Causation and Treatment of Psychopathic Diseases

THE CAUSATION AND TREATMENT OF PSYCHOPATHIC DISEASES

Boris Sidis, Ph.D., M.D.
Boston: R. Badger, 1916

THE main source of psychopathic diseases is the fundamental instinct of fear¹ with its manifestations, the feeling of anxiety, anguish, and worry. Fear is one of the most primitive instincts of animal life. Our life is so well guarded by the protective agencies of civilization that we hardly realize the extent, depth, and overwhelming effect of the fear instinct. Fear is rooted deep down in the very organization of animal existence; it takes its root in the very essence of life,—the instinct of self-preservation. Primus in orbe deos fecit timor.

“The progress from brute to man,” says James, “is characterized by nothing so much as the decrease in frequency of the proper occasion for fear. In civilized life in particular it has at last become possible for large numbers of people to pass from the cradle to the grave without ever having had a pang of genuine fear. Many of us need an attack of mental disease to teach us the meaning of the word. Hence the possibility of so much blindly optimistic philosophy and religion. Fear is a genuine instinct, and one of the earliest shown by the human child.”

Similarly, Sully says: “Fear appears early in the life of the child as it seems to appear low down in the zoological scale. Fear probably appears in the vague form (i.e., without any distinct representation of a particular kind of evil) in connection with presentation, e.g., of strange animals, which have contracted no associations from individual experiences and which derive their emotive force from special inherited associations. Experience is, however, the chief determining factor in the evocation of fear.” “Fear,” says Darwin, “is the most depressing of all the emotions: and it soon induces utter, helpless prostration, as if in consequence of or in association with the most violent and prolonged attempts to escape from the danger, though no such attempts have actually been made.”

The fear of coming evil, especially if it is unknown and mysterious, gives rise to the feeling of anxiety. “If we expect to suffer,” says Darwin, “we are anxious.” James regards anxiety, especially the precordial anxiety, as morbid fear. “The anxious condition of mind,” says Bain, “is a sort of diffused terror.” Fear often expresses itself through cardiac and circulatory affections, giving rise to the feeling of anxiety. Anxiety is nothing else but the working of the instinct of fear.

James makes an attempt to enumerate the various objects of fear in men, and especially in children. Among these he regards “strange animals, strange men, strange places, such as the fear of the sea in children who have not seen the sea before. The great source of terror to infancy is solitude. Black things, and especially dark places, holes, caverns, etc., arouse a peculiarly gruesome fear. This fear, as well as that of solitude, of being ‘lost,’ are explained after a fashion by ancestral experience. High places cause a fear of a peculiarly sickening sort. Fear of the supernatural is one variety of fear. This horror is probably explicable as the result of a combination of simple horrors. To bring the ghostly terror to its maximum many usual elements of the dreadful must combine, such as loneliness, darkness, moving figures, inexplicable sounds, especially of a dismal character, moving figures half discerned, or if discerned, of dreadful aspect, and a vertiginous baffling of expectation. This last element, which is intellectual, is very important. It produces a strange emotional curdle in our blood to see a process with which we are familiar deliberately taking an unwonted course. Any one’s heart would stop beating, if he perceived his chair sliding unassisted across the floor. The lower animals appear to be sensitive to the mysteriously exceptional, as well as ourselves. My friend, W. K. Brooks, of the Johns Hopkins University, told me of his large and noble dog being frightened into a sort of epileptic fit by a thread which the dog did not see. Darwin and Romanes have given similar experiences. The idea of the supernatural involves that the usual should be set at naught. In the witch and hobgoblin, other supernatural elements, still of fear, are brought in—caverns, slime and ooze, vermin, corpses, and the like. A human corpse seems normally to produce an instinctive dread which is no doubt somewhat due to its mysteriousness, and which familiarity rapidly dispels.”

The fear of the unknown, of the unfamiliar, of the mysterious is quite common with children, with savages, and barbaric tribes. The fear of coming unknown, unfamiliar evil is specially a source of anxiety to the young or untrained, uncultivated minds.

All taboos of primitive societies, of savages, of barbarians, and also of civilized people take their origin, according to recent anthropological researches, in the “perils of the soul,” or in the fear of impending evil. As the great anthropologist Frazer puts it: “Men are undoubtedly more influenced by what they fear than by what they love.”

We know how in the case of the ancient nations omens, whether religious or meteorological, such as storms, thunders, lightnings, comets, and eclipses, were regarded with great terror. Armies used to throw away their arms and run panic-stricken on the occasion of the appearance of a comet or of an eclipse. Even in the civilized times of the Athenian republic there was a terror of eclipses and of other unfamiliar natural phenomena. Thucydides, in his history of the Peloponnesian wars, puts the appearance of comets among national disasters. The fear of coming unknown, unfamiliar evil is especially a source of anxiety to the young or untrained, uncultivated minds. This fear of some unknown evil befalling a person may become a source of great fear and anxiety when developed in early childhood. This fear of strangeness, of unfamiliarity, a feeling of being lost, developed in early childhood, may remain unassociated and thus give rise to a state of vague fear. Different forms of epilepsy are often associated with the fear instinct.

In most men the instinct of fear is controlled, regulated, and inhibited from very childhood by education and by the whole organization of civilized, social life. There are cases, however, when the instinct of fear is not moderated by education and civilization, when the instinct of fear is aroused by some particular incidents or by particular objects and states. In such cases, fear becomes associated with definite situations, giving rise to morbid fear and anxiety, resulting in the mental diseases known as psychopathies or recurrent mental states, psychoneuroses and somatopsychoses.

In all such cases we can find the cultivation of the instinct of fear in early childhood. Superstitions, and especially the early cultivation of religion, with its “fear of the Lord” and of unknown mysterious agencies, are especially potent in the development of the instinct of fear. Even the early cultivation of morality and conscientiousness, with their fears of right and wrong, often causes psychoneurotic states in later life. Religious, social, and moral taboos and superstitions, associated with apprehension of threatening impending evil, based on the fear instinct, form the germs of psychopathic affections.

What we find on examination of the psychogenesis of psychopathic cases is the presence of the fear instinct which becomes associated with some interest of life. The interest may be physical in regard to bodily functions, or the interest may be sexual, social; it may be one of ambition in life, or it may be of a general character, referring to the loss of personality, or even to the loss of mind. The fear instinct may become by cultivation highly specialized and associated with normally indifferent objects, giving rise to the various phobias, such as astrophobia, agoraphobia, claustrophobia, erythrophobia, aichmophobia, and other phobias, according to the objects with which the fear instinct becomes associated. Objects, otherwise indifferent and even pleasant, may by association arouse the fear instinct and give rise to morbid states, like the “conditional reflexes” in Pavloff’s animals.

¹ Under “fear instinct” are included all afferent and efferent processes, sensory, glandular, and motor reactions that accompany this fundamental instinct. The sensory, glandular, and motor processes, the latter processes in the form of afferent kinaesthetic sensations, all enter in a synthetized state of what is regarded as the affective, emotional experience of fear. The sensory, glandular, and motor elements, the afferent and efferent processes, are not separate and distinct from central elements, as some psychologists and psychopathologists are apt to suppose, but these peripheral processes are intimately related to and even enter into the very constitution of the so called central elements or central affective processes of the instinct.