Psychopathology

Front matter

YALE MEDICAL LIBRARY

HISTORICAL LIBRARY

PSYGHOPATHOLOGY

Preface

This book has been written for the professional student of human behavior who must have an unprejudiced insight into human nature in order to deal justly and intelligently with problems of abnormal behavior as they are brought to the physician, rectory, police courts, prisons and asylums, and the directors of schools and colleges, and the commanders of military and naval organizations.

In order to avoid speculation and theorizing, most of the space is devoted to plain expositions of the actual difficulties of cases. They are presented to speak for themselves. Naturally an enormous amount of valuable data on delusions, hallucinations, symbols, symptoms, defensive and compensatory methods of thinking, different types of inferiorities and causes of inferiorities, etc., is scattered through these cases. The most important illustrations have been collected together in the index to be readily accessible to the reader. For this tedious, difficult work I am especially indebted to Mrs. Kempf. The index has greatly increased the usefulness of the book.

Most of the case material has been taken from the cases admitted to St. Elizabeths Hospital, and for this privilege I am indebted to Dr. W. A. White, superintendent of the institution. I am also indebted to Prof. Adolf Meyer for the privilege of using some case material I worked out while assisting him at The Phipps Psychiatric Clinic in Baltimore. The members of the staff of St. Elizabeths Hospital assisted me materially in collecting the more interesting cases ami I wish to thank especially Drs. Mary O'Malley, Anita Wilson Harper, Helen Clarke Kempf, Lieut. Col. Paul Freeman, U. S. A., M. C, and Dr. James C. Hassell for collecting interesting observations on the wards which would otherwise have been lost. I wish also to thank Miss Clara Willard and Mrs. Kempf for correcting and editing the manuscript and Mr. Edward Clements for his patience and kindness in typewriting it.

Edward J. Kempf.

St. Elizabeths Hospital, Washington, D. C.

vii

CHAPTER I The Physiological Foundations of the Personality 20

Tlie Autonomic Apparatus, 21; The Projicient Apparatus, 21; Peripheral Origin of Cravings (emotions, wishes, sentiments) in Different Segments of the Autonomic Apparatus, 21 ; Mechanism of Postural Tensions, 21 ; The Influence of the Autonomic-Affcctivc Cravings on Postural Tensions and Kinaesthetic Sensations, 22; The Mechanism of Conflict between Segmental Cravings anil between Segmental Cravings and the Ego, 28; The Value of the Projicient Apparatus to the Autonomic Apparatus, 29; The Nature of Consciousness and the Content of Consciousness, 31; The Conditioning of Autonomic-Affcctivc Cravings, 30 ; Substitutions of Symbols, Fetiches, Images, Delusions, Hallucinations for Realities Which Are Needed to Gratify Uncontrollable Cravings or Relieve Wear, 39; The Affect and the Use or Disuso of Organs, Anaesthesia and Hyperesthesia of Receptors, 49 ; The Physiological Nature of Memory, 49; Complex Nature of the Autonomic-Affcctivc Stream, 52; The Development of the Ego, 52; Mechanism of the "Transference," 50; Origin and Nature of the Will, 57; Affective Adjustments, Suppression, Heprission, Summation, Dissociation, Regression, Compensation, Readjustment, Assimilation, Sublimation, 61; Psychopathic Eliminations or Simulations, 69; Formula of the Affective Conflict, the Environment and Behavior, 74.

Chapter II

The Conditioned Autonomic-Affcctivc Cravings of the Individual and the Influence of his Associates, 76 ; His Associates and Environmental Situations as Compound Stimuli, 77; The Insidious Repressive Influence of Parents and Associates Who tend to Repress their Own Cravings, 80; The Psychopath and the Influence of Associates, 80; The Judge and His Son, 82; The Russian Peasant Girl, 83; The Letter of A Business Man about His Mother's Influence upon Himself and His Brothers and Sisters, 87; The Family's Resistance and Pernicious Regression and Dissociation of the Youth's Personality, 8S; Causes of Variations in Family Adjustments and Matings, 91; The Child that Binds the Mismated, 93; The Child that is Hated Unconsciously and the Matured, Brooding Psychopath, 93; The Wife's Disgust for Sexual Relations and Her Insidious Castration of the Husband, the Husband as a Homosexual Regressive, 94 ; The Foundation of the Oedipus and Eleetra Love Fixation in the Child Due to the Dissatisfied, Erotic, Clinging Parent, 102; The Homosexual Father and Parricidal Inspirations in His Matured Son as Biological Compulsions, 103; Competition for Social Esteem and the Serious Influence of Flirtatious, Flattering Parents and Teachers, 104; The Insidi-

CONTENTS

PAGE

ous Pathological Influence of Dominating the Child to Strive to be "First" and "Best," 112; The Despair of Relative Organic Inferiority, 112; Transmission of Familiar Functional Traits through the Conditioning Influence of Associates, 117.

