I hesitate to accept Ribot’s classification, inasmuch as we have pointed8 out that fear is prior to pain. In most lower animals it is hardly probable that not having representations that there is present a fear of pain in advance of the pain itself. Fear under such conditions can only be awakened10 by an actual sensory11 experience whether it be painful or not. In fact Ribot himself agrees to the fact that “There is a primary, instinctive12, unreasoning fear preceding all individual experience, a hereditary13 fear.”
Perhaps a word may be said in regard to the factor of disgust as having a common basis with fear. It is only by a stretch of imagination, if not by a stretch of words, that fear and disgust can be identified. There may be fear where there is no disgust, and there may be disgust where there is no fear. The two are independent variables, and can hardly be referred to as one and the same fundamental reaction, such as withdrawal and flight. The object of disgust does not preclude14 approach. The avoidance or aversion, the nausea and vomiting are all subsequent phenomena15. Disgust may even follow after an abuse of food, of pleasant or necessary objects of nutrition, such as satiety16.
[349]
The reactions of the fear instinct run the contrary way, approach is precluded17 from the very start. Fear is not associated with useful objects or events, unless it be in morbid18 states of fear.
And still fear and disgust may become intimately associated when disgust and its objects awaken9 the fear instinct, and the fear becomes the fear of disgust or of the disgusting object. Disgust is more of a specialized19 character, and is associated with particular events or specific objects, while fear, in its primitive20 form at least, is more of a generalized character.
In the higher forms of life disgust may be so intimately related to fear that the two become synthesized, so to say, and are felt like one emotional state, the state becoming one of fear disgust. In such cases the fear instinct, fear disgust, is a determining factor of the morbid state. This is confirmed by clinical experience of the various cases of psychopathic functional21 neurosis and psychosis.
In the various morbid states of the depressive types fear is awakened long before any pain is actually suffered, or any particular cause is found by the patient to account for the terror that dominates his mental life. The fear comes first while the representative cause is assigned by the sufferer as the cause of the fear.
Similarly in the functional psychosis and neurosis the object, experience, event, may be quite ordinary[350] without any suggestion of pain or distress22 in it. In fact, the experience may be indifferent or even pleasant, but when associated with the fear instinct may become the nucleus23 of a very distressing24 pathological state. The experience is the occasion, while the fear instinct, the intimate companion of the impulse of self-preservation, is the only cause of functional psychopathic maladies.
The fear instinct in its primitive state is anterior25 to all experiences of danger, pain, and suffering, as is the case in most of the lower animals. In the higher animals where memory is developed, the fear instinct is associated with some form of representation, however vague, and then fear becomes posterior to experience. In man both forms of fear are present. The anterior form is specially26 found in children, while in adults the posterior form is, under normal conditions, predominating. The primitive anterior type of the fear instinct is by no means absent, in fact, it is more overpowering, its effects are overwhelming when it comes forth27 from the subconscious28 regions to which it is confined, and is manifested under conditions of lowered vitality29.
When the strata30 of dynamic energies are passed and the strata of reserve energies are reached, the reserve energy not being accessible, the fear instinct is elemental, fundamental, while the fear of pain and of some definite representation of danger, or of suffering is a secondary consequence. People may suffer[351] from pain, disease, and even danger, and still have no fear, while others may have never experienced the pain or disease, and still be obsessed31 by intense pangs32 of fear. Fear is sui generis, it is at the foundation of animal life.
The fear instinct may be awakened directly by a sensory stimulus33, when, for instance, one finds himself in darkness and feels some creeping, slimy thing, or when attacked suddenly with a club or a knife. The fear instinct may again be aroused by an expectation, by something to which his dynamic energies cannot respond adequately, while the reserve energies are in abeyance34, such for instance as the expectation of some threatening event either to himself or to the objects bound up with his life existence. When one is threatened with some misfortune, with torture, death, or with a mortal disease, or with a serious operation, or when confronted with great danger against which his energies prove inadequate35, in such cases the fear is ideational. These types of fear may in turn be either conscious or subconscious.
