The diseases of personality

Front matter

WORKS BY THE SAME AUTHOR.

AUTHORISED TRANSLATIONS.

The Psychology of Attention.

Preface To The Fourth Edition

Since these studies were first published (in 1884), the questions involved in the disorders and alterations of the personality have given rise to numerous works.* It is not my intention here to epitomise those investigations. That would furnish matter for a separate volume.

If we pass in review all the cases in which the personality, the unity of the ego, has been at all impaired, from slight and fugitive partial alterations to complete metamorphosis, we shall be able, I think, to divide them into two large groups : spontaneous alterations and provoked alterations.

The first, or natural alterations, are to be reached only by observation and in grave cases spring from some deep and permanent disorder of the vital functions.

The second, the artificial alterations, produced by experiment, usually by hypnotism, come from without, do not always penetrate to the profoundest parts of the individual, and remain essentially superficial and transitory, unless by repetition they create a new mental habitude.

Although the history of our subject does not go very far back, —

* Binet and Féré, Le magitHisme animal: Binet, Etudes de i>sycholosic extêrimentale : Pierre Janet, L'automatisme psychologique : Azam, Hypnotisme, double conscience et altérations de la personnalité: Bourru and Burot, l'urialions de la Personnalité: Paulhan, L'activité mentale et les éléments de l'esprit : W. James, Principles 0/ Psychology, vol. i, ch. x, numerous articles in the Proceedings 0/ the Society far Psychical Research; Max Dessoir, Das Doppel-Ich, etc., etc.

vi THE DISEASES OF PERSONALITY.

extending, at most, over forty years, — it has two periods. In the first, spontaneous alterations were exclusively studied ; in the second, following the renaissance of hypnotism, psychologists were wholly occupied with provoked and artificial disorders. While fully recognising the significance of the last-named class, I am yet inclined to believe, till proof is brought to the contrary, that the spontaneous alterations, which are the principal and almost exclusive subject of the present volume, still remain the solidest data for the study of the morbid manifestations of personality.

Th. Ribot.

Paris, May, 1891.

Introduction

PAGE

Definition and division of the subject i

Consciousness : nature and origin 3

Consciousness, a perfection of definite physiological events. . . 6

Facts supporting this hypothesis 7

Importance of the psychical factor 16

Chapter I. Organic Disorders

The sense of the body, its importance and complexity 18

Slight variations of the personality in the normal state 29

More serious cases 32

Cases of double personality 33

Personality of double monsters 36

Personality of twins 43

Chapter II. Affective Disorders

Classification jj

Depressions and exaltations of the personality 53

Their alternation in circular insanity 57

Complete metamorphosis of the personality jg

Sexual characters : eunuchs, hermaphrodites, opposite sexuality 61

Total transformation of character 67

Foundations of the personality: personal unity and identity the psychic expression of the unity and identity of the organism gj viii THE DISEASES OF PERSONALITY.

Chapter III. Disorders Of The Intellect

PAGE

Alterations proceeding from parsesthesia and dysesthesia 92

Alterations proceeding from hallucinations 100

Cerebral dualism and double personality: discussion 106

Rôle of the memory 113

Rôle of ideas ; transformations proceeding from above ; their

superficial character ; "possessed " and hypnotised subjects 117

Disappearance of the personality in mystics 123

Chapter IV. Dissolution Of Personality

Progressive dementia : cases of real double personality; periods of the dissolution 126

Attempt at a classification of the diseases of the personality; three principal types : alienation, alternation, substitution. . 133

Conclusion

Zoological individuality and its ascending evolution 138

Colonial consciousness 140

Physical synthesis and psychical synthesis of personality in

man 145

The ego is a co-ordination 150

Index 159

THE DISEASES OF PERSONALITY.

INTRODUCTION.

