Unfavorable Mental Influence


Much as may be accomplished by psychotherapeutics through favorable

mental influence--the modifying of the mental attitude towards

disease, diversions of mind from aches and pains, concentration of

attention on subjects apart from ailments--much more may be done by

removing any unfavorable mental influence. This of itself produces

symptoms either by interfering with normal processes through

surveillance of them, or by
o exaggerating, through attention to

them, slight symptoms that may be present that patients are made quite

miserable, though there is no adequate physical cause for their

condition. Perhaps the most striking example that we have of

unfavorable mental influence as productive of the persuasion that

disease is present, is familiar to every physician who is close to

medical students when they are first introduced to the symptoms of

disease. It is almost a rule that certain members of the class

immediately conclude that they are suffering from one or more of the

symptoms which they are studying, and that, therefore, they must have

the diseases with which the symptoms are associated. If at this time

they walk on the shady side of a street on an autumn day and have a

little shivery feeling, or when they get into the sun they feel a

glow, these two very normal feelings are exaggerated into chilliness

and fever, and the student has to go to his professor to have his

mental malaria or typhoid treated. To the student, his symptoms are

for the moment very real, and unless someone in whom he has confidence

reassures him, his discomfort will probably continue for some time.





Pathological Suggestion.--In a word, suggestions of disease are much

easier to take than is usually imagined, and if people read or hear

much about diseases they are likely to jump to the conclusion that

they are sufferers. Under present conditions there are many more such

sinister suggestions put before people than used to be the case. The

newspapers are constantly reporting curious cases and rare diseases,

and usually those of absolutely unfavorable prognosis and inevitably

fatal termination are particularly dilated on. Pathology has become a

source of many sensations, until the community generally has come

to eke out the thrills of the day's news by reading about fatal

diseases and fatal injuries, whenever murder and suicide sensations

fail. As a consequence, many become persuaded that they are suffering

from forms of disease of which they have not a symptom, and, not

infrequently, the wonderful cures that are reported in the newspapers

consist of nothing more than recoveries from these imaginary ills into

which people have suggested themselves as the result of reading about

morbid states.



A typical illustration of the power of the mind to influence the body

unfavorably is recognized in many of the comic stories that have had a

vogue in recent years. Their underlying thought is that if a man is

only told often enough, and by a number of different people, that he

does not look well, or if he is even asked a little solicitously as to

whether he feels well or not, he will almost invariably begin to

persuade himself that there must be something the matter with him.

After a time, under the influence of this unfavorable suggestion, he

begins to feel tired and is likely to think that he cannot go on with

his work. When meal time comes his appetite fails him. A victim has

been even known to go home and send for the doctor, persuaded that

there is something the matter, simply because a series of friends, for

a joke, or sometimes through a mistake, have insisted on asking him

questions that called attention to his state of health. Few men are

strong enough to stand the influence of unfavorable suggestion of this

kind, if it is frequently repeated. More direct forms of suggestion of

disease have, of course, even greater effects. Many a man goes to a

quack only feeling a little out of sorts and wanting to reassure

himself, but easily becomes persuaded that there is something serious

the matter with him.





Unfavorable Suggestion in Ancient Times.--This unfavorable influence

of the mind on the body, even to the extent of the production of

disease by means of suggestion, was recognized by the ancients. They

knew and wrote of hypochondriasis and, indeed, they invented the term.

In many of these cases the seat of auto-suggestion is supposed to be

the digestive organs and the localization of the discomfort is in the

hypochondria, that is, in the upper abdominal region. The Grecian

writers seemed to recognize clearly that the symptoms were the result

of thinking over much about self and concentration of attention upon

unfavorable suggestions.



Plato, in the "Republic," says:



In former days the guild of Asclepius did not practice our present

system of medicine, which may be said, he declares, to educate

diseases. He cites the example of Herodicus who, "being a trainer

(of gymnasts) and himself of a sickly constitution, by a happy

combination of training and doctoring, came to the invention of

lingering death; for he had a mortal disease, which he perpetually

tended, and, as recovery was out of question, he passed his entire

life as a valetudinarian." Plato, finishing the description, makes

us recognize the hypochondriac when he says: "He could do nothing

but attend upon himself, and he was in constant torment whenever he

departed in anything from his usual regimen, and so dying hard, by

the help of science he struggled on to old age."



The picture of the neurasthenic, or hypochondriac, who has educated

himself, as Plato says, into disease, is an interesting parallel to

modern conditions in this matter.



Nowhere more than in this matter of knowledge of disease, can weight

be attached to Pope's dictum that a little knowledge is a

dangerous thing, and that one must drink deep or touch not the Pierian

Spring of medical information. The teaching of pathology under the

guise of physiology, now so common in our schools, is likely to do

more harm than good. Various pathological conditions, such as those

produced by alcohol and tobacco, have been emphasized to such an

extent as to produce unfavorable suggestions in the pupils' minds with

regard to the untoward events that may happen in their insides, and

the serious lasting pathological changes that may occur, though all

unconsciously, to the sufferer as the result of indiscretions. The

study of the morbid changes produced in the mucous membranes of the

digestive tract by the use of stimulants, impresses ideas on the mind

that are readily transferred to other abuses in eating or drinking.

