles
in the field of psychopathology to the younger members of my "
staff. I trust it may find a wider usefulness in other similar
W. A. W.
Government Hospital for the Insane,
Washington, D. C.
June 15. 191 1.
A few words only by way of introduction so that the reader
may be assisted to an understanding of the plan of this book. It
is always helpful to get a bird's-eye view of a city one is about to
explore, or to look at a field under the microscope first with a
low-power objective, for purposes of general orientation, before
examining the minute details with a lens of higher magnification.
In the first place the book does not pretend to an exhaustive
setting forth of all the principles underlying psychopathology, but
only to an explanation and emphasis of certain fundamentals
which appear to me absolutely essential to an understanding of
the problems of present-day psychiatry.
The first chapter is devoted to a consideration of the building
up of the structure of consciousness, the organization and opera-
tion of the forces at work and somewhat of the laws of their
interplay. The second chapter accounts, in a general way, for
the content of consciousness, the nature of that content, and gives
a general account of certain types of reaction. The third chapter
deals somewhat more specifically with the content of conscious-
ness as illustrated by dreams, the content of the psychoses, and
certain phenomena of the content of the race consciousness — folk-
lore. The fourth chapter is devoted to a definition of the com-
plex and an explanation of its effects both in the normal mind and
in the psychoses. Chapter five carries out the principles eluci-
dated in the preceding chapters in the setting forth of the problem
of hysteria, while in chapter six the principles are applied to an
explanation of the problem of art, both from the standpoint of
the creation of art and the nature of its appeal. Chapter seven
sets forth the methods by which, in accordance with the princi-
ples thus far laid down, it is possible to attain to a knowledge of
the content of consciousness, and discusses certain therapeutic
issues; while the final chapter, chapter eight, is a general discussion
of the bearing of all that precedes upon the problems of preventive
medicine, with some suggestions as to methods of procedure.
SOME CONSIDERATIONS ON THE CONSTITUTION OF CON-
SCIOUSNESS—RELATION OF MENTAL AND PHYSICAL
The human mind is the crowning attainment of organic evolu-
tion and as evolution proceeds from the simple to the complex
it, and its physical substratum the human brain, are coordinately
the most complex of the results of this process.
Notwithstanding the fact that its placement in the scheme of
things of necessity implies its complexity, it is remarkable how
few people consider the mind and its phenomena as requiring any
special consideration in order that they be understood. Either
the most patent and obvious of explanations of mental facts are
deemed sufficient or else, mirabile dictu, no explanation at all is
conceived to be required. 1 We laugh " because we are happy " —
nothing simpler — and if in passing along the street the number
of a certain house is perceived and remains fixed in our memory
why "it just happened so" and "there's an end on't."
Undoubtedly one of the great reasons for this naive attitude
towards the phenomena of mind is due to their familiarity. It is
the unusual that attracts our attention and demands an explana-
tion — not the every-day occurrence that confronts us at each
moment of the day's work. A display of the northern lights
invariably brings out exclamations of admiration and wonder, but
no one stops for a moment to marvel at the phenomenon of human
It is this strange state of lack of appreciation of the complexi-
1 Ernest Jones: Rationalization in Every Day Life. Jour, of Ab. Psych.,
2 MENTAL MECHANISMS
ties of the mind and of the laws governing its actions that is
responsible for much that is crude in psychological conceptions.
It naturally becomes of the first importance for one entering upon
the study of psychiatry — abnormal psychology — to get rid of such
preconceived crudities if he has them or if not to start at any
rate with a comprehensive grasp of what mind means in the large.
We can only arrive at an understanding of the meaning of mind
by considering it at once from the biological and evolutional view
The simple organisms, the unicellular organisms, have problems
of function that do not require the service of a nervous system
at all. Their structure is relatively simple and the processes of
ingestion, digestion and egestion are participated in by the body
as a whole. The environment consists of but two kinds of
forces — those attracting and those repelling, and the stimuli from
them are conveyed at once by the protoplasmic mass without the
necessity of special paths.
As we proceed from this simple state of affairs, through the
animal series, we advance by successive steps to structures that
are progressively more and more complex and which correspond-
ingly come into more and more complex relations with their
With this gradual increase in the complexity of both structure
and the relations with the environment there goes hand in hand
an increase in the complexity of the nervous system and of that
part of the nervous system in which we are primarily interested —
the brain. The particular thing to which attention is invited by
this survey is that at some point in this scheme of things con-
sciousness makes its appearance.
What consciousness is no one can say. It is a something about
which all of us have certain immediate experiences and informa-
tion but it is one of those fundamental, inscrutable facts of
nature that defies definition.
For our purposes it is unnecessary to discuss its nature or its
THE CONSTITUTION OF CONSCIOUSNESS 3
origin further than to call attention to the fact that its advent
appears to be associated with a relatively complex and advanced
stage in evolution. We shall have occasion again to point out
the apparent relation between the occurrence of the phenomena
of consciousness and complexity in the relationship and adjust-
ment between the organism and its environment. The thing
primarily we are interested in is the constitution of consciousness,
its functions, and the laws governing its activities. Questions of
ultimate nature and the like belong to the metaphysicians.
The fact that consciousness comes into existence only at a rela-
tively late stage in evolution and in association only with rela-
tively complex organisms would seem to indicate that it had some
function in connection with the adjustment of the organism to its v
environment and it is from this view point that we can with best
advantage consider its activities.
Speaking broadly the mind may be considered as an adjustive ^
mechanism or more properly as a complex of adjustive mechan-
isms. To give a simple illustration of this rather abstruse state-
ment. A man standing in the middle of the street sees a runaway
team dashing towards him. It is because this man has a mind,
served by numerous sense organs that bring in to it information
about his environment, that he is able to use that information,
assimilate it to similar experiences, and profiting thereby initiate
certain activities calculated to remove him from the path of the
runaway team and by so doing bring about a relation between
himself and his environment that is efficient in saving him from
injury and perhaps death.
This illustration while it may appear simple at first sight is in
reality a complex situation and also one which is unusual in the
course of the average man's life. The functions of the bodily
organs are much simpler and much more usual in the sense that
the same activities are repeated each day and perhaps several
times each day. The adjustment of the functions of the several
internal organs to one another, the timing of these several activi-
4 MENTAL MECHANISMS
ties, so, for example, that respiration will be accelerated on
increased muscular exertion and accurately related to it, is also
a function of the nervous system but not a function of mind.
Here we have a relatively simple activity, frequently repeated in
precisely the same way and giving rise to well defined results
along definitely established nervous paths and taking place without
the intervention or cooperation of consciousness.
From this illustration we may gather that mind brings about
only adjustments to outside conditions, that internal adjustments
are not effected by the mind, and that these external conditions
are relatively complex and unusual while the internal adjustments
are relatively simple and frequent.
In other words, the lower nerve centers regulate the interrela-
tions of the functions of the several organs of the body while
the highest nerve centers that constitute the physical basis of the
mind have to do with the adjustment of the individual as a whole
— as a biological unit — to his environment.
To approach the problem in another way let us try and see if
we cannot shed light upon it by a survey of the way in which these
reactions are builded up.
In the first place every such reaction consists of three parts.
The receipt of information from the environment through the
medium of the special sense organs : the assimilation of this mate-
rial and its relation to the traces left behind of previous similar
experiences ; and the issuing as a result of certain actions that in
their ensemble constitute conduct.
The man in the example just given sees and hears the runaway
team dashing towards him but he is only able to appreciate his
danger because he has had innumerable experiences in seeing and
hearing before to which he can relate his present experiences.
The new-born babe in the same situation would derive no such
information from the same set of conditions. It is because he
knows the meaning of these experiences that he is able to initiate
the proper movements and so control his body as to remove it
THE CONSTITUTION OF CONSCIOUSNESS 5
Such possibilities of reaction as described are plainly seen to
be the result of experience, of the continuous coming into contact
with all sorts of external conditions which have to be reacted to,
extending over all of the years of life.
The child when born into the world has no mind, no conscious- *"
ness. It has, however, a central nervous system and special sense
organs. From the moment of its birth it begins to receive sensa-
tions from the outer world and to react to them. Some faint
conception of the tremendous mass of material that is poured into
the central nervous system through the medium of the special
sense organs can be gathered from the statement of Titchener 2
that it is possible to distinguish 44,435 sensation qualities and the
additional fact of the wide distribution of some of the special
sense organs, especially those located in the skin, so that there are
literally thousands, probably hundreds of thousands of points of
In no other way can the stuff out of which mind is made find
its way to the brain except by the sensorium. Whatever man
may become must in the last analysis depend upon this material
and so no conception of mind can fail to take it into account. A
person at any particular moment is the end result of all the proc-
esses that have been at work since his conception and in the same
way a given state of mind can only be conceived to be what it is
because of all that has gone before — it is the end product.
In order that results may be attained, in order that the reactions
of the individual should gradually develop from the meaningless,
ill-directed, diffuse motions of the infant to the well-directed and
efficient activities of the adult something more is necessary than
the mere receipt of all this mass of sensory material.
The mass of sensations that are hourly, even momentarily, being
conditioned by the constant stream of neural changes from the
periphery and which are the raw materials of mind, the matter
'Edward Bradford Titchener: An Outline of Psychology. The Mac-
millan Co., New York, 1899.
6 MENTAL MECHANISMS
later to be elaborated into percepts and ideas, are not received
without order or classification. From the beginning they tend to
group themselves about central points of interest, to be welded in
association with one another by the dominant affect. Attention,
■ interest, feelings of pleasure or pain and the whole host of affec-
tive states make differences of value among the elements of the
' perceptive mass and weld them into groups as a result. The ideas
and their accompanying affects become constellated.
The boy who has grown up in a Baptist home by living under
conditions that constantly impress him with the absolute truth
of the Baptist ideas, going regularly to the Baptist church and
hearing the sermons there ; never having any experience with
doubt as to the Baptist attitude invariably becomes a Baptist.
His perceptions have all been directed towards that end and finally
are constellated about a dominant idea and affect in a thoroughly
definite way. And so it is with other beliefs and attitudes of mind
or convictions. A man is a Catholic or a Protestant, a Repub-
lican or a Democrat, a believer in the inheritance of acquired char-
acters or a follower of Weismann, as an end result of the balances
that have been struck among his various experiences throughout
life that bear upon these several issues.
The sensory and perceptual material is then not received and
stored in disorder but arranged in definite and useful ways — con-
stellated. These constellations, of course, are of all degrees of
prominence and importance and bear all manner of associational
relations with one another, and so operate in the most complex
way to direct conduct.
A man may be born a Republican and a Catholic and there may
be absolutely no relation between these two convictions. But he
may be a Republican and believe or not in the wisdom of a tariff
commission, and finally his conviction on the wisdom of the tariff
commission may be the conviction of the minority and he may be
willing to renounce his attitude and go over with the majority to
avoid a split in the party. Here two constellations are intimately
THE CONSTITUTION OF CONSCIOUSNESS 7
connected but one is more powerful and dominates the other and
so controls the conduct of the individual.
And so is the mind made up. Growing through the years by
the formation of these constellations. Some are extensive and
complex. Some simple. Some are plainly and definitely estab-
lished and have been in existence for a long time, others are of
recent growth and not securely held together in their parts but
susceptible of relatively easy disruption. They have all degrees
of dominance and dependency and are related by a network of
associations. The complexity of their interrelations is very great
but conduct can only issue as a result of their interactions and
although it would seem almost a hopeless task to endeavor to
unravel this bewildering intricacy still it will appear that there
are certain laws that govern here as we find laws governing else-
where in nature and with their help we can define certain general
principles, at least, which may prove helpful. Let us look into
the method of growth of these constellations and examine some
of the conditions surrounding them and the ways in which they
For purposes of illustration let us take the example of the
person who is learning to play the piano and see what happens.
On the sheet of music there are a mass of signs that stand for
notes of different pitch and duration, combinations of such signs
indicating chords, other signs indicating pauses, and various direc-
tions as to rapidity or slowness, expression, loudness, repetition
of certain portions, etc. The piano keyboard is composed of
black and white keys arranged in certain definite relations to each
other. The notes on the sheet of music each refer to a certain
one of these keys and no other and in order to know exactly to
which it refers the player must be able to " read music."
All this mass of impressions presented to the learner are just
so many separate perceptions, jumbled together, without arrange-
ment and without meaning. As the days pass by, however, there
begins to emerge from this mass a perception of relationship
8 MENTAL MECHANISMS
among its several parts, it begins to become comprehensible, takes
on meaning. The relation between the printed notes and the
piano keys becomes definite, the keys are struck and sounds that
are pleasant are produced if the correct relationship has been
maintained in the striking, sounds of an unpleasant quality if a
mistake has been made. The mass of perceptions are beginning
to arrange themselves in an orderly way. Constellations are
Now this process continues and the orderly arrangement of
mental states as related to these outside conditions becomes more
and more extensive and more and more perfect. There is taking
place an adjustment of the individual to the environment, a build-
ing up of a certain relationship between the outside conditions —
the sheet of music and the piano keyboard — and the individual,
and this relationship becomes progressively more and more exact
and more and more efficient. As the adjustment becomes more
perfect disharmonies with their resulting painful mental states
are less frequent — the harmony and efficiency of the adjustment
is improved with practice.
It will be helpful at this point to point out briefly some of the
differences in the state of consciousness of the beginner on the
piano and of the finished product, the accomplished performer.
At first while learning, each movement is painfully conscious,
the fingers have to be watched, each note separately observed, and
the required movements are slowly and awkwardly executed.
When proficiency has been acquired the same results are accom-
plished far better, with much less effort, and with so little atten-
tion that an occasional glance over the shoulder and even enter-
ing into the conversation of those about does not seem to interfere.
At first a note has to be carefully looked at in order to recog-
nize it, then the signature, the tempo, the various directions, and
its relation to other notes in the other clef have all to be sepa-
rately observed before it can be finally sought out on the piano
and struck in its proper time and place. Later all these things are
THE CONSTITUTION OF CONSCIOUSNESS 9
appreciated at a glance and the reproduction is instantaneous.
In this way hundreds of notes in all sorts of relations and combi-
nations may be struck in a single minute as the eye skims rapidly
across the page of music, and the translation from the printed
signs to the appropriate sounds is relatively immediate.
It will be seen that a relationship has been established with out-
side conditions that is very definite, the adaptation of the indi-
vidual to the environment is highly efficient and takes place in a
way so nearly absolutely fixed that it is practically predictable.
There has been established by a slow process of growth a complex
of mechanisms, mechanisms that are automatic or quasi-automatic
in character so that whenever the appropriate stimulus is applied
the whole machinery goes off in a perfectly well defined way in
all its various parts.
In this description it will be recognized that we are describing
a sort of activity that reminds us of the reflex. The reflex, how-
ever, is still more rigidly defined in its possibilities, its response
is, to all intents and purposes, absolutely the same always, when-
ever a stimulus is applied. Then too it is no longer under the
control of the individual but occurs whether or no. The piano
playing activities on the other hand are always under the control
of the subject. He may play or not, as he sees fit, and he may
vary the production from the written directions to suit his own
whim. The various activities of his fingers in seeking the notes
are, however, not changed in either instance, they go on in their
accustomed way in both cases.
This type of activity is called automatic, though it will be seen
from the description that it is really a complex product containing,
it is true, many automatic components, but containing also many
that have not reached that degree of definiteness of response —
activities that are still in the proving ground of automatisms.
One of the changes then that has been undergone in the process
of learning is a change toward an automatic character of the reac-
tion. With continuous practice the activities become more and
10 MENTAL MECHANISMS
Another change, which is important for us to note, is a change
in the degree of awareness that accompanies these activities. The
change toward greater automatism implies this change. From a
condition of very acute awareness of every minute adjustment in
the beginning there is reached a condition of almost absent aware-
ness when a high grade of efficiency has been reached. At least
those portions of the adjustment that have become truly automa-
tisms have become activities of the unaware region of con-
To put the matter a little differently, when the same or similar
conditions in the environment are repeatedly presented to the
organism so that it is called upon to react in a similar or almost
identical way each time there tends to be organized a mechanism
of reaction which becomes more and more automatic and is accom-
panied by a state of mind of less and less awareness. Or to put
the obverse. Consciousness, or at least clear conscious aware-
ness, appears only upon attempts at adjustment to conditions that
are unusual, at " moments of conflict," on those occasions the like
of which have not previously occurred in the experience of the
individual and in relation to which, therefore, there has been no
possibility of organizing reactive mechanisms. To put it again
in a little different form. Clear consciousness does not accom-
pany reaction to stimuli when the issue in conduct can only occur
in a single direction, when there are no alternatives. Conscious-
ness is an expression, as it were, of conflict. It arises in response
to stimuli under conditions that make it possible to react by a
choice of a line of conduct in any one of many directions.
This state of affairs calls to mind an analogy. Consciousness
arises only under conditions of conflict, conditions of great com-
plexity, of increased resistance as compared with the facile reac-
tion along the definite lines of a reflex arc. When in the path
of an electric current, a complex network of wiring is introduced
that raises the resistance to the passage of the current, we find
that accompanying its passage there goes along a marked rise of
THE CONSTITUTION OF CONSCIOUSNESS I I
temperature. As heat goes along with increase in resistance in
an electric circuit so consciousness goes along with increase in
resistance in a mental circuit. Herrick 3 has said " the various
degrees or grades of consciousness are expressions of succes-
sively higher forms of the coordination of forces."
We must think then of full, clear consciousness as only accom-
panying those mental states of adjustment to new and unusual
conditions: conditions permitting of various reactions and involv-
ing therefore selective judgment, critique, choice — in short, rea-
son; and in proportion to the frequency of the repetition of the
same adjustment the mental state accompanying such repetition
tends to sink out of the field of clear consciousness. If we will
consider the infinitude of adjustments the individual has to make
to his environment we will see that this is a conservative process.
As soon as a given adjustment is well formed it is pushed aside
and the field of clear consciousness left free for new problems.
The same sort of process is responsible for phenomena in the
race consciousness. The word " chandelier " originally was ap-
plied to a holder for a candle. The application continued for a
long time, was frequently repeated, and was organized, therefore,
into a stably reacting mechanism. The change in the source of
light to gas failed absolutely to change the reaction and it is only
lately, now that gas has long since been replaced by electricity that
we occasionally hear the word " electrolier." Stated in this way
the method of reaction will be seen to have a biological signifi-
cance and not merely an individual or even a human importance.
All of these considerations go to demonstrate that the field of
full consciousness and rational self-control is a very limited one,
but that on the contrary the great majority of our mental states,
our desires, inclinations, and actions are conditioned by mechan-
isms of which we are more or less unaware. It is worth while in
passing to call attention to the principle that in proportion as the
' C. L. Herrick : The Metaphysics of a Naturalist cited by Professor
Mary Whiton Calkins in General Standpoints : Mind and Body. The Psy-
chological Bulletin, January 15, 191 1.
12 MENTAL MECHANISMS
control of conduct is outside of the region of clear consciousness
it is apt to go astray under conditions even slightly different from
those that were associated with the formation of the reaction —
acting in accordance with the established mechanism even though
conditions have changed, as with the example of the word " chan-
delier " just cited.
Up to this point we have been considering the constitution of
consciousness in respect principally to its vertical dimensions — its
depth. The illustrations have shown how reactions in propor-
tion to their frequency and definiteness are more and more sub-
merged from the region of clear consciousness to zones that are
deeper. There remains to be considered the constitution of con-
sciousness in its extent.
The broad general fact to bear in mind is that the various mental
processes and systems of ideas — constellations — require to be
synthetized and it is this synthesis that constitutes the personality.
J The breaking up of this synthesis, the dissociation, emancipation of
systems of ideas plays such an important part in psychopathology,
particularly in the psychopathology of hysteria, that they will be
discussed in the chapter on hysteria.
As may be inferred we probably are always dealing, in the realm
of the abnormal, with problems both of the depth and extent of
consciousness and not with either alone and it would be next to
impossible in a given case to define just exactly the relations of
the symptoms to these two dimensions. The important thing is
to have a general understanding of the make-up of consciousness
and its very great complexities and to realize that the obvious and
the superficial seldom lead on the right track.
The old idea of monomania is a good example of the sort of
error a following of the obvious leads to. A delusion, a belief,
whether it be the product of a disordered mind or not cannot pos-
sibly come from outside and be engrafted, as it were, upon the
surface of consciousness. The mere fact that it is a belief dem-
onstrates that it is something more than a formula repeated by
THE CONSTITUTION OF CONSCIOUSNESS 1 3
rote — that it is an expression of the individual, of the personality
which as we have learned is a complicated product of the entire
mental life of experience. On this point Mercier's 4 illustration
is worthy of quoting. He says:
"The delusion is not an isolated disorder. It is merely the
superficial indication of a deep-seated and widespread disorder.
As a small island is but the summit of an immense mountain
rising from the floor of the sea, the portion of the mountain in
sight bearing but an insignificant ratio to the mass whose summit
it is, so a delusion is merely the conspicuous part of a mental dis-
ease, extending, it may be, to the very foundations of the mind,
but the greater portion of which is not apparent without careful
sounding. Precisely how far this disorder extends, beyond the
region of mind occupied by the delusion, it is never possible to
say; but it is certain that the delusion itself is the least part of
the disorder, and, for this reason, no deluded person ought ever
to be regarded as fully responsible for any act that he may do.
The connection between the act and the delusion may be wholly
undiscoverable, as the shallow between neighboring islands may
be entirely hidden by the intervening sea. But nevertheless, if
the sea stood a hundred fathoms lower, the islands would be two
mountain peaks connected by a stretch of low country ; and if the
hidden springs of conduct were laid bare, the delusion and the
act might be found to have a common basis."
This illustration emphasizes the fundamental fact in the make-up
of consciousness, of the connection and interdependence of all its
parts. If this were not so a rational psychology would be impos-
sible and all our therapeutic efforts would come to naught.
Relation between Mental and Physical
It will have been appreciated by this discussion thus far that *
as reactions become more automatic and less aware, and approach
the nature of reflexes, that they present less and less the quality
4 Merrier : Criminal Responsibility. Oxford, 1905.
14 MENTAL MECHANISMS
of mental activities and become more and more physical in natuie.
This naturally opens up the whole question of the relations of
the mental and the physical.
While I do not think it would be useful to discuss this question,
at least from a metaphysical standpoint, still there are certain
fairly patent features of the relationship that are of practical
We are constantly meeting with evidences that go to show the
intimacy of the relations between mind and body. We see this
well under those conditions where a certain state of either mind
or body gives rise to certain results in the other. For example :
fear is a mental state and of mental origin but many physical
changes follow close upon its heels — the rapid pulse, cardiac pal-
pitation, vasomotor disturbances (pallor), dilated pupils, secre-
tory disturbances (sweating), tremors, etc. On the other hand,
the effect of the physical upon the mental is well seen in the
toxemias as uremia and alcohol, in the mental states that go with
certain diseases such as Basedow's disease, Addison's disease, and
general paresis. A cut finger illustrates this relation well, for
the cut is a purely physical thing while the pain is a purely mental
fact, and finally there is the James-Lange theory of the emotions
that accounts for our emotional states by preceding physical
My own opinion is that the individual reacts by the develop-
ment of mechanisms that include both physical and psychic com-
ponents, as the examples just cited indicate, and that between the
most definitely physical of bodily processes on the one hand, and
the highest psychic on the other an infinity of gradations exist.
The recent work of Pawlow, 5 on the salivary secretions of
dogs, illustrates this conception well. He has shown that the
physiological process, the flow of saliva, could be brought about
reflexly by stimuli of sight, sound, touch, temperature or odor
■ Pawlow : Naturwissenschaft und Gehirn. Wiesbaden, J. F. Bergmann,
1910. Yerkes and Morgulis : The Method of Pawlow in Animal Psychol-
ogy. Psych. Bui., August 15, 1909.
THE CONSTITUTION OF CONSCIOUSNESS I 5
provided only the stimulus had previously been applied in asso-
ciation with the giving of food. Having applied the stimulus
originally thus associated so that it entered into and became a part
of the mechanism of the dog's reaction to the food, later the reac-
tion took place by the application of the stimulus although the
association with the food was left out. The physiological process
had become organically linked with the psychic stimulus. In
other words a mechanism had been created which acted as a
whole. Like a watch, the parts were so intimately related that
no portion could be set in motion without setting the whole going.
Or like a train of gunpowder, no matter where it is lighted the
fire spreads rapidly throughout the whole train so that it all
explodes very nearly at the same time.
Even when a portion of the mechanism is destroyed the rest
may operate. The decerebrate dog turns and growls and bites
at the fingers that hold his hind foot too roughly. Here there
cannot be any possibility of the psychic state of anger. As Sher- v
rington 6 says, " The action occurs, and plays the pantomime of
feeling; but no feeling comes to pass."
In these two examples we have mechanisms each of which con-
tain both physical and psychic components. In the first the
mechanism was " touched off " from the psychic end, in the second
from the physical end.
The action of a complex mechanism as a whole is shown excep-
tionally well in a case reported by Prince. 7 The patient was sub-
ject to hay fever in a very severe form when exposed to roses.
On one occasion a bunch of roses was unexpectedly produced
from behind a screen. A severe attack followed with lachryma-
tion, congestion of the mucosa, dyspnea, etc., although the roses,
unknown to the patient, were but paper. Here a pure psychic
fact at one end of the scale produced a set of reactions which at
the other gave rise to sensory, motor, vaso-motor, and secretory
8 Sherrington : The Integrative Action of the Nervous System. London,
Archibald Constable and Co., 1906.
Prince: The Unconscious. Jour, of Abnormal Psych. Volume III, •
Nos. 4, 5 and 6. Volume IV, No. 1.
1 6 MENTAL MECHANISMS
disturbances which can hardly be conceived to be remotely psychic.
The important fact is that from the one to the other is an unin-
terrupted chain of associations.
Some further illustrations of the relation of mental and physical
that seem particularly apt have received comment in the recent
literature. They are important because they show clearly how
the mental may be the starting point for physical changes. It is
unnecessary to illustrate at any length the obverse — that the
mental state is influenced through the physical. Everyone's expe-
rience contains numerous patent illustrations of this relationship
from the more subtle effect upon one's mind from taking small
quantities of alcohol or other drugs to the grosser and more
obvious effects of a blow upon the head. This aspect of the rela-
tionship needs no support.
The recent experiences in thyroidectomy for exophthalmic
goitre show how very important the mental state may become in
relation to the physical. The success or failure of this operation,
with the resulting death of the patient in the latter case, has been
shown to depend very largely upon the possibility of so orienting
the patient emotionally with reference to the surgical procedure
that it is possible to do the operation under favorable conditions
so far as the mental state of the patient is concerned. Crile 8 in
a recent article has discussed this whole matter fully and out-
lined some of the methods for preventing or minimizing the ele-
ment of psychic trauma. In working over this subject in con-
nection with his study of a large series of cases he did some
experiments on rabbits, and concludes that pure fear is capable of
producing physical lesions in the cells of the rabbit's brain.
The recent work of Cannon 9 on adrenal secretion is very inter-
esting and suggestive. He found that a solution of I to 20,000,000
of epinephrin inhibits the contraction of longitudinal intestine
muscle. Blood taken from the vena cava of cats that had been
9 G. W. Crile: Grave's Disease. A New Principle of Operating Based
on a Study of 352 Operations. Jour. Amer. Med. Assn., March 4, 191 1.
9 W. B. Cannon and D. De La Paz: The Stimulation of Adrenal Secre-
tion by Emotional Excitement. Jour. Amer. Med. Assn., March II, 1911.
THE CONSTITUTION OF CONSCIOUSNESS 1 7
frightened by a dog produced this same result but no such result
followed in the control. If the adrenals were removed this effect
did not follow the excitement.
All of these illustrations go to demonstrate, to my mind, that
the relation between mental and physical cannot be expressed,
for example, by the theory of parallelism. This theory would "
have it that the two are absolutely different, that there is no real
relationship of cause and effect between them, but that they go
along side by side as a man and his shadow. All of the illustra-
tions I have given seem to demonstrate indisputably that there is
a relation of cause and effect between mental and physical, and
further, that the cause may be physical and produce mental effects,
or, on the other hand, that it may be mental and produce physical
The practical and helpful way to consider the situation is to
consider the individual as reacting as a biological unit. This *
reaction has certain mental and certain physical factors. Viewed
from one standpoint one set of factors is emphasized; viewed
from another standpoint the other set comes to the fore. The
real nature of these factors is a subject that, along with all such
questions that deal with the ultimate nature of things, may well
be left to the metaphysicians.
One more matter in this relation of mental and physical. One
not infrequently sees the statement that for every mental change
one must postulate a physical change, and whether these two are
considered to occur only side by side or to have relations of cause
and effect it is assumed that the occurrence of one implies the
occurrence of the other, and the two cannot be thought of in any
other way. A further implication of such statements is that a
sufficiently refined chemistry would give us the exact change from
the normal that has occurred when a fixed idea, for example, has
possessed the mind, and so there is no such thing as a strictly
While I am willing to admit that it must be conceived that there
is a physical change in the central nervous system corresponding
1 8 MENTAL MECHANISMS
to every mental state, still such an admission does not carry with
it the necessity for the further deductions that are often made.
A watch may be taken apart and the several wheels and springs
thrown into a heap. No examination of the structure of brass
or steel will show that any change has occurred. The structure
of the watch as a whole has been greatly damaged but the nature
of the several parts has not been changed. The disorder is a
disorder of the relation of the parts to one another, not of the
nature of the parts themselves. If a salivary duct is cut in two
so that the saliva does not enter the mouth, the whole function
of digestion may become disturbed; but the initial trouble was
not a tissue change, not even a chemical change, but a disturbance
in the relation of the several parts of a mechanism.
In the same way in the functional mental disturbances, those
of psychogenic origin, the individual as the result of bad educa-
tion, vicious example, poor environment, comes to have faulty
standards, distorted viewpoints, wrong ideas. There can hardly
be conceived to be a different chemistry for such ideas than there
is for the average individual. Of course it may be argued that
the cut in the salivary duct is a physical, and so a physicochemical
change, that accounts for the trouble; that the chemical changes
in people of faulty standards were abnormal at the point where
the ideas departed from the beaten paths and went wrong; that
the chemism of a certain mental state in one person must be dif-
ferent from a different mental state in some one else, and so on
ad infinitum. To my way of thinking all such statements and
arguments are academic in nature, and to say the least, bootless
so far as practical helpfulness is concerned. Whether we can or
cannot trace every fraction of a mental state to physicochemical
changes is a matter for the laboratory and for the future. In
the meantime it is decidedly more helpful to think of many con-
ditions as being purely mental and in such cases, where disorder
exists, to think of that disorder as being a disorder of relation
(association) of the several parts of the mechanism rather than
a disorder of the nature of those parts.
