AMERICAN NERVES AND THE SECRET OF SUGGESTION AMERICAN NERVES AND THE SECRET OF SUGGESTION BY ANNE STURGES DURYEA To fight aloud is very brave, But gallanter, I know, Who charge within the bosom, The cavalry of woe. Emily Dickinson Comrade, here is my neck! By God! you shall not go down; Hang your full weight upon me! Walt Whitman. THE CO. New York and London 1923 Copyright, 1923, by The Century Co. PRINTED IN ¥. S. A. To THE TURTLE ON ITS BACK FOREWORD This is an unpretentious volume written be- tween times and almost casually. It is written with a purpose and in behalf of nervous people who may find it useful in securing a better under- standing of their condition and their needs, for themselves as well as for their families and friends. These are the sort of people whom I know and with whom I have dealt during a period covering more than ten years of psychologic work with the functional neuroses, supplementing med- ical care. There are some nervous persons who appar- ently cannot help themselves. They try and fail. They seem temporarily to need freedom from per- sonal responsibility and some one to lift for them until they can get hold of themselves. Eecent literature on the subject of psycho- analysis will perhaps be helpful to many who are not in such extremity as the class to which I refer. These sufferers are by their own testimony only discouraged by it. Just another thing that puts it ‘ ‘ all up to me, ’ * they lament. vii viii FOREWORD While we warmly commend such an able book as “Outwitting Our Nerves,” written by Dr. Josephine Jackson, and published by The Century Co., we nevertheless venture to make this simple offering to the turtle on its back. Many years of intensive psychologic study, in the work of preparation and teaching, together with the added period of hand-to-hand dealing with the functional neuroses, in connection with medical care, has led to a strong predisposition in favor of the use, either with or apart from analysis, of what is commonly called suggestion. Reference is not made to suggestion given under hypnosis, the practice of which has been generally discarded. Somewhat crudely used at first, since much that has been known about it has been taught by the charlatan, it has presented some repugnant and quite unnecessary elements which one having an accustomed psychologic point of view must instinctively tend to eliminate if only as a matter of private satisfaction and psychologic integrity. When one has grown into the use of a simpli- fied, somewhat technical and “regularized” form of suggestive procedure, it takes shape in the mind as a method which appropriately classifies itself among natural educational processes. Ner- FOREWORD ix vous sufferers to whom it is offered commend it, especially as a last resort when tested forms of self-help fail, and they have requested this tenta- tive attempt at a formulated expression regard- ing it. Because of the more and more generally recog- nized quite simple and perfectly natural psycho- logic principle underlying the slightly specialized use of suggestion, it seems to many that what some one has called the conspiracy against nerves might gradually become obsolete. In writing informally on this subject the lan- guage used is that of the “family” discussing the “family” case about the fireside, at the break- fast-table, or sitting on the foot of sister’s bed, assuming, perhaps, that the member who has been to college has dabbled in psychoanalysis and uses its terminology with a fair degree of accuracy. As we find ourselves well under way with a special plan of consideration for the subject of nerves, a new planet swims into our ken; Coue appears upon the horizon. We hear what he has done in France, we hear what he has done in England, and before this book sees the light we shall know what he has done in America. We hear at the present moment a statement which gives us pause. It is said that Americans FOREWORD x in Europe who visit Nancy hoping for restoration from their nervous ills do not respond to Coue’s methods so successfully as do the French and the English. This fact would be surprising only to the casual observer. One familiar with the subject would expect precisely this thing to happen, for two reasons: because of the avowed nature of Coue’s appeal, and because of the character of American nerves. Since interest in Coue’s work is so wide- spread and his motive so apparently sincere it seems not inappropriate to make existing dif- ferences between American and foreign nerves and possible differences between American and foreign methods of using suggestion a special point of departure for the consideration of cer- tain phases of our question. We are giving more detailed attention than had been planned to the possibilities of self-help. We are recognizing self-consciousness and practicality to be outstand- ing characteristics of American nerves, and in view of these qualities we are making somewhat more explicit what, it seems to us, may be the se- cret of a more rational and therefore more lasting use of suggestion. As a result of these facts there appears to emerge an indication that it may remain for so- FOREWORD xi called practical minds, which must have a reason for the faith that is in them, to make clearer and more definite, the normal character of suggest- ibility and the physical basis of normal response to suggestion. It may be the contribution of American minds to formulate a more definite technique by which whatever benefit there is in this method of help, can as nearly as possible, be made permanent. What then remains but to bring the book into line with immediate interests and to rename it “American Nerves and the Se- cret of Suggestion”? A. S. D. CONTENTS PART ONE PAQB Why Conspiracy? 3 The Conspirators 8 The Victim 10 Experience in Nerves 13 Nerves and Personality 16 Indulgence 18 Roughness 20 The Hysteric 22 Emotional Conflict 24 The Hardy Doctrine 27 Recognizing Nervous Suffering 29 Willingness to Suffer 32 The Call to Courage 36 The Futile Appeal to Will 38 The Turtle on Its Back 40 Imaginary Suffering 43 Dual Personality 46 Neurotic Selfishness 48 The “Moral Element” 51 Conspiracy PART TWO Self-Help Autosuggestion 57 The Submerged Self 59 Self-Hypnosis 61 CONTENTS PAGE Controlled Suggestibility 63 The Unstable Mind 65 Cou£ and His Critics 67 “Self-Deception” 70 “Exemption Blindness” 71 Undeceiving Oneself 73 “Shell-Shock” 741 Peace Neurosis ............ 78 The Flexible Mind 81 Dangers 84 A Case of Over-Stimulation 87 Temporary Results 89 Discouragement 91 Organic Disease and Suggestion 94 A Case of Functional Deformity 96 Suggestion and Medicine 98 ‘ * Americ anitis ” 101 Imagination and Intelligence 103 The Reasonableness of Suggestion .... 106 PART THREE Cooperation Psychoanalysis HI Self-Analysis 114 “Comrade, Here Is My Neck” 118 A Path to the Seat of Trouble 121 A Psychologic Friend 124 A Physiologic Friend 126 The Secret of Suggestion 130 Servants and Friends 133 People Who “Can’t” 138 Weakening the Will 142 Strengthening the Will 145 Indirect Suggestion 148 Direct Suggestion 150 CONTENTS PAGE Friendly Cooperation ........ 153 Nature’s Way * 156 “The Primal Rest” 157 Analysis and Suggestion 160 The Use of Dreams 163 Blind Effort 167 Painful Analysis 169 Soothing by Suggestion 172 Analysis and Synthesis 174 Failures 177 The Argument for Rest 180 The Forward Look PART FOUR The Time-Fuse 185 A Case of Nerve-Shock 187 Responsibility 190 Independence 192 “The Flight from Life” ........ 195 Egotism 199 The Farmerette 201 Self-Consciousness 203 Nerves and Food 205 Occupation 208 The Pattern and the Peacock 211 Hand and Mind 213 Program 216 Adaptation 220 Indirection 222 The Power of Choice 225 Opposition 229 A Tribute 232 Fluidity 236 Detachment 238 The Religious Craving 240 CONTENTS PAGE Natural Religion 243 Appropriating Health 245 The Little Smiling Clown 248 The Knife Juggler 251 An Anchor out to Windward 254 PART ONE CONSPIRACY American Nerves and the Secret of Suggestion PART ONE CONSPIRACY Why Conspiracy? When a person is suffering from functional neurosis two things are of importance: the pa- tient’s condition and what he thinks about it. And sometimes what he thinks about it is more important than his condition. This statement or its practical equivalent is made by Dr. Herbert Hall, an eminent neurologist, after years of suc- cessful experience with nervous conditions. “If I said that, it was in reaction to something,” replied a man whose own words were recently quoted to him. One surmises Dr. Hall’s state- ment must have been made “in reaction to some- thing,” and one further surmises that something to have been what one of its self-styled “victims” 3 4 AMERICAN NERVES ■semi-humorously refers to as “the conspiracy against nerves.’’ In a natural intercourse with “the family” which results from the more or less intimate rela- tion of a psychologist to the nervous member, one observes how almost inevitably they either under- estimate the nervous condition or else rush to an extreme “scare” interpretation of it, especially if the existence of “mental” symptoms is sug- gested by the physician. They are inclined either to ignore or to assume something like a suspicious attitude. There is a tendency to misinterpret even simple remarks. They observe every move- ment of the patient though no one has suggested any necessity for close watching. In the kindest spirit in the world they patronize and they sweep aside. It takes a trained brain- center apparently to understand that a mind can be even seridusly disordered at one or more points and yet be perfectly normal at every other point. The only thing that is disproportionate beyond the outstanding depression or impulsion or obsession is a great supersensitiveness toward being treated normally as far as the mind is normal. The unconscious assumption seems to be that when a mind is in any way even slightly and temporarily disordered it becomes inferior, CONSPIRACY 5 and therefore it doesn’t make much difference how you treat it. The nervously or mentally supersensitive per- son needs to be handled with the most discriminat- ing care. He requires and deserves more cour- teous consideration than all the rest of the family put together. This does not mean a quantity of fussy attention which relegates him to the class of the nonentity or the incubus or the imbecile. It means a very fine quality of discrimination in adjusting everything you do to his mental need'. It is not easy. It is not even hard. It is im- possible. Try as you will, you will be likely to fail most of the time, but that is no reason for giving up. It is a reason for trying, not harder, but more carefully, more understandingly. It offers a wonderful educational opportunity. You can, if you will, learn enormously about human nature. It is the very kind and perfectly well-intentioned determination on the part of family and friends to take the best care of the patient, to get him well quickly, that either in its assiduous excess or its studied neglect presently begins to assume to the supersensitive mind of the patient the pro- portions of a conspiracy. He is being plotted againsfi He is not allowed to get well in his own 6 AMERICAN NERVES way. He is not even allowed to be ill in his own way. He must da it in every one’s way but his own till he is driven in half-humorous despair to exclaim, as I heard him recently, “Whose dog am I, anyway ?9 9 Plots and counter-plots forced upon him till he remarks, ‘ ‘ Remember I am still human, though nervous!” Quite appropriately in such a case the faithful physician’s valued opinion has first consideration. But there is inevitably superadded mother’s opinion or sister’s idea, possibly brother’s obser- vations, and quite casually father’s practical com- ments must be reckoned with. And there sits the innocent cause of it all, the sufferer, the victim, the double victim, victim of his own nerves and of the family conspiracy as well. If he speaks or she speaks, it is often considered just another “symptom,” whatever may be said, and little or no attention is given the matter. Very often the well and courageous side of the only partially ill mind sees that the situation is humorous and gives an understanding person in the background an indulgent wink, saying: “Aren’t they funny and dear? They want so much to help, and they understand so little. You know, it gives me that insane-asylum feeling. ” In CONSPIRACY 7 less fortunate cases the sense of humor is sub- merged, and the mind knows only perplexity and distress. The inside disturbance, the feeling of in- adequacy or indecision or confusion, so common in nervous ailments, which the family and friends may know about but do not experience or understand, is a bad background for a further confusion caused by the group about the patient. One confusion alone is bad enough but two con- fusions together, one inside and one outside, make a sorry combination and provide a strange total of distressing impressions. It is little wonder that permanently disordered minds do get fixed ideas of conspiracies and conspirators, or that minds only functionally disturbed express feel- ings akin to these delusions. “Nobody understands. I wish they would go away and leave me alone. I might get well by myself; but all this is simply impossible. It is all the worse because I suppose they mean well, though sometimes it seems as though everything they do is just for the sake of making it harder. “I am never allowed to talk about myself, and they won’t talk to me about my condition, which is to me the only important thing in the world 8 AMERICAN NERVES just now. It seems almost like another con- spiracy, a conspiracy of silence, which is perhaps the hardest part of the whole thing.’’ The Conspirators They begin at 7 a. m. before yon are out of bed. Naturally enough, mother is the first one. She calls you very early. She tells you at length just what to say to the victim when she keeps her eleven o’clock appointment. When the appoint- ment is kept, sister comes with her and makes a sign to you, surreptitiously, which the victim of course sees, to step out in the hall and have a little interview with her. She tells you everything you knew before, things that have nothing to do with the case. When brother goes out to luncheon down town he steps into a booth and calls you up to say that this is getting awfully on mother’s nerves and 11 Can’t you really do something about it V ’ Then father stops in on his way up town and releases some of the repressed family nervousness to the effect that he never expected to have what any one could call a disordered mind under his roof. “Can’t you get her interested in some young man? Wouldn’t she be better if she was married? If she would just make herself agree- CONSPIRACY 9 able and get out and have a good time! She doesn’t seem to be a very good mixer. Can’t you help her to get along better with people?” “Perhaps. That is what we are trying to do. All these troubles are just the sign that she is ill. You know the doctors said they judged very largely of a patient’s condition by her adapt- ability. ’ ’ “Well, if she’d just buck up I think she’d be better. ’ ’ ‘ ‘ Do you ? I think if she were better she would ‘just buck up.’ ” And in the meantime the conspiracy goes on at home. Though the patient has fits of depression, the doctor has said she was in no danger of doing any harm to herself or any one else—leave her alone if she prefers to be alone. With a dozen brilliant electric lights on in the parlor and brother jazzing at the piano the ob- ject of attention quietly leaves the room and goes up-stairs. Upon a little telegraphic signal from mother, sister tiptoes into the hall and up a few steps of the stair and stretches her neck to make sure just what “she” is doing, which kindly little at- tention the person who is being “shadowed” sees (as she always does see). The patient is only 10 AMERICAN NERVES planning to have a half-hour’s quiet enjoyment with a book before nearly all the family comes to put her to bed, though she is perfectly capable of going by herself. The Victim She is young, very often a year or so out of boarding-school or college, with perhaps a faulty nervous constitution which served well enough in the routine of institutional life when she was controlled from outside, but not taught to be a law unto herself. The removal of the framework of life that held her steady—desultory days, doubtless late hours, a love-affair or two that did not go right, or, worse, no love-affair at all when normally there should have been one—this or something like it —it does not matter what—has had a disorganiz- ing effect. There are cumulative results, and suddenly sleepless nights or crying “spells’’ or fits of depression or an antipathy to some member of the family—very likely her mother. She is tired all the time; she can’t do anything; she has an unreal feeling, etc. There is all of life before her, and the thought brings a haunting fear, a sense of inadequacy. CONSPIRACY 11 What is she here for? All of life! She can’t look forward. And, worst of all, she says she has no feeling, no emotional reactions. She ex- presses all the proper sentiments but does not feel any of them; she is dead, unresponsive inside. Her brother’s baby dies, and all in her little circle are overwhelmed with sympathy for him and grief for themselves. She does not feel any of it. She tells herself when she lies awake at night and thinks about it that really she does not care at all. She ought to care but she does not. Is it not dreadful! How awful it would be if they knew. What if she told them? She must not tell them, of course; but was she becoming a hypocrite? How dreadful, no feeling! and a hypocrite. Yet she was able to feel, for she felt it to be dreadful. But feeling didn’t mean any- thing to her, and there it was! Strange that without feeling she cried all the time! No, she did not cry. She had nothing to do with it. “It cried” in just the way in which “it rained.” It is all like this, or else it is different. The victim is a husky lad, just home from college, and, after all plans were made for him to go into father’s office, something snapped and everything 12 AMERICAN NERVES went wrong. Nerves! he always thought nerves were fool things for women and children. “Me fainting at a dance! Disgusting! ’’ Or else the victim is the happy young mother of a family of very important children who can’t possibly spare her to go to a sanatorium, or she is a mature woman in the dangerous forties, or the man of affairs at that masculine dangerous age about sixty-four. But, whoever or whatever, this is the way the kind conspirators talk to him: “Never mind, dear! Let’s not think about it now. Suppose I read to you. Won’t you lie down? Oh, I guess perhaps you slept a little more than you think you did!” These banalities in the face of abso- lute despair, of a particular or a general anguish which overwhelms the soul and from which there seems to be no retreat. Is it a wonder that mental pain, which is so little understood, which meets only rebuff, some- times becomes more silent, appears more stub- born, more withdrawn, and often more and more inaccessible? The conspiracy, which began in an ignorant kindness, has woven such a mesh of misunder- standing about the sufferer that life seems clos- ing in upon him in utter blank despair. CONSPIRACY 13 The substitute for this well intentioned but un- comprehending conspiracy is not an emotional but an understanding sympathy. This sympathy is made possible and in a sense easy by at least a partial understanding of the simple natural principles of psychologic activity through which the disorganized nerves may be brought again, if such a thing is possible, to self- possession and self-control; but one must have something more than emotional sympathy to help. Talking to these sufferers as though they were poor abused people and leaving it at that is not what we mean by sympathy. It is bad. It is of course forbidden by all good physicians. But denying them the harmful thing is a negative help. It does not supply them with the upbuild- ing influence they need. Neither is a rush to the opposite extreme allowable. Refusal to sympa- thize at all is almost worse. It is probably more harmful than even an overdone sympathy. Untimely silences, impatience, superiority, pat- ronage, and ill-suppressed sneers are of the essence of spiritual brutality. Experience in Nerves When the novice in a chosen field of interest proposes to become a master, he begins at the 14 AMERICAN NERVES bottom and works up. That is what a person, should do who even undertakes to help nervous people. He should begin by being a nervous sufferer himself. It may be well for him to be a constitutional neurotic, to have his trouble born in him and find some phase of it requiring to be dealt with all the time. He may be chronic, though not too severe a case, and he should catch himself early. He should learn all he can about reclaiming himself, go as far as he can by him- self, and get all the kinds of help he can from others. When he goes to the rescue of one who is tread- ing the wine-press alone, it is well if he can say, “I, too, have trod the wine-press alone.” “You know—then, you know? You have been through this and you came out? Then perhaps I can escape if you will just give me a hand and hold hard for a little.” Even when one has been initiated through suffering,—even though it was such pain as burned itself into the soul so that it seemed one could never get quite free, never escape the mem- ory of it,—when all is over one does often and mercifully forget. And, if one having been through such experience can forget, how should CONSPIRACY 15 one never having suffered it be expected to under- stand? How can we ask him to find his way in the strange and alien paths which the nervous sufferer must tread? One who has not expe- rienced cannot understand. More and more, scientific men are declaring that the secret of nervous disorder is not to be found in the structure of the nerve or in the organ itself. Nervous disorders are disorders of personality, of the self, and exist in the psychologic field in the realm of the human spirit, and the naturally “interior-minded” person is the one to render help here. Understanding requires power to discriminate spiritual values. Persons do exist who are able, either through experience or through some natural ability for understanding, seriously to accept the fact that pain in the mind can be more excruciating than pain in the body or that there can even be a real pain in the mind referred to some part of the body when no immediate occasion is provided by the body. We face the arresting fact that the boy whose feet were amputated and buried in the cemetery ten miles distant could lie awake all night with a sense of pain in his feet. An old 16 AMERICAN NERVES pain automatically continued in the brain cen- ters was just as real as though the feet them- selves had been there in which to locate the suf- fering. The principle of psychologic activity underly- ing such facts as this, if fully realized, would entirely transform the general attitude toward the nervous person. This principle has been recognized, accepted, for years, yet its far-reach- ing implications for suffering as well as for saving power have been largely ignored. Nerves and Personality Nervous disorders have been approached by the objectively trained mind through a long past from the physiologic point of view. That point of view has shed little light. Modern scientific opinion asserts that nervous trouble is almost never a matter of physiology. Those who suffer discover it to be a matter of psychology, of the naked, intimate, essential self. Nervous distress occurs at the fine point where you are most excruciatingly yourself, your stripped, raw self. It is difficult for the healthy or the phlegmatic to believe that there are many persons truly ill CONSPIRACY 17 with nerves. However they may look on the out- side,—rosy cheeks, bright eyes, perhaps,—inside, they are confused, decentered, disorganized, unable to help themselves, unable even to get a grip on themselves or to approach themselves at any point where a beginning may be made. Floundering in a very sea of impotence and despair, catching at straws like the drowning man, they need some one to row out to them in a safe little boat, lay hands on them, lift them, bring them to shore, and set them on their feet again. Not only that, but to lend a steadying hand while they stumble up the beach and take time gradually to find themselves in control of their powers. They need some one to stand by, not until “the other person” feels, but until they themselves feel that they are again in control and can take themselves back into their own keeping. This consideration must be granted. Upon an understanding cooperation the sacred- ness of all suffering personalities makes a right- eous demand. They need to be met with patience and a willingness to study their ability for ad- justment, their power of endurance, to find out how far they can go without discouragement. They deserve a willingness on some one’s part to 18 AMERICAN NERVES assist them in rebuilding themselves bit by bit like an organism that has been shattered and must be reconstructed, balanced, and organized till it recovers its old self-reliant and independent strength. Indulgence It is surely made sufficiently plain that no weak indulgence should be extended to the nervous per- son. Emotional sympathy—which leads nowhere, it cannot be too often repeated—is one of the most disintegrating things that could happen to him. Avoidance of the other extreme means elimination of harshness, roughness, sternness, or a forced appeal to the will. The person who con- ceives of either indulgence or harshness as the only means to be used should be despatched as far as the poles from the unfortunate nervous sufferer. The victim of nerves craves indulgence. The nervous sufferer longs for sympathy. Oceans of pity and commiseration would seem not to be enough to satisfy his insatiable appetite. At least, so it appears to the normal person who is called upon to provide this sympathy. But why should we have such unlimited confidence in our own inexpert impression? Why should we be so CONSPIRACY 19 arrogantly sure that a few pacifying words from us should put everything right? There is, let us say, something radically wrong inside; something has “slipped’’ in an exquisitely delicate piece of mental machinery. The inherent principle of coordination, or harmonious working is interrupted. The raw spiritual fibers are shrieking in pain, continuous pain, that will not abate, and see no way of escape. And you babble with a bland smile: “Never mind, dear, try not to think about it. Perhaps you ’ll feel better soon!” The nervous sufferer wants at heart not to be indulged but to be understood. Sometimes he is so confused that he does not know this himself and believes you when in your inexperience you tell him that he should not think about himself. And he blames himself and tries not to do it, though he knows and knows he knows that some- thing deep is wrong, very wrong, and should be understood, should be investigated, should be made right. Would a kind mother or nurse say cheerfully to a child screaming from the pain of even a pin- prick: “There, dear! never mind! try not to thing about it. You’d feel better if you’d try not to think about it. Perhaps it doesn’t hurt 20 AMERICAN NERVES quite so much as you think it does!” No, indeed; she investigates the seat of the trouble at once and takes steps to afford relief. Roughness The wisdom which has decreed that nervous persons must not be indulged has been misunder- stood by those who go from one extreme to the other. They are usually persons who have had little occasion to give attention to educational methods. They are unfamiliar with the processes of mind integration. They are not acquainted with the principles underlying the normal mental life. The average person doubtless knows the fact that in dealing with a young mind, an unorganized or a disorgan- ized mind, it may best be approached from its own point of view. It deserves that a natural point of contact should be found as a point of de- parture for whatever process one wishes to initi- ate. Knowing this fact is something, but how to get the point of contact is another matter. This needs experience. So far as my observation goes, there is no one so well fitted to deal with the disorganized nerv- ous mind as the teacher, the real teacher, of CONSPIRACY 21 little children—one who has been happy enough to learn the real psychologic principles of educa- tion. Such teachers are few enough; but, thank God, they do exist, and they are most likely to be found among good kindergartners. The person who has no knowledge of normal mental growth or of automatic mental processes, nor the fortitude that comes from intelligent deal- ing with children, has little equipment for dealing with nerves. Intuition, the almost startling capacity for un- conscious discrimination in the disorganized mind, is sometimes very keen. Even without knowing he knows, he does know and he despises a person who shows stupidity in dealing with him. He may remain silent. He often does, being infi- nitely more discouraged with our “hopelessness” than we are with his. The picture rises before me of a young lad whose mind had been set awry and was struggling to find itself. His action was slow and confused, and a trained attendant, an “expert” of mature years, laid hands upon him in an impatient effort to hurry him. The supersensitive chin went into the air; the head was raised in princely fashion: no word was spoken, but the disdainful eyes said, 22 AMERICAN NERVES “You stupid creature! how dare you touch me?” The nysteric—though hardly any one knows at the moment, except perhaps the Freudian, just what a hysteric is—may be excluded from the class of neurotics who do not profit by hardy methods, by occasional severity, though the fact that these are sometimes successful does not give license in their use. The reason why a stern tone, an unexpectedly firm manner, does help the so-called hysteric in moments when self-control is lost, need not be misunderstood. It is not and never will be be- cause roughness or harshness is deserved by nerv- ous people. It is only because of the value of a shock or “jolt” to shift the disorganized mind back into self-control. A woman of characteristic dignity and self- respect has in a moment of hysterical outbreak been promptly rolled over in bed and spanked in all seriousness and for the best therapeutic reason. This is no subject for a jest and the person who takes it humorously has momentarily lost his scientific point of view. On a summer evening, with the windows open, the patient in question had been screaming so that The Hysteric CONSPIRACY 23 she could be heard for blocks. The neighbors would talk about it to-morrow and she would be mortified. Having received a sharp spanking, which doubtless inflicted as much physical pain on the administrator as on the recipient, she was turned back to a normal position and a careful explanation was made to her. Her screams ceased at once, and she listened with attention and interest and apparent understanding. “Of course I didn’t spank you to punish you. You are not a naughty child. However, that paroxysm of screaming having begun, I saw that it had become automatic and you could not well stop it by yourself. You are a dignified and self- respecting woman, and you would presently re- gret having lost your self-control in this way and having aroused criticism on the part of persons who could not understand you. “The sharp blows shocked your nerves back into your control again. This might have been done in some other way. You might have had a pitcher of cold water poured over you, but that would have caused you discomfort and made you trouble, and this seemed a better way(i Wasn’t it? And you do feel better, don’t you?” “Yes, indeed, I do. I’m so quiet and comfort- able now. Wasn’t it dreadful? What made me 24 AMERICAN NERVES do it? I am ashamed, and I thank you so much for helping me.” Not a word of resentment, only appreciation, because in addition to the shock she was given such an explanation as a rational person deserved. Her family said that her recovering from a long illness, the nervous “end result*’ of an operation, began from that hour. A wise person is very careful, however, that he does not go about the country spanking hysterics. A public school teacher who thought himself to be dealing with a hysteric who needed steadying made a mistake. A spanking was administered but failed to have the desired effect, and the schoolmaster was arrested for assault. Emotional Conflict One common cause of distress in functional nervous conditions is the emotional confusion and conflict caused by opposing mental states. In many nervous cases there is a state approaching what is called a splitting of the personality, so that one portion of the self stands over against the other portion. The well part of the mind is able to judge and estimate the conduct of the other part, the sick part, which is misbehaving. The normal phase of the self is amazed to see CONSPIRACY 25 how the disordered part misconducts itself. It regrets such behavior just as the friends or the family do. It feels that it should be controlled. It wishes to exercise control. It condemns it- self for not getting into action and doing some- thing about it. But, alas! this is not so easy as it appears. Between the two parts of the self, the judging self and the misbehaving self, there is a great gulf fixed, a chasm which there seems no way of bridg- ing. There seems to be no place to begin, no point of contact. One section of the personality cannot get into operation regarding the other section. Or, if things do seem to get into opera- tion, even with one’s best efforts nothing happens. Sometimes this condition is spoken of as a disease of the will. That term could not have been applied by a psychologist or any one at home with ‘‘the things of the mind.” The will is not always in these conditions inactive*. It works; but it somehow does n’t get hold. It cannot pro- duce results. A great deal more sincere effort of will can go into some failures than would be required to bring in some cases very easy suc- cesses. An outsider cannot know how much effort has been made. Some of these dissociated or disorganized per- 26 AMERICAN NERVES sonalities will lament: “I have tried and tried and tried, and I cannot succeed. I know I ought to, but I can’t.’y We should believe them. They have tried harder perhaps than you or I have ever been called upon to try in all our lives. They have made heroic, noble, continuous effort, and they have failed because the two parts of the self were not working together. The dissociated person is very often quite in- telligent enough to understand this if it is ex- plained to him. Sometimes the dissociation is so slight that the very relaxation which comes from being relieved of the unnatural responsibility it had voluntarily assumed will give just the oppor- tunity the mind needs to readjust itself. The over-conscientious mind pulls down an un- merited burden of responsibility upon its own head. For, say what you will about the selfish- ness and the self-indulgence of neurotic minds, these people are nearly always conscientious (really not abnormally),—ready to condemn them- selves, determined to right themselves,—making pitifully futile efforts because they are not wisely helped to self-management. The wholly disordered mind, the field of whose consciousness is entirely covered by some obses- sion or delusion, may suffer less than the split CONSPIRACY 27 consciousness at odds with itself—two portions of one self in conflict with one another. Is it any wonder that the anguish of emotional con- flict in dissociated minds gave rise before the days of modern psychology to the idea of demoniacal possession! There is a school of thinkers which believes that if yon treat a person as though he were tough he will become tough. Some people can be tough- ened, and some die in the process. If you treat a tender plant as you would a hardy one, you kill it. Minds so mistreated fare little better. Professor James divided people into two classes, the “tough minded’’ and the “tender minded,” and woe be to the naturally tender- minded person who falls into the hands of the naturally “tough-minded” person. Because the hardier mind feels so and so, it assumes that every one must feel so and so. Because he can go blun- dering and stumbling about among the tender- minded sensibilities and not know that he is in- flicting pain, the quivering sufferer should not be hurt. “You ’retoo sensitive! You ’re too sensitive!” How often has this taunt been flung at the victim The Hardy Doctrine 28 AMERICAN NERVES of some tough-minded person’s obtuseness? Just as though the suffering person said: “Go to, now; I’m going to be sensitive. I’m going to be hurt.” The tender-minded do not enjoy pain any more than the tough-minded. Yes, I know all about “assets” and “defense reactions,” but theoretically at least they are not conscious choices. They are unconscious substitutions; and even if or when they are conscious they are not chosen because one “enjoys” suffering. They are chosen, observe, as the lesser of two evils as substitutes for other kinds of suffering which, because of repression, are unable to give them- selves relief. One evidently needs to be a seasoned psycholo- gist in order to know, not only for the moment but to keep on knowing, to realize and to make practical application of the fact that the func- tional nervous disturbance is in its origin uncon- scious. It is disturbing precisely because its cause is hidden, blind, submerged, outside the field of consciousness. The patient will ration- alize his feelings and behavior; that is, find a plausible reason for it, one which suits him, and suits him