WHY WORRY? CHAPTER X
OCCUPATION NEUROSIS


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

Chapter 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.

writer's crampThe 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

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