TYPES OF REACTION— DEFENSE AND COMPENSATION
I have spoken of the mind as a complex of adjustive mechan-
isms. It will be well to study some of its mechanisms in action.
In order that the nature of these reactions may be most easily
understood it seems expedient to approach their discussion by
first describing briefly the better known reactions of the same
character in the physical realm.
The types of physical action to which I refer are the bodily
reactions, defense and compensation reactions we may call them,
to the various inimical agencies that may be brought to operate
against the organism. For example: we know how the body
defends itself from the invasion of microorganisms and bacterial
poisons — how the invader is actively attacked and there are devel-
oped antibodies to counteract the disintegrating effects of toxins.
We know that sometimes these efforts are fully successful, that
sometimes they fail absolutely in the face of an overwhelming
invasion and the individual dies, and that sometimes there is a
compromise, the life of the host is saved, but at the expense of
more or less destruction of certain parts with the formation of
a scar. These are typical defense reactions. Then we have reac-
tions that are more noticeably compensatory. Injury and disease
frequently result in deformities, for example : a curvature of the
spine, and when this takes place, we can see the development of
a compensatory curve in the opposite direction so that the erect
posture is not jeopardized. The man who has lost his legs de-
velops tremendous strength in his arms and the muscles of the
shoulder girdle so that he can use crutches and gets about with
1 With certain additions (to be found in Chapter VIII) and minor
changes this chapter formed the substance of a lecture at Cornell Univer-
sity in the course in Hygiene and Sanitary Science, February 28, 191 1.
20 MENTAL MECHANISMS
remarkable facility. In cases in which the pathological changes
are brought about slowly it is astounding what the body can
accomplish in the way of adapting itself to new and unusual con-
ditions. I have for example seen at autopsy a tumor as large as
a hen's egg growing within the brain which it had distorted by
pressure in every direction without producing hardly any symp-
toms during life until near the end. The annals of medicine are
filled with instances of the distortion of viscera, the migration
and final extrusion from distant parts of foreign bodies and hosts
of other examples of the wonderful capacity of the body for
adjustment to conditions out of the ordinary. It is to this class
of physical facts that I desire to call attention for the purpose
of pointing analogies with certain classes of experiences in the
First, in order that these analogies may be the better appre-
ciated, let us bear in mind the conception of consciousness that
regards it as a means for adapting the individual as a biological
unit to his environment.
Whereas the functions of the lower nerve centers have to do
with the interrelations between the several organs of the body,
so, for example, that the respiration shall be increased at the
time of increased physical exertion and be accurately timed to
that need, the functions of mind, considered in the large, are to
bring about a proper relation of the individual as a whole to the
several factors of his environment, more especially for our pur-
poses, his social environment. He must be able to relate himself
to his fellows in a way that makes for relative efficiency and we
may say in a general way that those persons who find their way
>> into the hospitals for the insane are those who have been unable
to so relate themselves, have failed in making this adjustment and
so being unable to live efficiently in their social milieu have to
be taken out of its complexities and cared for in institutions.
This adjustment to environmental conditions is not, however,
limited to a passive moulding of the individual by the environ-
TYPES OF REACTION 21
merit but has an active side. The individual reacts upon his sur-
roundings and endeavors to shape the world of phenomena in
accordance with a plan he has in mind. He tries to mould the
world about him to suit his needs, his desires.
It will be at once apparent from this conception of mind as
being acted upon by the environment and in turn reacting upon
the environment under the stimulus of desire that conflicts must
constantly ensue, between desire and attainment, conflicts that
may reach a satisfactory conclusion, may rest in a compromise,
or result in failure.
It is at these points of conflict between the individual and
forces either from within or without that are inimical or destruc-
tive in tendency that there arise the types of reactions to which
I desire to call attention and which correspond to the defense and
compensatory reactions in the realm of the physical functions.
One of the simplest of the mental defense reactions is for-
getting. An analysis of examples of forgetting indicates that
it is not the simple process it is usually supposed to be ; that it is
not, in many cases at least, a passive process at all, but is emi-
nently both active and selective. Forgetting in other words is a
means of defense for it is the disagreeable and painful expe-
riences that are characteristically selected. Recall some embar-
rassing gaucherie you may have committed in the past, recall your
active attempt to put it out of mind and at least your partial suc-
cess, then compare the disagreeableness of having these remarks
perhaps remind you of it and you will realize how much that is
unpleasant you have been spared. This forgetting is a conserva-
tive activity putting out of mind the disturbing and the painful.
Sometimes considerable periods of time or a whole series of con-
nected events are dropped out of consciousness en bloc as it were,
and it will be found on analysis that these circumscribed amne-
sias, as they are called, characteristically relate to painful events,
such, for example, as the horrifying experiences of a train wreck.
From being so gross and obvious the process of forgetting often
22 MENTAL MECHANISMS
occupies itself with very small affairs. One of my patients for
certain reasons, which it is not necessary to detail, was not fond
of her husband, in fact entertained a certain resentment towards
him. He provided her, while in the hospital, among other things
with pencils as she was very fond of writing. Invariably, how-
ever, almost as soon as he gave her a pencil it was mislaid and
lost. The pencil was a concrete reminder, it originated a painful
emotional experience, so she defended herself from this source
of unhappiness by losing it, putting it hors de combat, so to speak,
where it could do no harm.
This example of the pencil symbol shows well the mechanism
by which a painful subject may be surrounded by danger signals
as it were, warnings that any further progress in that direction
will be disastrous. In this way a disagreeable or painful memory
may be surrounded by a wall of defense which may grow in
extent and circumference until there is hardly any approach to
the personality at any point. This is very well illustrated by a
case cited by the eminent French psychologist, Dr. Janet. 2 A
woman had lost a very dear friend by death. She retained only
one souvenir of him, an old dog. Two years after his master's
death the dog died. From this event the woman began to have
nervous crises at intervals. The details of her defenses are inter-
esting. These crises were brought on by simply hearing a dog
bark in the street, by seeing a cat pass by, or even hearing the
name of one of these animals pronounced. Certain other words
had the same effect, such as " love," " affection," " happiness,"
and she absolutely forbade their use. The mention of a certain
date was similarly painful and so for fear of being reminded of
that date she forbade the mention of any date whatever in her
presence. My patient of the pencil symbol by this sort of mech-
anism finally developed the delusion that she was dead and this
idea made her almost inaccessible from any direction.
2 P. Janet : The Mental State of Hystericals. G. P. Putnam's Sons, New
York and London, 1901.
TYPES OF REACTION 23
It is in the realm of the abnormal that we often find the clearest
examples of such defense reactions for we must remember that
here, as in the phenomena of disease in the body, we are dealing
with an experiment of nature — an experiment such as we are
unable to make in the laboratory but which pulls apart and dis-
sects for us the complicated structure of the mind and shows us
what is going on within.
Another of my patients 3 who was suffering from an hallucinosis
heard a voice that advised him as a father would a son; it sug-
gested to him to become a Catholic for he would then have a
priest who would be a father to him. It is noteworthy that his
father was dead — that he had been remiss in his religious duties
and had been drinking a great deal, in fact his psychosis was the
result of over indulgence in alcohol. His better self literally
spoke to him in the form of this hallucinatory voice.
A very instructive case is reported by a Swiss psychiatrist 4 of
a Russian Jew, who, greatly against the dictates of his conscience,
had decided to become a Christian. His mother appeared to him
in a dream and said, " If you do this I will choke you." Here
the " still small voice " literally spoke and he obeyed. Another
most interesting case 5 is cited of a young woman who was so
beside herself that she decided on suicide as the only escape from
her sufferings. She went to the water's edge and was about to
throw herself in when the image of a physician, in whom she had
great confidence and upon whose advice she had learned to lean,
rose from the water, took her by the arm and led her home, mean-
time counciling her upon her duties to her children and otherwise
pointing out to her how wrong was her contemplated act. See
how wonderful are the defense mechanisms in these cases that
3 Wm. A. White: A Case of Unilateral Hallucinosis (Alcoholic). Bul-
letin No. 1, Government Hospital for the Insane, Washington, D. C.
'Jung: Uber die Psychologie der Dementia Praecox. v
"Flournoy: Automatisme Teleologique Antisuicide. Un cas de Suicide
Empeche par une Hallucination. Arch. d. Psychologic, Tome VII, Octo-
24 MENTAL MECHANISMS
serve to keep the individual to the right path and even in the last
case actually to save a person from destruction.
Although the defense mechanisms may work with great effi-
ciency, in serious conditions when the pain is very great they
do not succeed. No matter how thick or how high they build
their wall the pain is still within and has to be reckoned with.
Some compromise is now sought. Some compensation that
will enable the person to bear his burden. We all know the
usual examples. Emerson 8 has cited a number of the common-
places and our experience has given us others. We are familiar
with the great sorrow that turns out to have been a blessing in
disguise, we have seen harsh, severe characters made mild and
sweet by illness, we know of misfortune that has brought out
great strength of character and efficiency in an individual that up
to that time had shown only weakness, we have seen time and
time again the disappointed and bereaved turn to the consolation
of religion. These are the usual things. But the mechanism of
compensation is more widespread than these simple instances
would indicate. The character by which we are known is often
the result of this sort of solution to the inner conflicts. People
who are noted for their wit or for their cynicism are often per-
sons sad at heart who have developed a character which expresses
quite the opposite of what they really feel and as in the phe-
nomena of immunity the bodies developed in the organism to
antagonize a poison are always developed in greater quantity than
necessary, here the reaction goes beyond the requirements and
the wit and cynicism become obtrusive features in the character.
It is these inner conflicts, the results of the discrepancies be-
tween desire and possibility of accomplishment that furnish much
of the energy, by a process of sublimation for our activities. It
is a commonplace that the love-sick maid or youth may have their
interests distracted by social activities and amusements — the
energy of their conflict may be drafted in other directions. In
* Essay on " Compensation."
TYPES OF REACTION 25
the same way we believe that, often at least, the beautiful things
produced by the artist are the result of sublimated energies
devoted to his art. These inner conflicts must be handled in
some way. In the weak and poorly organized they literally tear
the individual apart and make only too often nervous invalids or
even result in chronic deteriorating psychoses. One of the most
efficient of the mechanisms developed for dealing with them is the
mechanism of compensation.
It is no empty phrase, the saying that " an artist is wedded to
his art." For a life of sorrow, bitterness and disappointment his
art offers him the only avenue of expression, in this direction only
can he mould to suit himself, here is the only opportunity for
expression, for fulfilment, and he turns to it and finds in the
oblivion it brings him his only happy moments.
Look for a moment at the lives of those two Titans in the
realm of art — Beethoven and Michelangelo. See Beethoven, a
strange, distorted personality, practically a recluse, often with
barely enough money to buy food, and living in poverty and want.
He lavished all of his affection upon his worthless nephew who
brought first one and then another sorrow upon his shoulders,
disappointing him over and over again and finally indirectly caus-
ing his death. In the latter part of his life he is still further cut
off from the world and even from his music by deafness and still
we find him repeatedly under all these miserable conditions in a
very ecstasy of joy when possessed of some grand conception
which he is weaving into a musical composition.
So much as we know of Michelangelo reminds us of Beethoven,
a sad, depressed, resentful character, forced by successive Popes
to paint when he himself declared he was not a painter but a
sculptor, and finally fighting for the liberty of his beloved Florence
and seeing it fall and then with the irony of the relentless fate
that pursued this tortured soul he was forced to serve its new
In more recent times we see, I think, quite clear evidences of a
26 MENTAL MECHANISMS
tremendous, unresolved internal conflict in the life of Tolstoy.
This remarkable character was always at war with himself,
always unhappy and dissatisfied. The conflict at the end, when
by age and sickness he had lost the power of keeping it in control
produced that dramatic but bizarre, almost grotesque fugue just
preceding his death that was almost pathological in its outward
And so we find innumerable examples of men who have brought
things to pass, creative geniuses in all walks of life who have been
torn by inner unrest, but who have been able to turn all their
magnificent energies into their life work — to sublimate.
Let us turn again to nature's great psychological laboratory —
the mind deranged. Here we find compensatory mechanisms
quite characteristically. Take the following case: A man of
sixty-five. During his early days he had been very successful
and succeeded in acquiring a competency and was able to retire
from business. Toward the latter part of his life, however, there
was a falling off in efficiency and he lost all his money. Having
been in the naval service of the United States he entered one of
the naval homes. Here he secured a position in the office at
clerical work. He is recorded as having exalted ideas of his
own ability and being suspicious of those about him. He finally
came into such acute conflict with his surroundings (personal
encounters) that he was sent to the Government Hospital for the
Insane. The explanation of his mental state is relatively simple.
Having fallen off greatly in efficiency he is defended from the
painful realization of this fact by exalted ideas of his ability.
His work, however, as a matter of fact is not well done. He is
again protected from the painful realization that it is because
of his inefficiency by the ideas of suspicion which places the blame
upon others who are jealous of him and try to injure him. Re-
moved from the setting in which these troubles developed he at
once calmed down and presented on the surface quite a normal
TYPES OF REACTION 2"]
In the mental disorders that are associated with deterioration
the combination of exalted ideas with delusions of malevolent
J outside influences is quite common. It is the protective device
• erected as the result of a compromise between desire and accom-
I take it Kipling gives us just such an example in his works.
In saying this you will understand that I draw no hard and fast
lines between the normal and the abnormal. My illustrations
from the pathological are only illustrations and have no further
connotations. The same mechanisms are found in every-day life
as are disclosed in the insanities. To return to Kipling and see
if we have not an excellent evidence of the productions of a
writer as the result of a comproimse between desire and fulfil-
ment. His story " They," written after he lost by death his
favorite child, is a story of children, not real children but the
children of fancy that are everywhere in evidence but yet have
no real existence, the creatures of the mind, the wish children of
the writer described in the pages of his book.
This example calls to mind those delightful Alice stories
written by Lewis Carroll — a bachelor, a semi-recluse, a mathema-
tician — and seems inevitably to suggest the same kind of expla-
Not only does the author reap compensations from his work
but the reader may, too. In a delightful bit of Stevenson's, an
essay on popular literature, he discusses the reasons for the vogue
of the penny-a-liners. The type of story affected by the bar
maid and the shop girl is usually a fervid tale of love under
difficulties in which the heroine, who is, mark you, of the bar
maid or shop girl persuasion, is finally won by her hero, a real lord,
married and translated from her lowly state to the peerage. See
what such a story offers. From the sordid life of serving mugs
of ale at the corner pub Maggie has a magic wand with which she
can at a moment's notice transfer herself into the land of dreams,
the land where things come true, and identifying herself with the
28 MENTAL MECHANISMS
heroine live through the chapters of the story another life in
which all her wishes are realized. It is no small happiness that
Maggie gets out of her story and it is no small service to have
We psychiatrists must acknowledge that many of the things
that we have discovered with great labor have been known in-
stinctively by the writers for a long, long time.
And this brings us to the land of real dreams. The most recent
•* theory of dreams regards them without exception as wish-fulfil-
ing. To cite an example: One of the most profoundly depressed
women I have ever known, so depressed that she finally succeeded
after several attempts in taking her own life, invariably had the
pleasantest of dreams, always dreaming that she was at home,
happy with her children.
The dream is not usually so obviously wish-fulfiling as this.
For reasons into which I will not enter now, the real mean-
ing of the dream is so hidden that it can only be discovered by
tedious methods of analysis. In such cases the meaning is gen-
erally expressed in symbolic form. One of my patients dreamt
that she stood beside a casket in which she saw her own dead
body, the hands crossed and a red rose held in one of them.
Analysis disclosed the meaning to be her desire to be united to
her lover from whom she had ben cruelly separated, even though
that union be in death. He and she had been schoolmates as
children and every morning he used to bring her a bouquet of red
roses from his mother's garden and place them on her desk. The
red rose symbolized her girlhood's sweetheart.
The child's dream is much more frankly wish-fulfiling than
that of the adult. He has not yet become so complex as to pro-
duce a symbolic dream like the last one I cited. He goes frankly
and directly to the point. Yes, and more than that. He dreams
in his waking state and in his play lives out his dreams so that
the child world is very different from the world of realities, the
world of cold facts that the adult learns to know.
TYPES OF REACTION
It is a fascinating theory that assures us that after all, no matter
how hard the world may be, we have but to sleep and presto ! all
is as we wish it.
There is considerable collateral evidence, however, that this may
be so, evidence that goes to show that man will have his way
whether or no, if not in the world of facts, then in the world
If we turn to folk-lore we will find that just as the heroine in
the penny-dreadful represented all of the fondest wishes of the
reader realized, so the hero of folk-lore stands for the realization
of all that the race believes desirable. There is a remarkable
similarity in the stories, particularly as to the origin of peoples
and tribes. Almost in every instance the origin is traced in some
myth back directly or indirectly to a god head.
See here the same mechanism precisely that we saw in the
dream, in the production of the artist and the wish-fulfiling of
the writer and the reader, and in the self-aggrandizement of the
insane man. People wish to be great and verily they are great.
The child lives in a land of dreams, a fairy land of fancy. *"
The myths, the legends, the folk-lore are the dreams of the child- v
hood of the race. And as there are many grown-ups who still
believe in ghosts so there are advanced races who stick to the
legends of their childhood. Do our preachers not tell us that
" man is made in the image of God ? "
I have said that man will have his way, if not in the realm of
facts then in the realm of fancy. It often happens, however, that
things do not go as he wishes, they refuse to do his bidding, as
it were. Particularly is this so with regard to his own impulses
and actions. The reaction under these circumstances is inter-
esting and instructive. Let me illustrate. I was talking a short
time since to a man who had been sentenced to life imprisonment
for manslaughter. He had killed a man by stabbing him in a
quarrel. I questioned him for the purpose of seeing just how
he felt with regard to his act. In the first place he was very
30 MENTAL MECHANISMS
emphatic in his blame of the deceased for picking a quarrel with
him. He was very much bigger than the prisoner and so the only-
way he could adequately defend himself was with some weapon.
The deceased knew this and was virtually taking his life in his
hands when he started the trouble. Then again the doctor didn't
treat the wound as he should. The man came to his death really
through his own foolhardiness and the lack of skill of the physi-
cian. This was all told with a smiling countenance and without
the remotest suggestion that the man blamed himself in the least.
This is the reaction to which I referred. The reaction of justi-
fication. The prisoner convicted of a crime, has deluded himself
into the belief that he is blameless and that what happened was
unavoidable and must simply be made the best of. Those who
have the disagreeable duty of holding this man in custody are
convinced that it is for the good of society and so you see every-
body is happy, even the criminal, and we might say with Pangloss,
"All is for the best in this best of all possible worlds."
We see this reaction of justification on all sides. The drinker
drinks when it is hot to cool off, he drinks when it is cold to
warm up, when he is joyous to celebrate, and when he is sad to
drown his sorrow. All of which simply means that he cannot
control his habit so he must find a good reason for indulging it
and so justifying his conduct to himself.
The " sophisms of the indolent " are perhaps best known. Go
down into your own soul and recall your reasonings when your
desk was filled with work and a beautiful summer's day beckoned
you to a day of recreation in the company of kindred spirits. We
all indulge in the weakness but some do little else their whole lives
long but invent excuses for being idle.
There are many, many more types of defense. Sleep is per-
haps the best organized one. We do not sleep because we are
fatigued. We sleep long before the deleterious effects of fatigue
are in a way to damage the organism. Sleep is a biological
defense against fatigue. We sleep so that we may not become
TYPES OF REACTION 3 I
(fatigued. And so with laziness and diffused attention. These
are not always to be condemned. They are often the only means
at hand for preventing undue stresses. One could hardly invent
■ a better means for preventing mental overwork and strain than
: by a diffused attention, a degree of distractibility that prevents
! close application. We must not after all be too harsh in our
! judgments of the indolent but remember that they number in
their ranks many relatively inefficient persons who are unable to
bear the stresses incident to prolonged continuity of effort.
From these illustrations, the thought I am endeavoring to con-
;■ vey can, I think, be gathered. As the biologist sees in living
beings creatures constantly at war with their surroundings, devel-
oping weapons of offense and defense, succeeding, failing, but
more frequently coming to some compromise in the struggle, so
we may look upon the world of minds and picture each individual
mind in just such a struggle with just such kinds of results.
THE CONTENT OF CONSCIOUSNESS— DREAMS— SYMBOLISM
—THE PSYCHOSES— FOLK-LORE
The fundamental conception which it will be the object of this
v chapter to set forth is that every psychic fact must have been
preceded by an efficient psychic cause. As we have already had
repeatedly emphasized by examples, ideas, or better, mental states
do not arise de novo. They must always be the outcome of other
mental states from which they necessarily issue. This is so
throughout the field of psychology, normal or morbid. It is true
even in the realm of the psychoses due to organic changes in the
brain. That an alcoholic should have a delirium may well be
dependent upon a toxemia, but whether he sees in his delirium
snakes or monkeys, visions of his office or of hell must depend
upon purely psychic causes, upon the preexisting psychic material
which has become involved in the disorder. Whether a paretic
is exalted or depressed, whether the exaltation is largely erotic
or expresses itself by delusions of great wealth must find its
explanation in the mental make-up of the person afflicted, and
the character of his psychic trends. The cards may be indefinitely
shuffled or arranged in any way, but there are only fifty-two in
the pack, and the result whatever it may be, must be conditioned
by that fact.
With this fundamental conception the psychiatrist, for example,
is in a position to remind us of the chemist or the astronomer.
>f If there is a hiatus in the logical connections of the different steps
in a psychosis, like the chemist he can with confidence look for
an element to fill the space. If there is a disturbance somewhere
along the line he may expect, like the astronomer, to find a hith-
erto unknown source of energy to account for it.
Our assumption then is that every psychic fact has an efficient
THE CONTENT OF CONSCIOUSNESS 33
psychic cause ; that an idea does not spring into existence without *■'
having been the logical outcome of other ideas; that for every
mental state, for every idea or feeling, there is an adequate expla-
nation whether that explanation can or cannot be found. It im-
plies for example that every psychosis, if all the facts were known,
by that is meant internal, conscious facts, would be found to
have arisen as a logical necessity step by step ; that every state of
mind should theoretically be capable of reconstruction from the
elements that analysis shows it to consist of.
If this is true it should hold under all circumstances, normal or
abnormal, for we must always remember that there is no qualita-
tive difference in the mental processes in disease and health — the
difference is only quantitative.
This conception has received a certain popular vogue in the
general expression that we cannot dream of anything we did not
previously know about though we might dream of an animal with
a lion's head, a crocodile's body, and horses' hoofs still all the
component parts were well known — nothing has been created.
A good illustration of this view came within my experience
during a recent ocean crossing. We were nearing the other side
and were beginning to pack and get ready to land. As is usual
we were often asked to write in each other's albums, exchange
cards, etc. One of my fellow-travelers, in giving me a " souvenir
de voyage " signed it as on board the " Kroondam." Now there
is no such ship as the " Kroondam." There is a " Kroon-land "
and we were on the " Noor-dam," so the material out of which
the new name was made is plain to be seen. Of course I have no
knowledge of the reasons that led to this lapsus calami.
Another example will show this point perhaps better. A pa-
tient during a delirium called a cigarette " Thingvalia." An
analysis of this expression showed that the patient had once won
some money betting on a horse by that name and that with the
money thus won he had purchased some of a particularly expen-
sive brand of cigarettes. The association thus became plain and
34 MENTAL MECHANISMS
the reason for the use of the word to designate cigarettes clear.
And so again we find an apparently fortuitous incident fully and
adequately accounted for.
Let us look further, into some of the different kinds of con-
sciousness, particularly in dreams and the psychoses and see
whether this principle holds true there, and first let us take up
One of my patients dreamt of a log cabin in the mountains
with which he was familiar as a boy. There appeared in the
dream two dogs, then two wild cats, a house cat, a man and finally
a big gray wolf. The two dogs, the house cat and the man be-
longed to the place as he remembered it. Wild cats, too, were
plentiful in that locality and he had often seen them. He never
saw but one wolf, however, and that one had been poisoned and
was dead when he came upon him suddenly near the house one
day, and he was badly frightened. This wolf, though, was a
yellow wolf while the dream wolf was gray. The discrepancy
is accounted for by the fact that he had been to the zoo a day or
two before and had seen some gray wolves. This is an excellent
example, not only of how the dream is conditioned by the just
preceding waking experiences, but of the detailed picking out of
a single element and its modification by such preceding experience.
Let us take a more complex example. A young woman dreamt
that she was standing on the edge of a precipice; a man came
along and pushed her off. At the base of the cliff was a mass
of writhing serpents; just as she was about to fall among them
she screamed and awoke. The impression was created on listen-
ing to the recital of this dream that she had been much frightened
at being pushed from the cliff. This, however, was but the elabo-
ration of the waking consciousness. She was not frightened to
any extent. The analysis shows why. The cliff was familiar
to her as being a place she had frequently visited. Standing on
the edge of the cliff was symbolic of a social and moral danger.
THE CONTENT OF CONSCIOUSNESS 35
She had never seen an old-time lover since she had married, and
had wondered, if she were thrown with him, if he would try and
tempt her. The man who pushed her off the cliff was her lover,
and the falling down really representing a moral fall, did not
frighten her very much, but was rather pleasant as it involved his
companionship. As she nears the bottom, however, she sees the
den of serpents. The serpent for her represents sin and recalls
the sin in the garden of Eden. Her fall has been pleasant until
she sees its end in sin. This end is so hateful to her that she
cannot even permit the idea to enter her thoughts. The censor
of consciousness, lulled by sleep, has permitted this symbolic
wish-fulfiling play to go on up to this point, but now must be
aroused to full activity and press back to the furthest and darkest
recesses even the suggestion of a sinful denouement. The patient
So much for the meaning of the dream. It will be interesting
and instructive to trace one of its component parts — the part
played by the serpents. In the first place, we already have the
utilization of the snake symbol in the dream, conditioned by its
occurrence in the Bible as a symbol of sin in the story of Adam
and Eve in the Garden of Eden. In passing it might be men-
tioned that the snake appears very often in the folk-lore of many ^
peoples as a symbolic emblem. In addition to this, however,
analysis disclosed three distinct snake experiences previous to this
dream, and all had occurred within a period of three weeks.
First : There was a disturbance in the hen house, and she went
with her mother to see what the trouble was. They found a large
snake coiled up on the eggs. Her mother, who had brought a
pistol, shot it. The next morning she found its dead body nearby.
Second: While walking out with her mother a snake (she
thinks a spread-head adder) ran across the walk, and her mother
stamped on it and crushed its head with her heel.
Third : On the occasion of a visit to her sister's grave she found
a snake coiled up on the grave.
36 MENTAL MECHANISMS
These three snake experiences were elicited by the method of
free association (see Chapter VII) from the snakes of the dream
as a starting point, and so I think we may be sure that they all
played a part in conditioning that portion of the dream. The
dream snakes, we would say, were over determined. That is,
their occurrence was brought about from several directions, from
Certain further ramifications of the serpent symbol are inter-
esting, particularly in view of its frequent phallic significance in
dreams, art and legends.
When she was twelve years old (it was after the three snake
experiences) a man passed her as she was sitting in a carriage
with a girl friend. He returned, asked where she lived and later
called on her parents. He became a constant caller, wanted to
adopt her and finally induced her parents to let him take her for
a few weeks to Havana. One day he grabbed her and tried to
kiss her. She fought and screamed, was much frightened and
went to her room and cried; shortly after she returned home.
In describing this man she says she does not know how to express
herself, but that his forehead was wrinkled, his shoulders drew
together, expressing a disagreeable and disgusting feeling, and she
says she always thought of him as a sort of snake.
After her marriage she resorted to the usual means to prevent
conception, but always considered it wrong. She used to then
recall the snake coiled up on the eggs (first snake experience)
and think of it as symbolic of her sinfulness in preventing con-
Previous to the patient's admission to this hospital she was in
a sanitarium for some months. While there she was occasion-
ally given a hypodermic injection, and used to think of it each
time as the sting of the spread-head adder (second snake expe-
rience). One night — she had been taking bromides for a long
period — she awoke and saw the room full of snakes of every
kind. They were on the ceiling even, and the quarter round was
THE CONTENT OF CONSCIOUSNESS 37
a tape worm. On another occasion she looked out from a watch
tower upon the sea of eternity, upon which was a rowboat in
which were her husband and children. She tried to get to them
but could not, because a large boa constrictor was wound about
her. On one occasion she told of this vision somewhat differ-
ently. Said her dead child called to her from the boat, " Mamma,
please come with us ! " But she realized that she was lost and
could never get to them. Did not recall about the boa constrictor
when reminded of it, but says she feels as though a big snake was
coiled about her every minute of her life.
Another dream of the same patient is equally illuminating. To
understand this dream it must be known that the central event
which was the determining factor in producing her psychosis was
her separation from the man she loved through the machinations
of her mother, who brought it about in such a way that she
thought he had deserted her, and her subsequent marriage to the
man of her mother's choice whom she did not love.
One month after the separation she attended the funeral of a
young man who had been engaged and whose fiancee had nursed
him in his last illness. At the funeral she wished it were she
that was dead, and thought it would have been better to have died
than to have been parted. Following this experience she had the
first of what I shall refer to as the coffin dreams.
She dreamt that she was standing beside a coffin in which she
saw, instead of the body of the young man, her own dead body.
The coffin of the dream was the coffin she had seen. It was black,
had silver handles, and was lined with white satin. Her hands
were folded across her chest, too, just as his hands had been.
There were certain differences, however. There was one candle
burning at the head and another at the foot of the coffin, and in
her hand she held a red rose.