exactly because it is not the right one. He is all unconsciously the victim of self-decep- CONSPIRACY 29 tion, which in complete innocence he is practising upon himself. Giving a person in this condition a hook on psychoanalysis to read or a set of rules to incor- porate into his daily life is psychologically a con- tradiction of the very theory these methods pro- fess to teach and may make, in fact has in specific cases made, more trouble than it saved. One who is tough-minded and not very badly off may be helped in this way, and this is very fortunate. Let us help all the people we can in all the ways we can; but let us not apply the hardy method to the person who with the best intention in the world finds himself crushed by it. Because some one whom he supposes to be wiser than he offers it and expects him to be helped by it, he thinks he should be helped by it. He pursues the new method faithfully but finds himself in the end worse off instead of better, having added de- spair to the discouragement of his already failing efforts. JRecognizing Nervous Suffering Here behind the scenes there is a keen con- sciousness of just how unpopular much of all this may be with many of those who have never ex- perienced nervous suffering, although the nerv- 30 AMERICAN NERVES ous person will perhaps be grateful that ac- knowledgment is made of the pain which he most courageously bears. By this time it may have become evident that I am not avoiding the use of the word suffering, which one might be supposed to do. It may be because we have sometimes been unwilling to give due recognition to the suffering of others, though we do not hesitate to acclaim our own, that this idea of a conspiracy against nerves has come about. The word “conspiracy” was advisedly taken from the lips of a “victim” because it is some- times employed by those in whom pain and lack of understanding have bred suspicion and because it is indicative of some serious mental conditions. It does not seem impossible that some disordered minds are turned toward the imagination of con- spiracies against them just because many of those who are supposed to help seem to be doing many things to hinder. A patient suffering from functional nervous conditions has been told often and often, “There is nothing the matter with you,” when he knows perfectly well that there is something the matter with him. From the point of view from which the statement is made, it is perfectly true and en- tirely justifiable. There is nothing the matte? CONSPIRACY 31 with him, nothing physical. That statement made after a careful physician’s examination means that there is no organic disease which needs medi- cal treatment. Functional conditions have in the past been too often looked upon as negative conditions. A medical specialist who believed in psycho-thera- peutic methods as used by the trained psychologist in connection with medical care said to a psychol- ogist who worked with him: “Here is a patient whom I have been trying to send to you, but she won’t go. What shall I say to her ? ’ ’ “What did you say to her?” “I told her that aside from the trouble I was taking care of there was nothing wrong and that she would better go to you and let you straighten her out.” Why straighten her out if nothing is wrong? Why pay another fee to another person if there was nothing the matter? Why should not the natural statement be: “There are two things wrong with you. One is in my field, and one is n’t. One I am taking care of, and, if you will go to this psychologist and have the other looked after, between the two of us we can put you right in half the time.” This explanation seems only reasonable. It is 32 AMERICAN NERVES owed to the intelligent nervous patient. There is no more cause for thinking that selfishness and self-indulgence are at the bottom of a nervous person’s desire to have his woes recognized than there is to assume the person with physical ail- ments to be selfish and self-indulgent because he asks understanding and help. In fact, the desire to have illness of any kind recognized and dealt with is a sign of a certain degree of normality. A man is surely very ill if he is too ill to know he is ill or to wish to get better. There is no such desperate condition as that of the person who has the inward sense of malaise, who knows himself to be nervously ill, disqualified, but with nothing to prove it, nothing to show for it, as it were. I have heard those suffering with nerves cry aloud in an anguish of despair, “Oh, if I could have typhoid fever or smallpox or a cancer, some- thing, anything, that could be seen, that would in the family’s eyes justify my feeling miserable, ex- cuse my going to bed, call for an operation, or be a visible reason why I need to be taken care of!” Willingness to Suffer This complaint does not mean that the patient wants to be sick. It means that he wants to be well. It means that he wants an opportunity CONSPIRACY 33 to set the process of getting well into operation. The almost uncanny intuitional wisdom which so often goes with the neurotic temperament gives a strangely philosophic resignation to his suffer- ing when suffering is necessary. But the normal portion of the dissociated self is somehow nearly always and truly convinced that it is not nec- essary that he should be ill. I know of no greater courage of endurance than has been exhibited by nervous sufferers who see a possible lifetime of continuous nervous torture stretching away before them into the years. An instructor in the Bomance languages in one of our great universities fell into a supersensi- tive nervous condition. In the pursuit of his pro- fession, he had spent years in scrutinizing every intonation of his speech and bringing it to perfec- tion. As he was notably proficient in the Spanish language, he was expert in lisping the Spanish ‘1 s.91 This had made him especially acute regard- ing that particular consonant. He said: ‘ ‘ Every time I hear a harsh or over-emphasized ‘s,’ as I do constantly on the streets and elsewhere, it gives me an acute pain. It hurts. It’s like a sharp stab of real physical suffering. This goes on all day every day whenever I hear people talk, and I must bear it; but if I should try to explain 34 AMERICAN NERVES it to the average person how impossible it would be for him to understand! I must just endure it, and, not only that, I must try to smile while I am doing it, smile for the people who do not under- stand.” Much less often among the mental than among the physical sufferers do we meet that type of personal resentment which demands, “Why should this happen to me?” I have heard the expression from deaf people, blind people, crip- ples, those suffering from chronic physical disease. I do not recall that I have ever met this assump- tion of injustice and inflicted outrage on the part of a nervous sufferer. This statement is made bearing fully in mind and clearly distinguishing the weak acquiescence, the too ready adaptability, the patience of the neu- rotic which is not a virtue but a symptom. The thing referred to is something quite different. Making a point of this willingness to bear, to culti- vate endurance on the part of the nervous person, does not imply an over-indulgent attitude toward him, but it is necessary to understanding. The normal mind is in favor of a willing accep- tance of that suffering which rightfully belongs to it—the fortitude which bears, as cheerfully as it may, distresses which are inevitable in whatso- CONSPIRACY 35 ever form they may appear. It is largely a matter of habit whether we are able to endure when trial comes—of habit in onr attitude toward ourselves. Capacity for endurance is very often determined by our habitual expectation, by what we have been wont to claim as our right from the powers that be. If in our own thought we have made exceptions of ourselves, if we have indulgently singled our- selves out from others, if it has seemed right enough that trouble or pain should come to the man around the corner or some distant relative or our brother or sister but not to us, then we are very likely to go down, under adversity. It is safe to think of ourselves as naturally open to such a universal experience as suffering but as having something within us which is equal to any emergency. Call it what you may, register with yourself that it is there and that when crises come yon will call upon it and it will answer. It will fortify your power of endurance. One cannot repeat too often the heartening in- cident of the man who in the height of his career was stricken with paralysis of the legs. Word went about among his friends of his distress. His comrades, full-blooded, strong, and fit, said, “How dreadful! but we must do the decent thing, 36 AMERICAN NERVES of course, and go and see him when we are allowed.” His nearest friend took his courage in his hands and, as he entered the sick-room, in his embarrassment stammered out the old familiar formula, “Well, how are you?” and the ringing answer came back from the nearly helpless man, “I am all right and bigger than anything that can happen to me. ’ ’ Some natural philosopher has said, “It isn’t trouble that counts; it’s the way you take it.” The Call to Courage One is seldom bored by having the sane and fortifying doctrine of courage preached to him, if he possess a self which is in working order to come to his rescue. But what if his self is split in two? What if the thing he has courage with is disintegrated and so for practical purposes not there? It is like trying to lift oneself by one’s own boot-straps, a discouraging effort. He tries and tries and tries, but he cannot lift. Nothing happens. His best efforts fail, and what next? Nothing next. But he has done his level best, gone his limit, and there is his life before him and nothing, nothing, nothing in the way of help— just this dreary waste or this unutterable fatigue or this haunting fear or that besetting impulsion CONSPIRACY 37 or this horrible distress, and no one to under- stand, no one to help. It can’t be put into words, and, if one tries, the words seem to convey no meaning. They seem like a foreign tongue to those who only appear to listen. And there one is, thrown back upon oneself again, and the same old dreary round of failing effort. Because the functional nervous condition has become automatic, is carried on outside the field of will, beyond the field of consciousness, the will without some unusual stimulus simply cannot handle it. The volition reaches out over the chasm between the two parts of the self, but it cannot bridge the chasm. Every such failure causes the normal rational part of the mind to register, “I can’t; I can’t; I can’t”; and that conviction which is sincere and definite in its ex- pression, strengthens and “fixates” the trouble- some automatic habit, whatever it may be. Each failure pushes the thing to be handled still further away. It anchors it beyond reach, and it widens the chasm. Because of this simple psychologic fact, familiar enough to those who are at home with the “things of the mind,” Dr. Hall, already quoted, has said in one of his help- ful little books, that in such cases a deliberate effort of will helps not at all and it very often 38 AMERICAN NERVES hinders. It hinders just precisely because the patient’s sincere protest only emphasizes the bad habit, and widens the breach between the will and the thing it is trying to grasp. All this means that it is a rather precarious undertaking to appeal to the nervous patient to arouse his courage and use his willi. One needs to be more expert than almost any human can be to know when the appeal to will should be made. The probability is that if a nervous invalid is able to make the effort at your suggestion he would have made it without your prompting. You may prod the inert or the timorous or the shrinking person and get no response. You cannot know when in the depth of his inner self he is only add- ing to, definitely building up by his inner protest to your unwise appeal, the very obstacle to action which is hidden away in the unconscious. The person who can respond easily to suggestion, his own or some other person’s, is probably fairly near to normal, and so hardly within the class of cases we are considering. The Futile Appeal to Will Conditions under which an appeal to the will proves to be futile are illustrated by the case of CONSPIRACY 39 a physically healthy but mentally disturbed youth who for reasons of his own took to his bed and turned his face to the wall. A physician and nurse were in attendance. The physician said to the nurse: “The patient is just as well able to come and see me as I to come and see him. Get him to come. Keep his coming as an objective before his mind. Mention it to him every day until he does it.” There was a psychologist on the case using suggestion in its technical form addressed to the unconscious mind in the dissoci- ated state. The psychologist said to the nurse: “As a matter of professional courtesy, I can- not countermand the physician’s order; but the strong probability is that when the patient gets into action he will not go to the doctor’s office, and your urging it will perhaps delay his doing something else. Though he may not protest aloud when he refuses your appeal, he will silently register a protest in his mind which will strengthen the inner tendency already opposed to action. “If I have success in the work I am trying to do, it will be by stimulating the natural impulse toward activity, though not by suggesting any particular course. It will be through the libera- 40 AMERICAN NERVES tion of inhibited motor processes, the stimulation to old familiar lines of action, and a spontaneous desire to return to normal life again.” After ten days the young man sat up in bed and said, “I am going to the movies,” a thing he had not done for two years. He did not go to the doctor’s office or make any mention of doing so and he did go to the movies. The psychology of this case seems simple enough. Understanding and application of the principle involved saves a deal of nagging, which helps no one except perhaps the nagger. It does not take long to discover whether the appeal to will works in such cases. If it does not elicit a rather quick response it may prove irritating and harmful. The Turtle on Its Back A simile which seems to represent the in- ability of some nervous people to help themselves is that of the turtle on his back. He rocks to and fro in aimless gyrations, stretching and straining himself hopelessly in an effort to connect with something that will give him a purchase, some- thing to get his claws into. But as far as he is concerned he might be rocking in infinite space. The ground beneath him might be non-existent CONSPIRACY 41 so far as it gives him any help; with eyes look- ing out upon an inverted world, confused, per- plexed, an unfathomable mystery is here. Why doesn’t something happen! Why when he writhes and twists in his perfectly sincere attempt to establish relations with life, why is there no result ? Unless he is a quite modern turtle in closer touch with current thought than with the ground, he is not likely to know the full significance of the word “inhibited.” He should look it up in his dictionary; but how, on his back, can he? He can’t precisely because he is accurately illustrat- ing the word at the moment. He is inhibited. He has lost his contact. He is a “dead connec- tion. ’ ’ Along comes a kind friend and gibes at him: “Oh, I guess you could turn over if you really wanted to, if you’d just make one really good effort!” The next person who passes by on the other side says, because he has not time or inclination to help: “It’s all up to you. No one can help you but yourself.” Then comes the good Samaritan who sees with half an eye what is needed and has a little mercy. He extends his foot, lifts the poor beast with his 42 AMERICAN NERVES toe, and flips him over. The helpless claws scramble into connection with Mother Earth. His contact is made again, and he drops back into the old motor habits of his accustomed life once more. There is no implication that neurotic inhibi- tion is as easily liberated as the turtle’s was, and yet some cases are almost as simple. "We are reading still how the returned soldiers suffering from the war neurosis known as “shell-shock” were almost instantly jolted back into normal con- dition by one good laugh at a moving picture show. There is our dear friend of that time-worn illustration, the bed-ridden woman, who suddenly acquired the ability to run down-stairs when the house was on fire. There is a case on record of a man who had suffered with nervous pain in his head for thirty years and was entirely relieved by an experience which lasted not more than ten minutes. “But wouldn’t the turtle turn himself over after a bit, and do not these nervous conditions work themselves off in time?” “Yes, you human brute, sometimes; not always. The stabbing pin would work out of the baby CONSPIRACY 43 in time, perhaps. Your howling toothache would pass off in a week, as the dentist might casually remind you if he wasn’t intelligent about taking your tooth out.” Dr. Du Bois, after recommending the philo- sophic acceptance of pain and suffering, adds this pertinent remark: “Remember that this philo- sophic attitude is most appropriately assumed, not toward other people’s suffering, but toward your own.” Imaginary Suffering There is no such thing as imaginary suffering. Suffering is measured by thought and feeling. A person suffers precisely as much as he thinks he does. An even elementary knowledge of mental states should teach us this. It is inexcusable that we should fail to make the application. An abnormal condition of body reported by disturbed nerves to the mind causes pain. The pain felt in the mind is referred by the mind back to the abnormal state in the body. The pain may be caused in the body, but it is felt in the mind. A sufficient illustration of this statement is found in the fact that no matter how abnormal the bodily condition may be a person who is unconscious does 44 AMERICAN NERVES not suffer. Bodily cause may be present, but tbe mind, failing temporarily to function upon it, does not know pain. Though mental suffering is more elusive, the law covering it is the same. The inaccurate statement, “You do not suffer as much as you think you do,” was formulated and became cur- rent before the layman began to think about mental states as familiarly as he is doing to-day. It is often taken up from other lips and repeated carelessly with little thought. The sufferer who suffers real suffering,—just as much as he thinks he does,—being no better psy- chologist than his critic, although he knows per- fectly well that he is suffering, makes an effort to believe what is told him. He says: “They tell me I don’t suffer as much as I think I do. They say there is nothing the matter with me, no reason why I should suffer; that I needn’t suffer if I would only think I didn’t. But I have thought I didn’t, or tried to. I’ve tried and tried, and I do suffer. Do they think I wouldn’t stop it if I could? Do they think I like it? They say there isn’t any reason for it. But if there wasn’t a reason it wouldn’t happen, and it does happen.” This is the conclusion of the normal half of the CONSPIRACY 45 mental house divided against itself, just as able to reason, more eager to solve the problem, just as courageous in undertaking a hard fight as you would be, I was going to say. Who knows but it is a great deal more courageous than that? Who knows; who knows? The nervous sufferer could usually be given a simple explanation of this slight cleavage, of this dissociated, this separated or partially disinte- grated state of the mind, and told that he could have help in changing the condition. One of our well-intentioned but not very well- informed conspirators objects: ‘ ‘ But it is n’t safe to let nervous people think they are n’t entirely responsible. If you do, they will become more and more self-indulgent and grow worse. You must make them keep up a continual effort toward re- covery.” We have the word of experts that effort in func- tional conditions seldom helps and often hinders. Help is needed, and there is a kind of help which tends to reintegrate the divided self. People do sometimes get well of themselves. Yes, the turtle usually, after the passage of time, writhes over upon his feet. The broken leg may heal alone somehow; the typhoid case may recover by itself; 46 AMERICAN NERVES pneumonia cases struggle through alone some- times; but that does not mean that it would not be better for them to have help. If the mental sufferer who is told that he does not suffer as much as he thinks he does gets better, it will probably be because of some other agency at work to help him and in spite of rather than because of the dictum of his kindly-inten- tioned but uninformed friend. Dual Personality The normal personality is dual. If it were not so, we should have no ability to pass judgment upon our own actions, no reason, no power of discrimination, no conscience. Were it not for natural duality in a normally integrated mind, we should have an impulse and carry it out, think a thought and act upon it, without knowing we were doing it. In other words, we should all be something like monomaniacs, without power of conscious initiation of action or power to prevent or inhibit it when once it had commenced. The establishment of a balance between the separate phases of self, the maintenance of a mental equilibrium, is the chief business of mind. It is the aim of education, the goal of culture: even, one might say, it is the final achievement of CONSPIRACY 47 religion. It is the secret of what is known as conversion. Some one speaks of “that readjusted balance which we call forgiveness.” The self which has arrived at equilibrium has attained mental health, which, according to the old Anglo-Saxon deriva- tion, is health, “holth,” wholeness, or holiness. Equilibrium, adjustment, implies right relation. So the final concept of the self is not an uncon- scious mono-self, if one may use the term, but a dual self in equilibrium. When we speak of the split personality, we mean a self that is just a little more dual than it ought to be; the cleavage is over-emphasized. The different parts of the self lose touch with each other; they do not coordinate or cooperate. A young woman who was constitutionally neu- rotic, after many years of various forms of mental distress, fell into the habit of explaining and ex- cusing and justifying everything she did on the ground that she had been told she was “a dual personality,” as though she were an exception to the rule. We are all dual, perhaps various, and the busi- ness of life is to get our two or our various selves into equilibrium. We are all of us almost as dual as the small boy who, when he was told he must 48 AMERICAN NERVES not do some naughty thing, answered, “But I have to, ’ ’ with the accent on the ‘ ‘ have. ’ ’ The cleavage between the good boy and the bad boy was over- emphasized for the time being. They could not quite get together. They could not in fact get close enough to have any consciousness of rela- tionship. They did not even wish to coordinate. It helps one to get a perspective on this point if we realize this further fact, that there is said by experts to be no difference in quality between normal and abnormal mental states. The differ- ence is in quantity only. Even in the insanities there are no new kinds of mental states. It is only that normal states, those common to indi- viduals in mental health, are become over-em- phasized or under-emphasized. They are either in excess or in defect, so that what is needed to restore the mind to soundness is a readjusted bal- ance. Realizing this fact does not solve the prob- lem, but it does seem to simplify it and bring its solution more nearly within the realm of the pos- sible. The normal self should be a self in equilib- rium. Neurotic Selfishness These phases of thought seem to suggest that an over-emphasized or selfish self and nerves may CONSPIRACY 49 be very closely allied. Perhaps they are, but possibly not in just the way which might at first appear. Attention is arrested when a person who has been suffering from nervous disorder and is liberated through psychologic methods vol- untarily offers the information, “I find I am so much less selfish than I used to be.” When an explanation is asked and a little analysis is made, it appears not that the person feels less selfish or more unselfish but that he is able to carry out his previous unselfish impulses with freedom and enjoyment. That which before had appeared like selfish- ness, self-centeredness, was in reality a preoccu- pation with the disordered interior conditions which seemed to need guarding. A man with a broken leg, a dislocated arm, or a carbuncle on his neck in going about the world naturally looks out for and instinctively protects the injured and suffering member. Experience seems to prove that the sick places in the mind call for guarding in the same way. When these sick places are made well, when the interior dislocations are readjusted and health reigns, the guarding self seems to be set free. It is at leisure to turn itself outward again and busy itself with adjusting its social relations. 50 AMERICAN NERVES A realization suggested by the old poem quoted in our childhood has been recently expressed by a recovered nervous sufferer. She said: “I feel now that I am ‘at leisure from myself.’ I have an old relative whom I have always felt I ought to go and see. I wanted to go and see him but I just couldn’t. Now I don’t want to go any more than I did before. I have always wanted to go, but now I’m better I find I can go. I’m set free. I can stop guarding myself and really live a little. ’ ’ The impulse toward the kindly deed had been there all the time, but action was inhibited. When the young woman recovered she did not say: “Now I’m well, I suppose I must go and see my uncle. I have no excuse for staying away any longer.” She suddenly discovered that, having wanted to go without being able, she could now have the pleasure of fulfilling her desire and went with a real and spontaneous pleasure. Possibly the sniffs and sneers sometimes in- dulged regarding the nervous person are not all deserved. “If she would forget herself and think about others she would be as well as any of us.” Possibly the cart is placed before the horse. Suppose it were like this: suppose the truth were actually to be, “If she were as well as CONSPIRACY 51 any of us she would forget herself and think about others. ’ ’ Just perhaps! and you know we would not be unjust to her for the world. The “Moral Element” Since the modern psychologic emphasis has been brought to bear on the functional neuroses, we hear something of the “moral element’’ in nervous disorders. It is not easy to discriminate just the application of this phrase or to get into words whatever we may be fortunate enough to understand about it. The moral element evidently comes in not as cause but as effect. The disorganized mind, as might naturally be supposed, disorganizes the moral nature or perhaps, more accurately, the moral nature in its expression. Wherever it comes in or whatever is wrong, reading a moral lecture to the patient seems to be the very last thing to prove helpful. Conscientiousness appears to be a symptom of nervous disorders. Morbid conscientiousness it may be, but, whatever it is, lecturing and moral- izing seems not to be what it needs. A very kindly person, as gently and considerately as possible, was putting up the moral argument to a woman who had gone to him for help. She listened 52 AMERICAN NERVES quietly and patiently till he was through. Then she said: “If that’s all you have to say, I ’ll go. You don’t know me yet, and you know very little about me. If you are going to lecture me you need some data which you have n’t got. But if a lecture is what I need I can give it to myself better than any one else, because I know the cir- cumstances as no one else does. However, as I’ve been giving myself a moral lecture for the last twenty years and have grown worse instead of better, I thought at last I’d go to some one who could do something about my condition. But if you can’t do anything I ’ll go.” Until the nervously ill person gets upon his feet, he needs to be relieved of moral responsibil- ity for himself. The typical case of the person who is agonizing because he has “committed the unpardonable sin” is a case in point. He does not need to be prayed with. His obsession is quite evidently pathologic. Since the unpardon- able sin can be unpardonable only because the sinner has become so hardened that he has lost his capacity for regret or desire for pardoning, it is a contradiction of terms to speak of a per- son’s worrying because he has committed the un- pardonable sin. If he has committed it, he will not worry. Losing the capacity for regret when CONSPIRACY 53 one has sinned is the unpardonable sin; the per- son who worries has not committed it. A conviction that one has committed this sin is not uncommon among mentally disordered people. It is quite obviously disease and not sin and is dealt with as disease, not lectured or prayed over but treated with the hope of cure. PART TWO SELF-HELP PART TWO SELF-HELP A utosuggestion If autosuggestion is so simple a thing as many persons appear to think, why does not every one who is nervous undertake to autosuggest himself into a cure of all his ills? Why may not this be done? Why need anybody’s help? The civilized world has been “thrilled’’ by ac- counts of the clinic of Emile Coue at Nancy and his further work in England in which he is said to teach the sick and suffering to do just this thing, to cure themselves by autosuggestion. We are confronted by printed statements, for- tified by portraits of lords and ladies, to the ef- fect that these representatives of nobility have, under Coue’s instruction, been almost miracu- lously restored to health by autosuggestion. We are further somewhat horrified by a rumor passed about in mysterious whispers asserting that in one of Coue’s clinics for cases of war neurosis a hysterical subject experienced a spas- 57 58 AMERICAN NERVES modic seizure, spreading confusion and panic among the whole group—which, of course, might have happened in any hospital, has undoubtedly happened in medical practice. Whether such an episode really occurred in this case or not it might readily have done so, thereby proving the prompt efficacy of the power of suggestion. While this forceful dynamic may have operated in the given case with some tem- porarily unfortunate results, the whole point and purpose of Coue’s work is to show people how to reverse this possibly harmful action and to utilize the principle behind it as a natural force for good rather than permitting it to do harm in a random and unregulated manner. Reversal of action of the perfectly natural psychologic principle of influence is what Coue is attempting to accomplish. If he can make even a beginning in this direction he will place a powerful and beneficent agent in the hands of the people to whom it rightly belongs, since the equipment for the little enterprise is by nature installed within their own physical and mental life. The fact that some persons are in a condi- tion which renders them unable to do this service for themselves is no reason why those who find themselves able should not undertake it. SELF-HELP 59 There are different sorts of people who, from various motives or just because they “don’t like the idea,” will advance many and curious argu- ments against Coue and his methods. Quite impartially if we may, not just on the ground of our personal preference in the matter, it might be interesting to clear our own minds for a better understanding of Coue’s work. A recognition of its value when it can be used may reassure those who are excluded from its use, when something else is offered them. The funda- mental presupposition of this effort of Coue’s to turn some obscure though perfectly natural phases of mental activity to our own account is the exist- ence of what is called subconscious or unconscious mind, the portion of the self below the level of consciousness. The Submerged Self It is easy to become entangled in a snarl of confusion by talk and argument around and about this subject. This is unprofitable and leads no- where. If one wishes to discredit the subcon- scious mind there are a number of things to be written about it which would seem to the casual reader convincing. The subconscious mind is not an object. It does not exist in time or space. 