_ CHAPTER II. DREADS
"O, know he is the bridle of your will.
There's none but asses will be bridled so."
A Comedy of Errors. It must be a surprise to most people, after the demonstration of the power of the will in the preceding chapter, that so many fail to make use of it. Indeed, the majority of mankind are quite unable to realize the store of energy for their health and strength and well-being which is thus readily available, though so often unused or called upon but feebly. The reason why the will is not used more is comparatively easy to understand, however, once its activity in ordinary conditions of humanity is analyzed a little more carefully. The will is unfortunately seldom permitted to act freely. Brakes are put on its energies by mental states of doubt and hesitation, by contrary suggestion, and above all by the dreads which humanity has allowed to fasten themselves on us until now a great many activities are hampered. There is the feeling that many things cannot be done, or may be accomplished only at the cost of so much effort and even hardship that it would be hopeless for any but those who are gifted with extremely strong wills to attempt them. People grow afraid to commit themselves to any purpose lest they should not be able to carry it out. Many feel that they would never be able to stand what others have stood without flinching and are persuaded that if ever they were placed in the position where they had to withstand some of the trials that they have heard of they would inevitably break down under the strain.
Just as soon as a human being loses confidence that he or she may be able to accomplish a certain thing, that of itself is enough to make the will ever so much less active than it would otherwise be. It is like breaking a piece of strong string: those who know how wrap it around their fingers, then jerk confidently and the string is broken. Those who fear that they may not be able to break it hesitate lest they should hurt themselves and give a half-hearted twitch which does not break the string; the only thing they succeed in doing is in hurting themselves ever so much more than does the person who really breaks it. After that abortive effort, they feel that they must be different from the others whose fingers were strong enough to break the string, and they hesitate about it and will probably refuse to make the attempt again.
It is a very old story,--this of dreads hampering the activities of mankind with lack of confidence, and the fear of failure keeping people from doing things. One of his disciples, according to a very old tradition, once asked St. Anthony the Hermit what had been the hardest obstacle that he found on the road to sanctity. The story has all the more meaning for us here if we recall that health and holiness are in etymology the same. St. Anthony, whose temptations have made him famous, was over a hundred at the time and had spent some seventy years in the desert, almost always alone, and probably knew as much about the inner workings of human nature from the opportunities for introspection which he had thus enjoyed as any human being who ever lived. His young disciple, like all young disciples, wanted a short cut on the pathway that they were both traveling. The old man said to him, "Well, I am an old man and I have had many troubles, but most of them never happened."
Many a nightmare of doubt and hesitation disappears at once if the dread of it is overcome. The troubles that never happen, if dwelt upon, paralyze the will until health and holiness become extremely difficult of attainment.
There is the secret of the failure of a great many people in life in a great many ways. They fear the worst, dread failure, dampen their own confidence, and therefore fritter away their own energy. Anything that will enable them to get rid of the dreads of life will add greatly to their power to accomplish things inside as well as outside their bodies. Well begun is half done, and tackling a thing confidently means almost surely that it will be accomplished. If the dread of failure, the dread of possible pain in its performance, the dread of what may happen as a result of activity,--if all these or any of them are allowed to obtrude themselves, then energy is greatly lessened, the power to do things hampered and success becomes almost impossible. This is as true in matters of health and strength as it is with regard to various external accomplishments. It takes a great deal of experience for mankind to learn the lesson that their dreads are often without reality, and some men never learn it.
Usually when the word dreads is used, it is meant to signify a series of psychic or psychoneurotic conditions from which sensitive, nervous people suffer a great deal. There is, for instance, the dread of dirt called learnedly misophobia, that exaggerated fear that dirt may cling to the hands and prove in some way deleterious which sends its victims to wash their hands from twenty to forty times a day. Not infrequently they wash the skin pretty well off or at least produce annoying skin irritation as the result of their feeling. There are many other dreads of this kind. Some of them seem ever so much more absurd even than this dread of dirt. Most of us have a dread of heights, that is, we cannot stand on the edge of a height and look down without trembling and having such uncomfortable feelings that it is impossible for us to stay there any length of time. Some people also are unable to sit in the front row of the balcony of a theater or even to kneel in the front row of a gallery at church without having the same dread of heights that comes to others at the edge of a high precipice. I have among my patients some clergymen who find it extremely difficult to stand up on a high altar, though, almost needless to say, the whole height is at most five or six ordinary steps.
