We have learned that psychic causes may play a great role in the occurrence and the prevention of disease. We may confidently assert that without the presence of a psychic component8 which invokes9 the disease hardly a single case of nervous disease could occur. Paradoxical as this may sound it is nearer the truth than the orthodox teachings of our day. For who does not recollect10 times in his childhood when he longed to be sick that he might not have to go to school, and that he might at the same time [Pg 126]be petted and indulged by his parents? A little of this infantilism persists with us throughout life. Hysterics especially are distinguished11 by the infantilism of their thoughts, their feelings, and their ideas. This being so, we must agree with Bleuler when he asserts that the most common cause of hysteria is the desire to take refuge in disease. It will be of interest here to reproduce Bleuler’s report of one of his cases (from his book on “affectivity, suggestibility, and paranoia,” published by Karl Marhold in 1906).
“A paterfamilias suffers an injury in a railway accident. How terrible it would be if he were so disabled that he could no longer provide for his family and if he had to go through life that way, suffering all the time, and half the time unable to work! How much better it would be if he were dead or wholly disabled. His attorney informs him that his annual earnings12 equal the interest on 80,000 francs, and that he could bring an action for that amount—a sum which would insure his family against want for the rest of their lives. Are there not indications enough that he will need this sum? Isn’t it a fact that he is already suffering from insomnia13? Work fatigues14 him—his head aches—railway journeys make him apprehensive15 and even cause attacks of anxiety; how helpful it would be, nay16, how absolutely necessary it would be, to prove that he is very sick and to get that 80,000 francs! And now the traumatic neurosis or psychosis is [Pg 127]established, and will in all probability not be curable until the lawsuit17 is satisfactorily settled.” Bleuler does not mince18 matters but roundly asserts that in this case the wish caused the neurosis. Would it be proper to call these people malingerers? By no means! For, naturally, all these wishes are not clearly known to these individuals; they suffer in good faith. The wish emanates19 from unconscious levels. Consciousness vehemently20 resents any imputation21 of the thought of simulation. Such invalids23 usually protest vehemently their desire to be well. “How happy would I be if only I had my health! Then I would gladly dispense24 with damages!”
Here I should like to report two cases from my own experience which serve to illustrate25 the refuge in disease even better than the case described by the distinguished Swiss psychiatrist26. The first was a very sick woman who had been bed-ridden for six years. No organic malady27 could be discovered. The diagnosis28 was hysteria. The deeper cause of her malady was as follows: Her husband was a coarse, brutal29 fellow, continually upbraiding30 her for something or other and raising fearful rows; but when she was sick his whole nature underwent a change. Then he became amiable31, affectionate and attentive32. As soon as she was well he became the old, unendurable, domestic tyrant33. Finally, there was nothing for this delicate, weak woman to do but to take refuge in disease. [Pg 128]Her limbs used to tremble and refuse their function, so that she had to stay in bed or be rolled about in an invalid22 chair. All the skill of her physicians—and she had the best the metropolis34 had to offer—proved unavailing. Naturally the cure of such a case is hardly possible unless one can remove the cause for the refuge in disease. In this case this solution was out of the question, and so the woman goes on enjoying the blessed fruits of her invalidism35, complainingly but not unhappily, exulting36 within, but miserable37 without.
Our everyday life furnishes numerous petty examples of refuge in disease: the nervous wife who breaks out in a hysterical38 crying spell if her husband reproaches her; the schoolboy who complains of headache when he cannot get his lessons done; the husband who gets pains in the stomach every time his wife makes life unbearable;—they all take refuge in disease as a means of escape from their persecutor39. How often is this phenomenon observed among soldiers, for whom a few days of illness means the most delightful40 change! In these cases even the most experienced military physicians often find it impossible to distinguish between wish and reality.
A physician who does not know of the phenomenon we have designated as “refuge in disease” will be helpless in the handling of most cases of hysteria. A blooming young girl had for two years consulted specialists of the highest [Pg 129]repute about the raging headaches with which she was afflicted41. All the usual remedies, such as antipyrin, phenacetin, pyramidon, and even morphine, failed to give her even slight temporary relief. The experts thought of a tumor42 in the brain and of other dangerous maladies as the possible cause of these obstinate43 headaches. But it turned out that this headache, too, was only a refuge in disease. A casual remark of the father’s betrayed the true nature of the trouble: “My daughter is about to be married; she has been engaged for two years, and the young man is anxiously waiting for the wedding; but I can’t let her marry while she is suffering from such a severe disease.”
