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SYMPTOMATOLOGY, PSYCHOGNOSIS, AND DIAGNOSIS OF PSYCHOPATHIC DISEASES

Boris Sidis, Ph.D., M.D.

Boston: R. Badger, 1914



CHAPTER XXVIII

TRAITS AND THRESHOLDS OF DISSOCIATED SYSTEMS

ONE point is worth while emphasizing, and that is the fact of recurrence, so highly characteristic of the activity of dissociated subconscious states or moments-consciousness. The dissociated moment rises from the depths of the subconscious regions, oversteps the threshold of consciousness, manifests itself with an irresistible energy, throws the normal psychomotor reactions, for the time being, into a state of disorganization, and then lapses from consciousness, only to be resurrected under conditions favorable to its activity. Such dissociated, subconscious activities I describe under the term of recurrent moment-consciousness.

        This characteristic of recurrence is of great importance in psychopathology, as it brings the subconscious activities under one perspective view, gives an insight into their nature and mode of manifestation; and from a biological standpoint brings them in line with the mode of action of the lower mental types, which respond to special stimuli of the external environment with the same amount and quality of sensori-motor reactions.

        The sense of reality is usually described, by writers on the subject, as not being affected. This is not the case. A close study of the facts shows that the insistent mental states come with an intensity of the sense of their reality almost directly proportional to the insistence of the mental state, a reality which is truly delusional, or even hallucinatory, in character. This is especially true of the systematized, recurrent states of the sensory type. The dissociated subconscious states refer to a past reality, now subconsciously real. In the ideational or conceptual forms the sense of reality appears to be weakened, because of the weaker insistence of the ideational elements as contrasted with the sensori-motor elements.

        Another important and striking trait of the dissociated states is the violence, I would almost say the vehemence, with which they become manifested; they reveal an amount of energy which similar states do not possess in the normal condition, when the personal consciousness is in active relation with the external environment. The energy displayed is more than the individual is capable of putting forth under ordinary conditions of life.

        The sudden, mysterious onset of subconscious states, foreign to the whole character of the individual, as well as the sudden display of energies, until now unsuspected in the person, make those states appear as mystical in the eyes of the populace and the superstitious. No wonder that the church has regarded subconscious activities as supernormal and miraculous, and either ascribed them to divine powers, or to satanic agencies, demoniacal possessions and obsessions. In our own time we have men devoting time and energy to the investigation of the supernormal nature of subconscious phenomena.

        In my previous works on the subject I have discussed the energy and violence of the eruption of subconscious forces as due to lack of inhibitions. This follows from the very nature of dissociation. Dissociated subconscious systems being released from all relations with other systems and groups of mental elements, being let loose, so to say, from all associative bonds, will naturally display ail amount of energy, unusual for similar systems under the normal conditions of mental association.

        Still the phenomena of dissociation point to facts of a very important character. They point to an extremely important principle which I term ‘the principle of potential subconscious energy,’ a principle which is of importance from a theoretical as well as from a practical therapeutic standpoint. Meanwhile, we should keep in mind two characteristic traits of subconscious phenomena as manifested by dissociated states,—recurrence and latent energy.

        It may also be well to bring out another point of interest which holds true of the various types of insistent mental states,—they cannot be understood in the light of conditions under which they occur, or truer to say recur, since they bear no relation to their immediate environment, but to that under which the states have originally taken place. Unlike mental states of the personal consciousness characterized by direct adjustments to the present conditions, the insistent subconscious states are adjustments to past conditions. They have no meaning in the present. May we not describe recurrent states as resurrected moments?

        The theory of thresholds advanced by me in my former works accounts for the phenomena of dissociation with their manifestations, the recurrent mental states. The concept of threshold is not new,—it is at the foundation of physiology and psychology. The physiologist is familiar with the concept of threshold in his experimental work, and the same holds true in the case of the experimental psychologist. The theory of thresholds as advanced in my work is simply an extension of the work of the physiologist and of the psychologist to the domain of abnormal mental life.