CHAPTER III The Universal Struggle for Virility, Goodness and Happiness 118

Definition of Virility, Goodness, Happiness, 118; The Biological Laws of the Struggle, 119; The Bisexual Attributes at Birth, 120; The Influence of Associates and the Development of Aggressive and Submissive Masculine Traits in Competition where Adequate and Inadequate Compensations Are Developed through Training in Childhood, 122 ; The Influence of the Unconscious Attitude of Others toward Superior and Inferior Organic and Functional Traits, 122; The Seven Stages of Evolution of the Sexual Functions, 123; The Precedence of Homosexual Interests to Heterosexual Interests in Man and the Infrahuman Primate, 139 ; Marriages as Cures for Psychopathic and Painful Situations, 156; The Biological Struggles of Males and Females with Conventions and Perverse Resistances as Portrayed in Art and Myths, 165.

Chapter IV

Influence of Organic and Functional Inferiorities upon the Personality . 179 Competition and Contrast of Organs and Functions, 179 ; The Necessity of Compensation for the Inferiority, 180; Fear of Failure in Sexual Selection, 181 ; Failure and Avoiding Competition and Affective Regression, 1S3 ; Elimination of the Inferiority, 183; Castrations (Surgical and Functional) 184; Catatonic and Hebephrenic Adaptations, 184; Simulations and Eccentric Compensations (Paranoid), 184; The Influence of Hatred, 185.

Chapter V

Mechanistic Classification of Neuroses and Psychoses Produced by Distortion of Autonomic-Affective Functions 189

Necessity of Abandoning the Old Modified Kraepelinian System of Classification, 189; Advantages of a More Adaptable Simple Method, 192; Discussion of the New Method, 193; Table, 190.

CHAPTER VI The Mechanism of the Suppression or Anxiety Neuroses . . .... 201

Variations in Degree of Anxiety, 201; Symptoms of Anxiety and Spastic Tensions, 202; Anxiety and Sexual Impotence, 203; The Influence of Fear without Insight into the Cause, 203 ; Failures of Compensation, 205 ; The Anxiety Neurosis of Charles Darwin, 208; The Conditioning Factors in His Family that Determined His Professional Selections, 213; The Personal Sources of His Theory of Evolution, 241 ; The Wish to Hallucinate His Father, 244; The Anxiety Neurosis of a Scientist Which Later Developed Compensatory Paranoid Inspirations, 251 ; The Father 's Repressive Rivalry and

CONTENTS XI the Autoerotic Mother Fixation in Youth as the Foundation of the Parricidal Compulsion, or Crucifixial Psychosis, or the Sacrificial Suicide after Maturity,

PAGE

Chapter VII

Repression or Psychoneuroses ; Their Mechanisms and Relation to Psychoses Due to Repressed Autonomic Cravings ........ 289

Differentiation of Anxiety or Suppression Neuroses from Repression Neuroses, 289; Phobias, Compulsions, Obsessions, Delusions, Hallucinations, 292; Elimination or Castration Strivings and Simulation Strivings, 293; Case of Mysophobia, 293; Case of Convulsions, Vomiting, Anesthesia, Visual Constriction, Erythema and Itching, 297; Case of Functional Paralysis as a Castration of Incestuous Autoerotism, 318; Suicidal Compulsions as Castration of Incestuous Autoeroticism, 322; Perverse Sexual Cravings and Suicidal Compulsions, 323; Case of Fear of "Dying" and Choking, and an Abdominal Tic Relating to Submissive Homosexual and Impregnation Cravings, 327- Simulations to Escape Responsibility, Case of Railroad Spine, 335; Simulations of Pregnancy and Labor Produced by the Dissociated Erotic Cravings, 335; Simulation of Diseases and Functional Distortion as Defenses against External Causes of Fear in Fearful Perverse Erotic Compulsions, 345; Relation of Repression Neuroses to Dissociations of the Personality and Affective Regressions, 352.

