SEXUAL BASIS OF NERVOUS DISORDERS
Nervous disorders are so widely prevalent in the life of modern woman
that any serious attempt to throw light upon the subject is of decided
service to the cause of health.
Within comparatively recent years there has been a growing tendency in
various therapeutic circles to emphasize the relationship of nervous
disturbances to the sexual sphere. Freud, the Viennese psychoanalyst,
is probably more responsible than any other individual for this
trend. However, the policy of recognizing the sexual basis of nervous
disorders is not now by any means restricted to the Freudians, or
even the dissenting schools of psychoanalysis. All psychiatrists,
neurologists, and the medical profession generally, are coming more and
more to a realization of the potency of sex in starting off all sorts
of nervous ills.
Of course, it is not contended by the present writer that every case of
nervous disorder has its roots in sex; nor that there are not sometimes
other contributing factors involved. The human organism is so complex,
and the interrelations of its component parts are so marked, that it
is often exceedingly difficult to find the precise cause of a given
group of symptoms.
The conception of woman as a mysterious, sexually anesthetic being is
now largely a thing of the past. As Dr. Phyllis Blanchard remarks in
_The Adolescent Girl_: “One of the most tantalizing problems is woman,
because she has remained a baffling mystery, as shown by the folklore
and literature of every people at every level of culture, in spite
of her intimate relationship to man and the commonplaceness of her
existence. In the attempt man has made to fathom her soul, she has been
deified or endowed with demonic powers as the case may be.”
Now that woman has jumped off the pedestal (which in theory only man
had erected for her), and refuses to be classified as a demonic being
in her contrary moments and moods, we are free to consider her case
rationally and scientifically as that of a genuine human being.
SEX FACTORS IN ADOLESCENCE
The yearning and stress incident to the awakening of the sexual life of
the girl at puberty have very far-reaching effects, although normally
there is less concentration upon the genital zone than is the case
with the boy. But on account of the very fact of the lack of this
concentration, there is a wider distribution of the emotional reactions.
In general, the sexual impulse in the young girl manifests itself in
the form of reverie, hazy sensations, with presentiments that are apt
to lead to melancholy moods. If circumstances bring her in contact with
sexually experienced female friends, or other ardently erotic stimuli,
the sexual impulse may be transformed into a hectic flame.
Any sort of emotional outlet that lies at hand may be grasped at the
time of this upwelling of strange and conflicting forces. In former
times the objective emotional interests were found principally in
religion, poetry, music and esthetics. The religious zeal of the
young woman at the adolescent period was formerly a very commonplace
thing. It was something to which rich and poor alike had recourse to;
whereas the girl of poor family was denied the opportunity for finding
an emotional outlet in music, esthetics or poetry (her drab, prosaic
surroundings precluded the latter no less than music and beauty.)
Nowadays, young women are actively identified with every phase of
life--commercial, industrial, and otherwise, that offer opportunities
for emotional outlet that were formerly undreamed of. In addition to
these, of course, there is also the great personal freedom which girls
and young women now enjoy and naturally, sometimes abuse.
The love of early youth, Krafft-Ebing remarked, has a romantic,
idealizing tendency. In its first manifestations it is platonic,
and willingly exercises itself in poetry and history. But as the
sensibility awakens, the danger arises that this passion with its
idealizing power, will be transferred to persons of the opposite sex
who in intellectual, physical and social relations are by no means
all that could be wished, hence proceed misalliances, elopements and
seductions, with the entire tragedy of impassioned love, which conflict
with the dictates of morality and convention, and sometimes finds its
bitter end in suicide or a double self-destruction. Love in which the
senses play too prominent a part can never be a true and lasting love.
For this reason, first-love is as a rule very transitory, since it is
in most cases no more than the first flare of passion. Platonic love
is a thing without existence, a self-deception, a false description of
sexual sensations.
Bebel found that the number of suicides among women of the ages of
sixteen to twenty-one years is an exceptionally large one, and he
attributes this chiefly to unsatisfied sexual impulse, unfortunate
love, secret pregnancy, and to betrayal by men.