Now as to the meaning of this dream. In the first place, after
she had been separated from her sweetheart she had plunged into
social dissipation, opera, teas, social functions of various sorts,
38 MENTAL MECHANISMS
in order to distract her mind from her sorrow, and as a result
had become very much tired out. The candles were symbolic of
this state of affairs and were emblematic of the old adage, " Burn
the candle at both ends." The rose, too, had symbolic signifi-
cance. Her sweetheart, when they were children together in
school, used to lay a bouquet of red roses, that he had picked in
his mother's garden, each day upon her desk. The rose sym-
bolized her sweetheart, and in accordance with the theory of
Freud that all dreams are wish-fulfiling, we can interpret the
meaning as being the wish to possess her lover, even though that
possession were in death.
It is of great significance that this coffin dream occurred three
times during her life. Once after the funeral, then the night
before she was married, and finally the night before her second
child was born. Note the critical moments it selected for its
appearance, or more properly note that these are occasions, above
all others, when the thought of her girlhood's sweetheart would
tend to recur to her.
A further example of the symbolism of the red rose and the
vivid emotional coloring it received in her consciousness, is
offered by a visit to a florist. The place was filled with red roses,
she saw an hallucinatory figure of her old-time sweetheart,
greeted him with an exclamation of surprise and fainted. When
she came to she inquired if a gentleman had been standing
"there," and was, of course, told "no."
During her delirium in the sanitarium, and before admission to
this hospital, she saw her own funeral procession in the clouds.
She had considerable nose bleed at that time, and the bleeding
seemed like red roses gushing out, and the blood would rush out
forever, run down the stairs, and the people fled in terror.
So much for the phenomena of dreams. These examples show
the intimate relation of constellations in consciousness, and how
they are associated. It is naturally impossible to separate the
dreaming and the waking consciousness, because they are merely
THE CONTENT OF CONSCIOUSNESS 39
different experiences of the same thing; and so we see how the
same influences that condition the dream also condition certain
phenomena in the waking state.
A word only about symbolism in connection with this subject
of dreams, for it seems the most appropriate place, although the
phenomenon is widespread and by no means confined to expres-
sion in dreams.
A symbolic method of thought or expression implies a primi- v'
tive, simple type of mind ; one that does not look beneath the
surface of things, but accepts without question the obvious. One
thing resembles another in some single character only perhaps,
and immediately the conclusion is reached that they are related
in nature or perhaps even identical. This is the crudest of all
forms of reasoning — reasoning by analogy, 1 and gives rise not
only to all sorts of errors but to beliefs that are most grotesque
and fantastical. Examples are many and may be found in abun-
dance in the superstitions and folk-lore of all peoples.
We all know something of the good and evil spirits, in the
beliefs of different peoples, that are supposed to account for
things; of the dryads and nymphs, the demons and the furies, the
fairies and trolls, the banshee, hobgoblins, ghouls, ghosts and
gnomes. They could all be pressed into service as examples of
symbolism and reasoning by analogy.
Shute gives in illustration 2 the belief of the English peasants
that they hear in the gale that sweeps past their cottage the wail
of the spirits of unbaptized children, and cites Tylor, who
recorded an experience in Cornwall of the belief that " shingles "
was attributed to a kind of coiling serpent. A young girl was
afflicted and the family waited in grave apprehension lest the
animal completely encircle her. They believed that if the crea-
l D. K. Shute: The Philosophical Foundations of Charlatanry in Medi-
cine. Washington Medical Annals, Vol. VI, No. 6.
* Loc. cit.
40 MENTAL MECHANISMS
ture's head and tail should meet the patient would die. See on
what flimsy, superficial, inconsequential similarities an inherent
relationship of some sort between phenomena is posited!
y It is in the realm of dreams par excellence that the phenomenon
of symbolism manifests itself in all its richness. The dream con-
sciousness is uncritical ; ideas come and go without direction, the
whole scene suddenly shifts without calling forth even an excla-
mation of surprise; the faintest resemblance is enough to cause
one object to symbolize another. We are dealing with a state of
•J mind quite as lacking in intelligent selection as the mind of primi-
tive people ; and so, as we might expect, the results are similar, for
myths and dreams are quite alike in structure and meaning.
If dreams offer the best opportunity for symbolism, it is not
the only opportunity. We meet with this phenomenon constantly,
v especially in the psychoneuroses. As we have seen that the
symptoms of the psychoneuroses have their inception in a region
of consciousness that is removed from the full, bright light of
conscious awareness, a region that is not in the focus of atten-
tion, we might expect that the result would be similar to that
found in dreams. This is so. The symptoms of these disorders,
and in fact of the psychoses, have their birth in the twilight region
of consciousness, where critique is in abeyance. For the same
reason, therefore, as in dreams, we find that resemblances are
taken at an obvious face value that results in symbolism.
From this brief digression on the subject of symbolism, let us
now turn to the symptoms of
Here the evidence is often not so clear because of the rich
growth of material that has been going on for years, so that,
more than anywhere else, we will be led astray if we follow
the obvious. The psychosis, so far as the mental symptoms are
concerned, is an expression of a conflict in the individual's mind
between desire on the one hand and attainment on the other. The
THE CONTENT OF CONSCIOUSNESS 4 1
psychosis is an expression of failure plus the more or less well
organized compensatory and defense mechanisms. Let me illus-
trate by repeating a case cited in Chapter II.
A fairly successful business man 3 begins to lose efficiency in
the arteriosclerotic period of life. He had acquired what, at that
time (twenty years ago), and for such a man, was a fortune —
about sixty-five thousand dollars. With the falling off in effi-
ciency he lost all this and entered the Naval Home. Here,
because of his business experience, he was given a place in the
office at clerical work. He came into immediate and frequent
conflict with those about him. Two sets of ideas developed side
by side, both of which are expressions of a defense reaction to his
failing efficiency. He had very exalted ideas of his own ability.
Such ideas you see are distinctly defensive, for they save him
from the pain of a realization of his defects. Then along with
these ideas goes the delusion that he is being interfered with by
those about him. Another defense reaction which serves to ex-
plain how a really efficient man, such as he considers himself, can
after all, turn out such poor work. Again he is saved from a
realization of his failings.
You see how, if we seek to understand our patients, each symp-
tom will be found to have its raison d'etre, and not be in any sense
whatever fortuitous or accidental. This association of grandiose
and persecutory ideas is frequent and I am sure often has a simi-
lar explanation. Take another case. 4
A single woman, in middle life, breaks down and develops a
well marked prsecox type of reaction, with a loosely organized
system of delusions of marked sexual coloring. She believes that
she is married to a Mr. A , that she has had a criminal opera-
tion performed on her, complains of having had a vaginal hemor-
rhage and says she has two large cuts in the vagina. Without
going into details I may summarize the situation by saying that
'White: The New Functional Psychiatry. Case II, Arch, of Diag.,
4 Case III, loc. cit.
42 MENTAL MECHANISMS
here we are dealing with a woman in whom the conflict is a
sexual one, with the development of a compensatory and wish-
fulfiling delusional system. Wishing for a child she becomes
impregnated. Being a virtuous women this has to be accounted
for, and she therefore develops the delusion that she is married to
Mr. A . Inasmuch as no child appears upon the scene, a
delusion that she has had an abortion performed accounts for its
absence. But because this is a criminal operation and there-
fore repugnant to her, a further delusional formation meets the
difficulty. The operation was performed without her knowledge
while she slept. See how logical such a delusional system really
is! Note also how it compensates for certain well-defined defi-
ciencies in the patient's life.
To revert again to the patient already mentioned, the one who
had the snake and coffin dreams. She had the delusion that she
was dead and spoke of herself constantly in the third person as
" the corpse." Without going to the full length of analyzing and
explaining the growth of this delusion, I want to invite your
attention to the great number of unusual experiences that she had
in her lifetime with death.
At the age of five, when she was living in New Orleans, a
convent in that city burned down. It had double walls and be-
tween the walls were found many babies' bones. She used to be
frightened as a child in passing the convent for fear they might
get her and throw her down between the walls.
When about fourteen she read " The Murder of Nancy by Bill
Sykes," and fainted while reading it.
She has read Voltaire, Paine, " Letters from Hell," etc.
She saw three of her schoolmates drowned. One of these
drowning accidents occurred just a week before her only mis-
She had two experiences in the South in seeing a crowd of men
about to lynch a negro.
During the Spanish-American War she dreamt of seeing a
THE CONTENT OF CONSCIOUSNESS 43
young man, the son of friends, who had gone to Miami where
the troops were stationed. He was seated on a bench on a long
wharf and was quarreling with a soldier who was walking in
front of him. He got up and struck the soldier, they had a strug-
gle, and the soldier stabbed him and threw him overboard. As
his body struck the water she awoke. At ten o'clock that morn-
ing the boy's mother received a telegram informing her that her
son had been murdered. (The temporal relations may of course
be reversed — paramnesia.)
After her little boy died she received three postal cards, each
bearing the picture of a stork, but sent by different persons.
When twenty-three years old a funeral passed the house. She
said to a woman present that she envied the corpse. The woman
remonstrated with her.
In 1894 she took tea one day at the house of Mrs. O. Next
morning a lady met her and told her she had news for her, and
asked her if she could imagine what it was. She replied that
Mrs. O. was dead. This was the fact. Mrs. O. had been found
dead in bed; was well the night before when she was there.
(This may also be paramnesia.)
About one month before her marriage a girl friend at whose
house she was married, sent her her photograph. She had been
ill and looked bad as a result. On the back of the picture she
had written, " Susie going to her own funeral."
Her mother has always had a depressing influence upon her.
Says it seems as though her whole life had been a struggle against
the gloomy view of life of her mother. Her mother was always
saying, "What's the use of life," etc., and when she was eight
or ten years old she remembers her mother used to talk about life
and take a gloomy and pessimistic attitude towards it. Only yes-
terday (June 4) she received a letter from her mother telling,
among other things, of three suicides among her friends.
She had three experiences taking railway journeys, and found
out after she had completed them that the dead body of a friend
was on the train.
44 MENTAL MECHANISMS
Once she was discussing death with a girl friend. Her friend
said she had never had a death in her family. Just then the door
bell rang three times. Mrs. W. said, " Maybe that's a death now."
It was a telegram announcing the death of her friend's father.
She received a letter from a friend who committed suicide.
The letter arrived after her friend was dead.
When she was twenty-two a young man whom she knew was
arrested for running up and grabbing an actress. Later he mar-
ried a girl friend of hers, and three years afterwards was found
murdered in a house of ill-fame.
When she was eighteen she had a flirtation with a young man
in a town she was visiting. This man was noted for the con-
quests he had made, but he fell in love with her. He asked her
to marry him and she refused. He asked her again, with the
understanding that her answer would be final. She refused again.
He walked home with her and blew out his brains in front of her
house. As a result of this experience she was ill for several
A lieutenant who had asked her to marry him was killed at San
She had a narrow escape from death once in a cyclone. The
house was nearly destroyed and two nearby houses were. The
horse was killed and her mother stunned.
She used to recite a great deal, for example at Chautauqua.
She recited once " Death Doomed " by Will Carleton. There
were three thousand people present. The professor had told
her to really see the gallows when she was reciting. Says she
actually did see them for an instant and felt as though she were
being led to be hung.
She says that of the different recitations she used to give she
cannot recall one that did not have to do with death.
She remembers such things as Tennyson's comparison of mar-
riage to a winter funeral, and recalls Marie Corelli's book " Ven-
detta " begins, " I who write this am dead."
THE CONTENT OF CONSCIOUSNESS 45
There are other features in this case that led to the culmination
in a delusion of death. These I will not enter into here. It
would seem to be quite evident, however, from this rich expe-
rience, that the subject of death was held before her mind very
prominently throughout her entire life; that her life must have
been distinctly colored by these numerous, often highly emotional
experiences, and that later on it was a matter of comparative
ease, an issue that might almost have been expected, for the psy-
chosis to take up this material and use it in weaving a delusional
It is hardly open to question that this is exactly what happened.
All of these experiences were obtained from this patient by the
method of free association with her delusion as a starting point,
so that it is clear that they all had associational relations with the
delusion. The delusion then bears at least a similar if not the
same relation to the several experiences as did the snakes of her
dream to the actual srtake experiences — it is over-determined.
The delusion was brought about as a result of tendencies, pres-
sures from many different directions. It has the value of an
over-determined idea, an over-valued idea, a hyper-quantivalent
idea or a dream thought continued in the waking state. The pre-
cipitating reagent that brought all this material together so that
the delusion of death issued therefrom I will not discuss.
The thought I wish to convey is that no idea, no desire, no
impulse, no action of any sort whatever but what has its sufficient
cause, and that cause, too, in the realm of mind.
There has recently been an attempt made to apply to folk-lore
the principles that have been brought out in the study of dreams
and in the psychoanalysis of the mentally deranged. The dream
as related, the obvious, or as it is generally called, the manifest V
content of the dream, is but the fagade behind which one finds
the essential, that is to say, the idea of the dream or the latent
46 MENTAL MECHANISMS
content. Similarly with the psychoses, and in fact with any
mental fact that is not most simple. To follow the indications
of the obvious is only too often to go astray.
The study of folk-lore, the fairy tales, myths, and legends, has
led to conclusions of the same character as the study of dreams
and the psychoses by psychoanalysis.
The principles of wish-fulfilment and of symbolism appear
characteristically in the various fairy stories, fables and legends.
Ricklin 5 particularly deals with these principles in relation to such
fairy stories as are found in Grimm, the Russian fairy stories,
and the Icelandic sagas. He particularly lays stress upon the
appearance of certain similar features in all these stories, no
matter what their origin. There appear to be some common fea-
tures that are more fundamental than race or environment. He
traces these fundamental features to certain infantile psycholog-
Abraham 6 endeavors to relate the subject matter of dreams
and myths. He calls attention to the results of the analysis of
dreams, namely, that if a considerable number of dreams are
analyzed in a large number of persons it will be found that certain
dreams are common in their essential characteristics, that is, are
fundamental and seem to belong to the race. The analysis of
these dreams shows that in each instance they have their root in
childhood experiences. Now over against these facts of analysis
of dreams he takes up for discussion the Prometheus saga, the
birth of Moses and of Samson, particularly discussing the myth
of Prometheus. He applies to the elucidation of these myths the
same principles which Freud has brought to bear in his analysis
of dreams. He discovers as a result in all the myths funda-
5 Franz Ricklin: Wunscherfullung und Symbolik im Marchen. Schriften
zur angewandten Seelenkunde. Zweites Heft. Franz Deuticke, Leipzig
und Wien, 1908.
"Karl Abraham: Traum und Mythus. Eine Studie zur Volkerpsychol-
ogie. Schriften zur angewandten Seelenkunde. Viertes Heft. Franz
Deuticke, Leipzig und Wien, 1909.
THE CONTENT OF CONSCIOUSNESS 47
mental, underlying common factors which are hardly varied even
superficially in their expression. These fundamental, underlying
factors are the same underlying factors that were found in the
fundamental dreams. These fundamental dreams which have
their origin in the childhood of the individual are therefore in
every way analogous to the myths which have their origin in the
childhood of the race.
Rank, 7 in his study of the myths relative to the birth of heroes,
especially Sargon, Moses, Kama, CEdipus, Paris, Telephos, Per-
seus, Gilgamos, Kyros, Romulus, Heracles, Jesus, Siegfried,
Lohengrin, shows that in these myths we have the same psycho-
logical mechanisms that go with the dreams and fantasies of
childhood. The childish dreams are egocentric. The child occu-
pies the center of the stage and the events of the dream serve
for his aggrandizement. In the same way the people in explain-
ing their origins have traced them back in each instance, me-
diately or immediately, to a god-head, serving thus to aggrandize
These studies all tend to show that the human mind reacts
according to certain fundamental principles no matter under what
conditions or circumstances it may, for the time being, be placed.
Even if the several authors had not suggested or endeavored to
demonstrate what that principle was the remarkable similarities,
amounting in many instances almost to identity, which they have
pointed out in the folk-lore of widely different races and separate
peoples would indicate that there must be such a principle to
account for such results.
In the face of such a principle we would expect to find here,
in the realm of mind, as elsewhere in the course of bodily devel-
opment, that there would be certain relations, certain similarities,
between the development of the child and the development of the
7 Otto Rank: Der Mythus von der Geburt des Helden, versuch einer
psychologischen Mythendeutung. Schriften zur angewandten Seelenkunde.
Fiinftes Heft. Franz Deuticke, Leipzig und Wien, 1909.
48 MENTAL MECHANISMS
race. This is shown in the similarities between the fundamental,
common types of dreams and myths. There is then a childhood
of the race which has a certain likeness to the childhood of the
individual. The principle is a well-known one in biology — onto-
genesis epitomizes phylogenesis.
CHAPTER IV 1
THE " COMPLEX "—TYPES OF "COMPLEX" REACTIONS-
MODES OF EXPRESSION— GENERAL CONSIDERATIONS
The term complex as used in this chapter is comparatively new
but like most new terms it does not correspond to an altogether
new idea. It is but the recent German clothing of an idea that has
found expression for many years in France and later in this
country under the designation of " dissociated state." With the \S
advent of the theory of the complex, however, the study of what
had formerly been called dissociated states received a new impetus
and as a result, complex, as used to-day, has a considerably dif-
ferent connotation than dissociation. 2
In order that we may approach the discussion of the " com-
plex " logically and for the purposes of clearness in presentation
it will be worth while to introduce the subject by still further
illustrations of mind as adaptive mechanism.
True to this characterization it is constantly exhibiting adaptive
phenomena. While we all recognize those more patent adapta-
tions of the individual, mental in origin, whereby he adjusts him-
self to the social conditions in which he lives, adopts the customs,
observes the conventions, and obeys the laws, we hardly appre-
ciate the extent and the minute detail to which efforts of adjust-
ment are carried under circumstances where they are not quite
1 This chapter was printed, substantially as it appears here, under the
title " The Theory of the ' Complex,' " in the Interstate Med. Jour., April,
2 Janet: The Mental State of Hystericals. (Trans.) New York, 1901.
Sidis : Psychopathological Researches in Mental Dissociation. New /
York, 1902, Boston, 1908.
White: The Retraction Theory from a Psychical Standpoint. Proceed-
ings Am. Med. Pysch. Assn., 1899, and Arch, of Neurol, and Psychopath., </
50 MENTAL MECHANISMS
Some years ago during a vacation trip abroad I saw for the
first time the Alps. My drive over the Furka Pass was a reve-
lation of the most gorgeous scenery I had ever beheld, but I was
nevertheless disappointed. The mountains did not seem nearly
so stupendous as I had pictured them to my " mind's eye." My
companion who had been through the Alps many times insisted
that I was drawing entirely erroneous conclusions as to dis-
tances. But I knew better, for could I not see? However, he
was so positive in his statements, that I " lay about " with my eyes
for proofs to disconcert him. I no sooner did this than I began
to find that I was wrong — not he. Distances that had seemed
insignificant were thousands of feet, and mountain peaks where
I was sure I could have seen a man, had he been standing there,
proved to be at such an altitude that a man would have been lost
to vision as an insignificant speck against a neutral background
long before reaching them. The marvelous grandeur of the Alps
was beginning to unfold itself before my vision. The character
of the images on my retina had not changed but it took my mind
some time to adapt itself to these new circumstances and sur-
roundings, some time to realize — to see — the stupendous heights
which were presented to its wondering gaze for the first time.
In many cases the adjustment is not so readily made nor is the
difficulty at all appreciated. Those who are fond of music and
who are affected by a voice know how tiring a recital may be if
the singer is, for any reason, unequal to the proper rendering of
a difficult piece and must make a very constant and very evident
effort in the interpretation. The listener finds himself uncon-
sciously trying to assist, his muscles at times actually tense, and
if he is a singer he may actually go home with a throat tired out
by his efforts to assist the artist in reaching high notes and sus-
taining difficult phrases.
So, too, we get a feeling of unrest from certain illy balanced
structures. The Greeks recognized this in their architecture.
The Greek column is made bulging in its middle and is thus rein-
THE " COMPLEX " 5 I
forced at a point which, in a column with straight lines, seems
weak and therefore gives a sense of unpleasantness to its con-
This consideration of mind as adaptive mechanism is necessary
in order to understand its various modes of reaction under dif-
ferent conditions. Here as elsewhere in natural science we are
most often assisted in understanding difficult and intricate mech-
anisms by a study of those cases in which, for any reason, the
machinery is out of order, and so a few of the simpler examples,
particularly those where the adaptation fails, are worthy of note
as forming a natural introduction to the subject of this chapter.
Whatever it may in essence be, the mind has its limitations and
restrictions which in every-day life must be observed. Like any
mechanical force its operations cannot be spread efficiently over ^
a wide area. To accomplish results the attention must be cen-
tered on the work in hand to the more or less complete exclusion
of other and distracting influences. The college professor who
takes out his watch to observe the time and then calmly tosses it
into the nearby lake, or while pondering over a mathematical
problem runs into a cow and raises his hat politely with a " beg
pardon" are familiar examples of the defects of conduct resulting
from this conservation of mental energy — its restriction in narrow
channels — the so-called absent-mindedness.
Of a considerably different type is the case communicated to
me of a young man who as a child had been disagreeably affected
by seeing some criminals and who all through life thereafter
would walk any distance out of his way to avoid passing a prison
or a jail. Similarly the case of a child who was frightened by a
false face and always thereafter had a marked dislike for a
homely countenance. Mosso 4 gives the interesting reply of an
old soldier to the query as to what his greatest fears had been.
He said: "I have only had one, but it pursues me still. I am
'Judd: Psychology. New York, 1907.
52 MENTAL MECHANISMS
nearly seventy years old, I have looked death in the face I do not
know how many times, I have never lost heart in any danger, but
when I pass a little old church in the shades of a forest, or a
deserted chapel in the mountains, I always remember a neglected
oratory in my native village and I shiver and look around, as
though seeking the corpse of a murdered man which I once saw
carried into it when a child, and with which an old servant
wanted to shut me up to make me good."
These last three examples all show modes of reaction to dis-
agreeable conditions in the environment and were all developed
upon the basis of states of fear.
In this connection it is in order to make a passing comment on
the much worn subject of the relation of body to mind (discussed
in Chapter I ) . The fact for us to consider is that the individual
reacts to external conditions not simply from a physiological or
from a mental basis but that he reacts as a whole — as a biological
unit — and in this reaction are both physiological and mental ele-
ments, sometimes one and sometimes the other, dominating the
picture. Now in fear, for example, we know that there are many
physiological changes — the tachycardia, dilated pupils, tremor,
relaxed sphincters, respiratory and secretory disturbances — but
the only reason we give it a name that applies primarily to the
mental rather than to the physical state is simply because the
mental facts so overshadow the others that they are quite over-
This fact, that mental reactions, illustrated by the extreme case
of fear, are fundamentally reactions of the whole individual, is
important to bear in mind and serves to explain many otherwise
inexplicable phenomena in psychopathology and to indicate the
directions in which explanations for still others may be found.
So far all my examples are from normal reactions. The way
to the abnormal, however, is not far and these are, of course,
what interest us most. We see in all these cases that ideas, ten-
dencies, inclinations, fears, disappointments, are capable of bring-
" a>^-..-t.t T^-«r "
THE COMPLEX 53
ing about mental reactions that are manifested entirely apart from
the individual's volition. The forgetting, a sudden religious fer-
vor, a pleasant dream, perhaps, come about without any reason so
far as the subject knows.
Take for example the case of Irene, cited by Janet. 5 This
poor girl, living in a garret in abject poverty, nursed her mother
through a long illness with consumption ending in her death.
During two months she watched her mother gradually nearing
her end and was at the same time forced to work at sewing to
get a little money for the bare necessities of life. Her mother
died and in her anguish she tried to revive the corpse which during
her manipulations fell to the floor and was only lifted back to the
bed with great exertion. After all this was over Irene forgot
completely not only her mother's death but the amnesia was retro-
grade and she did not even remember her illness. She said, " I
know very well my mother must be dead since I have been told
so several times, since I see her no more ; but I really feel aston-
ished at it. When did she die? What did she die from? Was
I not by her to take care of her? There is something I do not
understand. Why, loving her as I did, do I not feel more sorrow
for her death ? I can't grieve ; I feel as if her absence was nothing
to me, as if she were traveling, and would soon come back."
This example from the realm of hysteria, gives us a good idea
of what is meant by a complex. This term is employed to desig-
nate a group of ideas (constellation) 6 clustered about, constel-
lated as it were, a central event, which event has a large content
of painful emotional coloring. You will see how this describes
our cases if you will review them for a moment. All of the
acutely painful circumstances of her mother's death and even
such associated ideas as those connected with her early illness are
dropped in toto from Irene's memory.
The special thing to note is that the ideas that are thus asso-
8 The Major Symptoms of Hysteria.
•See Chapter I.
54 MENTAL MECHANISMS
ciated together are grouped about a certain event and that this
event conditions a highly painful emotional state.
It is to such a constellation of ideas, cemented by painful emo-
tion, that the term " complex " is applied and when the complex
produces a mode of reaction (in this case amnesia) without the
patient being aware of its existence it is spoken of as dormant.
Let us, however, go a little further in this direction. Muthmann 7
has compared the complex to an abscess and the defensive reac-
tions to the limiting wall of fibrin. I think, however, that it
were better compared to a localized inflammation with its sur-
rounding area of tenderness. Take for example the lover who
has had a quarrel with his mistress : He enters into conversation
with a lady when a chance expression, a vague suggestion of the
odor of a well known perfume, a something equally as trivial
reminds him of her and the quarrel, he flushes, becomes confused,
changes the topic of conversation, leaves unceremoniously and
otherwise shows that the sore spot has been touched and the
defense reactions are brought into play to remove him from the
source of irritation. This method of reaction is quite common
and typical of the dormant complex with large emotional content.
We typically find evidences of the complex then under circum-
stances in which the mental reactions are aimed at an effort of
adjustment to inimical, disagreeable, disintegrating factors in the
environment. Under such circumstances we find a series of pro-
tective reactions, guarding the mind against these inimical influ-
ences, which are just as well defined as the protective colorings
of insects are the defense reactions of the body against infection.
Types of " Complex " Reaction
Of this class of reactions the various types of forgetting are the
most pronounced. Painful, disagreeable experiences, the mind
in its protective, conserving efforts tends to avoid, to put aside,
*Zur Psychologie und Therapie Neurotischer Symptome.
the "complex" 55
to consign to the limbo of the forgotten. With all the thousand
and one things to be done the painful facts of life must not be
permitted to occupy the center of the stage — they must give way
to the business of the hour. Take, for example, the case of the
young man cited by Jung. 8 He suffered the pangs of unre-
ciprocated love — the young lady married another man. When
later he came to have business relations with his rival he found
himself always unable to call his name and had repeatedly to ask
it of others in conducting his correspondence. Or take the case
cited by Maeder. 9 A young man sees a performance of Samson
and Delilah; it awakes a series of painful memories. A few
weeks before he had read the review of a book to his fiancee,
which treated of the indelible impressions of the first love on a
woman. He thinks of the possibility of a separation from her
and later the whole event, together with the contents and author-
ship of the book, very kindly drop from his memory. Later they
are revived under the influence of an optimistic mood which they
are incapable of affecting.
Another type of reaction which is wisely provided for in the
general scheme of things is the " compensating." For the sadness
and sorrow, the blasted hopes and disappointments, the trials and
tribulations, the mind again comes to the rescue. We are familiar
with the way in many cases. We understand the young woman,
disappointed in love, who takes herself to a nunnery and devotes
her life to the service of religion. We have all seen men under
similar circumstances plunge into the distractions of a strenuous
life, or not infrequently into the elusive forgetfulness of alcohol
or opium. The ideal occupation of the disappointed woman is
that of a nurse — for while it brings forgetfulness in new interests
8 Ueber die Psychologie der Dementia Prsecox. (Translation is pub-
lished as No. 3, of the Nervous and Mental Disease Monograph Series.)
8 A la Psychopathologie de la Vie Quotidienne. Archives de Psychologie.
Tome VII, No. 27. (February, 1908.)
56 MENTAL MECHANISMS
it likewise affords compensation by giving play to the maternal
How large a part these compensations play in daily life, what
a tremendous force they are against the "slings and arrows of
outrageous fortune " we can hardly appreciate. It is well worth
while to read the philosophy of the great German immoralist from
this standpoint. Nietzsche founded his explanation of Christian
ethics upon the theory of compensation. The Jews, a weak and
persecuted race, made of necessity a virtue and glorified humility
and the " poor and lowly in spirit." This, the " slave-morality "
shows us on its obverse side a fully adequate compensation for
the sorrows of life, not in this world, but by life and a " joy ever-
lasting " in the next. Whatever may be said of Nietzsche's phi-
losophy we surely know many persons whose path is made easier
among many troubles by an abiding faith that all things are for
the best, and everything will ultimately come out all right, if not
in this life then in the life to come.
Among the very common types of compensation are the wish-
fulfiling dreams and the wish-fulfiling deliria. We are all more
or less familiar, for example, with the very remarkable life of
imagination which children lead, how they live in a world of
fancy peopled by the creations of their own minds and teeming
with events of the most dramatic interest. For hours these little
ones at play will live in a world all their own, associated with kings
and queens and waited upon by mighty soldiers, and in their hours
of sleep they find in the land of dreams their hopes and ambitions
all realized. The little boy dreams he is a motorman, or a police-
man, the little girl reigns as a beautiful princess, so with these
wish-fulfiling dreams added to the day-time fancies the world
becomes a beautiful place to live in even under circumstances in
which we older ones find little that makes for happiness.
Quite parallel with this example, we find in the realm of the
abnormal, that many cases of the most profound melancholia have
compensatory dreams. If they are parents, for example, they
THE COMPLEX 57
dream of being back with their family, surrounded by their chil-
dren and those they love, and so the misery of the day often finds
relief in the visions of the night — certainly a very practical, and
undoubtedly efficient, so far as it goes, defense reaction against
conditions that tend to destroy.
Or take another case cited also, I believe by Janet, 10 in which
a young girl about to be married is deserted at the altar by her
fiance. She falls into a wish-fulfiling delirium 11 in which all the W
events of the marriage as it would have occurred, take place.
What I have called a vicarious psychosis. The patient in order
to get what she wants out of life and what she had expected and
prepared for, resorts, so to speak, to the device of a psychosis.
(c) Mental Attitudes, Moods, Character
We are surrounded at all times by innumerable examples of
the effects on conduct of suppressed disagreeable or painful emo-
tional states. Take for example the man who is past middle life
and with whom the subject of his age is a somewhat tender point.