Chapter VIII

Benign Compensation or Regression Neuroses, with ok without Dissociation of Personality, Manic-Depressive Psychoses. Elimination or Simulation for Wish-fulfillment in Affective Crises ..... 353

Two General Types of Depression, With Anxiety or Without Anxiety, 353 ; Case of Prudish, Intelligent Woman Trying to Eliminate Uncontrollable Eroticism, 355; the Autoerotic Significance of Skin and Hair or Scalp Rubbing, Picking, Scratching, Finger Biting, Rubbing Sputum in the Skin and Hair, Clothing or Furniture, Picking out Threads, as Extraneous Bits and Placing Them in the Mouth, 369; Oral-Gastric Erotic Cravings and Swallowing Sticks, Glass, Needles, Nails, Hair, etc., 377; Autoerotic Fancies and Their Fixation, 378; Depression Without Anxiety, as an Affective Regression to an Infantile or Intrauterine Level, 379; The Erotic Flight Followed by Renunciation of the Love-Object and Infantile Affective Regression, 379; The Mechanism of the Manic-Erotic Flight and the Unrestrained Incestuous Fantasy, 379; The Sublimated Parental Attachment, 384; Case of Unrestrained Erotic Indulgence and Dissociation of the Personality, 385; The Ego's Gradual Reassimilation of the "Mysterious" Hallucinations as "Imaginations" (Meaning Wishfulfilling Creations), 400; Case Organic Inferiorities and Erotic Fancies Revealing Mechanism of Compensation, 402; Manic Compensatory Striving as a Defense against Uncontrollable Eroticism, 407; The Double Value of the Symbols used and the Behavior, 410 ; Anal-Erotic Compulsions and the Defense to Conceal Them in One Case and the Heedless Indulgence in Another, 41S; Differentiation of the Attitude Toward the Erotic Compulsions by the Dread of, or Delight in Getting into Rapport with the Physician, 419.

Xll CONTENTS

Chapter IX Page

Pernicious Repression Compensation Neuroses. The Psychopathology of

Paranoia 421

The Particular Nature of the Biological Inferiority and the Eccentric Compensatory Struggle to Develop Virility and Win Social Esteem, 421; Competition and Contrast of Inferior Organs and Functions, 421 ; The Phylogenetie Foundations of the Dread of being Biologically Inferior, 421; Compensations for Sexual Impotence and Fear of becoming Homosexually Submissive, 422; Perpetual Motion Machines and Eccentric Inventions as Compensations, 423; Language Creations as a Defense and Self -aggrandizement, 431 ; The Potential Dangerousness of the Paranoiac lies in his Fear of becoming Perverted and his Hatred of any Influence in that Direction, 435; The Domineering Father and Parricidal Inspirations, 430 ; The Resultant Affective Compulsions that Culminated in the Assassinations of Lincoln and Garfield, 440; The Mechanism of Dissociation of the Personality in the Paranoiac and His Defense Without Deterioration, Differentiated from His Defense With Deterioration, 449; The Enduring Nature of the Final Dissociated Adjustment When the Individual Becomes Convinced that the Erotic Compulsions Are Caused by Secret Plots of Other People (Case PD-1), 450; Marriage as a Defensive Solution of Homosexual Compulsions, 457 ; The Paranoid Defense of Homosexual Compulsions in the Female, 472 ; The Relation of Paranoid Compensations to Similar Compensations for Functional Inferiorities having an Organic Foundation But a Perverse Tendency, 473.

Chapter X

The Psychopathology op the Acute Homosexual Panic. Acute Pernicious

Dissociation Neuroses 477

Mechanism of the Homosexual Panic, 477; The Sensory Disturbances and Hallucinations Caused by the Uncontrollable Erotic Cravings Which Become Dissociated, 478 ; The Ego 's Desperate Defensive Striving and Terror of Eternal Disgrace and Biological Impotence, 478; The Significance of Delusions about "Poison" in the Food and Oral, Nursling Erotic Cravings, 480; The Erotic Cravings Compelling Impulsive Gratification after the Ego Has Lost Control, 480; Series of Cases Illustrating Homosexual Panics and Homosexual Submissions, 480; Symbolic Manner of Describing Difficulties, 482; Symbolism of the Hallucinated Snake, Poison, Dope, etc., 488; Paranoid Mechanism in Women, 507; "Freezing" Repressive Influence of the Female upon the Homosexual Male, 511; The Regressive (Intrauterine) Significance of Some Suicides, 511; The Prognosis of Homosexual Panics, 514.

