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
The frequency with which the delusion of mutual death occurs in stupor
is another evidence of its regressive psychology. The partner in the
spiritual marriage is rarely, if ever, the natural object of adult
affection, but rather a parent or other relative to whose memory the
patient has unconsciously clung for many years, reawakening in the
psychosis an ambition of childhood for an exclusive possession that
reaches its fulfillment in this delusion. Closely allied with this is
another delusion, that of being actually dead, which the patients
sometimes express in action, even when not in words. The anesthesia to
pin pricks, the immobility and the refusal to recognize the existence of
the world around, in patients who give evidence of some intellectual
operations still persisting, are probably all part of a feigned death,
with the delusion expressing itself in corpse-like behavior.
Finally we must consider the meaning of the deep stupor where no
mentation of any kind can be proven and where none but vegetative
functions seem to be operating. This state is either one of organic
coma, in which case it marks the appearance of a physical factor not
evidenced in the milder stages, or else it is the acme of this
regression by withdrawal of interest. As has been stated, back of the
period of primitive childish ideas there lies a hypothetical state of
mental nothingness. If we accept the principle of regression we find
historically an analogue to what is apparently the mental state of deep
stupor in the earliest phases of infancy. This view receives
justification from the study of the phenomenon of variations in
symptoms. Mental faculties at birth are larval, and if such condition be
artificially produced mental activity must be potentially present (as it
would not be if we were dealing with coma). In Chapter IV phenomena of
interruption of stupor symptoms were detailed. One case that was
mentioned is now of particular importance as demonstrating that an
appropriate stimulus may dispel the vacuity of complete stupor by
raising mental functions to a point where delusions are entertained.
This patient retrospectively recalled only certain periods of her
deepest stupor, occasions when she was visited by her mother. At these
times, as she claimed, she thought she was to be electrocuted and told
her mother so, adding, “Then it would drop out of my mind again.”
Otherwise her memory for this state was a complete blank. Here we see a
normal stimulus producing not normality but something on the way towards
it, that is, a condition less profound than the state out of which the
patient was temporarily lifted.
Public-domain text, read in full here on John Shaqi.
Benign Stupors: A Study of a New Manic-Depressive Reaction Type — John Shaqi
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