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
It will be remembered that Charlotte W. had freer intervals when she
responded and was less constrained generally, and that it was in these
that the ideas above mentioned were gathered. Since they were spoken of
in the past tense, we regarded them as not belonging to the actual
situation but to the more stuporous period. It seems tempting now to see
whether the ideas which are expressed in the present tense are different
in character, the general aim being to discover whether any tendencies
can be found in regard to the types and formulations of delusions
associated with different clinical pictures. We see that on November 2
the patient, when speaking much more freely than before, said she had
felt that she was mesmerized, was dead, and that she had gone to Heaven,
ideas which we have taken up above as belonging to the stupor period. In
addition to speaking much more freely in these intervals, she showed at
times some affect. Thus to the physician whom she called Christ, she
said, with tears, “You came to tell me what was right,” or again with
tears, “I will have to be crucified,” or she spoke in a depressed manner
about her children, “I can’t see them any more,” “I must stay here till
I die,” and she spoke of having to stay here till she picked her eyes
and her brains out; or she claimed her husband or her children had to
pick them out. Once she exclaimed crossly and with tears, “You are
trying to keep me from Jim” (husband). Another idea was not plainly
associated with affect. She said she had come back from Heaven, “The
wedding ring kept me on Earth.” What strikes one about these
formulations is that they are, on the one hand, sometimes associated
with an affect, and that, on the other hand, they refer much more to her
actual life, her marriage, her husband, her children. At least this
seems to be a definite tendency. A similar tendency may be seen later:
On November 4, while generally stuporous, this suddenly lifted for a
short time, and with feeble voice she uttered some depressive ideas. She
said she wanted to go to a convent, that it would be better if she were
dead, that she could not do anything right. On November 5 and 6 she
said she wanted to go to Jim in Heaven (in contradistinction to the
retrospective statements that she had gone to Heaven), and on the 8th,
when she had the idea of being in a boat, she said with some anger that
she had wanted to get her husband into the boat, but that the doctor
kept him out and took his place.
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