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

naturally follows some stimuli; sorrow others. Disappointment or loss, shock, failure, death of loved ones, illness in ourselves or others, do not normally bring joy. A keen sense of suffering, temporarily, perhaps, of numbness; the inability to grasp the calamity; or flowing tears, an aching heart, or the stress of willed endurance, are natural, and normal reactions to such stimuli.

A developed will may refuse indulgence in the outward expression of the normal feeling of shock, grief, and loss; and this may be normal. But normal volition does not force us to laugh and dance and be wildly merry in the face of grief and loss and pain. It only suggests the adequate, reasonable acceptance of the facts that cannot be changed—the acceptance of love, faith, and hope that sees in present suffering a means of consecration to service; it does not convert the emotion of sorrow and loss into a pleasurable one. Normal reason does not suggest that will force the reactions to loss and suffering that belong by nature to attainment and success.

Nor does reason suggest the long face, the bitter tears, a storm of anger, in response to comedy and farce, in the face of a good joke, or to meet success; and normal will puts reason’s counsel into effect.

Normal Emotional Reactions

Some emotions, that seem exaggerated at first thought, may be normal under the circumstances. For no one can know the whole background for emotional response in the life of another. After being long shut up in a darkened room, with bandaged eyes and aching head and sick body, the first visit to the bit of woods back of the house—when all the pains have gone—may bring almost delirious joy. The green of the foliage, the blue of the sky, the arousing tang of the air, the birds, the sense of freedom—all go to the head like new wine. The abandon of joy is a normal response under the circumstances, now. It would hardly be normal to one whose habit it is to visit this same bit of woods every day, to one who loved it, but for whom it had lost the force of newness.

To the child, who has never in all his little life had a wish not gratified, the denial of a desired stick of candy is as great a calamity as is the loss of a fortune to the grown man. And the child reacts to feeling equally intense. These are normal reactions to stimuli—normal, under the circumstances.

The Normal Mind

The normal mind reasons clearly with the best data at hand to results that will stand the test of conformity to reality; the normal mind uses reason and feeling, guided by reasonable attitude; in the normal mind reason advises action and will brings it about; in the normal mind feeling proportionate to the circumstances accompanies every thought and every action. And in the well-balanced man or woman every function of the mind leads to action as its final end.

But man only approximates the normal. The perfectly balanced man or woman is so rare as to be a marked person. The average intelligent individual only in general approximates this standard. He goes beyond it in spurts of untrammeled genius, to wrench lightning from the heavens, and to send his trains through the air; or he allows his feelings to dictate to his reason, and much of the time so exaggerates or depreciates the simple facts of life that the results of his reasoning no longer conform sufficiently to reality as to be thoroughly dependable.

CHAPTER VII
PSYCHOLOGY AND HEALTH

In the use of its functions the mind manifests certain powers and certain modes of expression which can act as powerful allies or as damaging enemies of health. We speak of man as adaptable, but also as a being of habits. We speak of him as “feeling” when we wish to express the fact that his emotions influence his body. We expect of the average man a certain amount of suggestibility. We say that he is tremendously affected by his environment, which simply means that his attention, naturally centered chiefly on the things at hand, largely determines what he is. But we recognize that a man of trained mind can choose and will to substitute for his present surroundings thoughts upon more constructive things from past experience, or from future possibilities, or from within the mind’s own storehouse. His ability to largely modify his life by his will, we recognize as man’s greatest power. Adaptability, emotional response, suggestibility, attention, thought-substitution, habit-formation, and will can minister vitally to health, or can prove damaging avenues of disease.

Necessity of Adaptability

Adaptability is as essential to life of mind as to life of body; and health of mind as well as health of body is determined by the individual ability to adjust himself to environment.

There are dreamers who have lived in their ideal world so long that they cannot meet the stern realities of life when they come. The shock is too great for the mind that has accepted only the fantastic, the real as the dreamer would have it; and he lets go altogether his hold on the actual, accepting the would-be world as present fact. And we call him insane. Other visionaries wakened rudely to life as it is, accept it as unchangeable fate, lose all their true ideals and become cynical, or victims of utter depression for whom life holds nothing that matters. Still others go on through the years self-satisfied and serene because they simply refuse to believe unpleasant truths; they “pretend” that their wishes are realities, and acknowledge as facts only the pleasant things of existence. The first two groups have failed to adapt self to life as it is, and the mind is lost or so damaged as to no longer serve its body properly. The “pretenders” have adjusted themselves, and so long as they can remain happily self-deceived all goes well for them, though they complicate living for others. However, they have made an adaptation, a defective one, it is true, but one through which the mind may survive. Some of this class, however, finally build up a more and more elaborate system of self-deception until they, too, are insane.