See how by his attitude he resents being helped on with his coat.
He refuses to acknowledge to himself that time has wrought any
changes and he resents such a suggestion from another no matter
what the kindly motive behind it.
We see again these defense reactions toward special situations
shown exceptionally well by the deaf who insist upon appearing
to understand what is said to them though perhaps hardly hearing
a word. They attempt by their attitude to conceal their infirmity
and thus ward off criticism of their defect and consequent de-
Persistent moods are also often conditioned by dormant, sub-
merged complexes. That witticisms, jokes, puns, are means of
side-tracking painful emotions is a commonplace, while the sad
and melancholy mien of the professional funny man is proverbial.
10 1 have been unable to verify this reference.
"The word delirium here is used in the sense given it by the French,
namely, to apply to the sum of the patient's delusional experiences.
58 MENTAL MECHANISMS
The anecdote is told of a noted Parisian entertainer who sought
the advice of a physician for great depression of spirits. The
physician advised his patient to go to the theater and hear a
certain wonderful comedian for, as the physician said, "Mon-
sieur X. can make any one laugh." His patient replied, "Alas,
doctor, I am that unfortunate individual myself."
And so complexes not only dominate special attitudes, and con-
dition moods, but if persistent, deep-seated, and continuous, they
are often at the bottom of the prominent traits of character.
These prominent character traits are especially well seen in those
cases in which the complex has been constellated by a painful
emotion of sexual 12 origin. The stereotyped example of the
" old maid " scandal monger is a case in point. Deprived of that
"J great boon to woman, maternity, robbed of love, living a life of
bitter disappointment and unfulfilment, if she mayhap has a dis-
tinctly sexual longing she takes this method of adjustment, this
method of approach and contact. The reading of an erotic novel
would be distinctly improper, and if she were discovered would
be adversely criticised, but the scandalizing of her neighbor is a
highly respectable proceeding and keeps her quite within the con-
ventions, and so the delectable morsel is rolled over and over
again and as life becomes more bitter, as fulfilment becomes more
and more impossible so does her resentment show more and more
aggressively, more and more openly.
The phrase "misery loves company," takes its origin from the
desire of those who have failed to pull others down to their level.
It is an expression of the jealousy, envy, resentment, that they
feel for the successful, for if they cannot succeed literally they
can at least play at it in their fancies. Compensation is approached
by a mental trick, a deception practiced upon one's self.
"The word sexual is not used here in the narrow sense in which it is
often employed but with the broadest possible meaning. It refers not only
to the physical relations between the sexes, but to the most distant and
most indirect mental and emotional reverberations. It is used to include
a domain much more extensive than that usually comprised in the word
the "complex" 59
Modes of Expression
We have already seen in our previous examples several means
by which the complex asserts its presence and seeks expression.
We have seen how, in hysteria especially, the means employed is
often amnesia for the painful occurrences. 13 In certain condi-
tions of depression the dream comes to the rescue, while in certain
other states displacements occur and methods of expression are
chosen to take the place of those denied.
Quite frequently the mind seizes upon a single feature in con-
nection with a painful incident and the complex reaches expres-
sion through this alone. This feature thus becomes the complex
One of my cases, a young girl, had received a severe shock by
the suicide of a young man at a party. She saw the blood and
was deeply affected. The memory of the whole affair dropped
completely out of her mind but it was only necessary to show her
something red to produce the feeling of fear. I sent her on an
errand one day to a ward carpeted in red. She quickly came run-
ning back to me, trembling, crying and frightened, although she
could not explain why she was so affected.
The case of Janet's 14 (cited in Chapter II) of the woman who
lost a very dear friend by death shows a very similar condition.
She only retained a souvenir of her friend — a valuable old dog.
Two years after his master's death the dog died. The lady had
a very profound emotional disturbance as a result and later
suffered from hysterical seizures which might be brought on by
simply hearing a dog bark in the street. The case shows well how
thoroughly the outposts can be sentried to protect the vulnerable
point. Not only the barking of a dog but certain words might
bring on an attack so she forbade the use of them in her pres-
ence. The words, "love," "affection," "happiness," are exam-
13 White : Mental Dissociation in Psychic Epilepsy, in Sidis : Psychopath.
"Mental State of Hystericals.
60 MENTAL MECHANISMS
pies. She forbade also that any date be mentioned before her —
in fear of being reminded of a certain date she forbade the men-
tion of any.
Not only are such incidents or accompaniments singled out as
complex indicators as are illustrated in these two cases but quite
frequently the motor accompaniments become much exaggerated
and in attacks so overshadow every other symptom that the cases
seem to have lost their essentially mental characteristics and in
fact may be mistaken for epilepsy.
Sidis 15 cites the case of a young man who had epileptiform
attacks that manifested themselves by " shaking spells." The
shaking began in the extremities and soon involved the whole
body. Sometimes he fell down shaking and trembling all over.
The attacks were traced to his experience as a child when he was
forced to sleep in a dark, damp, and bitterly cold cellar.
This last well illustrates the association of the physiological
with the psychic. These physiological disturbances are constel-
lated with the mental and the two classes of phenomena recur
together. We have already seen that with emotional experiences
there always go along certain physiological disturbances. In
these cases the physical appears in the foreground and the mental,
while it exists, is not apparent on the surface. But why should
this prominence be given the physical? Why should not the emo-
tional expression find its natural, mental, channel of outlet?
The answer to the question why the complex does not express
itself by mental phenomena primarily is that the whole affair is
a defense reaction, a protective device for repressing the complex,
for keeping painful mental facts out of consciousness. These
repressed emotions must, however, find an expression somehow.
Their episodic manifestations in crises finds an explanation not
unlike that for the epileptic attack. The complex with its large
emotional content being repressed, dissociated, falls out of asso-
15 Studies in Psychopathology. Boston Med. and Surg. Jour., March and
THE "COMPLEX" 6 1
ciation with the other facts of mental life and so its accumulated
energy finds no easy channels of exit. The complex therefore is
dynamogenic and when sufficient energy has been accumulated to
overcome resistance, to break down barriers, an explosion — an
attack — takes place. In this attack the energy set free naturally
flows along lines of least resistance. If we consider the various
activities of consciousness as constituting a hierarchy we will see
that the psychomotor levels are relatively low, so that as the ten-
dency in attacks is for the energy to seek lower rather than higher
levels, these" psychomotor outlets furnish the channels of least
resistance. Ideas tend always to expression. Expression is
mainly a matter of conduct and so largely muscular. We find,
therefore, convulsive phenomena — conversions — quite the rule.
Distinct sensory types of reaction may also be found and when
sensory disturbances come on apparently spontaneously and pre-
cede the crises the similarity to epilepsy with a sensory aura is
often marked. One of my patients had attacks resembling petit
mal each time preceded by a headache. She had during an early
seizure fallen and hurt her head. Another case had psychic
attacks preceded by a sensation of green. His original trauma-
tism occurred on a stage carpeted with green baize from which
he was carried, face downward.
A more baffling method of manifestation of the complex still is
the symbolic. One of my patients 16 in his delirium when asking
for a cigarette used a peculiar sounding expression which I dis-
covered later was a foreign word. The explanation of the appli-
cation of this word as the name for cigarette transpired when I
discovered that he had upon one occasion been to the races and
won considerable money by betting on a horse of that name.
Afterwards he had indulged himself in some very expensive cig-
arettes with the money thus won. The connection is obvious —
the cigarette was symbolically represented by the race horse.
Jung 17 cites a very instructive example. " A gentleman wish-
" Case cited in Chapter II.
62 MENTAL MECHANISMS
ing to recite a poem beginning ' a pine tree stands alone, etc./
with the words ' with white sheet ' " he forgot everything. This
seemed so peculiar that Jung got him to reproduce what came into
his mind with these words. The following very significant series
of associations resulted. "White sheet makes one think of the
cloth for the dead — a linen cloth with which one covers a dead
person — (pause) — now I think of a near friend — his brother died
quite recently — he is supposed to have died of heart disease — he
was also very corpulent — my friend is corpulent too, and I thought
it might also happen to him — probably he does not exercise enough
— when I heard of this death I suddenly became frightened, it
could happen to me, as we in our family are predisposed to obesity
— my grandfather also died of heart disease — I too find myself
somewhat too corpulent and have therefore within the last few
days begun treatment for reducing fat."
Here we see how the repressed anxiety which this gentleman
had about his condition resulted in a reaction while reciting a
poem in which he saw himself symbolized by the pine tree envel-
open in its white sheet of snow. Jung also explains the wish to
recite this poem as based upon a desire to effect, in this symbolic
act, a discharge of the complex tension.
If this explanation of Jung seems far-fetched, think again of
some of the phenomena of wit. We all know how frequently the
man whose life is filled with sorrow and disappointment becomes
noted for his witticisms, while the explosion of a jumble of puns,
thin jokes, and " airy nothings " is a method belonging to the
stock-in-trade of every " emotional actress " to use to turn away
suspicion when surprised in a situation she cannot explain.
These displacements of emotional expression into channels other
than the normal and usual ones are quite common. The transfer
may become permanent and often takes on a symbolic character.
Take, for example, a certain type of childless woman who lavishes
all sorts of affection upon dogs, cats, or birds. Here the nature
of the repressed complex is quite evident, while the cat, or the
THE " COMPLEX " 63
dog, as the case may be, becomes symbolic of this complex and so
may be considered as a symbolic complex-indicator.
An excellent example of symbolism in dream consciousness is f
given by Freud. 18 In this case the dreamer is symbolized by a
powerful brown horse that was being hoisted by a thick belt to a
great height. Suddenly the belt broke and the horse was precipi-
tated to the ground but soon rose and galloped away. The
strength of the horse stood for the power of the dreamer to work,
the ascent to dizzy heights his ability to succeed, the belt indicated
that he could not succeed by his own efforts alone but must have
help, the breaking of the belt showed failure when this influence
was withdrawn, but the fact that the horse was not killed but got
up and galloped off symbolized his indomitable energy and ability
to rise again when once defeated.
These displacements, conversions, symbolisms and other phe-
nomena form interference complexes with each other and with
the train of thought and produce very complicated results that
often become practically impossible to unravel. It is really won-
derful, however, how successful psychoanalytic methods applied
with great patience have been. In Jung's 19 classical case of para-
noid dementia praecox the apparently incoherent remarks amount-
ing at times to "word salad" and the neologisms of the patient
which she freely made use of, were explained in a way little short
of marvelous. He was able to explain, for example, the expres-
sion "double polytechnic," which was frequently used by the
patient, as an expression standing for the highest art and wisdom.
The words "Hufeland" and "unhufeland" are found to refer to
a once celebrated doctor by that name while the sentence " I affirm
a million Hufeland to the left on the last fragment of earth on
the hill above " Jung says is a metaphoric paralogic condensation
M Cited by Jung, loc. cit. tS
64 MENTAL MFXHANISMS
for what to a normal mind would be expressed approximately by
" For the bad treatment of the physicians which I have to endure
here and with which I am tortured to death, I claim a high
And so we see how the mind develops certain modes of reac-
tion which are aimed at adjustment with surrounding conditions
or as we often say " getting square with events." We see, too,
how, when disease has pulled the mental superstructure to pieces
and it comes tumbling down in ruins, the same effort at adjust-
ment continues, but it is, of course, expressed in a much more
imperfect and incomplete way. Such studies as I have indicated
V lead us to the inevitable conclusion that nothing mental is fortui-
tous, that for every mental fact, be it the most trivial or apparently
meaningless expression, there is an adequate reason. If the
theory of the complex had done nothing more than this it would
have accomplished a great deal for it has given us a new outlook
upon the mental factors in the psychoses. We no longer should
, I \ feel satisfied with passing mental symptoms by with the remark
I that they are " strange," " remarkable," " incoherent " and with
the use of like vague and meaningless terms. We should feel
that we have a new avenue of approach, that a host of new facts
have been opened up and that much can be accomplished by pa-
tient, intelligent observation and study of cases.
I feel quite sure, for example, that the patient who says to me,
" Now you have a body like a young man who says he is of the
prestigitis," or the other patient who says, " I have been raking
away at it outside and in and inside and out again. I have tried
to write poetry, but could not write any more than six fools,"
have both fairly definite ideas at bottom of this apparent incoher-
ence to which their methods of expression correspond.
This whole matter harks back to the fundamental necessity of
having our mental facts in their proper setting if we are to under-
stand them at all. A very simple incident will illustrate what I
mean. I had called at a home one evening to see a patient when
THE " COMPLEX " 65
I noticed that the nurse, a Miss B., who had had charge of the
case, had been replaced. I asked where she was and was in-
formed that she had gone in conformity with a previous arrange-
ment to take care of Mr. X.'s daughter who had recently been
married and expected to be confined. Just then the telephone
rang and some one inquired for the nurse. The young lady who
had given me the information about the nurse answered the tele-
phone and I heard her say that she had left but she could not tell
where she had gone as she did not know who the people were,
the nurse having failed to tell her their name. The first impres-
sion, very naturally, might well have been that my lady was
indulging in that well known social evasion a "white lie," but
when she returned from the telephone with the comment that it
was rather unfortunate for the nurse to go away without telling
her the name of the family where she was going, that she did not
know who Miss so-and-so married, the explanation was perfectly
clear. We cannot expect to be able to judge of mental facts in other
than their mental setting, a thing, however, which we have been
trying to do for long years with rather discouraging results.
From another view-point the illustration given by Jung 20 is ^
instructive. Suppose we go into a man's office and while seated
engaged in a business conversation with him a clerk brings in a
paper and lays it down upon his desk. Immediately the man flies
into a passion, gets red in the face, gesticulates, and uses forceful
language. We wonder what ails him but when we find out that
day after day, time after time, he has cautioned the clerk, told
him not to do just that particular thing we can understand his
behavior. The act of the clerk was simply the " last straw " that
served to break the back of his self-control. And so how often
in life we only see the last link in a chain of events, and how prone
we are to draw conclusions which would probably be entirely dif-
ferent if we knew all the facts.
Another and equally instructive example in the realm of the
20 Loc. cit.
66 MENTAL MECHANISMS
abnormal is that of Miss P., a case of dementia prsecox. She
wrote the following letter to her uncle
"Washington, D. C.
I am insane as I have been place — in the asylum in the brain favor as
Uncle Bee — was once accused of being craisy over seeing to much of the
Doctor intuition of being deying of death over worrying of seeing my own
self Home, where I belong as I am " Eplay, in trouble all my life & Hope I
re gain cinarc tonces of mind in Body & Kind show me by my own be able
in Doctor Office I hope Mrs. E. & Aunt Ida I join love to all Very own to
claim my own Mind bye from
Affection Neice Sarah."
This patient although noticeably demented presented a quite
natural appearance to casual observation and despite the fact that
her writing is so incoherent, talked well about simple things and
answered questions with a fair showing of intelligence. I showed
her this letter and asked her to read it aloud and tell me if she
wrote it. She took the letter and read it with a perfectly serious
manner and said that she had written it. Her whole attitude
when reading the letter and being questioned about it gave no
indication that it impressed her as in any way strange. On the
contrary it was quite natural and she appeared while reading the
letter to have a full comprehension of its contents. Here again
we are not justified in coming to hasty conclusions without the
proper mental setting for the mental facts. The mere fact that
this letter is hopelessly incoherent and incomprehensible to us
does not necessarily mean that it was to her, and her attitude while
reading it certainly indicates that it was not.
I am tempted at this point to illustrate a conception of mind,
which the consideration of complexes leads to, by a figure of
speech. The mind cannot be conceived as consisting of or con-
taining ideas which are deposited here and there, helter skelter,
without order as the scraps of paper that are thrown carelessly
into the waste basket. Quite the contrary. Ideas are grouped
about central experiences, constellated as we have seen, built up
into coherent and harmonious structures not unlike the way in
THE " COMPLEX " 6j
which bricks and stones are brought together to form buildings
and these buildings are again grouped according to the purpose
they fulfill, as government, business, residential, etc. The city is
built according to a general, though often not very definite plan,
it has its avenues of approach, its highways and byways, its sys-
tems of traffic lines communicating between the different sections,
etc. The central part of the city is pretty well organized and con-
structed, here little change goes on, but in the outskirts new ways
are being opened up and we see lying all about building material
not yet assembled to form new structures. Now suppose an
earthquake destroys the city — what happens? All these fine
buildings come tumbling down. The walls crack and crumble and
the bricks come falling to the ground. Here and there only a
wall, a tower, perhaps a whole building remains standing. The
foundations of all these buildings, however, remain fairly well
preserved, in outline at least; it is for the most part the super-
structure that has been destroyed. Now suppose we try to enter
the city by the usual way, we will find ourselves almost imme-
diately arrested by masses of debris, we will see that the streets
that we were familiar with are blocked at many points, that the
whole picture looks unfamiliar and that landmarks are very diffi-
cult to recognize. Here for example the foundation of a church
which was razed by the shock has been buried beneath the bricks
of an adjoining commercial house. All of the component parts
of the city are still here but in quite different relations and in this
mass of confusion only the trained eye of the old resident can
see the traces of the old order of things and pick out the old
And so it is with many of our patients, particularly our praecox
cases, where the dilapidation of thought is so pronounced. The
fundamental things of mental life, the foundations, remain until
the last but they are often buried under masses of debris and their
location indicated by ideas with which before they never had any
connection. So, too, if we try to approach these cases we will
68 MENTAL MECHANISMS
find them quite inaccessible by the usual avenues ; we must take
our bearings anew, draw up a new ground plan — the old one will
Our patients live a mental life all their own, even talk their
own language which is incomprehensible to us. If we are to gain
access to them we must learn the avenues of approach. No atten-
tion may be paid to ordinary efforts at conversation but the use
of a complex indicator may open the flood gates so that all there
is left for us to do is to listen.
The differences between the sane and the insane, however, are
only differences of degree, not of kind. Every process that we
may divine in the insane mind has its counterpart in the sane.
This is especially well seen in the manifestation of complexes that
are dormant or submerged. In the insane these buried complexes
determine largely the symptoms of the mental disorder, while in
the sane they are often at the bottom of the moods, the disposi-
tion, the " make-up," in short the character of the individual, and
it is the organized constellations that determine his actions along
conventional lines, lines prescribed by training and custom.
A study of the conventions and customs, the folkways, would
be very instructive in showing us the methods by which these
buried constellations operate. They would show, for example,
that reactions directed by them are not amenable to reason — in
this respect resembling the obsessions of the psychasthenic. For
example, to show respect we uncover our heads, the Orientals
uncover their feet. Why is this? The reason for it lies buried
in history, the foundation for their reaction has long since been
hidden by a complicated and bewildering superstructure. The
foundation being inaccessible it would be quite impossible to
change the custom by an appeal to reason which does not reach
to the root of the matter ; it is not the avenue of approach.
This example reminds one of another much nearer home and
more familiar. It might be facetiously referred to as the bipolar
variation of modesty. I refer to the changed feeling of shame
THE " COMPLEX " 69
which affects the modern society woman depending upon whether
she is in a ball-room or on the sea-shore. The dictates of fashion
in this instance have nothing reasonable about them and I think
it would be quite easy to gain general assent to the proposition
that the mere surroundings could not possibly affect the funda-
mental question as to the inherent impropriety of the exposure
of a certain portion of the body. But even though we gained this
assent we surely would not expect the custom to change as a
result. The whole reaction seems ridiculous just as an obsession
does because we do not know the real rationale of it. It would
seem more absurd still in comparison with other peoples. For
example, among the Tuaregs — an Arabic tribe of the Sahara —
the men wear a veil over the mouth and would consider it im-
proper to remove it except in extreme intimacy. It is worn while
eating and not even removed to sleep. 21
And so I might go on indefinitely with illustrations from normal
and from abnormal mental life and from the realm of the social
customs and usages. In the end we find that we have a some-
what broader and more comprehensive view-point of the phe-
nomena of mind in action, a view-point I believe pregnant with
many results for the future. Much has already been accom-
plished, as a result of the new outlook, in the way of developing
methods of examination and analysis of cases, and as a corollary
to these new methods we are beginning to see the way to a more
rational treatment. 22
The main conclusions to which this chapter tends are that the
operations of the mind are never fortuitous — if we ever seem to
see mental events that have no efficient cause it is only because
we are not in possession of all the facts. Ideas neither arise
spontaneously nor do they exist without having established rela-
tions with other ideas — again because of a good and sufficient
reason. The relationships thus established are brought about and
21 See Sumner: Folkways, 1907.
23 See Chapter VI.
yO MENTAL MECHANISMS
cemented by the emotional content of the event which brings them
together and they bear thus a relation of interdependence as
among themselves — they are constellated. These constellations
exist as the mental counterparts of events and correspond to expe-
riences which have emotional content. Thus do our sorrows and
our pains, our longings and our desires, in fact, all of the springs
for action, exist as organized though submerged groups of ideas
which, from behind the scenes, as it were, direct our conduct.
CHAPTER V 1
CURRENT CONCEPTIONS OF HYSTERIA— PSYCHOLOGICAL,
PHYSIOLOGICAL, BIOLOGICAL AND CLINICAL THEORIES
The various phenomena now comprised under the term hysteria
have always, throughout the period of man's history, been matters
of interest, of mystery, and of speculation. It is only in recent
times that it has been possible to approach the subject in a sci-
entific way that offered hopes of getting somewhere, as it has only
been in the last few years that adequate methods of investigating
such problems as hysteria presents have been evolved.
The fundamental idea upon which present-day conceptions of
hysteria are built is that the phenomena of hysteria are mental —
that hysteria is a mental disorder — a psychosis, and not a neurosis
as has been at times supposed. This idea has been of gradual
growth, but has been slowly increasing until it has become a wide-
spread conviction as a result of the constantly repeated observa-
tion that hysterical phenomena could be brought on, influenced,
and made to disappear by means which in their last analysis were
almost invariably shown to be appeals more or less directly to
The psychic origin of hysteria is the prevailing note now run-
ning through its theoretical consideration. There are still, how-
ever, many phenomena, especially vaso-motor, secretory, and
visceral upon which the several theories break. Some very easily
escape from the difficulty by excluding such symptoms from their
conception. Supposing hysteria to be a mental disorder, certain
symptoms occur which are not mental, therefore, they are not
hysterical — an excellent example of an argument in a circle.
1 This chapter was printed, substantially as it appears here, under the
title " Current Conceptions of Hysteria " in the Interstate Med. Jour.,
J2 MENTAL MECHANISMS
Others, because of these supposedly physical disturbances, prefer
a theory more physiological than psychological.
The end result of all this seems to be quite clear — namely, that
hysteria has not yet been defined, its inclusions and limitations
are yet unknown.
To discuss a theory of an indefinable subject might be consid-
ered premature except that numerous theories actually do exist
to account for the phenomena, and as a matter of fact the theories
themselves are after all attempts at explaining the nature of hys-
teria, so that the discussion of theory goes along hand in hand
with the attempt at definition.
In this chapter it is my intention to discuss very briefly the
most prominent of the hysteria theories, those especially which
throw most light on the hysteria question. These theories can
be divided, according to their predominant note, into psycholog-
ical, physiological, biological, and clinical.
I will leave out of consideration, because I think them unim-
portant, the many attempts to explain hysterical phenomena from
the purely physical side, such as the various chemical theories,
the theories of auto-intoxication and the like.
The strictly psychological theories have much in common and
are the best known and most widely accepted. We can probably
come to an understanding of these theories best by way of certain
experimental work done on hysterics a number of years ago, espe-
>y cially by Binet. 2
Binet's most significant work was done with the hysterical
anesthesias. For example he placed a patient with anesthesia of
the hand and arm so that the anesthetic arm was passed through
a screen which shut it and the hand out from the patient's view.
If now the skin of the hand was pinched or pricked, or the fingers
•/ 2 Binet: On Double Consciousness. Chicago, The Open Court Pub. Co.,
1896. Also Alterations of Personality. New York, D. Appleton & Co., 1896.
CURRENT CONCEPTIONS OF HYSTERIA 73
seized and moved the patient felt nothing and could give no infor-
mation as to the position of the fingers which were hidden from
her sight. If a pen were placed in the anesthetic hand it was
immediately grasped in the appropriate way between the thumb
and index finger and the hand assumed the position of writing.
This though the patient had no knowledge of what was going on.
Let the experiment be still further complicated. With a pen in
the anesthetic hand the hand was made to trace a word but in so
doing an error was made in spelling. When this was done the
hand would sometimes, still without the patient's knowledge,
re-write the word correcting the error.
A still further elaboration and we have the phenomena of
automatic handwriting. Not only will the anesthetic hand as
above trace words, but some subjects will write page after page
with no knowledge of what they are going to write and no con-
scious effort. Such writing is as novel to the subjects themselves
when they come to read it as to strangers. The writing often
contains information which is entirely new to the patients and as
to the knowledge of which they can give no clue.
These experiments and many others of similar kind prove con-
clusively that the anesthetic hand is actuated in its movements by
an intelligence. Binet concluded that there was a condition of
double consciousness, that is, two streams of consciousness flowing
side by side, relatively independent, and separated by amnesia.
This is well shown in one of my own experiments upon a case
in which this class of phenomena was studied by Dr. Sidis 3 and
The subject in her normal state was given a book; she was
directed to read aloud to some one in the room, in a slow, clear
tone, taking pains meanwhile to understand clearly what she was
reading. While she was reading I approached her from behind
and spoke to her in a low tone of voice, directing her to raise her
8 Sidis and White: Mental Dissociation in Functional Psychosis in Sidis;
Psychopathological Researches. New York, G. E. Stechert, 1902.
74 MENTAL MECHANISMS
right hand to the table; the hand obeyed; I placed a pencil in the
hand, and the hand grasped it. Now any question that was pro-
pounded to her was answered in writing while she continued to
read aloud. If a suggestion of a visual hallucination was given
to her, the hand wrote, in reply to a question, that she saw the
thing suggested. It was noticeable, however, that the two proc-
esses interfered with one another, and that while one was carried
on at its best the other was interrupted and hesitating. When
she stopped reading, she had no recollection of anything said or
suggested, and her remembrance of what she had read was rather
indistinct. If, however, she was hypnotized after one of these
experiments, she remembered everything said and what her written
replies had been. When questioned once during this period of
distraction about an hallucination of a rose which had been given
her in a former hypnotic state, and asked if she remembered it,
the hand wrote " Yes," asked what she did with it, the hand wrote
" I gave it to Mrs. S.," which was a correct answer and showed
complete recollection of the hallucination. Questioned after she
finished reading, she had no recollection either of the hypnotic
state or of the answers her hand had written.
Here we again have evidence of two streams of consciousness
separated by amnesia. The experiments also indicate that areas
of hysterical anesthesia, Jn this case anesthesia of the hand, are
connected with the submerged stream of consciousness, and
further that the hypnotic state is such a submerged stream tem-
porarily brought to the surface during hypnosis but sinking back
again during the waking, normal state.
Similar demonstrations were made with other anesthesias. For
example, retinal anesthesia. Objects so placed as to be reflected
on the anesthetic area, could of course not be seen, but it was
shown both by automatic handwriting, and by hypnosis that the
patient actually had full knowledge of them.
With this introduction we are in a position to take up the
modern dissociation theories of hysteria. The first one I will
CURRENT CONCEPTIONS OF HYSTERIA 75
describe will be that of the eminent Parisian psychologist, Dr.
Janet 4 believes hysteria to be entirely a mental malady. This
conception he clearly outlined in his address on the subject at
the Amsterdam Congress in 1907. There and in his latest work 5
he sums up his views and defines hysteria in purely mental terms.
For him there exists in consciousness a region below, if such a
term be permissible, the normal waking, or personal conscious-
ness, which is called the subconscious. Groups of ideas may
exist in this, so to speak, twilight region without being at all clearly
perceived by the individual — in fact without being known at all,
and yet they may operate to produce results very much as if they
were the subject of voluntary attention. The hysteric is an access
of delirium lives through fancied experiences about which he
knows nothing when he " comes to " ; he has an amnesia for all
of these events.
The hysterical amnesia does not confine its manifestations to
such conditions but invades the details of every-day life. The
patient who is sent on an errand forgets what she is sent for be-
fore she gets half way to her destination. This is a simple, but
common example. Janet would explain this by a disorder of
attention. The directions are imparted to the patient but they are
not acutely attended to and drop at once into the region of the
subconscious — they are forgotten by the waking, personal con-
sciousness. The anesthetic arm is explained in the same way.
The patient does not attend sufficiently to the sensations from the
arm to perceive them.
The hysterical symptoms then are dependent upon an increase "V
in the field of the subconscious and correspondingly in its activi-
ties dependent upon a defect of attention and resulting in a nar-
rowing of the field of the personal consciousness. In fact the
* Janet: L'Hysterie maladie mentale. i er Congres International de Psy- ^
chiatrie, de Neurologie, de Psychologie et de l'Assistance des alienes. Am-
8 Janet : Les Nevroses. Paris, 1909.
j6 MENTAL MECHANISMS
narrowing of the field of the personal consciousness and the
defect of attention are different sides of the same phenomenon.
/ Events do not come into the clear light of the acute waking self,
they are not perceived within the field of the attentive, personal
consciousness, they fall outside into the subliminal, subconscious
It will be seen then that this process of enriching the subcon-
scious does so at the expense of the personal consciousness. It
is the synthesis of mental processes into a coherent whole that con-
V stitutes the personality. The hysterical process causes a splitting
up, a disintegration, or as Janet says, a doubling of the person-
ality. He thus comes to the definition of hysteria as " A form of
mental depression characterized by the retraction of the field of
personal consciousness and by the tendency to the dissociation
and the emancipation of systems of ideas which by their synthesis
constitute the personality."
A prominent feature of Janet's theory is that he believes the
hypnotic state to be the same thing as an hysterical somnambu-
lism. In other words, to be suggestible is to be hysterical and
only hysterics can be hypnotized.
The essential things in Janet's theory are then the tendency to
disintegration, splitting up, or as he says doubling (dedouble-
ment) of the personality, its outward sign the presence of a
pseudo-amnesia due to defect of attention, and the identity of the
hysterical and the hypnotic states based upon the common factor
V Sidis' theory is similarly a dissociation theory. Sidis, however,
lays more stress upon the process of dissociation, and the inde-
pendent, automatic activity of the subconscious ideas or systems.