We may thus classify the fears as follows:
{ Conscious
I. Sensory {
{ Subconscious
{ Conscious
II. Ideational {
{ Subconscious
[352]
The fear of the etherized or chloroformed patient is entirely36 of the subconscious type. It is the arousing of subconscious fear which, from the nature of the case, cannot be reached and alleviated37 that gives rise to functional psychosis and neurosis.
From this standpoint it may be said that psychopathic diseases are subconscious fear states, in other words functional psychosis or neurosis is essentially38 a disease of subconscious activities. This is, in fact, confirmed by my clinical experience and by my psychopathological research work.
Dr. L. J. Pollock, professor of nervous diseases at Northwestern University Medical School, made an extremely interesting “Analysis of a Number of Cases of War Neurosis.” This analysis fully39 conforms to the results obtained by me in my work on functional psychosis and neurosis carried on for a great number of years. It fully confirms the results of my studies, clinical and psychopathological, that the causation, or etiology of functional psychopathic states depends on fluctuations40 of the levels of neuron energy, or physical exhaustion41, fatigue42, hunger and thirst, or shock to the system, and more especially on the ravages43 of the fear instinct, aroused during the dangers and horrors of war.
“Of several hundred cases which I observed in base hospitals in France, copies of about 350 records were available. From these 200 of the more detailed44 ones were selected to determine the relative[353] frequency of some of the factors.... From the numerical group has been excluded cases of emotional instability, timorousness45, hospital neuroses occurring as an aftermath of an illness or a wound, the phobic reactions of gassed patients and constitutional neuroses, and those not directly related to the war.
“Heredity as a factor plays but a small part, and the incidence of neuropathic taint46 constituted little over 4 per cent.
“Of these 43 per cent followed shell fire, 36 per cent after concussion47 as described by the soldier.... A definite history of fatigue and hunger was obtained in 30.5 per cent. Both probably occurred in a greater percentage, but were frequently masked by other symptoms which occupied the patient’s attention to a greater extent. Fatigue and hunger are important factors, not only because they prepare the ground for an ensuing neurosis by breaking down the defensive reactions, but also in that when the patient is more sensitive and impressionable, the natural physical consequences of fatigue are misinterpreted by him as an evidence of an illness, and give rise to apprehension48 and fear.
“As frequently as fear is seen in some form or other in the neuroses of civil life, so does it manifest itself in the war neuroses. Fifty per cent of the cases admitted considerable fear under shell fire. Concussion was the immediate49 precipitating50 cause[354] of the neuroses in 31 per cent of the cases. The symptoms of the neuroses could be divided into those of the reactions of fear and fatigue.”
These results corroborate51 my work on neurosis as due to exhaustion of Neuron Energy and Self-Fear.
In fact, in one of my works written at the beginning of the war, I predicted the wide occurrence of what is known as shell shock, war shock or war neurosis. The prediction was fully corroborated52 by the facts.
Fear, Self, Reserve Energy, and Fatigue are the main factors in the formation of the psychopathic or neurotic53 condition. Janet, in a recent article of his, lays stress on the fear states in psychopathic affections and refers these conditions to the levels of vital energy. There is no doubt that Janet lays his finger on the very heart of the psychopathic diathesis.
In my work I come to a similar conclusion only I lay more stress on the fear states, being referred to the fundamental instinct present in all animal life as a primordial54 condition of existence. This instinct is intensified55 and extended in the psychopathic diathesis.
The level of energy and the fear instinct are vitally interdependent. A low level of energy, especially a dissociation or inhibition of the store of reserve energy, arouses an excess of reaction of the fear instinct, and vice56 versa the excessive reaction[355] of the fear instinct locks up the stores of reserve energy, thus intensifying57 and extending the psychopathic states with their fear-fatigue conditions. Janet refers indirectly58 to the impulse of self-preservation which is of the utmost consequence in psychopathic affections. On the whole, I may say that my work and clinical experience are in accord with that of the great French psychopathologist.
