Nerves and the man; a popular psychological and constructive study of nervous breakdown

Front matter

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Contents

CHAPTMR PAGH

I Introduction 13

II The Nervous System 17

Introduction

The ominous phrase "nervous breakdown" is a painfully familiar one to an increasing number of men and women in these days. Happily, it is merely a phrase to the vast majority of us. But, to an ever-growing number, we fear, it speaks of one of the most distressing realities of life. It is because the writer himself knows what the thing is, and because he has had exceptional opportunities of meeting and dealing with many others who also know, that he has determined to publish his experience, in the hope that it may bring a little light into the gloom which mostly accompanies those nerve troubles to which multitudes are victims.

The first note the writer would strike is the note of hope. He is confident that, for most victims of the malady of nerves, there are solid grounds for assurance; and that, given the right outlook, suitable conditions, and obedience to certain simple rules, restoration and renewal are well within the reach of the sufferer. It seems to be a part of the lot of this special kind of victim, however, that hope is just the state of mind he lacks, and hence he is often found to be one of the most difficult to set free. Still, it is generally true that we are saved by hope ; it is eminently true in this particular case. As a matter of experience, it is commonly found that almost the first essential, in dealing with nervous disorders, is to open the mind to hope, which, either in ethics or physical well-being, is the first among the healing and redeeming forces of life.

It is not necessary at this point to describe, in detail, the various weaknesses, pains, fears, and forebodings which usually accompany nervous breakdown. Its victims know all too well the thousand and one clouds that darken the mind which, like the sea, is the home and mirror of storms of varying kinds and degrees. In taking up a book like Benson's "House of Quiet," they instantly recognise a brother in misfortune, in the statement, "I found myself disinclined to exertion, bodily and mental, easily elated, easily depressed, at times strangely somnolent, at others irritably wakeful."

In the class with which we are dealing, the emotions are so lively, and they occupy such a large place in consciousness, that the craving for sympathy becomes almost insatiable. And whilst it is not wise for the sufferer's friends to yield freely to the demand, it is due to the victims themselves to try and understand them, and not to irritate them by giving cheap advice which has no basis in knowl-

Introduction 15 edge and understanding. The writer of these pages understands, and it is because he knows the "ins" and "outs" of this most painful and distressing malady that he ventures to hope that the following pages will give hope and cheer.

It should be said, further, that nervous disorders often seem to fasten upon the best and most delicate types. Just as the finest and most intricate machines are most liable to get out of order, so, it would seem, it is precisely those bodies and minds which are fashioned in the finer moulds which are predisposed to go wrong.

"Capacity for pain is the mark of rank," it has been said. Certainly, if that is so, those suffering from nervous breakdown have the consolation that their afflictions are the defects of their qualities, and that whilst their sufferings are many and severe, there are compensations: for if they suffer much, they also enjoy much; if they know the bitterness of the depths, they also know the exhilaration of the heights.

All things considered, the wonder is that the human machine runs as well as it does. When we reflect how the machine is strained and neglected, how we so commonly drain both body and mind, giving little thought to the restoring and renewing processes of life, we might well agree with the old couplet :

"Strange that a harp with a thousand strings Should keep in tune so long."

In view of the new times ahead, therefore, bringing with them, as they are sure to bring, still more severe and continued strain, it is highly important that we fully realise the nature and causes of nervous breakdown. It is also important that we know something of the lines along which a cure for the trouble may be looked for, and it is to these ends that the following chapters will be directed.

Chapter II The Nervous System

Before attempting to set forth the nature and general symptoms of nervous breakdown, perhaps it would be well to give the reader some general idea as to what the nervous system is. In general terms, it is the mechanism by means of which we acquire our knowledge of the world. The endless number and kinds of sensations which are necessary for the birth of a thought, the formation of a sound judgment, or the forming of a resolution, all come to us by means of the nervous system. Needless to add, it is by this same means that our physical life finds its highest and most efficient expression.

For our purpose, it is not necessary to enter fully into the minutise of the system, since it is so extremely intricate that special study is required in order to realise its extraordinary ramifications, and its complex mode of operation. The fundamental unit of the nervous system is the neurone, the protoplasmic cell, along with its out-going fibres. The brain is the principal part of the system, which consists of a series of (l) nerve cells, (2) nerve fibres, and (3) nerve end organs. For the most part, the

*7 .__ nerve cells are located in the brain and the spinal cord, though they are found in all parts of the bod)\ Of course, there are degress of importance in the nerve cells, those related especially to one's thought-life being of special interest. Millions of these are stored away within the convolutions of the brain, and it is largely to these that we are indebted for the extent and richness both of our conscious and subconscious life.

