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 {20} 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 {21} 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, {22} 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 {23} 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 {24} 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 {25} 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, {26} 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 {27} 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 {28} 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 {29} 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, {30} 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 {31} 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 {32} 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 {33} 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 {34} 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 {35} 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 {36} 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 {37} 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 {38} 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 {39} 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 {40} 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 {41} 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.
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