Applied Psychology for Nurses by Mary F. Porter (good short books .TXT) 📖

all the past. Definite tendencies, they are, to certain specific reflex actions in response to certain sensations. These responses, from the very beginning of animal life, have been toward avoiding pain, and toward receiving pleasure. It is as though the stimulus presses the trigger—instinct—and the muscle responds instantly with reflex action. This mechanism is the means of protection and advancement, and takes largely the place of intelligence in all animal life. It is what makes the baby suck and cry, clutch and pull, until a sense memory is established. So instinct is really race memory. We call instinctive those immediate, unthought reactions which are the same with all mankind.

The pugnacious instinct—the desire to fight—is the natural reaction of every human being of sane mind to attack. The inner necessity of avenging is so strong in the child or man of untrained mind or soul that he acts before he thinks. He strikes back, or shoots, or plots against his enemies. Only rare development of spirit or the cautious warning of reason which foresees ill consequences, or a will trained to force control, can later make the instinct inactive.

Where instinct ends and sense memory, imitation, and desire step in is difficult to determine. Later in life probably most of what we consider instinctive action is simply so-called reflex action, depending on sense memory, action learned so young that it is difficult to distinguish it from the true reflex action, which is due only to race memory.

James, in his Talk to Teachers, gives us a partial list of the instincts. Thus:

Fear Ownership Shyness Love Constructiveness Secretiveness Curiosity Love of approbation The ambitious impulses: Imitation, Emulation, Pride, Ambition, Pugnacity

To this partial list we would add self-preservation, reproduction, etc.

But instincts conflict with each other, and man carries about with him in babyhood many of them which may have been very useful to his prehistoric ancestors, but which only complicate things for him. Fear and curiosity urge opposite lines of conduct. Love of approbation and shyness are opposed. Love and pugnacity are apt to be at odds. So, gradually, as intelligence increases, the child refuses to allow such impulses to lead him to action. When fear-instinct and love-instinct are at war, reason is provided to come to the rescue.

Instincts are racial tendencies of sensational or emotional states to determine action.

Instincts are the germs of habit, and when instinct would give rise to a reaction no longer useful, reason, abetted by new habit formation, in the normal mind, weakens instinct’s force; and the habit is discarded and the instinct gradually declines.

In prehistoric times when food was scarce, and man had not learned the art of tilling the soil, hunger forced him to fight for what he got to eat. As there was often not enough to go around, he maimed or killed his fellow-man that he might have all he wanted, obeying the instinct to survive. So, now, the baby instinctively clutches for all that appeals to him. But an abundance of food for all, or the intelligent realization that co-operation brings more to the individual than does fighting, and a developed sense of responsibility toward others; or merely the fear of the scorn of fellow beings, or the desire to be protected by the love of his kind; perhaps a genuine love of people, acquired by spiritual development, puts the primitive habit of food-grabbing into the discard. Finally, the very instinct of self-preservation may be transformed into desire to serve others. No better illustration of this can ever be offered than the sacrifices of the World War.

Memory

No mind retains consciously everything that has ever impressed it. It is necessary that it put aside what ceases to be of importance or value and make way for new impressions. We found early in our study that the subconscious never forgets, but harbors the apparently forgotten throughout the years, allowing it to modify our thinking, our reactions. But the conscious mind cannot be cluttered with the things of little importance when the more essential is clamoring. So there is a forgetting that is very normal. We forget numberless incidents of our childhood and youth; we may forget the details of much that we have learned to do automatically; but the subconscious mind is attending to them for us.

Do you know how to skate? and if so, do you remember just how you did it the first time? Probably all you recall is that you fell again and again because your feet would slip away from where you meant them to be. When you glide over the ice now it is as natural as walking, and as easy. You cannot remember in detail at all how you first “struck out,” nor the position of your feet and arms and legs, which you felt forced to assume. At the time there was very real difficulty with every stroke—each one was an accomplishment to be attempted circumspectly, in a certain definite way. All you remember now is, vaguely, a tumble or two, soreness, and lots of fun.