Chapter XI

The Psychopathology of Chronic Pernicious Dissociation of the Personality with Defensive Hatred, Eccentric Paranoid Compensations and

Pernicious Deterioration gjg

The Reconstructive Influence of a Positive Transference in the Cases that Recover, 516; Cases of so-called Paranoid Dementia Precox, their Behavior, Fear, Defense, and Manners of Recovery, 518; The Paranoiac 's Vicious Circle because of Blaming Others for his Inferiorities When the Cause of the Sensory Disturbances Lies in the Repressed Dissociated Cravings, 523; The Unadjustable Conflict When the Family Becomes Intimately Involved, 533;

CONTENTS Xlll

PAGE

The Sexual Fixation of the Male Paranoiac on the Mother and the Female on the Father, 551 ; The Significance of Crucifixion Tendencies in the Paranoiac in Contrast with the Overt Crucifixion in the Catatonic, 554.

Chapter XII

The Pstchopathologt op Chronic Pernicious Dissociation op the Personality with Crucifixion and Catatonic Adaptations to the Repressed

Catatonic Adaptations in Animals and Man to Causes of Fear Associated with Sexual Excitation, 550; The Dissociated Sexual Cravings and the Catatonic's Defensive Adjustment to Environmental Temptations but Submissive Enjoyment of the Erotic Fancies, Hallucinations, etc., 557: The Ego's Yielding Crucifixion to the Uncontrollable Affect, 557; Impregnation and Labor Fantasies, 56.°,; Feelings of Dying and Rebirth, 503; The Significance of the Catatonic Male 's and Female 's Feelings of Being Crucified and Being "Christ,'' 569; Christ as the Symbolization of Equally Active Bisexual Tendencies, 578; Variations of Adjustment, to the Erotic Pressure to Become a Love-Object, from Fanatical Compensations to Utterly Heedless Resignation, 51*0 ; A Case of Spontaneous, Unreserved Confession of Erotic Perverseness with Gradual Assimilation of the Repressed Cravings and a Practical Reconstitution, 005 ; The Essential Differences between Catatonic, and Paranoid Adjustments to the Erotic Pressure and the Differences in the Conditioned Nature of the Erotic Pressure, 613.

Chapter XIII

The Pstchopathology of Chronic Pernicious Dissociation of the Personality with Hebephrenic Adaptations — Predominance of Excretory Erotic

Paranoid, Catatonic and Hebephrenic Adaptations to Failure Determined by the Conditioned Nature of the Erotic Cravings, 015; Fascination for the Excretions among Primitive Peoples, the Illiterate, and the Medical Profession of Yesterday, 615; Case of Persistent Affective Repression, Pernicious Regression to the Intrauterine Level with Dissociation of the Personality, Panic and No Insight, Predominance of Excretory, Autoerotic Interests followed by Progressive Reconstitution of the Personality through Psychoanalysis, 017; Influence of the Positive Transference, 654; Episodic Anal Erotic Compulsions and Episodic Confusions of the Epileptoid Type, 061 ; Anal Eroticism and Cravings to Destroy, 662 ; Love of Filth and Waste in Anal Erotic, 662 ; Comparison with Mysophobic Compulsions in Attempts to Eliminate Anal Erotic Cravings, 662 ; Case of Insidious Development of Anal Eroticism and the Tendency to True Epileptic Orgasms, 6S4; Hebephrenic Self -Cures, 690; Hebephrenic Impregnation Fantasies, 691 ; An Anal Erotic Paranoiac without Deterioration, 691 ; Summary, 693.

CHAPTER XIV Reconsideration of the Conditioned Autonomic Affective Determinants of

Abnormal Variations of Behavior 698

The Forces of the Personality, 698 ; The Repressed Segmental Craving and the Symbol, Ritual, Fetich, Fancy, Fairy Tale, Novel, Psychosis, 704;

XIV CONTENTS

PAGE

Influence of Affective Cravings on Postural Tensions, 706; Differences in the Mechanisms of the Neuroses and Psychoses, 710; Determinants of the Prognosis of Affective Distortions, 715; Symptoms of Affective Conflicts, 720.

Chapter XV

The Problem of the Ego and the Segmental Craving, 733; The Suggestive Method of Treatment, 733; The Psychoanalytic Method, 734; The Necessity of Restoring the Vigor of the Ego before Beginning a Psychoanalysis, 737; The Development and Control of the Transference, 738; The Absolute Necessity of Freedom of Association of Thought, 742 ; The Use of an Assistant in Psychoanalysis when the Transference cannot be Controlled, 742; Responsibility of Penal Institutions and Asylums, 743; Because of the Wholesale Erotic Perversities that Must Occur Where Men or Women are Isolated and Discouraged from Again Winning Social Fitness and Freedom, 745 ; The Biological Castration Tendency of Present American Social Practices, 746.