The headache was obviously the means of getting out of a hateful marriage. Of course one who would have been content with her first story would never have discovered the truth. What stories she told about her wonderful love! How ardently45 she loved her betrothed46! There was nothing she longed for more than the wedding-day! How unhappy she would be if she lost him! But a careful psychoanalysis brought forth47 ample and convincing confirmation48 of the above-mentioned suspicion. The girl had been engaged once before; in fact she had not yet completely broken off her relations with her former lover. In addition thereto there were confessions49 about the death of all erotic feelings during the second engagement, as to which we cannot go into details. It was [Pg 130]quite clear that her malady was a refuge in invalidism. I advised breaking the engagement. The advice was not followed. On the contrary, the family hoped that a speedy marriage might bring about a cure of the hysterical condition. But the young woman is still going about, complaining and whimpering, with her malady (from which her husband, notwithstanding his inexhaustible patience, suffers more than she). Will she ever be well? If she ever learns to love her husband she may recover her health. But where such powerful, unconscious counter-impulses, such powerful instincts, contend against an inclination50, it is scarcely possible that this inclination will develop into full sovereignty of the soul.
What we have just said of the neurosis is also true of the delusions51 of insanity52. A delusion also is a fleeing from this world into another one in which some particular overvalued idea represses all other ideas and dominates the mind. It will not be long ere this conception will be an accepted doctrine53 of all psychiatrists54. For the time being it is the common property of creative literary artists, who, because of their intuitive insight into human nature, have frequently given expression to this idea. It is perhaps most beautifully expressed by Georges Rodenbach, the Flemish artist, unfortunately too early deceased, who says in one of his fine posthumous55 novels (“Die Erfüllung,” Dresden, 1905):—
“The insane have nothing to complain of. Often they achieve their purposes only in this way. They become what they have longed for and what they would otherwise never have become. They obtain the coveted56 goal and their plans are fulfilled. They live what once they dreamed. Their delusion is, to all intents and purposes, their inner fruition, inasmuch as it corresponds to their most ardent44 desires and their most secret yearnings. Thus the ambitious one ascends57 in his delusions the heights that have beckoned58 to him; he possesses endless treasures, orders the destinies of great nations, and moves only among the great rulers of the earth. Religious delusion brings its victim to the throne of God and makes life in Paradise a tangible59 reality. So that delusion always realises the goal that each has longed for. It gratifies our desires to the utmost limit. Sympathetically it takes a hand in our affairs and completes the altogether too pretentious60 destiny of those upon whom fulfillment never smiles.”
What a beautiful idea! Delusion is a wish-fulfilment exactly as the dream is. The madhouse is the paradise of thoughts, the heaven in which wishes meet with unlimited61 fulfilment. And human beings sicken so often, and madness increases with such uncanny rapidity, because our most secret wishes are never gratified, because in these dull times the miraculous62 has died, and because life demands so much renunciation and yields so little happiness.
Let us draw these lessons from the foregoing remarks: to keep one’s desires within bounds means to assure one’s spiritual health. Inordinate63 ambition, which foolish parents kindle64 in their children’s hearts, is often the cause of an early breakdown65. We must school ourselves and our children to wish only for the attainable66 and to attain67 our desires. Our ideals must live in our breasts, not in the outer world. Then we may find in ourselves what the world denies us. They who can find refuge in their health will escape having to take refuge in disease.