Sexual emotion, tension or preparedness, as Dr. Frink has pointed out,
is less dependent on external conditions than are the other normal
emotions. We do not feel continual normal anger or fear unless we are
continuously subject to an external danger. But sexual tension, or
preparedness, may arise in the absence of any external stimulation, and
tends to persist until temporarily relieved by some suitable action, of
which coitus, in the adult, is normally the most satisfactory.
Thus, in the absence of actions adequate in quality or in frequency to
discharge the tension, there may come about a state of organic sexual
preparedness which is chronic--even though the individual is not
continuously aware of sexual desire. In other words, a lack of adequate
sexual outlet may result in the accumulation in the blood of abnormal
quantities of thyroid secretion and perhaps, sugar, adrenin, and
other substances which constitute also an important part of the state
of preparedness for non-sexual exertion, such as attack or flight,
and this very likely is accompanied by corresponding changes in the
sympathetic nervous system.
DISORDERS DUE TO ABSTINENCE
Whereas in youth, abstinence is more easily borne by woman than man, at
full maturity woman’s sexual urge, as unconsciously manifested, if not,
indeed, consciously--when not adequately gratified--may be quite as
insistent as in man.
Nystrom states that abstinence has often as severe an effect upon woman
as upon man, although some difference occurs in the manifestations,
because of the difference in the physiological organization of the two
sexes.
The consequences of prolonged self-denial, especially in women whose
sexual desire has been thoroughly aroused by erotic experience, are
much the same as in men. They show the same symptoms of functional
disturbance, embracing a wide range of disorders.
The most common disturbances due to abstinence are chlorosis (a form
of anemia), “female diseases,” nervousness in its many phases, cramps,
hysterics with a tendency to alternate laughing and crying, hilarity
and sadness, insomnia, hallucinations, mental disorders, etc.
Professor Erb, who has made important investigations in this domain,
is under the impression that the health of many young women of
good breeding and exemplary morals has suffered from abstinence.
He considers that undoubtedly innumerable older, single women of
refinement and education become sick or ailing from abstinence.
A number of married women who had been neglected by their husbands, and
widows, have told him that they suffered severely from their enforced
continence, and most of them became neurasthenic and hysterical. Nerve
specialists generally, who so often come across these cases, have
reported the same experience.
Numerous young, healthy, normal women related to Erb how, from the
mid-twenties, they have become ill from semi-conscious sexual desires
and ungratified craving for love, have experienced sexual fancies and
hallucinations, melancholy and “female diseases,” etc.
Of course, there is a considerable number of women who are sexually
anesthetic, or frigid, and appear to have no primary sexual feeling
whatever. In true cases of this kind, they never experience the
sexual urge, even after having borne children. Their genital organs
are so insensible to feeling that they do not respond to artificial
irritation, such as electricity, etc.
It is generally believed by sexologists and gynecologists, however,
that a considerable proportion of cases of so-called frigidity is not
organic or constitutional, but are due to long-established repression,
fear of pregnancy and false, prudish ideas of sex--considering
it “nasty.” They are the victims of miseducation. Another not
inconsiderable number has been improperly initiated by a blundering
husband. Their first sexual experiences were rude, brutal awakenings
which so revolted them that it established a chronic feeling of
antipathy, or at best apathy, toward the sexual function. Some women
never overcome this attitude, implanted by an ignorant or inconsiderate
husband. In others, under the influence of love and kindness, and
with the later acquisition of insight into sexual problems, there is
gradually established the normal sexual feeling.
Dr. Hegerisch has written: “Although I agree with Malthus in
appreciation of womanly virtue, I must as a physician express as my
opinion that the chastity (abstinence) of woman nevertheless is a
crime against nature, and often is followed by serious functional
disturbances and symptoms of diseases.”
Practically all the leading authorities in this field have supplemented
their general comments by citing numerous cases, showing specifically
the results of abstinence in normal, sexually mature women.
Occasionally, of course, we find brilliant, intellectual women living
an active, productive life without apparently suffering from sexual
abstinence.
Then there is another type of woman, full of energy, some of which is
possibly transferred from the sexual goal, who interests herself in,
or more literally throws herself into, various movements and organized
activities, sometimes with remarkable constructive and consistent
results, and at other times merely as a means of “expressing herself,”
without capacity for co-operation or tolerance for the ideas of others
who show a dissenting opinion.
