CHAPTER I - INTRODUCTORY
BY: GEORGE LINCOLN WALTON, M.D.
CONSULTING NEUROLOGIST TO THE MASSACHUSETTS GENERAL HOSPITAL
When Thales was asked what was difficult he said, "To know oneself"; and what was easy, "To advise another."
Marcus Aurelius counselled, "Let another pray, 'Save Thou my child' but do thou pray, 'Let me not fear to lose him.'"
Few of us are likely to attain this level; few, perhaps, aspire to do so. Nevertheless, the training which falls short of producing complete self-control may yet accomplish something in the way of fitting us, by taking the edge off our worry, to react more comfortably to our surroundings, thus not only rendering us more desirable companions, but contributing directly to our own health and happiness.
Under the ills produced by faulty mental tendencies I do not include cancer and the like. This inclusion seems to me as subversive of the laws of nature as the cure of such disease by mental treatment would be miraculous. At the same time, serious disorders surely result from faulty mental tendencies.
In this category we must include, for example, hypochondria, a disturbance shown by undue anxiety concerning one's own physical and mental condition. This disorder, with the allied fears resulting from the urgent desire to be always absolutely safe, absolutely well, and absolutely comfortable, is capable, in extreme cases, of so narrowing the circle of pleasure and of usefulness that the sufferer might almost as well have organic disease.
Neurasthenia (nervous prostration) has for its immediate exciting cause some overwork or stress of circumstance, but the sufferer not infrequently was already so far handicapped by regrets for the past, doubts for the present, and anxieties for the future, by attention to minute details and by unwillingness to delegate responsibilities to others, that he was exhausted by his own mental travail before commencing upon the overwork which precipitated his breakdown. In such cases the occasion of the collapse may have been his work, but the underlying cause was deeper. Many neurasthenics who think they are "all run down" are really "all wound up." They carry their stress with them.
Among the serious results of faulty mental habit must be included also the doubting folly (folie du doute). The victim of this disorder is so querulously anxious to make no mistake that he is forever returning to see if he has turned out the gas, locked the door, and the like; in extreme cases he finally doubts the actuality of his own sensations, and so far succumbs to chronic indecision as seriously to handicap his efforts. This condition has been aptly termed a "spasm of the attention."
The apprehensive and fretful may show, in varying degree, signs of either or all these conditions, according as circumstances may direct their attention.
Passing from serious disorders to minor sources of daily discomfort, there
are few individuals so mentally gifted that they are impervious to the
distress occasioned by variations of temperature and of weather; to the
annoyance caused by criticism, neglect, and lack of appreciation on the
part of their associates; to active resentment, even anger, upon moderate
provocation; to loss of temper when exhausted; to embarrassment in unusual
situations; to chronic indecision; to the sleeplessness resulting from
mental preoccupation; and above all, to the futile regrets, the querulous
doubts, and the undue anxiety included under the term worry, designated
by a recent author "the disease of the age."
Something may be accomplished in the way of lessening all these ills by
continuous, properly directed effort on the part of the individual. Every
inroad upon one faulty habit strengthens the attack upon all, and each gain
means a step toward the acquisition of a mental poise that shall give its
possessor comparative immunity from the petty annoyances of daily life.
In modern psychotherapy the suggestion, whether on the part of the
physician or of the patient, plays a prominent part, and it is in this
direction, aside from the advice regarding occupation and relaxation, that
my propositions will trend. I shall not include, however, suggestions
depending for their efficacy upon self-deceit, such as might spring, for
example, from the proposition that if we think there is a fire in the stove
it warms us, or that if we break a pane in the bookcase thinking it
a window, we inhale with pleasure the resulting change of air. The
suggestions are intended to appeal to the reason, rather than to the imagination.
The special aim will be to pay attention to the different varieties of
worry, and to offer easily understood and commonplace suggestions which any
one may practice daily and continuously, at last automatically, without
interfering with his routine work or recreation. Indeed the tranquil mind
aids, rather than hinders, efficient work, by enabling its possessor to
pass from duty to duty without the hindrance of undue solicitude.
In advising the constitutional worrier the chief trouble the physician
finds is an active opposition on the part of the patient. Instead of
accepting another's estimate of his condition, and another's suggestions
for its relief, he comes with a preconceived notion of his own
difficulties, and with an insistent demand for their instant relief by drug
or otherwise. He uses up his mental energy, and loses his temper, in the
effort to convince his physician that he is not argumentative. In a less
unreasonable, but equally difficult class, come those who recognize the
likeness in the portrait painted by the consultant, but who say they have
tried everything he suggests, but simply "can't."
It is my hope that some of the argumentative class may recognize, in my
description, their own case instead of their neighbor's, and may of their
own initiative adopt some of the suggestions; moreover, that some of the
acquiescent, but despairing class will renew their efforts in a different
spirit. The aim is, not to accomplish a complete and sudden cure, but to
gain something every day, or if losing a little to-day, to gain a little
to-morrow, and ultimately to find one's self on a somewhat higher plane,
without discouragement though not completely freed from the trammels
entailed by faulty mental habit.
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