ILLUSTRATIONS

FIG. PAGE

1. Hygeia Frontispiece

2. African Phallic Wand . . 39

3. Aztec Phallic Ceremonial Knife 39

4. Symbols of Sexual Union 40

5. Symbols of Sexual Union

A. Winged Phallus 42

B. Phallus Grasped by Crab . . 43

G. Maiden and Serpent .... 44

D. Copulation Design 45

E. Double Vase 46

P. Copulation Design . 47

6. Symbolic Postures of Hands . . ... 48

7. Maha-Kali, Wife of the God Siva 9.1

8. Egyptian God Phtha . 97

9. Java Temple and Legend 100

10. Costa Rican Phallus as Diety 107

11. Pygmalion and Galatea — Rodin 108

12. Courtesan — Rodin 114

13. Martyr— Rodin 115

14. In the Garden— Brush 116

15. Costa Rican Copulation Fetich (Prehistoric) . . 125

16. Mars and Venus United by Love — Veronese 126

17(a) Two Natures of Man — Barnard 137

(Ij) St. Michael, the Archangel — Zurbaran 137

(c) Theseus Slaying Minotaur — Barye . 137

(d) Theseus Slaying Centaur— Barye 137

IS. Centaur and Cupid 13S

19. Hercules and Oniphale — Boulanger 142

2(1. Eternal Spring -Rodin 143

21. Lost Hour and Maternity — Beveridge 146

22. Caryatid— Rodin 147

23(a) The Storm— Cot 148

(b) The Ring— Alexander 148

24. Madonna of the Rose — Dagnnn-Bouveret 149

25. Mother — Lewin-Funeke 150

26. Bacchante — MacMonnies 151

27. Der Sphinx— Aron Stuck 153

28. Requiem — from Pfister 160

29. Isle of the Dead— Boecklin . 161

30. Fetal Position of Egyptian Burial 163

31. Buddha 164

32. Ivory Coast African Copulation Fetich 167

33. Aztec God— Phallic Border of the Robe 168

Xvi ILLUSTRATIONS

PAGE PIG.

