A very interesting statement of one of our contemporaries is that any person, to one degree or another, is both a psychologist and a philosopher - they say, life forces him to. On the one hand, the main driving force of every person is the craving for knowledge, the desire to reach certain social heights, the desire to be wise in any everyday situations - and this is the philosophy of life. Applied Psychology for Nurses by Mary F. Porter (good short books .TXT) đź“–
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It is not uncommon to hear a doctor say, “Nothing but his will pulled him through that time.” It does not mean quite what it says, for the patient’s will would have been helpless to cure him without the medicine and the treatment. But it does mean that in some cases when life is hovering on the brink, even the most skilful treatment cannot hold it back if the will to live is gone. The chances may be half and half. Lack of desire to live may drop the balance on the death side. Determination and hope and confidence may overweigh the life side. For the influence of will in refusing to surrender to depression may throw the needed hair’s weight in favor of more normal circulation. Depression and emotion may so effect the sympathetic nervous system as to cause a lowered circulatory activity. Determination, based on volition, may stimulate a response from the sympathetic system which will increase heart activity. And certainly, when it is not a matter of life and death, but a prolonged recovery, will is a saving grace. The patient who sets all his sick energies to the task of winning health reaches his goal quicker than the hopeless and depressed. Perhaps his will merely brings utter relaxation for the time, forces acceptance of present helplessness only for the sake of giving the body a better chance to recuperate; but the very fact that it is acting to hopefully carry out orders lightens by half the nurse’s task of getting him well; and she can encourage this will to co-operate with the doctor’s efforts by suggestion, by her directness and honesty, by the quiet assurance that at least a reasonable degree of health is won by effort.
We have touched upon only a few of the laws of the mind. The nurse can help develop saving mental habits and wholesome attitudes while she helps to strengthen sick bodies; she can make a cure a little more certainly lasting who will remember that:
Adaptability is essential to life and health. There is no neurosis without a psychosis. Suggestion may be a powerful factor for health. What we attend to determines what we are. Thought substitution is possible. Habit is a conserver of effort. Will is a saving power. CHAPTER VIIIVARIATIONS FROM NORMAL MENTAL PROCESSES Disorders and Perversions
Life would be a very simple proposition if the mental machinery always worked right. But this is peculiarly subject to damage both from without and from within. From without it may be damaged by the toxins of food, as in the acute toxic psychoses; by the poison of drink, as in the alcohol-produced psychoses, such as acute alcoholic hallucinosis; by lack of muscular exercise, resulting in a deficient supply of oxygen to burn up the accumulated toxins from energy-producing foods; by the infections, which may result in the infection-exhaustion psychoses; by wrong methods of education, and by surroundings which demand too severe a mental strain in the struggle toward adjustment. These damages from without we class roughly as environmental.
From within the mental workings may be injured by emotional dominance; by bad habits of thinking and feeling and doing—often the result of wrong methods of education; by defective heredity; by undeveloped will; by the insanities. These danger sources from within we might classify as self-produced and hereditary.
There may be disorders of any or every function of the intellect, disorders of feeling, and perversions of will. Some of the most commonly met we list below.
Systematized Transient Fixed Somatic as in hypochondriasis. Persecutory as in paranoia. Unworthiness as in simple depression or melancholia Grandeur as in mania or paranoia. Nihilistic often found in melancholia. Reference as in paranoia. Altered personality as in hysteria. Perverted personality (patient may believe he is a dog); as in dementia. Emotional thinking. Shut-in personality as seen in the deficient social capacity of potential dementia præcox. Disorders of Judgement Defective judgment in all insanities; in hysteria. Ex.: Patient who accepts mental suggestion of disability as reality. Perverted judgment in severe dementias—as influenced by unreasonable fear, hatred, etc.; in all acute insanities—as manifested in inability of patient to rid himself of his delusions. Absence of judgment in all acute insanities; in later dementias. Limitations in many so-called normal and in all the abnormal. Disorders of Emotion Suggestibility in hysteria. Excitement in mania. Depression in melancholia. Phobias as found in psychasthenia. Deficiency as in the apathy of depression. Perversion in mania, in depression, in catatonia. Deterioration in dementia. Sense of unreality found in all borderland cases. Disorders of Will Wilfulness in many “normal.” Very common in hypomania. Willessness (aboulia or paralysis of will) often found in psychasthenia; and in depressive states. Morbid inhibition as in depressive states. Indecision as in psychasthenia; as in simple depression. Obsessions found pre-eminently in psychasthenia. Tics in many borderland cases; in the hypersensitive as often the only expression of any neuropathic tendency. Distractibility as in hypomania and frequently in hysteria. Negativism as in catatonia. Mutism as in catatonia. Compulsive acts as in psychasthenia, hysteria, etc. Psychomotor overactivity (volition unable to check) as in mania. Psychomotor retardation (volition unable to energize) as in depression.
