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| Applied Psychology |
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| for Nurses |
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| By |
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| Mary F. Porter, A. B. |
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| _Graduate Nurse; Teacher of Applied Psychology, |
| Highland Hospital, Asheville, N. C._ |
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| Philadelphia and London |
| W. B. Saunders Company |
| 1921 |
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Copyright, 1921, by W. B. Saunders Company
PRINTED IN AMERICA
PRESS OF
W. B. SAUNDERS COMPANY
PHILADELPHIA
TO THE MEMORY OF
MY FATHER
FOREWORD
This little book is the outgrowth of a conviction, strengthened by some
years of experience with hundreds of supposedly normal young people in
schools and colleges, confirmed by my years of training in a
neurological hospital and months of work in a big city general hospital,
that it is of little value to help some people back to physical health
if they are to carry with them through a prolonged life the miseries of
a sick attitude. As nurses I believe it is our privilege and our duty to
work for health of body and health of mind as inseparable. Experience
has proved that too often the physically ill patient (hitherto nervously
well) returns from hospital care addicted to the illness-accepting
attitude for which the nurse must be held responsible.
I conceive of it as possible that every well trained nurse in our
country shall consider it an essential to her professional success to
leave her patient imbued with the will to health and better equipped to
attain it because the sick attitude has been averted, or if already
present, has been treated as really and intelligently as the sick body.
To this end I have dealt with the simple principles of psychology only
as the nurse can immediately apply them.
The writer wishes to acknowledge her indebtedness for criticism of this
work and for several definitions better than her own, in the chapters
_The Normal Mind_ and _Variations From Normal Mental Processes_, to
Dr. Robert S. Carroll, who through the years of hospital training helped
her to translate her collegiate psychology from fascinating abstract
principles into the sustaining bread of daily life.
MARY F. PORTER.
ASHEVILLE, N. C.,
_August, 1921_.
CONTENTS
PAGE
CHAPTER I
WHAT IS PSYCHOLOGY? 11
CHAPTER II
CONSCIOUSNESS 20
The Unconscious 23
Consciousness is Complex 29
Consciousness in Sleep 31
Consciousness in Delirium 32
CHAPTER III
ORGANS OF CONSCIOUSNESS 34
The Central and Peripheral Nervous Systems in Action 35
The Sympathetic Nervous System 37
CHAPTER IV
RELATION OF MIND AND BODY 40
The Cerebrum or Forebrain 43
CHAPTER V
THE NORMAL MIND 47
CHAPTER VI
THE NORMAL MIND (Continued) 59
Instinct 59
Memory 62
The Place of Emotion 67
The Beginning of Reason 69
Development of Reason and Will 71
Judgment 72
Reaction Proportioned to Stimuli 75
Normal Emotional Reactions 77
The Normal Mind 77
CHAPTER VII
PSYCHOLOGY AND HEALTH 79
Necessity of Adaptability 80
The Power of Suggestion 84
One Thought Can Be Replaced by Another 89
Habit is a Conserver of Effort 90
The Saving Power of Will 93
CHAPTER VIII
VARIATIONS FROM NORMAL MENTAL PROCESSES 95
Disorders and Perversions 95
CHAPTER IX
VARIATIONS FROM NORMAL MENTAL PROCESSES (Continued) 101
Factors Causing Variations from Normal Mental Processes 108
Heredity 108
Environment 109
Personal Reactions 110
CHAPTER X
ATTENTION THE ROOT OF DISEASE OR HEALTH ATTITUDE 112
The Attention of Interest 112
The Attention of Reason and Will 118
CHAPTER XI
GETTING THE PATIENT'S POINT OF VIEW 124
What Determines the Point of View 124
Getting the Other Man's Point of View 126
The Deluded Patient 133
Nursing the Deluded Patient 135
The Obsessed Patient 136
The Mind a Prey to False Associations 137
CHAPTER XII
THE PSYCHOLOGY OF THE NURSE 139
Accuracy of Perception 141
Training Perception 142
Association of Ideas 143
Concentration 146
Self-training in Memory 150
CHAPTER XIII
THE PSYCHOLOGY OF THE NURSE (Continued) 152
Emotional Equilibrium 152
Self-correction 160
Training the Will 161
CHAPTER XIV
THE NURSE OF THE FUTURE 164
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INDEX 169
Applied Psychology for Nurses
CHAPTER I
WHAT IS PSYCHOLOGY?
Wise men study the sciences which deal with the origins and development
of animal life, with the structure of the cells, with the effect of
various diseases upon the tissues and fluids of the body; they study the
causes of the reactions of the body cells to disease germs, and search
for the origin and means of extermination of these enemies to health.