I

By " person " in psychological language we understand generally the individual, as clearly conscious of itself, and acting accordingly : it is the highest form of individuality. To explain this attribute, which it reserves exclusively for man, metaphysical psychology is satisfied with the hypothesis of an ego, absolutely one, simple, and identical. Unfortunately, however, this is only illusive clearness and a semblance of solution. Unless we attribute to this ego a supernatural origin, it will be necessary to explain how it is born, and from what lower form it proceeds. Accordingly, experimental psychology must propound the problem differently, and treat it by different methods. Experimental psychology learns from natural scientists that in the majority of cases it is difficult even to establish the characteristics of individuality, which are far less complex than those of personality. Hence it mistrusts simple solutions, and, far from regarding the question as solved at the outset, it looks for the solution at the close of its researches, as the result of long and laborious investigations. Therefore, it is but natural that the representatives of the old school, slightly bewildered at the situation, should accuse the adherents i THE DISEASES OF PERSONALITY.

of the new school of "filching their ego," although nothing justifying such a charge has ever been attempted. However, the language and the methods of the two sides are now so different, that all mutual understanding is henceforth impossible.

At the risk of increasing the already extant confusion, I propose to investigate what teratological, morbid, or simply rare, cases can teach us concerning the formation and disorganisation of personality, though without the pretension of treating the subject in its entirety, deeming such an undertaking at present premature.

Personality being the highest form of psychic individuality, the preliminary question arises : What is the individual? There are few problems that have been more debated in our time among naturalists, or that remain more obscure for the lower stages of animal life. This is not the place to go into the details of the problem. At the close of our work, after we have studied the constituent elements of personality, we shall consider this question as a whole. It will then be time to compare personality with the lower forms through which nature has essayed to produce it, and to show, that the psychic individual is the expression of an organism, being, as that is, low, simple, incoherent, or unified and complex. For the present, it will be sufficient to recall to readers at all familiar with the subject, that in descending the animal scale we always see the psychic individual formed of a more or less complete fusion of simpler individuals, as also "a colonial consciousness" created by the co-operation of local consciousnesses. These discoveries of modern naturalists are of the utmost importance to psychology. By them the problem of personality is completely transformed. Henceforth that problem must be stud-

INTRODUCTION.

ied from below ; while we are led to ask, whether the human person itself is also not un iout de coalition — a whole by coalition — the extreme complexity of which veils from us its origin, and the origin of which would remain impenetrable, if the existence of elementary forms did not throw some light upon the mechanism of that fusion.

The human personality — the only one of which we can speak with any fitness in a pathological study — is a concrete whole, a complexus. To know it, we must analyse it. But analysis here is disastrously artificial, since it disjoins groups of phenomena which are not juxtaposed, but co-ordinated, their relation being that of mutual dependence, not of simple simultaneousness. Still, the work is indispensable. Adopting a division both clear and, as I trust, self- justified, I shall study successively the organic, affective, and intellectual conditions of personality, chiefly emphasising their anomalies and disorders. Our final study of the subject will permit us to group anew these disjoined elements.

II

But before entering on the exposition and interpretation of facts, it will be profitable, in the interests of clearness and candor, to get first some understanding of the nature of consciousness. It is not a question here of a monograph, embracing, so to speak, the whole of psychology; it will suffice to present the problem in a precise form.

Neglecting details, we are confronted with only two hypotheses : the one, a very old hypothesis, which regards consciousness as the fundamental property of "the soul " or " mind," as that which constitutes its es-

4 THE DISEASES OF PERSON ALU Y.

sence ; the other, a very recent theory, which regards it as a simple phenomenon, superadded to the activity of the brain — as an event having its own conditions of existence, appearing and disappearing according to circumstances.

The first hypothesis has held sway for so many centuries, that it has become an easy matter to appraise its merits and deficiencies. It is not for me to call this theory to the bar ; I shall restrict myself to showing its radical incompetence to explain the unconscious life of the mind. For a long time it took no notice of this unconscious life. The precise and profound views of Leibnitz upon this question were forgotten or, at least, were not applied ; and up to the present century, the most renowned psychologists (with few exceptions) wholly limited themselves to consciousness. When finally the problem was thrust upon them, and it became plain to all that to reduce psychic life to the exclusive data of consciousness was a conception so poor and scant as to be practically useless — then great confusion arose. So-called "unconscious states" were admitted — an ambiguous and half-contradictory term, which has spread rapidly, and has its equivalent in all languages, but which clearly betrays the period of confusion in which it was born. What are these unconscious states? Prudent writers attest their existence, without any attempt at explanation. The more venturesome speak of "latent ideas," of "unconscious consciousness expressions so vague and inconsistent that many authors have frankly admitted their defects. In fact, if the soul be conceived as a thinking substance, of which the states of consciousness are modifications, it will be impossible without manifest contradiction to impute to it unconscious states ; all shifts

JNTR on UCT J ON.

of language or of dialectic are of no avail here ; and as we cannot deny the high importance of these unconscious states as factors of the psychic life, there is no exit from this inextricable situation.

