Benign Stupors: A Study of a New Manic-Depressive Reaction TypeHoch, August
Science
Benign Stupors: A Study of a New Manic-Depressive Reaction Type
Hoch, August
Manic-depressive illness; Stupor
In this connection, however, two other cases should be taken up which
show a condition which reminds one somewhat of that we have just
discussed, but in which the rebirth motif appeared, not as prospective,
but, as in the stupor, as an actual situation. At the same time this
situation was not passively accepted but conceived as a dangerous
situation. The significant phenomenon in both these conditions was that
there was not anxiety with freedom of action but a bewildered uneasiness
with marked reduction of activity.
The first case is that of Johanna S., whose history has been given in
this chapter. It will be observed that in the fourth period the patient
presented two days of typical stupor with the idea that she was dead. We
are familiar with this. But this was followed by several days of
bewildered uneasiness and slow restlessness, with ideas that she was at
the bottom of the deep, dark water and for a time she made attempts at
stepping out of the water or swimming motions. All of this was in a
general setting of reduction of activity with bewildered uneasiness. In
the ideas about being at the bottom of the deep, dark water, we
recognize again the rebirth motif, yet the situation is not accepted
but attempts are made by the patient to save herself, i.e., the attitude
is one in which the situation is taken to be one of danger. It is
interesting in this connection that immediately following this state
there was one day of ordinary retardation with sadness and ideas of
being bad and sick. That is, when the element of anxiety, the
uneasiness, disappeared and sadness supervened, the rebirth ideas were
no longer present.
In Mary C. (See Chapter II, Case 7) we have, unfortunately, not a direct
observation, but we have, at any rate, a description from the
Observation Pavilion which seems so plain that we should be justified in
using it here. The condition we refer to is described as a dazed
uneasiness, with ideas of being shut up in a ship, of the ship being
closed up so that no one could get out, of the boat having gone down, of
the people turning up. We should add here that the condition was not
followed by a typical stupor. Essentially it was a retardation, in which
only on one occasion was a definite akinesis observed. During this phase
she soiled her bed. Perhaps the persistent complaint of inability to
take in the environment belonged also more to the retardation of stupor
than to that of depression. We have again, therefore, in this initial
phase, a similar situation, namely, ideas belonging essentially to the
rebirth motif, formulated as of a threatening character if not as
actually dangerous.
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