Part 11 (2/2)
The young woman had always been irritable, egoistic, and sensitive. As a girl if anything happened to ”shock her nerves”, _i.e._ to displease her, she fainted, vomited, or went into ”hysterics.” As a result her family treated her with great caution and probably were well pleased when she married off their hands and left the home.
Married life soon provided her with sufficient to displease her. Her husband drank but not sufficiently to be cla.s.sed as a heavy drinker. He was a quiet, rather taciturn man, utterly averse to the pleasures for which his wife longed. She wanted to go to dances, to take in the theaters, to live in more expensive rooms, and especially she became greatly attached to a group of people of a sporty type whom her husband tersely called ”tinhorn bluffs” and whom he refused to visit.
They quarreled vigorously and the quarrels always ended one way,--she became sick in one way or other. This usually brought her husband around to her way of thinking, at least for a time, and much against his will he would go with her to her friends.
Finally, however, she set her heart on living with these people, and he set his will firmly against hers. She then developed such an alarming set of symptoms that after a while the physician who asked my opinion had made up his mind that she had a brain tumor. She was paralyzed, speechless, did not eat and seemed desperately ill.
The diagnosis of hysteria was established by the absence of any evidence of organic disease and by the history of the case. The relief of symptoms was brought about by means which I need not detail here, but which essentially consisted in proving to the patient that no true paralysis existed and in tricking her into movement and speech.
When she was well enough to be up and about and to talk freely, she and her husband were both informed that the symptoms arose because her will was thwarted, and _that_ part of their function was to bring the man to his knees. He agreed to this, but she took offense and refused to come any more to see me,--a not unnatural reaction.
The outlook in such a case is that the couple will live like cats and dogs. Such a temperament as this woman's is inborn. She is essentially, in the complete meaning of the word, unreasonable. Her nature demands a sympathetic attention and consideration that her character does not warrant. Throughout life she demands to receive but has no desire to give. Nor is she powerful enough to take, so there arise emotional crises with marked disturbance in bodily energy, and especially symptoms that frighten the onlooker, such as paralyses, blindness, deafness, fainting spells, etc. Whatever is the source of these symptoms, they are frequently used to gain some end or purpose through the sympathy and discomfort of others.
Not all hysteria, either in men or women, is united with such a character as this woman's. Sufficient stress and strain may bring about hysterical symptoms in a relatively normal person and short hysterical reactions are common in the normal woman. The height of cynicism may be found in the discovery that war causes hysteria in some men in much the same way that matrimony causes hysteria in some women. A humorous review of a paper on the domestic neuroses was ent.i.tled ”Kitchen Sh.e.l.l Shock.”
But severe hysteria, when it arises in the housewife, springs mainly from her disposition and not from the kitchen.
Case X. The unfaithful husband.
Monogamous marriage is based upon the a.s.sumption that loyalty to a single male is moral and possible. It is probable that in no age has this agreement been loyally carried out by the husbands; it is probable that in our own time the single standard of morals has first been strongly emphasized. With the rise of women into equality one of the important demands they have made is that men remain as loyal as themselves. Therefore the reaction to unchast.i.ty or unfaithfulness on the part of the man is apt to be more severe than in the past, on the theory that where more is demanded failure in performance is felt the keener.
The housewife, Mrs. F.C., aged thirty-five, is a prepossessing woman, the mother of two children, and has been married for nine years. Her health has always been fairly good, though in the last four years she has been somewhat irritable. She attributed this to struggle to make both ends meet, her husband being a workman with wages just over the border line of sufficiency. They quarreled ”no more than other couples do”, were as much in love ”as other couples are”, to use her phrases.
She was above her cla.s.s in education, read what are usually called advanced books, was ”strong for suffrage”, etc. However she was a good housekeeper, devoted to her children and faithful to her husband. Their s.e.xual relations were normal and up till six months before I saw her she thought herself a well-mated, rather fortunate woman.
Out of a clear sky came proof of long-continued unfaithfulness on the part of her ”domestic” husband: a chance bill for women's clothes fluttered out of his pocket and under the bed, so that next morning she found it; an unbelieving moment and then a visit to the address on the bill, and proof plenty that he had been disloyal, not only to her but to the children, who had been obliged to scrimp along while he helped maintain another woman. Humiliated beyond measure by her disaster, unable to endure her past memories of happiness and faith, with an unstable world rocking before her, through the revelation that a quiet, contented, loving man could be completely false, she found no adequate reason for living and became a helpless prey to her troubled mind. ”A temporary unfaithfulness, a yielding to sudden temptation” she could understand, but a determined plan of duplicity shattered her whole scheme of values. A very severe psychoneurosis followed, and her children and she were taken over by her parents and cared for.
