All these manifestations are best controlled by selecting a suitable
environment, and as a rule the character of the environment is
determined by the temperament and disposition of those who live in
close contact with the patient. Like the tiny children with whom we
have dealt so far, the behaviour of neuropathic persons is subject
wholly to the direction of stronger and more dominant natures. With
faulty management at the hands of those around them, no matter how
loving and patient these may be, the conduct of the neurotic tends to
become abnormal.
In children beyond earliest infancy we recognise a gradual approach to
the conditions of adult life. Fractiousness and naughtiness,
ungovernable fits of temper, inconsolable weeping and inexplicable
fears should disappear with early childhood even if management has not
been perfect. If they persist to older childhood we shall find in an
increasing percentage of cases evidence of definite neuropathic
tendencies which urgently call for investigation and for a precise
appreciation of the nature of the abnormality. It may be that the only
effective treatment is that which we recognise as essential in the
grosser mental disturbances--removal from the surroundings in which
the abnormal conduct has had free play, and separation from the
relatives whose anxiety and alarm cannot be hidden.
In young nervous children fear is the most prominent psychical
symptom. The children are afraid of everything strange with which they
come in contact. They are afraid of animals, of a strange face, or an
unfamiliar room. Older children usually manage to control themselves,
suppress their tears, and prevent themselves from crying out, but it
is nevertheless easy to detect the struggle.
Often we find those distressing attacks to which the name
"night-terrors" has been given. The child wakes with a cry,--usually
soon after he has gone to sleep,--sits up in bed and shows signs of
extreme terror, gazing at some object of his dreams with wide-open
startled eyes, begging his nurse or mother to keep off the black dog,
or the man, or whatever the vision may be. Even after the light is
turned up and the child has been comforted, the terror continues, and
half an hour may elapse before he becomes quiet and can be persuaded
to go back to bed. In the morning as a rule he remembers nothing at
all.
Public-domain text, read in full here on John Shaqi.
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