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
_Brief survey of the ideas associated with the states preceding the
stupor:_ If we now return to the study of the further occurrence of such
ideas in the cases described, we find motifs, similar to those seen in
the stupor, in the period which immediately precedes the more definite
stupor reaction. Indeed we find the ideas there with greater regularity.
In Meta S. (Case 15) the stupor followed upon six days with reduced
activity and crying, with self-accusation, but also with entreaties to
be allowed to go home and die with her father. At the very onset of her
breakdown, the desire for death had also occurred. Anna G. (Case 1)
expressed a wish to be with her dead father, and, at the visit of a
cousin, she had a vision of the latter’s dead mother. A second attack of
this same patient began with the idea that the dead father was calling
her. Maggie H. (Case 14) saw dead bodies, and during outbursts of
greater anxiousness, she thought her husband was going to die. In
Caroline De S. (Case 2) the psychosis began with a coarse excitement,
with statements about being killed, with entreaties to be shot, with the
idea of going to Heaven, again with frequent calling out that she loved
her father (who was dead since her ninth year), while immediately before
the stupor the condition passed into a muttering state in which she
spoke of being killed. Mary D. (Case 4) began by worrying over the
father’s death (dead four years before), had visions of the latter
beckoning, and she heard voices saying, “You will be dead.” Mary F.
(Case 3) had a vision of “a person in white,” and thought she was going
to die. In Henrietta H. (Case 8) the stupor was preceded by nine days of
elation, with ideas of shooting and of war, but this had commenced with
hearing voices of dead friends, and with ideas that somebody wanted to
kill her family. In the case of Annie K. (Case 5) we find before the
stupor a state of worry, with reduction of activity, and then a vision
of the dead father coming for her. In Charlotte W. (Case 12) the stupor
was preceded by a state of preoccupation, with distress and entreaties
to be saved, partly from being put into a big hole, partly from the
electric chair.
We see, therefore, in the introductory phase of the stupor in almost
every case ideas of death, and in one case an idea belonging to the
rebirth motif, namely, of being put into a dark hole. In well-observed
cases apparently we do not find the stupor reaction without either
coincident or preceding ideas of death.
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