Then there are people who have an exaggerated dread of the dark, so that it is quite impossible for them to sleep without a light or to sleep alone. Sometimes such a dread is the result of some terrifying incident, as the case in my notes in which the treasurer of a university developed an intense dread of the dark which made sleep impossible without a light, after he had been shot at by a burglar who came into his room and who answered his demand, "Who is that?" by a bullet which passed through the head of the bed. Most of the skotophobists, the technical name for dark-dreaders, have no such excuse as this one. Victims of nervous dreads have as a rule developed their dread by permitting some natural feeling of minor importance to grow to such an extent that it makes them very miserable.
Some cannot abide a shut-in place. Philip Gilbert Hamerton, the English writer and painter, often found a railroad compartment in the English cars an impossible situation and had to break his journey in order to get over the growing feeling of claustrophobia, the dread of shut-in places, which would steal over him.
There are any number of these dreads and, almost needless to say, all of them may interfere with health and the pursuit of happiness. I have seen men and women thrown into a severe nervous state with chilly feelings and cold sweat as the result of trying to overcome one of these dreads. They make it impossible for their victims to do a great many things that other people do readily, and sadly hamper their wills. There is only one way to overcome these dreads, and that is by a series of acts in the contrary direction until a habit of self-control with regard to these haunting ideas is secured. All mankind, almost without exception, has a dread of heights, and yet many thousands of men have in recent years learned to work on high buildings without very much inconvenience from the dread. The wages are good, they
want to work this way, and the result is they take themselves in hand and gradually acquire self-control. I have had many of them tell me that at first they were sure they would never be able to do it, but the gradual ascent of the building as the work proceeded accustomed them to height, and after a while it became almost as natural to work high up in the air as on the first or second story of a building or even on the level ground.
The overcoming of these dreads is not easy unless some good reason releases the will and sets it to exerting its full power. When this is the case, however, the dread is overcome and the brake lifted after some persistence, with absolute assurance. Men who became brave soldiers have been known to have had a great dread of blood in early life. Some of our best surgeons have had to leave the first operation that they ever saw or they would have fainted, and yet after repeated effort they have succeeded in overcoming this sensitiveness. As a matter of fact, most people suffer so much from dreads because they yielded to a minor dread and allowed a bad habit to be formed. It is a question of breaking a bad habit by contrary acts rather than of overcoming a natural disposition. Many of those who are victims have the feeling that they cannot be expected to conquer nature this way. As a result, they are so discouraged at the very idea that success is dubious and practically impossible from their very attitude of mind; but it is only the second nature of a habit that they have to overcome, and this is quite another matter, for exactly contrary acts to these which formed a habit will break it.
Some of these dreads seem to be purely physical in origin or character yet prove to be merely or to a great degree only psychic states. Insomnia itself is more a dread than anything else. In writing for the International Clinics some years ago (Volume IV, Series XXVI) I dwelt on the fact that insomnia as a dread was probably responsible for more discomfort and complaints from mankind than almost anything else. Insomniaphobia is just such a dread as agoraphobia, the dread of open spaces; or akrophobia, the dread of heights; or skotophobia, the dread of the dark, and other phobias which afflict mankind. It is perfectly possible in most cases to cure such phobias by direct training against them, and this can be done also with regard to insomnia.
Some people, particularly those who have not been out much during the day and who have suffered from wakefulness a few times, get it on their mind that if this state keeps up they will surely lose their reason or their bodily health, and they begin to worry about it. They commence wondering about five in the afternoon whether they are going to be awake that night or not. It becomes a haunt, and no matter what they do during the evening every now and then the thought recurs that they will not sleep. By the time they actually lie down they have become so thoroughly occupied with that thought that it serves to keep them awake. Some of them avoid the solicitude before they actually get to bed, but begin to worry after that, and if after ten minutes they are not asleep, above all if they hear a clock strike somewhere, they are sure they are going to be awake, they worry about it, get themselves thoroughly aroused, and then they will not go to sleep for hours. It is quite useless to give such people drugs, just as useless as to attempt to give a man a drug to overcome the dread of heights or the dread of the dark or of a narrow street through which he has to pass. They must use their wills to help them out of a condition in which their dreads have placed them.