60 AMERICAN NERVES It is not an entity. The same arguments may be urged against the existence of the conscious mind. They are not valid. The late Professor Miinsterberg of Harvard University wrote articles and books on the sub- conscious mind and efficiently and helpfully dem- onstrated its existence in his laboratory. He himself said he enjoyed writing magazine articles, and it was natural that he should continue to write on this subject. So when almost every- thing had been said about it and he came to the point of turning his subject over and beginning again, his new departure was initiated by an un- expected statement to the effect that the story of the subconscious mind is soon told: there is no such thing. But, in continuing his discussion to prove the non-existence of the subconscious mind, he finds it necessary—before he is half- way down his first page, unless visual memory fails—to refer to “states below the level” of con- sciousness. His case is lost. He cannot even undertake to disprove subconscious mind with- out assuming its existence. All the psychologist means by subconscious mind is a recognition of “states below the level” of consciousness. Those who undertake to disprove the existence of the submerged mind or self use it every day and SELF-HELP 61 could form no judgment without its being there to provide them out of its dark recesses with the memory of that past experience which they are comparing with present experience in order to form a judgment regarding it, It is this sub- merged field of mind which underlies Coue’s work. Self-Hypnosis A very naive and convincing proof of the action of autosuggestion through the power of subcon- scious mind was reported at the time the story of Trilby was presented on the screen in New York. There is no need to emphasize the fact that the artist would do his uttermost with Svengali’s eyes. One feels sure they would be hypnotic to the wth power, if light and shadow judiciously arranged on the screen could achieve this effect. So strong was the influence of the skilfully com- bined streaks and patches of light and shade which were made to represent these notoriously hypnotic eyes that easily suggestible natures in the audience, convincing themselves how very hypnotic they were, autosuggested themselves under their influence into a deep hypnosis. The janitor passing through the auditorium after the audience had departed was obliged to waken these 62 AMERICAN NERVES hypnotic sleepers, set them on their feet, and send them home. Svengali was not there, there were no eyes, there was no hypnotic power, just the operation of the mind’s own influence upon itself, stimulated by dark patches on the screen which through a natural principle of psychologic activity conveyed a strong idea. Without taking the trouble to look up the janitor and verify this practical demonstration of the power of autosuggestion, the psychologist knows that exactly this thing might easily happen. In fact, it would be almost inevitable that it should happen to a small class of persons under the given conditions. There the tendency is, resident within us, act- ing unconsciously under favorable circumstances harmfully or helpfully. Why not recognize its existence, its power, and comparative ease of con- trol, and, instead of letting it play curious little tricks upon us like putting us to sleep in a theater chair through the influence of some combination of chemicals representing a fictitious pair of eyes, take it up and use and direct it consciously, in- telligently, and constructively for the better organization and more effective use of our physi- cal and mental life! Coue’s aim is to help us do just this thing. While he is not likely to make us SELF-HELP 63 or the world entirely over in the near future, it might be worth while to bring our minds sanely to bear upon this subject and to become intelligent about it. We may, at least, save ourselves from the mental disgrace of getting under the heel of silly superstition and crass ignorance regarding this perfectly natural and easily helpful tendency of the normal human mind, called suggestibility, to exercise a radical automatic influence upon it- self. Controlled Suggestibility Suggestibility is an inclusive word. It covers normal as well as abnormal mental states. Since, many years ago, Charcot conceived the idea that hysterics were particularly susceptible to sugges- tion and autosuggestion, the idea of suggestibility has fallen into ill repute. Persons who consider themselves very wise, very superior, accuse others in patronizing tones of being “very suggestible.” Suggestibility is not in itself a defect. It is not merely a characteristic of a weak mind. It is a normal phase of mental activity and has various forms and degrees. It is neither wholly good nor wholly bad. On one extreme, in excess, it would mean practical imbecility, no mind of one’s own, only the power of uncontrolled response to the 64 AMERICAN NERVES ideas of others. At the opposite extreme, in de- fect, it would mean no capacity for any compre- hending intelligence, since this is based on a nor- mal power of response, of suggestibility, to ideas which are presented to the mind. Since real power comes from a proper understanding and control of our natural capacities, the thing to do with suggestibility is to study it and understand it, regulate and direct it, not become its servant, but make it ours. The man who can control his own suggestibility, apply or lift the mental brakes at will, is a powerful man destined for achieve- ment. A strong will does not mean inability to come under the influence of another or of oneself. There is no strength in any inability. Strength lies in controlled ability. A man of logical mind, a lawyer of some attainment, who prided him- self on his strength of will, and justly, was inter- ested in seeing a certain experiment in hypnosis produced by variation in so-called “occult” breathing, combined with suggestion. One eve- ning in the midst of a hectic atmosphere of danc- ing, exciting music, stimulating lights, and social interchange, he suddenly remembered his desire to try this experiment. He beckoned his psycholo- gist up a short flight of stairs where there was only SELF-HELP 65 comparative quiet, lay flat on the floor of the hall, and said, “Now show me.” The response was, “Yes, if you will do just as I say.” Directions were given for the taking of three different kinds of breath in a certain position, six breaths of each kind, and with the last six a few quieting suggestions were given. Before the eighteen breaths were taken the man was in a pro- found slumber, breathing stertorously, and re- quired a smart shaking to be awakened. The Unstable Mind He was immensely interested and could hardly credit his senses. Being eager to share his dis- covery with a friend who was fox-trotting below, he summoned him and undertook to have him put through the same experience. The man was a rather light-minded, undisciplined person, flus- tered, suspicious, with no power either to focus or relax his attention at will, and the experiment failed utterly in an uncontrolled burst of laughter on his part. The well-disciplined mind which had cultivated the power of self-direction was the one that could experience this interesting phenomenon when he wished to do so, and was able for his own purposes voluntarily to relax his will and fall in 66 AMERICAN NERVES with the suggestion of the psychologist. This fact could not place him in any sense in subjection to the mind of the other person, even though that person had wished it. As soon as he shook him- self awake and stood upon his feet, the lawyer was the same self-contained, strong-minded, powerful-willed person that he had been before. His ability to control his mind covered the power of relaxing as well as the power of focusing his attention. He could, in other words, become sug- gestible because and when he wished to do so. This is as much a part of mental control as is the power of concentration or focusing, and is some- times more difficult of achievement. The unyield- ing person who says, ‘ ‘ I allow no one to influence me,” has not grasped the first principles of men- tal control. He is something like a man who might pride himself on being six feet tall and who, in some dangerous position from which he could extricate himself by bending down to pass through an opening three feet high, should refuse to stoop, even for his own safety, fearing to lose the power and dignity of his six feet of height. “Absurd,” one says: “The man would be a maniac or an imbecile! ’ ’ He would be. He would be precisely the sort of imbecile we allow ourselves to be- come when we imagine we possess or display some SELF-HELP 67 mental superiority in refusing to become sugges- tible through the unbending of our minds and the temporary leveling of them if that is the position in which some good may come to us. Looked at from the point of view of simple and sound psy- chologic intelligence, the power of regulated sug- gestibility is a necessary equipment of a trained or even a sound mind. It is this power, recognized as normal, seen to be useful for one’s own better- ment, and put into operation by oneself, to which Coue directs our action. The popularity of Coue’s method of self-help by autosuggestion demonstrates a willingness on the part of many to undertake the cure of their own ills. The very general acceptance of his offering of a definite simple something to do dis- closes the fact that the average person is eager to help himself when he is shown how. When the victim of nerves has gone down before the overwhelming conclusion which decrees that no one can do anything for him, no one can help him but himself, it may have been because, though he was eager to help himself, he failed to do so merely because he was given no method of procedure. One may as well throw a set of school-books at a Coue and His Critics 68 AMERICAN NERVES child and say to him, “Be educated,” as to tell a person suffering from nerves to make himself well, giving no instruction as to how the matter is to be accomplished. The explanation of the fact that one man’s presentation of an old idea, by a somewhat novel method of appeal, through slightly rhythmic for- mulae, can seem to set the world on fire, is prob- ably a matter of crowd psychology, or of the art of advertising, which comes to the same thing. One having had experience with popular move- ments, as those living on the highways of civiliza- tion are bound to have, will not take them too seriously, either for fanatical adherence on one hand, or for sneering cynicism on the other. The sincere person will be glad if good is being brought by any reasonably safe method to a multi- tude of people the condition of whose nerves needs betterment. These are certain things that may be said and truly said about popular enthusiasms of this sort, which may be uttered in such a way as to imply condemnation and scatter suspicion and limit the good that might otherwise be accomplished. Stat- ing that an interest of this sort will not last, even when the prophecy proves to be true, is not espec- ially in its disfavor. Some of the best and most SELF-HELP 69 permanent influences in the world have been started, blazed up, and then died down. This means only that even in appropriating its good things the undeveloped human race is variable, fluctuating, quickly diverted, needing variety. There are new and changing phases of activity in all fields of experience in, religion, education, medicine, surgery, and social reform. Things good in themselves which come in waves appear and disappear, often during the passage of cen- turies, working finally up to some valuable and permanent good. Evanescence does not always measure value. It measures only the instability of the human mind, its lack of power of constant vision. It does not condemn the movement in question. Claiming or implying that some new method has possibilities of harm is not a just comdemnation and should not turn people away from its reason- able and guarded use. All the most useful agents in the world have possibilities of harm—religion, medicine, and surgery; again, common necessities like food, even with the best and sincerest intentions for good, can be used and are daily used to do serious harm. That is no reason for giving them up, and intelli- gent persons do not advocate their abandonment 70 AMERICAN NERVES but only that their use should be guarded. In- struction may be given, caution may be urged, in- experienced persons may be restrained, and, further, the fact must be faced that as in the intro- duction of many things of ultimate value, auto- mobiles and aeroplanes, for instance, some un- avoidable sacrifices must be made. Those who are instructed regarding the new interest can further human welfare by explaining limitations, urging care, and modifying absurdly extreme expectations, rather than by becoming alarmists and turning a thing which may be good in itself into an instrument of the very harm against which it claims to be safeguarding. “S elf-Deception” One of Coue's critics, after some casual and rather patronizing though not entirely unfavor- able comment, adds that of course even when his little day-by-day formula does seem to help people this is done only through “a sort of self- This opinion would almost seem to be a fly deliberately introduced into the ointment, and, further, it is not a very careful statement. The critic may have believed it to be true, may have made it in all sincerity, but that does not prove it to be true, and its impression is mislead- SELF-HELP 71 ing. The more accurate statement would be that at the time when the patient consciously or un- consciously brought the original functional trouble upon himself, the one of which he wishes to rid himself by autosuggestion, he did then literally deceive himself into the condition, but that now, in reversing the maladjusted balance caused by that self-deceit, he is actually undeceiving him- self. There is scarcely anything which a straight- forward person resents so much as the charge or implication of self-deception. To the person who is sincerely trying, by the use of Coue’s better- and-better formula, to help himself, no explana- tion is given by this critic. This statement re- garding self-deception is made baldly by one who is supposed to know, or why should he assume to speak thus arbitrarily? The average reader is not provided with data to help him in understand- ing this matter, so, fearing self-deceit almost more than anything else in the world, he turns away from a virtually harmless measure which might quite likely have been for him an agent of very real benefit. “Exemption Blindness If a thing is true it is usually possible to ex- 72 AMERICAN NERVES press it quite simply, and a few suggestions as to the best way of making a new thing helpful would seem to be more useful than the giving of alarm- ist warnings against its possible, though fairly remote, dangers. This idea of deception in the use of suggestion is not an uncommon misapprehension, but it need not be a hindrance when reasonably understood. During the war a group of soldiers were brought into one of the large city clinics for diagnosis of a sudden and inexplicable inability to see. When their story was told the conclusion was reached that the men were suffering from what was pro- nounced “exemption blindness.” The draft had called them at a point in their private affairs when they felt they could not respond. Some domestic responsibility, an aged mother, an in- valid sister to be cared for, a prospective family about to arrive in a newly established home, made the devoted son, brother, or husband feel that his real duty held him here. He had been examined and in every case passed as fit, but the reiterated assurance to himself in the deep of his mind, per- haps in the half-waking hours of the night or early morning, that he could not go, he could not go, something must happen, an insurmountable SELF-HELP 73 obstacle must arise which would keep him, finally worked self-deception and literally misled him into temporary but actual blindness. When the assertion that something must or must not happen is registered in the subconscious mind with a cer- tain quality and degree of emotional fervor, the subconscious automatically accepts the fact and is deceived into doing something about it, and so it sends up in these cases blindness to the unsuspect- ing eyes, which had not consciously bargained for this result. These cases were diagnosed by leading neurologists as functional exemption blindness. Undeceiving Oneself Now, may not the process of undoing this actual though organically false condition, of removing by suggestion or autosuggestion the perfectly un- necessary blindness, fairly be called a process of undeceiving oneself! The eyes of these soldiers were all organically sound and showed no physical cause for blindness. They were self-deceived into blindness; not into thinking they were blind, but into being blind, into real true blindness. They were unable to meet the tests given them in the clinics because they 74 AMERICAN NERVES had made an anxious overstatement to their sym- pathetic nerves and subconscious minds that they could not be spared from home. When a physician kindly, without any spirit of censure since none was deserved, explained this automatic action of the nervous system in response to one’s earnest desire, and quieted and reassured the now really frightened men, they understood that this condition was not necessarily permanent. They might themselves reasonably have begun the process of correcting the blindness into which their strong feeling had accidentally deceived them. Whether Coue’s formula would in these cases have been sufficient for the work of unde- ceiving, or whether they would need help, is an- other matter, but these cases fairly illustrate the point in question. "Shell-Shock” The boys who came out of the war with mental confusion, reversed automatic action, introver- sion, extraversion, or any of the other forms of war neurosis, those conditions known in common parlance as “shell-shock,” might have made or might still make use of a hundred Coues if they were at hand. SELF-HELP 75 In England Coue handled shell-shock cases in groups. Wetterstrand, the distinguished psychoneurolo- gist of Sweden, whose work will be referred to later, many years before the war classified his functional cases and treated them in groups; so Coue had medical authority for using this method. This was not done with any idea that all cases would respond immediately, but that some or per- haps many who were but slightly disturbed might experience a quick reaction, and the other cases which proved to be more serious might be con- sidered later, personally and in a more detached manner. There is hardly a question that many cases of war neurosis, such as those which from time to time come back to normal through some slight and common jolt of every-day life, some old familiar sound, an unexpected joy, a sudden burst of laughter, a fresh experience in concentrated occu- pation, an afternoon at a moving picture, cases which respond by normal readjustment to any of these untechnical correctives, might fairly be classified among those which would have been re- stored earlier had technical measures been used. For those soldiers who were suffering from a 76 AMERICAN NERVES less well-defined neurosis, who were merely apathetic, confused, or inhibited, unable to take an interest in work, if some one had been able to give a little psychologic understanding and some degree of technical attention in helping them or showing them how to help themselves, much good might have been accomplished. No one doubts or questions or underestimates the help that was rendered in various ways*. The use of electricity in recognition of the classification of cases called physiopathic as the outcome of Babinski’s experi- ments under chloroform, whether it did its work through physiotherapy, or psychotherapy as lead- ing neurologists aver, brought good results. But there were many cases that needed something more. There was valuable work on the part of the fine body of women who in the department of psychiatric social service tabulated in detail, took careful histories, followed up, did special social work; but very much more than this was needed in the way of technical psychologic attention which in the wide-spread confusion was somehow over- looked. Many of the returned soldiers were even repu- diated by their families because they could not work. The “dear ones’’ who sent them sweaters and socks and soap when they were far away SELF-HELP 77 have entirely misunderstood their inability to work because there was no one at hand to explain that shell-shock could put them in a condition in which, though one part of the mind wanted to work, the other part was in a sense paralyzed and could not get hold of itself to make a beginning. There is undoubtedly ample work for Coue and others if they could get access to the multitude of boys who are slipping beyond help in various institutions because some psychologic technique of reversal and reintegration is not put into opera- tion. The “poor whites’’ in the Southern mountains of whom we have long known, who have been kicked and cuffed and sneered at as “no-account trash,” have in some cases been redeemed in a night from constitutional indolence. It is the statement of reliable medical authority that this has been done through the use of the specific for hook-worm. Not long ago this would have seemed beyond belief, either miraculous or absurd. Now it is quietly being done. It is a no more unreason- able claim that by a psychologic technique such as Coue uses informally, or by a more specialized heterosuggestion, the misunderstood and often compromising indolence of many of the war- neurosis cases might be dispelled. 78 AMERICAN NERVES Peace Neurosis It would help many of the sufferers from war neurosis, and their friends as well, if they could clearly discriminate the meaning of the more accu- rate term which neurologists have provided for that functional condition which became commonly known as shell-shock. It should be recognized as no fixed or organic “mental trouble’’ but as a possibly passing functional disturbance which may of itself disappear and which admits of improve- ment if not cure through application of psycho- logic methods. Further, it should help those who have an ignorant suspicion of mental disturbance as something uncanny and who think of war neurosis as special, different, something which be- cause it came out of war is comparable to nothing known under peace conditions. Habit fatigue, from which many persons suffer almost continuously and perhaps unnecessarily, is a case of what might be called peace neurosis and is similar in some of its effects to the war neurosis which made it difficult for returned serv- ice men to take up an occupation. The self- conscious fear of over-tiring oneself, apprehen- sion that after doing some fatiguing duties one may not be able to do certain further duties, con- stant over-caution, some sorrow or shock, any SELF-HELP 79 one of a group of common daily influences may in unguarded moments deceive us into a fixed feel- ing of fatigue and inability. These conditions are actual and often most distressingly real, though there is no justification of them, the doc- tor says, in the organic condition. The body is sound, it is generating energy, energy that one uses without disastrous results, and energy that one should feel and enjoy in the using. Yet, hav- ing bit by bit and cumulatively as the days went by unconsciously deceived oneself into a constant impression of fatigue, one does really suffer from it, and it makes life a useless burden. Such a sufferer, having had this matter explained to him, may well assume the undeceiving process for himself. The intelligent and quietly persistent use of any appropriate little formula might be sufficient. No one can assert that it will help him, but it reasonably may, and that in entire accord with sound psychologic procedure. It is always possible that there may be resistances which may not be so easily overcome, but the experiment is worth trying. There is no trickery about it, no occasion for cynicism or contempt, and no one need feel called upon to apologize for attempting the use of this kind of help. All that has been said of this method of dealing 80 AMERICAN NERVES with this not uncommon peace neurosis is equally true of war neurosis, in cases in which the subject is sufficiently normal to undertake himself, or is sufficiently intelligent about his condition to know something curable is wrong and to seek the help of another person. A stalwart young officer comes to you in his mental emergency because some one told him he might receive help. He explains that, of course, he does not expect you to understand very well as you did not “go over” and are not familiar with conditions over there, but he will try to make it as plain as he can. Then he begins to unfold a tale showing the feelings of unreality, inadequacy, detachment, inhibition, etc., which you have been listening to every day from those who stayed at home. You feel a little sorry to puncture this bubble of subtle superiority to the people who did not go. You explain as cautiously as you can and let him down very gently instead of saying, “My dear boy, all those years before the war, while you were motoring and dancing and playing foot- ball, just around the corner, some of us were daily engaged in the hand-to-hand struggle with pre- cisely these painful mental states which, though brought on by the explosion of domestic and other sorts of bombs during peaceful days at home, are SELF-HELP 81 the counterparts of conditions which you went to the trenches to find.” War neurosis and peace neurosis are in char- acter the same, the only difference being that one was induced under war conditions, the other under conditions in effect the same, though encountered in times of nominal peace. If informal suggestion given by oneself or sug- gestion in its more technical form given by Coue or by some one else can in any degree meet the needs of those suffering from peace neurosis, there is no question that Coue might give some of the help which many cases of war neurosis still greatly need. The Flexible Mind While some fortunate people who have a special temperamental adaptability can undertake self- help even in a haphazard sort of way and secure very good results, the giving and receiving of auto- suggestion is really a rather delicate and some- times difficult matter. The general and rather casual use of it which Coue recommends largely gains its influence, in all probability, from its popularity, from the crowd spirit of everybody doing it, and from con- stant repetition which tends to secure the entrance AMERICAN NERVES 82 of at least some of the suggestions into the sub- conscious field. The people who easily take up the use of it are just those who are by nature calculated to get results. That is, the tempera- ment which takes it up easily and the temperament which gets results are one and the same. This does not necessarily imply a weak suggestibility as in the hysteric. It may mean that the person has a natural philosophic bent and that the appre- hension of psychologic truth comes easily to him. This is a fortunate fact for him, and the cynical person who ridicules him on account of this ten- dency might better cultivate less cynicism, more faith, and some common psychologic intelligence. The rhythmic and indirect emotional appeal of Coue's formulae is, in a simple and perfectly le- gitimate way, as has already been said, helpful to the emotional person if he does not analyze it too much. It is quite in accord with a normal mental activity that good results should come in many cases from this informal and untechnical use of autosuggestion, but nothing good could come of it unless nature's laws were at work in the back- ground. Any one who finds himself resenting the fact of the efficiency of autosuggestion, or tending to become sarcastic regarding it, might safely acquaint himself with simple psychology. SELF-HELP 83 The ultimate result of the use of suggestion by oneself or by some one else comes, as has been stated repeatedly, from its influence upon the sub- merged part of the mind. In some cases for various perfectly obvious reasons this lower mental level is not reached by the general and what might be called untechnical use of sugges- tion. How fundamental and how reliable is the action of the natural principle of mental activity utilized in suggestion is indicated by the promptness and apparent ease with which it does work and give what to the uninitiated mind seems to be startling results, when by any happy combination of cir- cumstances the casual suggestion penetrates to the submerged field. When, however, this does not happen, when there is some hitch, some self-consciousness, some fear, some anxiety, or even impatience for quick results, which forms an obstacle in the conscious mind, a clearing of the channel of consciousness may be necessary. In order consciously to do this for himself as Coue recommends, the self-operator must be something of a mental acrobat. He must be able deliberately to hold his mind in two oppos- ing conditions at the same time. He needs to re- main quiet, sufficiently dissociated to receive his 84 AMERICAN NERVES own suggestion, and needs at the same instant to be active enough to give the suggestion, to pro- pel it into the subconscious field. While this does not require force it does need a steady firmness, which is rather likely to disturb the necessary quietness in the conscious mind. So, for the person who with sincere good will undertakes to help himself by Coue’s method and meets only with failure, we are glad there is the further help of cooperation from another mind which can do for him the active service while he performs for himself the quieter and less taxing part of the process. He accepts from another the operation while opening his mind to the partial anesthetic. Dangers The fact that the realm of mind, conscious and otherwise, is to the average person uncharted territory, makes it very easy to frighten him re- garding what may happen there. Just a sugges- tion of danger if he ventures into a little intelli- gent investigation serves to drive him back to the familiar and seemingly safe ground of his old stupidity. When all is said and done regarding the need of flying danger-signals to warn of lurking peril in this or that new cult, probably one of the most SELF-HELP 85 really dangerous things a person can do mentally is just to live every day in the old dull common round, exposed to his own deadening mental in- ertia or his tendency to inhibiting automatic habits or the lax, undirected influence of the average person in the casual experience of daily life. The danger of this sort of thing is that it does not feel dangerous. It is in that particular like the com- fortable drowsiness that creeps over the person who is freezing to death. It is in the mental world as in the physical world dangerous to live the protected and un- adventurous life. With subways and automobiles and every other conceivable menace, the statis- tician proves that more harmful things can hap- pen to the person who sits at home in his rocking- chair than to him who ventures upon the highway. The mind is likely to be rather safer than at other times when it is deliberately controlling and directing itself with a good motive in pursuit of some wholesome and constructive object, even though it may fail in its attempt. Effort is whole- some. The greatest harm that is likely to arise from the popularity of Qoue’s methods is the scare opposition it is bound to arouse and that on the part of well-intentioned people who without know- ing just what they may be have conceived a vague 86 AMERICAN NERVES idea that there really are grave dangers in try- ing to better your own mind and nerves in this quite simple way. If people of average intelligence take it up in a reasonable mood, understanding that there is simple but sound psychology behind it, it can do much good in a variety of nervous ailments. It need not be pushed too far. If one gets discour- aged or out of sorts with his attempt, it might better be dropped temporarily, to be taken up again when the tension of effort is relaxed and when after rest a fresh impulse springs up spon- taneously. One of the most obvious dangers in the use of autosuggestion is that it'may, by an enthusiast, be overdone and result in stimulation which drives to excessive activity, fatigue, and finally results in a temporary collapse. This will be followed perhaps by a fit of hysterical weeping, the family will become frightened, the dictum will be pro- nounced that this is dangerous business and should be abandoned. Then the victim of her own nerves, the indignant family, and friends warn against it and spread a note of alarm over the neighborhood. It is not Coue’s methods that have produced this result or that should be blamed. It is a wilful or unintelligent application of the SELF-HELP 87 methods. Any patient of any regular practitioner of medicine may injure himself in precisely the same way, by misuse of the medicine the careful doctor has wisely and safely prescribed. There is a great difference in the constitutional and temperamental reaction of different persons to remedial agents—medicine, electricity, or sug- gestion. A patient may suggest to a doctor after one or two electrical treatments, for instance, that the current be reduced, as the one previously used was found to be too stimulating and kept him awake all night. The operator accepts the suggestion with the observation that the current used produced exactly the right effect with the last patient but a little experimentation is some- times necessary, as different people do react dif- ferently. Varying temperaments in the same way show a varying reaction to autosuggestion. A Case of Over-Stimulation A young woman suffering from what her physi- cian had pronounced hystero-epilepsy had fallen into the habit of taking bromide, which practice had continued for many years. The physician placed her in the hands of a psychologist. After consulting with the physician, the psychologist decided not to undertake the interruption of the 88 AMERICAN NERVES bromide practice until the spasmodic seizures should show some signs of improvement, and told the patient so. When in a short time she began to realize an improvement in her original trouble she became so elated that she thought she could do anything herself by autosuggestion and, telling neither physician or psychologist of her intention, abandoned entirely her use of bromide. She ex- perienced no disadvantage, had brief periods of quite excessive energy, almost exaltation, and then collapsed. This quite unnecessary experience dis- couraged both herself and her family. An igno- rant suspicion of both suggestion and autosug- gestion was engendered, and both were very un- wisely abandoned. This unfortunate result was not due to the methods used but to an over-con- fidence in one’s independent judgment in the use of autosuggestion. However, though many lay- men show much less wisdom and produce much more serious results in the misuse of medicine, no one suggests that the practice of medicine should, for this reason, be given up. Those who are interested in the use of autosuggestion must be and are cautioned that it may be misused in over-stimulation and that it is so effective an agent that it should not be lightly dealt with. No highly specialized knowledge is necessary, how- SELF-HELP 89 ever; just ordinary common sense. If the patient mentioned or her family had been less ready to give way to suspicion, they might have realized that the same method which was used to produce the unfortunate stimulation might have been again employed to reverse the condition. The well- directed autosuggestion or, failing that in the given emergency, the help of outside suggestion might reasonably have carried this case through to a happier ending. A criticism is frequently made regarding the use of autosuggestion that its results do not last. The implication of this criticism would appear to be that in the use of all other therapeutic methods results do last. The devotees of Christian Science, metaphysics, New Thought, are known to relapse. Even those experiencing miraculous cures at the sacred shrines sometimes fall from grace. Danger of a return of diseased conditions was implied by the Healer of Galilee when he cautioned, “Go and sin no more lest a worse thing come upon thee”; and if medical treatment always cured finally and forever what would become of the medical profes- sion? Why urge against one method of help a Temporary Results 90 AMERICAN NERVES defect which is common to all known forms of therapy? This point is perhaps more easily con- trolled and regulated in the use of autosuggestion than in almost any other practice when a person is able to use it at all, because the subject depends upon no one but himself for his medicine—no ap- pointments, no fees, no consumption of precious time, as the dose can be taken on the street, in bed, at the dinner-table, or while one is shaving. A little application of common sense in the use of a procedure based on common sense may help to regulate this matter of results. Help once secured might naturally be made permanent by varying the routine of the formula after improve- ment has appeared. Though it is quite possible for some people to be very much better in general health than they can in their ordinary condition of half-dead-and- aliveness imagine, there must conceivably come a time when full capacity of health has been reached. The chances are strongly against any discovery that by an indefinitely continued use of the “day by day, better and better” formula we can drive ourselves on to such a mammoth achievement in health as will develop in the next few months or years a race of Amazonian women and of super- mem It is unlikely that Coue himself would SELF-HELP 91 encourage any one to the consideration of such a possibility. When one has obtained definite re- sults from the use of the general formula it would seem reasonable to discontinue the “better and better’’ phrase and substitute a suggestion that one will keep the improvement which has been already gained, that the operation of the same law which made one better would keep one well until health became a fixed and permanent habit. The “better and better” suggestion should never be used to push one on to artificial stimula- tion, causing an increasing nervous tension, work- ing up to a climax followed by temporary col- lapse as in the case quoted. The action of the subconscious mind requires to be regulated ac- cording to common sense and reason. The effect of its principle of automatic action is that once we succeed in establishing communication with it, it does exactly as we tell it and it sometimes makes the effort to do so even when the body is not able to respond. But it is for some people virtually their own affair to get the sort of result they wish out of this system of self-help. Discouragement This idea that the effects of autosuggestion and 92 AMERICAN NERVES of heterosuggestion, as the giving of the sugges- tion by another person is sometimes called, are fleeting and temporary is very much exaggerated. Many persons whose nerves have fallen into bad habits and are continuing all sorts of very se- rious ills—such afflictions as blindness, deafness, dumbness, paralysis, inhibiting fears, obsession, and even such obviously physical troubles as dis- tortions, tumors, suppuration, and blood-poison- ing—medical authority asserts may show some- times an immediate abrogation or reversal of the functional law and actually demonstrate under the influence of suggestion what appear to be miraculous restorations. When a large body of people are suggesting themselves publicly as in a clinic or at a shrine, so that one or two cases of instantaneous restoration add their influence and heighten the faith of those hoping for help, a very great deal of good to many sufferers may be done in a very short time and in a very simple way. This seems to be a positive gain and spreads hope and faith and joy among a large number of people. The practice of our best physicians covers failures, relapses, and discouragements in both medicine and surgery. This must inevitably be so. It is no reflection on their work. No one SELF-HELP 93 doubts that the gain outweighs the loss, and the physician’s life is, on the whole, one of good cheer, because, despite the failures and dis- couragements, there are more successes than failures. Why should it be otherwise in the use of psychologic methods? The alarmist and the pessimist are not allowed to deprive us of the benefits of medicine and surgery; why should their excessive caution be given an over-emphasis here? The ethics of the medical profession is the ethics of hope. It is best so even at the possible risk of giving the balm of encouragement in cases where there is little actual ground for the ex- pectation of relief. Why should not this ethics of hope be extended to such work as that of Coue, as well! Why be so unyielding, so over-punctil- ious, in the case of this particular form of help? The actual fact of the matter is, if reliable medical opinion is not in error, that in the application of any psycho-therapeutic practice to the cure of functional disease one should expect a much larger percentage of success than in the applica- tion of general medical methods to general or- ganic conditions, for psycho-therapeutic methods are conceded to be the specific for functional conditions. An old-time physician treating ma- 94 AMERICAN NERVES laria with quinine, for instance, would quite fairly expect a larger proportion of success than some other physician handling general diseases for which no specific had been discovered. Rec- ognizing psycho-therapeutic methods as the spe- cific for functional conditions does not mean, of course, that they always and finally cure any more than quinine always and finally cured ma- laria. It means only that the application of psychologic procedure is indicated in functional disturbance. On acknowledged scientific grounds it would appear that there was a sufficient justifi- cation for encouragement in the use of Coue’s methods even were we unflinchingly to face the fact of as large a number of failures as are pres- ent in medical practice and even though we may expect in this, as in other efforts to improve the condition of the sick, that some will be unable to retain the benefit they have but temporarily en- joyed. Organic Disease and Suggestion And the final shock of Cone’s work to the con- ventional mind is that he is said to claim organic as well as functional conditions to yield to this therapeutic approach from the field of psycho- logic control. Whether this accredited claim of SELF-HELP 95 Coue’s is actual may hardly be assumed with safety from across the sea. But it would sur- prise no one who is familiar with this kind of work to discover the foundations of the state- ment to be that diseases which have been