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concentration necessary for success. He

was then referred to the United States Public Health Service,

where I saw him, and he became my patient.

 

My first problem was to restore the power of sleeping. This I

succeeded in doing by means that were entirely “physical.” With

that accomplished, the man became hopeful of further results, and

this enabled one to bring about a desire for food, again by

physical means, medicine, in short. The problem of awaking S.‘s

interest simmered down to that of finding an outlet for his

ambition. The Federal Vocational Board granted him the right to

take up a business course in a college. Though he found the study

hard at first, he was encouraged to keep on and told to expect

little of himself at first. This is an important point, for if a

man holds himself to a high standard under conditions such as

those of S., then failure brings a discouragement that upsets the

treatment. At any rate this method of readjustment, with its

reliance on medicines to bring sleep and appetite and on training

to bring hope and relief from introspection, worked splendidly.

 

The fact is that no abstruse complicated psychological analysis

was necessary here or in most cases. A man is “jarred” from

light-hearted health to a grim discouraged state. This

discouragement brings with it sleeplessness and loss of appetite,

and there gradually develops a series of habits which lower

endurance and energy. The habit elements in this condition are

not enough recognized, and also the fact that most of the

disability is physical in its development though psychological at

the start. That is, A. had a severe emotional reaction to a

horrible experience; this brought about insomnia and disordered

nutrition, and these, by lowering the endurance and ability,

brought to being a vicious circle of fatigue and depression, in

which fatigue caused depression and depression increased fatigue.

The treatment must be directed at first to the physical factors,

and with these conquered the acquired forms of anhedonia usually

yield readily.

 

It would be interesting to consider other types related to the

anhedonic personality. The complainer, the whiner, the nag, all

these are basically people who are hard to satisfy. The artistic

temperament (found rather frequently in the non-artistic) is

hyperesthetic, uncontrolled, irritably egoistic and demands

homage and service from others which exceeds the merit of the

individual; in other words, there is added to the anhedonic

element an unreasonableness that is peculiarly exasperating. I

pass these interesting people by and turn to the opposite of the

anhedonic group, the group that is hearty in tastes and

appetites, easily pleased as a rule and often crude in their

relish of life. There are two main divisions of these hearty

simple people,—those who are untrained and relatively

uneducated, and whose simplicity may disappear under cultivation,

and another type—cultivated, educated, wise—who still retain

unspoiled appetite and hearty enjoyment.

 

Briefly let me introduce Dr. O., an athlete in his youth and

always a lover of the great outdoors.

 

O. is Homeric in the simplicity of his tastes. A house is a place

in which to sleep, clothes are to keep one warm, food is to eat

and the manner of its service is an indifferent matter. He enjoys

with almost huge pleasure good things to eat and good things to

drink, but as he puts it, “I am as much at home with corned beef

and cabbage as I am with any epicurean chef d’oeuvre. I like the

feel of silk next my body, but cotton pleases me as much.” He is

clean and bathes regularly, but has no repulsion against dirt and

disorder. At home, among the utmost refinements of our

present-day life, he prefers the rough bare essentials of

existence. To him beauty is not exotic, but everywhere present,

and he sees it in a workman clad in overalls and breaking stone

quite as much as in a carefully harmonized landscape. He has no

pose about the beauty of nature as against the beauty of man’s

creations, and he thinks that a puffing freight engine, dragging

a load of cars up a grade, is as much a thing to enthuse about as

a graceful deer sniffing the scent of the hunter in some pine

grove.

 

Imbued with a zeal for living and a desire for experience, O. has

not been as successful as one more cautious and less impetuous

might have been. He loves his profession so well that he would

rather spend a day on an interesting case in the ward of some

hospital than to treat half a dozen rich patients in his

consulting room. His purpose is indeed unified; he seeks to learn

and to impart, but the making of money seems to him a necessary

irrelevance, almost an impertinent intrusion upon the real

purposes of life. He is eager to know people, he shows a naive

curiosity about them, an interest that flatters and charms. All

the phenomena of life—esoteric, commonplace, queer and

conventional—are grist to his mill.

 

His sexual life has not differed greatly from that of other men.

In his early youth his passions outran his inhibitions, and he

tasted of this type of experience with the same gusto with which

he delved into books. As he reached early manhood he fell in love

and pledged himself to chastity. Though he fell out of love soon

his pledge remained in full force, and though he cursed himself

as a fool he held himself aloof from sex adventure. When he was

twenty-seven he again fell in love, had an impetuous and charming

courtship and married. He loves his wife, and there is in their

intimacy a buoyant yet controlled passion which values love for

its own sake. He enters into his duties as father with the same

zeal and appetite that characterizes his every activity.