        It may be well to call attention to the recent tendency of introducing metaphysical considerations of teleology and of meaning into the phenomena of abnormal mental life. Meaning is forced on abnormal mental life whether it is there or not. ‘There is a reason’ it is claimed and a reason must be found and expressed in teleological terms of purpose, wish, desire, and meaning. I must say once for all that they who try their ingenuity and fanciful symbolization and mental conflicts in order to squeeze out some important meaning out of psychopathic symptoms in the present life adjustments of the patient miss the essential point of psychopathic states. Psychopathic symptoms are essentially meaningless.

        Psychopathic symptoms are like the actions and reactions of a hypnotized subject or of a somnambulist whose adaptations are to an unreality, to a world fanciful and certainly widely different from the actual surroundings. To search for a present meaning and for an adaptive purpose in the symptom-complex of psychopathic states is to misconceive their nature.
Psychopathic states in the individual closely correspond to outlived, social customs and meaningless religious rites and traditions which society keeps on practicing in reverence and which some thinkers attempt to rationalize, pointing out that the meaningless customs are fraught with a hidden, symbolic meaning. As Dr. Frazer puts it well: “The history of religion is a long attempt to reconcile old custom with new reason, to find a sound theory for absurd practice.” The same holds true in the case of the phenomena of abnormal mental life. There is no symbolic or hidden meaning in the symptoms of psychopathic states for the simple fact that they have no meaning at all.

        The symptoms of psychopathic states can only be understood in the light of the patient’s past life experience, but they have no meaning in the present. Psychopathic symptoms are recurrent reversions to a former life period in the patient's life, a period which has gone, which has no further existence, but to which psychomotor reactions keep on taking place. The psychomotor reactions of the pathological symptoms-complex have no meaning in the present life, because the conditions, circumstances and relations are no longer in existence.

        We find the same states in animals of low intelligence, when the conditions of their existence are suddenly changed, the animals keep on making adaptations which are now useless, meaningless, and even harmful, they make adjustments to conditions of a former environment which is no longer in existence. The duckling goes through swimming motions in a dry pan; the squirrel keeps on hiding nuts in the cage, dining room or the parlor; the beaver builds a dam with books in the library. Psychopathic affections are like the heliotropism of the moth attracted by light, burning its wings and perishing in the flame. The psychopathic symptom-complex is a survival from an ancient, long past period of the patient’s life, a period still subjectively surviving in the patient's subconscious life, giving rise to psychomotor manifestations which are meaningless, useless, harmful, and therefore pathological. Psychomotor reactions are psychopathic, not because they have a hidden meaning, the mystical symbolism of which the physician is to read by the aid of a deep, cabalistic ‘interpretation of dreams and psychoanalysis,’ but the symptom-complex and its reactions are useless, meaningless, and even absurd.

        It cannot be too much insisted on the fact that absence of meaning and lack of adaptation are essential characteristics of psychopathic states. Psychopathic states are disease states, not because they have meaning, but just because they are devoid of all meaning. Like tumors, cancers, infections, and poisons of the body all the significance psychopathic states possess is disease, degeneration, dissociation, disintegration with consequent suffering and mental decay.

        The concept of threshold is of importance to a right understanding of psychopathic states. The concept of threshold appears difficult and complicated. As a matter of fact it is simple and easy to comprehend. We know that a certain amount of friction is necessary to ignite a match, or a definite amount of pressure is requisite to press on the electric button to light an electric lamp or ring a bell. That amount of energy which is just sufficient to produce the effect may be termed the stimulus threshold, the energy requisite to overcome the resistance or the release of a certain amount of energy is termed threshold.

        It is clear that, if the energy falls below the threshold, the effect cannot be called forth. A rise of threshold would mean that more energy is requisite to bring about the desired effect. The match is harder to light, and the button is harder to press.

        One of the main characteristics of living protoplasm is its adaptability to the conditions of the external environment. External stimuli give rise to reactions of adjustment on the part of living substance. This property, known in physiology as irritability, is characteristic of all living matter, or of what Huxley so aptly describes as “the physical basis of life.”