NEURASTHENIA
Freud makes the astounding statement that in a normally constituted sex
life no neurosis is possible.
This is based on a vast experience in the realm of nervous and mental
disorders. It is not my purpose to defend this opinion _in toto_, but
to offer it as the thoughtful observation of the world’s foremost
medical psycho-neurologist.
If it has even a seventy-five per cent basis of fact to sustain it, it
is still a remarkably striking recognition of the potency of sex in
dominating our lives, even when we are not aware of the force that is
tossing us hither and yon.
It must not be assumed that this statement of the influence of the
sexual libido on the individual refers exclusively, or even in a major
respect, to the present status of the person’s sex life. It includes
the entire range of sexual history of the individual, meaning every sex
impulse, thought, act and experience, either in relation to another or
others, or purely autosexual acts and experiences.
If the individual sex history (from infancy) has been sound and
healthy, if fate has interposed no deleterious experiences, and, of
course, if heredity has been kind and generous, then there is the
foundation for a healthy sexual constitution.
Assuming that this brings us up to the portal of adulthood, in the
present case, _womanhood_--there follows the obligation to lead a sex
life that is in harmony with the normal impulses and at the same time
with the ideals.
If the ideals are irrational, or if difficulties intervene and prevent
the living of a sane sex life, even then upon the good foundation
of sexual health, there may develop neurasthenic flaws in the
superstructure of sexual disharmony.
In his classification of the neurasthenic symptom-complex, Freud
maintains that the cause of attacks of anxiety-neurosis is very
frequently to be found in a number of injurious influences in the
sphere of sexual life. In women, these anxiety-neuroses occur:
1. As virginal anxiety, or anxiety of adolescents. This authority
has observed a number of unequivocal instances showing that a first
encounter with the sexual problem, a rather sudden unveiling of what
has hitherto been concealed, as, for instance, the sight of some sexual
object or act, or something read or heard in conversation, may, in a
girl at the time of puberty, give rise to an anxiety-neurosis, which is
in a very typical manner combined with hysteria.
(This is an excellent argument for the proper enlightenment of young
people regarding the nature of sex and what the continuance of the race
implies. They have to find out sooner or later, and if the subject is
treated by parents in a matter of fact manner, these vital facts of
life are gradually and unobtrusively absorbed, without alarm, shock or
stimulation.)
2. As anxiety of the newly married. Young wives who have been without
sexual feeling in their first experience are not infrequently attacked
by an anxiety-neurosis, which, however, disappears as soon as the
sexual feeling becomes normal. Since, indeed, the majority of young
women who lack sexual feeling in their first experience of sexual
intercourse remain nevertheless quite healthy, it is evident that some
other cause must co-operate in arousing the anxiety-neurosis.
3. An anxiety in married women whose husbands suffer from _ejaculatio
praecox_ (premature ejaculation) or from great diminution of sexual
potency, or
4. Whose husbands practice _coitus interruptus_, or _coitus
reservatus_. Cases in these two classes are closely associated, since
it is easy to ascertain from the analysis of a sufficiently large
number of cases that the really important question is, whether during
coitus the wife obtains or fails to obtain sexual satisfaction. In the
latter event, the condition requisite to arouse the anxiety-neurosis is
supplied.
5. As anxiety in the climacteric period, during the termination of the
reproductive life, which frequently involves a flare-up of passion.
Various anomalies of the genital organs which give rise in the virgin
to no trouble whatever, display their influence during maturity
by unfavorably affecting the nervous system. Thus, in cases of
malformation of the external organs of reproduction, imperforation of
the vaginal canal, a rudimentary condition of the vagina, rigid hymen,
or local disturbances in the vagina, it is only when sexual intercourse
begins that neuroses or hystero-neurasthenic troubles ensue.
In a paper setting forth his views on the etiology of the neuroses,
Freud states: “I was above all surprised in the frequency of coarse
disturbances in the sexual life of patients. The more I was in quest
of disturbances, during which I remembered that all men conceal the
truth in things sexual, and the more skilful I became in continuing the
examination despite the incipient negation, the more regularly such
disease-forming moments were discovered in the sexual life, until it
seemed to me that they were but little short of universal.”