The crises of hysteria are due to the automatic activity of these
dissociated ideas, or better, as Sidis 6 says, constellations. Ideas
alone have no existence, not only are they indissolubly bound up
with a feeling-tone, but they necessarily exist only in association.
"Sidis: Psychopathological Researches. New York, G. E. Stechert, 1902.
CURRENT CONCEPTIONS OF HYSTERIA 77
To a group of ideas associated together, or more properly to a
mental state grouped about a central idea or event, Sidis gives the
name " constellation." It is these constellations that exist disso-
ciated and more or less independent in the subconsciousness.
The dissociation having once begun tends to continue and new
material is constantly being added to the subconsciousness by
further cleavage and also by assimilation by this state itself as
it begins to lead an independent existence — secondary state. Thus
the tendency is for it to continually grow, and when that growth
takes place by repeated cleavage, to grow at the expense of the
These split-off constellations tend always to become dynamic.
In the normally functioning mind there is constantly going on a
" battle of motives," a struggle for supremacy among the different
tendencies present, not unlike the struggle which has been de-
scribed among the physical elements of the body and which leads
to certain structural types. The result is that differences of ten-
sion — psychological tension Janet would probably say — tend to
occur in the various systems. As these systems are all con-
nected intimately by association, discharge takes place along the
lines of least resistance and so drains the systems at high tension
— inhibition by drainage as McDougall 7 would have it.
Now in these dissociated states, separated from the personal con-
sciousness by a plane of cleavage, energy accumulates, and because
of an absence of avenues of association through which drainage
can take place, accumulates to the point of explosion and breaks v
over the gap separating it from the upper or personal conscious-
ness producing a paroxysm.
On the other hand, during periods of inactivity of the upper "
consciousness, as in hypnotic, hypnoidal, and dream states, the sec-
ondary states tend to assume the ascendancy.
Whether the secondary states ever assume the dignity of a per-
7 McDougall : The Nature of Inhibitory Processes Within the Nervous
System. Brain, 1903.
78 MENTAL MECHANISMS
sonality or not is merely a question of degree. They tend to
organize and to grow and if the process keeps up it is only a ques-
tion of time when a new personality will be born. If these states
grow largely at the expense of the personal consciousness this
latter may finally assume a position of relative inferiority.
Sidis' theory of the hysteric state and the hysteric attacks is
closely bound up with his therapeutic ideas and really can only be
fully understood by taking them into consideration.
His principle of treatment is by reassociation of the dissociated
states. The secondary state is gradually merged into the upper
consciousness so that the cured patient no longer has two indepen-
dent states separated by an amnesia but the events of both states
are fully known to the personal consciousness. A significant fact
is that the cured patient is no longer hypnotizable, which speaks
J strongly for Janet's position as to the identity of the hysterical
and hypnotic states.
This cure is brought about through the intermediation of the
hypnoidal state — a state Sidis 8 places between waking and sleep
on the one hand and hypnosis on the other. It is, he believes, the
primitive rest state of animals and in the higher animals has devel-
oped by differentiations into sleep. Under certain conditions,
however, hypnosis may develop instead of sleep. The therapeutic
value of the hypnoidal state is due to its being the portal to the
psychic " reserve energy."
As we are all possessed of more liver, more kidney, more
everything than is necessary for our ordinary needs and are sup-
plied with a large surplus to be called on in times of emergency,
so it is with psychic energy. Through the utilization of the
psychic reserve energy the dissociated systems may be restored
to equilibrium. 9
The main features of Sidis' theory then are — the process of
8 Sidis : An Experimental Study of Sleep. Jour, of Abnormal Psych.,
Vol. Ill, Nos. i, 2 and 3, 1908.
9 Sidis : Studies in Psychopathology. Boston Med. and Surg. Jour., Vol.
CLVI, Nos. 11, 12, 13, 14 and 15, 1907.
CURRENT CONCEPTIONS OF HYSTERIA 79
dissociation, the principle of dynamogenesis and automatic activity
of the dissociated systems, the cure by reassociation, and the
principal of reserve energy and its accessibility through the hyp-
Breuer and Freud in their " Studies " 10 published in 1895, set 1^
forth also a modification of the explanation by dissociation. They,
however, devoted more attention to the process and causes of the
dissociation. For them dissociation occurred at the moment of
psychic trauma. It might be the result of a single severe shock
or a multitude of small ones.
The reason the dissociated states are able to continue actively
and in their original clearness year after year without growing
dimmer as time goes on as do other mental states, is that they
are isolated from the upper consciousness and from the world
of events in general and are therefore not thrown into the back-
ground and rendered obscure and buried by the rush of events
day by day.
The characteristic of the psychic trauma which produces hys-
teria is its large content of painful affect. A painful affect fully
reacted to at the time may produce no harm, but if for any reason
reaction fails, and the feelings are contained and repressed, the
possibilities of dissociation are created.
Failure of reaction may be due to the failure of conditions that
make efficient reaction possible, as for example, an insult is " swal-
lowed " or a dear friend or parent who cannot be replaced, or for
whose loss there seems to be no compensation, is lost by death.
This gives rise to " retention hysteria." Again ideas, usually of a
sexual nature, which are incompatible with the personal conscious-
ness are repressed — reaction is not permitted, no effectual " ca-
tharsis " takes place. This condition produces " defense-hysteria."
Finally experiences occur in a hypnoid state. This is a condition
midway between waking and hypnosis, a dreamy state of mind
10 Breuer and Freud: Studien uber Hysteric Leipzig und Wien, Franz
80 MENTAL MECHANISMS
such as is favored, for example, by the needle work that women
y do so universally. The essential point is, however, that it is a
split-off, dissociated state. Events occurring in this state of mind
never having reached the personal consciousness, have of neces-
sity and by implication always been dissociated — they produce the
so-called " hypnoid hysteria." Freud is inclined, however, to find
the real basis of all three varieties in the principle of defense.
The final principle of the Breuer-Freud theory is the principle
of conversion. The strangulated affect, the unreacted-to emotion,
belonging to the dissociated state which has been repressed, finds
its way into bodily innervation thus producing the motor phe-
nomena of hysteria. In this way the strong idea is weakened by
being robbed of its affect — the real object of conversion.
From 1895 on Breuer's activity in the realm of hysteria ceased.
Freud, however, continued his investigations and elaborated still
further the position he took in the " Studies."
v The really most important and significant feature of Freud's 11
theory is the tracing of every case to a trauma of sexual nature.
Not only does hysteria always originate in sexual traumatism
but the original traumatic moment must have been in childhood —
in the pre-pubescent period.
These infantile sexual traumas are of the nature of seduction
by grown people or older children, they consist of actual irritation
of the genitals (coitus-like processes), and occur before puberty
(which occurs earlier in the psychic sphere than the maturing of
the body). Freud has traced this class of traumas to very early
life, three and four years of age, and in one instance actually to
one and one half or two years.
The reason why sexual experiences of infancy and early child-
hood are so potent for trouble in later years is because of the
peculiarity, in one particular, that sexual experiences have — dif-
fering in this respect from all other psychic experiences. Ordi-
11 Freud : Selected Papers on Hysteria and Other Psychoneuroses. Nerv.
and Ment. Dis., Monograph Series No. 4, New York, 1909.
CURRENT CONCEPTIONS OF HYSTERIA 8 1
narily a mental experience once had tends to fade out and become
progressively more indistinct as time goes by. Sexual ideas pro-
duce actual genital excitement. Now — if these ideas which origi-
nated before sexual maturity are revived after sexual maturity,
puberty having intervened in the meantime, has rendered the
affective and genital capacity for reaction much greater so that
the response instead of being less has actually accumulated powers
for being greater. This disproportionate capacity for increased
reaction taking place in the subconscious is responsible for the
mischief. In the words of Freud "hysteria is the expression of
a special behavior of the sexual function of the individual " and
" this behavior was already decisively determined by the first
effective influences and experiences of childhood." —
These infantile sexual traumas form the necessary precondi-
tion for the outcrop of hysterical symptoms in later life. These
symptoms may be produced by the most banal occurrences and
even by bodily traumatisms.
There must, however, be a connecting link between the infan-
tile sexual trauma and the later manifestations. This connection
Freud finds in the so-called " hysterical fancies." These are the
" day dreams " of erotic coloring, " wish gratifications " originat-
ing in privation and longing. These fancies hark back to the
original traumatic moment and either originating in the subcon-
scious or shortly becoming subconscious are transformed into
hysterical symptoms. They constitute a "defense" of the ego
against the revival as reminiscences of the repressed traumatic
experiences of childhood.
We find, therefore, an infantile sexual trauma which has been
repressed. In certain individuals this repression results in an
independent activity of the repressed experiences (complexes).
These repressed experiences condition the erotic fancies which
take forms incompatible with the personality and are in turn
repressed. The repressed ideas are rendered harmless, greatly
weakened, by the transformation of their affective excitement into
82 MENTAL MECHANISMS
bodily innervation — a process Freud calls " conversion " while the
mental symptoms of the attack represent the incursions of the
erotic day dreams to the surface. Thus in Freud's words : " Psy-
choanalysis of hysterical individuals show that the malady is the
result of the conflict between the libido and the sexual repression,
and that their symptoms have the value of a compromise between
both psychic streams."
The only one of the physiological theories which is of sufficient
prominence to be taken up at this time is that of Sollier. 12 His
definition of hysteria is as follows : " Hysteria is a physical, func-
tional disturbance of the brain, consisting in a torpor or a sleep,
localized or generalized, temporary or permanent, of the cerebral
centers, and manifesting itself consequently according to the cen-
ters affected by vaso-motor or trophic, visceral, sensory and
motor, and finally psychic disturbances, and, according to its
variations, its degree and duration, by transitory crises, perma-
nent stigmata or paroxysmal accidents. Confirmed hysterics are
only vigilambulists, whose state of sleep is more or less profound,
more or less extensive."
This definition is nothing but a statement of dissociation in
physiological terms. An explanation still further removed for
while dissociation may be a theory it is an interpretation of cer-
tain psychic facts. Sollier's hypothesis is, on the contrary, purely
conjectural without any facts additional to those of the dissocia-
tionist on which to rest. It is interesting and without the other
theories might be helpful but it has no facts to support it.
In the consideration of the psychological theories of hysteria
it was shown how the hysterical manifestations were a result of
dissociation. This dissociation occurs in the realm of the per-
13 Sollier : Hysterie et Sommeil. Arch, de Neurol., Mai et Juin, 1907.
CURRENT CONCEPTIONS OF HYSTERIA 83
sonal consciousness and constitutes a breaking down, a disin-
tegration of the personality. It would seem to follow from this
view that dissociation and disintegration of the personality would
occur in those individuals in whom the synthesis of the person-
ality was defective, that is, in persons in whom the elements that
go to make up the personality are not being held together, not
closely knitted by association but fall apart upon slight provo-
This is a conception of the hysterical type which is essentially
biological. Snyder 13 holds hysteria to be a mode of reaction in
persons of naive, simple, infantile mentality. A mentality lacking
in development and defective in judgment and critique. Such
individuals placed in a new environment to which they cannot
adapt, or adapt only with difficulty, develop the hysterical type
Similarly — as hysteria is a manifestation of an infantile men-
tality so it is, when considered racially, the manifestation of the
infancy of the race, of people who are primitive and simple. For
example Kraepelin 14 found it very prevalent among the natives
of Java. That and dementia prsecox were the most prevalent of
mental disorders — both disorders incident to poor development of
the mental powers.
Snyder would explain the outbreaks of hysteria among the
masses that occurred so frequently in the middle ages as the
result of the repression of the human spirit. Wherever the aspi-
rations, the Teachings out, the efforts to go ahead have been re-
pressed, as they were by the conservative forces of society during
the middle ages, then hysteria comes to the front and as the repres-
sive forces operated on all the people alike we find the reaction
commensurately widely distributed. This is the period of the
" infancy of individualism " according to Hellpach, 16 who thinks
18 Snyder : Definition et nature de l'hysterie. L'Encephale, Aout, 1907.
"Cited by Jelliffe: Hysteria and the Reeducation Method of Dubois.
N. Y. Med. Jour., May 16, 1908.
u Cited by Snyder, loc. cit.
84 MENTAL MECHANISMS
that the socialistic aspirations of the proletariat of to-day are the
equivalent of the hysteria of the masses of the middle ages.
It is at least interesting to contemplate, in the light of Freud's
ideas of repression and retention, that the individual through
many avenues, public speaking, newspapers, etc., has many ways
open of letting off steam, means for emotional catharsis that were
denied him in times past.
Claparede 16 in his consideration of hysteria lays special stress
upon the fact that the hysteric shows a marked resistance to the
recall of painful memories which he considers to be biologically
a defense reaction. Equally also is suggestibility a defense reac-
tion against personal peculiarities and tendencies which never
could be given free play or they would isolate the individual from
the social world in which he lived. Instead of yielding to these
impulses the suggestion of another is followed because safer.
The theory of Claparede 17 is a portion of a broader theory which
would explain sleep, not as it is usually explained, as a negative
function, but as a positive function. We do not sleep accordingly
because we are exhausted but in order not to be. In other words,
sleep is a function of defense. It makes itself felt before real
fatigue. Prevent the animal from sleeping and it becomes ex-
This digression into the theory of sleep is interesting because
of the close relation sleep bears in theory to hysteria. Sidis 18 in
recent studies has come to the conclusion that the primitive state
of rest in animals is a semi-waking state to which he gives the
name hypnoidal. Out of this state there develops on the one
hand sleep — on the other the hypnotic state, so that it is impos-
10 Claparede : Quelque mots sur le definition de l'hysterie. Arch, de Psych.,
"Claparede: Esquisse d'une theorie biologique du sommeil. Arch, de
Psych., Tome 4, Nos. 15 and 16, February and March, 1905. Reviewed by
Vaschide : La Theorie Biologique du Sommeil de M. Claparede Revue de
Psych. April, 1907.
"Sidis: loc. cit.
CURRENT CONCEPTIONS OF HYSTERIA 85
sible to pass into or out of the sleeping or hypnotic state without
passing through the hypnoidal.
The consideration of sleep from a biological standpoint is espe-
cially interesting. Claparede considers both sleep and hysteria
as being defense reactions, while Sidis develops both sleep and
hypnosis from a primitive hypnoidal state. These facts are par-
ticularly significant when we recall that Janet believes that to be
hysterical is identical with being hypnotizable. Then Bernheim,
for instance, believes the state of hypnosis to be clearly allied to
sleep and now lately we find McDougall 19 pointing the similari-
ties between sleep and hypnosis, and explaining hypnosis as a
state of dissociation, and treating of the dynamics of the disso-
ciated states in a way quite like what we are already familiar with.
What I have called here clinical theories might almost better be
called clinical definitions. The very attempt to define, however,
although perhaps not primarily directed to a discovery of the
nature of the thing defined must by implication consider it.
The principal author to be considered here, because of the
great attention his pronunciamento relative to hysteria has re-
ceived, is Babinski, and we will see that whereas his effort is
primarily addressed to the definition of hysteria, still it necessarily
implies somewhat of its nature.
The fundamental proposition of Babinski 20 is that the hysterical
phenomena are distinguished by the fact that it is possible in cer-
tain subjects to "reproduce them by suggestion" "with vigorous
exactitude " and " cause them to disappear under the exclusive
influence of persuation." To the condition in this group of cases
in which the symptoms are capable of being produced by sugges-
tion and removed by persuasion Babinski has given the name
19 McDougall : The State of the Brain During Hypnosis. Brain, Vol.
20 Babinski: My Conception of Hysteria and Hypnotism. Alienist and
Neurologist, Vol. XXIX, February, 1908.
86 MENTAL MECHANISMS
His distinction between suggestion and persuasion is to my
mind wholly academic. It is suggestion to influence a patient to
accept an idea which offends the reason, which is manifestly irra-
tional, while it is persuasion if the idea is reasonable, rational.
Babinski believes that a large number of the symptoms mani-
fested by the hysteric are caused by the examinations of the phy-
sician. The methods employed, for example, to determine the
presence or absence of anesthesias, suggest these very anesthesias
to the patient who forthwith presents them. This I think will be
admitted as true in not a few instances.
Similarly he would exclude from the realm of hysteria dis-
turbances of the tendon reflexes, cutaneous ecchymoses, paralysis
of the third nerve, anesthesias of the cornea and conjunctiva,
inequality of pupils, mydriasis, visceral hemorrhages — hemopty-
sis and hematemesis — anuria, fever, etc.
It will thus be seen that Babinski relegates the phenomena of
hysteria to the psyche and to the higher psychic functions at that.
It is interesting to note further that for him hysteria and hyp-
nosis are the same except that hypnosis requires the intervention
of a second person to develop its manifestations while hysteria
From a consideration of all these theories it seems to me that
I the most fruitful conception of hysteria is that expressed by Janet
in the phrase "weakening of the faculty of psychological syn-
thesis," which condition is brought about by the repression of
painful experiences — complexes — and their subsequent quasi-
independent activity with the resulting phenomena as described
in Chapter IV. The personality, which is the highest expression
* J of the psyche, the acme of complexity of association in a har-
i monious psychological synthesis, tends rather easily to fall apart.
The associations are not sufficiently strong, sufficiently binding
and it splits up under the influence of certain kinds of stresses.
This aptitude for disintegration has both an ontogenetic and a
CURRENT CONCEPTIONS OF HYSTERIA 87
phylogenetic substratum. It is the infantile mentality that is thus
affected and when hysteria has manifested itself in the masses,
the people have been afflicted while the race was in its childhood.
As to the manifestations of the hysterical type of reaction their
number is legion, their forms protean. All attempts up to the
present time to gather them together within a given definition
have, to my mind, been quite futile.
From a conception of hysteria that admits a symptomatology
covering the entire realm of nervous and even visceral disorders,
implicating both the psyche and the unquestionably physical bodily
processes the effort of Babinski is a reaction while Bernheim 21 goes
even further and says " hysteria is not a morbid entity, it is not
a disease," " the disease hysteria, such as is described, does not
exist." Bernheim 22 would reserve the name hysteria solely for
the crises, a position some others also take. In harmony with
this tendency we see coming into general use the word " hysteri-
form " to express conditions which resemble hysteria but because
of associations with other conditions are supposed not to be.
The whole question of the relation of hysteria to other diseases,
to mental diseases such as dementia prsecox, to neuroses such as
epilepsy, to multiple sclerosis, chorea, etc., has been admirably
and sanely reviewed by Voss 23 in his recent work.
If, as seems to be generally acknowledged, the hysterical An-
lage, the tendency to hysteria, or hysterisability as Bernheim
would have it, may remain indefinitely latent until something hap-
pens to produce the characteristic response, then I do not see why
the so-called hysteriform accompaniments of these various dis-
eases cannot properly be considered as true hysteria. Why should
not a multiple sclerosis be the activating agent in breaking down
the resistance to the outcrop of the hysterical reaction?
All these efforts to limit, to bind in, to define hysteria within
"Bernheim: Conception du mot Hysteric. Paris, 1904.
23 Bernheim : loc. cit.
23 Voss: Klinische Beitrage zur Lehre von der Hysteric Jena, Gustav
88 MENTAL MECHANISMS
certain prescribed boundaries are not at all convincing and they
fail, it seems to me, simply because hysteria does not confine its
manifestations to any definite limits. It spreads out into all the
available and adjoining territory and is indefinite and hazy in its
outlines quite like other natural phenomena. We must not forget
that definitions are human devices — nature has few sharply de-
The effort of Babinski to exclude all phenomena which seem
to be physical in character seems to rest on entirely inadequate
conceptions. The whole field of psychopathology has too long
been dominated by that bug-a-boo, the relation of the mental and
the physical and the implied necessity of conceiving of each as in
essence different from the other. This is but another example of
an attempt to define an artificial boundary where none exists.
As between the most definitely physical of bodily processes on
the one hand and the highest psychic on the other, an infinity of
gradations exists and at no point can it be said that what was one
has become the other. It is much more stimulating and effective
to stick to facts wherever they may lead us than to create arbitrary
boundaries which later on only serve to cut off our entrance to
It seems to be very well demonstrated that the individual reacts
to conditions by the development and organization of mechanisms
which in their complex manifestations may include both physical
and mental components (as set forth in Chapter I).
It seems to me that in a consideration of such facts we may
find an explanation for the association of physiological disturb-
ances with hysteria, such as the false gastropathies for instance,
and also an explanation of those cases which start as hysteria
apparently but which later on show symptoms of permanent
mental deterioration. Those cases, which lead to a change of
diagnosis from hysteria to dementia prsecox, also lead to the belief
that the original diagnosis was in error. Why? Could it not be
possible for a hysterical type of reaction in a badly organized
CURRENT CONCEPTIONS OF HYSTERIA 89
individual to gradually unloose bits of physiological mechanism
until organic changes had wrought permanent damage ?
And so I think we must come to recognize the hysterical type
of reaction wherever we see it whether in connection with other
conditions or alone. By so doing we will have a broader under-
standing of our cases than by always insisting upon a one-disease
THE PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART
To anyone who has felt the intense pleasure that comes from
the contemplation of a work of art, and who at the same time is
of an enquiring and analytical turn of mind, there must have at
times arisen the query as to wherein lies the explanation of this
pleasurable feeling-tone. If an inquiry has been pursued in this
direction, if the critics have been read for light on this problem,
there must have come as a result a more or less well defined feel-
ing of dissatisfaction with the conclusions. Why are some works
of art great? Why have they survived the centuries in the
hearts of men? These are the questions for which we have in
vain sought a satisfactory response. The explanations of the
critics are not only unsatisfactory but contradictory.
To dilate upon the wonderful poise of the Venus de Milo, the
perspective of a Turner, the chiaroscuro of a Corot, the coloring
of a Tintoretto, a Ruebens or a Raphael, the high lights of a
Rembrandt, or the grouping in a Franz Hals, touches only the
surface, and after all resolves itself largely into a matter of tech-
nique. Whether the paint is applied with a brush or with the
finger, whether with the minute care of a Memling or laid on in
large thick pieces of color after the pointilliste method, is of little
or no consequence.
While the arrangement of the draperies on the figures of
Etruscan vases or the strange lack of perspective in Giotto's
frescoes have great chronological importance, great works of art
seem in some way to rise superior to such details of composition
and technique. Although reflecting the taste and the customs,
the religions, conventions and superstitions of the age and peoples
in which they originated, the great masterpieces have risen supe-
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART 9 1
rior to locale and to time. Time, change of customs, new stan-
dards of critique, nothing in fact, has dimmed the glory of the
Venus de Milo, Michael Angelo's il Pensieroso or his marvelous
decorations of the Sistine Chapel, the Raphael Stanze, Giotto's
Campanile, Homer's Iliad, or Shakespeare's Hamlet. What is it
that lives in all these great works ?
Whether we turn to the art critic or the artist himself for a
solution of this riddle we meet with results that are far from
satisfactory. In fact we find that they really have no explana-
tion, for the explanations they offer have little in them that is at
It is this apparent paradox, a great work of art produced by
one who does not understand the nature of the motives actuating
him, and viewed by an enthusiastic but uncomprehending public,
generation after generation, that seems to me most significant.
To my mind this lack of comprehension is the rule, not the
exception, and its explanation lies in the fact that the work of art
takes its origin from motives which are not clearly in the con-
sciousness of the artist; and the effect of the work of art in like
manner is exercised not upon the superficial, clearly comprehended
elements of the mind, but that they reach deeper, beyond the
fagade of our intellectual and emotional life; they have entered
the portals of our personality, and if they have continued to exer-
cise this effect throughout the centuries it is because they have
penetrated to a something fundamental, a something common to
all mankind which is therefore and necessarily independent of
time, place or the particular social, religious or political condi-
tions of the age in which the artist lived.
That the true raison d'etre of a work of art and the secret of
its effect upon us is not to be readily explained, that the reasons
are not on the surface, where " he who runs may read," is at once
evident if we turn to the writers on art for light on the subject.
Here we find that the Good, the True, the Beautiful, the Ideal
and the Sublime, play a very large part in explanation ; but unfor-
92 MENTAL MECHANISMS
tunately what constitutes goodness, truth, beauty, perfection and
sublimity seems to be at least open to great difference of opinion.
Some see art only in works that set forth great religious or moral
truths, while others would have it that art is justified by simply
pleasing, and that it can necessarily have no useful purpose. And
so the story goes. Some authors write entertainingly and well ,*
others, because they are trying to set forth through the medium
of the intellect something they feel but cannot intellectually formu-
late, write mere twaddle.
The situation has had its counterpart frequently in medicine.
When we see all sorts of remedies extolled by different but equally
able practitioners as effective in a certain condition, we have a
right to suspect them all, and to conclude that the explanation of
their apparent results lies elsewhere. We must not fail to remem-
ber, though, that there is probably some grain of truth in all of
the experiences — probably the natural tendency of the disease to
get well, irrespective of the remedy applied.
Now this state of affairs is precisely what we would expect
if it is true that the origin and the effects of art are confined to
that region below clear consciousness, to which have been vari-
ously applied the terms, subconscious, co-conscious and even
unconscious. This region we know is not susceptible of being
reached by introspection. It is therefore self-evident that what
occurs in it must be unknown to the possessor. It is therefore
not strange that the results of a subconscious activity, the springs
of which are unknown to the possessor, should receive many and
That the artist is, as a matter of fact, unconscious of the under-
lying motives that prompt him to produce, I may illustrate by a
couple of examples. Bernard Shaw, 1 one of the most incisive of
our present-day critics, speaking of the necessity which forced
him " to make up his mind definitely as to what Ibsen's plays
meant," says: "I allow due weight to the fact that Ibsen himself
1 The Quintessence of Ibsenism.
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART 93
has not enjoyed this advantage ; but I have also shown that the
existence of a discoverable and perfectly definite thesis in a poet's
work by no means depends on the completeness of his own intel-
lectual consciousness of it." The same writer 2 quotes from
Wagner in a letter he wrote to Roeckel as saying : " How can an
artist expect that what he has felt intuitively should be perfectly
realized by others, seeing that he himself feels in the presence
of his work, if it is true art, that he is confronted by a riddle,
about which he, too, might have illusions, just as another might? "
It is this subconscious origin of the forces which result in the
creation of a work of art which has led to the common explana-
tion of inspiration. This feeling impelling the artist to create,
coming from he knows not where, he was unable absolutely to
clearly explain. Inspiration was a sufficiently hazy conception to
fit the state of mind, and so was accepted, and effectually clouded
the issue and prevented any effort to find out what lay beneath.
If these instances are proof of the subconscious origin of the
artistic sentiments, so also, I believe, is the possibility of translat-
ing the same feelings from one mode of artistic expression into
another. Wagner, for example, has been accused of being a
painter at heart. His conceptions, it has been claimed, were more
calculated to create great canvases than great operas, while his
stage settings are criticised as being examples of pictorial art to
which the music and verse were secondary.
This confusion of the different art fields and translation of
the feeling-tone from one to the other is quite common. The
great effort of operatic music is that it should help to express the
idea conveyed by the words and actions, and though music is not
nearly so definite a means of expression as written or spoken lan-
guage, the leit motif in the hands of Wagner reached a definite-
ness practically verbal in quality. A recent specific effort is that
of the Russian pianist and composer Rachmaninoff to translate
into music the " Isle of Death," that masterpiece of the German
mystic painter Boecklin.
2 The Perfect Wagnerite.
94 MENTAL MECHANISMS
The poem of Hildegarde Hawthorne 3 to St. Gaudens' master-
piece, the Adams memorial, is to my mind not an interpretation
of that wonderful work, but a translation from stone to verse.
It has the same mystery, the same elusiveness, and I have often
wondered whether, if an artist were given the poem without
having seen the statue, and asked to sketch the effect it produced
on him, he would not produce something like the statue — a figure
draped, silent, calm, accepting, yet full of mystery.
The character of the emotional tone that comes from the sub-
merged regions of consciousness is of importance. Freud has
emphasized the dominance of the sexual emotions in their influ-
ence upon thought and actions. Their importance is great; per-
haps it can hardly be exaggerated, especially when we consider
that in the last analysis all life centers down to and resolves itself
into the problems of self-preservation and the preservation, by
propagation, of the species. Perhaps, too, these are only dif-
ferent aspects of the same thing; for what, after all, is a desire
for children than a desire, from another point of view, to preserve
our life beyond our personal existence, to extend our influence
into future generations?
8 Yea — I have lived, pass on
And trouble me with questions nevermore.
I suffered, I have now a solemn peace,
My peace forevermore.
Leave me in silence here
I have no hope, no care,
I know no fear,
For I have borne, but nevermore can bear.
Deep-hid sorrow calls me kin,
But my calm she cannot break;
I know not good, I know not sin
Nor love not hate can me awake.
Though I have sought — I care not now (o find,
If I have asked — I wait for no reply.
Mine eyes with too much seeing have grown blind,
I am not dead — yet do not need to die.
Pass on — you cannot reach me anymore,
Pass on, for all is past.
Hush — silence settles ever more and more
Silence and night at last.
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART 95
It is unfortunate that we have no word in our language that
better expresses what I have called sexual. This word has dis-
agreeable reverberations that I wish might be done away with.
The term is here used in the broadest of senses to comprise all
the broad and complex group of experiences centered about the
differences of sex. It includes not only those more immediate
experiences associated with the sexual approach, but the secon-
dary, tertiary and even more remote sexual characteristics which
distinguish the sexes ; such as the differences in habits of thought,
decorative features of dress, social life, and is represented in art
all the way from a Velasquez Venus to a della Robbia bambino.
Perhaps for our purposes we might substitute for the word the
term love motive.
To consider this love motive as the spring from whence come
the aesthetic experiences of art has a certain considerable sanction.
In the first place, no variety of experience begins to furnish such
a rich content of feeling as this. About it centers not only the
sweetest experiences of our lives but the bitterest conflicts, the
deepest hatreds, the profoundest repulsions. It is a never failing
source from which to draw on feeling, and if we will consider
we will perhaps be surprised to note the extent to which its use
has been obviously put. The galleries are filled with paintings
that openly profess it; poetry would indeed be poor without it;
music is essentially sensuous, while dancing is obviously so.