We forget details we have intrusted to others as not a part of our responsibility. We forget the things which in no way concern us, in which we have no interest and about which we have no curiosity. And it is well that we do so. If it were not for the ability to forget, our minds would be like a room in which we have lived a lifetime, where we have left everything that has been brought into it since our birth. It would be piled ceiling high, with no room for us, and with difficulty only could we find what we want. As we grow from babyhood to childhood, from childhood to youth, from youth to maturity the room changes with us. We put off childish things. They are stored away somewhere, in an attic or basement, or destroyed. And day after day something new is added, displacing something else. In the case of the mind all these things are stored and cataloged in the subconscious, and forgotten, until some need causes us to look into our catalog-index and see the experience again, or some association calls it back, relating it to something new. So our discussion of the subconscious involved also a discussion of memory.

But what of the things we must use frequently and cannot find in our minds? What of absent-mindedness and faulty memory? In such cases our minds might be compared to a cluttered room full of things we need and want to use every day, but in confusion. We know where many of them are, the ones we care most about; but we have to rummage wildly to find the rest. We have no proper system of arrangement of our belongings. You laid down that book somewhere, absent-mindedly, and now you cannot tell where. You were thinking of something else at the time, and inattention proves a most common cause of poor memory. Perhaps you simply have more books than the room can hold in an orderly way, and so you crowded that one in some corner, and now have no recollection of where you put it.

Poor memory is the result of lack of attention, or divided attention at the time the particular attention-stimulus knocked. You asked me to buy a ribbon of a certain shade and a certain width when I went to town. I was thinking of my dentist appointment. However, I heard your request, answered it graciously, took the money you offered, still wondering if the dentist would have to draw that tooth. And the chances are that I forgot your ribbon. I was giving you only a passive and divided attention.

Or I have more to do than I can possibly accomplish in the next six hours. You ask me to buy the ribbon. I attend accurately for the moment, think distractedly, “How can I do it all?—but I will”—and crowd the intention into an already overburdened corner of my mind, fail to associate it with the other thoughts already there, and return six hours later without the ribbon. My sense of hurry, of stress, of the more important thing to be done, or a reaction of impatience at the request, forced back the ribbon thought and allowed it to be hidden by others. I was really giving you only partial attention, or an emotion interfered with attention; and I forgot.

Hence we find that a faulty memory may exist in an otherwise normal mind when poor attention, or divided attention due to emotional stress or to an overcrowded mind, which makes it impossible to properly assort its material, interferes.

Again, we forget many things because they are unpleasant to remember. We have no desire, no emotional stimulus to make us remember; or because some of the associations with the forgotten incident are undesirable. We forget many things because if we remembered them we would feel called upon to do some unpleasant duty. You forgot your tennis engagement with B, perhaps, because you were so engrossed in a pleasure at hand, or in your work, that anything which interrupted was, under the circumstances, undesirable. You may have wanted very much to play with him, but some more pressing desire—to care well for your patient, or to continue the present amusement—was stronger. Or you forgot because you did not want to play with him and had no excuse to offer at the time. You wished to forget. Perhaps he does not play a good game, or you do not like him, or at least you like some one else much more, and he happened along; so you forgot B. The unconscious mind saw to it that something else was kept so prominently before your attention that it could not return to the less desired.

Thus a forgetting may be purely the result of an emotional interference which makes it, all in all, more pleasant to forget than to remember. If we would help ourselves or our patients whose memories are faulty, and who make them worse by their continual fretting over their disability, we must train ourselves to be willing to forget all that does not in the least concern our interests or those of the people about us, and does not add anything desirable to our knowledge. Thus we may avoid overcrowding the mind. But when we would remember let us give our whole active attention at the moment of presentation of the new stimulus, and immediately tie it up with something in past experience; let us recognize what it is that we should remember, and call the reinforcement of will, which demands that we remember whether we want to or not. Sincere desire to remember will inspire early and frequent recalling, with various associations, or hooks, until the impression becomes permanent. The average patient’s poor memory is made worse by his agitation and attention to it, and his conviction that he cannot remember. The fear of forgetting often wastes mental energy which might otherwise provide keenness of memory. If the nurse ties up some pleasant association with the things she wants the sick man to remember, and disregards his painful effort to recall other things, then—unless the mind is disordered—he will often find normal memory reasserting itself.

We shall consider this question of memory in more detail in a later chapter of practical suggestions for the nurse.

The Place of Emotion

Feeling Cannot Be Separated from Thinking.—Emotion we found the constant accompaniment of every other mental activity. It is first on the stage of consciousness and, in the normal mind, last to withdraw.

When I am working at a problem in doses or solutions, trying to learn my materia medica, or wrestling with the causes of disease in my medical nursing, or thinking how I can eke out my last ten dollars till I get some more, I am pursued