The second hypothesis escapes from all this logomachy; it precludes the factitious problems that crop up in the first (for example, whether consciousness is a general or particular faculty, etc.), and we may fearlessly claim for it the benefits of the lex parcimoniœ. It is simpler, clearer, and more consistent. In contrast to the other, it may be characterised by saying that it expresses the unconscious in physiological terms (states of the nervous system), and not in psychological terms (latent ideas, non-felt sensations, etc.). But this is only a particular case of the hypothesis, which must be considered in its entirety.

We will first remark that consciousness, like all general terms, must be resolved into concrete data. Just as, generally speaking, there is no will, but only volitions, so also, generally speaking, there is no consciousness, but only states of consciousness. They alone are the reality. To define the state of consciousness, the fact of being conscious, would be a futile, supererogatory task ; it is a datum of observation, an ultimate fact. Physiology tells us that its production is always associated with the activity of the nervous system, particularly of the brain. But the reverse does not hold true. All psychic activity implies nervous activity, but all nervous activity does not imply psychic activity. Nervous activity is far more extensive than psychic activity. Consciousness, therefore, is something superadded. In other words, it is to be considered, that every state of consciousness is a complex event, which supposes a particular state of the nervous system ; that this nervous process is not an adscititious, but an integral part of the event ; what is more, that it is its basis and fundamental condition ; that, when produced, the event exists of itself, but as soon as consciousness is added, it exists for itself ; that consciousness completes and perfects the event, but does not constitute it.

By this hypothesis it is easy to understand how all manifestations of psychic life, sensations, desires, feelings, volitions, memories, reasonings, inventions, etc., may be alternately conscious and unconscious. There is nothing mysterious in this change of states, since in all cases the essential conditions, i. e., the physiological conditions, for each event remain the same, while consciousness is simply its perfection.

It remains to establish why this perfection is sometimes present, and sometimes wanting. For, if in the physiological phenomenon itself there were not something more present in the first case than in the second, the victory would indirectly remain with the adverse hypothesis. Could it be proved that every time that certain physiological conditions exist, consciousness appears ; that whenever they are wanting, consciousness disappears; and whenever they vary, consciousness also varies — then we should no longer have an hypothesis, but a scientific truth. We are still very far from this goal. In any event, we may be sure that consciousness itself will not furnish the necessary light. As Maudsley justly observes, consciousness cannot at the same time be effect and cause— cannot be itself and its molecular antecedents. It lives only for a moment, and cannot by a direct intuition return to its immediate physiological antecedents ; beiJMmon ucTioN.

sides, to revert to those material antecedents, would be to lay hold of, not itself, but its cause.

At present it would be chimerical to attempt even a rough establishment of the necessary and sufficient conditions of the appearance of consciousness. We know that the cerebral circulation, in the double aspect of quantity and quality of blood, is of great importance. A palpable proof of this is furnished by experiments on the heads of freshly beheaded animals. We know that the duration of the nervous processes in the centres is also of influence. Psychometric researches demonstrate daily that the more complex a state of consciousness is the longer time it requires, and that, on the j other hand, automatic acts — primitive or acquired, the ' rapidity of which is extreme— do not enter consciousness. We can also assume that the appearance of consciousness is connected with the period of disassimilation of the nervous tissue, as Herzen has exhaustively shown.* All these results, however, are only partial conquests ; the scientific knowledge of the genesis of a phenomenon supposes the determination of all its essential conditions.

The near future, perhaps, will furnish these. In the meantime, to corroborate our hypothesis, it will be more profitable to show, that it alone explains a chief character (not a condition) of consciousness— its iniermisston. To avoid at the outset all dubiousness, I shall observe that it is not a question here of the discontinuity of the states of consciousness among themselves. Each has its limits, which, while permitting It to associate with others, at the same time preserve its peculiar individuality. It is not this that occupies us vité cérébrale, 18S7.

here, but simply that well-known fact that consciousness has its interruptions, or, as we say in popular parlance, that "we do not always think."