diag- nosed as organic do apparently yield to auto- suggestion. One needs a mind made by long study thoroughly familiar with the strange possibilities in the field of functional disease to realize how difficult it is sometimes, as the most highly spe- cialized physicians agree, to distinguish between conditions which are of a functional nature and those arising from an organic lesion. This distinction between the organic and func- tional in disease is a medical distinction, and the layman must take it from the trained expert just as it is given. If a qualified authority can not know, how should an untrained lay mind be able to determine! We must respect our authorities. We cannot too often repeat that the term or- ganic in this matter applies not to the expression of the disease but to its origin, which is a very different matter. An organic condition may ex- press itself in functional disturbance; a func- tional condition may express itself in organic lesion, as has been said, in inflammation, sup- 96 AMERICAN NERVES puration, blood-poisoning, death. The most care- ful physician maintains that it is impossible at times for any one to distinguish between the or- ganic condition which is cause and that which is an effect of functional disturbance. A diagnosis recently rendered by leading neurologists in one of the outstanding clinics of the country may be quoted in illustration of this point. A Case of Functional Deformity A soldier had received a wound in the wrist from a large wood-saw in a lumber camp. The tendons in the wrist were severed. Being far from civilization, he was able to secure only poor and much delayed surgery. As weeks and months went by his condition was unsatisfactory and his recovery slow. The injured hand became use- less and merely flapped as an inert appendage, turned back upon the outside of the forearm. The upper arm and biceps were withered, atro- phied apparently, the shoulder dropped several inches, and the shoulder-blade protruded, all quite obviously the result, any casual observer would say, the general physician had said, either of the original accident or of the unsatisfactory surgery. The trained neurologists said other- wise. After careful examination and due con- SELF-HELP 97 sideration the conclusion was reached that the entire condition was functional, resulting from the patient’s probably neurotic constitution, fear, worry, apprehension during the slow inert months of recovery, in an unfortunately appropriate state of mind to autosuggest himself into the very crippled and disabled condition which he had feared. The neurologists’ exposition of the case made the situation appear quite simple. If the helpless hand had been the result of the original injury or the poor surgery, it must have been turned in the opposite direction, falling forward instead of backward. Step by step by clear ex- planation the deformity was by expert knowledge put out of the class of organic and external causes into the field of functional disturbance. Many such cases could undoubtedly be quoted by the experienced physician to prove that it is not by any means safe to conclude a condition to be of organic origin because bodily disturb- ance or even deformity is evident. If such a case as the one described above were restored in one of Coue’s clinics it would give ample ground to the casual observer for the conclusion that or- ganic diseases were amenable to autosuggestion. Until science has gone further than at the time is recorded we are on safe ground when we ac- 98 AMERICAN NERVES cept the generally stated medical opinion that an ailment cured by suggestion is thereby proved to be, no matter how obscurely, of a functional nature. Autosuggestion does evidently cure physical expression of functional disturbance. If it cures diseases of organic origin we leave the problem in the hands of our trained medical men, who should have the first right to formulate an explanation. The late Dr. Butler in a recently published volume has given valid ground for his relief that not less than 90 per cent, of all disease is of a functional nature. If this medical opinion is correct, even though Coue’s methods are found to apply only to functional conditions, it gives him a fairly extended field of operation. Suggestion and Medicine The ever-recurring question raised by the use of any form of psychologic therapeutics is re- garding the use of medicine. This question is the outcome of the well-known dictum of the Christian Scientist that the taking of medicine implies a lack of faith in spiritual power to which appeal is made in their practice. The Christian Scientistsy aim to specialize a natural readjust- ment of disturbed mental function in the seeking SELF-HELP 99 of health and to attribute to it a peculiar re- ligious value explains their emphasis on the need of a repudiation of medicine. Coue is using the psychologic principle which is active in sugges- tive therapeutics for its simple psychologic value and if he is a good psychologist he will not deny any true thing that may strengthen faith in those he is trying to help. To those who have a deep and broad conception of divinity as implicit in all things there can be no idea of any closer relation between religion and health than between religion and other benefits which may come through the natural rights of divine inheritance. Too often there is no question of medicine for those who seek relief through psychologic help. They have or believe they have exhausted all the possibilities of medication and turn to this seem- ingly new thing only as a last resort. Experience with psychologic methods should disclose the fact that no patient is likely to get such careful med- ical attention as the person who is in the hands of the psychologist. The tendency is and natur- ally should be to send a patient back and again back to the physician, with the request that, if possible, he find something more to do for him, to build up his body, put it in better condition, and so make a better instrument for the psychol- 100 AMERICAN NERVES ogist’s use in his effort to organize and reeducate the automatic mechanisms. Sometimes the very- best results come and come only from a balanced and cooperative effort between the physician and psychologist. The practical psychologist has no impulse to endanger any one by denying him the use of medicine or surgery or electricity or osteop- athy or massage or anything that might pos- sibly help. That restriction is not within his province, and the agency he utilizes is too deeply and radically a part of nature to be seriously interfered with by physical agents. One serious hindrance to many nervous persons in consider- ing the possibility of receiving help from psycho- logic methods is the fear that needed medicine may be denied them. The helper who is at home in this field of effort understands and welcomes cooperation with any one who may fortify his efforts in behalf of the nervous sufferer. Whatever may or may not be said of Coue’s work, the accusation that he is to be classed among charlatans is obviously unjust. The charlatan is one who undertakes to cure by trickery or decep- tion. Coue’s aim is to make people understand, to explain the simple laws by which natural psychologic principles regulate themselves with a little help, and to give whatever faith his patients SELF-HELP 101 have a basis in sound psychology. We honor him for the intelligence which discards reliance on the trick alone and trusts the natural action of the psychologic principle which has always been, is, and must always be at work behind any trickery in the hands of either scientist or charlatan, when- ever definite results are secured. “A mericanitis” To the American, who has developed such char- acteristic nervous conditions that he has evolved a new disease all his own called “ Americanitis,” it is interesting to contemplate such possibilities as are held out by Coue’s theories. But those of our countrymen and countrywomen who have visited the clinic at Nancy are said to meet some- times with disappointment when they submit themselves to the treatment which brings prompt and gratifying results to Coue’s own countrymen or to his British neighbors. The explanation of this fact may lie in differ- ences of temperament. The volatile, emotional Frenchman might easily be able to respond to the approach made by Coue, which he himself con- ceives to be, and frankly offers as an appeal to the imagination. But English people with their quieter nerves and phlegmatic temperament are 102 AMERICAN NERVES able also to reap results from the use of both sug- gestion and autosuggestion! The response of the Britisher, on his sea-girt isle, surrounded by his relaxing fogs which soothe his nerves to a degree of self-forgetful- ness, is probably of a different nature from that of Coue’s compatriots. It would naturally be the result of an ability for un-self-conscious ac- quiescence rather than through the response of imagination to emotional stimulus. Of course, all this, if true at all is true in broad and general terms. Fine discriminations are not for the mo- ment necessary. American nerves have neither the fluid French emotionalism nor the native English relaxation to help them in their search for nervous equilibrium. It is generally conceded that we are the result, to a certain extent, of our climate and our very modern civilization. That is why, they tell us, we made such good soldiers in the late war. Our taut nerves and our practical common-sense point of view seem to be, under given conditions, of immense value for certain uses, but unfortunately they do not provide just the conditions needed for appropriating health through the emotional ap- proach. The sort of self-consciousness to which we as a nation frankly plead guilty, a probable SELF-HELP 103 result of our comparatively dry and very vari- able climate, renders American nerves some- times exceedingly uncomfortable and often un- manageable instruments, and easily induces that national disease which has got itself christened Americanitis. Once within its clutches we find it difficult to control the degree of our sugges- tibility. Our practical minds are not endowed with imaginative power which equals the ability of our intelligence to grasp an explanation. Therefore, it is natural that neither in the French spirit of emotionalism nor in the British spirit of voluntary relaxation could American nerves easily adapt themselves to the appeal of Coue’s methods. Imagination and Intelligence One great disadvantage which the science of psychology suffers at the hands of average hu- man nature is that we must all be practical psychologists, whether we have any technical knowledge of the subject or not. From the underlying consciousness, the state of being “aware,” which is fundamental to all other mental states, we live and move and have our being in the field of psychologic experience. As it is much more difficult for a musician who plays 104 AMERICAN NERVES by ear to submit himself to the rigors of instruc- tion than it is for a person who knows only that which is taught him, it is difficult for every one who must practise informal psychology every day of his life to fall in line with such technical knowledge of it as we have. Coue is doing a great service in emphasizing the fact that the efficacy of suggestion does not lie exclusively in the field of will. If people would understand this it would eliminate a great mass of silly and ignorant superstition regarding the malicious power of one person over another and clear the way for more wholesome ideas re- garding this entire matter. Coue’s point of view is characteristically French and apparently some- what informal in that he places a great degree of emphasis upon the use of imagination. This is well enough for those persons whose imaging activity is in a fluid state, but what about the people whose imagination is inhibited by the di- rect appeal in precisely the same way in which others find the exercise of volition inhibited by the direct appeal? Coue’s emphasis on imagina- tion is as discouraging to some minds—and proba- bly to the American mind—as the old-time and outworn exclusive appeal to will is discouraging to other minds. It is not surprising that Bau- SELF-HELP 105 douin, being a Frenchman, should also place an over-emphasis on imagination, but it seems strange that such writers as Tansley should ignore the practical and physical basis of the efficacy of suggestion and continue to encourage the mystery theory. When William James re- cast our categories for us and in his idea of the stream of consciousness lifted an undue emphasis from intellect, sensibility, and will as faculties of mind he gave us a more fluid conception of them, as merely phases of mental activity, of no one of them as ever acting alone, of each one al- ways implicit in the action of the other. Coue himself recognizes this fact, though for American nerves and minds it seems to need a more explicit emphasis. While appeal is made to the imagination Coue constantly reminds that the demand made must be within reason. His application of reason seems to be to the individual case rather than to an account of the method he uses and to its natural psychologic foundations. His method still holds a good deal of the mysteri- ous. The idea still remains that if things hap- pen, if restoration occurs, there is something of the magic, the marvelous, about it. In other words, while he has made an advance in abandon- ing the will theory and recognizing the action of 106 AMERICAN NERVES imagination he needs to go still further and eliminate the mysterious and the casual element, and ground his whole system where it belongs in cold, practical, every-day intelligence. This does not imply an elimination of either emotion or will, which would of course be impossible. An effort to do that would be as great a mistake as the effort to eliminate intelligence. The will to be well must operate, the power to image health must be active, mildly and without the violent effort which tends to inhibit. The success of these two phases of mental activity should, how- ever, depend on an intelligent recognition of the fact that recovery can occur because and only because the mental and nervous (which here means physical) mechanisms in which the proc- esses of restoration must take place, if they do take place, are a natural part of the human or- ganism and it is precisely their business to func- tion so and not otherwise if they are given the opportunity. The Reasonableness of Suggestion In seeking release from nervous distress in this way we are not resorting to some strange, accidental, extraneous, and questionable practice. This is Nature’s way. She has installed her SELF-HELP 107 plant in the basement of our minds,—or the trans- marginal field, if that expression is more pleas- ing,—and has shown where and how the button is to be pressed. When we put the simple mental powers of which we are speaking into operation we are making our claim, appropriating our health, which by reason of our origin is usually implicit within us, in the same way in which the householder presses the button and calls on his electric plant installed in his basement to provide him with light, in the same way in which he ar- ranges his thermostat in the library and calls for warmth from his heater down below. If things are in proper working order he will get his re- sult. A reason for the faith that is in him, for the normal operation of will, for the normal func- tioning of imagination in his search for health, may prove necessary to the American mind. The nervous self-consciousness which is his na- tional inheritance together with his practical, common-sense point of view, may appropriate these facts; and why may they not also standard- ize the technique or the method which results, so far as it can be standardized, and embody it in a system, we might say, of therapeutic educa- tion, or, if you like, of educational therapeutics! 108 AMERICAN NERVES If something like this could be done, and, underneath the vague feeling of a need for will power and the confusing demand upon an imagination which does not know how consciously to respond, the nervous sufferer could have a plain call upon his simple every-day intelligence, it might help to make such efforts as Coue’s lasting rather than evanescent, and it might more often render such restorations as result from sug- gestion permanent instead of temporary. Why should not American minds do this thing for American nerves? A further consideration of the reasonableness of this possibility will be found under the head of “The Secret of Sug- gestion. *9 PART THREE COOPERATION PART THREE COOPERATION Psychoanalysis Twenty years or more ago Dr. Freud of Vienna came to the relief of many nervous sufferers with his psychoanalytic methods. The discovery of repressed emotional states as trouble-makers seems to be a practical contribution toward the solution of many nerve problems. The freeing of resistances caused by repression, the breaking up of unwholesome complexes by mental analysis, marked a new departure in the handling of nerv- ous and mental disturbances. This curious, much-discussed, and much-abused theory of nervous troubles has become in its unpopular way rather popular. In addition to its being a therapeutic medium for the general practitioner, the neurologist, and the psychia- trist, so loosely is it related to medicine and so closely is it allied to mental and moral reorgan- ization, the work of the teacher and the pastor, and the work of the literary interpreter as well, 111 112 AMERICAN NERVES that the new field has invited many theoretical and practical experimenters. While the Freudian psychology and the psycho- analytic theory are in general illuminating, physi- cians agree that the field for the use of psycho- analysis is found to be a limited one. It applies as a therapeutic agent to a very small class of cases as compared with the great variety of nerv- ous conditions which exist. Specialists who recognize the validity of the psychoanalytic method themselves limit its use to a restricted group of cases. It is supposed not to apply to persons of middle or advanced age. The homo-sexuals are excluded from its use, and there are many among the chosen few to whom it might apply who, contrary to theory, simply will not analyze. They have and continue to provide no available dream material to work upon. Early memories refuse to be uncovered and the subject is in general uncommunicative, inaccessible. Then, of those who go painfully through a long analysis, there are many who find in the end simply that nothing happens. They are just as badly off as they were before. The theoretic conclusion must be that they are “over- determined,”—in a sense, mentally reinfected,— and a new analysis is undertaken. If that fails, COOPERATION 113 as it often does, the final opinion is that back of all the trouble is a “constitutional tendency” that apparently refuses to be overcome. And there you are! One is grateful for the help analysis does give to the limited number of cases. Those who make large use of psychoanalysis and are devotees of the various schools which have arisen are in dis- agreement regarding the cause of improvement in cases which show improvement or seem to be complete cures. The layman need not, there- fore, be immediately concerned as to whether he got better because of the analysis or through the freeing of resistances or the breaking up of the complexes or the transference to the physician or, as some skeptics assert, by the happy suggestion of the new and flatteringly personal method. Whatever the hidden process by which the new evangel transforms our categories, whether or not it makes any real difference that we refer to complexes rather than to temperament as of old, it all helps to get away from the old physical idea that there must be some organic lesion be- hind all nervous and mental states. The specialist whom some one calls the physio- logical neurologist will still stoutly maintain that tflat is such a lesion, that if he had a microscope 114 AMERICAN NERVES strong and fine enough he could discover this physical cause, but that until he has discovered it we must assume its presence somewhere. That position provides an excellent argument for re- search work, which is, of course, desirable and necessary. That takes care of the research worker; but we do not all belong to his class. The dictum which fastens him to his laboratory and his microscope for the next twenty or fifty or one hundred years leaves the nervous sufferer where? Up a blind alley and his unfortunate nerves still with him. Self-Analysis Psychoanalysis is always self-analysis. Con- trary to the popular idea, neither the physician nor the psychologist analyzes the subject. He analyzes himself. One meets those who know something about this practice and who imagine the analyst dragging things out of the sufferer’s subterranean depths by a long series of searching questions—something like the “third degree.” The physician or psychologist guides, en- courages, explains, interprets; but any real anal- ysis is done by the subject himself. This fact is given by leading physicians who are ex- ponents of the psychoanalytic theory to explain COOPERATION 115 why they take as assistants some quite young and apparently inexperienced laymen with no medical and little psychological training. To the person who has a naturally psychologic mind, who is interested in mental problems, nerves, and their influence on mental life, the theory of analysis is interesting. The idea of repressions and conflicts and resistances and ra- tionalization and consors is intriguing, and even fascinating, to many people. It is a subject to read about if one is fairly well in mind and body. Those who deal with the sensitive, the disorgan- ized, the self-distrustful nervous sufferer can, however, hardly imagine his taking a book on psychoanalysis and reading it by himself and making much progress toward his own recovery. Cases in which a book of this sort can be used with advantage may be those of moderately well people who need regulating; but they are not quite of the class on whom our attention is at present fixed. It is decidedly contrary to the psychoanalytic theory to expect a novice to regu- late himself if he has troublesome complexes or to break up his own resistances without help. This theory and practice are based upon the existence of the submerged self, the unconscious mind. If the sufferer’s trouble is not entirely 116 AMERICAN NERVES buried, if it is only just under the edge of the unconscious mind, in what is sometimes called the fore-conscious or the pre-conscious mind, it may perhaps be dealt with by the subject himself. But, if it is buried deep, it is absurd to expect a person to unearth and dissolve his resistance by himself through merely reading a book. By some happy accident this may happen, but it is hardly regular to depend upon its doing so. The well-intentioned expectation that this may occur exists in the minds of those who, while ac- cepting the fact of the unconscious mind, do not fully realize its implications. They do not grasp its significance. Unconscious in this case means unconscious, and the person who takes something he finds lying within the field of consciousness and thinks he has “got” his complex is probably dealing with merely his rationalization of his re- sistance, which only buries the trouble still deeper. His little procedure satisfies him that he understands his trouble and gives him a com- plaisance which has a decided element of finality about it. His satisfaction in his own erroneous explanation will be the proof that his trouble still exists and has been only more deeply im- bedded by his effort to deal with it single-handed. The recognition of this fact does not in any COOPERATION 117 sense mean that one discourages independent and competent persons in their commendable effort at self-help. When one says, “I have read so and so, and it has helped me,” the answer is, “Good.” There are many persons disorganized or unregu- lated nervously and mentally who are yet close enough to the line of normality to bring a fairly healthy mental equipment to bear upon them- selves to do at least some preventive work and with a better knowledge restrain themselves from wandering into by-paths that had previously seemed harmless enough. The nervous sufferer who is looking for relief, courageous in his willingness to extricate him- self, sometimes says, “Perhaps a book would help,” and asks for something to read. There is probably no book written which he will find al- together helpful, but something is recommened. He takes it to himself hopefully and devotes him- self to it assiduously. He discovers a passage that seems to be particularly intended for him. Later he finds also something that appears to con- tradict the helpful passage, and his feeble, fluc- tuating, self-distrusting mind is unable to rec- oncile two seemingly discordant statements. His brave effort only discourages him and leaves him worse off if possible than he was before. 118 AMERICAN NERVES There is undoubtedly a class of cases who need and need desperately to be relieved temporarily of all responsibility for themselves. No one can specify offhand which cases belong to this class; but a little conversation with them will usually disclose the fact. They are, many of them, people who have been much alone or those who have been the unfortunate victims of the well-inten- tioned family conspiracy of the dear kindly but unknowing people who try to help by not sympa- thizing, by neglecting, by ignoring, or by a strained and hollow optimism which belies itself through the very deadness of the tone in which it is proffered No ultimate blame attaches to the poor dear conspirators. They are doing as they have been told, doing their noblest, and having a bad enough time of it themselves. They bravely struggle on with methods that are repugnant to them, methods that seem so unfeeling that at times they have quite disgraceful lapses into a maudlin sympathy which might well undo any good which may have been accomplished by a period of tenacious adherence to the hardy doc- trine they have attempted to follow. And there is the wretched self-accusing cause “Comrade, Here is My Neck99 COOPERATION 119 of it all floundering in his misery (for it is just as likely to be his misery as her misery), wonder- ing and wondering, like the turtle on its back, why he cannot right himself, questioning how long it must go on, analyzing and reanalyzing the problem as to why they, family and friends, can- not understand, listening now to catch what they are whispering about in mother *s room or discuss- ing down in the library with father—the innocent storm-center of the turmoil sitting, not quietly at the heart of the storm but with the storm raging all about him,—from very despair, silent, stolid, perhaps furtive,—feeling, as some one of them has described it, like a sane person shut up in an insane asylum with no one to get the fact that he is unjustly restrained. One has no disposition to force this sort of situation on households where it does not exist. When happier, simpler conditions ease the nerv- ous sufferer and the family along, we rejoice. Eeference is made to frequently experienced situations which are fairly represented by this description. No one need go searching for them. They are not the concern of the person who does not recognize the picture. The person who knows, the one who is looking for some way of escape for himself or for some one else, will do 120 AMERICAN NERVES his own recognizing with no call for prompting from any outsider. It is in many such cases both safe and fair to make an offer of help when one has a simple practical knowledge of certain principles which may cover the immediate need. I say, may cover the immediate need. There is nothing excessive in the confidence of the per- son who can quote in good faith to the suffering victim of nerves, under these conditions, those sturdy reassuring words of Walt Whitman: Comrade, here is my neck! By God! you shall not go down! Hang your full weight upon me. This encouragement contains no infallible promise. It means only, if you will let go of yourself for a bit, relax that high tension which may be half the cause of your panic or your de- spair, the strong chances are in favor of your getting help. This is no fanatic offer to allow some inert parasite to drape himself upon your person to be carried about for the rest of his life. No, curb your imagination! But just such a clear-cut ringing statement as this, without modification or equivocation and with the sharp jolt of the out- COOPERATION 121 standing and arresting appeal to deity, may be just the sort of approach some despairing fellow- creature needs to penetrate his misery and con- vince him that there is possibly some practical help at hand. A Path to the Seat of Trouble Authorities on psychoanalysis offer help to nervous persons who accept that method of treat- ment in a period covering from six months to two years. It is fortunately true that some sub- jects of analysis experience very definite relief from the beginning of their interviews and do not need the patience required for the longer period. But, to some, results appear to be very far away, and the long and tedious process does not seem to offer the immediate relief craved and needed by acute nervous and mental condi- tions. This being true, it seems the more curious that many if not most of those who use the psycho- analytic method have virtually abandoned a more direct and immediate approach to the uncon- scious which had previously been in use by a small circle of physicians and psychologists. This is the practice of reaching the unconscious mind, in which it is recognized functional nervous 122 AMERICAN NERVES trouble has its origin, by the use of what is called “suggestion.” This rather weak word seems a poor and inappropriate one by which to describe the procedure to which it is applied; but we shall employ it for the present, since it is in current use. The history of suggestive procedure is so familiar, and it has been so often reviewed since the beginning of this century, that there is no point in reproducing even a sketch of it here. Bernheim and Liebeault at Nancy, Charcot and Janet at La Salpetriere in Paris, Wetter strand in Sweden, Forel in Switzerland, Braid and Bram- well, Lloyd Tuckey and their later followers in England, Moll, Krafft-Ebing, Schrenck-Notzing in Germany and their followers, Prince, Sidis, Coriat, and others in this country, had made almost a household word of the term “sugges- tion” before psychoanalysis appeared on the scene. When the new psychoanalytic gospel came across the sea, the older method seems to have gone into the discard. It was hoped and believed that analysis would give more satisfactory and more lasting results than had yet been secured by the use of suggestion. Then, too, the new method was very fascinating. COOPERATION 123 Some objections to the suggestive method were that it required the use of hypnosis, which many people were still ignorant enough to fear. Even those who had a scientific knowledge of its harm- lessness in the right hands found the adamantine wall of crude prejudice against it too formidable to break down. Those who continued to use sug- gestion under hypnosis found it sometimes very difficult to induce. Some subjects needed a long time to learn to be hypnotized, and some were never able to cooperate with the hypnotist. Later it was learned that the use of deep hypnosis was unnecessary, that the subject re- sponded readily to suggestion given in light states of dissociation, which were nothing more than normal sleepiness. But complaint was made that help secured in this way did not last and that persons so helped became dependent upon the operator, as the person making the sugges- tion is called by those of the French school who use this method of help. Some of those who abandoned the older medium for the new and fascinating analysis must have rejected their tool before acquainting themselves with its full value. Its great value is that more frequently than analysis it gives immediate access to the seat of trouble. 124 AMERICAN NERVES A Psychologic Friend The practice of addressing suggestion to the un- conscious mind, using the slightly dissociated con- scious mind as the channel through which the sug- gestion passes, is a psychologic procedure. The psychologist at home with “the things of the mind” finds himself turning familiarly to this medium in dealing with the disturbed, the de- pressed, or “panicky” self and finds it a method worthy to be reclaimed and rehabilitated. It is capable of fine adjustment and adaptation to the needs of the nervous sufferer. It may be used in a manner which secures immediate and lasting results, when this is the direct aim and when tech- nical care is taken that the result wished for is secured. It also becomes evident that if the subject develops a spirit of dependence upon the opera- tor it is only because the operator did not ex- ercise sufficient care that this should not occur. The same definite handling of that matter which is used in banishing troublesome nervous condi- tions ordinarily gives results. With definite in- tention and technical care in this matter, I have never known failure and I have known many suc- cesses. The highly specialized use of suggestion, the technically detailed and finely adjusted applica- COOPERATION 125 tion of this method in the light and perfectly normal “sleepy state,” offers the accustomed psychologist a medium of approach which justi- fies him in offering to the nervous sufferer the privilege he craves and which he has usually earned, the privilege of relaxing his sense of per- sonal responsibility for the time being. This is just and fair to him because science has shown us that this trouble does not lie in the mental field which is normally covered by the will. It is, with no magic or mystery about it or any claim to an especially high degree of ability on the part of the psychologist, that he takes over the temporary responsibility of the nervous sufferer. It seems fairly reasonable to suppose that, the trouble of the functional nervous distress being located in unconscious mind and the psychologist having in a technically refined method of sug- gestion a medium of direct and immediate ap- proach to the unconscious mind, he should be able to reach the seat of the trouble. There is noth- ing either fantastic on the one extreme or in- fallible on the other in this claim. No sane and sincere psychologist promises re- sults. Experience justifies his expectation that, the diagnosis of the physician on which he of course relies being correct and the subject 126 AMERICAN NERVES normally cooperative, good results should natu- rally follow his efforts. The untrained mind, which is not at home in the field of psychologic technicalities, may declare this “all bunk,” as a self-confident skeptic did pronounce it recently. He further proclaimed that if anything of that sort would help a person he would get well anyway. Every one recognizes the possibility of that happy issue out of nervous troubles. This fortunate event is always possible, as it is quite possible that a typhoid or pneumonia case may recover without the aid of a physician. This has often occurred. Nevertheless, in such cases we usually send for the physician if he is at hand, and when recovery ensues we assume that the physician’s services have probably been a factor. A Physiologic Friend The deep and thorough relaxation of a nervous person when he is once relieved by physician or psychologist of immediate responsibility for him- self is pathetic indeed. It tells a story of the immense strain he has been under, floundering in his own impotence and “stewing in his own juice/1 as the homely saying goes. The more his right temporarily to abandon effort in his own behalf COOPERATION 127 is emphasized, the greater will be his relief and the more helpful will be his relaxation. “They keep telling me that I should try to be more cheerful or less anxious about myself, less afraid. They think I could sleep more if I would just expect myself to, and I do try. I have tried and I keep on trying, but it does n’t do any good.” So the lament goes on and on. “Yes, yes; I know,” or some such response, is not a sufficient answer. It is not adequate to the situation. It is entirely out of proportion on the minus side. Such an answer does not fit a long- continued tragedy of pain and effort. The per- son who is at home in dealing with such a ease, who grasps the true inwardness of what is needed, will lay himself out for a few minutes—not seconds, minutes. Minutes! what are they to give in recognition of this inner and continuous tragedy of mental pain and futile effort! “I know, I know all about it. I do know. I understand. I’ve been through something like it myself, and it is horrible. It’s just as horrible as you think it is. Some one ought to have told you that you cannot cure yourself without help. The trouble is where you cannot reach it. You’ve been trying to do the impossible, and you’ve been splendid; you’ve been wonderful. You are a 128 AMERICAN NERVES hero. You are a heroine. I place the victor’s crown upon your brow because you’ve been more courageous than many heroes are ever called upon to be when they meet with success. And now you mustn’t try any more. Just give the whole big burden over to me. Dump the whole miser- able thing off upon my shoulders. Don’t you carry it another moment. This is my job. That’s what I’m here for. And, what’s more, I hope I can carry it just as long as you need me to carry it if you can let me. 4‘Don’t even think of ever taking it back. If you get where you can manage yourself, you ’ll know it and want to take charge of yourself again. You ’ll enjoy it. You ’ll be just as glad to be rid of my help