Causation and Treatment of Psychopathic Diseases

THE CAUSATION AND TREATMENT OF PSYCHOPATHIC DISEASES

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

Psychopathic diseases are not hereditary—they are acquired characteristics. “Weak nerves,” “a run down, exhausted nervous system,” whatever the terms may mean, may overlap psychopathic conditions, but the two are by no means equivalent, much less identical. Psychopathic states are not “weak nerves” or “fatigued nerves.” Above all, there is no need to obscure the matter and resort to the much abused, mystical and mystifying factor of heredity. It is easy to shift all blame on former generations, where in most cases the fault is close at hand, namely, a debased environment, a defective training, and a vicious education.

Under the rigorous conditions of primitive life individuals who have been unfortunate, and have become affected with mental troubles and emotional afflictions are mercilessly exterminated by the process of tribal and social selection. Each generation weeds out the individuals who have been unfortunate enough to fall under unfavorable circumstances, and have become mentally sick, suffering from acquired psychopathic disturbances. In primitive life the crippled, the maimed, the wounded, the sick fall by the way, and are left to perish a miserable death. In fact, the less fortunate, the wounded and the stricken in the battle of life, are attacked by their own companions—they are destroyed by the ruthless social brute. The gregarious brute has no sympathy with the pains and sufferings of the injured and the wounded. The faint and the ailing are destroyed by the herd.

Civilization, on the other hand, tends more and more towards the preservation of psychopathic individuals. We no longer kill our sick and our weak, nor do we abandon them to a miserable, painful death—we take care of them, and cure them. Moreover, we prevent pathogenic factors from exercising a harmful, malign social selection of the “fit.” We do our best to free ourselves from the blind, merciless, purposeless selection, produced by pathogenic micro-organisms and by other noxious agencies. We learn to improve the external environment.

We do not condemn people to death, because they are infected with smallpox, typhus, typhoid bacilli, or because of an infected appendix. We no longer regard them as sinful, unclean, accursed and tabooed. We vaccinate, inoculate, operate, and attempt to cure them. By sanitary and prophylactic measures we attempt to prevent the very occurrence of epidemics. Our valuation of individuals is along lines widely different from those of the stone age and the cave man. We value a Pascal, a Galileo, a Newton, a Darwin, a Pasteur, and a Helmholtz far above a Milo of Croton or an African Johnson.

Civilization is in need of refined, delicate and sensitive organizations, just as it is in need of galvanometers, chronometers, telephones, wireless apparatuses, sensitive plates, and various chemical re-agents of a highly delicate character. We are beginning to appreciate delicate mechanisms and sensitive organizations. We shall also learn to train and guard our sensitive natures until they are strong and resistant to the incident forces of an unfavorable environment. The preservation of psychopathic individuals accounts for the apparent increase of neurotics in civilized communities.

It may be well to add that, although the occasions for sudden, intense, overwhelming shocks are not so prevalent in organized societies as they are in primitive savage communities, the worries, the anxieties, the various forms of slow, grinding fears of a vague, marginal, subconscious character, present in commercial and industrial nations, are even more effective in the production of psychopathic states than are the isolated occasions of intense terrors occurring in the life of the primitive man of the paleolithic or neolithic periods.

In my works I lay special stress on the fact that the psychopathic individual has a predisposition to dissociative states. Early experiences and training in childhood enter largely into the formation of such a predisposition. Still, there is no doubt that a sensitive nervous system is required,—a brain susceptible to special stimuli of the external environment. This, of course, does not mean that the individual must suffer from stigmata of degeneration. On the contrary, it is quite possible, and in many patients we actually find it to be so, that the psychopathic individual may be even of a superior organization. It is the sensitivity and the delicacy of nervous organization that make the system susceptible to injurious stimulations, to which a lower form of organization could be subjected with impunity. An ordinary clock can be handled roughly without disturbance of its internal workings, but the delicate and complicated mechanism of a chronometer requires careful handling and special, favorable conditions for its normal functioning. Unfavorable conditions are more apt to affect a highly complex mechanism than a roughly made instrument. It is quite probable that it is the superior minds and more highly complex mental and nervous organizations that are subject to psychopathic states or to states of dissociation. Of course, unstable minds are also subject to dissociative states, but we must never forget the fact that highly organized brains, on account of their very complexity, are apt to become unstable under unfavorable conditions. A predisposition to dissociation may occur either in degenerative minds or in minds superior to the average. Functional psychosis requires a long history of dissociated, subconscious shocks, given to a highly or lowly organized nervous system, dating back to early childhood.

As Mosso puts it: “The vivid impression of a strong emotion may produce the same effects as a blow on the head or some physical shock.” We may, however, say that no functional psychosis, whether somopsychosis or psychoneurosis, can ever be produced simply by physical shocks. In all functional psychoses there must be a mental background, and it is the mental background alone that produces the psychosis and determines the character of the psychopathic state.

The basis of functional nervous or psychopathic maladies is essentially a pathological process involving the nervous system in as definite a way as the invasion and infection of the organism by various species of bacteria, bacilli, and other micro-organisms which attack the individual during his lifetime.