Apart from these neurotic dreads, quite unreasoning as most of them are, there are a series of what may be called intellectual dreads. These are due to false notions that have come to be accepted and that serve to keep people from doing things that they ought to do for the sake of their health, or set them performing acts that are injurious instead of beneficial. The dread of loss of sleep has often caused people to take somnifacients which eventually proved ever so much more harmful than would the loss of sleep they were meant to overcome. Many a person dreading a cold has taken enough quinine and whisky to make him more miserable the next day than the cold would have, had it actually made its appearance, as it often does not. The quinine and whisky did not prevent it, but the expectation was founded on false premises. There are a great many other floating ideas that prove the source of disturbing dreads for many people. A discussion of a few typical examples will show how much health may be broken by the dreads associated with various ills, for they often interfere with normal, healthy living.
"A little knowledge is a dangerous thing" applies particularly in this matter. There are many morbid fears that disturb mankind and keep us from accomplishing what might otherwise be comparatively easy. A great many people become convinced that they have some diseased condition, or morbid elements at least, in them which make it impossible for them to do as much as other people. Sometimes this morbid persuasion takes the form of hypochrondia and the individuals feel that they have a constitution that unfits them for prolonged and strenuous effort of any kind, so they avoid it. The number of valetudinarians, that is of those who live their lives mainly engaged in caring for their health, though their physicians have never been able to find anything organically wrong with them, is much larger than might be imagined. This state of mind has been with us for many centuries, for the word which describes it, hypochondria, came to us originally from Greece and is an attempt to localize the affection in connection with its principal symptom, which is usually one of discomfort in the stomach region or to one side or the other of it, that is, in the hypochondria or beneath the ribs.
Such a state of mind, in which the patient is constantly complaining of one symptom or another, quite paralyzes the will. The individual may be able to do some routine work but he will not be able to have any initiative or energy for special developments of his occupation, and of course, when any real affection occurs, he will feel that he is quite unable to bear this additional burden of disease. Hypochondriacs, however, sometimes fairly enjoy their ill health and therefore have been known not infrequently to live on to a good, round old age, ever complaining more and more. It is their dread of disease that keeps them from getting better and prevents their wills from throwing off whatever symptoms there are and becoming perfectly well. Until something comes along and rouses their wills, there is no hope of affecting them favorably, and it is surprising how long the state may continue without any one ever having found any organic affection to justify all the discomforts of which they complain. Quite literally, they are suffering from complaints and not from disease in the ordinary sense of the word.
Sometimes these dreads of disease are dependent on some word which has taken on an exaggerated significance in people's minds. A word that in recent years has been the source of a great deal of unfavorable suggestion is "catarrh", and a mistaken notion of its meaning has been productive of a serious hampering of their will to be well in a number of persons. In itself, both according to its derivation and its accepted scientific significance, the word means only that first stage of inflammatory irritation of mucous membranes which causes secretion to flow more freely than normally.
Catarrhein in Greek means only to flow down. [Footnote 2]
[Footnote 2: The word has, by the way, the same meaning as rheumatism, which is also from the Greek verb, to flow, though its application is usually limited to the serous membranes of the joints or the serous surfaces of the intermuscular planes. By derivation, catarrh is the same word also as gout, which comes from gutta in Latin, meaning a drop and implying secretory disturbances. These three words--catarrh, rheumatism, gout--have been applied to all sorts of affections and are so general in meaning as to be quite hard to define exactly. They have for this very reason, their vagueness, become a prolific source of unfortunate suggestion and of all kinds of dreads that disturb health.]