It is said that there is no psychosis without its corresponding neurosis, which means that there is no movement of the mind without a corresponding movement of some part of the nervous system. Thoughts, feelings, recollections, decisions, are severally accompanied by characteristic movements in the brain cells. These actions and reactions are more wonderful than, though very like, a vast telephone system, with its endless wires and connections. The brain is the great centre or "exchange," through which passes an almost infinite number of calls and messages.

There is this great difference, however, between the telephone system and the nervous system: whilst the former manipulates sound waves only, the latter deals with waves of colour, scent, taste, and touch in addition. Further, generally speaking, it is the function of these multitudes of nerve cells to generate nervous energy. It is this energy which expresses itself in sensation, consciousness, memory, reasoning, feeling, and the movements of the body.

The Nervous System 19

As to the nature of nerve energy, comparatively little is known. The theory is, however, that the nerve cell has within it certain chemical compounds, which constitute its energy. Energy having been discharged from the nerve cell, it needs to be replenished, from time to time, before it can do further work. Rest is therefore one of the prime essentials for nerve cell restoration. Further, new reserves of energy are possible only as fresh materials are brought to the nerve cells, by means of the blood. In proportion as the blood is purified and enriched is the nerve cell re-stored with energy.

When it is remembered that the brain and spinal cord contain probably some 3000 millions of nerve cells, we get some idea of the immensity and complexity of the nervous system generally, and consequently the serious results which must follow when, through exhaustion, its natural efficiency is impaired. It has been computed that if we could make a model of the human brain, using for its nerve fibres wires so small as to be barely visible to the eye, in order to find room for all the wires employed, space considerably larger than that of Selfridge's great stores would be required.

Thus we may realise to some extent what a wonderful machine the nervous system is. When we speak, therefore, of nervous breakdown, we are speaking of the breakdown of the most marvellous piece of mechanism in the world. The smooth working of this machine presents us with the greatest results on earth, a sound mind in a sound body. It conditions the highest thought, the noblest emotions, and the strongest will, which are the marks of the elect of our race. The highest attainments in poetry, art, politics and religion, as well as the greatest achievements in science, war and discovery, each and all are possible only as this vast, intricate and mysterious machine, the nervous system, performs its myriad functions easily and without friction.

But what does nervous breakdown mean, in the experience of those who have come under its dread spell? It must be admitted that comparatively little is known as to what it really is, apart from actual experience.

The term neurasthenia has been explained as "a generalised irritable weakness of the entire nervous system, characterised by hypersensitiveness of the sensorium, loss of mental and bodily vigour, inaptitude for work, disturbed sleep, and irritability of temper; and by muscular weakness, restlessness, nervousness and vague pains; and usually accompanied by various phenomena referable to the vasomotor and sympathetic systems." Some authorities divide the trouble into many varieties. For our purpose it is sufficient to regard neurasthenia as of two kinds, cerebral and spinal. Usually each of these implies the other, and it is rarely found that the one exists entirely without the other. It is spoken of, quite commonly and simply, as "chronic enfeeblement of nerve strength," or "nervous exhaustion," or "functional nervous weakness of the

The Nervous System 21

spinal cord." But whatever terms are used to describe the malady, the sufferer alone knows what the disease really is, and what a dread shadow it casts over both mind and body.

Neurasthenia, in one form or another, has probably existed, more or less, in all times, where the stress and strain of life have been especially severe. It would be an interesting study to trace out nervous disorders in the field of literature. For example, to what extent, it might be asked, is the tragic element in Hamlet,the melancholy Dane, due to nervous exhaustion^ Still, there can be no doubt that nervous troubles have become accentuated and more prevalent in recent times. Most authorities agree in affirming that they are steadily and increasingly fastening themselves upon an ever-growing number of the best and most active lives.

It is with some concern, therefore, that one contemplates the future. As a result of the world-wide war, we are confronted with a new order of things in an almost new world. This would seem to mean that the game of life is going to be keener and faster, and that the race will be to the swift and the strong. Hence it is of the highest importance that we know what dangers are in front of us, and what the new pressure of a new age is going to bring in its train. If we are to stand the test, we must not be handicapped and hindered by those nervous disorders which, of all the ills to which flesh is heir, most unfit us for the duties and demands of that coming time of reconstruction which is already upon us.

