WHY WORRY? CHAPTER V
WORRY AND OBSESSION


Do not worry. Manifest your destiny.
WHY WORRY?
BY: GEORGE LINCOLN WALTON, M.D.
CONSULTING NEUROLOGIST TO THE MASSACHUSETTS GENERAL HOSPITAL

V.

WORRY AND OBSESSION

So much are men enured in their miserable estate, that no condition is so
poore, but they will accept; so they may continue in the same.
--Florio's Montaigne

"You may as well be eaten by the fishes as by the worms," said the daughter of a naval commander to me one day, when discussing the perils of the sea. Such philosophy, applied to each of the vexatious and dangerous situations of daily life, would go far toward casting out worry.

We have already referred to two important elements at the foundation, and in the framework, of the elaborate superstructures we rear with such material as worry, doubts, fears and scruples. The first is exaggerated self-consciousnessobsession.

With regard to self-consciousness, the worrier will generally realize that even as a child he was exceptionally sensitive to criticism, censure, ridicule and neglect. He was prone to brood over his wrongs, to play the martyr, and to suffer with peculiar keenness the "slings and arrows of outrageous fortune." I remember once leaving the table on account of some censure or careless remark. I fancied I had thrown the whole family into a panic of contrition. On the first opportunity, I asked what they had said about it, and was told that they had apparently not noticed my departure. This salutary lesson prevented repetition of the act.

To the self-conscious person the mere entrance into a public vehicle may prove an ordeal. It is hard for him to realize that the general gaze has no peculiar relation to himself, and that if the gaze is prolonged this is due to no peculiarity of his beyond the blush or the trepidation that betrays his feeling. If he can acquire indifference to this feature of his case, through the reflection that to others it is only a passing incident, the blush and the trepidation will promptly disappear, and a step will have been taken towards gaining the self-control for which he aims.

The usual cause of stage-fright is exaggerated self-consciousness. The sufferer from stage-fright can hardly fail to be a worrier. A certain shyness, it would seem, may also result from too acute a consciousness of one's audience, as in the case of Tennyson, whom Benson quotes thus:

"I am never the least shy before great men. Each of them has a personality for which he or she is responsible; but before a crowd which consists of many personalities, of which I know nothing, I am infinitely shy. The great orator cares nothing about all this. I think of the good man, and the bad man, and the mad man, that may be among them, and can say nothing. He takes them all as one man. He sways them as one man."

This, I take it, hardly spelled stage-fright. At the same time, it is improbable that one so sensitive to criticism meant to convey the impression that it was of his audience alone he thought in shrinking from the effort.

It appears that Washington Irving suffered from actual stage-fright.

In the Library edition of Irving's works appears the following anecdote from the reminiscences of Mrs. Julia Ward Howe, then a young woman of twenty-three:

"I was present, with other ladies, at a public dinner given in honor of Charles Dickens by prominent citizens of New York. The ladies were not bidden to the feast, but were allowed to occupy a small ante-room which, through an open door, commanded a view of the tables. When the speaking was about to begin, a message came suggesting that we take possession of some vacant seats at the great table. This we were glad to do. Washington Irving was president of the evening, and upon him devolved the duty of inaugurating the proceedings by an address of welcome to the distinguished guest. People who sat near me whispered, 'He'll break down,--he always does.' Mr. Irving rose and uttered a sentence or two. His friends interrupted him by applause, which was intended to encourage him, but which entirely overthrew his self-possession. He hesitated, stammered, and sat down, saying, 'I cannot go on.'"

(Henry) Cavendish, the chemist, suffered from a constitutional shyness attributable only to self-consciousness. He is said to have carried so far his aversion to contact with others, outside of his colleagues, that his dinner was always ordered by means of a note, and instant dismissal awaited the female domestic who should venture within his range of vision.

Lombroso cites, among his "Men of Genius," quite a list--Corneille, Descartes, Virgil, Addison, La Fontaine, Dryden, Manzoni, and Newton--of those who could not express themselves in public. Whatever part self-consciousness played in the individual case, we must class the peculiarity among the defects, not signs, of genius. "A tender heel makes no man an Achilles."

To the second faulty habit, obsession, I wish to devote special attention. This word we have already defined as an unduly insistent and compulsive thought, habit of mind, or tendency to action. The person so burdened is said to be obsessed.