By abuse, however, the word
catarrh has come to mean in the minds of a great many people in our time a very serious inflammation of the mucous membranes, almost inevitably progressive and very often resulting in fetid diseased conditions of internal or external mucous membranes, very unpleasant for the patient and his friends and the source of serious complications and
sequelae. This idea has been fostered sedulously by the advertisers of proprietary remedies and the ingenious exploiters of various modes of treatment. As a result, a great many people who for one reason or another--usually because of some slight increase of secretion in the nose and throat--become convinced they have catarrh begin to feel that they cannot be expected to have as much resistive vitality as others, since they are the subjects of this serious progressive disease. As a matter of fact, very few people in America, especially those living in the northern or eastern States, are without some tendency to mild chronic catarrh. The violent changes of temperature and the damp, dark days predispose to it; but it produces very few symptoms except in certain particularly sensitive individuals whose minds become centered on slight discomforts in the throat and nose and who feel that they must represent some serious and probably progressive condition.
As a matter of fact, catarrh has almost nothing of the significance attributed to it so often in magazine and newspaper advertisements. Simple catarrh decreases without producing any serious result, and indeed it is an index of a purely catarrhal condition that there is a complete return to normal. Sometimes microbes are associated with its causation, but when this is so, they are bacteria of mild pathological virulence that do not produce deep changes. As for catarrh developing fetid, foul-smelling discharges or odors, that is out of the question. There are certain affections, notably diphtheria, that may produce such serious changes in the mucous membranes that there will always even long after complete recovery be an unpleasant odorous condition, but it is probable that even in these cases there exists a special form of microbe quite rare in occurrence which produces the state known as
ozena.
As to catarrh spreading from the nose and throat to the other mucous membranes, that is also quite out of the question if it is supposed to occur in the way that the advertising specialist likes to announce. Catarrhal conditions may occur in the stomach, but like those of the nose and throat they are not serious, heal completely, and produce no definite changes. A pinch of snuff may cause a catarrhal condition of the nose, that is an increase of secretion due to hyperaemia of the mucous membrane; the eating of condiments, of Worcestershire sauce, peppers, and horse-radish may cause it in the stomach. It may be due to microbic action or to irritant or decomposing food, but it is not a part of a serious, wide-spreading pathological condition that will finally make the patient miserable. It is surprising, however, how many people say with an air of finality that they have catarrh, as if it should be perfectly clear that as a result they cannot be expected at any time to be in sufficiently good health to be called on for any special work, and of course if any affection should attack them, their natural immunity to disease has been so lowered by this chronic affection, of which they are the victims, that no strong resistance could be expected from them.
All this is merely a dread induced by paying too much attention to medical advertisements. It is better not to know as much as some people know, or think they know about themselves, than to know so many things that are not so. Their dreads seriously impair their power to work and leave them ill disposed to resist affections of any kind that may attack them. It is a sad confession to make, but not a little of the enforced study of physiology in our schools has become the source of a series of dreads and solicitudes rather than of helpful knowledge. We have as a result a generation who know a little about their internal economy, but only enough to make them worry about it and not quite enough to make them understand how thoroughly capable our organisms are of caring for themselves successfully and with resultant good health, if we will only refrain from putting brakes on their energies and disturbing their functions by our worries and anxieties.
Another such word as catarrh in its unfavorable suggestiveness in recent years has been auto-intoxication. It is a mouth-filling word, and therefore very probably it has occupied the minds of the better educated classes. Usually the form of auto-intoxication that is most spoken of is intestinal auto-intoxication, and this combination has for many people a very satisfying polysyllabic length that makes it of special significance. Its meaning is taken to be that whenever the contents of the intestines are delayed more than twenty hours or perhaps a little longer, or whenever certain irritant materials find their way into the intestinal tract, there is an absorption of toxic matter which produces a series of constitutional symptoms. These include such vague symptomatic conditions as sleepiness, torpor after meals, an uncomfortable sense of fullness--though when we were young we rather liked to have that feeling of fullness--and sometimes a feeling of heat in the skin with other sensations of discomfort in various parts of the body. At times there is headache, but this is rather rare; lassitude and a feeling of inability to do things is looked upon as almost characteristic of the condition. Usually there are nervous symptoms of one kind or another associated with the other complaints and there may be distinctly hysterical or psycho-neurotic manifestations.