34. Aegean Goddess, with Serpent Attributes 169

35. Falling Leaves — Merle 17°

36. Graziella— Lefebvre 171

-i r-o

37. Laehryma: — Leighton ±'-J

38. Eve— Rodin 17:!

40. Simulation of Manhood . J-i":'

41-A. Spastic Distortion as Defense against Anal Erotic Cravings 347

41-B. Biting off Lips as Defense against Oral Erotic Cravings ... . . 351

42. Cupid and Psyche — Rodin • 354

43. Posture of Regression 355

44. Mother Earth as Madonna 363

45. La Pensee — Rodin 371

46. Centauress — Rodin 372

47. Captive — Michelangelo 374

48. Hand of God-Rodin „ 382

49. Die Hoffnung — v. Bodenhausen 406

50. Inspired, Dissociated Paranoid Type with Purified Hands 413

51. "First Church— Perpetual Motion "—Patient 428

52. Cover of Magazine — Erte . . 489

53. Desperate Striving to be Fiercely Masculine 552

54. Pieta — Michelangelo 565

55. The Resurrection or Rebirth 567

56. Seal of Lichfield Cathedral 569

57. Window of Dumblane Abbey 569

58. The Vulva and its Symbol, the Ellipse 571

59. Imitation of Christ as a Biological Type 604

60. Catatonic as God 610

61. Leda and Swan — Michelangelo 640

62. Fetal Posture of Negress 642

63. Regression to Early Childhood 655

64. Costa Rican Sculpture, Fetal Position (Prehistoric) 659

65. Hebephrenic Fetal Postures 660

66. Hebephrenic in Primitive Posture 661

67. Crochet Work Showing Preadolescent Incest Fantasy (A and B) . ... 694

68. Regression to Infancy 696

69. Masculine Compensation in Homosexual Female ... 701

70. African Fetich Tree 705

71. Omnipotence as a Compensation for Impotence 706

72. Asylum Group 707

73. Characteristic Biological Result of Dissociated Oral Eroticism 708

74. Auto- and Anal-Erotic Catatonic Showing Posture of Hands 721

75. Autoerotic Joy 721

76. Autoerotic Terror 722

77. Prayer to be Saved from Oral Eroticism 722

78. Anal Erotic Joy 723

79. Anal Erotic Hate . 723

80. Anal Erotic Terror 723

81. Oral Erotic Suppression 724

82. Adaptations to Anal Eroticism 725

ILLUSTRATIONS XVI 1

PIG- PAGE

83. Adaptations to Perverse Eroticism . . .... ..... 726

84. Adaptations to Perverse Eroticism . .... ... 727

85. Castration of Eye as Defense against Auto Eroticism (Incestuous) .... 728

86. Contrite Virgin ... . 72$

87. Aesculapius ... . 739

ILLUSTRATIONS ARRANGED ACCORDING TO THEIR AFFECTIVE 07? SYMBOLIC SIGNIFICANi E

Phallic

2. African Phallic Wand .... ... . 39

3. Aztec Ceremonial Knife . , , 39

10. Costa Bican Phallus as Deity . , ]07

33. Aztec God — Phallic Border of Robe . . . 168

34. Aegean Goddess, with Serpent Attributes 169

70. African Fetich Tree 70S

Vulvar

56. Seal of Lichfield Cathedral . ... 569

f)7. Window of Dumblane Abbey . ....... 569

58. The Vulva and Its Symbol, the Ellipse , .171

Symbols of Sexual Union 1. Hygeia .... Frontispiece

4. Sexual Union . . . 411

5. Sexual Union 12-47

6. Symbolic Postures of Hands , 4S

15. Costa Rican Copulation Fetich . ]2"i

16. liars and Venus United by Love 120

32. African Ivory Coast Copulation Fetich . 107

51. First Church — Perpetual Motion . 428

87. Aesculapius .... 739

Sexual Attachment to Parents or Children

11. Pygmalion and Galatea 108

27. Per Sphinx ... 153

61. Leila and Swan . 640

07. Crochet. Work 004

Heterosexuality

13. Martyr 115

14. In the Garden 116

20. Eternal Spring 143

21. Lost Hour and Maternity 14c,

22. Caryatid 147

48. Hand of God 382

40. Die Hoffnung . . 406

XVlll ILLUSTRATIONS

FIG. PAGE

23. A. The Storm . 14s

B. The Ring ... . . a4s

24. Madonna of the Rose 149

25. Mother 150

26. Bacchante 151

35. Falling Leaves . . ... . 170

3b\ Graziella 171

37. LachrymEe . . 172

42. Cupid and Psyche ...... . . 354

44. Mother Earth as Madonna 363

Homosexuality

7. Maha-Kali 95

17. A. Two Natures of Man . 137

B. St. Michael, the Archangel 137

C. Theseus Slaying Minotaur . . . . 137

D. Theseus Slaying Centaur ... 137

18. Centaur and Cupid 138

19. Hercules and Omphale . 142

52. Cover of Magazine. 552

72. Aslyum Group . 707

73. Dissociated Oral Erotic Personality . . 70S

74. Catatonic, 721

77. Prayer to be Saved from Homosexuality 722

78. Anal Erotic Joy 723

79. Anal Erotic Hate 723

80. Anal Erotic Terror 723

81. Oral Erotic Suppression . . . ... . . .... 724

82. Adaptations to Anal Eroticism . . . , . . 725

83. 84. Further Adaptations to Perverse Eroticism 726-727

Autoeroticism

S. Egyptian God Phtha 97

31. Buddha 164

45. La Pensee 371

46. Centauress . . . 372

47. Captive - 374

75. Autoerotic Joy ... 721

76. Autoerotic Terror 722

Regressions

62. Fetal Posture of Negress . . 642

55. The Resurrection or Rebirth 567

63. Regression to Early Childhood ... 655

64. Costa Rican Sculpture, Fetal Position (Prehistoric) . . . . . . 659

65. Hebephrenic Fetal Postures . . . . ... . . . 660

66. Hebephrenic in Primitive Posture 661

68. Regression to Infancy 696

28. Requiem 160

29. Isle of the Dead 161

30. Petal Posture of Egyptian Burial 163

4:;. Posture of Regression . , .... 355

Compensations and Defenses

40. Simulation of Manhood ... 182

41. A. Spastic Distortion 347

B. Destruction of Lijis . 351

50. Purified Haiuls in Autoerotic . , 41.",

53. Desperate Striving to be Fiercely Masculine 552

59. Imitation of Christ . . . . (304

<in. Catatonic as God . . . . . 610

09. Masculine Compensation in Homosexual Female Till

71. Omnipotence as a Compensation for Impotence 706

85. Castration as a Defense Against Erotieism 7:28

80. Contrite Virgin .... ... 72s

LIST OF CASES

AN = Anxiety neurosis

PN = Psyclioneurosis

1ID = Manic depressive dissociation

P = Paranoia

PD = Paranoid dissociation

CD = Catatonic dissociation

HD = Hebephrenic dissociation

OP = General paresis

AS = Arteriosclerotic deterioration

CASES PAGE

AN-1. Fixed grandfather attachment with hallucinations and suicidal compulsions 83 AN-2. Affective sources of Darwin's inspirations and anxiety neurosis .... 20S AN-3. Mother fixation, father domination, autoerotism and pernicious sense of inferiority with parricidal inspiration in maturity, final suicide as a sacrifice ... ...... . — ->1