Few children are quite free from obsession. Some must step on stones; others must walk on, or avoid, cracks; some must ascend the stairs with the right foot first; many must kick posts or touch objects a certain number of times. Some must count the windows, pictures, and figures on the wallpaper; some must bite the nails or pull the eye-winkers. Consider the nail-biter. It cannot be said that he toils not, but to what end? Merely to gratify an obsession. He nibbles a little here and a little there, he frowns, elevates his elbow, and inverts his finger to reach an otherwise inaccessible corner. Does he enjoy it? No, not exactly; but he would be miserable if he discontinued.

An unusual, but characteristic obsession is told by a lady in describing her own childhood. She thought that on retiring she must touch nothing with her hands, after she had washed them, until she touched the inside of the sheets. In case she failed she must return and wash the hands again. The resulting manoeuvres are still fresh in her mind, particularly when her sister had preceded her to bed and she had to climb the footboard.

It is during childhood that we form most of the automatic habits which are to save time and thought in later life, and it is not surprising that some foolish habits creep in. As a rule, children drop these tendencies at need, just as they drop the rôles assumed in play, though they are sometimes so absorbing as to cause inconvenience. An interesting instance was that of the boy who had to touch every one wearing anything red. On one occasion his whole family lost their train because of the prevalence of this color among those waiting in the station.

The longer these tendencies are retained in adult life, the greater the danger of their becoming coercive; and so far as the well-established case is concerned the obsessive act must be performed, though the business, social, and political world should come to a stand-still. Among the stories told in illustration of compulsive tendency in the great, may be instanced the touching of posts, and the placing of a certain foot first, in the case of Dr. Johnson, who, it appears, would actually retrace his steps and repeat the act which failed to satisfy his requirements, with the air of one with something off his mind.

A child who must kick posts is father to the man who cannot eat an egg which has been boiled either more or less than four minutes; who cannot work without absolute silence; who cannot sleep if steam-pipes crackle; and who must straighten out all the tangles of his life, past, present, and future, before he can close his eyes in slumber or take a vacation. The boy Carlyle, proud, shy, sensitive, and pugnacious, was father to the man who made war upon the neighbor's poultry, and had a room, proof against sound, specially constructed for his literary labors.

The passive obsessions are peculiarly provocative of worry. Such are extreme aversions to certain animals, foods, smells, sounds, and sights, or insistent discomfort if affairs are not ordered to our liking. A gentleman once told me that at the concert he did not mind if his neighbor followed the score, but when he consulted his programme during the performance it distressed him greatly.

Such instances illustrate the fact that when our obsessions rule us it is not the noise or the sight, but our idea of the fitness of things, that determines the degree of our annoyance. A person who cannot endure the crackling of the steam-pipe can listen with pleasure to the crackling of an open fire or the noise of a running brook.

It is said that the sensitive and emotional Erasmus had so delicate a digestion that he could neither eat fish nor endure the smell of it; but we are led to suspect that obsession played a part in his troubles when we further learn that he could not bear an iron stove in the room in which he worked, but had to have either a porcelain stove or an open fire.

If we can trust the sources from which Charles Reade drew his deductions regarding the character of the parental stock, Erasmus came fairly by his sensitive disposition. In "The Cloister and the Hearth" we find the father of Erasmus, fleeing from his native land, in fear of his life on account of a crime he thought he had committed, frozen, famished and exhausted, unable to enter the door of a friendly inn on account of his aversion to the issuing odors. Forced by his sufferings at last to enter the inn, he visits each corner in turn, analyzing its peculiar smell and choosing finally the one which seems to him the least obnoxious.

I have heard somewhere, but cannot place, the story of a prominent writer who was so disturbed by the mechanical lawn-mower of his neighbor that he insisted upon the privilege of defraying the expense of its replacement by the scythe.

Peculiar sensitiveness to sights, sounds and smells seems to be a common attribute of genius. This sort of sensitiveness has even been credited with being the main-spring of genius, but it is improbable that the curbing of such aversions would in any way endanger it. However this may be, such supersensitiveness ill becomes the rest of us, and these extreme aversions surely clog, rather than accelerate, our efforts.
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The natural tendency of the healthy mind is to accustom itself to new sensations, as the ring on the finger, or the spectacles on the nose. The obsessive individual resists this tendency; he starts with the fixed idea that he cannot stand the annoyance, his resentment increases, and his sensations become more, instead of less, acute. His reaction to criticism, slight, and ridicule is similar; he is prepared to start, blush, and show anger on moderate provocation, and can often reproduce both the sensation and its accompanying physical signs by merely recalling the circumstance.