 

O. is no mystic, proclaiming his unity with all existence, in the

fashion of Walt Whitman. Rather he is a man with a huge capacity

for pleasure, not easily disgusted or annoyed, with desires that

reach in every direction yet with controlled purpose to guide his

life. As he passes into middle age he finds his pleasures

narrowing, as all men do, and he finds his appetites and tastes

are becoming more restricted. This is because his purpose becomes

more dominant, his habits are more imperious, his energy less

exuberant. In thought O. is almost a pessimist because his

knowledge of life, his intelligence and his sympathy make it

difficult to understand the need of suffering, of disease and of

conflict. But in emotion he still remains an optimist, glad to be

alive at any price and rejoicing in the life of all things.

 

Apropos of this contradiction between thought and mood, it is

sometimes found reversed. There are those whose philosophy is

optimistic, who will not see aught but good in the world, yet

whose facial expression and actions exhibit an essential

melancholy.

 

In every category of character there are specialists, individuals

whose main reactions are built around one great trait. Thus there

are those whose egoism takes the form of pride in family, or in

personal beauty, or some intellectual capacity, or in being

independent of others, who worship self-reliance or

self-importance. There are the individuals whose social instincts

express themselves in loquacity, in a talkativeness that is the

main joy of their lives, though not at all the joy of other

lives. A fascinating series of personalities in this respect come

to my mind—L. B., who talks at people, never with them, since he

seems to take no note of their replies; T. K., who seems to

regard conversation as largely a means of demonstrating her

superiority, for she picks her subjects with the care a general

selects his battlefield; F., who is a born pedagogue and seeks to

instruct whoever listens to him, whose conversation is a lecture

and a monologue; R. O., the reticent, says little but that

pertinent and relevant, cynical and shrewd; and R. V., who says

little and that with timidity and error. So there are specialists

in caution and “common sense,” self-controlled, never rash,

calculating, cool and egotistic, narrow and successful. Every one

knows this type, as every one knows the “fool,” with his poor

judgment, his unwise confidence in himself and others, his lack

of restraint. There is the tactful man, conciliating, pliant,

seeking his purposes through the good will of others which he

obtains by “oil” and agreeableness, and there is the aggressive

man, preferring to fight, energetic, at times rash, apt to be

domineering, and crashing on to victory or defeat according to

the caliber of his opponents and the nature of the circumstances.

 

Those whose ego feeling is high, whose desire for superiority

matches up well with their feeling of superiority are often

called the conceited. Really they are conceited only if they show

their feelings, as, for example, does W. Wherever he goes W.

seeks to occupy the center of the stage, brags of his

achievements and his fine qualities. “I am the kind” is his

prefix to his bragging. W. thinks that everything he does or says

is interesting to others, and even that his illnesses are

fascinating to others. If he has a cold he takes a remarkable

pride in detailing every pain and ache and every degree of

temperature, as if the experience were remarkable and somehow

creditable. But W. is very jealous of other’s achievements and is

bored to death except when he can talk or perform.

 

W. does not know how to camouflage his egoism, but F. does. Fully

convinced of his own superiority and with a strong urge at all

times to demonstrate this, he “knows enough” to camouflage, to

disguise and modify its manifestations. In this way he manages to

be popular, just as W. is decidedly unpopular, and many mistake

him for modest. When he wishes to put over his own opinion he

prefaces his statements by “they say,” and though whatever

organization he enters he wishes to lead, he manages to give the

impression that he is reluctant to take a prominent part. A man

of ability and good judgment, the narrow range of F.‘s

sympathies, his lack of sincere cordial feeling, is hidden by a

really artistic assumption of altruism that deceives all save

those who through long acquaintance know his real character. One

sees through W. on first meeting, he wears no mask or disguise;

but F. defies detection, though their natures are not radically

different except in wisdom and tact.

 

Half and more of the actions, poses and speech of men and women

is to demonstrate superiority or to avoid inferiority. There are

some who feel inwardly inferior, yet disguise this feeling

successfully. This feeling of inferiority may arise from purely

accidental matters, such as appearance, deformity, tone of voice,

etc., and the individual may either hide, become seclusive or

else brazen it out, so to speak.

 

A famous Boston physician was a splendid example of a brusque,

overbearing mask used to hide a shrinking, timid, subjectively

inferior personality. Always very near-sighted and unattractive,

he was essentially shy and modest but decided or felt that this

was a rough world and the way to get ahead was to be rough.

Towards the weak and sick he was kindness itself—gentle,

sympathetic and patient—but towards his colleagues he was a

boor. Distant, haughty, quick to demand all the consideration due

him, he was noted far and wide for the caustic way he attacked

others for their opinions and beliefs and the respect he required

for his own. The general opinion of physicians was that he was a

conceited, arrogant, aristocratic man, and he was avoided except

for his medical opinion, which was usually very sound. Those

admitted to the sanctum of this man’s real self knew him to be

really modest and self-deprecatory, anxious to

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