Another patient sits on the ground all day long, buttoning and
unbuttoning his clothes.
An old gymnast maintains while he stands a professional attitude
in which his head is raised, his right fist closed on his hip, his
right leg crossed in front of the left, and his right foot elevated
vertically.
Conditions such as these present the most intimate analogies to our
attitude tics, though in the case of the latter there is always a more
or less pronounced exaggeration of muscular contraction, a certain
degree of tonic convulsion.
Parakinetic stereotyped acts are of common occurrence, and embrace every
variety of movement or gesture.
A former acrobat leaps staircases, climbs railings, exercises his
arms rhythmically and regularly, etc.
A patient promenades untiringly in the same corner and at the same
pace.
An old engraver, now a dement, passes the day in reproducing in a
more or less modified form certain actions associated with his
former profession.
Alike in tics and in stereotyped acts, a time comes when the motor habit
establishes itself, for no apparent reason or purpose; hence the
co-existence of the two classes in chronic delusional insanity, in
dementia precox, in catatonic states, in systematised mental disease of
other forms, and in general paralysis.
Stereotyped acts may be the embodiment of ideas of persecution and of
grandeur, or the outcome of mystical, hypochondriacal, and other states.
A patient with delusions of persecution writhes because he is being
"electrified." A hypochondriac rests motionless because he believes
himself made of glass. A mystic maintains an attitude of genuflexion for
hours at a time.
Obsessions also play a part in the genesis of the acts we have under
consideration, but of all delusional ideas those of defence are the most
fertile in this respect.
A patient under the care of A. Marie used to carry a fragment of glass
between his teeth and other pieces beneath the soles of his feet, the
idea being that they formed insulating cushions whereby to protect
himself from the electricity of his enemies.
The suggestion was thrown out by Bresler that the movements of tic are
often of a defensive character--that the disease, in fact, is a sort of
"defence neurosis" linked to hyperexcitability of psychomotor centres.
This theory is not unlike the view of hysteria taken by Brener and
Freud, and as the movements themselves are usually of the nature of
mimicry, Bresler has proposed the term _mimische Krampfneurose_.
Public-domain text, read in full here on John Shaqi.
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