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
[10] As a matter of fact, if the views of Clark and MacCurdy[B] be
accepted, some reason for these epileptic-like attacks may be imagined.
According to them, epilepsy is a disease characterized by a lack of the
natural instinctive interest in the environment which is expressed
chronically in the deterioration, and episodically in the attacks, the
most consistent feature of which is loss of consciousness. Now, in
stupor we have an analogous reaction where, although consciousness is
not disturbed in the sense in which it is in epilepsy, it is
nevertheless considerably affected, inasmuch as contact with the
environment is practically non-existent. The coincident thinking
disorder is quite similar, both in epileptic dementia and the torpor
following seizures and in these benign stupors. MacCurdy has suggested
tentatively that the epileptic convulsion may be secondary to a very
sudden loss of consciousness which removes a normal inhibition on the
muscles, liberating the muscular contractions which constitute the
convulsion. If this view were correct, it would not be hard to imagine
that during the onset of these stupors the tendency to part company with
the environment, which ordinarily comes on slowly, might occur with
epileptic suddenness and hence liberate convulsive movements. This is,
however, a pure speculation but not fruitless if it serves to draw
attention to the analogies existing between the stupor reaction and some
of the mental symptoms of epilepsy. These analogies are strong; aside
from the obvious clinical differences, the stupor and epileptic
reactions are dynamically unlike in that they are the product of
different temperaments and precipitated by different situations.
FOOTNOTES:
[B] Clark, L. Pierce. “Is Essential Epilepsy a Life Reaction Disorder?”
_Am. Jour. of the Medical Sciences_, November, 1910, Vol. CLVIII, No. 5,
p. 703. This paper gives a summary of Dr. Clark’s theories.
MacCurdy, John T., “A Clinical Study of Epileptic Deterioration.”
_Psychiatric Bulletin_, April, 1916.
CHAPTER X
PSYCHOLOGICAL EXPLANATION OF THE STUPOR REACTION
In the previous chapter mention has been made of our view that
manic-depressive insanity is a disease fundamentally based on some
constitutional defect, presumably physical, but that its symptoms are
determined by psychological mechanisms. In accordance with this
hypothesis we seek, when studying the different forms of insanity
presented in this group, to differentiate between the different types of
mental mechanisms observed, and by this analysis to account for the
manifestations of the disease on purely psychological lines. If benign
stupors belong to this group, then we should be able to find some
specific psychology for this type of reaction.
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