A Psychiatric Milestone: Bloomingdale Hospital Centenary, 1821-1921
History
A Psychiatric Milestone: Bloomingdale Hospital Centenary, 1821-1921
Bloomingdale Asylum for the Insane; Mental illness
A very great number of phenomena observed in neuroses and psychoses are
in connection with depression and agitation. Convulsive attacks, diverse
fits of agitation, prove to us that before the fit there existed
disproportion between the quantity and the tension of the psychological
forces, and that the spending of forces during the fit re-establishes
the equilibrium. But at the same time, after this spending, one observes
a notable lowering of the mental level, a real psycholepsy. It is very
likely that studies of this kind will produce some day the key of the
epilepsy problem, for vertigos and certain epileptic fits are certainly
phenomena of relaxation, the meaning of which we do not comprehend
because we do not study sufficiently the state of psychological tension
before and after the accidents.
The difficulty of accomplishing superior acts, the exhaustion resulting
from their accomplishment, renders them fearful to the patient who has
the fear, the phobia of these acts, just as he has the terror of that
depression which gives the feeling of the diminution of life. The
shrinking of activity and conscience, phobias, negativisms, generally
take their starting point in this fear of exhaustion caused by some
difficult action. In other cases the patient feels incapable of
accomplishing correctly the reflected acts necessary to social and moral
life, and feeling no longer protected by reflection, he is afraid of
willing or believing something, as one is afraid of walking in a
dangerous path, when one cannot see. The vertigo of life produces itself
like the vertigo of heights, when one is not sure of oneself.
Depressed patients have felt, wrongly or rightly, a certain excitation
after a certain action. Through some curious mechanism, certain acts,
instead of exhausting them, have raised their psychological tension. The
need, the desire to raise themselves inspires them with the wish to
renew such acts, and we behold the impulsions to absorb poisons,
impulsions to command, to theft, to aggression, to extraordinary acts,
varied impulsions which play a great part in psychoses as well as in
neuroses.
I shall not insist any more on a very interesting phenomenon in
connection with the oscillations of the mind and which still plays a
great part in these diseases. I am speaking of the change of feeling
which may accompany the same action in the course of the oscillations of
the mind. At the level with the reflected action, more or less complete,
the thought of an action which appears important and of which one often
thinks, determines interrogations, doubts, scruples. If the individual
descends one degree, if he becomes quite incapable of reflecting and
therefore of doubting, the same action he continues to think about may
present itself under the form of an impulsion more or less irresistible.
Public-domain text, read in full here on John Shaqi.
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