Then again, another and most important reason for giving the |/*
love motive due consideration is its universal character. Tradi-
tional, historical, social, economic, political conditions may all
change ; men, nations, aye civilizations may come and go, but the
love of a youth for a maid endures. This is surely a most impor-
tant consideration. If great works of art have endured through
the centuries and have been enjoyed by people under all varieties
of existence, it can only be because they have appealed to a some-
thing in man more fundamental, more lasting than the changing
conditions under which he has lived. May not the love motive
be that something?'
g6 MENTAL MECHANISMS
If we look to the writers on art who have endeavored to define
the nature of artistic experience, we will find here and there a
vague appreciation of this possibility.
"According to Burke 4 (1729-1797, Philosophical Inquiry into
the Origin of our Ideas of the Sublime and Beautiful), the sub-
lime and beautiful, which are the aim of art, have their origin in
the promptings of self-preservation and of society. These feel-
ings, examined in their source, are means for the maintenance
of the race through the individual. The first (self-preservation)
is attained by nourishment, defense and war; the second (society)
by intercourse and propagation. Therefore, self-defense, and
war, which is bound up with it, is the source of the sublime;
sociability, and the sex-instinct, which is bound up with it, is
the source of beauty." I shall return to this definition later.
According to Schiller, Darwin and Spencer, 5 " Art is an activity
arising even in the animal kingdom, and springing from sexual
desire and the propensity to play."
The reasons, then, that the love motive is considered necessary
for great works of art are the necessity for a universal motive,
common to mankind in every phase of their existence — the
strongly emotional character of the motive, the obviously fre-
quent use of it, more frequent in fact than any other — the vague
realization of its necessity by many who have examined into the
If this motive is accepted it will explain many phenomena.
Symbolism in art, in religion, in folk-lore is, we know, largely
of sexual origin. Such are, for example, the allegory of the
origin of sin, the biblical song of Solomon and the whole subject
of phallic worship. The origin of such symbols can be explained
by an appeal to this motive on the principle of the Freudian psy-
chology. We lead two more or less distinct and conflicting
psychic lives. One rich in emotion but submerged beneath the
* R. Kralik : " Weltschonheit, Versuch einer allgemeinen ^Esthetik,"
cited by Tolstoi: What is Art?
8 Tolstoi : op. cit.
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART 97
region of clear consciousness, is the home of our crude, untamed
desires of which the sexual is the most prominent. The other is v
the fully conscious life, the psychic veneer of civilization. Desire
speaks for recognition, convention refuses ; a conflict results.
Desire is primitive and strong, and will not down. Convention —
the result of education, suppresses the primitive because, accord-
ing to its standards, it is hateful. Finally a compromise is reached
by which desire may be recognized, received in the precinct of the
conventional, provided only it comes properly disguished — sym-
bolized. Legendary, folk-lore and particularly religion, where
the suppressive elements have their greatest sway, are rich in
examples. 6 It is sufficient to merely mention the symbolism of
the serpent, particularly in religious art, as representing sin.
Grant Allen 7 approached this explanation without realizing it
when he derived the feelings which give origin to poetry and
romance, and in large part to painting and sculpture from " day
dreaming or building castles in the air." This process he believed
to be " purely ideal " and " not connected with necessary vital
functions." The air-castle-building-day-dreaming idea is all right,
but is far from a useless procedure as Allen thought. Such
reverie has a distinctly compensatory function, it is wish-fulfiling
in its character, highly symbolic as a rule, and of sexual origin,
frequently at least.
Writers on art recognize this same thing. Rea writes: 8 "We
must all be conscious of a certain dreamland of our own, in which
things and ideas are pictured in our minds, not necessarily as they
really are, but as we should like them to be, and as they might be
were our mutual relations different."
Aside from this aspect of the question the love motive explains
why great works of art center about distinctly human interests
and represent the human form. No mere landscape ever rose to
8 A. Maeder: Die Symbolik in den Legenden, Marchen. Gebraiichen
und Traiimen. Psych.-Neurol. Wochen., May 2 and 9, 1908.
7 Physiological Esthetics.
8 Hope Rea : The Tuscan and Venetian Artists.
98 MENTAL MECHANISMS
universal acceptance as have works involving the human form.
Of course it must be remembered that landscape painting is
a comparatively recent development. As wonderful as Paul
Potter's Bull is, many people care little for it ; while I have never
heard anything but praise for Le Febvre's La Dame d'fiventail,
especially the Broun copies. The Greeks, of course we know,
from whom so many of our ideals come, worshipped the human
form, naked, undraped, and indeed it would be hard to find a
more universally accepted work of art than the Venus de Milo.
Although the Greeks made the human form the basis of their art,
it was not the Greek human form they portrayed. Albrecht Durer
painted idealized persons, but they were distinctly German. Franz
Hals and even Rembrandt painted not only characteristic types
of their day, but quite frequently they painted the actual indi-
viduals, so that their appeal was necessarily limited. The Greeks
painted a perfect human form, and added an idealized face that
might be German, Flemish, Dutch, Italian or what not, and so
appealed alike to all. They dealt truly in the universal motive.
This brings us naturally to a consideration of motives that are
less fundamental than the love motive; motives that are less
universal — the secondary motives. Before touching this subject,
however, the question may be asked — Is the love motive the only
fundamental, universal art motive?
We have seen that we may reduce all human activities to two
general categories. Those calculated to preserve and perpetuate
the race, and those addressed to self-preservation. The love
motive is an expression of the instinct to perpetuate the race.
Has the instinct of self-preservation, too, a fundamental emo-
tional element that may form the basis of an art motive ? I think
perhaps it has, and I would call it the mystery motive.
The instinct of self-preservation is stirred into great emotional
activity by conditions in the environment which are recognized
as of overwhelming power, 9 and the emotion aroused varies all
8 See Mercier : The Nervous System and the Mind. Mercier's classifi-
cations and definitions of feelings are illuminating in this connection.
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART 99
the way from terror when the conditions are recognized as over-
whelming and inimical and counteraction is not elicited — the indi-
vidual is transfixed — through fear, when the power is not over-
whelming but is superior, to states of vexation, resentment and
contempt when the conditions are recognized as of insignificant
A material factor in fear states is mystery — a failure to under-
stand the nature of the impending conditions. Mystery is the
half-brother of fear, and attaches itself to those experiences that
are unusual, outside of the realm of every-day experiences. The
horse is frightened by a simple piece of paper that suddenly, as
the result of a passing breeze, takes on the attribute of motion.
Then come the feelings of reverence and devotion to over-
whelming power which is recognized as beneficent and finally
states of feeling of awe and sublimity to great power in the envi-
ronment which is not directed towards the individual at all but is
merely contemplated in action or at rest.
It is not probable that such violent emotions as terror and fear
can become sources of art, but the allied mental state of mystery
frequently is a large factor. In fact I believe it is present in the
contemplation of tremendous edifices, such as the choir of Beau-
vais, which is so immense, so much larger than anything with
which we have any experience in our every-day lives, and have
therefore become adapted to, that it is simply impossible to take
in, to grasp, and we are apt to stand before its immensities agape
at the wonder of it all. Mystery, too, enters into many art pro-
ductions that are not overwhelming by virtue of their size. It
is a prevailing note, for instance, in St. Gaudens' Adams memo-
rial. When it comes to overshadow all other motives we find
it emerging as a distinct movement in art. Here, however, we
are probably dealing with an entirely different feeling-tone than
that which results from contemplating Beauvais or St. Gaudens.
This is rather the result of a motive often perilously near the
abnormal that takes obscureness as a criterion of beauty and
IOO MENTAL MECHANISMS
Of coequal importance to these fundamental motives in art is
beauty. Beauty is an essential of all art and lies at the basis of
aesthetics. The painting of an ulcer, no matter how well done,
could never be art. There are certain elements of it to which
I think it worth while to call attention. This particular thing is
brought out in classic architecture. If we will study the Greek
column, for instance, we find that it does not taper regularly from
below upward, but that there is a gradual swelling about two
thirds up. If this swelling were not there the column would look
weak at that point. A careful examination of the stylobate of
the Parthenon, the floor on which the great columns rest, will
show that it has a slightly upward curvature, else it would appear
sagged by the great weight. So the architrave has a similar curve
for similar reasons.
The physiological and psychological reasons which make it
necessary to make these corrections are, that if they are not made
a mental state of discomfort is produced as a result of the muscu-
lature being thrown out of harmonious balance. We uncon-
sciously make muscular efforts to correct such defects as these
when we see them, and are so made uncomfortable. This may
be better appreciated by an example within the experience of all.
How frequently we find ourselves moving this way and that, per-
haps distorting our faces in an almost grotesque way as we sym-
pathetically watch some person making a great effort of some sort,
perhaps an acrobat on the stage. Such movements can be seen
in their crudity in the schoolboy, twisting and squirming, with
outstretched tongue as he bends in wrapt attention over his copy
I believe the great charm of the simple Doric buildings lies in
their perfect balance, so that they give the impression of absolute
harmony in all their parts. All of the parts have been so arranged
that they not only, as a matter of fact, are in perfect balance, but
the lines have been curved a little here and a little there, a column
has been placed at a slightly different distance from its neighbor
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART IOI
than the one on the opposite side, so that aside from the real
harmony there is an apparent harmony; the structure looks bal-
anced, all of the distortions that optical illusions would have
created have been corrected. In contemplating such a structure
the muscular system remains in balance ; there are no disagreeable
sensations from muscular tensions unequally distributed in the
two symmetrical halves of the body, a condition of muscular calm
is brought about that produces a feeling of quiescence, of rest, of
harmonious adjustment that is pleasurable.
It is interesting, in this connection, to refer to Merrier. 10 He
refers to the view expressed by Grant Allen 11 who regards the
feeling of beauty as corresponding with the maximum of stimula-
tion with the minimum of fatigue or of waste. After some hesi-
tation, however, he discards this view and retains his own, which
regards it as the maximum of action of the environment on the
organism with the minimum of reaction of the organism on the
environment. The correspondence between this view and the
one just expressed is so great that I think it is worth while at this
point to quote Merrier in full. He says with reference to his
view as compared to that of Grant Allen : " Although the correct-
ness of this expression is not nearly so evident as that of Mr.
Allen's, it is not only more in harmony with the system of classi-
fication here expanded, but it brings into prominence elements
which I believe to be equally in accordance with truth and of more
fundamental character. Stimulation, it is manifest, can only
occur by an action of the environment on the organism. It is
not at first sight equally manifest that fatigue necessarily implies
action of the organism on the environment; but it will be admitted
that it usually does so, and I think it can be shown that it always
does. Fatigue as commonly used means the feeling that accom-
panies exhaustion of muscular power after exertion, — that is to
say, it implies much previous action on the environment. But we
speak also of fatigue of the eyes after working long at the micro-
10 Loc. cit.
u Loc. cit.
102 MENTAL MECHANISMS
scope, or after many hours in a picture gallery. In the former
case there is true fatigue — exhaustion of the ocular muscles, and
this may also be present to a certain extent in the latter — but the
feeling here is not mainly, I think, one of true fatigue ; it is mainly
a feeling of satiety. There is, however, another application of
the term fatigue which must be admitted to be correct, and which
appears at first sight to have no reference to muscular action — to
reaction on the environment. This is the feeling that follows con-
tinued intellectual exertion. When this feeling is present there
may have been no preceding muscular exertion. The body may
have been in complete repose with reference to its surroundings.
Yet there has been great internal activity, and there is a consid-
erable volume of feeling to which the term fatigue is universally
applied. Can this feeling be said to correspond with action of
the organism on the environment? If by correspondence is
meant direct correspondence, of course it cannot; but if the cor-
respondence is to be thus restricted, neither can fatigue of the
muscles of the eye and ear be said to correspond with such action.
Intellectual exertion is on the physical side the opening up of new
elements — the rendering permeable of new tracts — for the cur-
rents or the waves of molecular movement in the cerebral cortex.
Every conclusion reached, every judgment formed, every simi-
larity perceived, every difference distinguished, implies a modifi-
cation of the structure of the brain — implies a redistribution of
the resistance to molecular change — implies a modification in the
direction that future changes must follow. But the cerebral cor-
tex, regarded physiologically, represents combinations of muscular
movements; and a modification of the structure of the cerebral
cortex is, on the physiological side, a modification in the grouping
of muscular movements — is a modification of the way in which
the organism acts upon the environment. Now if we bring
together the first and last links in this chain of reasoning we find
that intellectual exertion necessarily implies a modification of
the action of the organism on the environment, and that the
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART IO3
fatigue which follows great intellectual exertion is the feeling
which corresponds indirectly with a modification of the action of
the organism on the environment."
We get a very interesting confirmation of this general position
from a study of sound stimuli. A recent study of melody by
Bingham 12 is particularly illuminating, especially when taken in
connection with the more modern view of attention as essentially
an affective state, and with a recognition of the muscular-tension
components of this state. In the course of this study several of
the observers remarked upon certain motor adjustments, strains
and tensions, which were relieved when the melody seemed to
them to possess "finality." This suggested the study of the
effects of melodic stimuli upon muscular movement. The author
concludes among other things, that a melody begins by upsetting
some set of muscular tensions ; it " includes the taking of a proper
'attitude,' the organization of a set of incipient responses," and
ends finally "with the arrival of a phase of the complex ongoing
activities in which the balanced tensions can merge into each
other, etc." " Two or more tones are felt to be ' related ' when
there is community of organized response." " Unrelated pitches
fall apart because each demands its own separate attentive act of
Thus we see that there are at least two fundamental elements
to be considered in the explanation of the effect works of art
have upon us. One is distinctly psychic and the other both psy-
chological and physiological. This latter element I have already
illustrated in the balance of the Greek architecture, the muscular
imbalance brought about by seeing one make an effort, the relief
of certain muscular-tension states by the resolving of a melody.
One more important matter should be considered in connection
with this psycho-physiological factor, especially with reference to
" Studies in Melody by W. Van Dyke Bingham. Psychological Review
Monograph, No. 50. Review by T. L. Bolton, Jour, of Phil., Psych. & Sci.
Methods, January 19, 191 1.
104 MENTAL MECHANISMS
painting; that is the fact that the eye is never at rest 13 but is in
constant and rapid motion. A landscape, therefore, is never
actually seen by the eye, disregarding for the moment the receiv-
ing mind, for two consecutive instants the same. In endeavoring,
therefore, to reproduce a landscape upon canvas the very best
that can be done is to paint something that will be an acceptable
compromise with all these shifting perceptions.
When we take into account the varying quality of the perceiv-
ing minds it is easy to understand how many different schools
have arisen with their several theories as to how nature should be
portrayed on canvas. The important thing in all these illustra-
tions is that, in order that a work of art shall be beautiful, it must
strike a certain number of psycho-physiological balances. If
these balances are thrown out beyond a certain point, if for ex-
ample, a badly constructed melody results in muscular strains and
tensions that are disagreeable, the feeling of the artist, no matter
how properly a subject for art, cannot be conveyed effectively.
The medium is inefficient. Beauty is lacking.
Now let us consider the more distinctly psychic element and see
if the two cannot be effectively correlated.
Art is the language of the emotions. We have already seen
that there is reason for believing that if a work of art is at all
great it must appeal to a fundamental emotion, and I have sug-
gested what I designated as the love motive as perhaps the most
That this thesis is correct in its general statement, at least, can
be more readily appreciated by a series of illustrations of the limi-
tations of appeal and their reasons. This will involve a consid-
eration of certain secondary motives.
Many motives are relatively universal only. That is, they are
universal only for a certain group of people or during a certain
u On this subject of eye movement see the work of Judd, McAllister,
Steele, Cameron, Courten, which is accumulated in several articles and
published as No. i, Vol. VII, of the Monograph Supplements to the Psy-
chological Review, March, 1905.
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART 105
period of time. One of the dominant motives of medieval art,
for example, was Catholicism, and its greatest appeal was made,
and is still made for that matter, to the Catholic world. The
appeal is not a universal one, a Roman Catholic motive would
hardly appeal to a Buddhist and vice versa.
Quite comparable to the relative universality of Catholicism
is the beauty motive, that is, the use of beauty as an end and not
a means. We must remember that while beauty is essential to all
works of art the standards of beauty vary greatly among different
peoples. In that resplendent period of French art which grew
up largely during the reign of Louis XIV and just antedating the
Revolution, we find a notable tendency to subordinate all motives
to the production, above all else, of a work of beauty. Pictures
embody no great idea, they are largely decorative in purpose and
often, naturally as a result of royal patronage, even directly per-
sonal. Watteau is the type of the appeal to the beauty motive.
His picture — The Embarkation for Cythera — is the type in which
each individual feature is subordinate to the one fundamental
purpose of beauty. More restricted still than either the religious
or beauty motives is the war motive. The restrictions of this
motive, so far as we are concerned at least, are temporal largely,
depending much on historical interest though the abstract, gen-
eral idea of conquest and the exultation that comes with victory
which are so often associated with the war motive, are well nigh
universal motives and are the obverse of the mystery motive.
Meissonnier's pictures, representing specific historic incidents,
and in their minutest detail true to the actual conditions of the
time, are excellent examples.
And so we might pick out this and that motive and discuss it in
its various bearings down to motives that are really minute — so
minute in fact as to make it very doubtful if they deserve at all
serious consideration. The boiled lobster-cabbage-asparagus type
of picture of Snyder's seems to me to hardly deserve considera-
tion as a work of art at all, while if the pots and kettles of the
106 MENTAL MECHANISMS
Dutch genre painters are more worthy it is because of the implied
human motive that they stand for. As symbols of a simple, aus-
tere, God-fearing people they have their raison d'etre.
We have seen thus far how the value of a work of art is depen-
dent upon the nature of its appeal, the dominant motive it stands
for. It is evident from this analysis that no mere landscape or
still life can ever be great except symbolically, while they mostly
resolve themselves into being pretty or as exhibitions of a specially
developed technique. It is evident, too, that the majority of
works of art appeal to many motives and that they vary to a
considerable extent according to the nature of the person appealed
to. Millais's Sower was supposed by many, when it was first
exhibited, to be symbolic of anarchy. The attitude of the peasant
appeared to indicate that he was hurling maledictions against the
conditions that bound him to toil.
It must be plain also that the great work of art not only makes
appeal by use of a fundamental motive, but that the use of that
motive is simple and direct and not surrounded by and made
obscure by secondary and minor motives. Piloty's Thusnelda at
the Triumph of Germanicus is, to my mind, a really splendid
work, but one must know something of the story to fully appre-
ciate it. This same principle of limitation of appeal is well illus-
trated by Poussin's picture " I too have been in Arcadia." Four
figures are grouped about a tomb. One of them is stooping and
rubbing away the collection of lichens and moss to more clearly
reveal an inscription. The inscription reads " Et Ego in Arcadia."
Unless the percipient knows Latin much of the appeal, the real
meaning of the picture, is lost. No one, however, thinks to ask
for the story of the Winged Victory of Samothrace. Perhaps
there is a story, but if there is it wouldn't add one bit to the
appreciation of the marvelous grace and beauty of this, to my
mind, the greatest of all works of sculpture. In the same way
one needs no explanation of Giotto's Campanile. That it is the
bell tower for the Duomo beside which it stands is not necessary
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART 107
to know to feel all of the charm of its unexcelled grace, harmony
and beauty. I believe Ruskin has said that it was the finest
product of architecture in the world.
There are heights to which art rises, however, which are greater
than any thus far discussed. There is what has been called the
sublime in art and which, of course, has only been most rarely
attained. However, here too I believe we are using a relative
term. For a certain time, for a certain people, more particularly
for the Union soldier, Lincoln's Gettysburg oration 14 rises to sub-
lime heights. That the appeal is not so simple and straightfor-
ward as in the examples we have just given, but requires some
knowledge of something not in the oration itself I can perhaps
illustrate by an example. The epitaph written by Simonides to
the three hundred at Thermopylae, 15 although expressing almost
identical sentiments in a wonderfully simple and direct way, still
I hardly think will stir at all deeply those who do not know the
story; while even those who do will hardly respond with one
tenth part of the emotion of an old Union veteran to Lincoln's
"Fourscore and seven years ago our fathers brought forth upon this
continent a new nation, conceived in liberty, and dedicated to the propo-
sition that all men are created equal. Now we are engaged in a great civil
war, testing whether that nation, or any nation so conceived and so dedi-
cated, can long endure. We are met on a great battlefield of that war.
We have come to dedicate a portion of that field as a final resting place
for those who here gave their lives that that nation might live. It is
altogether fitting and proper that we should do this. But in a larger sense
we cannot dedicate, we cannot consecrate, we cannot hallow this ground.
The brave men, living and dead, who struggled here, have consecrated it
far above our power to add or detract. The world will little note, nor
long remember, what we say here, but it can never forget what they did
here. It is for us, the living, rather to be dedicated here to the unfinished
work which they who have fought here have thus far so nobly advanced.
It is rather for us to be here dedicated to the great task remaining before
us, that from these honored dead we take increased devotion to that cause
for which they gave the last full measure of devotion ; that we here highly
resolve that these dead shall not have died in vain ; that this nation, under
God, shall have a new birth of freedom, and that government of the
people, by the people, and for the people, shall not perish from the earth.
10 " Thou who passeth by say at Lacedaemon we lie here in obedience to
I08 MENTAL MECHANISMS
The effect that a work of art produces upon a person varies
directly according to the mental makeup of that individual —
varies in accordance with the character of his mental constella-
tions. If his mind has never been constellated with reference to
Latin, a picture requiring a knowledge of Latin for its under-
standing fails in appeal.
That the nature of the individual's constellations can be worked
out with reference to an aesthetic factor has been well shown by
Bullough 16 in an analysis of color and perception. He was able to
differentiate four perceptive types, viz., objective, physiological,
character and associative, and a considerable number of " combi-
nation criteria " ; i. e., the effect produced in different persons by
combinations of colors, the way in which one color influences
another when associated with it.
It is plain to be seen then that a work of art, to make an at all
broad appeal, must strike deep in its emotional appeal and reach
those elements that approach, at least, to being the common pos-
session of all mankind.
It is plain also that as we get away from this fundamental
appeal we are dealing with relatively minor motives that are
always of more restricted effect, and that therefore the risk be-
comes progressively greater of striking a combination in any
individual that is not simply less pleasant but perhaps actually
unpleasant. As we saw that beauty required the striking of cer-
tain psycho-physiological balances, so here, with reference to the
more purely psychic factor in art appreciation, we may conclude
that the appeal depends upon the striking of certain emotional
Beauty may be both means and end and its use to both ends is
fully justified. Beauty alone though has a relatively restricted
appeal as we may appreciate by comparing the ideals of the Occi-
dent and Orient, and as we may appreciate even better by consid-
" Edward Bullough : The ' Perceptive Problem ' in the ^Esthetic Appre-
ciation of Simple Colour-Combinations. British Jour, of Pysch., Decem-
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART IO9
ering a beautiful bit of lace. The lace is beautiful, it is true,
but its appeal is a very superficial one, it fails absolutely to touch
The great works of art use beauty as a means; and a funda-
mental motive, a profound emotional appeal is made through this
means. I believe, too, that this appeal must be made in a rela-
tively simple manner because of the reasons already cited — that in
proportion to the complexity of the work the danger is increased
of touching discordant tones in the observer. It is in this respect
that Wagner erred. He failed to appreciate both this fact and
the further fact that the different forms of art — painting, sculp-
ture, architecture — have developed from a more or less homo-
geneous beginning in which they were scarcely at all differentiated.
The greatest art, according to Wagner, in accordance with the
views thus far expressed, should be possible in grand opera.
Here the motives may be universal and dominant, and secondary
motives may be subordinated to the fundamental appeal, and that
appeal is made through music, poetry, dancing, and all of the
motives of architectural and pictorial art — the stage setting and
stage picture. The effect sought is comparable to that of the
orchestra or church organ in music. 17 We hardly expect to pro-
duce great musical effects from the simple instruments such as
the flute, the oboe, the French horn, or cornet. It is only in the
more complicated instruments that we begin to find such possi-
bilities as in the violin, the cello, or the piano, while for the great-
est effects a complete orchestra is required. The only simple
instrument that combines the qualities of a whole orchestra is the
church organ with its several banks of keys, multitude of stops,
and pedal base. So in grand opera all means are made to make
for the same end and the results are correspondingly massive.
As an actual matter of fact, though, we are disappointed in the
"As a matter of fact the orchestra is necessary to produce harmony,
impossible upon many single instruments such as the flute. The complex
of orchestral tones is no more complex than the complex of color tones
in a picture.
110 MENTAL MECHANISMS
appeal made by grand opera if we expect all that I have indi-
cated. We really go to opera to hear Madame this or Seignor
that sing a certain part, for which, quite likely, they are especially
noted and if our sensibilities are at all easily jarred we are con-
stantly offended by the awkwardness of the chorus, the poor
support of the prima donna and such like details. The whole
thing is so complex that some parts of it offend some persons.
As to the artists' state of mind I refer to what was said in the
forepart of this chapter and particularly to the quotations from
Wagner and Shaw (pp. 92, 93). Here we are confronted by a
demonstration that the springs from which arise the activities
leading to the production of a work of art are without the clear
field of conscious awareness. The evidence all goes to show that
the activity is of the same character, in reference to the attitude of
the artist towards it, as the activity which has its origin in that
region I have called the proving ground for automatisms. It is
the same in kind as that arising from a " complex."
The work of art then is peculiarly the expression of the indi-
vidual because it has its origin in the hidden springs of character
which are beyond control.
The inability to get away from these submerged determinants
of conduct is admirably illustrated by the Flemish painters who,
at the time of the Italian renaissance tried to borrow from the
artists of Florence and Rome. Taine, 18 in his inimitable style,
describes the result.
" There are two traits characteristic of Italian art, both of which
run counter to the Flemish imagination. On the one hand Italian
art centres on the natural body, healthy, active and vigorous,
endowed with every athletic aptitude, that is to say, naked or
semi-draped, frankly pagan, enjoying freely and nobly in full
sunshine every limb, instinct and animal faculty, the same as an
ancient Greek in his city or palestrum, or, as at this very epoch,
a Cellini on the Italian streets and highways. Now a Fleming
M H. Taine : The Philosophy of Art in the Netherlands.
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART III
does not easily enter into this conception. He belongs to a cold
and humid climate; a man there in a state of nudity shivers.
The human form here does not display the fine proportions nor
the easy attitudes required by classic art; it is often dumpy or
too gross; the white, soft, yielding flesh, easily flushed, requires
to be clothed. When the painter returns from Rome and strives
to pursue Italian art, his surroundings oppose his education; his
sentiment being no longer renewed through his contact with living
nature, he is reduced to his souvenirs. Moreover, he is of Ger-
manic race; in other terms he is organically a morally good-
natured man, and even modest; he has difficulty in appreciating
the pagan idea of nudity, and still greater difficulty in compre-
hending the fatal and magnificent idea which governs civilization
and stimulates the arts beyond the Alps, namely, that of the com-
plete and sovereign individual, emancipated from every law, sub-
ordinating the rest, men and things, to the development of his
own nature and the growth of his own faculties. Our painter is
related, although distantly, to Martin Schcen and Albert Diirer;
he is a bourgeois, almost docile and staid, a lover of the comfor-
table and the decent, and adapted to family and domestic life.
... It is evident that pupils of this class, even with great labor,
will produce but little more than academic figures ; man, according
to their conceptions, is a draped body ; when, following the ex-
ample of the Italian masters, they attempt the nude, they render
it without freedom, without spirit, without vivacity of invention ;
their pictures, in fact, are simply cold and meagre imitation ; their
motive is pedantic; they execute servilely and badly that which,
in Italy, is done naturally and well. On the other hand, Italian
art, like Greek art, and, in general, all classic art, simplifies in
order to embellish; it eliminates, effaces, and reduces detail; by
this means it gives greater value to grander features. Michael
Angelo and the admirable Florentine school subordinate or sup-
press accessories, landscape, fabrics, and costume ; with them the
essential consists of the noble and the grandiose type, the anatom-
112 MENTAL MECHANISMS
ical and muscular structure, the nude or lightly draped form taken
by itself, abstractly, through the retrenchment of particulars con-
stituting the individual and denoting his profession, education and
condition ; you have man in general represented, and not a special
man. Their personages are in a superior world, because they
are of a world which is not ; the peculiar feature of the scene they
depict is the nullity of time and space. Nothing is more opposed
to Germanic and Flemish genius, which sees things as they are in
their entirety and complexity; which, in man, takes in, besides
man in general, the contemporary, the citizen, the peasant, the
laborer, this citizen, that laborer, that peasant; which attaches as
much importance to the accessories of a man as to the man him-
self; which loves not merely human nature but all nature, ani-
mate and inanimate — cattle, horses, plants, landscape, sky, and
even the atmosphere — its broader sympathies forestalling any
neglect of objects, and its more minute observation requiring the
fullest expression. You can comprehend how, in subjecting itself
to a discipline so contrary, it loses the qualities it had without
acquiring those it had not ; how, in order that it may arrogate the
ideal, it reduces color, loses the sentiment of light and atmosphere,
obliterates the true details of costume and of interiors, deprives
figures of original diversities peculiar to portrait and person, and
is led to moderate the suddenness of motion constituting the im-
pulsiveness of nature's activity, and thereby impairing ideal sym-
metry. It finds difficulty, however, in making all these sacrifices,
its instinct only partially yields to its education. Flemish remi-
niscences may be traced underneath Italian velleity; both in turn
predominate in the same picture; each prevents the other from
having their full effect; their painting, consequently, uncertain,
imperfect and diverted by two tendencies, furnishing us with
historical documents and not beautiful works of art."
A man cannot get away from himself. He is what he is at any
one particular moment because of everything that has gone
before. Whether he produces art or is merely an appreciator of
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART I 1 3
it the result depends upon the whole mass of mental material
which has gone to the construction of his personality.
One is constantly running across admirable illustrations of
this principle in reading — particularly of the old works of art.