It was Freud’s particular experience in this field, even comparatively
early in life which led him to the conclusion that “in a normal sex
life no neurosis is possible.”
Years after he originally made this statement, he was confirmed in its
correctness, although he had passed a good way beyond his former point
of view in his opinions concerning the relation of sexual traumas to
health in general. This gave him a deeper insight into the problems of
sex in their universal application.
For instance, by chance his former material furnished him with a great
number of cases of infantile histories in which sexual seduction by
grown-up persons or older children played the main role. He therefore
over-emphasized the frequency of these occurrences (otherwise not
to be doubted), the more so because he was then in no position to
distinguish definitely the _deceptive memories_ of hysterical patients,
whereas he subsequently learned to explain many a seduction fancy as a
defense against the reminiscence of the patient’s own sexual activity
(infantile masturbation).
“The emphasis laid on the ‘traumatic’ (wounding) element of the
infantile sexual experience disappeared with this explanation, and
it remained obvious that the infantile sexual activities (be they
spontaneous or provoked), _dictated the course of the later sexual life
after maturity_.”
Of course, there is an almost immeasurably wide range of variations
in the psychic and nervous constitution of individuals--ranging for
our present purpose--from the ultra-sensitive to those of extremely
low sensibility. Those persons of the former type, being most
_impressionable_, are more readily influenced by psychic traumas or
soul wounds at any time of life.
The opposite types (the “tough-minded” of William James’
classification), are less susceptible to psychic wounds and hurts, and
therefore do not so readily become victims of the various neuroses.
No group of human beings, however, is exempt from the possibility
of neurasthenic troubles, if conditions are favorable for their
development.
And no ground is so propitious a breeding place for these disturbances
as the fertile soil of sex under the highly artificial development of
modern civilization, and the confusing ideas that prevail upon the
vital question of sex ethics.
Transcriber’s Note:
Text that was in italics is enclosed by underscores (_italics_).
Text that was in bold is enclosed by equals sins (=bold=).
- Inconsistencies in hyphenation have been standardized.
- Minor punctuation errors have been changed without notice.
- The “table for calculating the date of confinement” originally
spanned across pp. 26-27 horizontally. This could not be recreated in
the .txt file, so it was split between two pages and moved to the end
of the paragraph.
- Spelling was retained as in the original except for the following
changes:
Page 4: “presence of abnormal erotism” to “presence of abnormal
eroticism”
Page 5: “over the calibre or” to “over the calibre of”
Page 8: “lost in the magnificant” to “lost in the magnificent”
Page 10: “Deutschlands litt und rel. Verhaltn in Reformations zeit” to
“Deutschlands lit. u. relig. Verhältnisse im Reformationszeitalter”
Page 18: “the first menstruation occuring” to “the first menstruation
occurring”
Page 25: “days, one way of the other” to “days, one way or the other”
Page 25: “demands of the embyro” to “demands of the embryo”
Page 27: “22 22 24” under “Jan.” to “22 23 24”
Page 30: “Indian book of _Susruta_” to “Indian book of _Suśruta_”
Page 31: “and in the rigid” to “and in the frigid”
Page 32: “well-to-do, whose modes” to “well-to-do, whose mode”
Page 37: “the head, epileptic paroxyms” to “the head, epileptic
paroxysms”
Page 39: “of the household, Clauston” to “of the household, Clouston”
Page 42: “and of the metabulism” to “and of the metabolism”
Page 42: “after effects of childb-irth” to “after effects of
childbirth”
Page 45: “has been, the moral” to “has been, the more”
Page 47: “researches of Andral and Gavaret” to “researches of Andral
and Gavarret”
Page 49: “at late as 57” to “as late as 57”
Page 50: “this condition. Edgar Selwin’s” to “this condition. Edgar
Selwyn’s”
Page 51: “concurred. Her husband has” to “concurred. Her husband had”
Page 51: “brightly as in the heydey” to “brightly as in the heyday”
Page 56: “proceed misalliances, elopments” to “proceed misalliances,
elopements”
Page 62: “suffer from _ejaculatio precox_” to “suffer from _ejaculatio
praecox_”