Home Boris Sidis Archives Table of Contents Chapter I
SYMPTOMATOLOGY, PSYCHOGNOSIS, AND DIAGNOSIS OF PSYCHOPATHIC DISEASES
Boris Sidis, Ph.D., M.D.
Boston: R. Badger, 1914
We are getting more and more awake to the importance of the study of the phenomena of abnormal mental life. The student of normal psychology begins to realize the necessity of a knowledge of the various manifestations of the abnormal mind, both conscious and subconscious. The phenomena that lie on the borderland of what is regarded as normal mental activity are of great interest and importance, because, being deviations or variations from the normal and the familiar, they are apt to call attention to the mechanism, causation and laws that govern mental activity in general―normal and abnormal, conscious and subconscious.
The normal psychologist has learned to pay attention the facts of abnormal mental life, since a knowledge of them sheds a good deal of light on the various manifestations with which he himself deals, manifestations which have resisted psychological analysis, such as emotion, will, personality, and even such apparently simple mental functions as associative processes and perception. Not that the normal psychologist has not made contributions to the understanding of all those processes, but many of the studies touched the surface and did not penetrate deep into the subconscious soul of mental life, into the subconscious activity where all the sources of mental life have their being, where mental processes have their origin, and whence all mental processes come to light in the focus of consciousness:
The phenomena of memory are of vital importance in normal psychology, and while a good deal of work has been accomplished by the normal psychologist in this subject, and some far reaching laws, such as those of Ebbinghaus, have been formulated, still we are far from a real understanding of this fundamental function. In this respect abnormal psychology is of material help, on account of the great number of variations which that function presents to the psychopathologist. In fact, most of the studies of recent psychopathology may be regarded as researches in the domain of memory. From a certain standpoint psychopathic maladies may be regarded as affections of memory. Studies in abnormal psychology are thus of vital interest to the investigator in normal psychology. A study of the anaesthesias, abulias, amnesias is of consequence to a right understanding of memory and volitional activities; the phenomena of dissociation of personality or of multiple personality give an insight into the labyrinth of human personality, while dreams, illusions and hallucinations give a broad view and clear understanding of the various elements of perceptual processes.
If, however, abnormal psychology is of importance to the normal psychologist from a purely theoretical standpoint, it is certainly of the utmost consequence to the medical profession. A clinical knowledge of the facts of abnormal mental life should be in the curriculum of every medical student. Every medical practitioner should be more or less familiar with the symptoms of psychopathic diseases.
We must not forget that mind and body are intimately related. The two cannot be separated. One reacts on the other. Physical disturbances bring about mental aberrations which in their turn influence physical functions. It is a kind of a closed circle. Nearly every disease of a physical character, if it is chronic, brings about nervous and mental disturbances which in their turn aggravate the physical disorder. In many disorders with purely physical symptoms the main trouble is mental,―a fact which many an experienced, general practitioner will readily concede. This is strongly brought out by the researches of various investigators in the domain of abnormal psychology or psychopathology.
To be able to recognize the mental and to be able to differentiate it from the purely physical is certainly of the highest consequence to the general practitioner, even if the treatment may fall into the hands of specialists who have devoted their life to such work. The reason why all kinds of occult cures have become so rampant in this country is because the medical profession ignores the mental side of the patient. The medical student, the practitioner, is in sore need of a training in psychology, normal and abnormal.
Our medical colleges are apt to run in a routine, they give special courses in ophthalmology, otology, in special nervous organic diseases and even in tropical maladies which a general practitioner may not see in a life time, but they ignore psychopathic maladies which almost crowd the office of the general practitioner, and which he finds not only difficult to treat, but is even unable to recognize and diagnose. It is sincerely to be hoped that this hostile attitude to the mental requirements of medical students will be changed, and medical colleges will realize that they have to give some mental equipment to their students.
The courses given in Psychiatry do not cover the ground of psychopathic diseases. To one case of insanity there are thousands of cases of functional neurosis and psychopathic affections which have absolutely nothing to do with insanity, affections which the psychiatrist, from the very nature of his training, is neither in a condition to grasp nor able to deal with.