They study the laws of physical well-being. They seek for the chemical
principles governing the reactions of digestive fluids to the foods they
must transform into heat and energy. So the doctor learns to combat
disease with science, and at the same time to apply scientific laws of
health that he may fortify the human body against the invasion of
harmful germs. Thus, eventually, he makes medicine itself less
necessary.
But another science must walk hand in hand today with that of medicine;
for doctors and nurses are realizing as never before the power of mind
over body, and the hopelessness of trying to cure the one without
considering the other. Hence psychology has come into her own as a
recognized science of the mind, just as biology, histology, chemistry,
pathology, and medicine are recognized sciences governing the body. As
these are concerned with the "how" and "why" of life, and of the body
reactions, so psychology is concerned with the "how" and "why" of
conduct and of thinking. For as truly as every infectious disease is
caused by a definite germ, just as truly has every action of man its
adequate explanation, and every thought its definite origin. As we would
know the laws of the sciences governing man's physical well-being that
we might have body health, so we would know the laws of the mind and of
its response to its world in order to attain and hold fast to mind
health. Experience with patients soon proves to us nurses that the weal
and woe of the one vitally affects the other.
"Psychology is the science of mental life, both of its phenomena and
their conditions."
So William James took up the burden of proof some thirty years ago, and
assured a doubting world of men and women that there were laws in the
realm of mind as certain and dependable as those applying to the world
of matter--men and women who were not at all sure they had any right to
get near enough the center of things to see the wheels go round. But
today thousands of people are trying to find out something of the way
the mind is conceived, and to understand its workings. And many of us
have in our impatient, hasty investigation, self-analytically taken our
mental machines all to pieces and are trying effortfully to put them
together again. Some of us have made a pretty bad mess of it, for we
tore out the screws and pulled apart the adjustments so hastily and
carelessly that we cannot now find how they fit. And millions of other
machines are working wrong because the engineers do not know how to keep
them in order, put them in repair, or even what levers operate them. So
books must be written--books of directions.
If you can glibly recite the definition above, know and explain the
meaning of "mental life," describe "its phenomena and their conditions,"
illustrating from real life; if you can do this, and prove that
psychology is a science, _i. e._, an organized system of knowledge on
the workings of the mind--not mere speculation or plausible theory--then
you are a psychologist, and can make your own definitions. Indeed, the
test of the value of a course such as this should be your ability, at
its end, to tell clearly, in a few words of your own, what psychology
is.
The word _science_ comes from a Latin root, _scir_, the infinitive form,
_scire_, meaning to know. So a science is simply the accumulated, tested
knowledge, the proved group of facts about a subject, all that is known
of that subject to date. Hence, if psychology is a _science_, it is no
longer a thing of guesses or theories, but is a grouping of confirmed
facts about the mind, facts proved in the psychology laboratory even as
chemical facts are demonstrated in the chemical laboratory. Wherein
psychology departs from facts which can be proved by actual experience
or by accurate tests, it becomes metaphysics, and is beyond the realm of
science; for metaphysics deals with the realities of the supermind, or
the soul, and its relations to life, and death, and God. Physics,
chemistry, biology have all in their day been merely speculative. They
were bodies of theory which might prove true or might not. When they
_worked_, by actually being tried out, they became bodies of accepted
facts, and are today called sciences. In the same way the laws of the
working of the mind have been tested, and a body of assured facts about
it has taken its place with other sciences.
It must be admitted that no psychologist is willing to stop with the
_known_ and _proved_, but, when he has presented that, dips into the
fascinations of the yet unknown, and works with promising theory, which
tomorrow may prove to be science also. But we will first find what they
have verified, and make that the safe foundation for our own
understanding of ourselves and others.
What do we mean by "mental life"?--or, we might say, the science of the
life of the mind. And what is _mind_?
But let us start our quest by asking first what reasons we have for
being sure mind exists. We find the proof of it in consciousness,
although we shall learn later that the activities of the mind may at
times be unconscious. So where consciousness is, we know there is mind;
but where consciousness is not, we must find whether it has been, and is
only temporarily withdrawn, before we say "Mind is not here." And
_consciousness_ we might call _awareness_, or our personal recognition
of being--awareness of me, and thee, and it. So we recognize _mind_ by
its evidences of awareness, _i. e._, by the body's reaction to stimuli;
and we find mind at the very dawn of animal life.
Consciousness is evidenced in the protozoön, the simplest form in which
animal life is known to exist, by what we call its response to stimuli.
