Psychotherapy by Hugo Münsterberg (world of reading .TXT) 📕
Read free book «Psychotherapy by Hugo Münsterberg (world of reading .TXT) 📕» - read online or download for free at americanlibrarybooks.com
- Author: Hugo Münsterberg
- Performer: -
Read book online «Psychotherapy by Hugo Münsterberg (world of reading .TXT) 📕». Author - Hugo Münsterberg
Quite similar is the situation with cocainism or with the combination of morphine and cocaine which is so frequent nowadays with young physicians. I have repeatedly seen cures where the case already gave the impression of insanity. Again I give a rather extreme case.
A physician had acquired the habit of using and misusing cocaine for the treatment of a disease of his nose. The habit grew to a craving for cocaine while the cocaine itself poisoned the brain. Acoustical hallucinations began; he heard voices from every corner of the room, and on the street the voices took persecutory character. He connected them with his brother living in Europe, heard his voice in the denunciations, and developed a pathological system of ideas around the central thought that his brother had a telepathic influence on him. His reason succumbed, he lost all consciousness of delusion, and believed himself really to be under the control of the absent brother. When he came to me he had been without sleep and without food for several days, and he was not seeking my help to get rid of the mental disturbance but to overcome the power of his older brother. He did not connect the fear at all with his misuse of cocaine. When I discovered the rôle which the cocaine played, I determined to try the suggestive influence, the more as I found that he was in a half-hypnotic state as soon as he had entered my room. I suggested to him to sleep and to take food and to reduce the cocaine dose by a fourth. The next day he was an entirely different man by the effect of ten hours' sleep and a large breakfast. Now I concentrated my efforts on the reduction of the cocaine. After ten days of hypnotic treatment he gave up cocaine entirely, after three weeks the voices disappeared and slowly the other symptoms faded away. The pathological idea of the telepathic influence lasted a while after the voices had gone until this idea, too, yielded to suggestion. It still took six weeks before he himself felt that he was entirely normal.
The way in which the average physician nowadays neglects the simple tool of suggestive treatment, when it can be used for the protection of society, is perhaps nowhere so reckless as in the case of the morphinist and cocainist. To give a typical case of this neglect I may mention that of a highly intelligent young man who had been in the habit of using both cocaine and morphine for ten years when at his own request he was sent to a New York hospital. He had been taking alternately morphine for a year or two, then cocaine for a year or two, and had sometimes alternated and sometimes combined both in an irregular way. When he entered the hospital in May, 1908, he was in a cocaine period and was taking the enormous dose of one hundred and eighty grains of cocaine every day. In the hospital they withdrew the drug altogether. During the first weeks, he was entirely sleepless. They energetically refused him any substitutes and after six weeks he began to feel comfortable. He gained steadily in weight and after three months, when he left, he had gained fifty pounds, felt entirely comfortable, and seemed in all respects normal again. Before twelve hours had passed after leaving the hospital, he had again taken thirty grains of cocaine and ten grains of morphine, and this dose rapidly grew until after a few weeks it again reached a hundred grains of cocaine and up to sixty grains of morphine a day. Then came the complete breakdown. If that man in the last two or three weeks of the hospital treatment, when he felt entirely comfortable and normal and had gained his normal weight, had received even a slight suggestive treatment suppressing any desire for cocaine or morphine, he would easily have been saved. To let such a man after a drug career of ten years go out again to the places of his old associations, where the desire had to be stirred up, is inexcusable at a time when psychotherapeutics has won its triumphs in this field. It might have been sufficient to give him preventive treatment at least for the first three days of his freedom. And such a case is typical of hundreds.
The overstrong impulse and overstrong desire finds its counterpart in the abnormal lack of energy and lack of attention. The patient—and it is especially the neurasthenic patient—has lost his usual strength, he shrinks from every undertaking, he cannot decide upon any action, he needs a disproportionate effort for the smallest task, and cannot concentrate his attention in spite of his best will. The varieties of this lack of power and inertia are familiar to every physician. They certainly often need much more than merely psychotherapeutic treatment, although on the physical side no schematic method is admissible. The laziness of the anæmic needs a different treatment from the laziness of the exhausted but in every case psychological factors can be of decisive influence, whatever the physical and chemical treatment besides them may be. A few letters may again illustrate the varieties. Here again there is no sharp demarcation line between the normal and the abnormal. Letters like the two following, for instance, are hardly letters of patients. They show a variation which is still entirely within normal limits and yet a source of suffering; it is a disturbance which usually can be removed by psychotherapeutic means.