The medical profession must realize the importance of a working knowledge of subconscious mental affections. More than one-half of the patients that come to the general practitioner are cases of psychopathic disorders. An early recognition and appropriate treatment would not only vindicate the professional man, but would help the patient at the right moment and prevent him from becoming a chronic invalid.
I must say that many medical men, regarding themselves as belonging to the conservative type, show a good deal of opposition to abnormal psychology. Thus some medical men accused me of carrying on work in spiritualism. Others with medical authority lecture on "the limitations of Psychotherapy". Vulgar Psychotherapy is all they know of the vast domain of psychopathology. It is but six years or so since a well known medical journal rejected, without as much as a comment, my clinical "Studies in Psychopathology," afterwards published in "The Boston Medical and Surgical Journal." I have not the least doubt that my present volume will meet with no less opposition from similar quarters, and especially with attacks by "psychologizing" neurologists and psychiatrists taking refuge under Freud's paternal wings.
I sincerely hope that in the course o£ time the more liberal, the more open minded and progressive men of the medical profession will be more appreciative of the work done in normal and abnormal psychology. The younger generation of medical men, I trust, will realize the importance of a working knowledge, both theoretical and clinical, of psychopathic mental diseases.
I may say that a knowledge of psychopathic troubles is of more material help to the practitioner than all his studies in experimental physiology, for instance, with its muscle-nerve preparations, more important than the bacteriological technique with its examinations of bacteria and bacilli, toxins and autotoxins, with the endless sera, often of a highly doubtful character, much advertised by commercial houses. Perhaps it may be well to remind the medical man that a good deal of what is taught in the medical schools as materia medica, or pharmacology, theory and practice, should be really regarded as courses in suggestive therapeutics, given under the guise of medicine, of virtues and properties of drugs so that the physician should have faith in them himself when he treats his patients.
The Nemesis of faith in the so called scholastic medical therapeutics with its lack of psychological knowledge is fast overtaking the medical man. The Freudian school with its symbolical, cabalistic, occult notions and sexual sensationalism, rivalling that of the yellow press, has become the favorite in certain medical quarters. Physicians innocent of all psychological knowledge publish voluminous pseudo-analytic papers under the impression that they furnish the last word in medical psychology. The sight of some medical dignitaries taking a regular bath in sexual filth, possibly as a matter of redemption and expiation, would be ludicrous, if it were not so pathetic.
It is amusing to read puerile compositions, each a mile long, going into detailed description of sexual experiences with a zeal worthy of a better cause. The Freudians select choice cases of sexual perversion and degeneracy, much of which is of a purely suggestive character, and describe them with a gusto that well displays their own subconscious trend. According to Freudian ‘pseudoanalytic science’ the world is a madhouse of sexual perversion and inversion. The Freudian gloats over his sexual experiences. In order to accomplish this remarkable result a whole mass of tokens, signs and symbols is formulated and organized into a systematized, paranoidal ‘complex.’ This Freudian verbigeration and rumination some medical authorities and their followers hail as the Gospel of medical psychology, a new up to date German importation, known under the high sounding name of psychoanalysis. Psychoanalysis is a form of medical bacchanalia. Is it not the Nemesis of psychology,―that mad medical dance of psychoanalytic worshippers round the shrine of Venus and the altar of Priapus?
It would have been amusing, if it had not been fatal to the mental and moral balance of the patients, to hear some medical authorities advising their patients to take a ‘course in psychoanalysis.’ If those neurological practitioners should understand what a course of treatment in psychoanalysis really means to a nervous person, they might as well advise him to commit moral suicide, or to take a course in sexual profligacy.
I have seen many a patient who has become a sexual ruin long before the psychoanalyst got through with his sexual courses. I have known many a patient who under the highly suggestive, psychoanalytic treatment has begun to masturbate daily and has become a sexual pervert.
Psychoanalysis is a conscious and more often a subconscious or unconscious debauching of the patient. Nothing is so diabolically calculated to suggest sexual perversion as psychoanalysis. Psychoanalysis paraded as psychological investigation is not only a danger to the patient, but it is a menace to the community. And yet this form of mental debauch commends itself to some medical authorities as a great discovery in the domain of abnormal psychology. Better Christian Science than psychoanalysis!
