OTHER TYPICAL CASES
Case VII. The ambitious woman discontented with her husband's ability.
In the American marriage relationship the woman makes the home and the
man makes the fortune. In some countries the wife is an active business
partner. This is notably true in France, among the Jews in Russia, and
many immigrant races in the United States. The wife may even take the
leadership if her superiority clearly shows up. Perhaps the American
method works well enough in a majority of cases, but there are superior
women yoked to inferior men who finally despair of their husband's
advancement, and who, as the phrase goes, ought to be "wearing the
trousers" themselves.
Mrs. D.J., thirty-nine years old, married fourteen years, two children,
had excellent health before marriage. Her family, originally poor, had
been characterized by great success. Her brothers occupy important
places in the business world and are wealthy. One of her sisters is
married to a man who is successful in law, and the other sister is an
executive in a department store.
Before marriage Mrs. J. was in her brother's business, and at the time
of her marriage earned a comfortable salary. She married a man who
inherited a small business, and when they married she was enthusiastic
over the prospects of this business. But unfortunately her husband never
followed her plans; he listened impatiently and went ahead in his own
way. As a result of his conservatism they had not advanced at all
financially. Though they were not poor as compared with the mass of
people, they were poor as compared with her brothers and brother-in-law.
In addition to the exasperation over her husband's attitude toward her
counsel (which was approved by her brothers), she developed a disrespect
for him, a feeling that he was to be a failure and a certain contempt
crept into her attitude. Against this she struggled, but as the time
went on the feeling became almost too strong to be disguised and caused
many quarrels. It is probable that if her own brothers and sisters had
not done so well her feeling toward her husband would not have reached
the proportions it did, for she became envious of the good things they
enjoyed and to a certain extent resented her sisters-in-law's attitude
toward her husband and herself as poor. The part futile jealousy and
envy play in life will not be underestimated by those who will candidly
view their own feelings when they hear of the success of those who are
near them. One of the reasons that ostentation and bragging are in such
disfavor is because of the unpleasant envy and jealousy they tend
involuntarily to arouse.
With disrespect came a distaste for sexual relations, and here was a
complicating factor of a decisive kind. She developed a disgust that
brought about hysterical symptoms and finally she took refuge in refusal
to live as a wife. This aroused her husband's anger and suspicions; he
accused her of infidelity and had her watched. The disunion proceeded to
the point of actual separation, and she then passed into an acute
nervous condition, marked by fear, restlessness, sleeplessness, and
fatigue.
The analysis of this patient's reactions was difficult and as much
surmised as acknowledged. With her breakdown her husband's affection
immediately revived and his solicitude and tenderness awoke her old
feeling, together with remorse for her attitude towards his lack of
business success. It was obvious to me in the few times I saw her that
she was working out her own salvation and that no one's assistance was
necessary after she understood herself. Intelligence is a prime
essential to cure in such cases,--an ignorant or unintelligent woman
with such reactions cannot be dealt with. Gradually her intelligence
took command, new resolves and purposes grew out of her illness, and it
may confidently be said that though she never will be a phlegmatic
observer of her husband's struggles she has conquered her old criticism
and hostility.
Case VII. The nondomestic type and the mother-in-law.
That there is a nondomestic type of woman to-day is due to the rise of
feminism and the fascination of industry. Where a woman has once been in
the swirl of business, has been part of an organization and has tasted
financial success, settling down may be possible, but is much more
difficult than to the woman of past generations. Such a woman probably
has never cooked a meal, or mended a stocking, or washed dishes,--and
she has been financially independent. For love of a man she gives all
this up, and even under the best of circumstances has her agonies of
doubt and rebellion.
Mrs. A. O'L. had added to these difficulties the mother-in-law question.
She was an orphan when she married, and was the private secretary of a
business man who because she was efficient and intelligent and loyal
gave her a good salary. She knew his affairs almost as well as he did
and was treated with deference by the entire organization.
She married at twenty-six a man entirely worthy of her love, a junior
official in a bank, looked on as a rising man, of excellent personal
habits and attractive physique. She resigned her position gladly and
went into the home he furnished, prepared to become a good wife and
mother.