Like infectious diseases, psychopathic deviations, abnormalities, and excesses are acquired by the individual in the course of his relations with the external environment, and are as real as syphilis, smallpox, diphtheria, cholera, and the bubonic plague. To regard them as imaginary, or to relegate them to the action of Providence or to heredity is theoretically a misconception, and practically a great danger to humanity.

There is nowadays a veritable craze for heredity and eugenics. Biology is misconceived, misinterpreted, and misapplied to social problems, and to individual needs and ailments. Everything is ascribed to heredity, from folly and crime to scratches and sneezes. The goddess Heredity is invoked at each flea-bite—in morsu pulicis Deum invocare. Even war is supposed to be due to the omnipotent deity of Heredity. Superior races by their patriotism and loyalty destroy the weak and the helpless, and relentlessly exterminate all peaceful tribes. Such warlike stock comes of superior clay. The dominant races have some miraculous germ-plasm (chromatin) with wonderful dominant “units” (chromosomes) which, like a precious heritage, these races transmit, unsullied and untarnished, to their descendants. Wars, carnage, butcheries make for progress, culture, and evolution. Our boasted civilization with its “scientific” business thoroughness and its ideal of “efficiency” attempts to carry into effect this quasi-evolutionary doctrine—this apotheosis of brute force under the aegis of science. The eugenic belief is really a recrudescence of the ancient savage superstition of the magic virtues of noble blood and of divine kingly stock.

All nervous, mental, neuropathic, and psychopathic maladies are supposed to be a matter of heredity. If people are poor, ignorant, superstitious, stupid, degraded, brutal, and sick, the eugenists unhesitatingly put it all up to poor stock. The eugenic remedy is as simple as it is believed to be efficacious: Introduce by legislation “efficient” laws favoring “eugenic” marriage, sterilize all the “unfit,” and teach the masses control of births. The select and chosen stock alone should multiply—the millennium is then bound to come. Such is the doctrine of our medico-biological sages.

“Scientific” farmers and breeders of vegetables, fruits, and cattle are regarded as competent judges of human “breeders.” Agriculturists and horticulturists set themselves up as advisers in “the business of raising good crops of efficient children.” Bachelors, spinsters, and the childless generally, are specially versed in eugenic wisdom and pedagogics. All social ills and individual complaints are referred to one main source—heredity. With the introduction of eugenic legislation, with the extermination of the socially unfit, among whom the greatest men and women may be included with the philanthropic sterilization of the “defectives,” with the breeding of good “orthodox, common stock,” and with the eugenic Malthusian control of births, all evil and disease on earth will cease, while the Philistine “superman” will reign supreme for evermore.

In the Middle Ages all diseases and epidemics, all wars, all social and private misfortunes were considered as visitations of Divine wrath. In modern times our would-be eugenic science refers all ills of the flesh and woes of the mind to an outraged Heredity. The dark ages had resort to prayers, fasts, and penitence, while our age childishly pins its faith to the miraculous virtues and rejuvenating, regenerative powers of legislative, eugenic measures, sterilization, seclusion, restriction of marriage, and to the eugenic Malthusian control of births.

Our scientists in eugenics gather hosts of facts, showing by elaborate statistical figures that the family history of neurotics reveals stigmata of degeneration in the various members of the family. “The Jukes” and their ilk are trumpeted about as great discoveries of eugenic research work. Any group of individuals of various “breeds” and “families,” living under the action of the same conditions, social, economical, and educational will have the same impress. Anthropology has found this out in the case of so-called “nations” and “races.” The eugenic inquirers do not stop for a moment to think over the fact that the same sort of evidence can be easily brought in the case of most people. In fact, the eugenists themselves, when inquiring into the pedigree of talent and genius, invariably find somewhere in the family some form of disease or degeneration. This sort of “scientific” evidence leads some eugenic speculators, without their noticing the reductio ad absurdum, to the curious conclusion or generalization that degeneration is present in the family history of the best and the worst representatives of the human race.

The so-called scientific method of the eugenists is radically faulty, in spite of the rich display of long pedigrees and family histories, of colored plates, stained tables, glittering biological speculations, brilliant mathematical formulae, and complicated statistical calculations. The eugenists pile Ossa on Pelion of facts by the simple method of enumeration which Bacon and the thinkers coming after him have long ago condemned as puerile and futile. From the savage’s belief in sympathetic, imitative magic with its consequent superstitions, omens, and taboos down to the articles of faith and dogmas of the eugenists we find the same faulty, primitive thought, guided by the puerile method of simple enumeration, and controlled by the wisdom of the logical post hoc, ergo propter hoc.

What should we say of the medical man who should claim that measles, mumps, cholera, typhoid fever, yellow fever, malaria, tetanus, and various other infectious diseases are hereditary by quoting learnedly long tables of statistics to the effect that for several generations members of the same family suffered from the same infectious diseases? What should we say of the medical advice, forbidding marriage to individuals whose family history reveals the presence of exanthemata? We stamp out epidemics not by eugenic measures, but by the cleansing of infectious filth and by the extermination of pathogenic micro-organisms.