There is at present a current in psychopathology that ascribes a good deal of importance to desire, to purpose, to meaning. This current is essentially Freudian in character. The representatives of this tendency are not satisfied unless they read some meaning, conscious or unconscious, into the various phenomena of abnormal mental life. They try to find in the abnormal symptoms of psychopathic patients some mysterious significance which they attempt to reveal by special interpretation. They try to find some hidden meaning in phenomena regarded as symbolic of unconscious trends which they decipher by a special code of procedures, signs and tokens. They are somewhat like the ancient augurs who could read the future from the flight of birds and the guts of animals. Others, carried away by the same influence, but rather more cautious in their speculations, attempt to find special meanings in each and every symptom of psychopathic cases, and are not satisfied until some meaning, however obscure and laborious, is forced out of the facts under their examination.
Now in all my work, carried on for years and published in various works and papers, I lay special stress on the fact that the phenomena of abnormal mental life do not present any purpose in the present; they are repetitions, recurrences of a past, but they have no aim, no purpose, no meaning in the present life existence of the patient. In fact, the symptoms are pathological, just because they have no purpose, no meaning in the life of the patient.
The most superficial and puerile method is that of tracing subconscious meanings in lapses of words, in amnesias, by means of association methods. The physician gives a series of words and the patient is supposed to answer with some words which are scanned by the physician as to time and quality. All kinds of symbolical and diabolical combinations are then formed by the physician who thinks he is doing great psychoanalytic work. All he does is ingenious, cabalistic casuistry worthy of mediaeval scholasticism.
When Freud's Psychopathologie des Alltagslebens was published I discussed the examples, so ingeniously worked out by Freud, with the late Professor James of Harvard. James laughed at the puerility of Freudian associations; he threw up his hands at the psychoanalytic absurdities, and characterized Freudian Psychopathologie as ‘silly and nonsensical.’ Some similar opinion is maintained by Wundt, Ziehen, Oppenheim, Aschaffenburg and others. Not a single psychologist or psychopathologist of note accepts Freud's sexual phantasies and Oneiromancy.
The association method used by the Freudian school, in order to discover the hidden meaning that lies in the subconscious or the unconscious, is arbitrary. The followers of Freud are inexperienced in the actual investigations of subconscious phenomena in which suggestibility plays such an important role. There is not a single case of the Freudian school that is free from artefacts of subconscious suggestion, played between patient and physician, in which the Freudian is the biggest dupe. In fact, the very methods of free association and oneiromantic interpretations are of such a character that any associations may be formed, according to the wish of the physician.
The Freudian himself is possibly the best illustration of his own theory that one may be duped by his own wishes. In this respect the Freudian does live up to his theory that everything can be explained by wish and its ideal fulfillment. As I put it in another place ‘if wishes were horses beggars would ride,'―the Freudian rides such horses.
On the whole, teleological psychology is questionable. One can find any number of purposes in mental symptoms and associations; speculations in that direction are often as idle as they are useless. When Harvey discovered the circulation of blood, the objection was the teleology of it, what is its purpose, what is its meaning. Harvey had to defend his theory against objections that claimed that he did not go deep enough into the subject, as he did not give the meaning of the circulation of blood, and, therefore, his discovery could not be true. "To those who repudiate the circulation" Harvey writes "because they neither see the efficient nor the final cause of it, and who exclaim cui bono? I have yet to reply, having hitherto taken no note of the objection which they take up."
Teleology is a tradition handed down through the scholastic Middle Ages from Plato and Aristotle and often comes tolife in sciences that have not reached their state of maturity. Not that I deny the purposive element in mental life, but I do claim that its sphere even in normal life is extremely limited, and that it is almost completely absent in states of morbid psychic affections. Freudism is a good example of it.
Morbid mental states have no meaning. In a certain sense we may even say that mental states are morbid, just because they have no meaning. The cure often consists in the fact of either having such states completely eliminated from the stream of mental activity, or in finding for them a meaning which originally they do not possess.
