We come to a third group. Some outside cause has harmed the central
nervous system directly, and has left it in a disabled state after the
cause itself has disappeared. Such causes may have been at first purely
functional: for instance, a neglect of training, or a wrong training, or
an over-activity, but the ill-adjusted function which involved, of
course, every time an ill-adjusted organic activity or lack of activity,
has led to a lasting or at least relatively lasting disturbance in the
system of paths. The neglect of training, for instance, in periods of
development may have resulted in the retardation which yields the
symptoms of a feeble-minded brain, or the wrong training may have
created vicious habits, firmly established in the mind-brain system and
gravely disturbing the equilibrium. Above all, the overstrain of
function, especially of emotional functions, may lead to that exhaustion
which produces the state of neurasthenia. It is true that not a few
would doubt whether we have the right to class neurasthenia here where
we speak of the harm done to the normal brain. Many neurologists are
inclined to hold that neurasthenia demands a special predisposition and
is therefore dependent upon a neurotic constitution of the brain itself.
But if defenders of such a view, as for instance, Dubois, acknowledge
that "we might say that everybody is more or less neurasthenic," we can
no longer speak of any special predisposition. Certainly there exists a
constitutional neurasthenia sometimes but we have hardly a right to deny
that overstrain in the brain activity may produce a series of
neurasthenic symptoms in any brain, and the special predisposition is
responsible rather for the particular selection among the innumerable
symptoms.
Neurasthenia certainly is the classical ground for the psychotherapist.
The patient's insomnia and his headache, his feeling of tiredness and
his disgust with himself, his capricious manias and his absurd phobias,
his obsessions and his fixed ideas all may yield to the "appeal to the
subconscious," and as a neurasthenic easily believes in the existence of
various organic diseases in his body, Christian Science can perform here
even "miracles." In the case of retardation, the psychical influence
will have to be in the first place one of training. Yet it would be
narrow to overlook that in neurasthenia, too, suggestion has to be only
a part of the psychical treatment. Training and rest, distraction and
sympathy and many other factors have to enter into the plan.
Incomparably small, on the other hand, is the aid which psychotherapy
can offer in cases of real destructions in the brain, as in the case of
tumors, hemorrhage, paresis or the degeneration by senility. More
effective may be its work in concussion of the brain and especially with
traumatic neuroses, as in the case when a railroad accident has put the
mind-brain system out of gear.
Public-domain text, read in full here on John Shaqi.
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