The practically adaptable man can dream dreams, but always recognizes them as dreams, and can stop at will; can vision a beautiful ideal, but comprehends that it is not yet reality, though it may some time become so if he learns and fulfils the laws leading to its realization. The adaptable man or woman recognizes the real as fact, desirable or otherwise, the fantastic as unreal and only to be indulged in as a pastime, and the ideal as the possible, a thing for which to work and sacrifice. So perfect adaptability would mean perfect mental poise.

It is for the nurse to realize that the greater number of her patients do not belong to any of these classes absolutely, but that some of them have tendencies leading in these various directions. And it is her privilege to recognize the trend of her sick patient’s mental workings, and to so deftly and unobtrusively encourage the recognition of facts as things which are to be used—not as stumbling-blocks—that her mental nursing, as her physical, shall be directed toward health. She can help her patient to accept illness and suffering as realities to be faced, and treatment as a means, whether pleasant or not, of making it possible for health to replace them. The understanding nurse can actively help her charge one step at a time toward adaptation to the new environment, remembering that many of the sick, particularly the depressed, cannot be encouraged or incited to effort by having future health held out to them. They are capable only of living in the present and doubting all the future.

There Can Be No Neurosis Without a Psychosis.—If the brain is the organ of the mind, then what affects the brain must perforce be at least registered by mind. So every physical shock, accident, toxic condition, infection—even the ordinary cold—rouses the mind at least to awareness, usually to discomfort. For the nerve-cells and fibers—those inseparable parts of the body mechanism—speedily report the fact that they are being tampered with. In the toxicity of the infections these very delicate tissues are nourished by toxic fluids; in accidents they carry all the messages from the injured part. Then the brain—that center of all man’s reactions and the organ of all his consciousness—receives the report of the disturbance and translates it into terms of more or less disability. The neurosis has become a psychosis. The physical condition has become a mental discomfort. Normally this ensuing mind state should be in accordance with the extent of the injury to the nerve-cells and fibers. But under long-continued discipline, or influenced by emotion, the conscious mind may not recognize the neurosis; whereas, in the hypersuggestible, consciousness will translate it into entirely disproportionate suffering.

A great problem of nervous education is what the mind will do with discomfort or pain. Will it put all its attention there and respond with nervousness, irritability, demand for sympathy; or will it relegate all the minor pains to their own little places, accepted as facts but to be disregarded except in so far as actual treatment is needed? Will it turn to attend to the host of other more desirable objects? Or in case of acute suffering, will it take it as a challenge to endurance? Will it use it as a means to strengthen volition, as a stepping-stone to self-mastery?

Realizing the force of the law—no neurosis without a psychosis—the nurse will try to eliminate unnecessary irritations to physical comfort, while she helps the patient to adjust himself to the ones which are inevitable. It is the doctor’s problem rather than hers, except as she carefully fulfils orders, to eliminate the toxic causes of psychosis. It is hers to help the patient to meet adequately the effects of the infections or toxins, and to prevent as far as possible the surrender to uncontrolled nervousness. Her object is to have him face the psychosis as one of the simple facts of science, then turn the sick mind’s attention to more important things; she would encourage will to force endurance; she would stimulate the feeling life to the forward look of confidence and faith, or to acceptance of life’s suffering as a challenge. The nurse knows that pains beyond the power of endurance the doctor will lighten. And the patient’s reaction to discomfort and suffering, the understanding nurse, without any preaching, can very largely influence.

The Power of Suggestion

One almost universal condition found in illness is hypersuggestability. Here is the nurse’s despair and her hope. Suggestion may come from without or from within. When from within, we call it autosuggestion.

Many of the sick are temporarily resting their reasoning faculties and their judgment. The sick body is causing a feeling of “jangling nerves,” and the mind, too, is strongly tempted to be sick. So every harsh sound, every jolt, almost every sentence spoken in their hearing suggests immediate nervous reactions. The mind does not wait to weigh them. The nervous system reacts to them the second the impression is registered. The whole self is oversensitive, and the very inflection of a voice has enormous significance. Let the nurse remember that her way of giving a treatment, her expression, or her very presence becomes a potent stimulus on the second, one to which the patient’s mind responds like a flash-light when the button is pressed.

The nurse must comprehend the principle of the nervous effect on the patient of all that is done and said,