Every human being has a predisposition to smallpox, cholera, tetanus, bubonic plague, typhus fever, malaria, and to like infectious diseases, but there is no inherent necessity for everyone to fall a victim to the action of pathogenic organisms, if the preventive and sanitary conditions are good and proper. No one is immune against the action of bullets, cannon balls, shells, and torpedoes, or to the action of various poisons, organic and inorganic, but one is not doomed to be killed by them, if one does not expose oneself to their deadly action. Every living organism is by the very nature of its cellular tissues predisposed to the wounding by sharp instruments, or to the burning action of fire, but this does not mean an inherent organic weakness to which the organism must necessarily submit and perish. We are all of us predisposed to get injured and possibly killed, when we fall down from a high place, or when we are run over by an automobile or by a locomotive, but there is no fatalistic necessity about such accidents, if care is taken that they should not occur.

We may be predisposed to neurosis by the very nature of complexity, delicacy, and sensitivity inherent in the structure of a highly organized nervous system, and still we may remain healthy and strong all our life long, provided we know how to keep away from noxious agencies. The creed of the inevitable fatality of neurosis is as much of a superstition as the Oriental belief in the fatalism of infectious diseases, plagues, and accidents of all kinds. Such fatalistic superstitions are dangerous, fatal, because they distract the attention from the actual causes and from the requisite prophylactic measures.

We go far afield in search for the remote source of our troubles, when the cause is close at hand. We need only open our eyes to see the filth of our towns, the foul, loathsome slums of our cities, the miserable training, the wretched education given to our children, in order to realize at a glance the source of our ills and ailments. We should lay the guilt at the door of our social order. We starve our young. We starve our children physically and mentally.

We piously sacrifice our tender children and the flower of our youth to the greedy, industrial Moloch of a military, despotic, rapacious plutocracy. Witness semi-civilized Europe with its lauded culture brutally shedding the blood of its youth and manhood on the altar of commercial patriotism. It is not heredity, it is the vicious conditions of life that stunt the physical, nervous, and mental growth of our young generation. When we are confronted with the miserable, degraded, crippled forms of our life, we fall back cheerfully on some remote grandparent and credulously take refuge in the magic panacea of eugenics.

The practical aspect is clear. Psychopathic neurosis in its two varieties, Somatopsychosis (Somopsychosis) and Psychoneurosis, is not hereditary, but acquired. We should not shift the blame on former generations and have resort to eugenics, we must look to the improvement of mental hygienic conditions of early childhood, and to the proper education of the individual.

It is easy to put the blame on grandparents,—they are dead and cannot defend themselves. Could they arise from their graves, they could tell some bitter truths to their ‘degenerate’ descendants who are ready to shift responsibility to other people's shoulders. It is about time to face the truth fairly and squarely, a truth which is brought out by recent investigations in psycho pathology, that the formation of psychopathic neurosis with all its characteristic protean symptoms, is not hereditary, but acquired. Neurosis arises within the life cycle of the individual,—it is due to faulty training and harmful experience of early child life.

Future medicine will be largely prophylactic, preventive, sanitary, hygienic, dietetic. What holds true of medicine in general holds true of that particular branch of it that deals with neurosis. The treatment will become largely prophylactic, preventive, educational, or pedagogic. It is time that the medical and teaching professions should realize that functional neurosis is not congenital, not inborn, not hereditary, but is essentially the result of a defective education in early child life.

Prof. J. M. Coulter of Chicago University presses tersely the biological doctrine of the hereditary character of the chromatin, and of the chromosomes as its “visible, organized units.” The dominant “units,” the dominant chromosomes, are supposed to determine the structure of the new individual. To quote Prof. Coulter (the italics are mine).

“It seems safe to conclude, therefore, that the nucleus contains the material essential to the phenomena of heredity; and if so, chromatin must be the material, and the chromosomes its visible organized units.

“Imagine the fusion of an egg and a sperm, each of whose nuclei contains two chromosomes. The nucleus of the fertilized egg would contain four chromosomes, two of them maternal (contributed by the egg), and two of them paternal (contributed by the sperm) Suppose that two of the four dominate in determining the structure of the new individual to be developed from the fertilized egg. It will be seen that there are four possible pairs: (1) The paternal pair (domination of paternal chromosomes), in which case the new individual would resemble the male parent; (2) the maternal pair (domination of maternal chromosomes), in which case the resemblance would be to the female parent; (3) two pairs, each consisting of a dominant male and female chromosome, in which case the new individual would be a mixture, resembling both parents. Expressing the chances in the form of a ratio, they could be represented as 1:2:1. This is a simple expression of Mendel’s law. . . . This chromosome situation supplies for it a cytological basis.” (See "Heredity and Eugenics," Ch. II, p. 32, 33, by Prof. J. M. Coulter, W. E. Castle, C. B. Davenport, E. M. East, and W. L. Tower. The University of Chicago Press, 1912).