Unfortunately there already was a woman in the house, Mr. O'L.'s mother.
She was a good lady, a widow, and had made her home with the son for
some years. She was a capable, efficient housewife, with a narrow range
of sympathies, and with no ambitions. There arose at once the almost
inevitable conflict between mother-in-law and daughter-in-law.
Some day perhaps we shall know just why the husband's mother and his
wife get along best under two roofs, though the husband's father
presents no great difficulties. Perhaps in the attachment of a mother to
a son there is something of jealousy, which is aroused against the other
woman; perhaps women are more fiercely critical of women than men are.
Perhaps the mother, if she has a good son, is apt to think no woman good
enough for him, and if she is not consulted in the choosing is apt to
feel resentment. Perhaps to be supplanted as mistress of the household
or to fear such supplantment is the basic factor. At any rate, the old
Chinese pictorial representation of trouble as "two women under one
roof" represents the state in most cases where mother-in-law and
daughter-in-law live together.
The senior Mrs. O'L. began a campaign of criticism against the younger
woman. There was enough to find fault with, since the wife was
absolutely inexperienced. But she was entirely new to hostile criticism,
and it impeded her learning. Furthermore, she was not inclined to try
all of the mother-in-law's suggestions; she had books which took
diametrically the opposite point of view in some matters. There were
some warm discussions between the ladies, and a spirit of rebellion took
possession of the wife. This was emphasized by the fact that she found
herself very lonely and longed secretly for the hum and stir of the
office; for the deference and the courtesy she had received there.
Further, the distracted husband, in his rôles of husband and son, found
himself displeasing both his wife and his mother. He tried to get the
girl to subordinate herself, since he knew that this would be impossible
for his mother. To this his wife acceded, but was greatly hurt in her
pride, felt somehow lowered, and became quite depressed. The house
seemed "like a prison with a cross old woman as a jailer", as she
expressed it.
Another factor of importance needs some space. The bridal year needs
seclusion, on account of a normal voluptuousness that attends it. No
outsider should witness the embraces and the kisses; no outsider should
be present to impede the tender talks and the outlet of feeling. It
sometimes happens that the elderly have a reaction against all
love-making; having outlived it they are disgusted thereby, they find it
animal like, though indeed it is the lyric poetry of life. So it was in
this case; the mother was a third party where three is more than a
crowd, and she was a critical, disgusted third party. The young woman
found herself taking a similar attitude to the love-making, found
herself inhibiting her emotions and had a furtive feeling of being spied
on.
The previously strong, energetic girl quickly broke down. Physical
strength and energy may come entirely from a united spirit; a disunited
spirit lowers the physical endurance remarkably. She became disloyal to
matrimony, rebelled against housework, and yet loved her husband
intensely. A prey to conflicting ideas and emotions, she fell into a
circular thinking and feeling, where depressed thoughts cannot be
dismissed and depressed energy follows depressed mood. Prominent in the
symptoms were headache, sleeplessness, etc., for which the neurologist
was consulted.
How to remedy this situation was to tax the wisdom of a Solomon. It
probably would have remained insoluble, had not the statement I made
that the main element in the difficulty was the mother-in-law _vs._
daughter-in-law situation come to the ears of the old lady.
Conscientious and well-meaning, that lady announced her determination to
take up her residence with a married daughter who already had a
well-organized household, and whose husband was a favorite of the
mother's. Despite the mother-in-law joke of the humorists, the
mother-in-law is far more friendly to a daughter's husband than to a
son's wife.
This solved part of my patient's problem. There remained the adjustment
to domestic life. This was hard, and though in part successful, it was
delayed by the sterility of the marriage. The husband and wife agreed
that pending a child she might well become active again in the larger
world. Though the best place would have been her old work, pride and
convention stood in the way, and so she entered upon more or less
amateurish social work. Finally, perhaps as an unconsciously humorous
compensation for her own troubles, she became an ardent and thoroughly
efficient secretary to a league of housewives that aimed at better
conditions. This work took up her time except for the supervising of a
servant, and this nondomestic arrangement worked well since she had no
children.