then as you are to have it now. But we ’ll just go along together for a little while, and you will give me a chance to try to reach past the place where your conscious mind is liv- ing, down into that deep, dark chamber where these bad nervous habits, these accidental bits of bad mechanism, have unfortunately established themselves and are going on without your con- sent and literally against your will! ’ ’ There! that might perhaps be enough! “What’s all that? That’s a speech. All that at once?” COOPERATION 129 “No, not necessarily all at once. Pauses and a few remarks thrown in between if you like; but a great overwhelming deluge of comfort if you can manage it. It ’s needed to compensate for the continuous deluges of pain and distress and anxiety those grinding nerves and minds have been giving with a good deal of help from the ‘family’ conspirators.” “But it is n’t safe! It’s wrong. You promise too much.” No, one doesn’t promise anything except to be willing to relieve of a burden which will probably very largely disappear into thin air at least tem- porarily while one talks, a burden which will seem to have been shifted upon other shoulders. There will be an experience of relief while the helper has no sense of added weight but some conscious satisfaction, however, in witnessing the relaxa- tion of suffering. Mothers, wives, husbands have asked, after such an interview: “What did you say or do to him, to her, to change his, to change her, face like that in such a short time! The face and expression are so different, so rested!” Just reassured him or her and relieved some anxiety and tension. We are talking about a physiologic friend. Yes, the wonderful habit-forming tendency in our 130 AMERICAN NERVES nerves and minds has done all the harm by wrong automatic action, and, reversed, it can undo the harm and reestablish old normal habits. Because you may rely on nature’s help through the very constitution and functioning of the physi- cal organism, it is safe to come to the rescue of the nervous person until the good work has been done if it can be done. The Secret of Suggestion The statement has been made that there is nothing magical or mysterious in the ability of one using psychologic methods to assist in the process of breaking up bad nervous habits and the reestablishment of normal habits. The secret of the efficiency of suggestion is an open secret. The fairly intelligent person who understands a little simple physiology will know that he is belit- tling himself if he assumes the possession of any special power or gift in giving this sort of help. The dynamic medium at work is resident with- in the subject. It is not in the operator. A person who claims or allows others to attribute to him any sort of peculiar power in the doing of this work must be, in the nature of the case, ignorant, thoughtless, or insincere. This applies COOPERATION 131 to all forms of remedial psychologic practice, “divine healing,” Christian Science, the method of the charlatan, and all the rest. The process which takes place in the mind and nerves of the sufferer from functional troubles when his distresses are relieved is the natural automatic functioning of nerves under specific stimuli. It is common knowledge among those who are ordinarily informed regarding our physiologic structure that we have a double nervous system: the cerebrospinal part, recognized to be the organ of the conscious mind, and the vegetative part, which concerns itself with the unconscious auto- matic functions of the body. These latter proc- esses, being carried on by the vegetative nerves, are not under the control of will but yet have some indirect connection with conscious mind. If this were not true, sudden embarrassment, which is a self-conscious mental state, could not interfere with the unconscious process of circulation and send the blood flying to the cheeks. If through conscious mind and its physical organ, the cerebrospinal system, there were not some connection with the unconscious functions of the body, a piece of bad news, exciting to a dis- 132 AMERICAN NERVES turbed mental state, would not interfere with the automatic function of digestion which we all know very well it often does. There are persons who still refuse to admit the existence of the unconscious mind, forgetting that the proofs of its existence are as sound as the proof of the existence of conscious mind. These common facts just stated imply that there must be such a thing as the unconscious field or some thing' equivalent to it. Its practical reality is established by authoritative minds, which further recognize that, as we know the cerebrospinal nerves to be the organ of the conscious mind, the vegetative nerves must be recognized as the organ of the unconscious mind. The vegetative system and the unconscious mind seem to control all automatic processes, good and bad, healthful and unhealthful, intentional and unintentional. When nervous habits like fear or indecision or sleeplessness or spasmodic twitching or inhibited motor processes persist by some accident in carry- ing themselves on despite the sincere effort of the will to interfere, it is because for the time being they have become automatic in some such sense as digestion and respiration and elimination are automatic. They have been taken over by COOPERATION 133 the unconscious part of the mind and its organ the vegetative nerves. These habits may not have gone so far beyond the field of volition that good sturdy effort of will, if the will is normal, cannot get them back. Then that is not a very serious condition. The bad habit may not have become so automatic that a good wholesome shock or jolt may not suddenly by accident or intention bring control back into the field of normal will. There is the bedridden woman and the accidental fire; there is the hysteri- cal lady and the intentional spanking; but such radical jolts as these do not occur to people every day. Servants and Friends Since nature has installed in us a compact, usu- ally well-organized nervous mechanism to take care of us, or still better, provided us with trained servants to do our heavy work down in the basement of the unconscious, leaving us free to live, with no responsibility for our “functions,” up in the parlor of the conscious mind, it seems but reasonable that we should have a friendly feel- ing toward these servants as toward fellow- workers. This might indeed be a case in which 134 AMERICAN NERVES one might appropriately say, “Henceforth I call you not my servants but friends.” Learning what good and constant though some- times unappreciated care they give us, our prac- tical and economic attitude might wisely be one of friendly cooperation toward them. Since our nerves do so much of our hard work, provide us with our finest discrimination of values and all our pleasurable reactions, and seldom desert us unless we abuse them, what need could there be for anything but cooperation between us? A house divided against itself gets into trouble. It would only cause a schism in the body politic if a divided plan of action were adopted. Since also the action of our servants below stairs must be automatic, without direct and independent in- telligence except through the conscious mind, and, since we “the intelligentsia” who live up in the parlor of consciousness are the householders who dictate the policy of the house, does it not devolve upon us to see that there is a community of in- terest, a mutual understanding, and a coordinated and harmonious life fostered by us within our own domain? Even when our nerves are misbehaving, since we find them so amenable to reason, since their very nature and life consist in a rhythmic con- COOPERATION 135 formity to the law of being, why should we ever find occasion to oppose or to outwit them? The picture of a contest of wits of one against the other, suggesting rivalry, perhaps, plots and schemes to get the better of one another, would not seem to be nature’s way. Some physician has recently said something like this: Every well-ordered organism, every body which is func- tioning normally, has a right to have always as a background of consciousness a systematic sense of well-being, or at least a semiconscious ease and comfort just in functioning wholesomely. This is probably what people feel when they say, “It’s good to be alive.” Where is our sense of well-being if there is a feeling of opposition anywhere, even friendly con- test, or the habitual attempt to get the best of any part of the self? As complete an integration as possible in every part, a deep confidence and sense of interdependence, and an understanding that we are doing team-work would seem to be the success- ful way within the bodily organization as in other organizations. Some one who had not gone very deeply into the subject of suggestion used as a remedial agent said to a psychologist who practised it, “I suppose you have to work pretty quickly and expect your 136 AMERICAN NERVES best results in the beginning.” Then, with a wink, “Doesn’t the trick wear out after a bit*?” The “trick” idea he must have got from some charlatan. The psychologist uses no triak of any sort. There is some misapprehension here. No trick is necessary. How could any sort of expe- dient produce results unless there were a great natural principle of action at work behind it? The psychologist identifies the principle and goes along with it as simply and directly as he can. He falls in line with that vital tendency of nature called “automatism,” the homely every-day ten- dency of repeated action to* become fixed habit. It is a-principle as deep as the universal life and as unerring in its operation for good as well as for evil if once even in our clumsy way we succeed in our effort to cooperate with it. Can the principle of rhythmic action which re- stores our bodily processes to health be other than that mighty power which turns the spheres and swings the tides,—the “cosmic force,” if you please,—specialized or “pointed up” in our in- dividual minds and nervous systems for our spe- cific purposes? This proves to be a big idea when once it is grasped. It reminds one seriously of the recent whimsical addition to Emerson’s line: COOPERATION 137 Hitch your wagon to a star; Keep your seat and there you are. The achievement is, of course, having hitched your wagon, to be sure of keeping your seat. So beneficent is the action of this natural prin- ciple when we submit ourselves to its remedial processes that we name it God and call it miracu- lous. It is as miraculous as all nature and as simple, so far as we can see into it. When our “spiritual healers’’ grow mysterious about their “cures,” we wonder if their God is not the God of the body and the mind, the God of their own physiology and psychology. This way of automatism is quite obviously the road along which all natural processes must travel in establishing good habits of health as well as bad ones. If one chooses to call a specific process into operation by an emotional appeal to deity rather than by the natural and direct psychologic approach, that is merely a matter of choice. But one quite reverently pictures a patient God re- plying, ‘ ‘ Oh, yes, if you like; but why not set the processes in motion yourself since I have shown you how and you know the current is always on, especially when there are still so many things that you have not yet learned to do for yourself?” 138 AMERICAN NERVES But what about the people who have, perhaps, with no blame to themselves, some serious handi- cap like poor physical inheritance, badly coordi- nated or “highly strung” nerves, excessive, acute, or chronic fatigue, which may conceivably have been brought on by some unselfish devotion ? They are not so fortunate as to be capable of a com- paratively easy readjustment^ Is it not fortunate that for these most helpless of all sufferers there has been installed by nature in their blessed old human anatomy that practical automatic mechanism, that gift of God, if you please, consisting of the coordinated conscious mind with its servants the cerebrospinal nerves, which, across the bridge of the vagus or pneumo- gastric nerve, are in direct communication with the unconscious mind and its servants the vegeta- tive nerves, which are working away down there in the basement carrying on all the regular mechanical work? They are ready when a con- scious, though quiet, mind above sends down through another cooperating mind a suggestion to the well-trained and perfectly amenable serv- ants below. The suggestion says: “A bad nerv- ous habit went down to you by mistake. Send it up again to the field of will.” People Who “Can't” COOPERATION 139 The habit having dropped by accident into the basement, the well-trained servants there took possession, just in routine, and kept it going be- cause it is precisely their business to keep things going. When they are working they keep every- thing going that they can get their hands on. They have a “work complex.” No one need be arbitrary here about, just the people who can and the people who cannot help themselves. Give a hand by all means to those who can by any fair method get hold of them- selves. And there is an enormous amount of good red courage displayed by people who honestly be- lieve that they “can’t” but yet honestly try and somehow do achieve their purpose like the in- verted turtle who finally writhes and squirms his way over. But this is not a pleasant or a normal process. The turtle’s legs might be more natu- rally employed in crawling on earth than in paw- ing air. The case of a woman comes to mind who had something to do which she could not do, which she knew she could not do. She kept repeating, “I can’t; I can’t; I can’t.” Then, suddenly re- membering certain instructions which she had re- ceived, she said: “There is one thing I can do, I can leave the ‘ t ’ off can’t. I can say, * I can; I 140 AMERICAN NERVES can; I can.’ ” She did this immediately possible thing and kept on doing it. She repeated ‘ ‘ I can ’ ’ fifty times, a hundred times, “and then some more,” she said. She woke up in the night and did it again—in a sleepy condition, which was good. Presently she said she began to think per- haps she could and then to feel a little surer and still surer. Finally she did the impossible thing. Such cases are taken into consideration. They are all accounted for, even the case of the man who, feeling hopelessly down and generally in- adequate to life, gets no more scientific help than a thump on the shoulder from some Philistine who knows no better method and the scornful taunt, “Oh, buck up!” Ungracious as it is, such an appeal does sometimes give the jolt that breaks the faulty mechanism and lands the cause of trouble upon the shore of volition when it is within control. Such cases can be quoted indefinitely, but they do not touch the scores and hundreds of suffer- ing minds whose trouble has become so automatic that it is literally out of reach. For one “shell- shocked” soldier who is jolted back to self-con- trol by a laugh at the motion-pictures, there are hundreds and hundreds whose troubles are being “fixated” in the unconscious for long periods or COOPERATION 141 for life because there has been no adequate tech- nical effort to reclaim the harmful automatic proc- ess which accidently got into the hands of those subterranean servants whose business it is to carry on everything that falls within their grasp. Because some nervous persons can help them- selves is no reason why people who have not dis- covered the happy combination for doing this should be denied help. Did you ever have any one set over you to determine that every naturally hard thing should be made just as difficult as possible before you were given the reasonable as- sistance which should bring the seemingly im- possible within easier range? It is conceivable that even the person who has not tried just as hard as he possibly can has a right to help if he can get it. Struggle with abnormal conditions is a waste if the cause for struggle can be averted. The energy that goes into a fight just to get upon a normal basis where one may begin to live might better be conserved and turned to some constructive purpose, if we must be so cold-blooded as to fall back on an ecomomic argument. Otherwise, if it is a good thing to create artificial causes for struggle, why not manufacture a few for your benefit? Why not hang a few bricks about your own neck, seal 142 AMERICAN NERVES up one of your eyes, bind your right arm, or put one of your legs in a plaster cast and then tell you to go about your business. Even then, with a normal mind and good nerves to help you adjust yourself, you would be a deal better off than some of these nervous people to whom it is constantly reiterated, “No one can help you but yourself.” Weakening the Will “This use of suggestion, getting another per- son to do for you something you think is too hard to do for yourself, is weakening to the will,” sagaciously urges some one who accepts as true the crude and outgrown ideas regarding the dominance of one will over another. Even if hypnotism were used as a medium of approach to the unconscious mind, the statement would not be true. Not even from the crudest charlatanic use of hypnosis do such false ideas arise. Hypnosis is a procedure in which minds must cooperate. The subject must voluntarily accept the idea of the operator. If a person resists hypnosis he cannot be hypnotized. There is very often even an unconscious resistance in the sub- ject’s mind which he may regret but which pre- vents him from securing the wished-for result. Reliable scientific or professional workers would COOPERATION 143 never undertake to hypnotize a person even for his own good without his consent, and one who tried to do so would fail. This is the consensus of the best scientific thinkers. But in such use of suggestion as we are considering hypnotism is not employed. The process is simple and natural, making use of only the normal psychologic prin- ciples which children use every day in their school life and without which no one could get even a common-school education. When your boy commits his tables to memory he commits them to his unconscious mind, and he makes as much use of this supposedly mys- terious region as a nervous person does in seeking relief by suggestion from functional neuroses, such as spasmodic twitching of the face, for in- stance, or insomnia or nervous indigestion. If a patient is dealt with by an operator of fair intelligence and sincerity, there is no more danger of weakening the will by this process than there is of weakening the will by learning daily lessons from a trusted teacher. The phase of mental activity employed in this process is not will but intelligence. Were a person planning to oppose his will to your help he would presumably not ask for it. If one does ask for help you ask him for the cooperation of his intelligence. You 144 AMERICAN NERVES help him to see that the thing he wants is reason- able. Having convinced him of this as well as you can, you encourage him to understand that if he could hold that idea long enough in just the right way it would pass over to the unconscious field and become habitual; but, since he does not wish to wait for the working out of that process and since it conceivably might not happen if he did wait, perhaps we together can hasten the action and “fixate” the idea in his subconscious as it already exists in his conscious mind. There is far more danger from the use of drugs in untrustworthy hands than in the use of this simple natural operation. Such is our confidence in the medical profession, however, that we con- stantly put ourselves with perfect safety in the hands of conscientious physicians, knowing them to be men of training and integrity who can be implicitly trusted. The psychologic procedure which undertakes to dislodge troublesome extraneous material from the unconscious mind and break up harmful auto- matic habits is a process of friendly cooperation between the nervous sufferer and the psycholo- gist. No intelligent or sincere person would un- dertake to relieve nervous conditions in this way on any other basis than that of cooperation, COOPERATION 145 because he would know that the effort must be destined to failure. The purpose of this sort of help is to readjust disordered conditions and, in addition, to qualify the nerves to take care of themselves in future. No such undertaking as this could be counted a full success unless both these results were secured. Some writer has recently referred to the use of suggestion as aiming only at removal of a symptom, leaving the cause of the symptom un- touched. This casual or unpsychologic method is long outdistanced by up-to-date people. The trained psycho-therapeutist, be he physician or psychologist, aims at no such superficial result. The removal of the symptom is but a part of the task. If the worker understands the principle of psychologic activity which he utilizes, he knows it will apply to the removal of the cause of the symptom in precisely the same sense in which it applies to the removal of the symptom; that is, assuming the physician’s diagnosis to be correct and the symptom not of organic origin. The cause of the patient’s distress can be handled in the same way in which the strengthen- ing of the will is handled, which is in the same Strengthening the Will 146 AMERICAN NERVES way in which the removal of the symptom is handled; that is, quite simply, by not neglecting it, by paying definite attention to it. By treating those automatic servitors down in the basement of the unconscious exactly as you would treat the automatic servitor in your own basement kitchen, giving them explicit, detailed, and reiterated directions regarding what is expected of them. It is fair to assume that they will attend and function as perfectly as the most perfectly trained English butler, unless you fail to make connections or there is some other very good reason for their doing otherwise. The “strengthening of will” is a formal term and no one knows precisely what it means. In functional neuroses we conceive of the unconscious mind with at least some of its attendant vegeta- tive nerves as disorganized. Something that does not belong there has been dumped into a smoothly working, usually automatic mechanism and forced the machinery awry. It needs to be readjusted. It is like a disorganized household, and it must be reorganized. That is too large an order for the very wisest human. Nature’s effort must be enlisted, but she may need some assistance. If the task is com- mitted to nature, the chances are that nature will COOPERATION 147 attend to it. The careful and definite suggestion of normal adjustment of equilibrium, of a read- justed balance, consciousness of a will normally and strongly centered and functioning seems usu- ally to do the work. It is not that one realizes a consciousness of ability to make greater effort of will, but that the unconscious falls into line and does its work automatically. This is followed by a dawning consciousness that things have righted themselves and the will can resume control. This point is nicely illustrated by the case of two young women who were receiving technical suggestion in the light dissociated state or common sleepiness. One, a public singer whose name is now familiar to many, was seeking release from stage-fright, the other from self-distrust and chronic indeci- sion. Neither one had happened to mention her lifelong fear of thunder to the psychologist. It was April, and an early thunder-storm during the night surprised both young women into the discovery that a readjusted balance, a newly established equilibrium, had covered the old long- standing childish fear, and in both cases it had literally vanished in a night. In the same way if one works deeply enough and broadly enough, in addition to specific bene- AMERICAN NERVES 148 fits one seems to get a general readjustment, with some by-products, which brings the power of normal will into its own again but more strongly than ever before. Any one may cavil at our forms of speech. It is difficult to express these things if one grows too matter-of-fact. We need to be fluid in our thought to accept the parable and grasp the mean- ing. If one becomes too critical we are reminded of the highly specialized neurologist who offered not long ago and expected serious allowance of the time-worn though, when analyzed, curious expres- sion, “a decay of moral fiber.” Morals are not fibrous unless we can accept “readjusted mental balances.” If we are over- burdened with scientific skepticism, various living examples come to mind who would joyously give their testimony and say that the experience of a strengthened balanced will is a reality whatever vague forms of speech we are obliged to use in describing it. With the recent and more highly developed use of suggestion by physicians and psychologists, a more definite significance attaches to the term. Though, as has already been said, the word seems Indirect Suggestion COOPERATION 149 inadequate, it is the best that has yet been found and is perhaps better than some stronger one which would carry the idea of arbitrariness or coercion. With the development of psychologic thera- peutics and reeducational methods, the term is more technically used. It is incorrectly applied to casual indirect conversational suggestion. It is considered scientifically to apply only to the giving of direct suggestion addressed to the unconscious mind in the dissociated or “primal” state, that is merely plain every-day sleepiness. Technically the term is not used as some persons casually use it, applying it to ordinary indirect conversational influence. If a person who thinks himself ill sits before you in a straight-back unrestful chair, with strong light shining directly into his eyes,—perhaps with distractions of various sorts and noises going on about him,—and you tell him ever so emphatically that he is looking better, he has more color than ten days ago, another week ought to make a decided improvement, and you hope when you see him next he will be still better—while you are in- directly making encouraging suggestions to him, that would not to-day be thought of by a techni- cally trained person as the scientific use of sug- 150 AMERICAN NERVES gestion. There is no telling but it might do good. No one can say that it would not be helpful; but no definite therapeutic or reeducational value could fairly be attached to it. If I had an object in my hand and there was a box over in the corner in which I wished the object placed, I would not shy the object at the box with the hope that it might by a happy accident knock the cover off and drop into the box, and that the cover by a happier accident might replace itself again. If it were of professional importance, say, that the object should be placed in the box, if, for instance, some one should be paying money to get the object put into the box and there were a sense of responsibility, the object should be technically put into the box—the cover first re- moved, the object placed in the box, and the cover carefully put on again. Direct Suggestion If it is of real importance that a good idea should be fixed in the unconscious mind, the cover of the unconscious mind may be taken off, the idea carefully placed within it, and the cover, as it were, replaced. The part of the process which corresponds to the removal of the cover is the quieting of the COOPERATION 151 conscious mind so that it may serve as an open- ing, a channel, through which the idea to be fixed in the unconscious mind may pass. Regarding this simple and natural process there has been much misunderstanding. Since the use of hypnotism has proved extreme and unnecessary and has been virtually abandoned, a lighter state of quietness or of dissociation has been used. Concerning this state there has been some discus- sion. It is, so far as any one knows, mere every- day sleepiness, and it is safe and natural to think of it in this way. With careful attention, an un- usually deep quietness and relaxation of nerves is sometimes secured, and this method of inducing quietness is just as dangerous as a mother’s cradle-song to her baby; no more so. The effect is merely of a very profound and agreeable re- pose, about which more will be said under the subject of “The Primal Rest.” Because the use of this comparatively light natural state has followed the rather mysterious and apparently uncanny practice of hypnosis, which was often rather roughly induced, it has appeared so simple a part of the process that some persons have thought it might be dispensed with. This seems not to be the case if one wishes to obtain serious and definite results. This quiet- 152 AMERICAN NERVES ness appears to be a very important and far- reaching part of the procedure. If one has diffi- culty in securing it,—and there is a marked differ- ence in differing temperaments in their power of response,—if only a slight degree of quietness can be secured, there is no reason for omitting it. That slight degree seems quite necessary. It is the uplifting of the cover of the unconscious, the establishment of communication with it. Even those operators who have given up the use of hypnosis, who do not intend to induce it, seem to hold more or less to the old form of procedure. The using of a stern tone, the ap- parent effort to dominate, holding down the eye- lids with the firm assurance that they cannot be opened—all this crudeness of form seems to the average psychologist unnecessary and inappro- priate and is virtually abandoned. It gives an unfortunately false impression of its purpose and of what the relation should be between the oper- ator or helper and the subject or nervous person to be helped. It keeps alive that old false idea that the work is done by the imposing of a strong will upon a weaker one, which very distinctly need not be the case. This misconception has given rise to the also misleading and unfortunate impression that there COOPERATION 153 is always danger through this process of a weak- ening of the will. With this whole procedure the will has vir- tually nothing to do. It is not a matter'of will power at all. (Indeed the operator may well be the weaker-willed and the subject the stronger- willed person of the two.) It seems impossible to rid even very intelligent and well-informed per- sons of this idea. To retain it means holding an unpleasantly false conception of this whole matter. Friendly Cooperation The process in the suggestive method of help is one of friendly cooperation and is so repre- sented to the nervous sufferer. The more active part is naturally taken by the one who gives the help. Sometimes a person who has vague ideas about this method, ideas which are unfortunately tinctured with a superstitious fear of “something hypnotic,” asks tremulously and eagerly, “What exactly do you want me to do!” and the answer is: “For the present, just exactly nothing at all. Your doing for the present is done. You have done enough. This is my affair. I am, with your permission, doing the whole thing myself. 154 AMERICAN NERVES Your very slight but very important share is just quietly to let me do it. If you can cooperate with me in this simple way, the time will proba- bly come when you will not need me or any one else to help you. You will then have much more satisfaction in relying upon yourself than you have now in relying upon me. Self-dependence when one is well, normally adjusted, is a natural outcome of those most fundamental instincts of self-preservation and self-protection. Presently your time will come, but while we are getting things right again, ‘Comrade, here is my neck!’ ” To one who sees in this process of nervous and mental reconstruction and adjustment a simple expression of a natural psychologic principle, it is repugnant in the extreme when any one at- taches to it any magical or “marvelous’’ signifi- cance—marvelous, if you will, in the way in which all nature’s work is marvelous, but requiring no special gift or power; just a little psychologic understanding and some human patience. The thing uppermost in the mind of the helper in dealing with a new person is the desire to show him the naturalness of everything that is done. In undertaking to help him secure the quiet state one tries, as in dealing with children, to “get the point of contact,” and so the method COOPERATION 155 of approach may be, “Do you ever get sleepy in the daytime?” What follows depends upon the answer. If it is “Yes,” that calls for some such response as this: “If I could have you at that time and sit beside you while you were dropping off, that would be the perfect way to get the sug- gestions into your unconscious mind.” If the answer is “No,” then: “Well, if you did that might help us, but since you do not, and if you would n’t mind lying down on the couch or sitting in the comfortable chair, perhaps you can get a little sleepy now. If we draw the shade and make you comfortable and quiet and surround you with naturally soothing influences, the reasonable thing would he for your nerves and mind to react with quietness, would n’t it? If a fire engine should go clanging by or jazz should start up outside the door, we should expect that to disturb and should allow it to do so for the moment. “Now, by precisely the same law by which we should allow disturbing influences to disturb, we are going to permit soothing influences to soothe. It will probably help to keep your mind from be- ing overactive if you will permit me to hold be- fore it a little succession of suggestions which will make it realize the quieting conditions by 156 AMERICAN NERVES which you are surrounded and give them an op- portunity to help you become quiet. ’ ’ Then a few moments of such suggestion as, “You are voluntarily giving yourself up to rest. Disturbances are shut away. You are surrounded by soothing and quieting influences, and they will naturally have a soothing and quieting ef- fect”; helping in this way to quiet the body and then the mind, and following this by the further suggestion that though the condition may not be very deep it is all that is necessary to give ac- cess to the unconscious mind. And then, “The unconscious mind is now accepting and holding and using these suggestions,” etc. They are then put in, with a change to a slightly firmer though a quiet and level tone, repeating with a steady emphasis the things which the person wishes to have 4 4 fixated ’’ or made habitual. And in all this process, observe, his intelligence is with you, not his will against you or yours against his. This is all along the line of normal nature’s least resistance, if we will understand and co- operate with our friendly nerves who know their business and are just waiting for orders. Why any need of a show of special power or Nature's Way COOPERATION 157 implication of “my stronger will,” or sugges- tion of force or coercion? Any self-respecting nerves resent that at once, and then the charge comes back from the aggressive operator: “You are you resisting me,” etc. To the psychologic mind which recognizes nature’s simple prin- ciples of mental action, this forceful method is offensive, seems to smack of the charlatan, and is waste. Why such little human bluster in the presence of great nature’s quiet unerring principles, so much stronger than we are and so much more ef- fective? If we fail it will not be her fault. Some- thing other than nature goes wrong. A prominent European neurologist has said in explanation of his rejection of the use of sug- gestion: “There is something distasteful in forcing upon another mind what it does not understand and may not want!” It is fortunate that, having only this conception of therapeutic suggestion, he has abandoned its use. ffThe Primal Best” Poul Bjarre, a disciple of Wetterstrand, the famous neurologist of Sweden, in a little book on the general subject of psychologic methods, refers to the preliminary quiet state which he seeks to 158 AMERICAN NERVES induce in his use of technical suggestion as ‘ ‘ The Primal Rest,’7 and he attaches great value to it. If the quieting suggestions are carefully given and any successful degree of cooperation on the part of the patient results, there is an unusual re- laxation of the whole nervous system. A deep and very acceptable sense of rest is experienced, and Dr. Bjarre aims in some cases at a continua- tion of this for a protracted period when long rest is needed. This is a modification of the previous practice of Dr. Wetterstrand, who believed in giv- ing some exhausted mental and nervous sufferers a long-continued hypnotic sleep. This was a dif- ficult thing to accomplish, as, contrary to the scare ideas of the average mind, the patient would not stay hypnotized. He tended to emerge about every twenty-four hours and required to be put back into hypnosis again, which was not always convenient. The lighter and perfectly natural rest secured by the sort of suggestion which has been pre- viously outlined is greatly valued by Dr. Bjarre. He has taught us to see a deep significance in it. Reasoning that this complete repose is most easily secured in children, less easily induced in adults,—though some degree of it is quite easily COOPERATION 159 attained even in old age,—Dr. Bjarre likens it in a sense to the fluid and formative prenatal condi- tion. One who has experienced and profited by this rest describes it as leaving one conscious ard quite able to move yet so perfectly reposeful that there is the greatest disinclination to do so. A previous morphine user, if not a habitue, in rousing herself from a short period of such rest, exclaims as she gathers herself together with a look and manner of refreshment, “Oh, it *s so much better than morphine!” There are many “constitutional neurotics” who believe themselves to be poor subjects for help because they have seen father or mother go- ing through nervous or mental experience which they recognize