Clinical psychopathology should not burden itself with all kinds of speculations and hypotheses, but stick to facts. Teleology or the finding of meanings, infantile and others, the discovering of hidden purposes and unconscious meaning, because of the metaphysical dogma that the unconscious can only wish and form desires which the symptom complex of the malady expresses as the meaning of the hidden conation, is to bind oneself with arbitrary speculative theories and metaphysical hypotheses. The most consistent of those speculators are unconscious followers of Schopenhauer who puts the Unconscious Will at the basis of his metaphysics. Will is at the heart of things, hence there is a craving in the Unconscious which is the very essence of the phenomenal manifestations of the Will.
According to Schopenhauer the phenomenal world is the manifestation of the Will, of the Kantian Ding an sich, of the noumenon which is beyond time, space, and causality. The Unconscious in nature is the Will which works and manifests itself in it. The world is the objectification of the Will. "The Will is the thing in itself, the content of all phenomena. . . . The phenomena are throughout necessary. . . . This follows from the unrestricted validity of the principle of sufficient reason. . . . In another aspect, however, the same world is for us, in all its phenomena, objectivity of will . . ." This metaphysical doctrine of Will is at the basis of Freudian "pseudoanalysis."
The doctrine of will, desire and suppression, resistance and Abwehr is a close copy of Schopenhauerian metaphysics: "In the resistance of the will" says Schopenhauer "to allowing what is contrary to it to come under the examination of the intellect lies the place at which madness can break in upon the mind. Each new adverse event must be assimilated by the intellect (the conscious, or das Bewusste), it must receive a place in the system connected with our will and interests whatever it may have to displace that is more satisfactory. Whenever this has taken place, it already pains us much less; but this operation itself is often very painful, and also in general, only takes place slowly and with resistance.
"However, the health of the mind can only continue so long as this is in each case properly carried out. If, on the contrary in some particular case, the resistance and struggles of the will against the apprehension of some knowledge reaches such a degree that that operation is not performed in its integrity, then certain events or circumstances become for the intellect (für das Bewusste aber nicht fiir das Unbewusste as the Freudian would say) completely suppressed, because the Will cannot endure the sight of them, and then, for the sake of the necessary connection, the gaps that thus arise are filled up at pleasure (by the activity of the unconscious) ; thus madness appears. For the intellect has given up its nature to appease the Will: the man now imagines what does not exist." And here comes another fundamental Freudian metaphysical tenet: "Yet the madness which has thus arisen is now the lethe of unendurable suffering; it was the last remedy of harassed nature, i.e., of the Will." Freudianism is Schopenhauerian metaphysics gone mad. Psychoanalysis is truly perverted ‘madical’ metaphysics.
In psychopathic cases the symptom complex of the functioning systems, characteristic of the pathological condition, has essentially no meaning in the present, although the patient especially with the help of the physician may find some meaning as do the insane when trying to account for their pathological state. The psychopathic symptoms are survivals, relics from a previous epoch of the life existence of the patient. The psychopathic symptom complex is a survival from a stage of experience the meaning of which is gone, and is therefore entirely irrational.
It is only when we come to realize the irrationality and lack of adaptation, inner and outer, of such pathological, meaningless systems, conscious and subconscious, that we begin to understand the psychopathic character of the symptom complex.
In this respect psychopathic systems are analogous to the irrational customs and myths found in various stages of human culture. This point is specially misapprehended and misapplied by the Freudians. As long as one attempts to force on myths a meaning, philological or sexual, one is sure to go astray and to be lost in a maze of verbiage and sophistry. Myths are survivals of savage thought, now meaningless and irrational. The Freudians clearly reveal their absurdity by the allegorical subtleties of their mythical, sexual psychology in which their sexual fancy runs riot.