Case VIII. The childless, neglected woman.
It happened that two of the severest cases I have seen occurred, one in
a Jewish woman and the other in a young Irish woman, with such an
identity of symptoms and social domestic background that either case
might have been interchanged for the other without any appreciable
difference. The factors in the cases might simply be summarized as
childlessness, anxiety, neglect, and loneliness, and in each case the
main symptoms were anxiety, attacks of cardiac symptoms, fatigue, and
sleeplessness.
The young Jewish woman, thirty years of age, had been married since the
age of twenty. Before marriage she worked in the needle trades, was well
and strong and had no knowledge of any particular nervous or mental
disease in her family. She married a man of twenty-four, who had also
been in the tailoring business and had branched out in a small way in
business. This business required him to go to work at about seven-thirty
in the morning and he finished at nine-thirty in the evening. In the
earlier years of their marriage he came home rather promptly at the end
of his long day and the pair were quite happy.
At about the third year after marriage the woman became quite alarmed at
her continued sterility. She commenced to consult physicians and in the
course of the next three years underwent three operations with no
result. She began to brood over this, especially since about this time
her husband began to show a decided lack of interest in the home. He
would come home at twelve and later, and she found that he was playing
cards,--in fact had become a confirmed gambler. When she first
discovered this, she became greatly worried; made a trip to New York
where his people lived and induced them to bring pressure to bear on him
for reform. This they did, with the result that for about six months he
remained away from cards and gave more attention to his wife.
The reform lasted only for a short period and then the husband plunged
deeper into gaming than ever, and there were periods of three and four
days at a stretch when he would not return home at all. At such times
the lonely wife, who still loved her husband, fell into a perturbed and
agitated frame of mind, the worse because she confided her difficulties
to no one. When he would return, shamefaced and repentant, she would
reproach him bitterly and this would bring about renewed attention,
gifts, etc., for a week or so,--and then backsliding. Finally even the
brief spasmodic reforms grew less common, her reproaches were answered
hotly or listened to with indifference, and she became "practically a
widow" except for the occasions when the sexual feeling mastered them
both.
The neurosis in this case approached almost an insanity. The dwelling
alone, the desperate obsessive desire for a child to bring back his love
and attentions and to satisfy her own maternal instinct, the pain the
sight of happy couples with children gave her and which made her shun
other women and their company, the fear that her husband was unfaithful
(which fear was probably justified), and the lack of any fixed or
definite purpose, the lack of a great pride or self-sufficiency, brought
on symptoms that necessitated her removal to a sanitarium.
This of course pricked the conscience of her husband. He visited her
frequently, vowed a complete change, promised to bring his business to
the point where he would be able to come home at six, etc., etc.
Gradually she improved and finally made a partial recovery.
Whether or not the husband kept his promises I cannot say. On the
chances he did. Most confirmed gamblers, however, remain gamblers. The
lure of excitement is more potent to such men than a wife whose charm
has gone, through familiarity, through time itself, through the
inconstancy of passion and love. The gambler usually knows no duty; he
is kind and generous but only to please himself. He is easily bored and
his sympathies rarely stand the disagreeable long; he knows only one
_constant_ attraction,--Chance.
The other woman suffered in much the same way except that she was
fortunate enough finally to be deserted by her husband. This ended her
doubts and fears, broke her down for a short while, and then she went
back to industry. In this I have no doubt she found only an incomplete
satisfaction for her yearnings and desires, but she had something to
take up her time, and built up contacts with others in a way that was
impossible in her lonely home.
Case IX. The will to power through weakness; a case of hysteria in the
home.
This case is classic in the outspoken value of the symptoms to the
woman. It is not of course typical, except as the extreme is typical,
and that is what is usually meant, Roosevelt, we say, was a typical
American, meaning that he represented in extreme development a certain
type of man. So this case shows very clearly what is not so clear at
first in many cases of conflict between man and wife.