themselves to be recapitulating. Even though this experience may be the result of their response to the unconscious suggestion of the domestic drama enacted before their young and impressionable eyes, they are dominated by the idea of inheritance and say: “It is no use; I was born this way. My father went through all this before me, and it*s my destiny. I might as well accept it.” Dr. Bjarre believes there is real ground for hope for some of these cases in this light but effective repose which he so comfortingly calls 160 AMERICAN NERVES “The Primal Rest” and associates with the nat- ural fluidity of the formative prenatal period. One may justly lead some responsive natures to expect an experience which, if not equivalent to being born again, may perhaps approach to be- ing made over. In effect the too inflexibly tightened screws of being may be temporarily loosened, some desired readjustments made, the mechanism made tight and firm and serviceable again, with a better ability for normal functioning, for more readily establishing the normal relations of life. Analysis and Suggestion There are some minds to which the Freudian theory of analysis makes a strong appeal and who employ it as the only form of psychologic practice. There are others to whom it is entirely repugnant and still others who find a combina- tion of analysis and suggestion helpful. In order to realize the difficulty of estimating the results of psychoanalysis, one must first lay hold of the far-reaching power of suggestion. One says, realizing that to be an absurd demand, that no living mind can know the effects of sug- gestion. There is not now nor can there ever be an exact medium of measurement. Paradoxical COOPERATION 161 as it may seem, suggestion appears from some points of view the one and only accurate and scientific therapy, because it is the only one that can be applied, having no other agent confused with it. In the use of medicine, in surgery, even in the use of electricity or psychoanalysis, we have to reckon with the fact that the most potent form of indirect influence, that is, unconscious suggestion, is always wrapped up within these various forms of therapy. And we cannot reckon with it. It is impossible that it should be reckoned with. It is an entirely elusive agent, and no laboratory demonstration can ever be made showing that it has been scientifically excluded if the patient knows that something is being done to help him. If we could grasp the far-reaching influence of this fact, a good many things would be made over. By intention, the use of psychoanalysis is in direct opposition to suggestion. But the inten- tion is a thing of air. The use of psychoanalysis always carries a strong suggestion with it, a fact before which the wisest physician or psychol- ogist is impotent. A young woman living in a rural town was a member of a large family, in which she and her 162 AMERICAN NERVES chronic nerves had been for a long and trying period the chief disturbing element. She was the family problem and had worn sympathy and en- durance threadbare. She had the introspective habit of the typical neurotic which seemed to predispose her toward psychology, and she took to psychoanalysis as a duck takes to water. She left behind her the monotonous life of the rural town, the jaded atmosphere and exhausted sympathy of “the family.” She went into the bustle and interest of a large city and courted the excitement and diversion of theater and music. She domiciled herself among congenial people who provided fresh sympathies and were in entire ignorance of the tired family at home-. She breathed different air and ate unaccustomed food. She was petted and made much of. She was the center of interest because she was hav- ing this new and fascinating psychoanalytic treat- ment about which she talked so interestingly. She spent hours in private discussion of her most interesting and intimate self with a cultured man, who brought a rather scholarly mind to bear upon her slightest emotion with a profound considera- tion. A thousand fresh influences, continuous subtle suggestions, and the analysis—no one can pos- COOPERATION 163 sibly know the cause of her improvement, though we are glad she got better. The Use of Dreams The new theory that dreams are the symbolic expression of repressed desires is so fascinating that every one, whether he knows anything about it or not, must “have a go’1 at interpreting his own dreams and those of his friends. Dream in- terpretation seems to be the modern parlor trick. There is a great deal of ideal chatter on the sub- ject which would not be so frank if those who chatter were more fully instructed. Any one who has given serious thought to the place of symbology in the development of mind from primitive times, who in past days has pored over Hargrave Jennings and the other pre-Freud- ian writers on the subject, and who has accepted the fact that the unconscious mind is the individ- share of the universal mind, will have little difficulty in embracing the dream theory. The student of the development of language has known for long that thought has always been expressed symbolically. Language, the chief medium of expression for thought, is nothing but a series of symbols,—in fact, as Emerson has said, “All thinking is analogising,”—establishing 164 AMERICAN NERVES analogues between things that are like or are sym- bols of other things. There is, indeed, no way to think but through symbols. It is an outstanding fact of psychology that the unconscious mind has no independent set of laws for its thinking. Its laws are the laws of the conscious mind. Therefore, waking or sleep- ing, it must express itself through symbols. Freud did not teach us this. He only showed us the unconscious expressing through symbols— showed us merely one way in which the thing is done. When you ask a person if he dreams and he says never so far as he remembers, you reply that, now we are opening up the unconscious field, perhaps he will have some dreams to tell you and he soon finds that he has. You do not know whether his unconscious life has been quickened or freed to expression or whether he just remem- bers his dreams because he has begun to observe them. When you find from experience that the average young woman from eighteen to twenty-five with whose inner life you deal rather intimately tells you dreams which contain in all sorts of varied forms the symbolism belonging to the mating and reproductive period, you are not surprised. COOPERATION 165 When you ask a young woman who has no in- formation to offer along the line of dreams if she ever dreams of rescuing any small helpless animal, for instance, from water (this being, as nearly every one now knows, a birth symbol), she answers, “No, never.’’ Then, beginning to laugh, she adds, “I did dream the other night about trying to rescue my uncle from water.” Quite hopeless, apparently, but, in response to the re- quest, “Tell me about uncle,” the answer is, “Oh, he is my mother’s youngest brother, a sweet thing whom we have always petted and made a baby of.” Not a puppy or a kitten but the family symbol of helplessness. It is delightful to see the free play and power of selection the uncon- scious makes use of in choosing its symbols. The dream question is put to another young woman who has recently lost her mother and has turned to a woman psychologist for help in nerv- ous troubles. After the first interview, when some confidence has been established, the girl who was grieving for her mother has begun to hope that she had found a mature woman friend on whom she could rely: she had dreamed that she was trying to put some one into her mother’s clothes; she was not sure who it was; the person did not seem to object, and she herself appeared 166 AMERICAN NERVES to be quite bent on succeeding, because sbe had the idea that some benefit would come to her from it. He who runs may read. No inside information seemed to be conveyed by the dream, however. No one learned anything by it that was not quite obvious before. It has grown to be quite generally the custom for even physicians who claim no special interest in the matter to ask nervous people about their dreams. It seems, however, more and more evi- dent that even the Freudian devotees who are entirely committed to belief in dreams as symbolic of repressed desires are doing less and less of what even a few years ago was considered de- tailed technical analysis of dreams. One uses dreams if they seem to help. If they become too intricate, only an enthusiast follows them to the last ditch. When, for the sake of experiment, one gives the ten o’clock caller her own, the experimenter’s, dream of last night to analyze and the eleven o’clock caller the ten o’clock caller’s dream, and tries the eleven o’clock feminine dream on the twelve o’clock masculine mind, things seem to come out precisely as well, with excellent results in the end. This development, along with experience in the COOPERATION 167 field of association tests, makes one feel that if there is troublesome repressed material and if continuous opportunity for free expression is given, one in time uncovers the cause of trouble. In other words, with quiet continuous patience, “all roads lead to Rome.” What the disordered mind needs is always long patience,—almost longer than almost any one can afford,—and every kind of invitation to free expression, to which by its suffering it has earned a right. One instructive fact in connection with dreams comes to light when under almost any form of psychologic procedure the troubled person begins to improve. Perhaps just before he realizes him- self that he is better, over and over again in re- peated cases he offers at this point a dream of seeing something killed or of himself as killing something—animals, obnoxious persons, in one case a very disagreeable foreigner whom the young lady intensely disliked. Blind Effort If we accept the theory that certain thoughts and feelings, which the mind rejects as inappro- priate or improper or unlawful, are not always wholesomely eliminated, thrown out, and disposed 168 AMERICAN NERVES of by our rejection, but instead are crushed down and forced into the unconscious mind to cause friction and disturbance, it will explain a deal of mental suffering. The motive for repression, though it may be a mistaken one, is usually in some sense good; so blame need not necessarily attach to the person who causes himself in this way so much distress. It may help intelligent people, when they are not too ill to think, to know that, as they them- selves are not deserving of blame, neither in all puobability is nature to be censured. Nature is not trying to punish or pay back for anything or to do any harm in any way when unpleasant or painful nervous experiences occur. Resentment of suffering, the why-should-this- happen-to-me spirit, is sometimes the worst part of an illness. It really should help and for- tunately it does help some people if they are able to see that their ills are the result of a blind effort on nature’s part toward cure. Something is wrong, and nature tries to correct it. Having no rational intelligence apart from that of the conscious mind, nature as expressed in the un- conscious mind does not know how to make a successful effort at self-cure. Therefore she auto- matically makes an unsuccessful effort. She COOPERATION 169 substitutes another unacceptable condition for the original one, the one she does not like and is try- ing to improve upon. Some physician has said that every neurosis is an effort at self-cure on the part of the organ- ism. If quietly and sanely the mind can be brought to bear upon this fact, it may help those who naturally shrink from disease as something abnormal—“horrible,’r as some one has recently expressed it. The philosophic mind is a great help, especially in mental and nervous illness. Its cultivation is recommended, not for the sake of others but for the sake of the sufferer. The resentful spirit, the spirit that refuses to accept things, is an un- comfortable companion. These expressions are not the vagaries of a fantastic optimism. That is as bad in its effect as resentment. It has been wisely observed that the optimists make the pessimists. We are not pushing our meanings too far. A more intimate observation of nature might teach us many com- forting things. Painful Analysis If, then, nature is always trying to cure, even when she kills in her unrational attempts, it should 170 AMERICAN NERVES not be difficult to grasp the idea that when we try to help ourselves she is working with us; and, further than that, when some one else tries to help us she helps them to help us. If the sufferer and the helper and nature are doing team-work, each with confidence in the other, there may naturally be a sense of cooperation. Instead of fear, suspicion, occasion for distrust, cause for conspiracy, however friendly, there will be a sense of contentment, confidence, of all-right- ness—just so far as things can be right. There is a scientific dictum, “Nature unaided fails.” While this may be true, she is a very good backer, and, with human intelligence added and good intentions into the bargain, she should go far, though the stages of the journey may not be always agreeable. Those who know something about psychoanalysis but have had no experience with it may not think of it as a painful method of help. Sometimes it is not. Sometimes, how- ever, it is true to the idea of catharsis, which has been applied to it. It does act like a cathartic. It stirs things up mentally. It gives one the mental gripes, and the sufferer knows he must bear the discomfort. He must be content to feel worse before he feels better. Digging up buried memories and emotions and COOPERATION 171 tearing them apart bit by bit, especially when you come upon intimate and painful things you did not know were there, and more particularly when, as Dr. Richard Cabot says, you find they have been not only buried but “buried alive”—it is no simple matter. At the end of a period of analysis a person may be completely exhausted emotionally and physically, with tense throat, burning eyes, and a general limpness which is altogether surprising. The probing of old wounds is a painful affair, and, after probing, a mental wound may be treated in the same way in which a physical wound is treated. It may be dressed, soothed, covered, made as comfortable as possible while the heal- ing process goes on. An analyst often sees in the immediately dis- turbing results of this radical treatment a quiver- ing, sobbing person, dabbing her eyes and trying to get herself together so that she may safely and respectably go out on the street and face the world on her way home. The sympathetic analyst will say, as in a case that comes to mind: “I’m sorry. It’s pretty hard. There does n’t seem to be any way in which we can make it easier. I wish there were, but I hope you ’ll feel better soon!” 172 AMERICAN NERVES Soothing hy Suggestion There is a way in which it can be made easier. A broad psychologic outlook is fluid. It realizes that hardly any method that helps need be ex- cluded by any other method,. Each may be used in its own place. The use of analysis, even when pushed to the extreme, is no reason for giving up the use of suggestion. Dr. C. J. Jung, the great neurologist of Zurich, has advocated the use of the two methods together. They are in no sense contradictory or incompatible from the psychologic standpoint. It seems unnecessary to take any other view of the case. No mortal can ever possibly know how much of the apparently good result of analysis comes from the suggestion, which, as surely as the world stands, must be wrapped in the analytic process as in every other remedial process. The analysis is for a purpose. What is the purpose? Possibly it is well not to specify too finely, especially in the beginning, except that it is to get well and keep well and emerge with a better nervous equilibrium, a better adjustment to life, and a greater power of self-mastery. Recovery may, with the best luck in the world, COOPERATION 173 happen through the analysis. It would be inter- esting to see, if this were possible, whether it did result from analysis alone; but it would be more interesting, perhaps, to be sure we were using every means at hand for the sufferer’s welfare, taking pains, no matter how we may cloud the issue for ourselves, that we are neglecting noth- ing that may help. It seems hardly necessary to send a person, weeping and unstrung, out upon the street after a painful analysis, when it is within one’s power to soothe by suggestion. Ten minutes or less of suggestion at the end of an hour of analysis will often help. With shades drawn, a comfortable couch or easy-chair, in close touch with the un- conscious through the dissociated conscious mind, soothing and steadying, effectively banishing the old outworn things that have been confronted but that should be allowed to trouble no more, one should make definite gain. New points of view that have begun to emerge, if the analysis is doing its work, may perhaps be clarified and “fixated.” The pain of the whole process can be minimized and progress not only hastened but emphasized and completed by sug- gestive and constructive work following the analytic period. 174 AMERICAN NERVES “Nature unaided fails.” A little synthetic assistance sometimes goes far, always, of course, following the patient’s initiative. The sigh of comfort, of returning control and a hopeful con- sciousness that one really is getting something out of this curious performance, the realization that the mental cathartic is working, the gripes are passing, and things are coming out right— these are plain indications after the brief moments of rest and reinforcing suggestion which follow an analysis. At the next visit revived memories and emo- tions which have been analysed and explained and relegated to their proper place may persist in lingering about after their work seems done. If, during this analysis, a further probing takes place and the matter is thoroughly attended to, the quiet suggestive period at the end of the hour gives an opportunity for further constructive help. Analysis and Synthesis The old educational saying, ‘‘Analysis only for the sake of synthesis,” finds an appropriate appli- cation here. Negative and destructive processes are never educational. Education is accomplished by building up and drawing out latent powers; COOPERATION 175 no analytic process has value that does not end in synthesis. And unfortunately the psychoanalytic process does not always end in synthesis. When there appears to be no readjustment, no reorganization, no reintegration of the personality, no synthetic impulse in the mental organism, it is an embar- rassing moment. Of course, “over-determina- tion”; but that does not always help. Failure of the synthesizing process as a com- pletion of the analytic experience may be an indi- cation that this has not been an appropriate case for analysis. It is difficult to tell sometimes just what conditions need analysis. It is not sur- prising that with the very best intentions mistakes should be made. But what to do with the person who does not synthetize, who does not seem to be elastic enough to react, and does not get himself together again? His last state is worse than his first, for now the long, hard drubbing he has had the courage to give himself seems to have been entirely unprofitable and regret begins to loom very large. “Why did I ever let any one make me tell all those dreadful things. There are some thoughts and feelings one should never tell to any one. I am so ashamed, ’ ’ etc. Such regrets have at times 176 AMERICAN NERVES developed into an obsession and plunged the patient into a melancholy condition only to be relieved by technical suggestion. There are some persons who go on with analy- sis year after year, never seeming to reach an end of their need. The fact that results do not come would seem to indicate that a few constructive touches through suggestion, direct suggestion, always with the patient’s understanding agree- ment, may help to “assemble” them, if we may use that term. And this can be done with no im- position of the analyst’s mind upon the subject or any effect of making him dependent. The person who is familiar with psychologic educational processes, who has the background of thought which comes from long dealing with the integration of normal mind in its elementary experience, is a person well adapted to get this point of view and to help make things happen. The more all media of approach to any disturbed mind can be brought into line with normal educa- tional processes, encouraging the recognition of every process of mental integration as educational (not even reeducational), the better it will be for nerves and minds and education. When we see crime classified as illness and illness as ignorance, and discover how the mind COOPERATION 177 is to be taught in order to accomplish a complete normal synthesis, we shall have gone far. Failures “Failures? Yes, indeed; of course we have them, and I am always glad to tell about them if people wish to listen. They usually wish to hear only about the successes and persist in thinking that there is some mystery about them, even though I try to explain that there really isn’t.” This answer was made by one who, using psy- chologic methods with nervous cases, had been speaking of them and especially of the use of direct suggestion to an audience of professional men. At the close of the evening, various ques- tions were asked or read from slips of paper. A number of successful and some quite arresting cases were described; then came the question about the failures, and a suppressed smile passed from lip to lip. Seeing it, the chairman of the meeting took occasion to say: “The laugh is on you, gentlemen. This question was written by the speaker, who particularly charged me to see that it was not omitted.” Persons who work in this field know that there is no panacea. It is strange that any fairly well- informed man or woman should imagine an intel- 178 AMERICAN NERVES ligent individual could assume that there might be. There are people who even undertake to extract a promise of “cure” at the beginning of their course. The answer is that only a charlatan promises. The greatest hindrance to improvement seems to be an over-anxious desire to get well. Some people are so eager, so impatient, that they play the part of the little child with his spring plant- ing. They Invite us to plant suggestive beans in their unconscious gardens, and then, before the seeds have an opportunity to grow and send up shoots of fulfilment into the conscious mind, they repeatedly drag them up by the roots to see if they are growing. A very intense and eager man who sought help in this way was possessed of such impatience and seemed to have no control in the matter. While the work was going on and little progress being made, he complained quite bitterly one morning of indigestion. The psychologist said: “There is a very comforting electric current given for that condition by Doctor So-and-So. I advise you to go and ask him if he does n’t think it would bene- fit you. ’ ’ This was done with the of course sincere desire to afford immediate relief for the discomfort. COOPERATION 179 There was, however, the secondary purpose of getting other beans into the sufferer’s garden so that he might perhaps give them some attention which would be diverted from the psychologic beans that were probably more important. But the poor distraught and suspicious mind jumped immediately at the conclusion that he was being, as he said, “let down easy,” that he was being tactfully shifted upon other shoulders, and he went off in a huff. Another hindrance to the getting of definite results from the use of direct or technical sugges- tion is the inability of some persons to secure the quiet preliminary condition which is considered to be and apparently is so important a part of this procedure. Some persons become self-conscious as soon as any attempt is made to suggest them into quiet- ness. Mechanical methods annoy them. They are the persons who drop asleep very quickly with no consciously relaxed and dreamy period between sleeping and waking. They are some- thing like the person upon whom a delicate opera- tion cannot be performed because he does not get the effect of the anesthetic. There is another cause for failure, perhaps the most disappointing to the person who is faith- 180 AMERICAN NERVES fully trying to help. It is met in the subject who loses interest in the possible ultimate benefit because his medicine does not taste good. Not that it tasted bad, but it does not give him the immediate pleasure of rest. The Argument for Rest A nervous person who has been habitually tense and uncomfortable experiences his first instalment of “primal rest.” The deep re- laxation of long-taut nerves is sometimes a great revelation of rest, a very luxury of repose. It may be a little more intense on the first occasion, as it is somewhat novel and in contrast to the pre- vious strained condition. After the first two or three experiences the re- laxation may not be quite so deep, though it continues, even when people do not fall asleep. There are some sensuous natures which are greedy with sleep as they are with food. Whether they need it or not, they are disappointed, irritable, if they do not secure it just as a luxury. They will announce: “I didn’t get ,any sleep last time. The effect is ‘wearing off.’ It is n’t doing me any good. I don’t think I ’ll come again.” An effort is made to explain that while you are very glad to have them get the comfort of sleep COOPERATION 181 it is not necessary to ultimate results and that a very slight degree of relaxation seems to be all that is required to open the mind effectively. They brush your information aside and refuse the medicine because they do not find their orig- inal pleasure in taking it. The earnest person will persist. I have myself in a course of such treatment from a physician experienced nervous chill on the street after every visit. Doubtless it could have been prevented had it been mentioned to the physician and more detailed care taken, hut it seemed unnecessary to complicate the situation by explanation. There was no serious construction put upon it. It did not seem to be a hindrance but rather proved that something was happening, and good results did follow. It was a helpful bit of experience, how- ever, and a note was made for future reference. One point in this procedure which apparently cannot be overemphasized is that the preliminary relaxation, even when very slight, appears to he important and should not be omitted. Even the slight degree of quietness that can, if necessary, be induced with no personal attention is somehow needed. Shutting your subject away alone in a room with the rhythmic beat of a metronome, as busy physicians do, proves sometimes to be 182 AMERICAN NERVES sufficient. Although the nervous lady in question may protest that the sound irritates her, if she will subside she finds a useful degree of relaxation results. Some persons are fortunate enough to fall very quickly into the quiet condition and often to exceed that which is required. A judge who was seeking some sort of help fell to snoring not more than two minutes after the quieting suggestions were begun. The psy- chologist roused him with a bit of asperity, say- ing: “Why do you do this? There was no oc- casion for you to go to sleep!” The judge responded: “Yes, there was. Your line of argument was so perfectly convincing.” The person who can give a full response to the preliminary quieting process has the best basis for an expectation of good results from the use of direct suggestion. PART FOUR THE FORWARD LOOK PART FOUR THE FORWARD LOOK The Time-Fuse During the war we heard something about a bomb made with what is called a time-fuse. This fuse is so arranged that it sets the dynamic power of the explosive into operation at some time after the bomb has been left to its own devices. This fuse provides us with an appropriate simile for use just here. There has not only been much misleading talk of the possibility of the nervous person’s becoming dependent on any one who undertakes to help wifh psychologic meth- ods, but, further there is an impression that without the helper’s continued attention an im- proved condition will not last. These adverse results virtually never occur un- less the person who helps fails to use his medium for full value. If either of them does arise it should be within control of the psychologist. Surely the matter of dependence is within control, and the matter of relapse should be also ex- 185 186 AMERICAN NERVES cept in cases of such deep “constitutional tend- ency” as already determine that no agency will avail. That seems a flat statement, perhaps. It is not given as personal opinion. The truth of the statement is implicit in the active principle at work in processes of mental reorganization. An automobile travels in one direction by precisely the same process that governs its progress in the opposite direction. It goes further in one di- rection according to the same law that brought it to a given point. One hardly imagines an ex- pert in automobiles expressing surprise that a car has the power to travel up the street as well as down the street. If he understands his prin- ciple but partially, or even understands some- thing about it, he will see it in its obvious ap- plications—all so simple as to annoy an in- telligent person that trouble is taken to ex- press it. One uses these similes aware that they may not be pressed to the extreme. If they might be they would not be similes. The scientific skeptic com- plains that you cannot make a laboratory dem- onstration. We find great use every day for various agencies which do not yield to strict scientific classification. But is it not evident that THE FORWARD LOOK 187 the principle which can be used to establish a good habit has only to be invoked to continue the habit? The principle that can do these things, put actively into operation in the right direction, can give self-reliance as well. Any psychologic method which gives even temporary relief justifies itself and has dem- onstrated its right to a place beside medicine and surgery as a therapeutic medium. Even when it serves merely to rouse the vicious circle, it still feels at home in this august company. But direct suggestion is used in such a manner that most good results can be made permanent and the patient can be given and is given self-reliance in the place of dependence. To the operator who loves the feel in his hand of such a beneficent instrument as technical sug- gestion, it continually invites to finer uses, and its possibilities seem at times almost limitless. A Case of Nerve-Shock A young woman was suffering from shock as an “end result” of surgery, according to medicinal diagnosis. She had gone through various phases of nervousness which were distressing to herself and her family. After many ups and downs she came quite definitely and successfully back to 188 AMERICAN NERVES herself through the use of technical suggestion. One of her friends said to the psychologist who helped in the reconstruction: “Well, I tried that once while she was asleep but didn’t get much result. I sat beside her and told her repeatedly that when she awoke she would feel better.” “Did she feel better when she awoke?” “Yes, but it didn’t last.” “Did you tell it to last?” “No.” “Didn’t it occur to you that if telling her to feel better helped her feel better telling her to ‘last’ would help her ‘last’?” He grinned and said, “No, that didn’t occur to me.” That was precisely the method by which she came to “last” finally. The routine would be something like this: “When you waken you will find yourself feeling better, and you will be con- vinced that you can stay better, and you will stay better. The thing within you that made you bet- ter will help you to grow better and better and better till you are well, well, perfectly well, and you can stay well and will know that you can stay well”—a mild suggestive bomb with a time- fuse. THE FORWARD LOOK 189 Once in a while those well-drilled kindly servi- tors below stairs in the unconscious treat us as well as we sometimes treat the well-trained Eng- lish butler. They give us a perquisite. They throw in something; they present a by-product. This is what the “lasting’’ would have been had it occurred in the nerve-shock case, since it was not called for. In the case of the two young women who were surprised that the lifelong fear of thunder-storms was abrogated when no one but themselves knew of the fear, we got a by-product though we did not really deserve it. There must have been a reason for this as there is a reason for every- thing. The vegetative nerves may have been at the moment well-nourished and elastic. The con- scious state was perhaps happily fluid and the unconscious, by reason of its well-qualified instru- ment, fortunately responsive. The readjustment which took place in the stage- fright mechanism in the one case and the inde- cision mechanism in the other, according to schedule, brought about a more general reorgan- ization than had been called for and in both cases covered the thunder-storm mechanism “in rou- tine,’ ’ as our medical friends would say. This may not be a very good description of 190 AMERICAN NERVES what really took place; but it probably approaches to something like it or resembles what really happened. But have we wandered far from the time-fuse? No, we are illustrating it by cases in which it unexpectedly worked. Responsibility In matters of importance the psychologist does not trust to the good fortune of having a well- trained basement servitor who is amiable enough to give a by-product or work overtime. We will hope that the vegetative nerves are responsive and the unconscious balance may be readily shifted, but we will not rely upon it. We leave nothing to accident. We rely only upon detailed work to make sure that normal processes are stimulated to voluntary operation not only for the immediate present but as the beginning of a fixed habit. Since it is the first business of the uncon- scious mind to “carry on,” since it does usually carry on everything it gets its hands on, even the wrong mechanism, it has done only part of its work when it has reversed a wrong mechanism but not established a right one. If the psychologist attends to this matter care- fully with the same sense of responsibility a THE FORWARD LOOK 191 physician feels in undertaking to reduce a tem- perature or regulate a heart or remove an ap- pendix, in amenable cases, and, if the medical di- agnosis is correct, the permanent result should be secured. In seeking help from a medical specialist de- mand is not necessarily made that one be entirely cured of his disease for the rest of his life. Though the lasting cure is something accom- plished, and we are glad if this is so, we do not call the physician’s work a failure if a tendency toward recurrence is not entirely overcome. In psychologic procedure, however, it may be more reasonable to expect the permanent result, since this medium deals directly with the habit- forming mechanisms upon which we depend for permanence. Dr. Forel, an eminent European neurologist, it is, unless memory fails, who gives this good il- lustration of the time-fuse sort of effect. He tells of a traveling man who constantly crossed the English Channel in his journeys, and each time he experienced the most serious seasick- ness. Having heard that this distressing ailment had been pronounced a nervous disturbance and was said to be relieved by suggestion, he gave himself the opportunity to test the remedy. 