to their consciousness, and so be enabled to live a comparatively normal life. THE OBSESSED PATIENT A patient who is suffering from obsessions must carry out certain abnormal actions, or be wretched. She cannot do otherwise. It is as though she were forced by some outside agent, though the forcing is actually from within. When the nurse realizes this, and the more essential fact--that many patients, who have not true obsessions, yet have a tendency toward obsessed ways of thinking and doing--when she comprehends it almost as she would if she were the victim, then she is ready to help the patient by gently making the action impossible, and at the same time diverting attention. THE MIND A PREY TO FALSE ASSOCIATIONS Sometimes a nurse reminds a patient of some one in the past who has complicated her life in an unhappy way, so she distrusts or dreads her or is made constantly uncomfortable in her presence. In such a case, if the nurse reports her patient as resistive, or fearful or cringing, or distrustful, she is really misrepresenting her; for under another's care that patient may show an entirely opposite reaction. The nurse can only sense the strength of the influence of heredity and environment and habit of thought, which would give the explanation of many things in her patient's attitude. Nor can she realize just what shade of meaning certain phrases and words have for her charge. To the nervously overwrought person the most innocent reference--father, sister, wife, home--may bring concepts that are unbearable. The association of the word may make for deep unhappiness, of which the nurse knows nothing. But she _can_ learn that all these things _do_ influence attitude, can appreciate the difficulty of her patient's effort at adjustment, and do all in her power to make that adjustment possible. If the patient is reasonable she can appeal to her reason. If she is too sick for that, the nurse can use happy suggestions. If the mind is deluded and obsessed she can use firm kindness. She can learn what loss of privileges will affect the rude and unco-operative patient, and may be allowed to try that. She can sometimes help the patient to self-control by making her realize that after each outburst she will be constructively ignored. But the point we wish to make is this: There are some sick reactions which the nurse, if she recognizes as such, can help the patient to transform into wholesome ones. At the very least the wise nurse can learn to simplify her own difficulties by accepting the unpleasant patient as possibly the result of her illness, and refusing to allow her trying attitude to get on her nerves. The patient may be reacting normally to the stimulus her untrained and toxic brain received. And when the nurse can see into the other's mental workings, get her point of view, she is ready to give fundamental help. CHAPTER XII THE PSYCHOLOGY OF THE NURSE