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SYMPTOMATOLOGY, PSYCHOGNOSIS, AND DIAGNOSIS OF PSYCHOPATHIC DISEASES
Boris Sidis, Ph.D., M.D.
Boston: R. Badger, 1914
VIVIDNESS, FUNCTIONAL PSYCHOSIS, AND HALLUCINATIONS
KEEPING to facts as closely as possible we may venture without much risk on the following generalization which may be regarded in the light of a working hypothesis. Just as sensory primary or secondary sensory elements vary in intensity and can be arranged in a continuous series of gradations of intensities, so do the representative elements vary in vividness and may be arranged in a continuous gradated series of vividness. Sensory elements have intensity, but no vividness, while representative elements have vividness, but no intensity.
Representative elements may refer to the same presentative content with different degrees of vividness. Vividness of representative elements, like intensity of sensory elements, may pass through all degrees of variation from maximum to minimum, and finally reach a vanishing point. In this respect vividness is like sense intensity, and as a matter of fact the two are usually interrelated.
Under ordinary conditions of psychic activity sensory intensity and representative vividness vary together. An intense sensation is vividly represented and a weak sensation less so, the vividness varying directly with increase or decrease of sensory intensity. This direct variation, however, is not always constant; there are conditions under which the two may part company, such, for instance, as are found in states of distraction or in states of dissociation. Under such conditions a strong stimulation giving rise to sensory elements of great intensity may awaken representative elements of but slight vividness.
In states of distraction, as well as in various states of mental dissociation, sensations of great intensity may meet with so little vividness in the representative elements as to fall below the threshold of consciousness, they may be submerged into the twilight region of the subconscious and “not be perceived at all.” From this standpoint we may say that the depth of dissociation varies inversely as the degree of vividness. When vividness is at its minimum, dissociation is at its maximum, and inversely. Briefly stated, dissociation and vividness are inversely interrelated variables.
Functional psychosis, the basis of which is dissociation, may also psychologically be regarded, according to the gravity of the psychopathic affection, as a decrease or even loss of vividness of representative elements. The diminution or total loss of vividness may be of different systems of representative elements, and will thus give rise to various forms of psychopathic amnesias, which play such an important role in functional psychosis, which in the main is a disease of representative life, consisting in a decrease of functional activity of representative elements, and which from the present point of view may be regarded as the tendency towards a minimum of the most important attribute of ideational elements, namely, vividness.
From this standpoint, the degree of vividness of ideational elements can no more confer on them sensory intensity than the idea of riches, however vivid, can confer upon one the power of wealth. Dream hallucinations, like hallucinations in general, are sensory in character, not because of the intensive nature of the central elements or ideas, but because of the primary and secondary sensory elements present, directly and indirectly peripherally initiated, as it is in the case of all sensory and perceptive processes. Hallucinations are induced peripherally, and are started either in the same sense organ, or indirectly in some other sense organ, the secondary sensory elements form, so to say, the hypertrophied portion of the hallucinatory percept, but they are always sensory in character and peripherally initiated.
The more closely one investigates hallucinations, the more one learns to trace cases of supposed mysterious hallucinations to external peripheral sources. A pure central hallucination is as rare as the fabulous phoenix. A central hallucination means an unanalyzed psychic state. Whenever an analysis of such hallucinations is made, the peripheral sensory character, primary and secondary, stands out distinctly in the foreground.
In the so-called “purely central hallucination” the nuclear primary sensory elements remaining in the background of consciousness cannot easily be traced to their appropriate peripheral sense organs and their external stimuli, and they are on that account regarded as “centrally initiated.” Dream hallucinations, hypnotic, hypnagogic and pseudo-hallucinations, if closely analyzed, can be clearly traced to peripheral origin,—to peripheral stimuli that give rise to primary sensory elements that form nuclei round which secondary sensory elements become organized as cytoplasm.
These so-called central hallucinations form the stumbling block of the psychologist and the psychopathologist. To account for them, the theory is commonly advanced that the irritability of the ideational centers may reach such a pitch as to give rise to intense ideational states amounting to a full-fledged sensation or perception, thus bringing about a pure central hallucination.
It is strange that such a theory should be maintained at all, and that it should gain currency. The theory does not accord with experience, its very principle disregards facts. For no matter what strength an image may attain it is still far from becoming a sensation. An image of a bell does not sound and an image of a blow does not strike. The fact is, as we have pointed out before, images or representations are qualitatively different from sensations; an image can as little be converted into a sensation as the sour taste of vinegar can be turned into the violet color of the spectrum.
Images and sensations differ fundamentally, they differ in kind and no amount of ideational activity can ever be made to become sensory in nature. A higher pitch of ideational activity will make an image more vivid, but can nowise confer upon it sensory qualities, just as all the immensity of space and infinity or eternity of time can not make them weigh as much as a grain.
A further modification of the same theory is given by those who maintain that central hallucinations are due to the irritability of the higher ideational centers from which “ideational” currents are propagated to the lower sensory centers. In other words, it is not the image that becomes by its intensity or by its vividness directly transformed into a sensation, but an intense or vivid image may give rise to a corresponding sensation without the presence of an external stimulus, or of a peripheral sensory process.
Psychologically as well as biologically regarded, the theory is untenable. For it is not in accordance with observed facts that an image, however vivid, should give rise to a corresponding sensation or percept. Were that the case the course of internal and external worlds would have become confused and confounded, man would have become the dupe of his own ideas, the world a gigantic madhouse, and the process of ideational activity would have long ago become eliminated in the struggle for existence.
From a physiological standpoint, the theory can hardly be considered, inasmuch as it is in direct opposition to the known physiological laws. Sensory excitation, ideational processes and motor reaction form, so to say, a sensori-ideo-motor arc,—the excitation going from peripheral sense organs to central systems, and thence to the muscles and glands. Now the conditions postulated by the central theory are such as to have the processes reversed. Sensory processes work upward, from periphery to center, while motor processes work downward, from center to periphery.
On the modified central theory, the sensory process in hallucinations is reversed, it goes downward instead of upward. There is not a particle of evidence for such reversal, the assumption being in contradiction to the principles of physiology. The claim of special structures for effecting such a reversal is unfounded. As far as can be ascertained, the neuron works “cellulipetally,” in the direction of the sensory ganglia and central neuron systems, while the neuro-axon works “cellulifugally,” that is from sensory ganglia and central neuron systems to the periphery to the muscular apparatus. There is on the other hand not the least bit of evidence that the functions of neuron systems can be reversed in their course.
The central theory then cannot stand the test of critical examination as it is neither in accord with the facts it is called to explain, nor does it fall in line with the facts and principles of physiology. We are therefore forced to fall back on the peripheral origin of hallucinations under the condition of central dissociation. According to our theory, the origin and structure of hallucinations, of dream hallucinations as well as of pseudo-hallucinations do not differ in the least from those of normal perception, a difference unwarrantly claimed by the theories of central origin of hallucinations. Hallucinations are peripherally initiated, hallucinations are abnormal percepts, occurring under the conditions of central dissociation with primary and secondary elements as their central nuclei.
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