192 AMERICAN NERVES After having received the prescribed course of treatment, he wrote,—and I believe I quote ac- curately, though from memory; the substance is at least correct,—“Thereafter for twenty years I crossed and recrossed the channel in the most violent storms when every one on board, includ- ing the captain, was ill, and I never felt a qualm.” In this case the time-fuse was evidently attended to. This whole matter of permanent results is largely determined by what one works for. If he carefully and persistently works for them, the strong tendency is in favor of his getting them. It is a matter of attention to detail. We do not get right results from wrong processes here any more than in other fields. The use of technical suggestion is not a haphazard performance. If the future is attended to in this way, there is little question of further dependence on the helper. Independence This subject deserves to be placed in a class by itself. Too much can hardly be said about it, since there is a great deal of unnecessary miscon- ception regarding it. The entirely groundless fear of becoming “dependent,’’ of letting some one get ‘ ‘ something like a hypnotic influence over THE FORWARD LOOK 193 yon, ’ ’ hinders many persons. It keeps those who deserve and need the help that technical sug- gestion could give from taking it. In extreme cases of this groundless fear some such line of reasoning as this has sometimes been employed. “Even if I had not the highest regard for the sacredness of your personality and a sense of great responsibility in preserving its integrity and a desire to do all in my power to help you get well and keep well and be stronger and more self-reliant than you ever were before, what in the world do you suppose I want with any hypnotic power over you? If I had no mind to preserve you from such a disaster for your own sake, I surely should take every pains to protect myself. I can imagine no greater calamity be- falling me. If such a result were the natural out- come of the processes that we between us set in motion, or if by common carelessness I were in the habit of letting people stay hung about my neck indefinitely, it would be not only you but very likely a dozen other people! Dreadful! Dreadful, indeed! The idea makes me shiver. You may be sure that I shall use the most exact measures never to let such a thing occur! There would be no free personal life for me in the future 194 AMERICAN NERVES and no opportunity to go on with my work and help others. ” This definite sort of argument usually brings a relaxed smile, an ‘ ‘ Oh, I see! ’ ’ and there is no further expression of fear on that score. But a further apprehension sometimes arises that even if one tries, even if one’s intentions are good and there is every effort not to let this dreadful thing happen, it may happen in spite of you. The answer to this is: “It does not happen. In twelve years of one person’s work with many people it has never happened once”; because the obligation to prevent it has been definitely assumed. From the very beginning, when a person is asked in preparation for the preliminary quieting period, “Do you ever get sleepy in the daytime?” the process of personal reintegration and re- gained independence begins. Quieting sugges- tions are made only with the subject’s permission. From the very first visit it is suggested that this whole process is for the sake of reestablishing self-command and power of self-direction; that the relaxation of tension, the release of inhibited power, the growing consciousness of creative energy, all these things may naturally result in a discovery of greater personal power and freedom THE FORWARD LOOK 195 than had ever been suspected within one’s self. The psychologist does nothing but help the nervous person discover and organize and assume control of the self. A clever woman who went through this experience wrote to the one who had helped her, “You have declared me to myself.” Any one is much more likely to be unfortunately affected by the casual influences of the home or the street or the tea-shop precisely because they are casual and there is no specialized good inten- tion in the careless mental contact. The fact that harmful influences usually sink into a mass of other impressions and are never sufficiently specialized to be recognized does not mean they are not there. In technical work one has a right to expect results. With a mutually recog- nized good intention and with mental processes working favorably, good results should be se- cured. With one person formulating desired ends according to an again mutually recognized and reasonable standard, while the other clears the ways of obstacles so that these ends can be estab- lished by nature’s kindly help, how should there not be results? "The Flight from Life” Psychoanalytic philosophy formulates most in- 196 AMERICAN NERVES terestingly and quite conveniently a common tend- ency in the experience of many sensitive people, to which is attached the engaging phrase, “the flight from life. ’' If you wish fully to under- stand it, you must read accounts of the primitive mind in mythology, folk-lore, fairy-tales, and see it in its unconscious expression as a race expe- rience. This is useful to show how deep down in human nature its roots are sunk, how good a right it has to be there, though this right provides no reason why it should be allowed still to over- shadow us. For when it is present it does over- shadow. Living, just living life, is no light matter. If you can feel that it is, be grateful to your in- heritance, your tissues, your organs, your happy coordinations, that they have been able to strike such a fortunate balance that a comfortable ad- justment has resulted. Be thankful that you are so made that you naturally find what some one has called “the plane of ease.” If you have found it, be glad. It is a gift to rejoice in and be humble about and use. If you contribute to its maintenance by care and moderation and regular habits, good; it is to your interest to do so; but even then you are still in the class of fortunate beings to be able to get results from THE FORWARD LOOK 197 your careful living. Others, no doubt, have lived as carefully and failed of their adjustment in the end because the organism with which they worked has been constitutionally defective or in- ferior. These are the people who are naturally shy, retiring, always on the outside of things, “poor mixers”; sometimes they are shrinking be- cause they have not enough of life’s dynamic to fight the natural shrinking tendency. They are sometimes distant or superior, even apparently condescending, because they have the impulse to- ward counteraction but do not know how to manage it. They add pressure or tension to weakness in a poor simulation of strength, and, since this is an artificial combination, it is likely to result in an unnatural product which is seldom convincing to itself and often succeeds in getting itself hopelessly misunderstood. Does this read like a pleasant way to live? Especially when no one understands and you find yourself only more hopelessly misunderstood and more particularly damned for the results of the very best and most excruciatingly courageous ef- fort your raw soul can make? Yes, “raw soul” expresses just what I mean. It would be a pity, a thousand pities, if we should accidentally mis- judge these gallant spirits! if, not being able to 198 AMERICAN NERVES guess from the drilled and apparently adequate exterior just what a seething anguish of effort was going on underneath the surface, we should accidentally demand what they could not give! When one sees in little children the indication of a beginning of this inclination to retreat, it should be a warning. The very little boy with the very big eyes who crawls in among the dark green boughs of the pointed fir-trees that grow close to the ground—he has worn a little pl&ce among the branches where he creeps in and snuggles up to the trunk and sits quietly and safely by the hour. This impulse shows itself in the young woman who distresses her mother by preferring to sit at home in a chosen corner with a book rather than to answer the call of life and plunge confidently into its relations and rivalries and achievements among her fellows. We see it in the mature bachelor son who is “so devoted to his mother that he never married” —such a shrinking from the responsibilities of life that he never gives himself an opportunity to fly from them. Like the child whom you see apparently playing “puss in the corner’’ with his mates, but who, if you observe, never leaves his corner. These are simple, common illustra- tions of the fact that some seemingly normal THE FORWARD LOOK 199 people get projected into life without being nerv- ously and mentally qualified for it. There are many extreme and even tragic examples which might be quoted. What if these people could be given with some preliminary house-cleaning the independence or the adjustment time-fuse? The mental disturbance which comes from a lack of that rightful sense of “systemic well- being” which should be the universal birthright, is often covered, unconscious, or semi-conscious and sometimes results in a confusion which leads to a strange misrepresentation of the self. The person who is not able to recognize all this within himself may go blundering and stumbling about, attempting impulsively to make his ad- justments without being adequate to the achieve- ment. He will be pushing, obtuse, never know- ing when he is snubbed; ‘ ‘ always butting in, ’ ’ is the reputation he finally earns. And to him there is always a mystery about it. Why do people treat him so? It never occurs to him that the explanation is within himself. These maladjusted people get the reputation of being egotistic. They are in a way but not quite in the sense of the criticism. They have not even Egotism 200 AMERICAN NERVES been thrown back upon themselves by their expe- rience, because, like the puss-in-the-corner child, they have never got away from themselves. They are from the beginning introverted, turned back upon themselves. They have not the normal outgoing currents of wholesome relationship to life and activity, and they are at a loss to know how to clear their channels and release their ac- tivity. No matter how much discomfort they cause others, they probably suffer more them- selves. They are perhaps no more naturally egotistic than the person who criticizes them for being so. In fact, on close analysis, it will us- ually be found that the best proof of egotism is the impulse to criticize others for that fault. The general effect of a constitutionally or acutely neurotic condition is quite evidently to throw the person back upon himself, and this is often where all the trouble lies. Any one offer- ing help should know that nothing will avail in the end that does not get the nervous person into wholesome relations with life. The flight from life must be replaced by an adjustment to life. The outgoing channels should be opened and some sort of creative activity established. THE FORWARD LOOK 201 The Farmerette “What do you want me to do for her?” asked the psychologist of a physician who commended a young woman to her care. “Qualify her for work. There is something wrong. She isn’t able to get into action. She is physically well, and she is intelligent, but she has never done anything. She would like to work. See if you can make her do it.” “I won’t make her do it, but perhaps I can help her to help herself.” There was no surprise and no censure and no moral talk. No appeal to character or self- respect was necessary. Both were evident at the outset. was given of the young woman’s sincerity and acceptance of the fact that if she wanted to work and could not there must be a reason why. Intimate questions were asked and answered, explanations made and satis- faction given which had evidently long been needed on the patient’s part. A few weeks of mental reorganization followed with little analy- sis, some technical suggestion, ending with the ad- vice to join a farming colony but no help given in making arrangements. Two months from that 202 AMERICAN NERVES time the hitherto inactive young woman wrote to her physician who had said she could not work, something like this: My dear Doctor: This is my week on stable duty. I get up every morning at six o ’clock and report for work at 6:30. I clean the stables and curry the horses before breakfast. My early garden has taken the prize and I am sending you some lettuce and radishes. The fact that such inhibition as held this un- willing subject was involuntary, is shown by the sense of freedom she expressed, when she was once liberated, in the joy of life she experienced and her satisfaction in her power of activity. There is no implication here that all nervous in- hibition can be so easily overcome; but if it can- not be overcome it should not be deepened and fixed by opposition. Quiet sympathy expressing itself in patient willingness to cooperate in in- vestigating and understanding will usually help. The trained mechanical mind understands and respects the physical laws which underlie the fine coordination of mechanical construction and me- chanical action. When one having such training sees an ignorant person or a novice fumbling an exquisitely balanced piece of mechanism, forcing THE FORWARD LOOK 203 or straining it because of failure to understand its delicacy, be has a sense of outrage. When the finely balanced mechanism happens to be also a conscious, suffering human spirit, greater intelligence and care are called for in its handling. If violence or pressure are ever to be used it should be by one who has knowledge as a basis of action. S elf-Consciousness Nothing has yet been said in detail about the self-consciousness which accompanies nervous troubles. Nervous and mental disturbances are likely to project feeling beyond the self or to turn it back too forcefully upon the self. Both extra- version and introversion give a sense of un- naturalness, of mental discomfort, which fixes attention abnormally upon the self. Too much outsidedness gives a sense of something wrong. Too much insidedness gives a sense of something wrong. Then, there is the unconscious effort to right things, sometimes with poor results, and often an additional conscious effort to right things to add to the confusion, or perhaps more often there is only the futile conscious activity of just going around in circles something like this: “Everything is wrong. What is wrong? Could 204 AMERICAN NERVES I help it? I ought to help it. I wonder if I could help it. Everything is wrong, etc.” It is like a hair-shirt or peas in the shoes; but one doubts if it is good for the soul. The result of all this is that it requires a per- son to think about himself every single moment. He is thinking about himself whether he thinks he is or not. In other words, his disordered condition, finding no relief, no solution, has be- come habitual, pushed through to the unconscious, and become unconsciously conscious. This is not the way a psychoanalyst would talk, but it is the way a nervous person talks about his misery. And do you think this eternal self-consciousness is comfortable? No one, not even a vain or conceited person, wants to think about himself all the time. Even if he thinks he does, he is mistaken. It is not normal. It is pathologic. But one whose personality is un- centered must think about himself. He is forced upon himself, one self upon another self, or, worse, two parts of one self, made by nature to work in the most delicately balanced unison and in exquisite equilibrium, “slipped,” set awry, forced out of working order. Bad enough in a fine mechanism of iron and steel, but in a mech- anism of human nerves, think of it! THE FORWARD LOOK 205 “You’d be all right if you didn’t think about yourself so much. Get busy! Get in- terested!” If you have tried it when it was impossible or seen any one else try it when he could not, you would know. This self-consciousness can often with help be lifted from this pressure upon itself, with time and care and a willingness in the helper to go very slowly. While it exists and cannot get hold of itself, the person who is laboring under it is open to all sorts of misjudgment. Nerves and Food A young man who was suffering from this not uncommon self-consciousness found that it fixed his attention especially upon the taking of food. He had great difficulty in eating at all. He just could not. If attention was called to the matter it made the situation much more difficult. Self- consciousness tightened his throat, and he was filled with distress. Of course it was not as simple as all that. There was much beneath the surface, but this is the way it looked to the family. The psychologist interrupted a trying con- versation between mother and son by inviting 206 AMERICAN NERVES him to take a walk with her. In passing a drug- store she said: “Do you mind waiting a moment while I do an errand ?” “No, not at all.’1 Stepping to the desk, the companion took two checks for something hot to drink. Ignoring the young man entirely, one drink was ordered. It was not for him. When the companion had fin- ished the glass, the second check was laid before the boy, and an errand occupied the other’s at- tention. The boy, with no apparent hesitation, ordered one of the more nourishing things offered, took it quietly by himself, was presently joined by his companion, and the two went out together. No reference was made to the little occurrence until just before they reached home. “How did you know I could take it if you did it that way?” “You were rigid with self-consciousness. It was natural enough that if attention was not only withdrawn from you but in connection with food centered upon some one else it would relieve your tension and make it possible for you to drink something. ’ ’ The tears came to his eyes as he said: “Why has no one ever done just that before? They THE FORWARD LOOK 207 would have been glad to, of course. It is such a simple thing; but they didn’t quite understand about it. ’ ’ “It’s all poppycock!” blusters uninitiated and very well-nourished father. “He could eat if he wanted to. It’s just a pose!” This observation recalls a small boy aged five who had this strange nervous self-conscious in- hibition regarding food. Thereby, of course, hangs a tale; but one cannot always get hold of the tale. In January, when strawberries were a luxury, the little fellow was given a glass of pure fresh juice, just crushed from the fruit. He held it between his hands for two hours and could not drink it. A keen observer might see the struggle going on: “to drink or not to drink”; that was the question. He cried if it was taken away and caught it back. When finally it was down, the child was filled with joy. He went from person to person all over the house showing the empty glass triumphantly as though a great victory had been achieved. For long after, one could feel the satisfaction of achievement in his atmosphere. “If he had been mine, I would have spanked him.” “Would you indeed, wise mother? Then you, 208 AMERICAN NERVES too, belong to the conspirators, and you would surely have found that you had a sicker boy on your hands than you had before with much more trouble made for yourself.” “But you can’t fuss with people like that! You can’t take grown boys out and spend time being ‘technically diplomatic’ buying bouillon checks when they won’t sit down at the table and make a good meal! ’ ’ No, one would not be likely to do this if such cases did not interest him. If he had no notion of what was going on inside the mind and no clue to what might perhaps help, it would be quite dull. Fortunately there are people who have interest to fortify their patience, and surely the world needs more of them. Think of the boys suffering from war-neurosis. Yes, I know trained nurses are fine and splendid; they do much to help; they do wonders. I pay them tribute! But per- haps some day they will have a more psychologic training. Occupation It is obvious that what many of these good suffering people need is to have the pressure of consciousness lifted from the self. There is little use in lifting and letting go again. The pressure THE FORWARD LOOK 209 is reestablished. The most practical aid comes through getting the consciousness freed, its ac- tion reversed, directed outward, and into a con- tinuous flow in the opposite direction. For the accomplishment of this there is nothing like oc- cupation. Occupation for the nervous is a sub- ject on which volumes might be written. Its bearings on mental welfare are as deep and wide as the beginnings of the human race. This is not by any means just a fixed idea of the work crank. The energetic person who, because he loves ac- tion, himself hustles about and is restless and troublesome until he gets every one else at work is a nuisance. We are not thinking of him or his ideas. Though the reasons why occupation helps are deep and real, they need not be explained to the nervous patient. Too much explanation is as bad as forcing work upon him. “It seems quite simple just to give a person something to do.” “Does it? Ask the occupational therapy teach- ers who tried to put the war-neurosis boys at work. It is sometimes impossible to get these patients into action; but usually the more dis- inclined they are to occupation the more they need it. I have known a faithful nurse to work 210 AMERICAN NERVES for days in order to get an apathetic woman to take half a dozen stitches. When she succeeded it was a great achievement and the beginning of steady improvement. Sometimes, though a confused and disordered mind is strongly disinclined to effort at the out- set and takes no interest whatever, ability for continuity and spontaneous interest will gradually come if one understands the method of approach; a little at a time, not enough to tire, and great care in giving the right sort of work. A de- pressed mind needs one sort of occupation, an irritable mind another. In general one might say that heavy work, like coarse wood carving in large pieces, will help the person whose nerves are “all on the surface.” Fine work is appropri- ate to the person whose nerves are good but whose attention is scattered and needs steadying. A woman grieving over the loss of her baby is advised to occupy her mind and keep busy. Excellent advice as far as it goes! But some one should be at hand to see that she makes a wise choice of occupation. Being a good housewife, she stops at the linen-store and orders the spring supply of table-cloths and napkins. She sits by the hour and turns and turns and turns little fine hems, and she hems and hems and hems— THE FORWARD LOOK 211 purely mechanical work that requires no thought, directs no currents outward. She sits in a sort of daze, which just invites her mind back into itself and frees her consciousness to go on brood- ing. As she turns and hems she lives over the last moments and sees the little white casket and breathes in memory the scent of funeral flowers, and more harm than good has been done. A novel or even a gossip would have served her better. The Pattern and the Peacock Suppose this woman had been given a plain piece of canvas with a paper pattern of, say, a peacock with spread tail to be done in cross- stitch on the canvas, with many colors to be changed constantly. A varied pattern, no re- petition, everything different from point of beak to tip of tail—stitches to count on the pattern, then to be reproduced on the canvas—six lines of red, three of green, then back to the red again, then seven of yellow and three groups of five in purple. No hard work; gentle varied action with pattern and canvas and colors going on and on. There is very much less opportunity for sad memories and haunting scent of madonna-lilies with this kind of occupation. But some one should 212 AMERICAN NERVES be at hand to know this and get the right thing done. This is a simple case. Others might be more difficult. Just setting people at work is not enough. Every occupational therapy school might have a course in the simple psychology of nervous states, and workers should know what sort of conditions they were dealing with before the kind of occupation was presented. This work is therapy, and the wrong prescription may do harm. Naturally, the physician cannot go into this. It is not his business. The trained nurse has general knowledge, kindliness, feminine in- tuition,—fortunately,—and all that helps. The psychologist is not always a woman, and, if she is, does not in every case know in detail about different sorts of hand-work. She cannot always oversee work even when she does know. A psychologist who was working in a psycho- pathic hospital was invited into the occupation- room to see the work of a young woman whom she was trying to help. Susan was melancholy, apathetic, and she was hooking a rug—mechanical work which provided none of the elements of action which her condition required. The occupational therapy teacher, being de- voted to her work and eager to do her utmost for the patients, asked for suggestions from the THE FORWARD LOOK 213 visitor. When the situation was pointed out, she said: “I see! Of course that is wrong. What shall I give her?” And plans for a differ- ent sort of work were made. Doing a temporary good to the nervous sufferer is a gain, but helping to establish the temporary good is infinitely better. This may be done by giving an intensively forward movement to the habit of action. The real worker will never be satisfied without aiming at this. Hand occupa- tion of the right sort, given and quietly guided by an understanding helper, may do wonders and may often be the means of effecting a permanent cure. It may not only do this but, rightly ad- justed and developed, may react on mental de- velopment, creative power, and character. It is literally, in the right hands and with some psycho- logic understanding, a therapy in itself. Hand and Mind It has been said that the most ambitious thing the human race ever did was to get upon its hind legs. There is a theory that in primitive times, when the animal lived in fear of every other animal, always on the watch for enemies, an advantage in outlook was gained by elevating the body upon the hind legs. The feat was at first 214 AMERICAN NERVES but momentary, though the passing experience showed that the thing could be done. This prac- tice is supposed to have led to the further dis- covery that while the animals were on the hind legs the front feet or paws were free to grasp branches, sticks, clubs, by which to defend them- selves from close attack. Turning front feet temporarily into hands for the sake of wielding weapons of defense suggested the further use of hands for convenience. Then must have fol- lowed the shaping of rough sticks and clubs into sharpened picks or prods by rubbing down the ends with rougher substances, then the making of crude forks or shovel-shaped affairs, the hol- lowing of thick pieces of soft wood by grinding or scooping out the depression with harder sticks, rough stones, or some such thing. Gradually the four-footed creature turned into the animal man, and his ascent to civilization (and nerves) was begun by the slow development of a forefoot into a hand. This process came about gradually through the crude creative effort of the animal. A call upon the beginnings of primitive mind for the use of ingenuity in adapt- ing the material at hand to its uses, the devising and fashioning of implements with which to make other implements, developed more mind. That THE FORWARD LOOK 215 mind made better implements, and the nse of these in new and varied activities reacted on the brain, with the result of a higher mental develop- ment. As the new member, the hand, grew more proficient, a crude love of beauty awakened and the first expressions of creative art began to ap- pear in simple borders round about the hand- made utensils, bowls, and platters and in mural decoration within the cave-dwelling. And from this or some such primitive beginning must have sprung all the achievements of the human race in the arts and sciences. With the first use of the hand mind grew, and from that time to this hand and mind have de- veloped together. One is of comparatively little value without the other. They have been from the dawn of intelligence so intimately related that when the mind becomes ill it needs the steadying and supporting power of its old friend the hand to help in its restoration to health. When a mind is temporarily disordered—dis- organized—it is in a sense disintegrated and needs to be built up again. The old primitive usage, the activity of the hand in cooperation with the mind, seems to be one of nature’s methods of healing. Confused mental action is untangled, straightened, and soothed again by ordered 216 AMERICAN NERVES rhythmic coordination with the motions of the hand. The creation through some artistic medium, of a simple primitive flowing border perhaps, will quiet unrest and restore the sense of balance. If a mind is weakened and fatigued, the materials used would naturally be coarse,—large, not rough,—used in long strokes or stitches so that rapid progress is made, giving the mind the ef- fect of quick accomplishment. This is strength- ening, encouraging. The flowing border in the wave-effects often repeated give the sense of rhythm, and, in clear lines on a background of contrasting color, may naturally react soothingly on disturbed or irritated nerves. Color has its own effects, and cool, soothing colors would be chosen for their help in irritable or excitable cases, and stimulating colors for use by those who needed to be roused and energized. Program One of the most characteristic conditions of the minds of nervous people is indecision. It is a very painful condition, and when it reaches a certain point it is literally beyond their control. There are very often cases in which the mind is fairly normal, the mental power good, if it could THE FORWARD LOOK 217 be got into action. But it seems to be pent up inside, going round and round, creating a par- ticular kind of interior anguish that few can ap- preciate who have not experienced it. These cases think they could do something if they could only begin. They cannot decide when or how or where to begin. One brave beginning is made only to be abandoned for another. As soon as it is abandoned there is a momentarily sure decision that it was a mistake to give it up, and much time must be spent in regret and self-reproach that so serious a mistake has been made. After some resting and backing water and fresh effort to decide what sort of attempt to make next so much time has been wasted in futile activity that the poor hunted soul is exhausted and has to go and lie down. This struggle may happen regarding almost anything. Comparatively well persons, those who may have a sense of dissatisfaction within themselves but whom no one will understand or excuse as nervous invalids, can spend so much time trying to decide whether to go out or stay in that by the time the decision is finally made the luncheon bell rings. A whole morning has been spent in indecisive action which is entirely unsatisfactory, nothing having been accomplished, and the mind 218 AMERICAN NERVES plunged into depression by its one futility. One’s distress conies, in reality, for lack of the regula- tion almost any wholesome occupation might have brought. Making beds or any sort of plain productive effort would give a more wholesome reaction than this devastating indecision. One who is at all capable of self-management, having passed through such temporary flounder- ing, should understand the reason in his own case for the virtue of prompt action. These periods may be averted if a person will learn from past experience that they are easily handled if taken in time, nipped in the bud. It must have been a Solomon suffering from neurotic indecision who uttered the profound truth, “He who hesitates is lost.” Doing ex- ercises, anything to get into motion, punching a bag, running around the block and then quickly projecting the energy so generated into some de- finite occupation, will sometimes save the day. But this is for the fairly normal person. The victim of indecision who is not so well able to direct his own activity needs help. If our con- spirators instead of just prodding aimlessly to action in general, or attempting to drive to some action in particular, would save their own nerves and those of the patient and those of “the THE FORWARD LOOK 219 family’’ as well by “plotting a program,” a world of distress might be averted. Not only that but the regular repetition of the regular routine which saves the racking distress of new decisions usually has a steadying and restorative effect upon the patient. Eepetition has in itself a constructive reaction on disordered nerves and will often, through the program, help people back upon the road to health where they can take charge of themselves. Only here again some knowledge is needed regarding what sort of program to make. It must natu- rally be adapted carefully and in detail to this particular person. It must be sufficiently varied but not exhausting. It should have the right amount of mental occupation, physical exercise, diversion, etc. It ought to be broken into periods that will not over-tire, but because we wish to make some gain every day it should be construc- tive and contribute to all the upbuilding process. This is no easy task that the conspirator takes on, but it is a step in the right direction, and with a little intelligence it can be done. The first program will not be the right one. It will be only experimental, something to try out and find where it is wrong and make over and adapt and readapt. And if it is a good program all the 220 AMERICAN NERVES more will it have to be made over. The nerves will improve on it, outgrow it at points, and changes will be needed in order to keep it up to improvement, till presently the patient outgrows it entirely and has no further need for it. To the nervous sufferer torn with indecision, a well- arranged program may be the very gift of God. Adaptation In doing this work of fine detailed adaptation to the subtle and probably changing demands of the nerves, there is call for a sort of help which, so far as I know, does not exist. It needs neither an academic nor a haphazard but a practical working knowledge of about equal parts of, say, biology, physiology, psychology, nursing, arts and crafts, kindergarten educational processes,—in particular, child training in general,—maternal instinct, mother-love, and the patience of deity— doubtless a number of other things that do not at the moment occur to me. Possibly you know the person described. His name is not on my visiting-list. When any sort of occupation is engaged in for the purpose of its reaction on the mind and nerves, its purpose should be always kept in view. For success this must be constantly to the fore. THE FORWARD LOOK 221 If one is clever enough to know when therapy or reeducation may be sacrificed to art, possibly it may sometimes be wisely done. But the main issue, that of getting the patient better if not well, is the one upon which first attention will be fixed. A young man of artistic temperament fell into a nervous and mental condition which engaged every known method and endeavor to restore his equilibrium. He was able to take lessons in art, and this was fortunate, for it might have been one of the helpful upbuilding factors in his program. A teacher was engaged who called himself a psychologist-artist. The boy gently asked for work in color. This request was met with a good deal of professional bluster about doing the thing right, beginning at the beginning if he intended to be an artist. The poor dis- turbed mind labored on with beginning black and white with no spontaneity and virtually no re- action. There could be no possibility of his be- ing an artist. His was too great a handicap for that. The lessons were arranged solely for the reconstructive effect on nerves and mind—a medicine, a prescription, for one and only one purpose, to get the boy well. With dull and spiritless eye he came from his 222 AMERICAN NERVES lesson saying and repeating: “I want color. I want color,” touching almost lovingly, fingering caressingly, beautiful bits of color-effect that came to his attention. He evidently craved color as a parched man craves water. We should have been thankful that there was some definite thing he did want, that it was something he could get. It might have been made his point of contact with improvement, the bridge on which he might have crossed to health. It was knowingly denied him for incidental reasons by some one who failed in the right sort of understanding, probably an associate member of the conspirators. Indirection Another case in which adaptation was needed recalls itself, a young woman inhibited by the haunting fatigue which overtakes the introverted —all natural activity pent up inside wearing upon the self and exhausting it much more rapidly than normal outflowing currents can possibly do. Weaving had been suggested. She was in- terested, but with her indecisive state there seemed never a time to begin. “Perhaps to-morrow. I won’t decide now.” Morning comes: “No, I don’t feel like it to-day, though I might take a little walk.” THE FORWARD LOOK 223 Friend helper says: “I am going over to the studio. It’s not far, an easy walk. You might come along and see some of the pretty things they are making, though you don’t feel like doing any- thing to-day. ’9 She goes along and looks about and rests a bit. Then she is shown the simplest and easiest thing to begin on. It should not in this instance be a large bath-room rug, as is often the case, be- cause it is not detailed and is considered rather easy work. The exercise given by the large loom used in making rugs is something like the exercise of playing the organ so far as the feet and legs are concerned,—something like rowing in the long reach of the arms,—an excellent combination of radical physical exercise with artistic creative work, the handling of pleasant material and satisfying color. The visitor sees all this, but it is denied her now—too strenuous. She might work up to it after a while. A small loom on which hat- bands and belts are made is indicated on which she may begin when she feels like it. But she said not to-day! No! Unless she wanted to sit down and work for fifteen minutes, then lie down on the couch for another fifteen, and have a glass of hot milk before going home! Just as she pleases. Well, if she feels like it, that’s great! 224 AMERICAN NERVES And she will find that in this easy way she has really begun the doing of the thing that she thought she could not do. It is not doing things that troubles these people. It is planning to do them, getting ready to do them, knowing they are going to do them. The realization weighs like lead. If all those weighty, preliminary, complicating tragic things (and they are tragic) could be avoided, the real beginning is not so hard. It is not difficult for any one who half understands, to sweep the troubles aside in this casual way, if so simple a thing will make a helpful new experi- ment possible to the fluctuating mind. It does not matter in the least if the patient knows per- fectly well in the beginning just what you are doing. My young woman knew from the beginning just what was happening. It was an open secret be- tween the two. The point of ease for the patient was that she was being momentarily convinced by the employment of the simple method of indirec- tion that nothing was being forced upon her. She was to be considered at every turn. This was entirely her affair. The principle underlying this method of pro- cedure suggests the relation of the soloist and THE FORWARD LOOK 225 his accompaniment, the place of which is a shade behind the singer so as not to interfere but close enough to be a cooperating support. In a sense a disorganized mind is like an unor- ganized mind, a not organized mind, like the mind of a child. It needs the same gentle handling. It needs more gentle handling really, if that is possible. One reason why a child’s mind is not fully organized is usually because there is not yet much of anything to organize. In fact, the proc- ess of mind development and what is called organization are one and the same. Brain is built by mental activity, and the building of brain is in a sense the building of mind. A disorganized mature mind needs almost more gentle consideration than the child mind because it has, by reason of its longer and higher develop- ment, greater power of discrimination, finer power of estimating values. Moreover, it is usually the finely integrated and finely balanced minds that seem most easily to lose their equilibrium, prob- ably just because they are finely balanced. Some one said to a psychologist who was try- ing to help nervous people, “You must need a good deal of diversion, because you are always The Power of Choice 226 AMERICAN NERVES dealing with inferior minds, and it must be very exhausting. 