        Verworn defines the irritability of living substance “as its capacity of reacting to changes in its environment by changes in the equilibrium of its matter and its energy.” In other words, living tissue responds to external stimulation with some discharge of energy. The form of the discharge depends on the peculiar protoplasmic structure, according as it is muscle, gland, nerve cell, or but slightly differentiated protoplasm, such as amoeba, or bacterium. The character of the reaction to stimuli depends on the state of organization of the living tissue.

        The delicacy of response of living matter to external stimuli has its limit. Very weak stimulations do not call forth any reactions. Living tissue can only be set into activity by stimuli of certain intensity. If the stimulus falls below that intensity, the protoplasm does not react. This holds true of all cells, from the simplest bacterium and infusorium to the most highly differentiated muscle-cell or neuron.

        The minimal intensity below which the stimulus remains ineffective is regarded as the threshold of stimulation. “Exceedingly feeble stimuli” says Landois “are without effect. The degree of intensity of stimulation that originates the first trace of sensation is called the threshold of sensation or the threshold-value.”

        The same is more clearly put by Verworn:

        “Let us imagine an organism, e.g., a muscle, under conditions in which no stimulus affects it, and let us bring to bear upon it a stimulus, e.g., the galvanic current, which varies in intensity from zero upward and can be graded easily and delicately. Then we should expect the muscle to exhibit phenomena of stimulation, i.e., to perform a contraction, as soon as the intensity is increased above 0. But this does not happen. The intensity can be increased considerably before the muscle performs even the slightest twitch. Only when the intensity has reached a certain degree does the muscle respond with a contraction. From here on the contraction is never wanting and up to a certain degree becomes more energetic the more the intensity is increased. The stimulus, therefore, begins to operate only at a certain intensity, and this point is termed the threshold of stimulation. Below the threshold the stimulus is ineffective; above it the effect increases with the increasing intensity of the stimulus. For the different forms of living substance the value of the threshold is very different. Thus nerve-fibres are put into activity by extremely feeble galvanic stimuli while amoeba demands very strong currents. The same is true of all other varieties of stimuli in relation to the various forms of living substance.”

        Psychologically, we may agree with Stout that “the point at which it (the stimulus) is just indistinguishable,—so that the least increase would make it distinguishable is called stimulus-threshold.”

        Külpe’s definition is short; “the just noticeable stimulus is technically termed the stimulus-threshold.”

        With the increase of stimulation the irritability of living substance diminishes,—the threshold rises. The same stimulus no longer brings about a reaction, the stimulus must be increased in intensity before any effect can take place.

        An excellent account of it is his “General Physiology:”

       “If a living object be stimulated by long continued, oft repeated, or very strong stimuli, after some time it passes into the condition of fatigue. The general characteristic of fatigue is a gradual decrease of the irritability of the living substance. This is expressed especially in the fact that with increasing fatigue, the intensity of the stimulus remaining the same, the result of stimulation becomes constantly less.

        “We have already become acquainted with some examples of this fact in considering galvanic stimulation. If a constant current of average strength be passed through an Actinosphoerium, at the moment of making there begin to appear at the anode marked phenomena of contraction. The protoplasm of the pseudopodia flows centripetally until the latter are drawn in. Then the vacuoles break; and a granular disintegration of the protoplasm results, which proceeds constantly farther from the kathode during the passage of the current. This disintegration, beginning with great energy, becomes slower and less extensive the longer the current flows, and after some time is at a complete standstill. This means that the living substance of the Actinosphoerium becomes fatigued in the course of continual stimulation, and decreases in irritability; hence the stimulus, which at first induced pronounced phenomena of disintegration, later produces no reaction at all. Pelomyxa is fatigued still more rapidly than Actinosphoerium. Stimulation for a few seconds is sufficient to make individuals of this genus wholly non-irritable to currents of equal intensity; a much greater intensity is then required to call out the same reaction.”

        The principle of variability of stimulation is of importance in the reaction of nerve-tissue. When the stimulus remains invariable, both in intensity and quality, no reaction follows.