Where the fear instinct, self, and inhibition of reserve energy are present, then any emotion, even that of love, and devotion, will give rise to psychopathic states. This psychopathic state is not produced, because of the intensity59 or repression60 of the emotion, but because of the underlying61 subconscious predisposition to fear-instinct, self-preservation, and inhibition of reserve energy.
The feelings of inhibited62 reserve energy produced by fear and self, make the individual hesitate in decision, in action, and finally demoralize and terrorize him. These conditions take away from him all assurance and security of life and action, and hold him in a perpetual state of anxiety until he becomes completely incapacitated for all kinds of action and reaction.
Events that threaten the impulse of self-preservation of the individual, such as misfortunes, shocks, losses, tend to bring about psychopathic states, on account of the aroused fear instinct, on account of the impulse of self-preservation, and sudden inhibition[356] of the stores of reserve energy. Events that may lead to dissolution of personality are, hence, attended with intense anxiety.
As we have seen, an intense state of fear, conscious or subconscious, produces a state of aboulia, a state of indecision, a state of incompletion of action, a state of insufficiency, a paralysis63 of will power, and a sense of unreality, all of which are intimately interrelated. For the fear instinct, when intense, inhibits64 and arrests the will and paralyzes action. The patient fears, not because he is inactive, but he is inactive, because he fears.
The impulse of self-preservation, the fear instinct, and the principle of subconscious reserve energy give an insight into the multiform symptomatology of the psychopathic diathesis.
The following classes of people are subject to psychopathic affections:
(I) Childless people.
(II) People who had been afflicted65 with various diseases in childhood.
(III) Children of sickly, nervous, psychopathic parents who have kept their progeny66 in a constant state of anxiety, full of terrors and troubles of life.
(IV) People who had been affected67 by a series of shocks and fears in childhood and youth.
(V) People whose parents suffered long from various systemic diseases, especially cardiac and tubercular troubles.
(VI) In a large family of children the first, or last child, or sickly child of psychopathic parents.
(VII) The only child, or sickly child, especially of a widowed parent who is of a psychopathic diathesis.
In all these cases the psychopathic state is due to early cultivation68 of the fear instinct, self-impulse, and low level or dissociated state of vital reserve energy.
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1
manifestations
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| n.表示，显示（manifestation的复数形式） | |
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prick
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| v.刺伤，刺痛，刺孔；n.刺伤，刺痛 | |
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defense
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| n.防御，保卫；[pl.]防务工事；辩护，答辩 | |
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defensive
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| adj.防御的；防卫的；防守的 | |
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withdrawal
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| n.取回，提款；撤退，撤军；收回，撤销 | |
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vomiting
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| 吐 | |
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nausea
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| n.作呕，恶心；极端的憎恶(或厌恶) | |
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pointed
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| adj.尖的，直截了当的 | |
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awaken
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| vi.醒，觉醒；vt.唤醒，使觉醒，唤起，激起 | |
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awakened
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| v.（使）醒( awaken的过去式和过去分词 )；（使）觉醒；弄醒；（使）意识到 | |
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sensory
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| adj.知觉的，感觉的，知觉器官的 | |
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12
instinctive
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| adj.(出于)本能的；直觉的；(出于)天性的 | |
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13
hereditary
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| adj.遗传的，遗传性的，可继承的，世袭的 | |
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14
preclude
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| vt.阻止，排除，防止；妨碍 | |
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15
phenomena
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| n.现象 | |
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16
satiety
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| n.饱和；(市场的)充分供应 | |
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17
precluded
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| v.阻止( preclude的过去式和过去分词 )；排除；妨碍；使…行不通 | |
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18
morbid
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| adj.病的；致病的；病态的；可怕的 | |
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19
specialized
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| adj.专门的，专业化的 | |
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20
primitive
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| adj.原始的；简单的；n.原(始)人，原始事物 | |
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21
functional
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| adj.为实用而设计的，具备功能的，起作用的 | |
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22
distress
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| n.苦恼，痛苦，不舒适；不幸；vt.使悲痛 | |
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23
nucleus
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| n.核，核心，原子核 | |
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24
distressing
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| a.使人痛苦的 | |
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anterior
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| adj.较早的；在前的 | |
