WHY WORRY?  CHAPTER XVIII

HOME TREATMENT

WHY WORRY?

BY: GEORGE LINCOLN WALTON, M.D.
CONSULTING NEUROLOGIST TO THE MASSACHUSETTS GENERAL HOSPITAL

XVIII.

HOME TREATMENT

Submit to what is unavoidable, banish the impossible from the mind, and
look around for some new object of interest in life.

--Goethe

In the treatment of faulty mental habits the chief reliance is the training
of the mind; physical measures are merely supplementary. This fact has
always been recognized in a general way. The need of such training was
emphasized by Epictetus thus:

"Not to be disappointed of our desire, nor incur our aversion. To this
ought our training be directed. For without vigorous and steady training,
it is not possible to preserve our desire undisappointed and our aversion
unincurred."

But there has always been an undercurrent of dissatisfaction with purely
mental treatment, and a desire for the drug, which has more than once,
doubtless, been prescribed for the purpose of "suggestion" only.

The movement for psychic treatment on scientific principles, of faulty
mental disorders, not of organic nature, is well under way. That the
American profession takes an active interest in this movement is shown by
the exhaustive paper on psycho-therapy by Dr. E. W. Taylor, recently read
at a combined meeting held in Boston and discussed by such representative
neurologists as Drs. Mills, Dercum, J. K. Mitchell, and Sinkler, of
Philadelphia; Drs. Dana, Sachs, Collins, Hunt, Meacham, and Jelliffe, of
New York; Dr. White of Washington, and Drs. Putnam and Prince, of Boston.

Such faulty mental habits as worry and obsession, doubting folly, and
hypochondria, are no more amenable to physical treatment than the habit
of swearing, or of over-indulgence in food and drink. Even the psychic
treatment, by another, of such disorders, as of such habits, labors under
the disadvantage that all attempts to influence another by exhortation,
ridicule, or reproach are met by active or passive resistance on the part
of the individual toward whom these efforts are directed. A conscientious
resolve on the part of the individual himself, whether started by a casual
hint or by a new line of thought, is often more effective than any amount
of outside pressure, however well directed.

It is my hope and belief that the over-solicitous individual will be
influenced by reading these descriptions to adopt, of his own initiative,
some of these suggestions. His most striking peculiarity is his conviction
that he cannot take the chances others do, that the criticisms he receives
are peculiarly annoying, and that his sources of worry are something set
apart from the experience of ordinary mortals. This conviction leads him to
meet argument by argument, reproach and ridicule by indignant protest or
brooding silence. The perusal of these sections may lead him to alter his
ideals. Suggestions for home treatment have been scattered through the
various pages; it only remains to sum them up.

We have traced worry back to exaggerated self-consciousness and obsession;
it is against these two faulty tendencies that training may be directed.

The first step is the initiation of a new attitude, namely, the
commonplace. The establishment of this attitude involves the sacrifice
of self-love, and of the melancholy pleasure of playing the martyr. The
oversensitive individual must recognize the fact that if people do not want
him round it may be because he inflicts his ego too obtrusively upon his
associates. He must realize that others are more interested in their own
affairs than in his, and that however cutting their comments and unjust
their criticisms, and however deeply these may sink into his soul, they are
only passing incidents with them.

He must realize that if two people whisper they are not necessarily
whispering about him, and if they are it is of no consequence, and merely
shows their lack of breeding. On public occasions he must remember that
others are thinking of themselves, or of the subject in hand, quite as much
as they are of him and how he behaves. He must realize that even if he does
something foolish it will only make a passing impression on others, and
that they will like him none the less for it.

He must practice externalizing his thoughts. If criticised, he must ask
himself whether the criticism is just or unjust. If just, he must learn to
accept and act upon it; if unjust, he must learn to classify the critic,
as unreasonable, thoughtless, or ill-natured, place him in the appropriate
mental compartment, throw the criticism into the intellectual waste-basket,
and proceed upon his way. This practice, difficult at first, will, if
assiduously cultivated, become more and more automatic, and will materially
modify a fruitful source of worry.

The next step is to practice the control of the dominating impulses
(obsessions). If one finds himself impelled continually to drum, or walk
the floor, he will find the habit cannot be dropped at once, but if he can
refrain from it for a few moments once or twice in the day, no matter how
lost he feels without it, and sit for a few minutes relaxed and motionless,
the intervals can be gradually increased. Even the chronic doubter may
appreciate the fact that this practice aids in preparing one for taking and
keeping, at night, the quiet and immobile position which favors sleep. The
bearing of this training upon worry may not be immediately obvious, but if
one cannot overcome these simple physical compulsions he will find it still
harder to overcome the doubts, the fears, and the scruples which underlie
his worry.

It is hard to give up the idea that we are so peculiarly constituted that
it produces a special disgust in our case if another constantly clears his
throat, and a peculiar annoyance if he rocks. It is difficult to relinquish
the belief that, however callous others may be, our nervous system is so
delicately adjusted that we cannot work when others make unnecessary
noise, and we cannot sleep if a clock ticks in our hearing. But if one
persistently cultivates the commonplace, he will at last find himself
seeking instead of avoiding the objects of his former torture, merely to
exercise his new-found mastery of himself, and to realize that "He that
ruleth his spirit is better than he that taketh a city."