        This is clearly brought out in experiments on nerve tissue. “The electrical current,” says Landois, “produces its strongest irritant effect upon a nerve at the time of its entrance into the nerve and at the time of its disappearance. In like manner any rapid increase or decrease of the current passing through a nerve has a strong irritant effect. If on the other hand, the current be allowed to pass gradually into the nerve trunk or to disappear, or the current passing through the nerve be gradually increased or diminished, the visible signs of nerve irritation are much less marked. In general, the stimulation is more pronounced the more rapid the current variation within the nerve, that is, the more suddenly the strength of the current passing through the nerve is increased or diminished.” This holds true in the case of the nerve in which, as Bowditch has shown, there is little or no fatigue.

        Where fatigue is present the principle of variability becomes a factor of the utmost consequence. The principle of variability of stimulation plays an important role in cells in general and in nerve cells in particular where fatigue easily sets in and the threshold is raised with the continuation of the stimulation and with the successive discharges of cell energy. Variability of stimulation and fatigue influence the fluctuations of thresholds.

        What is true in regard to unicellular organisms, such as the amoeba and cells and nerves in general, holds also true of nerve-cells in their various combinations, complex groups and systems, such as constitute the highly complex organization of the central nervous system. Each psycho-physiological system has its usual threshold of stimulation just sufficient to set it into activity. If under the influence of external and internal conditions, the thresholds rise so that the ordinary stimuli of the environment cannot arouse the system into activity, then that system is practically isolated from the rest of the functioning mental aggregate, constituting the moving equilibrium of the living organism. The system with the raised threshold is dissociated.

        An illustration may bring the matter home to the student. Let us imagine a telephone system of bells so arranged that the pressure on a knob or the taking of a receiver sends an electric current of a definite intensity through a series of systems of bells, causing them to ring. Suppose now that in one system the wires have become so changed in their diameter or constitution that a current of a different intensity is now requisite to set that system of bells into activity. The former current is no longer sufficient. The particular system can no longer ring by the action of the liberated current. That system is dissociated.

        By changing the intensity of the current or by tapping the system from a different direction we may be able to set ringing the disabled dissociated system of bells. This would indicate that the system of bells itself is in good condition, and that only its interrelation with other systems of bells has changed. Something similar takes place in mental life. When the threshold of a particular system has risen, that system has become dissociated, communication with the rest of the psychophysiological or mental systems becomes difficult.

        All the phenomena of dissociation are due to such a change or rise of thresholds. In that particular direction communication has become difficult. As some psychologists put it the paths have become blocked. This condition gives rise to functional anaesthesias, aboulias, amnesias, to all the manifestations characteristic of functional psychosis, or of functional nervous diseases.

        There is another aspect to functional psychosis which appears to be paradoxical. While the usual threshold of personal consciousness is raised, the subconscious thresholds may, on examination, be found lowered. In fact, we may even lay it down as the law of functional psychosis that all anaesthesias, aboulias, amnesias are also hyperaesthesias, hyperamnesias,—all losses are also gains.

        When the usual direct tracts are blocked, the indirect may do good service. To revert to the illustration of our disconnected or dissociated system of bells. When the wires ordinarily in use have become difficult to utilize, we may look for connections which have not been in use. It may be found that if such indirect, unused wires are properly tapped, the system may begin to ring louder, longer, and with a rather unwelcome noise and recurrence. The particular dissociated line once started cannot be arrested by other interfering lines, it is no longer inhibited by other associated lines, and hence, on a proper occasion, when called from a particular direction, the system of bells will respond with full vigor and without check.

        This illustration brings out clearly the character of recurrent mental states. Recurrence is the result of dissociation. The system keeps on ringing until the energy of the current is either exhausted or inhibited. The blocking of paths, due to rise of thresholds, constitutes the mechanism of functional nervous diseases.

        The state of dissociation furnishes the general rule for diagnosis of functional nervous and mental diseases. If a disabled system can function subconsciously, the malady is functional. This can be found by different methods and by the induction of such states as hypnosis, the hypnoidal, and by the occurrence of the hypnoidic state.
 

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