The woman in question was twenty-seven, of French-Canadian origin, but
thoroughly American in appearance and speech. She was of a middle-class
rural family and had married a farmer who finally had given up his farm
and was a mechanic in a small city.
The young woman had always been irritable, egoistic, and sensitive. As
a girl if anything happened to "shock her nerves", _i.e._ to displease
her, she fainted, vomited, or went into "hysterics." As a result her
family treated her with great caution and probably were well pleased
when she married off their hands and left the home.
Married life soon provided her with sufficient to displease her. Her
husband drank but not sufficiently to be classed as a heavy drinker. He
was a quiet, rather taciturn man, utterly averse to the pleasures for
which his wife longed. She wanted to go to dances, to take in the
theaters, to live in more expensive rooms, and especially she became
greatly attached to a group of people of a sporty type whom her husband
tersely called "tinhorn bluffs" and whom he refused to visit.
They quarreled vigorously and the quarrels always ended one way,--she
became sick in one way or other. This usually brought her husband around
to her way of thinking, at least for a time, and much against his will
he would go with her to her friends.
Finally, however, she set her heart on living with these people, and he
set his will firmly against hers. She then developed such an alarming
set of symptoms that after a while the physician who asked my opinion
had made up his mind that she had a brain tumor. She was paralyzed,
speechless, did not eat and seemed desperately ill.
The diagnosis of hysteria was established by the absence of any evidence
of organic disease and by the history of the case. The relief of
symptoms was brought about by means which I need not detail here, but
which essentially consisted in proving to the patient that no true
paralysis existed and in tricking her into movement and speech.
When she was well enough to be up and about and to talk freely, she and
her husband were both informed that the symptoms arose because her will
was thwarted, and _that_ part of their function was to bring the man to
his knees. He agreed to this, but she took offense and refused to come
any more to see me,--a not unnatural reaction.
The outlook in such a case is that the couple will live like cats and
dogs. Such a temperament as this woman's is inborn. She is essentially,
in the complete meaning of the word, unreasonable. Her nature demands a
sympathetic attention and consideration that her character does not
warrant. Throughout life she demands to receive but has no desire to
give. Nor is she powerful enough to take, so there arise emotional
crises with marked disturbance in bodily energy, and especially symptoms
that frighten the onlooker, such as paralyses, blindness, deafness,
fainting spells, etc. Whatever is the source of these symptoms, they are
frequently used to gain some end or purpose through the sympathy and
discomfort of others.
Not all hysteria, either in men or women, is united with such a
character as this woman's. Sufficient stress and strain may bring about
hysterical symptoms in a relatively normal person and short hysterical
reactions are common in the normal woman. The height of cynicism may be
found in the discovery that war causes hysteria in some men in much the
same way that matrimony causes hysteria in some women. A humorous review
of a paper on the domestic neuroses was entitled "Kitchen Shell Shock."
But severe hysteria, when it arises in the housewife, springs mainly
from her disposition and not from the kitchen.
Case X. The unfaithful husband.
Monogamous marriage is based upon the assumption that loyalty to a
single male is moral and possible. It is probable that in no age has
this agreement been loyally carried out by the husbands; it is probable
that in our own time the single standard of morals has first been
strongly emphasized. With the rise of women into equality one of the
important demands they have made is that men remain as loyal as
themselves. Therefore the reaction to unchastity or unfaithfulness on
the part of the man is apt to be more severe than in the past, on the
theory that where more is demanded failure in performance is felt the
keener.
The housewife, Mrs. F.C., aged thirty-five, is a prepossessing woman,
the mother of two children, and has been married for nine years. Her
health has always been fairly good, though in the last four years she
has been somewhat irritable. She attributed this to struggle to make
both ends meet, her husband being a workman with wages just over the
border line of sufficiency. They quarreled "no more than other couples
do", were as much in love "as other couples are", to use her phrases.
She was above her class in education, read what are usually called
advanced books, was "strong for suffrage", etc. However she was a good
housekeeper, devoted to her children and faithful to her husband. Their
sexual relations were normal and up till six months before I saw her she
thought herself a well-mated, rather fortunate woman.
