WHY WORRY?  CHAPTER X

OCCUPATION NEUROSIS

WHY WORRY?

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

X.

OCCUPATION NEUROSIS

Be not ashamed, to be helped; for it is thy business to do thy duty like a
soldier in the assault on a town. How, then, if being lame thou canst
not mount up on the battlement alone, but with the help of another it is
possible?

--Marcus Aurelius

The insistent and over-conscientious habit of mind plays so large a part in
the so-called occupation neuroses that a brief discussion of their nature
may here be in place.

The best-known form of this distressing malady is "writer's cramp." Upon
this subject the proverbially dangerous little knowledge has been already
acquired; a fuller knowledge may give comfort rather than alarm, and may
even lead to the avoidance of this and allied nervous disorders.

The term "writer's cramp" has unduly emphasized a feature, namely, the
cramp, which is neither the most common nor the most troublesome among the
symptoms resulting from over-use of a part. In occupation neuroses, other
than those produced by the use of the pen, pain, weakness, and numbness are
at least equally prominent, and even in writer's cramp the "neuralgic" form
is common.

The fact is generally realized that this type of disorder is particularly
frequent among persons of nervous temperament. The reason is twofold,
first, the resistance of such individuals is less than the average, second,
the insistent habit of mind leads them to overdo. It is against the latter
factor that our efforts may to advantage be directed.

I have in mind the case of a lady who complained of severe pain in the
right arm with no apparent physical cause. The pain, at first appearing
only when the arm was placed in a certain position, finally became almost
constant. She denied excessive use of the arm, but her husband stated that
she plied the needle to such an extent that it caused the family distress.
This she indignantly denied, and fortified her position by the statement
that she only took short stitches! Further inquiry elicited the
acknowledgment that she did so because she could no longer take long ones.
This is a fair example of an occupation neurosis.

Some time ago, after long continued and over-conscientious effort to
satisfy the requirements of an athletic instructor, I acquired what is
known as a "golf arm." Efforts at its relief were unavailing. A vigorous
course of massage only increased the pain. I finally asked a friend what
they did in England when a golf player suffered this annoyance. He replied
that no golf player ever did so; when it occurred among others the arm was
placed in wool for three months, at the end of which time a single movement
of swinging the club was made; if this movement caused pain the treatment
was renewed for another three months. I did not suppose he intended the
advice to be taken literally, but followed it, except as regarded the wool,
and I verily believe that I should otherwise have been experimenting with
the treatment of golf arm to-day.

My friend's advice indicates the general experience with occupation
neuroses including writer's cramp, for which every imaginable measure has
been tried, only to be replaced by protracted abstinence from the use
of the pen. The attempt to use the left hand proves, as a rule, only
temporarily efficacious. The speedy appearance of symptoms in the left hand
emphasizes the fact that it is tired brain, as well as the tired muscle,
that rebels.

The ranks of every profession, and of every trade, are daily depleted
of the most promising among their members, whose zeal has outrun their
discretion; their over-worked brains and hands have succumbed under the
incessant strain of tasks, often self-imposed.

It is hard, but essential, for the sufferer from an occupation neurosis to
abandon frantic efforts at combining treatment with continuance of labor.
He must bring all his philosophy to bear on the temporary, but complete,
abandonment of his chosen occupation, at whatever loss to himself or
others.

To avoid this contingency the over-conscientious worker will do well to
modify his ambition, and lower his pride if needful, consoling himself
with the reflection that an occasional interruption of his labor, even at
material loss, may be replaced by years of future usefulness. Cowper says:

  "Tis thus the understanding takes repose
    In indolent vacuity of thought,
  And rests, and is refreshed."

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Why Worry - Occupation Neurosis