The protozoön has a limited power of self-movement, and will accept or
reject certain environments. But while we see that mind expresses itself
in consciousness as vague, as dubious as that of the protozoön, we find
it also as clear, as definite, as far reaching as that of the statesman,
the chemist, the philosopher. Hence, the "phenomena of mental life"
embrace the entire realms of feeling, knowing, willing--not of man
alone, but of all creatures.
In our study, however, we shall limit ourselves to the psychology of the
human mind, since that concerns us vitally as nurses. Animal psychology,
race psychology, comparative psychology are not within the realm of our
practical needs in hospital life. We would know the workings of man's
mind in disease and health. What are the instinctive responses to fear,
as shown by babies and children and primitive races? What are the normal
expressions of joy, of anger, or desire? What external conditions call
forth these evidences? What are the acquired responses to the things
which originally caused fear, or joy, or anger? How do grown-ups differ
in their reactions to the same stimuli? Why do they differ? Why does one
man walk firmly, with stern, set face, to meet danger? Why does another
quake and run? Why does a third man approach it with a swagger, face it
with a confident, reckless smile of defiance?
All these are legitimate questions for the psychologist. He will
approach the study of man's mind by finding how his body acts--that is,
by watching the phenomena of mental life--under various conditions; then
he will seek for the "why" of the action. For we can only conclude what
is in the mind of another by interpreting his expression of his thinking
and feeling. We cannot see within his mind. But experience with
ourselves and others has taught us that certain attitudes of body,
certain shades of countenance, certain gestures, tones of voice,
spontaneous or willed actions, represent anger or joy, impatience or
irritability, stern control or poise of mind. We realize that the
average man has learned to conceal his mental reactions from the casual
observer at will. But if we see him at an unguarded moment, we can very
often get a fair idea of his mental attitude. Through these outward
expressions we are able to judge to some extent of the phenomena of his
mental life. But let us list them from our own minds as they occur to us
this work-a-day moment, then, later on, find what elements go to make up
the present consciousness.
As I turn my thoughts inward at this instant I am aware of these mental
impressions passing in review:
You nurses for whom I am writing.
The hospitals you represent.
What you already know or do not know along these lines.
A child calling on the street some distance away.
A brilliant sunshine bringing out the sheen of the green grass.
The unmelodious call of a flicker in the pine-tree, and a towhee singing
in the distance.
A whistling wind bending the pines.
A desire to throw work aside and go for a long tramp.
A patient moving about overhead (she is supposed to be out for her walk,
and I'm wondering why she is not).
The face and voice of an old friend whom I was just now called from my
work to see.
The plan and details of my writing.
The face and gestures of my old psychology professor and the assembled
class engaged in a tangling metaphysic discussion.
A cramped position.
Some loose hair about my face distracting me.
An engagement at 7.30.
A sharp resolve to stop wool-gathering and finish this chapter.
And yet, until I stopped to examine my consciousness, I was keenly aware
_only_ of the thoughts on psychology I was trying to put on paper.
But how shall we classify these various contents?
Some are _emotion_, _i. e._, feelings; others are _intellect_, _i. e._,
thoughts; still others represent _determination_, _i. e._, volition or
will.
There is nothing in this varied consciousness that will not be included
in one or another of these headings. Let us group the contents for
ourselves.
The nurses for whom I am writing:
A result of memory and of imagination (both intellect). A sense of
kinship and interest in them (emotion). A determination that they must
have my best (will, volition).
And so of the hospitals:
My memory of hospitals I have known, and my mental picture of yours made
up from piecing together the memories of various ones, the recollection
of the feelings I had in them, etc. (intellect).
What you already know.
Speculation (intellect), the speculation based on my knowledge of other
schools (memory which is intellect). A desire (emotion) that all nurses
should know psychology.
Child calling on street.
Recognition of sound (intellect) and pleasant perception of his voice
(emotion).
Desire to throw work aside and go for a tramp on this gorgeous day.
Emotion, restrained by stronger emotion of interest in work at hand, and
_intellect_, which tells me that this is a work hour--and _will_, which
orders me to pay attention to duties at hand.
So all the phenomena of mental life are included in feelings, thoughts,
and volitions which accompany every minute of my waking life, and
probably invade secretly every second of my sleeping life.
The conditions of mental life--what are they?
1. In man and the higher animals the central nervous system, which,
anatomy teaches us, consists of the brain and spinal cord. (In the
lowest forms of animal life, a diffused nervous system located
throughout the protoplasm.)
2. An external world.
3. A peripheral nervous system connecting the central nervous system
with the outside world.
4. The sympathetic nervous system, provided to assure automatic workings
of the vital functions of the body. These organs of the mind will be
discussed in a later chapter.