Neale and Webb 19 writing of church architecture say: "An age
of church-building, such as this, ought to produce good archi-
tects, not only from the great encouragement given to their pro-
fessional efforts, but from the increasing appreciation of the
principles and powers of their art. And yet it cannot be denied,
however we may account for the fact, that (at least among those
for whom we write, the members of our own communion), no
architect has as yet arisen, who appears destined to be the
reviver of Christian art. It is not that the rules of the science
have not been studied, that the examples bequeathed to us have
not been imitated, that the details are not understood. We have
(though they are but few) modern buildings of the most perfect
proportions, of the most faultless details, and reared with lavish
expense. It is that there is an undefined — perhaps almost un-
definable — difference between a true ' old church,' and the most
perfect of modern temples. In the former, at least until late
in the Perpendicular era, we feel that, however strange the pro-
portions, or extraordinary the details, the effect is church-like.
In the latter, we may not be able to blame; but from a certain
feeling of unsatisfactoriness, we cannot praise."
Their explanation runs as follows : " A Catholic architect must
be a Catholic in heart. Simple knowledge will no more enable
a man to build up God's material, than His spiritual temples.
In ancient times, the finest buildings were designed by the holiest
bishops. Wykeham and Poore will occur to every churchman.
And we have every reason to believe, from God's Word, from
Catholic consent, and even from philosophical principles, that
such must always be the case."
18 Introductory Essay on Sacrimentality : A Principle of Ecclesiastic?!
Design to William Durandus : The Symbolism of Churches and Church
Ornaments. London, 1906.
U4 MENTAL MECHANISMS
I think one must admit that it is quite impossible to imagine
how anyone not imbued to the depths with the faith could have
conceived of the marvellous beauties of the facade of Rheims or
the choir screen of Chartres.
Not only is this so but this work can not, apparently, be ade-
quately copied or reproduced at this day. Mrs. Pennell's 20
delightful descriptions of the French cathedrals are literally
filled with lamentations over the work of the restorer. She says
characteristically of Notre Dame of Laon : " But seldom any-
where has the restorer been so pitiless, and now, as you first
stand before the fagade, instead of being awed by its rudeness
and strength, you are impressed chiefly with the excessive care
the State has taken of it."
Art is a matter of emotion, not a matter of the intelligence. It
is concerned with states of feeling not with syllogisms. As we
have seen that feeling largely originates from springs of which
the individual knows naught, and therefore cannot control, we are
therefore prepared for an explanation of the problem of art which
takes that fact into consideration. The Hamlet tragedy 21 is one
of the very best illustrations of this condition. Here we have a
great work of art produced by a man who did not know the
motive actuating him, in which the principal character is through-
out unable to explain himself, and viewed generation after genera-
tion by an enthusiastic but uncomprehending public. These are
all characteristic of mental states that are conditioned by that
region of mind which is the home of the "complex": the place
from which emotions rise to the surface and make themselves
known though their source remains a mystery.
In concluding this essay it will be well to review the general
propositions which have been set forth.
20 Elizabeth Robins Pennell : French Cathedrals, Monasteries and Abbeys
and Sacred Sites of France. New York, 1909.
"Ernest Jones: The GEdipus-Complex as an Explanation of Hamlet's
Mystery: A Study in Motive. Amer. Jour. Psychol., January, 1910.
PSYCHOLOGICAL APPROACH TO THE PROBLEM OF ART I I 5
Beauty is what may be called the universal aesthetic motive.
Art must first of all be a beautiful expression. Beauty is the
medium, and the only universally necessary medium, for artistic
expression. In order that a thing may be beautiful there must
be produced by it in the observer a certain psycho-physiological
balance of effects. In addition to this it must produce, on the
purely psychic side, if it is a true work of art, a certain emotional
With beauty as a sine qua non must go certain motives pri-
marily in the soul of the artist, but which, as a matter of con-
venience, we have spoken of as residing in the work of art.
These motives are fundamental or primary and minor or secondary.
That fundamental motives are necessary to great works of art
is apparent from the fact that these works persist generation after
generation, despite changes in the political, social, economic con-
ditions, despite changes of standards, and are accepted by peoples
of different nations having widely different national traits of
The only springs of human character sufficiently fundamental
to be the starting point of such motives are the emotions asso-
ciated with self-preservation, and species-preservation. This
thesis is demonstrated in its application.
The minor or secondary motives are less fundamental and
relate to matters either of more restricted interest or resolve them-
selves into questions of technique.
All works of art are the result of, and appeal to, a complex
of motives. Art can only be great which appeals to the funda-
mental motives and it is greater in proportion either to the sim-
plicity and directness of that appeal or the complete domination
of the appeal to the fundamental and the subordination as acces-
sories of the minor motives, utilizing them solely to enhance the
appeal of the dominant.
Minor motives may be made dominant even in works where
appeal to the fundamental exists, and fundamental motives may
Il6 MENTAL MECHANISMS
be greatly limited in their appeal in various ways, thus impairing
the universality of their acceptance. Their appeal may be made
to only a certain class of people, or a certain nation ; to those
only who speak a certain language, or who know certain historic
The proper balancing of motives is the work of genius.
A full understanding of a work of art must be reached by an
understanding of the artist and of the nation to which he belongs,
which must include the social, political, economic, moral, religious
conditions, geographic and climatic conditions, etc.
CHAPTER VII 1
THE THEORY, METHODS AND PSYCHOTHERAPEUTIC VALUE
There seems to be an apparent, almost absolute, lack of com-
prehension which seems to be rife as to what may be included
under the term psychotherapy. On the one hand, I hear the sub-
ject discussed by those who know much about it but who invari-
ably assume, on the part of their audience, a knowledge which
I feel sure they do not possess. On the other hand I am con-
fronted on all sides by physicians who sum up all that is included
under the term psychotherapy with the word " suggestion."
These latter men see in the whole subject nothing but the use of
suggestion and assume very much the attitude towards its use as
a psychotherapeutic agent, as do many who consider the writing
of a prescription the crowning act of the practice of medicine.
These same men, too, will invariably make the statement that all
physicians use suggestion more or less in their practice, and have
done so since the days of Egypt and Babylon; and their attitude
implies that there has been very little, if any, progress in its use
or the knowledge regarding it since then. It seems to me high
time that this state of blissful contentment, comfortable as it may
be, should give way to some realization of the immense amount
of work that has been done along these lines in recent years and
to some of the results, both theoretical and practical, that have
In the first place we must escape from the influence of the
shibboleth " suggestion," 2 which for so long seems effectually to
1 This chapter was printed, substantially as it appears here and under the
same title, in the Interstate Med. Jour., September, 1910.
2 1 would define suggestion as the uncritical acceptance of an idea and
its realization in action.
I I 8 MENTAL MECHANISMS
have blighted any efforts at individual thinking. It has been in
the past a word to conjure with and use as a cloak for ignorance.
The average use of the term suggestion implies a conception of
mind that would permit of the addition of ideas, much as one
would sprinkle the particles of salt upon his morning egg and
permit their removal in quite as simple a way. There seems to
be a popular delusion to the effect that an idea is something
almost tangible in its definiteness, something distinct, and quite
apart from other ideas and other phenomena of consciousness.
To those who have some acquaintance with the phenomena of
mind it is hardly necessary to say that all this is absolutely not so.
As an illustration of the complexity of consciousness compared
with its simplicity, as implied in the conception of suggestion,
let us consider a relatively simple mental fact. Suppose I look at
an orange and so have what we call a percept of an orange. This
percept, it can at once be seen, is composed of many elements.
The perception is possible only as a result of the fusion of many
sensations — roundness, yellowness, and the complex sensations
coming from the eye-muscles in accommodation — plus the resid-
uals of many previous experiences of the same character and
which included the additional sensations of taste, touch, and
smell. In addition to all this mass of material necessary to the
formation of the percept, I tend to assume a certain attitude of
mind towards the orange, to relate myself to it. I am pleased or
displeased, the orange is mine or some one else's, and I tend to
reach out and possess it with the intention and desire to eat it
or I restrain myself because perhaps it is not mine. If now I
shut my eyes and think of the orange, the idea of the orange with
which I have replaced the percept is different from the percept,
and calls up still further and more complex associations. In this
illustration we can see how complex a simple mental fact is, and,
more important still, how intimately it is bound up in a complex
of associations with other mental material. Ideas cannot exist
alone; what does exist is a mental state conditioned by events in
the environment and related to those events.
THE THEORY OF PSYCHOANALYSIS II9
Every mental state is a synthesis and like a chemical compound
may bear little relation in its qualities to the qualities of its con-
stituent elements. Every mental state, too, reaches back through
an immeasurable line of other mental states to the very dawn of
consciousness. There is nothing fortuitous in mental life. De-
terminism holds as definitely in the psychic as in the physical
world and no mental fact can exist that has not its efficient cause
in antecedent mental states. The sum total of the material of
consciousness constitutes the personality, and I trust my illustra-
tion will give some vague idea of its almost infinite complexity.
The important thing to remember is the fact that all states of
mind have efficient causes and are definitely associated with those
causes in quite as inevitable a way as in the physical world.
Psychoanalysis would be quite impossible if it were not for the
presence of inexorable law in the field of mind.
Now let us examine a little the effects of suggestion. Perhaps
I can illustrate best by a case. One of my patients had a phobia
for red. Although very suggestible, sinking readily into deep
hypnosis, and accepting posthypnotic suggestions, I found it almost
impossible to remove this phobia except for a short time. It kept
coming back but I finally succeeded only after I had taken up
the same problem with other symptoms. The same patient often
thought of suicide. I suggested to her in hypnosis that when
the desire to kill herself came to her mind she would think of
an hallucinatory cat that had been suggested to her during a
previous hypnosis. After this suggestion was made, and I began
to work on the suicide idea, the fear of red disappeared. At
first the suggested cat came whenever she thought of killing her-
self. The cat amused her immensely and the idea of suicide was
robbed of its affect. Then the cat came less often and the suicide
idea resumed its sway until the suggestion was repeated. This
only worked for a short time. The same day she broke a window
to get glass to cut her throat. The next day the cat idea came
when she thought of killing herself, but it was too weak to dis-
120 MENTAL MECHANISMS
place the suicide idea. During the time these experiments were
going on I was trying also another substitution. She had an idea
at times that people hated her. I suggested in hypnosis that when
this idea came she would see a bright flash which would distract
her attention but not alarm her. This substitution worked very
well and the idea that people hated her and the hallucinated flash
of light gradually disappeared together. It was while this was
disappearing, however, that the suicide idea returned in strength
as described above. During this time a depression developed, a
fear that when she went home she would get worse again. It
was suggested that her right arm would jerk whenever she felt
this dread. This suggestion was not well carried out and the
idea that people hated her returned. Now, while in the midst of
these attempted substitutions, she complained that she could not
remember the names of persons and even of things ; she said that
this difficulty was getting worse.
These experiments suggest that we are dealing with conditions
similar to those in the physical world that are controlled by the
law of the correlation and conservation of energy. At first it is
impossible to make the phobia for red disappear. It goes finally
when the mind is taken up with the suicide idea. This is par-
ticularly rebellious, however. The idea of hate is made to dis-
appear like the phobia for red. The cat idea comes for a while,
then weakens and disappears. During this time a depression
develops. An attempt to substitute an arm jerk for this is not
carried out and the idea that people hate her returns. Then
appears an anterograde amnesia. She forgets names of people,
where she put her fancy-work, etc. There seems to be just so
much energy, but not enough to go around. When it is used in
one place it must necessarily be drafted from another, and so,
although a symptom may be removed it either returns or some
other takes its place. The basket will only hold so many eggs.
We see by these examples that suggestion really plays on the
surface. The fundamental, underlying conditions are not reached
THE THEORY OF PSYCHOANALYSIS 121
by suggestion. These underlying conditions which produce the
symptomatology of the psychoneuroses are the same conditions
that make suggestion possible. The accepted suggestion is quite
as much a pathological product as the various symptoms them-
The particular way in which a psychoneurosis manifests itself
is largely accidental. Given the pathological foundations, any par-
ticular thing that may be about and available at the time being may
be used as a vehicle of expression. For example, one of my
patients had epileptiform seizures preceded by an aura of green.
He had had a fall which rendered him unconscious. He was
lying upon a green baize face down so that the first thing he saw
on coming to was green. Had the baize been red his aura would
probably have been red. Had he been looking up instead of down
perhaps he would have had no aura. Another case fell striking
her occiput severely, became unconscious, and awoke in an attack
— the first one. Thereafter each attack was ushered in by pain
in the occiput.
These illustrations serve to show, I think, that the psycho-
neurotic symptom is an end-product only and that it may be varied
to any extent, even removed, without affecting the underlying
condition out of which it grew and which made it possible. Just
as the old psychiatrists sought patiently in the autopsy-room for
the solution of the insanity riddle without appreciating that they
were dealing only with end-results, so the psychotherapeutists
have for long been using suggestion without appreciating the
necessity of going deeper than the surface in attacking the
Psychoanalysis aims to avoid this superficiality and to go to the
root of the whole matter and disclose fully the mechanisms upon
which the symptoms depend. In order to explain how this can
be done a few words are necessary to outline a little further some
of the mechanisms of consciousness and the theory of these
abnormal mental reactions.
122 MENTAL MECHANISMS
The field of full, clear, conscious awareness is a relatively
restricted one. A mental act repeated a few times tends to be-
come automatic, to retire from the full light of attention so that
consciousness may occupy itself with new adjustments. The
example of the piano-player (Chapter I) is a good illustration.
The painfully conscious attention to every detail during the period
of learning is later substituted for a nonchalant, quasi-automatic
production of a piece while engaged in casually carrying on a
desultory conversation. Clear consciousness only arises at points
of conflict, at times when new adjustments are to be made. All
other acts tend to sink into the dimly lit, twilight regions from
which the focus of attention has been removed.
The majority of our acts then are controlled from this un-
aware region of mind, relatively few being directed from the
field of full, clear, conscious awareness. Let me give an example
to illustrate this and how clear consciousness only arises under
the necessity of a new adjustment. A lady to whom I had
occasionally to address a note had asked me to address her by
her given name and middle initial rather than the way I had
been addressing her. I had occasion to write to her several
times but did not comply with her request. She called me to
account for not doing so and thus forced me to discover why I
had not. In analyzing the situation I found that each time I
had written to her I had had a distinct feeling of conflict, when
I came to address the envelope, without being fully conscious of
the reasons for it. Further analysis showed the components of
this conflict to be a knowledge that there was another person by
the same surname in the apartment where she lived, and, while
I knew my letters had never heretofore gone astray, I did not
know the other person's given name, and thus felt the possibility
that they might be the same; then the name I was requested to
use called up a painful memory which I automatically escaped by
not using it. These inhibitions naturally interfered with carrying
out the request and I went on following the line of least resist-
THE THEORY OF PSYCHOANALYSIS 123
ance, controlled by the subconscious motives. By bringing the
whole matter fully to my attention, into clear consciousness, a
new adaptation, a compliance with the request, became possible.
This example is a very good illustration of the mechanism as
we see it in the psychoneuroses, for we must remember that there
is no difference in nature between the mechanisms of health and
disease. The psychoneurotic suffers from just such a disintegra-
tion of the elements of his personality. Certain mental states are
not adequately synthetized. These are the disagreeable expe-
riences of life. The mind in self defense endeavors to crowd
out, to relegate to the limbo of the forgotten, experiences and
memories that are painful. These experiences are, so to speak,
put aside, pushed into a dark corner, into the obscure regions of
consciousness outside of the focus of the bright light of attention.
To be technical, they are repressed. If repression has been
accomplished, however, it is not without a certain cost. These
experiences, crowded out of clear consciousness, out of the possi-
bility of synthesis with the rest of the personality, begin to lead
a quasi-independent existence. They constitute submerged
The complex, crowded out of relation with the personal con-
sciousness, seeks for expression and because it is not synthetized
with the rest of consciousness, because the individual is not aware
of its existence, its expression cannot be controlled and guided
into the usual channels and so it creates the symptoms of the
psychoneurosis. One of my patients suffered from accesses of
anxiety and fear without apparent cause. A short time before
her husband had been on a " spree " and one night got up about
two o'clock to go out. His wife was frightened for fear in his
condition he would associate with lewd women. The thought
was so hateful and painful to her, however, that it was crowded
out of consciousness. The detached emotion continued to mani-
fest itself even though the reason for it was not permitted to
enter her mind.
124 MENTAL MECHANISMS
This is a relatively simple example but shows quite well that
the feelings of fear this patient had and which prompted her to
throw herself out of the window could not have been reached by
suggestion. The mechanism on which they were dependent must
first be uncovered before there was any hope of dealing adequately
with the situation.
The extreme difficulty in locating and uncovering the complex
is due to the symbolic form in which it usually manifests itself.
The painful memories of disagreeable experiences, unethical, un-
conventional, and otherwise impossible and hateful wishes, while
crowded out of mind by what Freud has so aptly termed "the
censor of consciousness," nevertheless struggle to find expression.
The complex cries for recognition, the censor will have none of
it — the fight is on, the conflict wages, until finally a sort of com-
promise is reached by permitting the complex to come into clear
consciousness, but only on pain of not disclosing its true self,
under the cloak of a complete disguise.
For example Freud's case of Elisabeth. 3 She was engaged in
nursing her sick father who afterwards died. One evening,
spent away from home at the solicitation of her family, she met
a young man of whom she was very fond and he accompanied
her back home. On the walk home she quite gave herself up
to the happiness of the occasion and walked along oblivious of
her duties. On reaching home she found her father much worse
and bitterly reproached herself for forgetting him in her own
pleasure. She immediately repressed this disagreeable thought
from her consciousness. Now she had, each morning, to change
the dressings on her father's swollen leg. To do this she took
his leg upon her right thigh. The suppressed complex seized
upon the feeling of weight and pain of her father's leg upon her
thigh as a handy and efficient means of expression and so the
repressed erotic wish comes into consciousness under the disguise
* Freud: Selected Papers on Hysteria and Other Psychoneuroses. Jour.
of Nerv. and Ment. Dis., Monograph Series, No. 4.
THE THEORY OF PSYCHOANALYSIS 1 25
of a painful area of the right thigh corresponding in extent and
location to the place upon which she rested her father's leg.
From the situation as presented thus far two problems are
immediately suggested. First, of course, the therapeutic prob-
lem; and secondly, the problem of uncovering the submerged
complex, of discovering the hidden mechanisms of the psycho-
neurotic symptoms. They are the problems of psychotherapy
and of psychoanalysis. Let us take the latter first.
When we have a case that we have decided to try psychoanalysis
with, the first thing to do is to have a detailed talk with the patient,
covering the manifestations of the disorder and also touching
the main events of the entire life as far as possible. We must
remember that the symptoms with which we have to deal are only
end-products — the results, perhaps, of a mechanism that seems
fairly simple, but in the last analysis they are results made pos-
sible by all that has gone before — the entire psychic life of the
individual. Our initial talk, therefore, serves not only to give us
an account of the symptoms but to orient us with regard to the
general makeup of the personality with which we have to deal.
During the course of this conversation it is inevitable that cer-
tain points will stand out as being important to pursue further.
Here begins the real problem of psychoanalysis.
The method of procedure, the so-called method of free asso-
ciation, is roughly as follows : The patient needs to be alone
with the physician in a room as far as possible from distracting
influences — noises, bright lights, etc. To this end, too, the patient
should be disposed as comfortably as possible so that physical
discomfort or uneasiness will not interfere. It is well to have
the eyes closed also, so that distractions from the visual field may
be eliminated as far as possible. This general state of quies-
cence, and passivity can be enhanced by having him observe some
monotonous sensory stimulus that dominates the sensorium and
shuts out less insistent and inconsiderable sensations, such as the
buzzing of a faradic coil. In this condition the particular feature
126 MENTAL MECHANISMS
of the history that it is desired to pursue further is presented to
the patient, and he is asked to hold that event before his mind,
to make no mental effort of any sort, such, for instance, as trying
to remember, but to tell absolutely every thought that comes to
his mind, no matter how fleeting, no matter how inconsequential
it may seem or no matter how little bearing it may appear to have
on the question at issue.
The theory of this procedure is that if the patient does not
direct the thought in any way, every idea that comes must of
necessity have some relation to the event held before the mind
about which enlightenment is sought. The monotonous sensory
conditions are observed to prevent distracting influence from
outside sources. The directions to the patient, if carried out,
prevent distractions from inside sources.
It is difficult to secure this condition of passivity in many cases,
especially those who have never consciously used their minds and
therefore do not know how to comply with the directions. It is
difficult to get the patients to tell all the ideas that come. They
naturally refrain from mentioning those that appear to be entirely
fortuitous and to have nothing to do with the case. It will be
seen from the theory, however, that these ideas cannot be unim-
portant, and that they must bear some relation to the central event.
This is the method of attack to fill out the information acquired
in the initial conversation. The symptoms should all be dealt with
in this way for the purpose of uncovering the submerged com-
plexes and disclosing their mechanisms. As we proceed new
events will constantly be brought to light that must also be pur-
sued, as must also all the significant events of the patient's life.
Nothing is too trivial to be worthy of analysis, nothing but may
throw light upon the situation. All the little slips of the tongue,
forgotten incidents, points at which two recitals of an occurrence
do not agree, even witticisms are necessary to trace out, while the
dream life offers an abundance of rich material for study. Let
me give an example from a case I have been recently studying.
THE THEORY OF PSYCHOANALYSIS \2J
A young lady, refined, educated, and modest, entered a ball-room
at a country club, from the piazza where she had been strolling
with a gentleman with whom she was in love. She wore a bril-
liant diamond star at her breast. A gentleman stepped up to her
and admired the star whereupon she said : " Yes, the stars are
always brightest in the milky way." Immediately realizing what
she had said she retired, confused and blushing and filled with
apprehension as to what the gentleman would think of her.
Analysis of this gaucherie showed that while walking on the
piazza with her lover they had been observing the stars. They
had picked out the big and little dipper and she had remarked
that the stars were brighter in the milky way. Meanwhile a
popular song was being played " Love Me Only," and her lover
told her that her eyes were the only two bright stars in the world
for him. She was frequently told she had bright eyes and now
thinks of herself at this period of her life as having had bright
eyes. Incidentally she knew how to use them. She was wearing
a diamond ring given her by her lover on her birthday. She evi-
dently regarded it as an engagement ring for she wore it on the
engagement finger. She told him the ring reminded her of a star.
He told her that she was so good and kind that she would have
a good many stars in her crown. At this point I tried free asso-
ciation, and she told me of a time when a friend had written her
destiny to be opened ten years afterwards and read. This destiny
pictured her at twenty-six with three children, the youngest a
bright blue-eyed baby. She recalls also that her lover wrote a
poem to her called " My Star." It is significant that her lover
had bright blue eyes, that she always associated blue eyes with
him, that she dreamt of blue-eyed children, that once when hold-
ing the blue-eyed baby of a neighbor her lover had said to her,
" You make a pretty picture. Blue-eyed babies are becoming to
you." It is also significant that in the word associations her reac-
tion to the word " sky " was very long, 4.6", the preceding reaction
being 4" long, because it evidently was significant, while the sub-
128 MENTAL MECHANISMS
sequent association which was evidently indifferent was 3". Her
response to the word "sky" was "beautiful blue" and on repeti-
tion, " blue, sunny blue sky."
Pet I had once.
I've always loved to talk.
Carriage at home.
Blue, sunny blue sky,
No matter which way we turn we are confronted by love, mar-
riage, bright eyes and blue-eyed babies. I think the explanation
is fairly apparent. It meant a wish, concealed in the remark, to
belong to her lover and to have beautiful, bright, blue-eyed babies
of his at her breast.
We must never forget, too, to investigate the dream life. Freud
has shown that the mechanism of dreams is quite the same as
that of the symptoms, so we may expect to get valuable informa-
tion from this realm. The method of procedure is the same.
The patient quite likely will deny dreaming at all at first but pur-
suit of the inquiry may very well disclose a rich dream life. The
dreams are especially valuable and often throw a great deal of
light on the situation. To illustrate from the same patient: She
told me she dreamt she was standing by the edge of a precipice,
a man came along and pushed her off, at the base of the cliff was
a mass of writhing serpents, just as she was about to fall among
them she screamed and awoke. The impression was created on
listening to her tell of this dream that she had been much fright-
ened at being pushed from the cliff. This, however, was but the
elaboration of the waking consciousness. She was not frightened
to any extent. The analysis shows why. The cliff was familiar
to her as being a place she frequently visited. Standing on the
edge of the cliff was symbolic of a social and moral danger. She
had never seen her lover since she had married and had wondered,
if she were thrown with him, if he would try and tempt her. The
man who had pushed her off the cliff was her lover and the falling
THE THEORY OF PSYCHOANALYSIS 1 29
down really representing a moral fall, did not really frighten her
very much, but was rather pleasant as it involved his companion-
ship. As she nears the bottom, however, she sees the den of ser-
pents. The serpent for her represents sin and recalls the sin in
the Garden of Eden. Her fall has been pleasant until she sees
its end in sin. This end is so hateful to her that she cannot even
permit the idea to enter her thoughts. The censor of conscious-
ness, lulled by sleep, has permitted this symbolic wish-fulfiling
play to go on up to this point, but now he must be aroused to full
activity and press back to the furthest and darkest recesses even
the suggestion of a sinful denouement. The patient awakes.
See how full of information such a dream is of the innermost
thoughts, inclinations, and desires (Chapter III).
This is the method of unraveling the tangled network of mental
life. It takes weeks, months, perhaps years of constant effort.
There is no royal road, no short cut to results. What it has taken
a life time to produce cannot be laid aside in an hour. How dif-
ferent a conception dominates this method of procedure from
that of the method of suggestion.
At times in the course of the analysis it seems as though no
further progress were possible. At these points, and perhaps also
to start with, just after the initial conversation, it is well to try
some word associations. This is done by taking the reactions to
a list 4 of say one hundred words carefully chosen to cover the
ordinary field of the average person's possibilities of complex
formation. There may be distributed through this list words that
for some reason may be supposed to have significance.
The method of procedure is to read the words to the patient,
instructing him to answer immediately the first word or thought
that comes to his mind after hearing the word read, and recording
the time it takes for this reaction. The most practical way for
recording the time is by a stop-watch graduated to fifths of a
*For such a list see White: Outlines of Psychiatry. Jour, of Nerv. and
Ment. Dis., Monograph Series, No. 1.
I30 MENTAL MECHANISMS
second. After the list has been completed it is repeated in the
same way, the time need not be recorded, however. The patient
is asked to repeat the same associations he gave the first time if
he can recall them.
When one of the words in the list touches a complex, is a com-
plex indicator, a marked disturbance in the reaction is noted.
This disturbance shows in several ways : peculiarity of the type
of reaction ; increased length of reaction time ; irradiation of the
disturbance to the next one or two associations; and failure to
repeat the same association. I have already given some illustra-
tions. I will add another at this point. The association to the
word "wagon" in the same patient I have been giving illustra-
tions from, was "wagon, many I see on street," but took 11.8".
Free association disclosed an escape from a sanatarium and a
drive in a wagon, which she had come up with on the road, to her
friends. Another patient I casually gave a few words to. Know-
ing that her mental breakdown was associated with the stealing
of jewelry by her nephew, I included the word " pin." She could
not reply but said she could if the word were medal. She then
flushed, began to cry, and detailed an incident when her sister
had left a medal in her room and upon returning discovered it was
missing. It was quite evident that her nephew had stolen it.
She had never told of this incident although repeatedly questioned
with a view to discovering all the things of importance in her
history. Both of these instances illustrate the uncovering of
events in the lives of patients, which although in these particular
examples might not have been of much importance, still would
probably never have been brought out by ordinary questioning.
This method is valuable then for with it we may find some unex-
pected complex or some new line of inquiry, that we can continue
with to advantage.
The method of word association is often just a "fishing expe-
dition " in the hopes of catching something and the list of words
generally used is chosen to cover as wide a field as possible of
THE THEORY OF PSYCHOANALYSIS I3I
experience. Oftentimes, of course, words may be introduced
that are thought to be suggestive by the examiner.
It will probably occur to many to wonder how it is that we can
expect to find memories reaching back for years sufficiently well
preserved to be helpful. As a matter of fact the memories of all
repressed experiences are perfectly clear, no matter how old.
The explanation for this is that being repressed they are disso-
ciated from the every-day events of life, they are kept in their
original form, they have not been subjected to the attrition and
amalgamation with the intricacies of associational life. They do
not fade out by this process of absorption as do the memories of
indifferent events, but remain where ever after they may be
brought to light by analysis and used as helps for cure.
Thus we have three main inquiries, three avenues of approach
to our psychoneurotic patient — word association, free association,
and the analysis of dreams. With these at our disposal possi-
bilities, heretofore little expected, open up.
It will be seen from this short description what a far-reaching
method this is. A method of analysis from which no event of
life, no matter how apparently trivial, is free. A method that in
its results lays bare not only the immediate antecedents and
causes of the symptoms, but the whole innermost life of the
patient reaching back even to the period of early childhood. This,
of course, takes time. A case of any complexity and difficulty
quite generally takes several months, of at least two or three
seances each week, to reach a final result.
The element of time is an important one for more than one
reason. In the first place, it may, and does, largely preclude the
possibility of the general use of this method by the average practi-
tioner. It should not, however, lead to adverse and destructive
criticism of the method for that reason alone, as it has done in
some instances. If the psychology upon which the method is
based is true, we must of necessity accept it whether it meets with
our convenience or not. Then it is rather silly after all to have
132 MENTAL MECHANISMS
a scientific position condemned because to carry out the resulting
methods takes too much time. An effort might legitimately be
made to improve upon the method, but truth does not yield to
attack based upon such principles.
There is some reason to believe, however, that the time needed
to effect lasting results in this class of cases cannot be materially
shortened. These cases come to us in a sea of trouble, tossing
about blindly and hopelessly on the waves of emotion, far from
shore and safety, resigned often to a life of suffering, desperate
often at seeing no hope of release, but quite unable to help them-
selves at all. Of course, in the nature of the case, the real trou-
bles — the buried complexes — not only are not known by the pa-
tient, but they cannot be known, and the obvious explanations
for the symptoms that the patient often has ready at hand, not
only are not the real explanations but they cannot be. Never-
theless, the original repressions and the dissociations in conscious-
ness resulting are quite characteristically due to a false attitude
towards the problems of lfe. The young woman, in love with
some one of whom the father disapproves, may have a fleeting
thought that the father's death would straighten matters out and
enable her to marry without further opposition. Now, instead
of reacting to such a thought naturally, by realizing that as a
conscious human being such a thought was merely an expression
of her wish to marry the man she loved, by the expression of a
natural desire that the obstacles in the way be removed, and put-
ting it quietly and without passion aside as impossible of con-
sideration because of its unethical character, in fact unworthy of
even contemplation, she becomes terribly horrified that such a
thought could even find entrance to her mind and represses it
immediately as not only too horrible for consideration, but with
a sense of chagrin, shame, and self-reproach. Such a putting
aside, side-tracking of a disagreeable thought, such a refusal to
meet an unwelcome guest in the open, frankly, such a refusal
even to see the disagreeable does not make for effiecient reaction,
does not enable the individual adequately to adjust.