"I do almost everything with effort, nothing spontaneously. I have been writing for five years but am a mood writer of the worst type. The mood comes at such uncertain times that I seem to be absolutely at the mercy of caprice. This might not in itself be a misfortune but writing is my only calling and I suffer the proverbial torments of lost spirits when I am idle. The necessity of driving myself to every piece of work, aggravated by the fact that my parents allowed my constitutional inertness to have full play, has hitherto prevented me from forming any regular habit of labor. I am now thirty-eight. Would you suppose that if I kept my nose to the grindstone for one, two or three years, I might yet hope to work with some ease and regularity? That is, if I compelled myself to write a certain number of hours every day as a discipline, regardless of the quality of matter I produce, is there any probability that I might ultimately overcome the fearful paralysis that so often grips my faculties? Can constitutional indolence be overcome by determination? I put in a little time on a couch every day. When worried I get neurasthenia and all kinds of phobias. Just now I am afraid to look at the newspapers on account of the cholera in St. Petersburg, and I have seen the time when I found it difficult to drink water after I had boiled it myself."
Also the next man is familiar to all of us.
"Plainly we are told every man is born into the world to fill some purpose, or at least be of some benefit to himself or his fellowmen. For some reason I do not make friends among men. I have not the zeal or ambition to carry or even begin a conversation that will interest the individual man. I worry a great deal. I have never been able to concentrate my mind to study and figure out problems. I can read them zealously but apparently do not get to the bottom and cannot retain what I do read. If I could just get hold of the power of thinking and dig out that tangible something that holds me back, I could go forward and make myself what I know I should be. But I feel that so far I am a total failure. If I only had that one great gift, the power of concentration and will power, I would make what I so much desire, a success of myself."
A similar effect and yet psychologically a different condition exists where the lack of energy results from the suggestive power of the opposite, producing a constant indecision.
"I am thirty years old and nearly all my life since childhood I have been fearfully troubled with the habit of indecision and regretting whatever I do. It has grown into a habit so fixed that at times I am fearful of losing my mind. I feel anxious to do something and decide to do it, then as soon as it is done, I nearly go wild with regrets until I have to undo it, if possible, and then only to regret that. I am this way about the most trifling things and about the most serious. I can't perform any duty well. In business and in social affairs, it is always with me. It has me in its clutches, a horrible monster dragging me down. My friends misinterpret me and wonder what I mean by doing so when all the time I want to do what is for the best and cannot for this tyrant who is ever present with me. I will plod for hours and hours at a time, and at every turn I am handicapped. I am intelligent naturally and appear a perfect fool."
From the report of such chronic cases we may turn to the acute ones. Here a characteristic letter of, a typical neurasthenic young modern poet.
"These are my plans but I hardly think that I can carry them through, although perhaps you can help me by suggestion. I have the feeling that through the whole of last year my development did not go forward but backward. It is as if by a mental or physical overstrain, my whole personality has entered into a transition. I have no joy in life, no sensation in love, no satisfaction in labor. My will has become weak where it was strong. I am lazy, up to an absolute dislike of everything, while I have been energy itself. Often I have only the one desire, to end my life from mere fatigue. If there had been any external reason for ending my life, I should perhaps have done it long ago. I am so apathetic that I no longer take myself seriously. My successes do not please me; the idea of writing anything gives me anxiety. I have become less resisting, more sweet, more soft, I should almost like to say, more feminine. I became infatuated with a girl, simply because I knew that she hates all men. The inaccessible is still the only thing which can stimulate me somewhat. I have even written a poem on her, but nothing can satisfy me in love. I consider my state a disease of the will as a result of nervous exhaustion. I must find some one who, with kindly power, reënforces my will system. I need a strong mind—it may be a man or a woman. It would even be possible in the latter case that I might marry her.
"Even the writing of this letter has fatigued me so much that I should like best to sleep. In moments like the present I should like best to throw myself down on the street or ... quickly ... sink ... into the ocean. (I regret having made the little points. They look as if my expressions are a pose.) Yet there are moods in which I am entirely normal and no one fancies what I am passing through. I have even become superstitious lately. Are
Comments (0)