Out of a clear sky came proof of long-continued unfaithfulness on the
part of her "domestic" husband: a chance bill for women's clothes
fluttered out of his pocket and under the bed, so that next morning she
found it; an unbelieving moment and then a visit to the address on the
bill, and proof plenty that he had been disloyal, not only to her but to
the children, who had been obliged to scrimp along while he helped
maintain another woman. Humiliated beyond measure by her disaster,
unable to endure her past memories of happiness and faith, with an
unstable world rocking before her, through the revelation that a quiet,
contented, loving man could be completely false, she found no adequate
reason for living and became a helpless prey to her troubled mind. "A
temporary unfaithfulness, a yielding to sudden temptation" she could
understand, but a determined plan of duplicity shattered her whole
scheme of values. A very severe psychoneurosis followed, and her
children and she were taken over by her parents and cared for.
Sleeplessness was so prominent in her case and so evidently the central
physical symptom that its control was difficult and required a regular
campaign for success. With sleep restored and the resumption of eating,
the most of her acute symptoms were passed, though a profound depression
remained.
Her husband, thoroughly abashed and ashamed, made furtive attempts at
reconciliation. These were absolutely rejected, and from her attitude it
was obvious that no reconciliation was possible. "Had he not been found
out," said the wife, "he would still be living with her. I can never
trust him again; I would die before I lived with him."
Little by little her pride recovered, for in such cases the deepest
wound is to the ego, the self-valuation. The deepest effort of life is
to increase that valuation by increasing its power and its respect by
others; the keenest hurt comes with the lowering of the valuation of
one's own personality. A woman gives herself to a man, without lowering
a self-feeling if he is tender and faithful; if he holds her cheap, as
by flagrant disloyalty, then her surrender is her most painful of
memories.
With the recovery of pride came the restoration of her interest in her
children, and her purposes reshaped themselves into definite plans. Part
of the process in readjustment in any disordered life is to centralize
the dispersed purposes, to redirect the life energies. She agreed that
she would accept aid from the husband, as his duty, but only for the
children. For herself, as soon as the children were a year or so older,
she would go back to industry and become self-supporting. Her plans
made, her recovery proceeded to a firm basis, and I have no doubt as to
its permanence. Nevertheless, life has changed its complexion for her,
and there will be many moments of agony. These are inevitable and part
of the recovery process.
I shall not attempt to settle the larger problem of whether she should
have forgiven her husband and returned to him. Granting that his
repentance was genuine, granting that no further lapse would occur, she
would never be able to forget that when he deceived her he had _acted_
the part of a devoted husband. She would never be able fully to trust
him, and this would spoil their married happiness entirely. "For the
children's sake," cry some readers; well, that is the only strong
argument for return. But on the whole it seems to me that an honest
separation, an honest revolt of a proud woman is better than a dishonest
reunion, or a "patient Griselda" acceptance of gross wrong.
Case XI. The unfaithful wife.
In such cases as the preceding and the one now to be detailed, the
difficulties of the physician are multiplied by his entrance into
ethics. Ordinarily medicine has nothing to do with morals; to the doctor
saint and sinner are alike, and the only immorality is not to follow
orders. To do one's duty as a doctor, with one's sole aim the physical
health of the patient, may mean to advise what runs counter to the
present-day code of morals. This is the true "Doctor's Dilemma." In
such cases discretion is the safest reaction, and discretion bids the
physician say, "Call in some one else on that matter; I am only a
doctor."
A true neurologist must regard himself as something more than a
physician. He needs be a good preacher, an astute man of the world, as
well as something of a lawyer. The patient expects counsel of an
intimate kind, expects aid in the most difficult situations, viz., the
conflicts of health and ethics.
Mrs. A.R., thirty-one years of age and very attractive, has been married
since the age of eighteen. She has two children, and her husband, ten
years her senior, is a man of whose character she says, "Every one
thinks he is perfect." A little overstaid and over dignified, inclined
to be pompous and didactic, he is kind-hearted and loyal, and successful
in a small business. He is an immigrant Swiss and she is American born,
of Swiss parentage.