It is true, this assertion has been contested by the majority of metaphysicians. They never have furnished proofs in the support of their position, and as all appearances are against it, the onus probandi would naturally seem to lie with them. Their whole argument reduces itself to asserting that since the soul is essentially a thinking subject, it is impossible that consciousness should not always exist in some degree, even when no trace of it is left in memory. But this is simply a begging of the question, since it is precisely their major premise that the hypothesis maintained by us contests. Their alleged proof, in fine, is simply a deduction drawn from a contested hypothesis. It is beyond our plan here to examine this in detail ; a summary will suffice.

If, discarding all preconceived ideas, we abide by the simple observation of facts, we are confronted with the following great practical difficulty, that it is often impossible to decide whether the case presented is unconsciousness or amnesia (lack of memory). If a state of consciousness appears, lasts only a short time, does not organise itself in memory, leaves no trace of its passage, it is as good as non-existent for the individual. Now, the existence of such evanescent consciousnesses is demonstrated : it is not an absence of consciousness, but an absence of memory. Excludmg such cases, others remain, where for impartial criticism it is impossible not to admit that the complete disappearance of consciousness is the sole probable

hypothesis. ^

It has been maintained that there is no sleep with-

INTR on UCTION.

out dreams ; but this is a purely theoretical assertion. The sole argument of fact that can be pleaded in support of it is, that sometimes a sleeper, addressed or questioned, makes a proper reply, yet upon waking has no recollection of the matter. However, this fact does not justify a general conclusion.

It is to be further remarked — and this is an important point — that all who have investigated whether perfect cerebral sleep exists have been cultured and active minds, (psychologists, physicians, men of letters,) in whom the brain is ever upon the alert, like a delicate instrument vibrating to the touch of the slightest excitation, and possessed, as it were, of a habitude of consciousness. Thus, it happens that the very men who propound the problem: "Do we always dream ? " are really the least competent to supply a negative solution. But this is not the case with people engaged in manual occupations. A peasant living remote from all intellectual agitation, limited to the same occupations and the same routine of life, in general does not dream. I know several, who regard dreams as a rare accident of nocturnal life. Besides, some men of remarkable intellectual activity (Lessing, Reid, and others) affirm they have never dreamed. It is hardly probable that some sleeps, succeeding periods of great physical fatigue, are not, at least momentarily, free from dreams. In surgical operations artificial anaesthesia is rarely pushed to the point of absolute insensibility. It seems, however, that in some cases, studied by good observers * on their own persons, complete unconsciousness has been produced for a period varying from a few seconds to a minute and more. In epileptic

* See Lacassagne, Mémoires de l'académie de médecîfie, v. iii, i86g, pp. 30 and 36.

lo THE DISEASES OF PERSONALITY.

vertigo, known also by the names of petit mal" "absence," "attack," a complete loss of consciousness is often observed, accompanied by a sudden interruption of sentences and their resumption, after the attack, at precisely the same point.* But I ascribe without hesitation to the account of pure amnesia the states known by the name of "ambulatory comitial automatism," which lasts days and hours. Moreover, in coming back to the normal state many of these sick persons voluntarily declare that "they seem to have awaked from a dream." Shocks and blows on the head, sudden commotions usually produce unconsciousness with retroactive amnesia ; that is to say, the events immediately preceding the accident leave behind no traces in the memory, while there is produced thus in the mental life of the patient a gap varying in duration from a few seconds to several minutes. Dr. Hamilton, who has studied these accidents minutely from the point of view of medical jurisprudence,! and has collected twenty-six authentic cases, believes he can establish a law that retroactive amnesia is directly proportional to the duration of unconsciousness. If the last is partial and brief, retroactive amnesia embraces only a few seconds ; if it is total and long, the amnesia increases proportionately. J

I do not see what objections can be made to facts of this kind, unless, indeed, we revert to the inevit-

* Numerous examples maybe found in all authors treating of epilepsy. For interrupted conversations, see especially Forbes Winslow. On Obscur^Dt- ,eases of the Brain and Mind, p. ^^^ et seq.; Maudsley. Pathology of M.nd. (French Trans.) pp. 9, lo; Fuel, De la cataUpsie (Mém. de I'acad. de med..