Chapter III As Others See Him

It would seem that Nature, sometimes, plays strange tricks with us. Especially does it appear so in the case of the victim to "nerves." Not infrequently, judging by outward signs, there is nothing amiss with him. Usually appearances are all that could be desired. He looks well, has a good appetite, and is inclined to "put on weight." These signs are so common that the sufferer finds himself being told, by innuendo, if not by plain words, that he "imagines things," and that his trouble is more illusory than real.

To the keen observer, however, there are certain outward signs which indicate the presence of serious trouble. The face lacks repose. It is sometimes subject to uncontrollable flushing; the muscles of the face are apt to twitch, and the eyes have an uncertain movement and an unnatural light. When roused, either by anger or sympathy, the man talks voluminously and rapidly. His whole body lacks repose. At these times, it is best to "let him have it out," the stream will run dry, in due course; then the talker will shrink into himself, and become calm, once more clothed in his right mind.

As Others See Him 23

It has been pithily said that for this busy, bustling competitive world three things are necessary for most of us : a clear head, a warm heart, and a thick skin. The type we are considering has not a clear head ; far from it. His heart is certainly warm. As to his skin, figuratively speaking, it is abnormally thin, and so he is painfully aware of every east wind that blows. Indeed, the man is a walking barometer. At a sudden clang of a bell, or the bang of a door, he starts as if about to jump out of his skin, whilst his heart beats as if he were threatened with some dire calamity.

The very last place where we should look for a sense of proportion is in a mind upset by nervous disorder. The writer has on many occasions asked those suffering from neurasthenia how the sense of injustice, or a personal insult, affects their minds. In every case, the confession is the same, that it robs them, for the time being, of their due sense of proportion; it arouses such anger and indignation as to amount to positive pain. For weeks, and even months, passionate resentment will last, until eventually the victim sees that his anger was out of all proportion to the offence. Under the stimulus of strong emotion, thought, reason and judgment have fled. He makes mountains out of mole-hills. He gives to trifles immoderate importance.

Reason implies seeing differences and agreements. It means a sense of comparison, and it is precisely this sense that is absent in most cases of nervous disorder.

Further, in these days, and especially in the days that are coming, it is the man whom we call a "stayer" who is going to count. It is here again that the victim to nervous trouble is apt to fail, and must fail until, by some means or other, he rises above his disability. The trouble in these cases is that the man cannot conserve his energy. He wastes more than he uses. He burns the candle not only at both ends, but in the middle as well. He spends his energy like a spendthrift. He works by fits and starts. He uses up forces to-day which he will require to-morrow. He uses up his strength in unimportant things and, under the stress of strong feeling or passion, he squanders enormous potencies, which not only do no good but do positive harm.

Quite recently, a case came within our notice of a man suffering from nervous breakdown, and who within a few years had obtained and lost eight situations. "Sooner or later," he said, "I am found out." Conversation revealed the fact that he was a good "starter" but a bad "stayer." How could it be otherwise*? When the energy is not stored up and conserved, a man has to live, so to speak, from hand to mouth. He has no reserves, and, whether in war or in individual life, it is the reserves which tell in the end, and give us victory or defeat.

In severe nervous breakdown, it is noticeable also that the victim's mental life has been seriously dis-

As Others See Him 25

turbed. The mind is manifestly uncertain in its movements. It lacks grip. The impressions it receives are vague, and have not that definition and detail, which are the marks of mental health and power. Commonly the man will suddenly stop in the midst of a conversation or argument. The power of association, which is the law of thought, is weak, and hence the mind hesitates and flounders instead of pursuing the line of thought unerringly to the end. Cases are known to us in which clergymen, and public speakers, suddenly stop, in the middle of the argument, the mind becoming a blank, for some seconds, and then, after much confusion to speaker and hearer, the point is seized, and the discourse continues. It may be said that to lose the thread of a line of thought is not peculiar to those of the class with which we are dealing, but is common enough, especially in those of advanced age. Indeed, the same remark may be made respecting many of the mental defects incidental to nervous disorder. But, in nervous cases, these mental defects and failures are intensified and are frequently accompanied by such a sense of utter helplessness as to write fear and alarm upon the face itself, i A common symptom in nervous breakdown is the habit of what is called introspection. The cumulative effect of nerve trouble is that the vision becomes inverted and that the mind is so occupied with itself that interest in outside and natural things is almost absent. "The mere pursuit of health," says Mr.