Always romantic, Mrs. A.R. became greatly dissatisfied with her home
life. At times the whole scheme of things, matrimony, settled life, got
on her nerves so that she wanted to scream. She was bored, and it seemed
to her that soon she would be old without ever having really lived. "I
married before I had any fun, and I haven't had any fun since I married
except"--Except for the incident that broke down her health by swinging
her into mental channels that made her long for the quiet domesticity
against which she had so rebelled. Her daydreaming was erotic, but
romantically so, not realistic.
There are in the community adventurers of both sexes whose main interest
in life is the conquest of some woman or man. The male sex adventurers
are of two main groups, a crude group whose object is frank possession
and a group best called sex-connoisseurs, who seek victims among the
married or the hitherto virtuous; who plan a campaign leisurely and to
whom possession must be preceded by difficulties. Frequently these
gentry have been crude, but as satiation comes on a new excitement is
sought in the invasion of other men's homes. Undoubtedly they have a
philosophy of life that justifies them.
Since this is not a novel we may omit the method by which one of these
men found his way to the secret desires of our patient, and how he
proceeded to develop her dissatisfaction into momentary physical
disloyalty. She came out of her dereliction dazed; could it be she who
had done this, who had descended into the vilest degradation? She broke
off all relations with the man, probably much to his surprise and
disgust, and plunged into a self-accusatory internal debate that brought
about a profound neurasthenia.
Naturally she did not of her own accord speak of her
unfaithfulness,--largely because no one knew of it. Her husband did not
in the least suspect her; he thought she needed a rest, a change, little
realizing how "change" had broken her down. (For after all, the most of
infidelity is based on a sort of curiosity, a seeking of a new stimulus,
rather than true passion.) The truth was forced out of her when it was
evident to me that something was obsessing her.
When she had confessed her difficulty the question arose as to her
husband. She was no longer dissatisfied, no longer eager for romance;
but could she live with him if she had been unfaithful? Ought she not to
tell him; and yet she feared to do this, feared the result to him, for
she felt sure he would forgive her. In reality the conflict in her mind
arose first from self-depreciation and second from indecision as to
confession.
As to the self-accusation, I told her that though she had been very
foolish she had punished herself severely enough; that her reaction was
that of an _essentially moral_ person; that an essentially immoral woman
would have continued in her career, and at least would not have been so
remorseful. As to confessing, I told her that I believed that if she
came to peace without such a confession wisdom would dictate not to make
it, and that perhaps a little romanticism was still present in the
quixotic idea of confession. Discretion is sometimes the better part of
veracity, and I felt sure that she would not find it difficult to forget
her pain.
It may be questioned whether such advice was ethical. I am sure no two
professors of ethics could agree on the matter, and where they would
disagree I chose the policy of expediency. Moreover, I felt certain that
Mrs. R.'s remorse did not need the purge of confession to her husband,
that she was not of that deeply fixed nature which requires heroic
measures. Her confession to me was sufficient, and since it was apparent
that she would not repeat her folly it was not necessary to go to
extremes.
The last two cases make pertinent some further remarks on sex. It has
previously been stated that the sex field is the one in which arise many
of the difficulties which breed the psychoneuroses. It would not be the
place here to give details of cases, though every neurologist of
experience is well aware of the neuroses that arise in marriage, among
both men and women. Some day society will reach the plane where matters
relating to the great function by which the world is perpetuated can be
discussed with the freedom allowed to the discussion of the details of
nutrition.