''^^^'iLoL% Consciousness, in the Proc. of the Medico-legal Society of New York, 3rd series, 1886, p. 206 et seq.

IThis passage, from the words "Besides, some men, etc., replaces in the later editions of Les Maladies de la Personnalité a passage from Desp.ne. — Trans.

IN TROD UCTION.

II able hypothesis of states of consciousness that leave no traces in memory ; but, I repeat, this is a gratuitous hypothesis, destitute of probability. People who are subject to fainting spells with loss of consciousness, well know, that pending their duration they might fall down, hurt a limb, or upset a chair, yet on recovering their senses, not have the faintest idea of what had taken place. Is it likely that if these sufficiently serious accidents had been attended with consciousness, they would not have left some memory lasting at least a few seconds ? We do not deny for a moment that, in certain circumstances, normal or morbid (for example in hypnotised subjects), states of consciousness leave no apparent trace on awaking, but can later be revived ; we are willing to restrict to any desired limits the instances of complete interruption of consciousness ; but we have shown that there are some, and it would suffice if there were only one, to raise insurmountable difficulties against the hypothesis of the soul as a thinking substance. By the contrary hypothesis, everything is easily explained. If consciousness is an event dependent upon definite conditions, there is no cause for wonderment if it is sometimes lacking.

It would also be possible, if this were the occasion to treat exhaustively this problem, to prove, that by our hypothesis nothing uncertain or contradictory is presented by the relations of the conscious to the unconscious. The term "unconscious" may always be paraphrased thus : a physiological state, which, at times and in fact most frequently accompanied by consciousness, or at its origin having been so, in the present case is not so accompanied. This characteristic, although negative as psychology, is positive as physiology. It affirms that in every psychic event the fundamental and active element is the nervous process, that the other is only a concomitant. Accordingly, there is no further diflficulty in comprehending that all manifestations of psychic life can by turns be either unconscious or conscious. For the first case, it is necessary and sufficient that there be produced a definite nervous process, that is that there be put into play a definite number of nervous elements, forming a definite association, to the exclusion of all other nervous elements and of all other possible associations. For the latter, it is necessary and sufficient that supplementary conditions, be they what they may, be added, without alteration of the nature of the phenomenon, except making it conscious. We further comprehend how unconscious cerebration can perform such heavy tasks noiselessly, and, after long incubation, reveal itself in such unexpected results. Each state of consciousness represents only a very feeble portion of our psychic life, because at every instant it is supported and, as it were, instigated by unconscious states. Each volition, for example, dives to the very depths of our being; the motives that accompany and apparently explain it, are never more than a feeble part of its true cause. The same is true of a great number of our sympathies, and the fact is so manifest that even minds completely unused to observation often wonder at being unable to explain their aversions or sympathies.

It would be wearisome and beside our purpose to continue this demonstration. If the reader wishes, he may turn to the chapter "Phenomenology" in Hartmann's " Philosophy of the Unconscious. " * Here he will find classified all the manifestations of the uncon-

• English Translation, by W. G. Coupland, London, TrObner & Co.

JNTR OD UCTION.

scious life of the mind, and he will see that there is not a single fact there cited which is not explained by the hypothesis here defended.

One point still remains to be examined. The theory that regards consciousness as a phenomenon, and which is the outcome (as might easily be shown, if the digression were opportune) of the fundamental principle of physiology that "reflex action is the type of nervous action and the basis of all psychic activity," has seemed to many benevolent persons paradoxical and disrespectful. To them it seems to rob psychology of all its solidity and dignity. They are loth to admit that the highest manifestations of nature are unstable, fugitive, superadded, and subordinate as to their conditions of existence. But this is simply a prejudice. Consciousness, whatever its origin and nature, loses not an iota of its real value : it should be appraised in itself; and for him who places himself at the point of view of evolution, not the origin, but the elevation attained, is of consequence. Experience, moreover, shows that the higher we ascend the scale, the more complex and unstable are the natural compounds. If stability afforded the true measure of dignity, then the minerals would occupy the first rank. This purely sentimental objection, therefore, is not admissible. As to the difficulty of explaining by this hypothesis the unity and continuity of the conscious subject, at present it would be premature even to moot this subject. In due time this problem, too, will find its solution.