THE THEORY OF PSYCHOANALYSIS 133
These patients come to us with no adequate philosophy of life,
no raft with which they can safely reach shore in their sea of
trouble. They have narrow, distorted, perverted view-points, and
these it is necessary fully to appreciate in the course of the anal-
ysis, for these must be corrected. They cannot be corrected by
a pronunciamento, by laying down what the analyzer believes to
be the law and the gospel on the different questions involved, but
must be slowly changed by a process of reeducation in which the
personality of the physician and his attitude towards the whole
situation plays a prominent part. And herein lies the importance
of the element of time.
This reeducation of the patient is dependent perhaps more upon
the attitude of the physician than upon any particular thing he
may say. The personality of the physician plays a certain role.
Whereas, theoretically, his personality should be nil in its effects,
if the method were accurate, still the method is not perfect and
has to be carried out by human means. The patient, before the
analysis has proceeded far, sees that to go on means to bare his
very soul. One does not confess his innermost thoughts to every-
one; the hysteric, for example, is not impelled to unburden him-
self of his story to the passer-by like the Ancient Mariner. Quite
the contrary. The whole trend of his malady is toward conceal-
ment, repression. The personal characteristics of the physician
do, I think, play some part, although I am willing to admit that
this part is less in proportion to the perfection of the method.
Now as to the physician's attitude. In the first place his atti-
tude should be one of absolute lack of critique. The physician is
merely after facts, for by the analysis he hopes to help the patient
by removing the symptoms. He will in the course of his analysis
hear many intimate thoughts, learn of many wrong, perhaps dis-
gusting or even criminal acts. He should express no surprise.
They are but facts, that is all. The patient must not be blamed
or laughed at. He has already done that for himself many times.
In fact that is often the trouble. Self-blame may have been the
134 MENTAL MECHANISMS
cause for the original repression. His moral sense is already
keen, in fact, perhaps, too keen, and an element of prudery or
over-scrupulousness must be removed for a more healthy attitude
Sympathy is likewise not to be indulged in. The patient does
not want it and it is not helpful. The attitude of the physician,
however, has as an element the most important factor in sympa-
thy — understanding. To be understood is indeed a privilege.
For years the psychoneurotic has failed of being understood, has
refrained from talking to persons about himself, perhaps, after
one or two disagreeable experiences, for fear of being laughed
at. In fact, he has failed to understand himself. Now to find
some one who does understand — what a relief — and it is helpful
in no small degree in the progress of the work.
The demands upon the physician are very great. Not only
must he have no end of patience, and be able to give a great deal
of time, but he must be constantly on the alert to grasp every clue
and must be always resourceful in the face of the unexpected.
For example, a woman suddenly injects a query as to the sinful-
ness of preventing conception. Here is an opportunity for moral
orthopedia to be grasped, it must not be allowed to slip by. It
requires, however, full preparation, full preparedness. In the
particular case I have in mind a great deal of the emotional depres-
sion hinged about this question. It was necessary to discuss it,
but by no means was it easy to do so. A discussion of such a
subject, if it is to be helpful, requires a view-point free from all
narrowness, free from petty dogmatism, religious or otherwise,
broad, comprehensive and above all humanistic.
I am reminded in this connection of a recent experience. A
woman of education and refinement told me in the course of an
examination of a sexual experience in early childhood. She never
had told anyone else in her whole life about it and it was with
the greatest difficulty she could bring herself to speak of it.
When she had related it to me, however, I was able at once to
THE THEORY OF PSYCHOANALYSIS 135
correlate it with certain pre-nuptial practices carried out by the
women of certain savage tribes, and indicated to her how this
experience was an instinctive carrying out by children of practices
that were well developed by savages. This correlation was help-
ful in enabling a discussion of the occurrence from a social stand-
point and did much to rob the event of that disgust which is so
frequent and disturbing an element in the recollection of such
It is these elements in the attitude of the physician — his lack
of critique, and his understanding — that are the quiet determi-
nants making through the weeks and months of psychoanalysis
for a more wholesome, a more robust philosophy of life, and
finally when all the submerged complexes and the mechanisms of
the symptoms have been uncovered our patient emerges literally
born again. The disordered material which the patient brought
to us has, if we have been successful, been sorted over, re-arranged,
added to, and built into a new and enduring structure. Such, in
brief, are the theories, the methods, and the aims of psychoanalysis
as a psychotherapeutic agent.
CHAPTER VIII 1
PREVENTIVE PRINCIPLES IN THE FIELD OF MENTAL
The field of mental medicine, which by the way is much broader
than that implied by the term insanity, with which it is ordinarily
supposed to be coextensive, is generally presumed to offer little
either as a result of treatment or prophylaxis. It will be my
object in a few words to try and dispel this impression — to bring
a message of hope.
There are many causative factors that may operate to unbal-
ance the mind. In fact there are but few cases that come to us
but owe their condition to several rather than to one cause.
Many of these causes are familiar and well recognized. Such
causes as the infectious diseases, such as typhoid, yellow fever,
malaria, smallpox, diphtheria, I need not mention. The work
that is being done in controlling infections of this character nat-
urally controls also the mental sequelae that are not infrequent.
I may say in passing, however, that important as is the problem
of tuberculosis, and little as I would desire to minimize that
importance, still I am of the opinion that the two venereal dis-
eases, syphilis and gonorrhea, produce quite as much suffering
and I am sure that the former alone produces much more insan-
ity, directly at least than tuberculosis, and further, while the ten-
dency of tuberculosis is, to a considerable extent at least, to weed
out the unfit, here is a disease the distribution of which is con-
trolled by accident and so it takes from us only too often the
most useful and efficient members of the community while the
1 This chapter, in an abbreviated form, was read at the annual meeting
of the American Public Health Association in Milwaukee in the summer
of 1910 and is published under the same title in the Jour, of the Am. Pub.
Health Ass., February, 1911.
PREVENTIVE PRINCIPLES IN MENTAL MEDICINE 1 37
latter disease sterilizes many a woman who would make a good
The venereal diseases, particularly syphilis, are of extreme im-
portance in the causation of insanity and come directly within
the province of the public health officials. Of equal importance,
though having directly sociologic as well as medical bearings, is
alcohol. Alcohol and syphilis taken together are generally re-
garded as being responsible for 25 per cent, of the insane.
Although at first sight this statement is alarming on second
thought it is reassuring because both of these causes are strictly
However, it is not my intention to treat here with matter of
this sort but rather to call attention to some opportunities for
the utilization of preventive principles which are less obvious.
These preventive principles have to do with those mental dis-
orders that are not primarily dependent upon physical disease.
There are a host of such disorders that are dependent to a greater
or less extent upon purely psychological factors — mental causes.
The individual at some point or other comes into conflict with
the conditions about him, in which he must live, and to which
he must adapt if he is to proceed in life with anything like effi-
ciency and he fails to make the necessary adjustment. He is
unable, for example, to reach a condition of emotional calm after
the loss by death of a dear friend or relative, or after a disap-
pointment in love; he cannot get on his feet again after being
ruined by a trusted employe; he is placed in a position of too
great complexity for a limited mental equipment and cannot pro-
duce results that are up to reasonable expectations. At these
periods of conflict failure is not infrequently expressed by the
development of a psychosis. Failures of this sort, the inability
of the individual to square up with the events of every-day life,
upon analysis are found to depend largely upon faulty and erro-
2 Salmon, Thomas W., M.D. : Two Preventable Causes of Insanity. Pop.
Sci. Monthly, June, 1910.
I38 MENTAL MECHANISMS
neous view-points, upon vicious habits of thought, upon narrow
and inadequate ideals, false notions and ambitions, in short upon
a biased mental attitude towards the world of things and events.
Here are a series of conditions which strike one immediately
as due in the larger sense to bad education, and in fact they are.
The conflicts which arise, arise in large part because the mind
has been so constituted by previous experience as to make con-
flicts out of certain kinds of circumstances rather than to adjust
peaceably. Take for example the man who is always criticising
every one about him, this thing and that are wrong, his superior
in rank should have done thus and so, he would have done differ-
ently, etc. That man makes the greatest amount of trouble for
himself, he positively insists upon being unhappy, instead of
accepting conditions which he cannot change and making the best
of them he frets and chafes under them, he actually looks for
things with which to find fault, he positively will not be content
in the sense in which contentment is desirable. Such a man is
inviting disaster by using up his energies in a useless thrashing
about usually without the corrective of that satisfaction which
comes from things accomplished. The young woman, of a dis-
tinctly different type, who develops a hysteria as the result of a
disappointment has actually succumbed to a psychosis because of
her failure to accept — to adjust. Instances might be indefinitely
multiplied but the fact I mean to bring out is that numerous psy-
choses are dependent upon mental causes which in their nature
are removable or preventable, and subsequent attacks after re-
covery may be produced in the same way.
People such as these, who present characteristics unfitting
them for a peaceful adjustment to the difficulties of every-day
life owe their defects to faults of education — by which term I
include all that life of experience which is addressed directly or
indirectly to the preparation for the independent life of adulthood.
The places where this education is for the most part acquired
are two — the school-room and the home. Let us speak for a
PREVENTIVE PRINCIPLES IN MENTAL MEDICINE I 39
moment first of the home. The fundamental fact here is that
the important groundwork of later life is laid much earlier than is
ordinarily supposed — perhaps in the first four or five years of
life, and this is the period in which no one will question that the
mother's influence is supreme. Home conditions during this
period are therefore most vitally important for the future. I
will not mention the obvious effects of sickness, crime, alcoholism,
all of which go to make a sordid, wretched place for the child
to grow up in, but call your attention to two matters of impor-
tance. Child labor and the employment of women.
We cannot expect much of the generation the children of which
were brought up in the mines and factories. Child life that is
deflected into hard labor and unsanitary health-destroying sur-
roundings when it should be unfolding and developing character
in school, home and play must become deformed and stunted.
These industrial conditions have gone even further than placing
the child at labor. The mother, too, has found her way in large
numbers into the factories, so that again the child is robbed of
its own and not only he but the generations to come must pay
the toll of this greed for gold.
It has been shown that hard work by the pregnant woman tends
to bring about miscarriages, or if the child is born at term, to
result in a poorly, undeveloped child. The energy which should
have gone to the growing child has been deflected to the loom.
Children born under such conditions must of necessity be seriously
handicapped; they must find the difficulties of life often too great,
so what wonder that later they break down, become insane,
paupers, criminals, it matters not for all these are evidences
primarily of mental defect, mental insufficiency, inability to meet
life's problems. I am in hearty sympathy with laws governing
child labor and the employment of women. The laws governing
the employment of women that are in existence in most of the
European countries seem to be well conceived. They provide
for a certain number of weeks both before and after confinement
140 MENTAL MECHANISMS
free from labor with the salary continued. They are a healthy
reaction against the too great individualism of the present day
and an acknowledgment that we owe something to those others
in whose society we live and from which we derive so much.
The day is past when the individual will be conceived to have
the right to ruin as many souls and bodies as he wishes and then
toss them ruthlessly aside on the dump heap of public charity for
this and succeeding generations to care for.
A propos of this question of the child and the home Miss Dorr,*
in a recent magazine article, has emphasized the present condition
of affairs by calling attention to the lack of provision for the
child in the modern city. There is literally no place for him.
There is no ground for play and many apartment houses even
refuse families with children. Then again the conditions that
used to maintain in the home have changed. In the old days the
child not only could run wild in the woods but he was early
initiated into some form of wholesome craft work. Now, it is
the immense factory, and if the family be poor both child and
mother work there, while if they be rich or well-to-do the child
slowly becomes an artificial product of civilization with all the
animal trained out of him and neither he nor the mother have any
form of wholesome physical occupation.
A great deal is said about the strenuous life of the present day
as a cause of neurasthenia but my experience is that more people
become nervous because they have nothing to do then because
they have too much. The man is relatively well off and he may
always have work to do, but for the middle class and well-to-do
woman there seems very little. Everything she needs can be
supplied better and usually cheaper than she can produce it.
With practically nothing to do, with time hanging heavily upon
her hands, she ekes out a miserable existence of dreams that don't
come true, of ambitions unrealized, of lack of fulfilment — in short
8 Dorr, Rheta Childe: A Fighting Chance for the City Child. Hamp-
ton's Magazine, August (?), 1910.
PREVENTIVE PRINCIPLES IN MENTAL MEDICINE I4I
of failure. These are the potential neurasthenics and it is against
this hopeless, useless existence that so many of our women have
to lead that the so-called suffragette movement is to my mind a
At this point I cannot fail to mention that recent development
of the desire for race betterment — sterilization of the criminal.
It is very hard to find any justification for such legislation unless
it be the good intention back of it and we all know the fate of
so many good intentions. The only basis on which I can conceive
that such legislation might be founded is on that of the theory of
unit segregation and gametic purity as set forth by followers of
the Mendelian hypothesis. I have never heard the suggestion of
any such reason but even so this theory has already been vigor-
ously attacked and there seems little warrant for such applications
of hereditary principles.
The whole question of heredity is altogether too vague in its
application to man to warrant any such radical measures. Per-
haps the matter of heredity might be summed up best in the
characteristic chapter heading of Ellen Key 4 in her admirable
book, " The Century of the Child," as " the right of the child to
choose its parents." This is not a witticism but involves a funda-
mental privilege which is rarely consulted. How frequently in
this super-sensitive civilization of ours are the rights of the next
generation given consideration ? How often is the bringing of a
new soul into the world given as much consideration as the canary
or the selection of a suitable paper for the dining room? Why
we are not even permitted to talk of such things. A salacious
prudery which fills columns of the public press with the descrip-
tion of the seduction of a young girl insists upon a becoming
modesty in such matters that relegates the question of human
breeding to the background.
It is well to keep in mind that the symptoms of that group
4 Key, Ellen: The Century of the Child. G. P. Putnam's Sons, New
York and London, 19x19.
142 MENTAL MECHANISMS
of mental disorders comprised under the general term insanity
are acquirements. Whatever potentialities the germ may have
had these symptoms have been added to them and not developed
as an innate necessity — at least in the special form they assume.
The full possibilities of the influence of environment are only
beginning to be appreciated. If a change in environment will
actually change the shape of the skull in one generation, as has
been recently shown by Professor Boas, what may we not expect
from hygienic surroundings and proper educational methods?
Passing from questions of heredity and other factors that are
uncontrollable in the individual, let us consider the difficulties that
arise in the course of mental development.
I can approach this question by asking why it is that only in
adult life do dreams become symbolic and thus hide their real
meaning from us. The answer to the question is the crux of the
The child in his wish-fulfiling dreams, be they sleeping or wak-
ing* goes direct to the point unhampered by conventions, unre-
strained by social customs or the fear of disapproval. He knows
nothing of these things. The adult on the contrary has become
so painfully conscious of them all that he even disguises them to
himself, he is afraid to acknowledge them to himself and so
clothes them in a complex symbolism. At least so goes the theory.
What has happened in the meantime? Education.
One need not be disturbed by this use of the word education.
Remember that this term includes all that life of experience
which is addressed directly or indirectly to the preparation for the
independent life of adulthood. From our standpoint let us see
some of the things this process implies.
The whole process of education has to do very largely with the
building up of certain attitudes of mind towards the usual expe-
riences of life.
As has been seen, acts have been divided into reflex, automatic,
and voluntary. But this by no means exhausts all their possibili-
PREVENTIVE PRINCIPLES IN MENTAL MEDICINE 1 43
ties. Many acts result from experiences that have been so fre-
quently repeated that they issue as a natural consequence under
certain conditions but by no means sink to the level of the auto-
matic. The conventional mode of greeting, shaking hands, " How
do you do, I'm glad to see you," reaction has become so much a
habit that it does not require the clear consciousness of close
attention, nor hardly a grade of activity that could be dignified
by the term voluntary. Conscious volition may initiate the reac-
tion but once started it proceeds in the usual channels.
This region of consciousness, beneath the voluntary activities
but above the automatic activities, it will be recalled, is the region
which I have called the proving ground for automatisms. It is
the intermediate state on the way from the voluntary to the auto-
matic. We are all the time submerging into this territory, the
ready made mechanisms, as it were, for responding to the ordi-
nary events of life. The usual occurrences are soon reacted to
in an habitual, stereotyped fashion. And so with our attitudes
of mind, we come naturally and unconsciously to be pleased or
offended, as the result of our education, by the occurrences that
go on about us.
Certain types of reaction are common to a large proportion of
persons, as for example, the admiration displayed for acts of
physical courage or the disgust felt for acts involving moral turpi-
tude. On the other hand certain types of reaction vary among
individuals according to their education and their habitual expe-
riences. Human excreta generally give rise to feelings of dis-
gust. In the laboratory man, however, they frequently give rise
to quite opposite effects. The clinical pathologist is quite capable
of ecstasies over a urinary sediment which is to him beautiful.
For the scientific mind the saying that " dirt is matter out of
place " is quite true and might well be paraphrased to apply to
the moral sphere.
This submerged portion of consciousness, whence issue these
reactions we are discussing, is of great importance so far as the
144 MENTAL MECHANISMS
activities of the individual are concerned because of its large
emotional content. Human actions, to the everlasting despair of
the idealist, are initiated and controlled only to a limited extent
by reason. The vast majority are more or less automatically set
in operation by already organized mechanisms which determine
the attitude of mind de novo towards the experience whatever it
is. Attitude of mind is essentially an emotional, as opposed to
an intellectual state and so is rarely subject to review. The whole
process of education, the results of experience, are considered to
be successful or not depending upon whether the proper attitudes
of mind, the proper feeling-tones, emotional states, constellations
have been cultivated with reference to the experiences of life.
Education from beginning to end is a process, largely of sup-
pression. It is the " Thou shalt not " of the Mosaic law that
dominates at least in childhood. The spontaneous natural im-
pulses must be repressed and made to fit the mould of the social
conventions. This means that conflicts begin at once between
inclination and desire and the restraints that limit the individual
in carrying out his wishes. Some sort of compromise has to be
struck that will result in relatively adequate adjustment. When
we realize that one of the most serious of afflictions, an incurable
psychosis, may result from a failure to compromise, or from a
broken compensation, we can see how important becomes the
study of the laws that govern this process.
Think what it would mean to be able to appreciate the begin-
ning of the conflict, to understand the nature of the forces in-
volved before they had succeeded in impressing the phole psyche
into service ! Then would be the time to turn the forces aside into
more useful channels — to sublimate the conflict.
Pus is a product of the defense mechanisms of the organism,
but if left to itself may burrow from its place of origin and pene-
trate a vital organ and so bring about death. The surgeon, by a
skilful stroke of the scalpel, at the point of election can liberate
it and without in any way impairing the defenses of the organism
PREVENTIVE PRINCIPLES IN MENTAL MEDICINE 145
help to so direct them as to make for health. For the smaller
and less important accumulations of painful emotion a ready
outlet is usually found. The woman has her cry, the man roundly
curses his enemy whom he conjures up before his mind's eye.
These reactions are more often than not effective. As small col-
lections of pus near the surface are easily removed so in these
cases the emotional tension is easily relieved.
Some of the more serious conditions require more careful
handling. Talking the trouble out with a confidant is a frequent
means, while the confessional has through the ages served largely
as an agent of psychotherapy. Again the psychiatrist must
acknowledge his indebtedness — this time to the priest. The old-
time father confessor was wise beyond his generation.
The aim should be the same in the realm of mind as in the
realm of body — to direct the natural defenses of the organism.
The possibilities here are quite as great as in the other depart-
ments of medicine for not only may it be made possible to direct
the natural forces, but as the public health officer can so regulate
conditions as to prevent infection, why cannot the same principles
be applied to the educator to so form the mind as to do away, in
part at least, with the possibilities or probabilities of certain kinds
of conflict? The scheme is an ambitious one, but we are justified
in dreaming of the possibilities when a new outlook is opened to
us. When Franklin drew the spark from the clouds he could
have had no possible conception that within a century that same
force would be generated by mammoth dynamos and sent miles
over the surface of copper strands to turn the ponderous wheels
of factories employing thousands of human beings. Let us dream
if we will, but let us not forget and consign to oblivion.
I shall not try to tell you what has been accomplished in this
direction further than to say in passing that a form of treatment
has been outlined (Chapter VII), based upon this theory which
bids fair to produce results otherwise unattainable. The funda-
mental principle in this treatment is absolute honesty with one's
I46 MENTAL MECHANISMS
self. Many of the difficulties, such as I have been discussing,
come about from a failure to frankly face situations with a result-
ing effort at self-deception. The first requisite of navigation is
a compass. To insist upon seeing things as they are not — self-
deception — is as if the navigator expected to make a certain port
to the east by steering west. One must know clearly where he is
going otherwise the means he uses to get there are more apt to
be ineffectual than not. We have learned that much may be
accomplished by getting the patient to honestly probe his own
desires and motives and by getting back to first principles, as it
were, he can get hold again of the lost threads and so reassemble
the tangled network of his personality. He can so be given an
opportunity to begin afresh with a clean record and try again
from this new vantage ground the problem of adjustment.
The careful study of individual cases, particularly with a view
to determine the cause of the breakdown, has given a new impetus
to the study of character. Although not a very great deal of
progress has been made in this direction, owing to the extreme
complexity of the subject, still the problem has been fairly well
defined. We already feel that there are certain types of char-
acter that portend danger to the individual possessing them and
it is our aim, as far as possible, in dealing with the insane, to go
back in the history of the individual, previous to the development
of the psychosis, and endeavor to analyze the character make-up
and determine the factors that led to the break. We hope in this
way to accumulate that sort of information that will enable us to
see the danger ahead and teach us the means of averting it.
A cramming of the mind with information is not education.
Education should be a process both of unfolding and development.
Certain habits of mind should be fostered, others need to be dis-
couraged, to the end not only of bringing out all the latent facul-
ties, of developing the best that lies within the individual but more
important still of developing a properly balanced structure that
will not be forced out of equilibrium by the first breath of
PREVENTIVE PRINCIPLES IN MENTAL MEDICINE 1 47
We have already learned to study the imbecile to determine his
mental make-up and how he must be approached, what avenue
offers the greatest prospect of success, if we would develop his
faculties still further. In the same way, though the problem is
vastly more difficult, I believe it will be possible to study those
children who present certain danger signals and so outline their
education as to bolster up the weak points and perhaps prevent
hopeless disaster in the future.
Such a purpose is, I am sure, a worthy one and falls in line
with the great general principles of preventive medicine.
One of the inquiries we always make of a soldier or sailor
boy when he is admitted to the Government Hospital for the
Insane is as to the number of summary courts-martial he has
had. This is the simplest and most practical sign of the amount
of difficulty he has had in adjusting to the service and the charac-
ter of his conflicts with his new environment. In the same way
I believe that every boy and girl in school or college who is per-
sistently inefficient, as shown by their record in class, should be
the subject of inquiry. It may, of course, only prove to be the
outcropping of original sin but in practice I am sure it will be
astonishing how often such an inquiry will develop something
vastly more serious.
But to revert to the question of education. Many of the psy-
choses that later go to the making of the classes of chronic insane,
criminals, paupers, prostitutes, tramps, and ne'er-do-wells begin
early in life. They have their incipiency in the school-room
and in the factory, they develop often under the very eyes of
the teachers and, too, of the school and factory physicians. Our
studies lead us to believe more and more that these psychoses
are to a large extent preventable, yet they are only recognized
when in full bloom and at a time when the possibility of applying
preventive principles has long since past. They are not seen
when in the making.
The reason for this failure to see the obvious is because of lack
148 MENTAL MECHANISMS
of training of teachers and physicians in what to look for. We
see what we have learned to look for, few of us see anything else.
To say nothing of the pedagogic aspects of this state of affairs
and the training of teachers, we may well inquire into the reasons
for the neglect of psychiatry by our medical colleges. It is true
that in the past few years most of the medical colleges have added
a course on mental medicine to their curriculum, but it usually
consists only of a few didactic lectures, and almost always is
considered as a sort of extra subject dealing with a department
of medicine that the average practitioner will have little to do
with. While interminable amounts of time are spent in discuss-
ing the appendix or the gall-bladder the mind is almost totally
neglected, and yet after all the object of life is a contented, peace-
ful mind ; in short, happiness to which the body is only secondary.
The patient who consults a doctor does so because he is in pain,
worried, unhappy, and yet pain, worry, and unhappiness are
mental facts. What he really wants is peace of mind to which
the doctor contributes by making well again a sick body without,
as a rule, appearing to realize that a mind has been involved at
any point in the proceeding. How much we hear in our medical
schools of pathology and how little do we ever hear of mental
hygiene — of what Seneca has called the "business of a happy
life." In this respect our medical courses are open somewhat
to the same criticism as the miser. They fix their attention too
much upon the means to happiness and in doing so often miss the
goal by not using those means to purchase the desired thing.
In all preparations for life there is no suggestion that there is
anything to be learned about self-knowledge, self-mastery, no sug-
gestion that there is any light to be shed upon the problems that
arise within one's self, that it is possible to direct the forces of
our inner conflicts. We are not taught how to curb the hot bursts
of passion by passing them in review under the scrutiny of the
intellect nor how to compensate for the sorrows of life by their
sublimation through newly awakened interests. All these things
PREVENTIVE PRINCIPLES IN MENTAL MEDICINE 1 49
are left to mere chance. We know much of the efficiency of
engines under various loads and thought and money unlimited
have been spent upon making the necessary adjustments. But to
the development of efficient mental mechanisms to meet the loads
of adversity we devote hardly a passing thought.
Incipient mental cases in the community could be reached if a
regular dispensary service were established as in other depart-
ments of medicine. Each municipal hospital should have its
psychopathic ward to which patients could be admitted with no
further preliminaries than are needed for admitting a patient to
the general wards with, for example, a pneumonia or a broken
leg. Each community should have also an after-care society for
the purpose of caring for patients discharged from hospitals for
the insane and by helpful instruction and otherwise attempt to
establish them in the community — and prevent a recurrence of
those conditions which before led to the mental breakdown.
A law was passed at the last session of the New York legisla-
ture that should be of interest. It provides for taking out of
the hands of the poor authorities the care of the insane previous
to commitment and putting it into the hands of the health officer.
This is surely a step in the right direction. Not only are the
insane cared for by the poor officers in many localities but quite
as frequently by the police. I will not attempt at this time to
dwell upon the abuses that have resulted as a consequence but
only emphasize the fact that the problem of insanity is a medical
one from beginning to end and that it should be in the hands of
medical men only. The segregation of an insane person should
be considered as a quarantine measure and not dealt with from
the standpoint of criminal law. When this is done, when the
problem of insanity is definitely turned over to the medical pro-
fession it will not be long before the value of preventive princi-
ples will be recognized and efforts made to put them in effect.
The practical things then that may be done at once in any com-
munity are these :
150 MENTAL MECHANISMS
1. The securing of legislation that places the responsibility for
the care of the insane previous to commitment in the local health
2. Every city of 100,000 inhabitants, or over, should have a
psychopathic ward connected with its municipal hospital which
is as accessible for the mental case as the other wards are for
general medical and surgical cases. This ward should have an
3. The organization of an after-care society to assist persons
who have been discharged from a hospital for the insane to get
on their feet and to point out to them ways of avoiding the con-
ditions which led to their breakdown.
4. The passage of adequate laws for the control of the labor
of women and children.
5. Popular education. By the use of this term I am not merely
dealing in a glittering generality that may mean nothing or every-
thing. We have in this country nearly two hundred state hos-
pitals for the care of the insane. These hospitals, each one of
them, should be a center of information for the community in
which it exists and its medical officers should use their position to
spread information about mental disorders. The superintendent,
or a member of the staff, should deliver one or more popular lec-
tures each winter to which the public are invited. Much might
be accomplished in this way if all hospitals would do this.
6. Field work from the state hospitals and psychopathic wards
as centers to study conditions under which insanity has developed,
to furnish assistance to the hospital in dealing with its patients,
and to cooperate with the after-care society.
7. More liberal support by city and state of scientific research
work in this field, especially along the lines of etiology and pro-
In this connection it may be of interest to know that in 1906
there was organized at Milan an international committee for the
study of the causes and the prophylaxis of mental disorders. It
PREVENTIVE PRINCIPLES IN MENTAL MEDICINE I 5 I
is the object of this committee to form an international institute
for the study of the causes and prophylaxis of mental disorders
and the King of Italy has consented to become the patron of this
institute. Nineteen countries sent official delegates to this com-
mittee, but as yet no one of them has made any appropriation to
enable the work of the committee to be carried forward.
The possibilities of the application of preventive principles in
mental medicine are as broad as the multiplicity of human activi-
ties, as deep as the human soul. It has its medical, sociological,
economic, legislative, pedagogic and humanistic aspects. Of
prime importance, however, is the recognition of the problem and
to this end no one thing is more important, to my mind, than the
inclusion in our medical curricula of a course in mental medicine
that shall not be an unimportant secondary affair, but shall be
on a par in extent and importance at least with the course in
Twenty-five years ago a claim for the exaltation of mental
medicine to a position of such importance might well have been
criticised as unwarranted, but since then no department of medi-
cine has advanced more rapidly or attracted a relatively larger
number of able students. The advances in this field and the
cognate subjects fully warrant such a claim. There is now such
a mass of well established data in general psychology, child psy-
chology, pedagogy, psychopathology, and the anatomy and physi-
ology of the central nervous organs as to make it quite impossible
much longer to resist the claim of mental medicine to its proper
place in the medical curriculum and when that time comes the
mind will be in a fair way to attract as much attention from the
devotees of public health as does now the subject of infectious
diseases. We will have learned that a healthy body is of no use
to the individual or to society unless there dwells within a healthy
mind. The maxim "Mens sana in corpore sano" will still be
true but in a sense amplified and vitalized.
fterwus ana Mental Disease
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