Myths are relics of savage thought, recurrent manifestations of savage experience, surviving phases of savage Weltanschauung. All the Freudian ‘psychologizing’ about myths is nothing but idle pseudoanalytic fancy without the least foundation in fact. To the problem—why irrational ideas survive in myths—Andrew Lang pertinently says: "We may be asked why do savages entertain irrational ideas which survive in myths? One might as well ask why they eat each other, or use stones instead of metals. Their intellectual powers are not fully developed, and hasty analogy from our own unreasoned consciousness is their chief guide. Myth, in Mr. Darwin's phrase, is one of the "miserable and indirect consequences of our higher faculties." All the casuistry of Freudian mythology is arbitrary and sophistical. The Freudians use scholastic casuistry for the rationalization of what is essentially irrational. "It" (the myth) says Lang, "is a jungle of foolish fancies, a Walpurgis Nacht of gods and beasts and men and stars and ghosts, all moving madly on a level of common personality and animism, and all changing shape at random, as partners are changed in some fantastic witches' revel" . . . "The imagination of the savage has been defined as ‘midway between the conditions of a healthy, prosaic, modern citizen and of a raving maniac or of a patient in a fever ward.’”
Just as the irrational elements of myths are the survivals from a savage state of mind which has no meaning in the present life of civilized communities so we may say that mental, subconscious, psychopathic symptom-complexes are survivals of a former period of mental activity; they are atavistic systems which keep on recurring, like the type of recurring moment consciousness, under appropriate circumstances and favorable conditions, but which are now irrational, without meaning and purpose.
The Freudians have invented a psychopathic Oedipus complex of which they make much capital. They show however by it a sad lack of psychological understanding and a deficiency of scientific insight as well as absence of common sense. Neither is their analysis of the Oedipus myth in any way correct nor is their interpretation of clinical facts in the least approaching the truth. The whole of psychoanalysis is nothing but puerile, Talmudic hair splitting sophistry.
The Oedipus complex which is kept in so much reverence by the Freudian devotee is scientifically and clinically false. The Oedipus myth is wrongly interpreted by the Freudian sexual mythology and has absolutely nothing to do with the actual condition of psychopathic cases. All there is to the Oedipus "complex" is a matter of ordinary suggestibility to which psychopathic patients readily lend themselves and of which the psychoanalyst is the principal dupe.
Max Müller regards the Oedipus story as a solar myth. It is, however, quite probable, as J. G. Frazer points out, that there is in the myth a survival from the early savage period of matriarchate or mother-kin when the right to the throne was in the female line. The father exposed and slaughtered the son, and the son in his turn dethroned the father by force and murder. The savage chiefs and kings sacrificed and killed their male children, especially their first born sons, while the surviving sons assassinated their fathers. The myth is a reminiscence, a relic handed down from savage times of the struggle for existence, going on within savage communities for the tenure of kingship. The marriage with the king's widow was requisite in order to obtain the right to the throne. The father murdered the son, and the son, when he was rescued, had to assassinate the father. It was a matter of killing or being killed. What we find in the myth is another example of the working of the instinct of individual and more specially of social or tribal self preservation.
Father, son, and members of the royal family were sacrificed as an atonement for tribal sins, they were immolated and slain as an expiation for the transgressions of the community, and hence their deaths were supposed to ensure the prosperity of society. The Oedipus myth with its deaths of Laios, of Oedipus, of Jokaste and of the children of the royal house for several generations is a relic of savage practice in the struggle for self-preservation.
This is well brought out in the Greek myth of Athamas, current in Alus, a town in Thessaly. King Athamas and his family had to furnish victims as sin-offerings for the whole country and thus ensure its welfare. The wife and children suffered exile and death in various ways and king Athamas himself was ordered by the oracle to be sacrificed for the good of the community. The unhappy king was saved by his grandson, Cytisorus. Athamas became insane, quitted his country and went wandering in the wilderness. Here we have a modification of the Oedipus myth, a modification which shows the real nature of such stories, namely that they are relics, survivals, or recurrences of savage practices in the struggle of tribal self-preservation. The Freudian sophistic interpretation of their ‘Oedipus complex’ is as shallow as it is arbitrary,—it is pseudoanalytic rubbish, sexual trash without any rhyme and reason.
