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The psychopathic patient may be regarded as a case of parasitism. The parasite, living on his host, gradually loses all active functions, a condition followed by atrophy of organs no longer necessary to the life existence of the organism.
According to Demoor, "Atrophy begins with function when an organ has become useless. This uselessness may arise from two causes: the function may be no longer useful to the individual or to the species, or it may be assumed by another organ." When an organism turns parasite it is an economy of nutrition and energy to save as much as possible. The tendency of parasitism is to dispense with unnecessary functions in the struggle for existence.
The loss of function is from the less useful, to the more useful, to the functions absolutely indispensable to survival; from the less essential, to the more essential, to functions absolutely essential to the life existence of the individual. The life activity of the parasite becomes more and more narrowed, circumscribed, and dwindles down to a few functions requisite to its life existence, namely self-preservation, nutrition, and reproduction.
With the further increase of parasitism even the digestive and reproductive functions become simplified, the parasitic individual becomes reduced to the most fundamental of all impulses, the impulse of self-preservation and reproduction.
The penalty of parasitic life is the simplification of organic activities, the atrophy of all higher and complex life processes. This is what takes place in the case of the psychopathic individual. All higher activities, all higher interests cease.
In many neurotic cases of the severe type even the sexual instinct becomes gradually atrophied. The patient's life is narrowed down to the impulse which is absolutely requisite for individual life existence, namely the impulse of self-preservation with its concomitant fear instinct.
The growth of the impulse of self-preservation with its fear instinct brings about their hypertrophy which in turn hastens the degenerative processes or atrophy of all higher and more complex activities. The psychopathic patient in the process of degeneration and atrophy falls so low that not only moral, social, intellectual, but simpler psychomotor reactions become gradually diminished and atrophied. In severe cases even the instinct of sex, requisite for the preservation of the species, is made subservient to the impulse of instinct.
In psychopathic life all activities are narrowed down to the pettiness of individual existence. It is not sex, it is not species-interests, nor conflicts, nor self-repressions that trouble the neurotic patient. An abnormal impulse of self-preservation and fear f instinct are at the bottom of all psychopathic miseries. All psychopathic, neurotic interests are reduced to the sorry life of self and fear.
Lacking interest in anything but himself, terrorized by the fear of existence, the psychopathic patient lives a dreary, monotonous life out of which he seeks to escape. Monotony, ennui, indifference form the curse of his life. The patient is in a frantic condition, constantly in quest of interests which he cannot enjoy. Nothing can interest him, because he has no other interest but himself, and that is so narrow, that it can hardly fill existence.
As a matter of fact he is afraid to meet his fears, he is afraid of himself. He is afraid to come to a decision, never at peace, ever at war with himself. He is bored with himself, wearied with everything and with everybody. He is constantly eager to find new pastures and new excitements, so as to fill with some living interest his poor, narrow, mean, short existence obsessed by fear, misery, wretchedness, and brutish selfishness.
The patient is afraid to work because it may "fatigue and exhaust" him, and may bring about a state of disease, while he looks for health. He has no interest, because he only thinks of his little self, reduced to digestion, evacuation, and sleeping. The psychopathic patient leads an inactive existence of a sluggard, a lazy, idle existence of a parasite, and still he is driven to life and activity which, from the very nature of his narrow, parasitic individuality, he can no longer enjoy. He has the ideals of a hero and lives the life of a coward. This puts the patient in a state of dissatisfaction, discontent, and ceaseless contest with himself and others. Fear and self never leave him at peace. He is ever in a state of agitation, restlessness, and anxiety.
Obsessed with the anxious fears of self-impulse, the patient avoids the terrors of life, and drags the grey, monotonous existence of a worm. Hence there is a tendency in the psychopathic patient to be on the lookout for ever new energetic personalities, lean on them, suck out all the energies he possibly can, then reject his new friends unhesitatingly and brutally, and be again in search for new personalities who can disperse, for ever so brief a time, the fearful monotony and dread of his miserable, psychopathic, neurotic existence.
The neurotic patient may be characterized as a psychopathic leech, or truer still, a psychopathic vampire. For it is on the life and blood of other people that the psychopathic ogre is enabled to carry on his bewitched, accursed, narrow, selfish existence, full of terror and anguish of life.
"When the attack is on," exclaimed a psychopathic patient, affected with cardiac palpitation and intense fear, "I am too d--d scared about myself to think about her!" referring to the woman with whom he was in love. The psychopathic patient is a parasitic ogre with an hypertrophied ego.
Patients who claim to love children when the latter are well and healthy, avoid them, like a pest, when the children happen to fall sick, for fear of disease and for fear that the sick children may produce an evil influence on the patient's "sensitive" nerves. The patient is afraid to come near sickness, or even afraid to hear of evil things, such as description of misfortunes, ailments, accidents, and sufferings, because they may upset him and arouse his fears of himself.
All the patient wants is to be surrounded with cheer, joy, merriment, excitement, and happiness which he is unable to enjoy. The psychopathic patient is in constant search after happiness. Not that he is interested in the problem of happiness from a moral, philosophical, or even purely religious standpoint. His interest is of the crudest, the meanest, the most selfish kind. It is happiness for self,―for a low, mean, short, and brutish self. Psychopathic search for happiness is the anguish of the beast, cornered by terror. The patient is tortured by an unsuccessful search for happiness, ever tantalized by self and fear. Egotism, fear, ennui, restlessness, anxiety, discord are the harpies of psychopathic, neurotic life.
The love of the psychopathic patient is at bottom self-love; it is like the love of the wolf for the lamb. Lover, husband, child, friend, father, mother, brother, sister, are all victims to the patient's greedy self.
The fear instinct has a positive and negative aspect. There is the fear of life, fear of putting forth energy in meeting the exigencies of life. The patient is afraid to participate in the struggle of life. Struggle spells to him danger, peril,―fear of the external world. Struggle means to him fear, suffering, and misery. The patient avoids society, avoids not only strangers, but even his acquaintances, friends, and sometimes his own family.
While he constantly craves for ever new stimulations to his depleted nerves, he is at the same time in terror of everything that is new. The patient is afraid of life, he shirks duties, responsibilities, efforts, and joys of life struggle. Hence his love of automatism, routine, and fear-fatigue.
The fear manifests itself more often in the form of the negative side of life, such as fear of sickness, weakness, incapacity, degradation, loss of vitality, and generally the fear of death. Neurotic states are due to fear of life and fear of death.