The passive as well as the active obsessions can be overcome by cultivating the commonplace, or average normal, attitude, and resolving gradually to accustom one's self to the disagreeable. This change of attitude can be made in adult life as well as in youth. "You cannot teach an old dog new tricks," we are told. The reason is not that the old dog cannot learn them, but that he does not want to. I met in Germany a British matron who was obsessed with the belief that she could not learn the language. At the end of four years' sojourn she entered a store and asked the price of an article.

"Four marks," was the answer.

"How much in English money?" she inquired.

"Why, madam, a mark is the same as a shilling."

"I don't know anything about that; how much is it in English?"

"Four shillings."

"Ah, quite so; you might have told me at once."

Experience has shown that no time in life precludes the acquirement of new knowledge and new habits by one who thinks it worth while to make the attempt. The elderly person will be surprised at his progress if he will bring to bear upon a new subject a mind free from doubts of its usefulness, doubts of his own ability, worry lest he is wasting valuable time, regrets for the past and plans for the future.

It is not always possible to say just where useful habit merges into obsession. A certain individual, we will say, invariably puts on the left shoe before the right. This is a useful habit, fixed by constant repetition, useful because it relieves the brain of conscious effort. But suppose he decides some morning to put on the right shoe before the left; this new order so offends his sense of the fitness of things that he finds it hard to proceed; if he perseveres, his feet feel wrong to him; the discomfort grows until finally he is impelled to remove the shoes and replace them in the usual order. In this case an act which started as a useful habit has been replaced by an obsession.

Suppose, again, a person obsessed by the fear of poison is prevented from washing his hands before eating. He sits down, perhaps, fully intending to proceed as if nothing had happened, but the thought occurs to him that he may have touched something poisonous, though his reason tells him this is most improbable. He reviews the events of the day and can find no suggestion of poison; still the thought of poison obtrudes itself, and he finds it impossible to put anything which he touches into his mouth. He next wonders if he has not already put something into his mouth. This thought produces a mental panic, the blood mounts to his head, he becomes incapable of coherent thought or speech, and the task of finishing his dinner would now be beyond his power even if he had not lost all taste for it.

Such illustrations of obsession in daily life, by no means rare, could be multiplied indefinitely, and may be perhaps better appreciated than the text-book illustration of the man who neglected to flick off with his whip a certain stone from the top of a wall, and who could not sleep until he had returned to the spot and performed the act.

Suppose a man has always worn high boots and is accustomed to a feeling of warmth about the ankles. The desire for warm ankles may finally so dominate him that he not only cannot wear low shoes in mid-summer, but he cannot wear slippers, even in a warm room; and finally, perhaps, finds that he must wear woollen socks to bed. By this time the desire for a certain sensation is in a fair way to become an obsession. When you assure him that many wear low shoes throughout the winter, he asks if their ankles really feel warm. That is not the question. The question is, can one accustom himself to the ankles feeling cool, just as he accustoms himself to his face feeling cool. If he can, he has conquered a sensory obsession, and has made a step toward fitting himself to meet more serious vicissitudes with equanimity.

Similar instances can be adduced in all realms of sensation, both general and special. One person cannot bear the light, and wears blue glasses; another cannot breathe out-door air, and wears a respirator; another cannot bear to see a person rock or to hear a person drum.

If a family or circle of friends is so constituted that some are obsessed to do certain things and others are obsessed not to stand them the foundation is laid for a degree of irritability inconsistent with mental health. Mrs. X. simply cannot stand hearing Mr. X. tap the floor, and if he continues, her discomfort becomes acute; the sound so dominates her that she can think of nothing else and can accomplish nothing until the sound is stopped. She can stand anything but that. The daughter, Miss X., hardly hears the tapping, and is irritated and impatient to the last degree on account of her mother's "silly" notion. What Miss X. simply cannot bear is hearing her brother continually clear his throat, and if he does not stop she must leave the room or "go wild." Unfortunately, meantime, Mr. X. is so obsessed to tap the floor that he cannot follow his task without it, and Master X. must clear his throat every few moments with a peculiar note because he "has catarrh."