Distasteful as it is for me to do it, I find it my duty to enter a protest against the vagaries and absurdities of psychoanalysis which is nothing but a pseudo-science, the same as astrology, oneiromancy, palmistry and magic. On account of the sensational noise made by the devotees of psychoanalysis, the medical practitioner confuses psychoanalysis with scientific and clinical psychopathology. In condemning psychoanalysis many a clinical man of sound good sense also unjustly condemns all clinical, psychopathological research. The following statement is an extract from a letter written to me by an eminent medical man who stands at the head of the medical profession of this country:
"I think that the majority of men in general work do not separate psychopathology from psychoanalysis. Freud's theories and the whole trend of psychoanalysis have been so turned into the channels of distorted and perverted sexual life that it has blinded people to the fact that there are many dominant phases in mental life which are not sexual. The ordinary healthy minded and vigorous practitioner sees a lot of motives in life that are not sexual, and where everything is turned and twisted to one side, one ‘complex,’ he becomes indignant and disgusted, and condemns the whole broad subject of psychopathology."
My clinical work as well as my experimental investigations and observations prove to me conclusively that not all mental processes are purposive or meaningful. Mental life activities are a matter of habit, often silly, and meaningless, even hurtful or pathological. Quite frequently the activity is carried out reflexly in response to external stimulations often detrimental to the life existence of the individual. Most of the actions which have no selective value may be completely indifferent.
This lack of purpose and absence of meaning in normal life may be regarded as being even more emphatic in pathological cases. It is only paranoiacs or paranoidal cases that may put a quasi-meaning on their abnormal experiences, but this meaning is entirely delusional. Of the same paranoidal type may be regarded the kind of meaning put on the symptoms of psychopathic cases. Psychoanalysis is a matter of suggestion played between the physician and the patient. Both are deluded. Psychoanalysis is sheer humbug.
We may lay it down as a law that psychopathic life lacks meaning. I lay special stress on this principle,—lack of meaning is characteristic of psychopathic affections. This absence of meaning is the key to a right comprehension of the facts of psychopathology and of the methods of psychotherapy.
Perhaps it may be fitting here to say a few words about Psychognosis. Psychognosis is not a special method. All I wish to convey by it is what the term means, namely a study, an acquisition of a working knowledge of the patient's soul, so to say. The best way is to study the case by all kinds of methods, hypnoidal, hypnotic, and especially by a close observation of the Waking states. The best way is not to rely on cut and dried methods, such as pedantic laboratory tests, which are clumsy, awkward, and highly misleading.
It is best to live with the patient, to watch him closely when he acts spontaneously, converse with him, discuss wit him, work with him, be with the patient day and night, and labor with him for hours, as well as live with him intimately for weeks and months. It is only under such conditions that we come to realize the actual condition of the patient and can obtain a glimpse of the workings of his mind. Not cut and dried tests, reaction time or association time or tests with association words, and then leading the patient along lines suggested unconsciously by the physician, or any attempt at putting the cause into some pigeon hole of a classification, common with the neurologist and psychiatrist, such as dementia praecox, psychasthenia and so forth, can lead to any understanding of the case.
The best way is to study the case, know it by the description of the symptoms, and dig deeply into the conscious and subconscious sides of the patient’s character and life history. In short, we must learn to know the workings of the patient’s mind, we must learn his ideals of life, his attitude towards man and to the world, his actions and his total reaction in his adaptations to his environment. In other words, we must learn to understand not only the patient’s physical, nervous, and mental condition, not only his history and the development of his present trouble, but we must learn his personality as a whole, his attitude to his external surroundings, his Weltanschauung so to say.
This can only be accomplished by all methods at our disposal, by hypnoidal and hypnotic states, by examination in the waking state, by constant watching and observation, by drawing out the patient in discussion, and by closely observing him in his actions and behaviour in regard to his family, his friends and strangers for a long period of time. The knowledge thus obtained of the patient’s psychic life is what I regard as Psychognosis. Such knowledge is indispensable for a right comprehension of the patient’s condition, and is still more important, if we wish to cure him. In other words, psychognosis is of importance not only from a theoretical, psychopathological standpoint, but is of the utmost consequence to a right, practical, psychotherapeutic procedure and treatment.
I may add that some of the chapters included in this volume have been published by me in the form of articles in various medical and psychological journals.
Sidis Psychotherapeutic Institute
Portsmouth, New Hampshire
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