点击收听单词发音
1 alas | |
int.唉(表示悲伤、忧愁、恐惧等) | |
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2 immature | |
adj.未成熟的,发育未全的,未充分发展的 | |
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3 thrall | |
n.奴隶;奴隶制 | |
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4 materialistic | |
a.唯物主义的,物质享乐主义的 | |
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5 delusion | |
n.谬见,欺骗,幻觉,迷惑 | |
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6 psychic | |
n.对超自然力敏感的人;adj.有超自然力的 | |
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7 disturbance | |
n.动乱,骚动;打扰,干扰;(身心)失调 | |
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8 component | |
n.组成部分,成分,元件;adj.组成的,合成的 | |
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9 invokes | |
v.援引( invoke的第三人称单数 );行使(权利等);祈求救助;恳求 | |
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10 recollect | |
v.回忆,想起,记起,忆起,记得 | |
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11 distinguished | |
adj.卓越的,杰出的,著名的 | |
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12 earnings | |
n.工资收人;利润,利益,所得 | |
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13 insomnia | |
n.失眠,失眠症 | |
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14 fatigues | |
n.疲劳( fatigue的名词复数 );杂役;厌倦;(士兵穿的)工作服 | |
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15 apprehensive | |
adj.担心的,恐惧的,善于领会的 | |
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16 nay | |
adv.不;n.反对票,投反对票者 | |
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17 lawsuit | |
n.诉讼,控诉 | |
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18 mince | |
n.切碎物;v.切碎,矫揉做作地说 | |
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19 emanates | |
v.从…处传出,传出( emanate的第三人称单数 );产生,表现,显示 | |
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20 vehemently | |
adv. 热烈地 | |
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21 imputation | |
n.归罪,责难 | |
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22 invalid | |
n.病人,伤残人;adj.有病的,伤残的;无效的 | |
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23 invalids | |
病人,残疾者( invalid的名词复数 ) | |
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24 dispense | |
vt.分配,分发;配(药),发(药);实施 | |
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25 illustrate | |
v.举例说明,阐明;图解,加插图 | |
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26 psychiatrist | |
n.精神病专家;精神病医师 | |
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27 malady | |
n.病,疾病(通常做比喻) | |
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28 diagnosis | |
n.诊断,诊断结果,调查分析,判断 | |
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29 brutal | |
adj.残忍的,野蛮的,不讲理的 | |
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30 upbraiding | |
adj.& n.谴责(的)v.责备,申斥,谴责( upbraid的现在分词 ) | |
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31 amiable | |
adj.和蔼可亲的,友善的,亲切的 | |
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32 attentive | |
adj.注意的,专心的;关心(别人)的,殷勤的 | |
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33 tyrant | |
n.暴君,专制的君主,残暴的人 | |
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34 metropolis | |
n.首府;大城市 | |
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35 invalidism | |
病弱,病身; 伤残 | |
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36 exulting | |
vi. 欢欣鼓舞,狂喜 | |
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37 miserable | |
adj.悲惨的,痛苦的;可怜的,糟糕的 | |
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38 hysterical | |
adj.情绪异常激动的,歇斯底里般的 | |
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39 persecutor | |
n. 迫害者 | |
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40 delightful | |
adj.令人高兴的,使人快乐的 | |
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41 afflicted | |
使受痛苦,折磨( afflict的过去式和过去分词 ) | |
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42 tumor | |
n.(肿)瘤,肿块(英)tumour | |
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43 obstinate | |
adj.顽固的,倔强的,不易屈服的,较难治愈的 | |
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44 ardent | |
adj.热情的,热烈的,强烈的,烈性的 | |
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45 ardently | |
adv.热心地,热烈地 | |
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46 betrothed | |
n. 已订婚者 动词betroth的过去式和过去分词 | |
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47 forth | |
adv.向前;向外,往外 | |
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48 confirmation | |
n.证实,确认,批准 | |
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49 confessions | |
n.承认( confession的名词复数 );自首;声明;(向神父的)忏悔 | |
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50 inclination | |
n.倾斜;点头;弯腰;斜坡;倾度;倾向;爱好 | |
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51 delusions | |
n.欺骗( delusion的名词复数 );谬见;错觉;妄想 | |
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52 insanity | |
n.疯狂,精神错乱;极端的愚蠢,荒唐 | |
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53 doctrine | |
n.教义;主义;学说 | |
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54 psychiatrists | |
n.精神病专家,精神病医生( psychiatrist的名词复数 ) | |
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55 posthumous | |
adj.遗腹的;父亡后出生的;死后的,身后的 | |
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56 coveted | |
adj.令人垂涎的;垂涎的,梦寐以求的v.贪求,觊觎(covet的过去分词);垂涎;贪图 | |
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57 ascends | |
v.上升,攀登( ascend的第三人称单数 ) | |
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58 beckoned | |
v.(用头或手的动作)示意,召唤( beckon的过去式和过去分词 ) | |
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59 tangible | |
adj.有形的,可触摸的,确凿的,实际的 | |
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60 pretentious | |
adj.自命不凡的,自负的,炫耀的 | |
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61 unlimited | |
adj.无限的,不受控制的,无条件的 | |
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62 miraculous | |
adj.像奇迹一样的,不可思议的 | |
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63 inordinate | |
adj.无节制的;过度的 | |
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64 kindle | |
v.点燃,着火 | |
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65 breakdown | |
n.垮,衰竭;损坏,故障,倒塌 | |
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66 attainable | |
a.可达到的,可获得的 | |
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67 attain | |
vt.达到,获得,完成 | |
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