G. K. Chesterton, "always leads to something unhealthy." Introspection is often nothing more than a blind search for mental health, and inevitably it leads the victim into that slough of the mind we call depression. Professor Bain points out that the illeffects of depression upon the muscles are most marked. Its paralysing influence upon the imagination, upon the will, and upon all those generous impulses which keep us in touch with our fellows, is so manifest, that pity fills the heart of all those who have to do with these prisoners without hope. We think it was John Morley who said, "Emerson's landscapes are all horizons." The landscapes of the nervous wreck have no horizons. His sense of perspective has been destroyed, and, until that can be restored, neither body nor mind can regain the one thing that makes life worth living, and that is health. Quite commonly one of the victims, such as we are speaking of, will say, "I've lost interest in everybody and everything." The fact is, the only interest left him is interest in himself, for his vision has broken down, and he can no longer look out beyond the bounds of his own disorder. Occasionally, when the disease is not far advanced, he will turn to books dealing with psychology, hoping to find escape thereby. But this is to make confusion worse confounded, for, like the semi-invalids who read medical books instead of consulting the physician, he imagines that he has ills which he has not. After a fairly wide experience, we are confident that,

As Others See Him 27

for the mind which is ill through nervous disorder, nothing is worse than to dabble in "isms" and "-ologies," which only add fuel to the fire, and prevent the mind from getting back to nature, with its play and song, its green fields and blue skies, its fresh air, and its wide, open spaces.

Chapter IV As He Sees Himself

In order that we may understand more fully the nature of the disorder, as it affects the mind and its atmosphere, it may be well to set out the facts as known to the writer of these pages.

The trouble we are dealing with does not come upon us suddenly. It grows upon one. For some time, it is not realised that anything unusual is happening. Over and above the general feeling of exhaustion, there are other definite ailments present, in most cases. For the first time, it may be, the victim knows the meaning of the term headache. Even/this is of a ikind peculiar to his special trouble. It is not so much acute pain that he experiences as pressure, fulness, or restriction. He has the feeling that his head is being pressed, as if by a weight, or by a hat which is too small for him. Commonly, the pain is at the back of the neck. Sometimes it is in the forehead, or temples. It may be continuous, but often it seems to come and go rhythmically, and at intervals, not infrequently leaving the scalp so tender as to make it painful to brush the hair.

Then, perhaps less commonly, nervous breakdown

As He Sees Himself 29

means a most serious and distressing trouble at the lower part of the spine. It is not so much definite pain as intense weakness, and is similar to that painful weariness which ensues after sitting bolt upright for a long time. Perhaps nothing contributes more to his depressed spirits than this special weakness in the spine. The corollary to this trouble is often a restlessness which manifests itself in occasional jerkings and twitchings of the limbs.

Fortunately, these troubles come and go at certain intervals. The immediate causes are often difficult to trace. Here, as in so many other of the ailments incidental to nervous disorder* the one thing to be borne in mind is not to go beyond one's physical limitations, or, in other words, to keep well within the store of nervous energy at our disposal.

Further, in many cases of nervous breakdown there is a curious upsetting of our sleeping habits. Morning, noon, and night, the victim is on the borderland of sleep. He feels drowsy, listless, and sometimes almost overpowered with the spirit of weariness. Sometimes a paralysing calm settles upon him. His condition is something like that of the Ancient Mariner —

"Down dropt the breeze, the sails dropt down,

'Twas sad as sad could be: And we did speak only to break The silence of the sea."

And yet when the proper time comes for sleep often nothing is more difficult. The most trivial things, comparatively speaking, so irritate the mind and excite his emotions that excessive wakefulness at night is a serious trouble. A heated argument, a fit of bad temper, bad news, competitive games, in short, anything making unusual demands upon the feelings — each or any of these is a cause sufficient unduly to disturb the mind, and so to produce a state of sleeplessness.

From the foregoing, it may be seen that the physical disabilities of nervous breakdown are serious enough. Still more serious, however, are mental weaknesses which accompany them, and which to a large extent are the results of those disabilities. Perhaps loss of memory is among the first and earliest signs of nervous breakdown. And, to the fairly young and middle-aged, this is a serious handicap. In advanced age, of course, it is natural enough. When, however, the barrister or the city clerk, the author or the accountant, when these, in the heydey of their career, find their powers of recollection failing, and cannot remember important details, such as names and faces, as is often the case in nervous trouble, their alarm is natural and even wholesome. Something serious has happened.

The fact is that what has happened is easily explained. The impressions which are being made upon the mind are vague and indistinct. Owing to the abnormal state of the nerves, the mind flits from object to object, not resting sufficiently long upon anything, so as to see it in detail and

As He Sees Himself 31

clear outline. As the good photograph is conditioned by a good exposure, so memory is conditioned by good impression, that is, by detail and definition. Memory is the power of recalling impressions. Unless the impressions we wish to recall, therefore, and which are down in the subconscious mind, are vivid and distinct, it is too much to ask of the mind to make them live again in our conscious mental life.