From this limited survey of the mind’s disorders we realize that every departure from the normal mental attitude tends to associate itself with one of the following five states of mental disability.
Depression, Exaltation, Perversion, Enfeeblement, Deficiency. CHAPTER IXVARIATIONS FROM NORMAL MENTAL PROCESSES (Continued)
Hyperesthesia is abnormal sensitiveness to stimulation.
Anesthesia is loss, either temporary or permanent, of any of the senses.
Perversion is morbid alteration of function which may occur in emotional, intellectual, or volitional fields.
Example: The odor of a rose causing an acute sense of physical pain.
An illusion is a false interpretation of a perception.
The normal mind is quite subject to illusions, either due to a faulty sense organ, or to a preconceived state of mind which so strongly expects or presages something else than reality as to misinterpret what the senses bring.
Examples: The crooked stick as a snake. A ghost created from shadow. An ordinary ringing in the ears as sleigh-bells. Milk tasting like blood.An hallucination is a perception without an object.
The hallucinated individual projects, as it were, the things of his mind’s creation into the outer world, and accepts them as reality. He sees snakes where there is nothing to suggest them; sees a ghost where there is no shadow; believes that the taste of blood is constantly in his mouth.
There are possible hallucinations of every sense. Nonexistent objects are seen, touched, tasted, heard, or smelled.
Hypochondriasis is a state characterized by persistent ideas of non-existent physical disabilities.
The hypochondriac has every known symptom of indigestion, or of heart disease, or is threatened with tuberculosis—all in his mind; and whatever the disorder he seizes upon, his attention hovers there, while the ideas of that particular disability persist and strengthen.
A flight of ideas is an abnormal rapidity of the stream of thought.
Every perception so immediately is linked with some association of experience that expression is swift and often incoherent. One word will follow another with amazing rapidity, words suggested by sound association, usually, rather than by that of meaning.
Example: “Made a rhyme, had a dime, did a crime, got the time, bring some lime.” This association by rhyme is quite common. But the associations of meaning are not uncommon.
Example: “Made a rhyme. Mary was a poet. Mary had a little lamb. Where’s Mary?—Mary!—No Jim—Jim, all my children—calling, calling, calling,” etc.
A fixed idea is one which morbidly stays in the mind and cannot be changed by reason.
Example: In hypochondriasis, as given above.
Ideogenous pains are either pains born of an erroneous idea, or mental reproductions of pains now having no physical cause.
A suggestible person, learning that his grandfather died of an organic heart, conceives the idea that he has inherited the trouble, and begins to suffer cardiac pains; and as long as the idea persists the pain is felt.
Compulsive ideas are ideas which intrude, recur, and persist despite reason and will.
Example: The compulsive idea of contamination may lead its victim to wash and rewash his hands at every contact with matter, until finally, though they are raw and sore, he is incapable of resisting the act.
Disorientation is a state of mental confusion as to time, place, or identity.
Amnesia is pathologic forgetfulness.
Example: As sometimes found in the infection-exhaustion psychoses, when the entire past of the patient may be wiped out for the time. Cases of permanent amnesia are known.
Aphasia is a defect in the interpretation or production of language.
There may be motor aphasia, auditory aphasia, vocal aphasia, sight aphasia; and with disability to produce words, they may yet be recognized when seen; or when they can be spoken they may not be recognized when heard; or with inability to speak them, they are accurately sensed by hearing; or though understood when heard, they are incomprehensible when read.
A delusion is a false belief which cannot be corrected by reason.
A somatic delusion is one centering upon alterations in the organs or their functions.
Example: Absence of a stomach, inability to swallow.
A nihilistic delusion is one which denies existence in whole or part.
Example: Mother denies the existence of her child.
A delusion of reference is one in which the deluded individual believes himself an object of written, spoken, or implied comment.
Example: The actors on the stage are directing their remarks directly against the victim in the box.
A shut-in personality is one that habitually responds inadequately to normal social appeal.
Sense of unreality is one of the commonest psychic alterations through which customary sensation states are displaced by unnatural and usually distressing ones.
Examples: The breakfast table appears undefinably altered. Laughter is accompanied by strange, rather than by normal, sensations.Morbid inhibition is an abnormal, negative activity of the will.
Sometimes a patient will try pitifully to express some thought or feeling; the desire to explain is there, but will is blocked in action. Or the patient attempts to dress, makes repeated new beginnings, but cannot succeed. We say, “He is inhibited.”
An obsession is an idea which morbidly dominates the mind, constantly suggesting irrational action.
Obsessed patients may consistently step in such a way as to avoid the juncture of the flagstones on the pavement; may insist on removing their shoes in church; may hail each person met on the street and tap him on the arm; may refuse to ever leave the house without an open umbrella; or may try to attack
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