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specially
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| adv.特定地；特殊地；明确地 | |
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forth
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| adv.向前；向外，往外 | |
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subconscious
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| n./adj.潜意识(的)，下意识(的) | |
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vitality
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| n.活力，生命力，效力 | |
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strata
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| n.地层（复数）；社会阶层 | |
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31
obsessed
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| adj.心神不宁的,鬼迷心窍的,沉迷的 | |
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32
pangs
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| 突然的剧痛( pang的名词复数 )； 悲痛 | |
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33
stimulus
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| n.刺激，刺激物，促进因素，引起兴奋的事物 | |
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34
abeyance
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| n.搁置，缓办，中止，产权未定 | |
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35
inadequate
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| adj.(for,to)不充足的，不适当的 | |
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36
entirely
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| ad.全部地，完整地；完全地，彻底地 | |
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alleviated
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| 减轻，缓解，缓和( alleviate的过去式和过去分词 ) | |
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essentially
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| adv.本质上，实质上，基本上 | |
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fully
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| adv.完全地，全部地，彻底地；充分地 | |
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40
fluctuations
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| 波动，涨落，起伏( fluctuation的名词复数 ) | |
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41
exhaustion
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| n.耗尽枯竭，疲惫，筋疲力尽，竭尽，详尽无遗的论述 | |
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42
fatigue
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| n.疲劳，劳累 | |
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43
ravages
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| 劫掠后的残迹，破坏的结果，毁坏后的残迹 | |
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44
detailed
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| adj.详细的，详尽的，极注意细节的，完全的 | |
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45
timorousness
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| n.羞怯，胆怯 | |
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46
taint
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| n.污点；感染；腐坏；v.使感染；污染 | |
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47
concussion
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| n.脑震荡；震动 | |
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48
apprehension
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| n.理解，领悟；逮捕，拘捕；忧虑 | |
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49
immediate
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| adj.立即的；直接的，最接近的；紧靠的 | |
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50
precipitating
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| adj.急落的，猛冲的v.（突如其来地）使发生( precipitate的现在分词 )；促成；猛然摔下；使沉淀 | |
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51
corroborate
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| v.支持，证实，确定 | |
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52
corroborated
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| v.证实，支持（某种说法、信仰、理论等）( corroborate的过去式 ) | |
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neurotic
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| adj.神经病的，神经过敏的；n.神经过敏者，神经病患者 | |
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54
primordial
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| adj.原始的；最初的 | |
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55
intensified
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| v.（使）增强， （使）加剧( intensify的过去式和过去分词 ) | |
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vice
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| n.坏事；恶习；[pl.]台钳，老虎钳；adj.副的 | |
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intensifying
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| v.（使）增强， （使）加剧( intensify的现在分词 )；增辉 | |
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58
indirectly
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| adv.间接地，不直接了当地 | |
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59
intensity
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| n.强烈，剧烈；强度；烈度 | |
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60
repression
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| n.镇压，抑制，抑压 | |
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61
underlying
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| adj.在下面的，含蓄的，潜在的 | |
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62
inhibited
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| a.拘谨的，拘束的 | |
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paralysis
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| n.麻痹(症)；瘫痪(症) | |
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inhibits
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| 阻止，抑制( inhibit的第三人称单数 )； 使拘束，使尴尬 | |
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afflicted
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| 使受痛苦，折磨( afflict的过去式和过去分词 ) | |
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66
progeny
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| n.后代，子孙；结果 | |
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67
affected
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| adj.不自然的，假装的 | |
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68
cultivation
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| n.耕作，培养，栽培（法），养成 | |
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