Traumatic neuroses; War neuroses; World War, 1914-1918 -- Health aspects; World War, 1914-1918 -- Veterans -- Mental health
Moreover, it is perfectly clear that if we adopt any of the usual
views as to the relation between body and mind, not only disease, but
health too is “inconceivable without some underlying physical basis.”
Yet of the molecular or bio-chemical aspects of that basis we know
practically nothing which would help us to understand even ordinary
mental occurrences. So when a normal, physically healthy mother bursts
into tears of joy on her son’s return from the front, is sleepless
when she knows he is in the trenches, forgets some of her daily
duties in perpetually thinking of him, is “on edge” and irritable
when she has had no letter from France—though we may be perfectly
justified in believing that there are molecular or bio-chemical nervous
changes underlying her behaviour, we do not dream of invoking these
as explanations of her condition, for of them we know little. Neither
do we call her neurasthenic. We understand her condition in that we
correctly refer it to the action of instinct and emotion. Its cause is
clear to us, and if we attempted to treat it we should know beforehand
that the best cure would be the restoration of her loved one, the next
best, sympathetic help in facing her worries, the removal of unfounded
fears and the production of a serener outlook on the future. In other
words, the diagnosis, the tracing of causes, and the treatment would be
entirely mental, with no reference whatever to the physical basis, the
existence of which we obviously should not deny. Similarly, if a man is
troubled by a great moral conflict which produces in him sleeplessness,
irritability, abstraction and the rest, the physical basis of his
emotional condition may be “materially” treated. His sleeplessness may
be reduced by bromides, his irritability and depression by alcohol;
but who, if he knew of the great mental conflict, would dare merely to
prescribe these?
And this, in the case of many of the psychoneuroses is the crux of the
whole matter. The root of the trouble is mental conflict, the complete
details of which can seldom be found on the surface of the complex of
symptoms. To palliate them one by one is often to provoke new ones.
The conflict is sometimes clearly apprehended by the patient, but
even then is often jealously guarded from everyone else. Sometimes,
however, it is not clearly conscious in all its details, even to him.
This is especially the case, if as so often happens, he habitually
shuns the thought of it. Faced with an inability to adapt himself to
his circumstances, he instinctively relapses into a more childish way
of meeting the situation—hence the tears, the irritability, the mental
distraction and the rest. This phenomenon, we repeat, is not new. We
all acknowledge its existence when we say that the “nervy patient
behaves childishly,” though perhaps we do not realise what a true
conception of the matter we are expressing.
Public-domain text, read in full here on John Shaqi.
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