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
to be bothered. This emotional attitude was quite conscious with her,
whereas the acts and speech of the earlier period, when her stupor was
more profound, seemed more automatic and impulsive. In other words, the
resistiveness looks like a larval attempt to express an idea which is
probably not fully conscious and therefore gives the appearance of being
aimless. As another example of this we may cite the case of Pearl F.
(Case 9), who said when she recovered, “I was stubborn.” In addition to
the muscular resistiveness she had shown, she would often bite the bed
clothes or scratch herself when she was approached. Mary F. (Case 3),
while in a stupor, slapped at nearby patients quite aimlessly. When
somewhat better, this conduct appeared in a more conscious form, as
sullenness, indifference and smearing of feces (again the behavior of a
naughty child). Here one might quote Laura A. once more, whose
resistiveness when stuporous was intense but who in her manic spells
expressed her negativism in a definite idea, “I don’t want my face
washed.”
To summarize, then, we may say that negativism is apparently the result
of a desire to be left alone, and that muscular resistiveness is a
larval exhibition of the same tendency. But the appearance of this
attitude in such aimless, impulsive acts or habits reminds us strongly
of the dissociation of affect, which was commented on in the previous
chapter. It would seem to be another example of this rather fundamental
tendency of the stupor reaction, not merely to diminish conative
reactions in general, but to reduce their appearance to that of
isolated, partial and therefore rather meaningless expression.
3. CATALEPSY. The last of the cardinal symptoms to be considered is
catalepsy. It occurred in thirteen of thirty-seven cases, although it
was present only as a tendency in three of these. If we define it as the
maintenance of position in which a part of the body is placed regardless
of comfort, we can see that sometimes it is difficult to differentiate
from the phenomenon of resistiveness with its rigidity. It is most
frequently observed in the hands and arms, perhaps because it is, as a
rule, most convenient to demonstrate the retention of awkward positions
in the upward extremities. But any part or even the whole body may be
involved; for example, Charles O. retained standing positions even where
balance was difficult. This phenomenon is often accompanied by “waxy
flexibility,” where the joints move stiffly but retain whatever bend is
given them, like a doll with stiff joints.
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