It is the imperative duty of every sufferer from doubting folly to say to
himself, "I will perform this act once with my whole attention, then leave
it and turn my mind in other channels before I have dulled my perception by
repetition."

If one is prone to chronic indecision, he must remind himself that it is
better to do the wrong thing with single mind, than to work himself into
a frenzy of anxious doubt. In case the choice is not an important one, he
must learn to _pounce_ upon either task, and waste no further time. If
the doubt concerns an important matter, he must learn to devote only that
attention to the matter which is commensurate with its importance, then
decide it one way or the other, realizing that it is better to make a
mistake, even in an important matter than to worry one's self into utter
helplessness by conflicting emotions.

If insistent fear attacks one, he must remind himself that the worst that
can happen to him is not so bad as the state of the chronic coward and the
hypochondriac. He must practice taking the chances that others do, and must
learn to go through the dreaded experiences, not with his nervous system
stimulated into undue tension, but with body and mind relaxed by such
considerations as I have indicated.

The maxim is a useful aid in suggestion, but it should be carefully
selected. Most children seem to be brought up on maxims which presuppose
mental deficiency and constitutional carelessness. But the naturally
over-thoughtful and too-conscientious child, the child to whom applies Sir
John Lubbock's observation that the term "happy childhood" is sometimes a
misnomer, needs no admonition to "Try, try again," and to "Never weary of
well doing."

Among other sayings, whether of home manufacture or acquired, I have often
found comfort in a suggestion first called to my attention by my friend,
Dr. Maurice Richardson, who carries, I believe, Epictetus in his bag, but
who does not despise the lesser prophets. One day when I was borrowing
trouble about some prospective calamity, he said he always drew consolation
from the old farmer's observation:

"Mebbe 'taint so!"

Much unintentional self-suggestion is conveyed in one's habitual method of
expressing his attitude toward annoyances, thus: "That simply drives me
wild." Suppose, now, one should try a little substitution; for example:

  That    \
            drives me wild.
  Nothing /


                       (but that).
  I can stand anything
                       (at all).


        (not)          (this)
  I can       sleep in        position.
        (---)           (any)

The quieting effect is immediately perceptible.

Nor is the injurious effect of the explosive habit of speech limited to
the person who indulges it. The other day a lady, apparently in no haste,
sauntered into a station of the "Elevated" ahead of me, holding by the hand
a small boy. The boy was enjoying himself immensely, gazing about him
with the wide-awake, but calmly contemplative air peculiar to childhood.
Suddenly the lady saw that a train was about to leave the station, and was
seized by the not uncommon compulsion to take the last train instead of the
next one. She hurried the boy across the platform only to meet the closed
door of the departing train.

"Isn't that provoking!" she exclaimed. And the boy began to whimper.

Although the main object of this book is to call attention to the mental
rather than the physical treatment of these states, I cannot forbear
reminding the reader of certain routine measures which facilitate the
desired improvement in mental attitude.

It is well to start the day with a quick plunge in cold water, that is, in
water of the natural temperature excepting in the cold season, when the
extreme chill may be taken off to advantage. A brisk rub with rough towels
should follow. One should proceed immediately from the warm bed to the
bath, and should not first "cool off." A few setting-up exercises (bending
the trunk forward and back, sidewise, and with a twist) may precede the
bath, and a few simple arm exercises follow it. A few deep breaths will
inevitably accompany these procedures. When one returns to his room he
no longer notices the chill in the air, and he has made a start toward
accustoming himself to, and really enjoying, lower temperatures than he
fancied he could stand at all.

Every healthy adult should walk at least two miles daily in the open. We
have been forced to readjust our ideas as to the distance even an elderly
person can walk without harm since a pedestrian of sixty-nine has, without
apparent injury, covered over one thousand miles, over ordinary roads, at
an average of fifty miles a day.

The day's work should be started with the resolution that every task shall
be taken up in its turn, without doubts and without forebodings, that
bridges shall not be crossed until they are reached, that the vagaries of
others shall amuse and interest, not distress us, and that we will live in
the present, not in the past or the future. We must avoid undertaking too
much, and whatever we do undertake we must try not to worry as to whether
we shall succeed. This only prevents our succeeding. We should devote all
our efforts to the task itself, and remember that even failure under these
circumstances may be better than success at the expense of prolonged
nervous agitation.

"Rest must be complete when taken and must balance the effort in work--rest
meaning often some form of recreation as well as the passive rest of sleep.
Economy of effort should be gained through normal concentration--that is,
the power of erasing all previous impressions and allowing a subject to
hold and carry us, by dropping every thought or effort that interferes
with it, in muscle, nerve, and mind." (Annie Payson Call, "Power Through
Repose.")

The over-scrupulous and methodical individual who can neither sleep nor
take a vacation until all the affairs of his life are arranged must remind
himself that this happy consummation will not be attained in his lifetime.
It behooves him, therefore, if he is ever to sleep, or if he is ever to
take a vacation, to do it now, nor need he postpone indefinitely

    "That blessed mood
  In which the burden of the mystery,
  In which the heavy and the weary weight
  Of all this unintelligible world
  Is lightened."

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