PN-1. Mysophobia of young woman . . . . . . 293

PN-2. Convulsions, anesthesia, vomiting, erythema, itching of young woman . 207

PN-3. Functional paralysis . . . • .... . 318

PN-4. Compulsion to smash head . 322

PN-5. Compulsion to suicide ... .... 323

PN-6. Abdominal tic and laryngeal tensions . . 327

PN-7. Spastic distortion, defensive .... 345

MD-1. Anxiety because of eroticism and simulations of pregnancy . ... 355

MD-2. Anxiety because of erotic hallucinations ... 364

MD-3. Anxiety because of autoerotic compulsions . 372

MD-4. Anxiety because of autoerotic and oral erotic compulsions 376

MD-5. Periodic erotic flights and regressions ... . 379

MD-6. Manie-overcompensation to be mother's hero, followed by infantile regression, later followed by paranoid brooding 3S1

MD-7. Abandonment to erotic flight with hallucinatory gratifications .... 385

MD-S. Erotic fancies, overcompensation for organic and functional inferiorities . 402

MD-9. Fear of homosexual submissive compulsions with violent, bluffing defense 407

MD-10. Wild manic compensation for fear of inferiority 409

MD-11. Wild manic compensation as defense against uncontrollable anal erotic

MD-12. Abandonment to autoerotic cravings without fear 418

MD-13. Abandonment to autoerotic preadolesceut cravings without fear .... 516

xx

LIST OF CASES XXI

CASES PAGE

P-l. Heterosexual impotence, fear of homosexual submissiveness with defensive

compensations of divine omnipotence 42:'.

P-2. Similar to P-l in divine inspirations resulting in violent tragedy ... 4-'!4 P-3. Fear of small genitalia and sexual inferiorities with compensatory compulsions to invent world's most powerful cannon . . 436

P-4. Paternal persecution in youth with parricidal compulsions in maturity — Guiteau 440 P-5. Paternal influence in youth with parricidal inspiration in maturity — J. Wilkes

Booth 447

PD-1. Fear of homosexual submissive compulsions, with dissociation of personality, and brilliant literary compensations .... . 450

PD-5. Fear of homosexual submissive compulsions with marriage as a defense,

final pernicious dissociation of personality ... ... ... 4"7

PD-0. Fear of homosexual submissive compulsions with systematized delusions and

counterattack 458

PP/-7. Pernicious dissociation due to homosexual submissive cravings 95

PI) s. Pernicious periodic dissociation with eccentric omnipotent compensatory

PD-9. Fear of homosexual cravings with defensive marriage 4.1'.)

PD-10. Pernicious dissociation due to homosexual compulsions, finally suicide as

IT) 11. Fear of homosexual compulsions with violent counterattack 409 PD-12. Pernicious dissociation due to autoerotic cravings with compensatory fancies of developing omnipotence ..... ........ 470

PD-13. Pernicious dissociation due to homosexual cravings with omnipotence defense 480 PD-14. Acute panic upon homosexual regression in male with recovery . . 4S4 PD-15. Acute panic upon homosexual regression in male with recovery . . . 4S(i PDT6. Acute panic upon homosexual regression, marriage, with eventual pernicious dissociation 325

PD-17. Uncontrollable erotic simulations with panic at hallucinated homosexual

assault in female . . . 335

PD-18. Panic upon homosexual regression in male with pernicious dissociation . 489

PD-19. Homosexual regression without panic in male 491

PD-20. Acute panic upon homosexual regression in male, with recovery ... 493

PD-21. Acute panic upon homosexual regression in male, with recovery . 494

PD-22. Acute panic upon homosexual regression in male, with recovery . 496

PD-23. Panic upon homosexual regression in male, with recovery . ... 498

PD-24. Pernicious dissociation in negro . . . . . 500

PD-25. Pernicious dissociation with fear of castration . . 501

PD-20. Pernicious dissociation with crucifixion cravings ... ..... 502

PD-27. Acute pernicious dissociation with vivid wish-fulfilling hallucinations . 502 PD-2S. Pernicious dissociation in female, panic upon uncontrollable homosexual