9 ’ The answer was: “On the contrary, I deal only with superior minds. It is usually a mind above the average in quality which somehow gets set awry—off the point of equilibrium. This is the very sort of mind for which the experience would be most painful. An obtuse mind, if it did get into this condition, would probably suffer less. But the quality that would determine the lesser de- gree of pain is precisely the quality that would keep it from being overtaken by functional dis- turbance. ’9 One need not fear to express this to the subject of functional disorder. This fact is in a general way true, and we always in this work face facts. Honesty is our asset. The sufferer must have occasion to trust us, and he deserves frankness. Why not encourage him by making him feel that he is worth saving! He usually thinks poorly enough of himself—too poorly; he is often fairly wallowing in his own humility, which is the reason he sometimes seems so arrogant. He needs all the honest encouragement he can get; and, since the nervous and mental accident that has hap- pened to him inside is causing him so much trouble, why not make it as easy as we can from THE FORWARD LOOK 227 outside? Why not make him feel that in addition to being worth saving he has a right to be saved in his own way and it is our business to help him in his own way if we can find out what it is. There is a point here which is crying to be made, a fine distinction that must not be missed. How to deal with the halting indecision that has lost the power to make choices! This is a loss which strikes at the very foundation of person- ality. The power to create and the power to choose, different phases of the same thing, are said to be the human attributes which relate men most closely to deity. If this is true it may be the reason why this neurotic indecision is so ex- ceedingly painful a condition to bear. It surely is most difficult to deal with, and a wrong han- dling of it may do grave injury. Force should not be used, we know. Yet how to get things done without it! and things must be done, things like getting dressed and catching trains. In our strong desire to do just the right thing, having always in mind that force must not be used, we may perhaps in the sincerity of our ignorance go quite as dangerously to the other extreme. We then put the burden of every deci- sion upon the patient, and he cannot make it. Will you wear your gray suit? Wouldn’t you 228 AMERICAN NERVES better take your overcoat? Shall it be steak or chops? Would you like to go to bed now, or shall we read a while longer? In our earnest inten- tion not to use force or to “keep him from getting well in his own way,” we are dangling before his poor unable mind a lot of little choices toward which he is entirely indifferent. The point is that he does not make them and we get nowhere. Time is passing, and the train goes at three fifteen. One cannot do the humanly impossible, let him choose and still choose for him; but that is virtu- ally what we can and usually must do: quietly and simply put the matter before him without any “Now you have got to decide” manner; give him a fair opportunity without nagging. If he can- not do it, one may assume that he has decided upon the course which seems most reasonable and then act upon it. Even if he seems to “wabble” or recede from your decision, as he almost always will at first, one must proceed, going quietly on without seeming opposition through whatever plan is made. One finds that as soon as the decision is put into execution the patient’s mind does fortunately adjust itself and is perfectly acquiescent. It is restful to him that you have decided, but it is wise so far as possible to let it stand as his de- THE FORWARD LOOK 229 cision. There is a fine line of demarcation here between the successful and the unsuccessful way. There is a knack about it, not a trick but an art, if you please, which some people do master. It is an ability to scent the psychologic moment when one, having sufficiently and politely deferred, may go firmly but always kindly on as though no re- sponsibility had been taken. In a certain family the situation has been saved by one of its members, who had some knowledge or intuition which prompted to the successful cul- tivation of this art through the long chronic ill- ness of one of its members. Another family, in contrast, by staying just a shade on the wrong side of cleavage between the right and the wrong method with a chronic in- valid, has sunk deeper and deeper into the morass of most pathetic failure. Opposition The presence of what is spoken of as “the moral element” in nervous cases leads, as has already been said, into misunderstanding. It is some- times impossible for the wisest person to draw the fine line between pathologic and moral. It is recognized that the moral element may be in effect rather than in cause, as previously illustrated by AMERICAN NERVES 230 the people who quite happily found themselves able to act more unselfishly after recovery, though they had always been aware of the desire for un- selfish action. When a helper believes he has tried every method of patience and kindness and encourage- ment and indirection and every other method known to man, he often finds the results are un- happy. The patient seems to grow worse and worse, more lazy, more indecisive, more stubborn, more oppositions, till in despair one says: 1 ‘Well, this indulgence has got to stop. He gets too much consideration. He is getting spoiled. He needs a little firmness. We must appeal to his charac- ter. Character is the basis of everything. We mustn’t sacrifice character to health.” No, that all sounds like good, cold, common sense—per- fectly reasonable, admirable if it works. Try it; you are, in the common phrase, ‘ ‘ out of the frying- pan into the fire. ’ ’ A naturally sweet and gentle girl was pushed from a merely mild and shrinking unwillingness into a fixed resistance which was adamantine and lasted for months. This forcing was done by a sturdy moral determination on the part of her mother. The invalid had been allowed to sit too much, inactive in her chair, the mother THE FORWARD LOOK 231 thought. She was pulled by one member of the family into the car for a drive while another pushed from behind. This method was followed up in every phase of daily life till the family found itself facing a degree of resistance which a week ago would have been quite beyond the power of their imagination. With all the wisdom that any one has yet been able to muster regarding the management of these cases, there come times when appeal to the con- scious mind is realized to be of no avail, and a course of wholesome letting alone is as good a program as any one can follow. If at such times one can find any way of ap- proach to the unconscious mind, the use of tech- nical suggestion has proved acceptable to both family and patient in that it relieves the strain of opposition and the endless exhausting spirit of contention which it introduces into the family cir- cle. Opposition brings stubbornness, the set mouth, the contracted brow, because its appeal is being made to the wrong quarter where responsibility does not rest. Relaxation of the conscious mind, the really unresponsible part of the self, using it merely as a passageway to the field where the trouble lies, 232 AMERICAN NERVES the reaching in of the long arm of suggestion for the purpose of readjusting those adverse auto- matic habit mechanisms, sometimes frees the self at the point where the hitch has occurred; and the readjusted balance tends to set things right again. The normal mind begins to function, and the char- acteristic happy and acquiescent disposition has an opportunity to reassert itself. The modern and more explicit methods by which nervous conditions are now met fixes such con- centrated attention upon the sufferer, the patient, the nervous case,—it would be pleasant if we could find some appropriate term to cover him,— that the one who takes his part in the hand-to-hand contention with his malign antagonists often comes to be thought of by both patient and family chiefly as a machine constituted for their exclusive re- lief and convenience. They use him as they use their car or their house, or any other thing they have bought,—not always paid for,—the only busi- ness of which is to serve them. Standing in the outlying borders of this field, being hardly more than an adjunct to the work of the physician in cases in which he determines psychologic methods are indicated, one may claim A Tribute THE FORWARD LOOK 233 a privilege of plain speech which professional courtesy denies to the physician and his col- leagues. In one of the plays presented a few years ago, of which a physician is hero, he is seen in the final act sitting alone and as mere human being, feeling the need of just a little of the thought, the care, the patience, the under- standing, and the sacrifice which it is his long unending business to give to other people. He exclaims: “Every one is sorry for the weak. Is no one sorry for the strong?” The physician could never want pity, but it must sometimes be forced upon him that the very strong, steady quietness with which, in serious cases, he meets the call to add to his own discour- agement the discouragement of patient and family simply invites the world to look upon him as a mechanism of iron and steel, devoid of per- sonal consciousness or feeling or rights. An element of heroism appears when we remem- ber that the more perfectly the physician does his work, the better the form of his professional manner, and the stronger he proves to be as a rock of support, the more does he direct suspi- cion from the fact that he is doing anything worthy of admiration and regard. He does it so naturally that people suppose it must be easy. 234 AMERICAN NERVES It is just his business, they seem to feel. It is directly his business to be a physician, but not necessarily to listen to all your personal troubles, to help you solve your family problems, to be called up early and late, to be whined at because he is not helping the symptom or condition he is trying his best to help, which effort, by ignorance or indulgence, one may oneself be thwarting. Playing the part of mother or nurse or adviser or teacher or all these together, which the physi- cian is so often called upon to do, is usually not his business. It is this extraneous personal service added to the professional service which we un- wittingly call upon the physician to render, and which he does often so generously render, espe- cially to the nervous patient, that makes his hours long and his burden heavy. It is hardly reasonable to ask the lay mind to grasp a further point which only those who have an intimate knowledge of nervous conditions can fully understand. Nervous sufferers are perhaps the most unreliable class of persons in the whole community, filled with momentary indecision re- garding the keeping of appointments and with haunting apprehension and a strong sense of self- protection, which sometimes causes a disinclina- tion to part with money after services have been THE FORWARD LOOK 235 rendered, greedy of time and sympathy, so that they would hang upon one’s neck for hours if permitted when moments should naturally suffice. Just because these annoyances are but symp- toms of disease, the physician cannot protect him- self in these matters any more than he can protect himself from the misjudgment, misrepresentation, and often slander of the abnormal and irrespon- sible mind. The sacrifice called for here by those who try to help these conditions is unattended by any glory because virtually no one knows that it is being made. The physician’s understanding sympathy and gentle consideration of nervous and mental suffer- ing are further expressed in the modem method of conducting the psychopathic institutions of the day. As one goes about among the residents and hears them talk of their troubles and give their impressions, there is but one unanimous opinion: “They are all so good, so good. Every one is so kind. No one is allowed to be cross to us, but no one seems to want to be. It is only my own fault if I don’t get well because they are all doing every- thing in their power to help.” This tribute is repeated over and over again, and it tells that in the hands of these institutions and such organizations as the National Mental 236 AMERICAN NERVES Hygiene Association and the Psychopathic De- partment of the Rockefeller Memorial at New Haven, and some state institutions, a new era is already begun for the nervous and mental suf- ferer. Fluidity Persons nnnsed to dealing with minds other than those called normal sometimes express wonder at the degrees of patience needed for con- stant adjustment to the vagaries of nervous dis- orders. This experience of adjustment would be more difficult, perhaps humanly impossible, were it not for that mental quality we speak of as fluidity. A person may not consciously have cultivated it, he may not know he has it, but a de- gree of it he must have if his contact with those mental or nervous conditions is to result in bene- fit to the patient. This fluidity is not a quality so much as it is an attitude, not so much an atti- tude as it is lack of attitude; and it is not a special requisite for adjustment to disordered minds alone. It is useful in all the relations of life. It is needed in the family and society and in business and in the pursuit of art. It is, in fine, needed in all human relationships. It means chiefly a lack THE FORWARD LOOK 237 of personal rigidity. It could not, of course, be an aimless, flabby negativeness. It is relaxed but alert. It has fundamental principles of convic- tion and action. That is why it can be strong and yet never arbitrary in applying these principles. Because they are principles they must be true within their own limitations and so can be trusted. But, nevertheless, an excellent motto for guid- ance would be that adopted by Sherlock Holmes: “I always remember that I am never quite sure of anything.” This fluidity is always ready to be convinced that the method it had thought appro- priate to some particular situation is the wrong one, to be ready to drop it instantly, taking an- other, and then be just as ready to drop this pos- sibly right one which has been substituted for the obviously wrong one, and then being quite ready to fail in the end if a difficult experience chal- lenges to a situation which is found to be for the present quite unmanageable. The sort of fluidity wffiich is required by this work detaches itself, it de-personalizes itself so far as its own feelings are concerned, yet always retains the keenest sort of personal consciousness in order to place it at the disposal of the patient. It needs to be always ready to put itself into the patient’s place, to feel so far as possible as he 238 AMERICAN NERVES feels, using that feeling never as sentimental sym- pathy, but always as a guide to helpful action. It is ready always to overcome its own tendency to blame or criticize or be irritated by the nerv- ous condition with which it deals, whatever it may be. It is not guilty of that monstrous egotism which seems to imply that the suffering person is behaving in this disturbing way simply for the sake of annoying it, interpreting another's pain- ful extremity only in terms of its own personal discomfort. Detachment An apparently intelligent and capable attendant once complained of a disorganized nervous case in his care. He stated a long list of grievances, all those morally wrong things that the boy had done to fret and try him, until the only appropriate response to his complaint seemed to be, “You speak as though you must be paying this boy a large sum of money per day in order that he might provide you with so much mental comfort and ethical satisfaction. ” The very deeply rooted feeling that dates from the time when functional disturbances were even less well understood than they are at present, the assumption that the patient is “putting on,” THE FORWARD LOOK 239 “making believe,” that he is acting for effect, is gone by. Only uninformed persons believe that to- day. Even the malingerer, the person who really seems to be putting on, is now considered a sick man. It surely cannot be normal for a well man to wish to behave as though he were ill. Such an abnormal desire is illness. It is one thing for a person to be able to get this fluid or detached attitude for the moment; it is another thing to hold it so persistently as to be able to act upon it. A fine woman who has spent a lifetime in leading positions in the nurs- ing profession, in discussing a patient with a psychologist, said, “She acted as though she were in pain and said she was and thought she was.” “From our point of view, of course, you know a person does suffer just as much as he thinks he does,” said the other. “I think one deserves a great deal of credit to be able to see that.” “But you know it just as well as I do!” “Oh, yes, I know it for the moment. You not only know it but continue to remember it and are somehow able to go on acting as though you really believed it. ’ ’ The person who can do that must be possessed of at least some degree of fluidity which can re- 240 AMERICAN NERVES suit only from a deep psychological conviction, either conscious or unconscious, as a background of thought. One who has no sense of conviction to fortify his habit of fluidity will question his fitness for this field of service. There needs to be some sup- porting thing to lend a willingness and a desire to go on acquiring greater power of adaptability. Dr. Forel has said there is little danger of un- qualified persons coming permanently into this field. The seriously unqualified person who enters it will doubtless abandon it as distasteful. One who had continued for a long period in the field said, in speaking of a first interview with a new subject: “I never feel more relaxed than on these occasions, for I know I have nothing to do at the outset but to take in impressions, to learn my problem if I can. I feel something as I do when I go to the theater to see a play. I am en- tirely open to new impressions. I have nothing to do until I get a clue to my line of action.” The Religious Craving A very charming, modishly dressed, and alto- gether thoroughbred young person, on presenting herself for various kinds of mental readjustment, THE FORWARD LOOK 241 said a bit shyly: “I thought whatever help I got I would like to have come from the religious point of view. Could you give it to me in some way like that ? ’ ’ “Yes, indeed; surely. The nearer we get in consciousness to a realization of the base of our supply of health the better it is for us.” Some people come saying: “ Now, I don’t want any nonsense; no religious stuff. You don’t do it that way, do you? I have n’t any time to fuss. Can you make me better?” To this one the answer: “I hope I can. You have a right to take your help in any way you please. You may have just the plain practical expression of the simple psychologic principle we are trying to work with and not a word about causes if you like. Any one has a right to get health in any way he pleases if he can do so without radical wrong to himself or others.” The basis of the frequent craving to relate re- ligion and health comes perhaps from the close association of these two in the New Testament accounts of restoration. It may be quite possible that we have in our thought reversed the order of things and that “go and sin no more” on the lips of the great practical psychologist may have 242 AMERICAN NERVES implied the points covered under ‘ ‘ The Moral Ele- ment”: “Now you are better, you will find it pos- sible to be good.” The psychologist has the advantage of the thinker who is not at home with ‘ ‘ the things of the mind” in having a point of view which by habit has become second nature. Familiarity with thought processes clarifies the fact that what we think of as “spiritual experience” is inevitably mental experience. We have no choice in the matter. While consciousness is not held quite so arbitrarily as in the past to be the basic fact of mind, after all, it must be just that, allowing as much room as you please to the influence of the unconscious. We experience only that of which we are conscious. All the more recently disclosed phases of mental life which are attributed to unconscious activity could come to our knowledge and be of use to us only through consciousness. This obvious fact would seem to indicate that consciousness, the state of “awareness,” still remains the basic fact of mental life. It must be the basic fact of spiri- tual experience as well, since it is, as far as hu- man knowledge goes, the only avenue of approach to the self from any direction, from above or be- low or on its own mental level. THE FORWARD LOOK 243 Admitting any kind of mystical states you please, in dream or trance, the self knows them fully only when the cold light of common day is brought to bear upon them through consciousness. Whatever degree of ecstasy may be achieved, it has not reached its full value to the self until the exceptional state has passed and the every-day consciousness knows that it has had the unusual experience. Natural Religion The vague mind that does not yet see religious or spiritual experience as mental experience, as a normal phase of consciousness, is hardly yet a self at all. Instead, it is only the raw material for the making of a self, we submit, but not yet really integrated, not yet individually differentiated and then assembled into a practical working ma- chine. Spiritual experience can be nothing extraneous, superimposed from outside. What could it be other than the self or consciousness, aware of it- self in its highest relationship, its balanced adjustment to the source of being? The idea of so-called spiritual experience as the conscious health of the self in its highest relation of health— wholeness, holiness—brings a hitherto vague and 244 AMERICAN NERVES remote religion very comfortably into the field of the natural. It reveals the supernatural, not as something foreign and unsubstantial, but as simply a higher natural which we have not yet understood. It shows the meaning of the idea of the king- dom of heaven as something resident within us and makes it possible to understand. It gives the sense of a natural intimacy between the human self and the source of its life, so that it is not only a pleasing but a reasonable conception given us by the writer who says, “When I think about God it is God thinking about himself in terms of my consciousness.’’ The holding of this idea and the mastery of it as a principle of action calls for that fluidity of thought to which reference has pre- viously been made. If a person has a practical working theory of God the result will naturally be that he will not connect God with health any more than with the other experiences of life. These must all be com- prised in the complete relationship. God will be no less implicit in health, but he will be as evi- dently present in every other experience as he is now in the highest conception of health. Dr. Samuel Crothers says we make a false dis- tinction in differentiating religious and secular. THE FORWARD LOOK 245 There is no religious and there is no secular, not that religion from this point of view becomes secular, as in our natural doubt we fear he may be telling us, but that all we had thought secular stands revealed as innately religious. The person who realizes his relationship to the author of his being recognizes his health as com- ing from this source of sources just as truly when it comes though medicine or massage or electricity or psychology or metaphysics or prayer. Our petty little distinctions cannot make separation in the fundamental unity. It seems an elementary stage of religious consciousness that makes a special point of spiritualizing its health more than other common benefits which come from the source of universal supply. All things are ours whether we know it or not, if any of the simplest things we think we know about God are true. If we have grasped this fact, it will seem strange to “importune him for special benefits,” yet we shall not cease to appro- priate that which is ours till, as the spiritual philosopher has said, we find “every common meal a eucharist and every bush afire with God.” Appropriating Health It is as though a kind and faithful mother lifted 246 AMERICAN NERVES her child into his high chair, tied his bib about his neck, and set his bread and milk before him say- ing, “You can have more if you want it.” He pays no attention to it, not being hungry; but presently, when he feels hunger and craves food, he sets up a cry, “Mother, Mother, please give me my supper. If it be thy will, please give me my supper.” A quite appropriate answer would seem to be: “You foolish child, stop crying and eat your supper. You have already all the things that I possess. There is no more giving I can do. The only unfinished part of the business is for you to take what, as I have told you and shown you, is already yours.” Since the simile fails at the point of the bread and milk being upon our table, for the health we want is not quite so obviously ours as the food is the child’s, we may well ask to be shown how to take the health which we believe is already and from the beginning given but not yet claimed or appropriated by us. The wonderful fact of automatism buried deep in our physical nature, the explicit mechanical fact, must quite obviously be an instrument of the eternal, since precisely by it and by it alone from THE FORWARD LOOK 247 the unseen power resident within it do we “live move and have our being. ’ ’ When in response to any claim we make on the higher power, whether it be through one medium or another, we get a result of reestablished health, it can come only through the physical and mental processes in which our life consists. Consciousness of reestablished mechanisms is what restoration means. If these mental and physical instruments have been given us as a means of communication with the sources of life, it is unlikely that they should be too mean for any high purpose. Sentimentalize about it as we will, if health is restored through prayer or Christian Science or New Thought or psy- chology or medicine or even crude charlatanism, we have no way of receiving the fact except through consciousness of changed physical mechanisms. These instruments employed by the universal life, by the Supreme Power, would seem to be worthy of our attention. When a need is felc for a higher degree of health, it would seem as appropriate and reason- able that we busy ourselves with these instru- ments, these mental and physical processes, in the name of God, if you please, as it seems reasonable AMERICAN NERVES 248 for the crying child in the name of his mother to occupy himself with his bowl and his spoon. The suffering nervous soul should be yielded any point of departure that it pleases. It may travel along any highway upon which its feet can feel familiar toward the establishment of its claim upon the health which it craves and which was long ago given with all other things. It may even receive through the law of the by-product more than it understands enough consciously to need. Three expressions come to mind from the lips of three different persons who were feeling them- selves over and taking stock after having had a course in technical suggestion in which no effort had been made to get so-called spiritual results. A mature man said, “I have found God.” An artist states questioningly, “I have been taught that this which has come to me could be found only in conventional religious experience. ’7 A woman of the world exclaims, “It seems like the answer to a prayer I did not know enough to pray.” The Little Smiling Clown After this excursion into the serious, we hope no fine sensibilities will be jarred by the homely THE FORWARD LOOK 249 symbol which has often illustrated for us that inner equilibrium the desire for which prompts one’s search for nervous or mental or spiritual health. We stumble upon him among the belongings of our juvenile relations. He is the perfect embodi- ment of the kind of poise we all need and desire. He is like the partially paralyzed man, “bigger than anything that can happen to him” in his power to react, to hold his own in all the disturb- ing events of life. Everything may go wrong. The domestic peace may be rent asunder by every untoward circum- stance. The nursery may be in commotion. Johnny may fall from the apple-tree or the cat be having a fit. If any one, in rushing to the rescue, oversets our embodied equilibrium, he comes up smiling and serene. The secret of power is within though partly without, it is true. It lies in his adjustment to external conditions through having a rounded base, together with an inner hidden source of poise, which consists probably in exactly the right amount of ballast. It may be well not to analyze the inner adjustment too closely in his case. If we should find just the number and size of the weights he might possibly lose his AMERICAN NERVES 250 charm. He seems to have attained the perfect balance which we all desire. Were he conscious he would know that he possessed some inner secret which rendered him superior to disturb- ing conditions. If we are as kind to ourselves as we have been to him and refrain from analyzing too minutely, from demanding to know the exact shape and size of our power, we can perhaps gain something approaching to this enviable poise, this perfect equilibrium. We congratulate those who can accomplish it for themselves, as every one wishes to do. For those who cannot compass it, for those who have tried and failed, what has been referred to as the long arm of technical suggestion can reach down to the inner mechanisms and seem to set them in order. And this ordering does give in a greater or less degree the desired effect of a stabilized and centered personality. A conscious- ness that feels strong at its center, that can trust itself and its fouch with the “infinite reserves,” that knows it can meet the emergency, that need not live always in fear, in apprehension of the known or the unknown, that faces life calmly, even in turmoil and upheaval because it can feel THE FORWARD LOOK 251 that it is, inside, “bigger than anything that can happen” to it. Many persons are unable to gage their own inability to make the fight they so bravely are making until by some of the methods of help at hand they succeed in getting right. You did not know until the old scissors were sharpened how very dull they were. Had you realized you would have had them sharpened before. There is a large class of nervous and disorgan- ized people who need the experience of a woman who said “every adverse circumstance bowled me over.” “Now,” she wrote some weeks later, “I feel I have gained something that will not fail me in moments of crisis.” The Knife Juggler The story of the knife juggler is given here at the request of some of its friends, who have found, in their moments of crisis, that it serves to stimulate the consciousness of a newly found sense of mastery. Of all the artists in the circus the knife juggler is the one we like the best. His psychology is superb! What if he should forget? Suppose something should happen to confuse him! Sup- 252 AMERICAN NERVES pose a fly should light on his nose! Suppose he had to sneeze! Those great, glittering, cruel blades, four, five, six, or more of them flying all about him! How can he know that everything will go right? Sup- pose he should make a false move and surprise himself! He might do the next thing wrong, and then everything would go wrong. He might by accident catch just one knife by the blade and cut himself. That would confuse him so that he would go on catching blades till his hands were all cut and bleeding. Such a thing might con- ceivably happen. We are not any more sure of taking hold of the right end of our table-knives at dinner to-night than he seems to be, of grasping handle aftei handle as they come back to him when he has tossed then into the air. He does it quite ac- curately, and he does it repeatedly. Every time a knife comes along, there is his hand! He gages just the distance. He knows just where his hand should be. What is more, it is always there. Suppose some one handed you an armful of big carving-knives and told you that you must spend the next quarter of an hour throwing them up in the air and catching them by the handles— THE FORWARD LOOK 253 catching each one every time by the handle. Would it not be quite a wonderful thing to feel sure that you could do that! Here is an idea that it would be much more wonderful to have. There is a handle to every one of the dangerous things that life must sooner or later throw at us, a safe part to grasp it by. It would be a great thing, indeed, to know that the knives of life can be caught by the handle. The part that need not hurt too much. Maud Diver, in one of her fine stories, reminds us of the knife juggler. Her hero is breaking a piece of bad news to the heroine; life is asking him to throw a knife at her. He has to throw it. She sees it coming. She gets scared because she is afraid of suffering. This confuses her so that she does not even try to catch this knife by the handle. Her mind is fixed on the part that hurts just because it hurts. So, having her mind fixed on that part of the knife, that is all she sees to catch it by. And, seeing nothing but the blade, the part that hurts, she catches the knife by the blade. And it does hurt her. It hurts her very much. She is all cut to pieces. She cries out, having hurt herself with it, “Oh, how it hurts, this knife life has thrown at me.” Having the 254 AMERICAN NERVES blade in her hand, she goes on hurting herself with it, until she is all bloody and full of mental pain. After a while, after she has hurt herself a great deal, she begins to get herself together. All this time the hero has been standing by watching. Now he says to her, “My dear, when life throws a knife at you, be sure to catch it by the handle.” This is where the knife juggler’s psychology comes in. He gives a “laboratory demonstra- tion” that you can be ready. You know knives will come. If you are ready you can fix your attention on the less harmful part of them even before they reach you. You can make your ef- fort to catch them by the handle, the part that keeps the painful end from cutting and stabbing, the part that you control them by. We see people who catch life’s knives in that way. They are always in command of the situ- ation. They get the minimum of pain out of every painful experience. The safe part of the knife is always in their hands. A student who had been dogged by nervous fears of a troublesome nature had gone to a psychologist saying: “I could manage them my- An Anchor out to Windward THE FORWARD LOOK 255 self, I suppose, but I haven’t time to spend on them. I can devote my energy and my mental effort to better purposes. I feel as though these bothersome things should be brushed off as one would brush off a swarm of annoying flies.” In a comparatively short time the bothersome things were brushed off; and in speaking of them the young man said later: “Those fears have fought their last fight. They have no further power to trouble me. I have no expectation that they will return, but if they did I feel that in this method of managing such difficulties by direct suggestion, I have an anchor out to windward.” Those upon whom life makes large demands, who have ample use for the power of effort in the field of constructive work, need not spend time or strength in brushing off flies. Those who have conscientiously tried to meet the greater issues, the nervous conditions that loom larger than the flies, and have not succeeded, may feel that in the natural processes of the nerves and mind and the natural method of reaching them and turning them to our own good account, we have an anchor out to windward. It seems a waste that we should carry about with us every day in the mysteries of our physio- logic structure and organization the simple mech- 256 AMERICAN NERVES anisms which we can in a measure direct and control and adjust to higher ends, without making use of them. If we grasp the idea of the implicit “springs to action” of all the broadest and the highest, the most far-reaching, and the most ex- alted experiences of life, as gathered up, brought down, and put into our hands for direct controlj through the individual nervous system, it drives home a fact which we seem but partially to have valued, the momentous though at the same time very practical fact of the Supremacy of Nerves. This fact might well command our further thought in the conduct of our own lives. It may be a trustworthy guide in our effort to adjust ourselves and others in life’s wider relations and it remains in a very real sense for our future safety, a secure anchor out to windward.