Here we have a common starting-point for family discomfort, and here we have a clue to the advice of the physician who advises isolation as a step toward the cure of the member of the family who first breaks down, not simply under the stress of occupation, but of occupation plus the wear and tear of minor but constant sources of irritation.

It is said that the victim of jiu jitsu, by breaking one hold, places himself in the greater danger from the next. Similarly, after having conquered a few obsessions, one is overwhelmed with the obsession to set every one straight. Soukanhoff was right in warning the obsessive to beware of pedantry.

The question here presents itself whether this line of thought does not foster, rather than lessen, the pedantry and the self-study which it is intended to combat. Why not simply drop the worry and the doubt without further argument? The difficulty is that the mental processes of the over-scrupulous person are such that he cannot summarily drop a habit of thought. He must reason himself out of it. There is no limit to his ability if properly directed; he can gradually modify all his faulty tendencies, and may even finally acquire the habit of automatically dismissing worry, but it would be too much to expect that he suddenly change his very nature at command.

Soukanhoff's description of obsessives is peculiarly apt: "over-scrupulous, disquieted over trifles, indecisive in action, and anxious about their affairs. They are given early to morbid introspection, and are easily worried about their own indispositions or the illnesses of their friends. They are often timorous and apprehensive, and prone to pedantism. The moral sentiments are pronounced in most cases, and if they are, as a rule, somewhat exigent and egotistic, they have a lively sense of their own defects."

A common obsession is the compulsion to dwell upon the past, to reproduce the circumstances, and painfully to retrace the steps which we took in coming to an erroneous decision which led to a foolish, unnecessary, or perhaps even a wrong decision. One of my earliest impressions in golf was the remark of a veteran who was good enough to make a round with me. "If I had only approached better, I should have made that hole in five," I remarked, after taking seven strokes for a hole.

"Perhaps not," he replied; "if you had approached better, perhaps you would have putted worse and taken eight strokes for the hole. At all events, that hole is ancient history now, and you will play this one better if you leave that one alone."

He little realized how many times his advice would recur to me elsewhere than on the links. Retrospective worry can be absolutely eliminated from the most obsessive mind by the practice of the veteran's philosophy.

Mercier says the greatest intellectual gift is the ability to forget.

The conscientious self-analyst spends too much time in weighing his ability or inability to perform some task. Between his fear, his worry over the past, and his indecision whether the task should be attempted, he starts with an overwhelming handicap. If he learns to say, "Other people fail; it will not matter if I do this time," he will find the task already half accomplished.

The Rev. Francis Tiffany has observed that if a ship could think, and should imagine itself submerged by all the waves between here and Europe, it would dread to leave its moorings; but in reality it has to meet but one wave at a time.

The tendency of the average American in this bustling age, whether he is obsessive or not, is to live at least several hours in advance. On the train he takes no comfort and makes no observations, for his mind is upon his destination rather than on his journey.

Though the immediate object of these chapters is the promotion of the mental, and indirectly the physical, health of the individual, I cannot forbear referring to the effect of this training on the position of the individual in society and his relation toward his surroundings.

The endeavor to overcome obsessions is likely to be ignored by two classes: the self-centered individuals who see no reason for learning what they do not want to learn, and the individuals who have no time for, or interest in, self-training because of absorption in subjects of wider relation, as art, or science, or reform. The philosophy of Haeckel applies to both:

"Man belongs to the social vertebrates, and has, therefore, like all social animals, two sets of duties--first to himself, and secondly to the society to which he belongs. The former are the behests of self-love, or egoism, the latter love for one's fellows, or altruism. The two sets of precepts are equally just, equally natural, and equally indispensable. If a man desires to have the advantage of living in an organized community, he has to consult not only his own fortune, but also that of the society, and of the "neighbors" who form the society. He must realize that its prosperity is his own prosperity, and that it cannot suffer without his own injury."

The individual who is ruled by his obsessions not only paves the way for needless and ultimate breakdown, but is in danger of gradually narrowing his field of usefulness and pleasure until he is in little better case than Simeon Stylites, who spent nearly half a century on the top of a monument. Nor has he even Simeon's consolation that he could come down if he chose; for it seems that the authorities sent messengers demanding his return, with orders to let him stay if he showed willingness to come down--and he stayed.

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