Sleeplessness was so prominent in her case and so evidently the central physical symptom that its control was difficult and required a regular campaign for success. With sleep restored and the resumption of eating, the most of her acute symptoms were pa.s.sed, though a profound depression remained.
Her husband, thoroughly abashed and ashamed, made furtive attempts at reconciliation. These were absolutely rejected, and from her att.i.tude it was obvious that no reconciliation was possible. ”Had he not been found out,” said the wife, ”he would still be living with her. I can never trust him again; I would die before I lived with him.”
Little by little her pride recovered, for in such cases the deepest wound is to the ego, the self-valuation. The deepest effort of life is to increase that valuation by increasing its power and its respect by others; the keenest hurt comes with the lowering of the valuation of one's own personality. A woman gives herself to a man, without lowering a self-feeling if he is tender and faithful; if he holds her cheap, as by flagrant disloyalty, then her surrender is her most painful of memories.
With the recovery of pride came the restoration of her interest in her children, and her purposes reshaped themselves into definite plans. Part of the process in readjustment in any disordered life is to centralize the dispersed purposes, to redirect the life energies. She agreed that she would accept aid from the husband, as his duty, but only for the children. For herself, as soon as the children were a year or so older, she would go back to industry and become self-supporting. Her plans made, her recovery proceeded to a firm basis, and I have no doubt as to its permanence. Nevertheless, life has changed its complexion for her, and there will be many moments of agony. These are inevitable and part of the recovery process.
I shall not attempt to settle the larger problem of whether she should have forgiven her husband and returned to him. Granting that his repentance was genuine, granting that no further lapse would occur, she would never be able to forget that when he deceived her he had _acted_ the part of a devoted husband. She would never be able fully to trust him, and this would spoil their married happiness entirely. ”For the children's sake,” cry some readers; well, that is the only strong argument for return. But on the whole it seems to me that an honest separation, an honest revolt of a proud woman is better than a dishonest reunion, or a ”patient Griselda” acceptance of gross wrong.
Case XI. The unfaithful wife.
In such cases as the preceding and the one now to be detailed, the difficulties of the physician are multiplied by his entrance into ethics. Ordinarily medicine has nothing to do with morals; to the doctor saint and sinner are alike, and the only immorality is not to follow orders. To do one's duty as a doctor, with one's sole aim the physical health of the patient, may mean to advise what runs counter to the present-day code of morals. This is the true ”Doctor's Dilemma.” In such cases discretion is the safest reaction, and discretion bids the physician say, ”Call in some one else on that matter; I am only a doctor.”
A true neurologist must regard himself as something more than a physician. He needs be a good preacher, an astute man of the world, as well as something of a lawyer. The patient expects counsel of an intimate kind, expects aid in the most difficult situations, viz., the conflicts of health and ethics.
Mrs. A.R., thirty-one years of age and very attractive, has been married since the age of eighteen. She has two children, and her husband, ten years her senior, is a man of whose character she says, ”Every one thinks he is perfect.” A little overstaid and over dignified, inclined to be pompous and didactic, he is kind-hearted and loyal, and successful in a small business. He is an immigrant Swiss and she is American born, of Swiss parentage.
Always romantic, Mrs. A.R. became greatly dissatisfied with her home life. At times the whole scheme of things, matrimony, settled life, got on her nerves so that she wanted to scream. She was bored, and it seemed to her that soon she would be old without ever having really lived. ”I married before I had any fun, and I haven't had any fun since I married except”--Except for the incident that broke down her health by swinging her into mental channels that made her long for the quiet domesticity against which she had so rebelled. Her daydreaming was erotic, but romantically so, not realistic.
There are in the community adventurers of both s.e.xes whose main interest in life is the conquest of some woman or man. The male s.e.x adventurers are of two main groups, a crude group whose object is frank possession and a group best called s.e.x-connoisseurs, who seek victims among the married or the hitherto virtuous; who plan a campaign leisurely and to whom possession must be preceded by difficulties. Frequently these gentry have been crude, but as satiation comes on a new excitement is sought in the invasion of other men's homes. Undoubtedly they have a philosophy of life that justifies them.
Since this is not a novel we may omit the method by which one of these men found his way to the secret desires of our patient, and how he proceeded to develop her dissatisfaction into momentary physical disloyalty. She came out of her dereliction dazed; could it be she who had done this, who had descended into the vilest degradation? She broke off all relations with the man, probably much to his surprise and disgust, and plunged into a self-accusatory internal debate that brought about a profound neurasthenia.
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