Intimately connected with this failure of the mind to recall past impressions is the further inevitable result of nervous trouble, lack of the power of concentration. Indeed, this is partly the reason for loss of memory, as is easily seen. It is also the cause of many other mental, not to say moral, weaknesses. When the mind cannot focus itself upon the matter in hand, it has abdicated its supreme function, for it has ceased to exercise control, the will itself being enfeebled in all such cases. Any serious attempt to concentrate the mind upon matter not particularly interesting often means, in nervous wrecks, utter confusion, the mind becoming a blank for the time being.

That lack of concentration means also indecision and vacillation is quite natural. Decision of character rests upon a proper balance of the mental faculties. It means seeing the facts, and so feeling and thinking about them as to kindle the power of will in the mind. And it is here that the mind fails in nervous disorder. It does not see things aright, or feel or think about them aright, and hence decision and action are difficult to set in motion.

Then, we should hardly expect to find much self-confidence in the class of people we are dealing with. On the contrary, timidity is characteristic of their disorder. They dislike meeting strangers; they hesitate to cross a crowded thoroughfare; they are shy in company, until roused, and then they sometimes become noticeably bold.

Moreover, there is a constantly recurring sense of vague and indefinable fears. For hours, and sometimes days, the victim is oppressed with the feeling that something unpleasant, not to say dreadful, is going to happen. He may reason with himself as much as he will, proving, for the moment, that his fears and forebodings are groundless. Still, the cloud hangs heavily overhead. He broods and broods, shrinking more and more into himself, becoming silent and detached from those about him, until at last the cloud lifts, and without any known cause he is out in the open sunshine once more.

It is curious to note the effects of colour and sound upon those suffering from nervous disorder. To both they are, not infrequently, extremely sensitive. Quite recently, a distinguished man of fine, mental ability, but who was suffering from nervous disorder, confessed that, sitting in his garden in the evening, and hearing the sounds of church bells, coming to him from a distance, he is moved to tears. Such people often find that to attend church is most

As He Sees Himself 33

painful. The general appeal to the feelings, in the music and the living voice, so overpower them as to make regular attendance difficult if not impossible.

When it is remembered that colour is intimately and directly associated with sound, we can easily imagine what positive effects colour must have upon the mind. As a matter of experience, we know that the soothing influences of colours, for example, are so real that we are convinced that it should be classed among the curative methods of treatment in certain kinds of nervous trouble. In all such cases, it will be found that a room in the house, arranged according to some well-thought-out colour scheme, will be a haven of refuge to such sufferers, and do much to help them during the period in which they are regaining their lost nervous and mental health.

In this connection, we might point out that darkness often has a depressing effect upon the victim of nerves. Except when retiring to rest, those suffering from nervous breakdown are happiest in the light. Sunless days, and dark, dingy rooms, these are positive irritants, and the more they live in open spaces, and in the sunlight, the more at ease they are, and the better chance they have of rising above their naturally gloomy selves.

From all this, it may be thought that those suffering from nervous disorder are very disagreeable people. At times they are. In any case, however, they mostly have the charm of variety. You may like them or yQu may not, but you cannot ignore them. Moreover, whatever their qualities or defects may be, they comprise a large and growing section of the community, and, until the disabilities under which they live are removed, an enormous fund of the finest energy is being wasted and so lost to the general good.

Chapter V Heredity And Education

The question is often asked, what is the cause of nervous breakdown? In few, if any, cases can absolutely specific causes be assigned. Mostly there are several causes, each again having a deeper cause, and each contributing its share to the final and painful result.

Among the deeper sources of the trouble, there is undoubtedly the influence of heredity. Within what limits the influence of heredity works is not easy to determine. This involves the question of biology, the outposts of which fade away into mystery. There can be no doubt, however, that nervous breakdown in many cases can be traced to similar disorder in the parents or forefathers of the victim. Tennyson reminds us that —

"Sometimes in a dead man's face To those that watch it more and more, A likeness hardly seen before Comes out to some one of his race."

It is not strange, therefore, if nerve troubles are traceable to the highly-strung temperament of the father, and especially to that of the mother. Where there is present a neurotic tain t in one's family, there it is not infrequently found that nejxflusJbcgg^- down is easily apt to set in. Being at first simply a tendency, under pressure or neglect it takes definite form in the trouble with which we are dealing.