PD-29. Pernicious dissociation in female with systematized paranoid delusion of

persecution due to secret autoeroticism 508

PD-30. Panic with suicidal compulsions upon heterosexual failure in an illiterate

Russian male immigrant . 511

PD-31. Panic with suicidal compulsions upon heterosexual failure in an intelligent

American .... 513

XXI 1 LIST OF CASES

CASES PAGE

PD-32. Pernicious dissociation in anal orotic female having vigorous prostitution

compulsions .... ... 691

PD-33. Pernicious dissociation due to irrepressible oral homosexual cravings with

paranoid defense, recovery ...... 517

PD-34. Pernicious dissociation due to irrepressible homosexual cravings with paranoid defense, partial recovery ...... . 526

PD-35. Incestuous mother fixation, father-uncle hatred, homosexual fears, final pernicious dissociation ... . . . 533

PD-36. Pernicious dissociation in female with homosexual cravings and heterosexual aversions . . . . . . 547

CD-I. Homosexual regression in male with crucifixion to the father, catatonic

adaptation, impregnation, rebirth, reconstitution, manner of recovery . 557

CD-l'. Crucifixion to the father and mother, with catatonic adaptation to uncontrollable erotic compulsions in female, manner of recovery 572

CD-3. Uncontrollable autoerotic compulsions with catatonic adaptation, manner of

recovery . . . 579

ci) J. Uncontrollable homosexual crucifixial compulsions with wild compensatory

defensive strivings . . . . . 590

CD-5. Self-castration compulsions as compensatory defense against uncontrollable

autoerotic and homosexual cravings . ... 000

CD-(i. Acute homosexual panic in male showing erotic value of hallucinated snake 603

CD-7. Crucifixial inspirations and sublimations of father attachment . . 604

CDs. Chronic tendency to polymorphous sexual perverseness culminated bjr eccentric fervid compensatory compulsions, crucifixion and elimination of perverseness . . . 605

GD-9. Oral eroticism with panic and self-purification .... . . . 6U1

HD-1. Chronic sexual repression, pernicious dissociation, regression, reconstitution,

nianiur of recovery with insight . . . 617

HD-2. Pernicious dissociation with permanent regression to infantile level . . . 654 HD-3. Pernicious dissociation with permanent regression to infantile excretory

HD-4. Pernicious dissociation due to homosexual cravings with omnipotent compensatory defense . ... 662

HD-.j. Epileptoid convulsions in dissociated personality having uncontrollable

submissive anal erotic cravings ... 671

HD-6. Epileptoid stupor in dissociated personality having uncontrollable submissive anal erotic cravings ...... . ..... 672

HD-7. Stuporous confusion in hebephrenic erotic state . 673

I1D-S. Submissive anal erotic compulsions . . .... 673

HD-9. Submissive anal erotic compulsions in stupid dissociated personality . . 674 HD-1 1). Violent hatred in anal erotic female ...... .... 674

HD-11. Pernicious dissociation due to uncontrollable submissive anal erotic cravings, impregnation and father fancies (375

HD-12. Pernicious dissociation due to submissive anal erotic cravings, social re-

HD-13. Pernicious dissociation due to aiial and autoerotic cravings 682

LIST OF CASES XX111

CASES page HIM 4. True epilepsy of insidious development, pernicious regression in anal erotic

youth having an infantile mother attachment ... .... 6S4

HD-l.j. Pernicious dissociation with eccentric compensatory defensi s against autoeroticism . . . . . . . . . .... .'!:?•">

HD-lCi. Pregnancy feelings and fancies in male , , 691

HD-17. Naive cures for impotence ... , . . . . . .... 688

GP-1. Paretic with fears of heterosexual impotence and compensatory euphoric

GP-2. Paretic with homosexual fears and compensatory defense . . . 474

AS-1. Arteriosclerotic with compensatory defensi' for homosexual fears 47.j

Introduction

Psychopathology treats of abnormal behavior, that is, abnormal thoughts and actions and their causes as they are found in individuals. No other study must deal so intimately with the most tabooed and secret tendencies of human behavior. The psychopathologist believes that the most grewsome maladjustments of humanity can be understood and in many instances can ])c happily corrected, and this conviction justifies his study of phases of human behavior that are regarded by some as the most sacred interests of humanity, which must never be violated by doubts or questions, and by others are believed to be the perverted causes oL' most of humanity's suffering, which must be uprooted or suppressed at any price.