Auto-intoxication as just described has become a sort of fetish for a great many people who bow down and worship at its shrine and give some of the best of their energies and not a little of their time to meditation before it. As a matter of fact, in the last few years it has come to be recognized that auto-intoxication is a much abused word employed very often when there are serious organic conditions in existence elsewhere in the body and still more frequently when the symptoms are due merely to functional nervous troubles. These are usually consequent upon a sedentary life, lack of fresh air and exercise, insufficient attention to the diet in the direction of taking simple and coarse food, and generally passing disturbances that can be rather readily catalogued under much simpler affections than a supposed absorption of toxic materials from the intestines. Reflexes from the intestinal tract, emphasized by worries about the condition, are much more responsible for the feelings complained of--which are often not in any sense symptoms--than any physical factors present.
As Doctor Walter C. Alvarez said in a paper on the "Origin of the So-called Auto-intoxicational Symptoms" published from the George Williams Hooper Foundation for Medical Research of the University of California Medical School, [Footnote 3] as the conclusion of his investigation of the subject:
[Footnote 3: Journal of the American Medical Association, January 4, 1919.]
"Auto-intoxication is commonly diagnosed when a physical examination would show other more definite causes for the symptoms. Those who believe that intestinal stasis can account for a long list of disease conditions have little proof to offer for their views. Many of the assumptions on which they rest their case have proved to be wrong.
"The usual symptoms of the constipated disappear so promptly after a bowel movement that they cannot be due to absorbed toxins. They must be produced mechanically by distension and irritation of the colon. They occur in nervous, sensitive people. It has been shown that various activities of the digestive tract can profoundly affect the sensorium and the vasomotor nerves. The old ideas of insidious poisoning led to the formation of hypochrondriacs; the new explanation helps to cure many of them."
There are many other terms in common use that have unfortunate suggestions and make people feel, if they once get the habit of applying them to themselves, that they are the subject of rather serious illness. I suppose that one of the most used and most abused of these is uric acid and the uric acid diathesis. Scientific physicians have nearly given up these terms, but a great many people are still intent on making themselves miserable. All sorts of symptoms usually due to insufficient exercise and air, inadequate diversion of mind and lack of interests are attributed to these conditions. Some time or other a physician or perhaps some one who is supposed to be a friend suggested them and they continue to hamper the will to be well by baseless worries founded on false notions for years afterwards. What is needed is a definite effort of the will to throw off these nightmares of disease that are so disturbing and live without them.
It is surprising how much vital energy may be wasted in connection with such dreads. Unfortunately, too, medicines of various kinds are taken to relieve the symptoms connected with them and the medicine does ever so much more harm than good. Oliver Wendell Holmes declared a generation ago that if all the medicines that had ever been taken by mankind were thrown into the sea it would be much better for mankind and much worse for the fishes. The expression still has a great truth in it, especially as regards that habit of self-drugging so common among the American people. In the course of lecture engagements, I stay with very intelligent friends on a good many occasions each year, and it is surprising how many of them have medicine bottles around, indicating that they are subject to dreads of various kinds with regard to themselves for which they feel medicine should be taken. These dreads unfortunately often serve to lessen resistive vitality to real affections when they occur and therefore become a source of real danger.
All these various dreads, then, have the definite effect of lessening the power of the will to enable people to do their work and remain well. They represent serious brakes upon the flow of nerve impulses from the spiritual side of man's nature to the physical. This is much more serious in its results than would usually be thought; and one of the things that a physician has to find out from a great many patients is what sources of dread they are laboring under so as to neutralize them or at least correct them as far as possible. It is surprising how much good can be accomplished by a deliberate quest after dreads and the direct discussion of them, for they are always much less significant when brought out of the purlieus of the mind directly into the open. Many a neurotic patient, particularly, will not be improved until his dreads are relieved. This form of psycho-analysis rather than the search for sex insults, as they are called, or sexual incidents of early life, is the hopeful phase of modern psychological contribution to therapeutics. _