NEUROSIS AND HEREDITY
The following discussion in the form of questions and answers may
prove of interest to the physician and to the intelligent layman.
The discussion occurred in the course of correspondence. A friend
of mine thought the subject of sufficient importance to have it
brought to the attention of the cultured public.
The questions are as follows:
“Are not all neuropathic conditions the results of a morbid,
unstable nervous organism, the basis of which lies in a faulty
heredity?
“Are not weak nerves the cause of hysterical, neurasthenic and
neuropathic affections in general?
“Is not all neurosis due to defective parent stock?
“If the occasions for fear, as some psychopathologists claim, were
more frequent in primitive times than now, then the cave men must
have had more psychopathic affections than civilized man.”
To these questions the following answers are given:
Psychopathic diseases are not hereditary--they are _acquired_
characteristics, having their origin in the abnormal, hypertrophied
growth of the fear instinct which is at the root of the primal
impulse of self-preservation. This is proved by psychopathological
studies of clinical cases; and it can be further demonstrated by
experimental work in the laboratory even in the case of animals.
“Weak nerves,” “a run down, exhausted nervous system,” whatever
the terms may mean, may overlap psychopathic conditions, but the
two are by no means equivalent, much less identical. Psychopathic,
psychoneurotic states are not “weak nerves” or “fatigued nerves.”
Above all, there is no need to obscure the matter and resort to the
much abused, mystical and mystifying factor of heredity. It is easy
to shift all blame on former generations, when, in most cases, the
fault is close at hand, namely, a debased environment, a defective
training, and a vicious education.
There is good reason to believe that primitive man had a far
greater tendency to dissociation, to subconscious psychopathic
states than modern man. Even the Middle Ages teem with psychopathic
mental epidemics of the most puerile type. In the course of
evolution, social and individual, this neurotic, psychopathic
tendency has gradually diminished, but has never been completely
eliminated. Increase of knowledge, better education, the increase
of social safeguards, sanitary and hygienic conditions with
consequent increase of safety from dangers, have all helped
materially in decreasing the occasions for the cultivation of the
fear instinct.
Under the rigorous conditions of primitive life individuals who
have been unfortunate and have become affected with mental troubles
and emotional afflictions of the fear instinct are mercilessly
exterminated by the process of tribal and social selection. Each
generation weeds out the individuals who have been unfortunate
enough to fall under unfavorable circumstances and have become
mentally sick, suffering from acquired psychopathic disturbances.
In primitive life the crippled, the maimed, the wounded, the sick
fall by the way, and are left to perish a miserable death. In fact,
the less fortunate, the wounded and the stricken in the battle of
life, are attacked by their own companions,--they are destroyed by
the ruthless, social brute. The gregarious brute has no sympathy
with the pains and sufferings of the injured and the wounded. The
faint and the ailing are destroyed by the herd.
Civilization, on the other hand, tends more and more towards the
preservation of psychopathic individuals. We no longer kill our
sick and our weak, nor do we abandon them to a miserable, painful
death,--we take care of them, and cure them. Moreover, we prevent
pathogenic factors from exercising a harmful, malign social
selection of the “fit.” We do our best to free ourselves from the
blind, merciless, purposeless selection, produced by pathogenic
micro-organisms and by other noxious agencies. We learn to improve
the external environment.
We do not condemn people to death because they are infected with
smallpox, typhus, typhoid bacilli, or because of an infected
appendix. We no longer regard them as sinful, unclean, accursed,
and tabooed. We vaccinate, inoculate, operate, and attempt to cure
them. By sanitary and prophylactic measures we attempt to prevent
the very occurrence of epidemics. Our valuation of individuals is
along lines widely different from those of the stone age and cave
man. We value a Pascal, a Galileo, a Newton, a Darwin, a Pasteur,
and a Helmholtz far above a Milo of Croton or an African Johnson.
Civilization is in need of refined, delicate and sensitive
organizations, just as it is in need of galvanometers,
chronometers, telephones, wireless apparatuses, and various
chemical reagents of a highly delicate character. We are beginning
to appreciate delicate mechanisms and sensitive organizations.
We shall also learn to train and guard our sensitive natures
until they are strong and resistant to the incident forces of an
unfavorable environment. The recognition, the diagnosis, and the
preservation of psychopathic individuals account for the apparent
increase of neurotics in civilized communities.
It may be well to add that, although occasions for sudden, intense,
overwhelming fears are not so prevalent in civilized societies
as they are in primitive savage communities, the worries, the
anxieties, the various forms of slow grinding fears of a vague,
marginal, subconscious character present in commercial and
industrial nations, are even more effective in the production of
psychopathic states than are the isolated occasions of intense
frights in the primitive man of the paleolithic or neolithic
periods.