No one seriously doubts that women are breaking away from traditional
ideas in these matters. There was a time (the Victorian Age) in the
United States and England when prudery ruled supreme in the manners and
dress of women. That this has largely disappeared is a good thing, but
whether there is a tendency to another extreme is a matter where
division of opinion will occur. A transition from long skirts to dress
that will permit complete freedom of movement and resembling in a
feminine way the garments of men would be unqualifiedly good. It would
remove undue emphasis of sex and accentuate the essential human-ness of
woman. But a transition from long skirts to short tight ones, impeding
movement, is the transition from prudery to pruriency and is by no means
a clear gain. Plenty of scope for art and beauty might be found in a
costume of which pantalettes of some kind are the basis. I doubt if
women will ever be regarded quite as human beings so long as they paint,
wear fantastic coiffures, hobble along on foolish heels, and are clad in
over tight short skirts.
Similarly with the literature of the period. The so-called sex story,
the sex problem, obsesses the writers. Nor are these frank, free
discussions of the essential difficulties in the relation between man
and woman. Usually the stories deal with the difficulties of the idle
rich woman without children, or concern themselves with trivial
triangles. In the type of interminable continued stories that every
newspaper now carries, the woman's difficulties range around the most
absurd petty jealousies, and she never seems to cook or sew or have any
responsibility, and they always end so "sweetly." On the stage the
epidemic of girl and music shows has quite displaced the drama. Here sex
is exploited to the point of the risque and sometimes beyond it.
Sex is overemphasized by our civilization on its distracting side, its
spicy and condimental values, and underemphasized so far as its
realities go. The aim seems to be to titillate sex feeling constantly,
and a precocious acquaintance with this form of stimulation is the lot
of most city children. Such things would have no serious results to the
housewife if they did not arouse expectations that marriage does not
fulfill at all. This is the great harm of prurient clothes, literature,
art, and stage,--it unfits people for sex reality.
In how far the delayed marriages of men and women are good or bad it is
almost impossible to decide. That unchastity increases with delay is a
certainty, that fewer children are born is without doubt. Whether the
fixation of habit makes it harder for the wife to settle down to the
household, and the man less domestic, cannot be answered with yes or
no. There seems to be no greater wisdom of choice shown in mature than
in early marriages, though this would be best answered by an analysis of
divorce records.
That contraceptive measures have come to stay; that they are increasing
in use, the declining birth rate absolutely evidences. I take no stock
in the belief that education reduces fertility through some biological
effect; where it reduces fertility it does so through a knowledge of
cause, effect, and prevention. Some day it will come to pass that
contraceptive measures will be legal, in view of the fact that our
jurists and law makers are showing a decline in the size of their own
families. When that time comes the discussion of means of this kind
consistent with nervous health will be frank, and some part of the
neurasthenia of our modern times will disappear. The vaster racial
problems that will arise are not material for discussion in this book.
Though not perhaps completely relevant to the nervousness of the
housewife, it is not without some point to touch on the "neurosis of the
engaged." The freedom of the engaged couple is part of the emancipation
of youth in our time. Frankly, a love-making ensues that stops just
short of the ultimate relationship, an excitement and a tension are
aroused and perpetuated through the frequent and protracted meetings.
Sweet as this period of life is, in many cases it brings about a mild
exhaustion, and in other cases, relatively few, a severe neurosis. On
the whole the engagement period of the average American couple is not a
good preparation for matrimony. How to bring about restraint without
interfering with normal love-making is not an easy decision to make. But
it would be possible to introduce into the teaching of hygiene the
necessity of moderation in the engaged period; it would be especially of
service to those whose engagement must be prolonged to be advised
concerning the matter. Here is a place for the parents, the family
friend, or the family physician.
Men and women as they enter matrimony are only occasionally equipped
with real knowledge as to the physiology and psychology of the sex life.
That a great deal of domestic dissatisfaction and unhappiness could be
obviated if wisdom and experience instructed the husband and wife in
the matter I have not the slightest doubt. The first rift in the
domestic lute often dates from difficulties in the intimate life of the
pair, difficulties that need not exist if there were knowledge. That
reason and love may coexist, that the beauty of life is not dependent on
a sentimentalized ignorance are cardinal in my code of beliefs. He who
believes that sentiment disappears with enlightenment is the true cynic,
the true pessimist. He who believes that intelligence and knowledge
should guide instinct and that happiness is thus more certain is better
than an optimist; he is a rationalist, a realist.