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
If we look for some explanation or correlation of these symptoms, we
find that chance references to conduct seem to point in the same
direction, namely, to the desire to be left alone. This resentment
against interference again reminds us of the reactions of a spoiled
child. For instance, Laura A., in manic spells during which she was
still constrained and drooled, said, “I don’t want to have my face
washed.” In the intervals she showed an intense muscular resistiveness.
Mary G. used to say, “Leave me alone,” and covered her head or buried it
in the pillows. Maggie H. (Case 14) said in retrospect that she had
wanted to be left alone. Similarly Alice R. thought she did not want to
talk. Emma K. thought that she was in prison and apparently resented
this. Henrietta B. combined in her behavior tendencies both to
compliance and opposition. When her arms were raised they retained the
new position for a minute. Then she dropped them and said, “Stop
mesmerizing me.” But then she put them up again of her own accord, and
when she had done this presented intense resistiveness to any movement.
Later she extended her arms in front of her and said, “I am all right,”
in a theatrical manner, and then added, “Why don’t you go away?”
There seems to be some correlation between inaccessibility and muscular
resistiveness. For example, Charlotte W. (Case 12), whose condition
varied a great deal, always lost the resistiveness when she became
accessible, during which periods she also showed some facial expression.
The resistiveness would invariably return when the inaccessibility
reappeared. Caroline DeS. (Case 2) lost her resistiveness as she became
more accessible, although the inactivity and apathy persisted. This
tendency, which is quite common, suggests that muscular resistiveness
represents a lower level of expression of opposition which patients put
into words or purposeful actions when there is other evidence of some
contact with the environment. Sometimes one observes both general
resistiveness and specific acts. For instance, Mary G., who said, “Leave
me alone,” and covered her head or buried it in the pillows, accompanied
her muscular resistiveness with laughter. This shows the affective
nature of the apparently purposeless muscular tension. The case of Annie
K. (Case 5) is more instructive. In the stage of deeper stupor she had
the automatic type of resistiveness but also outbursts of anger,
particularly toward the nurses, striking one of them she said, “You are
the cause of it all.” When food was offered her, she said, “I wonder
people would not leave me alone sometimes.” Again, when her bed was
approached, she would clutch and hold the bed clothes in an apparently
aimless way as if the impulse to resist never reached its goal.
Retrospectively she could not account for her muscular rigidity on the
basis of definite ideas, and could recall only that she felt stubborn.
In a later period when more accessible, she felt cross and did not want
Public-domain text, read in full here on John Shaqi.
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