There is, however, one weak point in this hypothesis of consciousness as a mere phenomenon. Its most convinced partisans have defended it in a form that has procured them the name of theorists of pure automatism. According to their favorite comparisons, consciousness is like the flash of Hght thrown from a steam-engine, which illuminates it, but has no influence on its movements ; its efficacy is that of the shadow that accompanies the steps of the traveller. Viewed simply as forceful illustrations of the doctrine, no objection is to be taken to these metaphors ; but viewed strictly, they are exaggerated and inexact. Consciousness, in itself and by itself, is a new factor, and in this there is nothing mystical or supernatural, as we shall see.

In the first place, by the hypothesis itself (the state of consciousness supposing physiological conditions more numerous, or at least other, than the same state when unconscious) it follows that two individuals, the first being in the first state, the second in the other, all other things being equal, are strictly not comparable.

Still stronger reasons might be adduced — not logical deductions, but facts. When a physiological state has become a state of consciousness, it has acquired thereby a special character. Instead of taking place in space, that is to say, instead of admitting of conception as the putting into play of a certain number of nervous elements, occupying a definite spatial extent, it has assumed a position in time ; it has been produced after this, and before that, while for the unconscious state there is no before nor after. It has been rendered susceptible of being recalled, that is to say, recognised as having occupied a precise position among other states of consciousness. It has become, accordingly, a new factor in the psychic life of the individual — a result that may serve as a starting-point for some new (conscious or unconscious) work ; and far from being the product of a supranatural operation, it is reducible

INTR OD UCTION.

to that organic registration which is the basis of all memory.

For greater precision, let us take a few examples. Volition is always a state of consciousness — the affirmation that a thing must either be done or prevented ; it is the final and clear result of a great number of conscious, subconscious, and unconscious states ; but once affirmed, it becomes in the life of the individual a new factor, and, in its new position, it marks a result, the possibility of being begun again, modified, prevented. Nothing similar exists with respect to automatic acts not accompanied by consciousness. Novelists and poets, usually good observers of human nature, have frequently described the well-known condition in which a passion — love or hate — long brooded upon, unconscious, ignorant of itself, at last sees light, recognises, affirms itself, becomes conscious. Then its character changes ; it redoubles its intensity, or is stopped by antagonistic motives. Here, too, consciousness is a new factor, which has modified the psychological situation. One may, by instinct, that is, by unconscious cerebration, solve a problem, but it is probable that on some other day, at some other moment, the same person will succumb to a similar problem. If, on the other hand, the solution has been reached by conscious reasoning, a failure is not likely to occur the second time ; because every step forward marks a position won, and from that moment on we no longer grope in the dark. This, however, does not diminish in the least the part played by unconscious work in all human discoveries.

These examples taken at hazard will suffice to show, that the metaphors referred to are true of each state of consciousness in itself. In itself, it is indeed merely a light without efficacy, the simple revelation of an unconscious work ; but in relation to the future development of the individual it is a factor of supreme importance.

What is true of the individual is true also of the species, and of the succession of the species. In the sole point of view of the survival of the fittest, and irrespective of psychological considerations, the appearance of consciousness upon earth was a fact of the first magnitude. Through it experience, that is to say, adaptation of a higher order, became possible for the animal. It is not for us to investigate its origin. On this point, very ingenious hypotheses have been advanced, which enter the domain of metaphysics, and which experimental psychology is not obliged to discuss, since it takes consciousness as a datum. It is probable that consciousness was produced like every other vital manifestation, first, in a rudimentary form, and, to all appearances, without much efficacy. But from the moment it was able to leave behind it a vestige, to build up in the animal a memory, in a psychic sense, which capitalised its past for the profit of its future, from that moment a new chance of survival was created. To unconscious adaptation, blind, accidental, dependent upon circumstances, was added a conscious adaptation, uninterrupted, dependent upon the animal, surer and quicker than the other ; and that abridged the work of selection.