The rather vivid pictures and descriptions of the pathological

conditions that may develop, become a portion of the acquired

consciousness as to internal conditions, and this consciousness acts

as an unfavorable suggestive factor whenever there are any digestive

symptoms.





Bacteriphobia.--The development of bacteriology has had a similar

effect, especially because periodicals and newspapers like to take up

only the sensational side of biological discoveries. Most physicians

who have had anything to do with nervous diseases have seen cases of

misophobia, the fear of dirt, which in our day has taken on the

special character of fear of microbes. Those who are sensitive to the

possibility of contamination learn of the almost sacrificial

precautions that surgeons take to avoid wound infection, and conclude

that practically everything they handle must fairly reek with

microbes. They hesitate about touching the door knob or latch, and

invent all sorts of excuses to wait for a moment outside the door in

order to have someone else open it. Especially are they timorous about

touching the door knobs of a physician's residence, or the chairs in

his waiting room, or even to shake hands with him. Hospital walls and

doors become an abomination to them. These cases emphasize how much of

unfavorable suggestion there has been in the present spread of popular

knowledge with regard to microbes.



A writer on popular science once said that every time we spread a

piece of bread of the size of the hand with butter, we scatter over

its surface as many microbes as there are inhabitants in the United

States. The expression has gone the rounds, producing its effect on

sensitive people, occasionally causing even a disgust for so important

an article of diet as butter, more often giving rise to an extreme

sensitiveness with regard to any special savor that butter may have,

and it may have many according to the prevailing food of the cow.

There has been much emphasis laid on the potentialities for harm of

the microbes, and very little on the important part which they play in

the production of many forms of food materials. Most people know and

dread the fact that microbes produce disease. Very few seem to realize

that while we know many thousands of different kinds of microbes,

scarcely more than a score of them are known to be seriously

pathogenic, while all the others are either indifferent or, as we know

of very many, are actually benefactors of mankind.



People have heard much of the flora of the digestive tract, until they

have come to think with anxiety of the almost infinite number and

multitudinous variety of the minute plant life that finds a habitat in

the human intestine. Most people think that all of these are, in

tendency at least, harmful, and are only kept from being

positively dangerous by the overwhelming vital activity of the mucous

membrane and the secretions which keep them from exerting their malign

activity. Very few appreciate the fact that the intestinal flora, far

from being a disturbing factor, are often an aid to digestion, and

that the equilibrium established among them favors many biological and

chemical processes which help in the preparation of food and in the

breaking up of waste products that might be dangerous if reabsorbed

during their stay in the intestinal tract. Microbes we have always

with us and always will have, and men have lived to round old age, not

only in spite of them, but very probably partially because of them.

They are part of that beneficent mystery of nature of which as yet, in

spite of scientific progress, we know comparatively little.





Opposing Favorable Suggestion,--A recent striking change of

sentiment with regard to one form of food material furnishes a good

example of how little we know about the real effect of bacterial life

within the digestive tract. There was a time, not so long since, when

sour milk was supposed to be especially harmful, or at least only

likely to do good to those of particularly strong digestive vitality.

Metchnikoff's work on the influence of sour milk on the digestive

tract, however, has brought a complete reversal of opinion in this

matter. Now most physicians are convinced that the bacillus of sour

milk, acts in the intestinal tract to inhibit the reproduction and

growth of other, and possibly more disturbing, bacterial agents. Sour

milk is looked upon as one of the things that, by neutralizing certain

unfortunate bacterial processes in the digestive tract, lead to

longevity. There seems no doubt at all, that those who consume a great

deal of it, live longer lives than the average, and many old men have

taken to its use with a consequent amelioration of digestive

annoyances.



The popularization of bacteriology, then, has been one of those

moments of unfavorable suggestion that have affected a large number of

people. Such influences do not mean much for people of phlegmatic

temperament. For others, however, they have a weighty significance and

make every symptom, or more properly every sensation, that is at all

unusual in the digestive tract, seem of ominous import. Certain

sensations inevitably accompany digestion. The peristaltic movements

are usually said to be unfelt, but even a slight exaggeration brings

them into the sphere of sensation. Where attention is given to the

abdominal region and its contents, feelings that ordinarily are not

noticed at all come to be perceived. With the unfavorable suggestion

derived from the unfortunate diffusion of a superficial knowledge of

pathology and of bacteriology instead of hygiene and the science of

beneficent microbiology, these feelings produce a bad effect upon the

individual.





Familiar Examples of Unfavorable Suggestion.--There are many familiar

examples of the discomfort that may be produced by the mental

persuasion that something will disagree with us, or that certain

feelings have a significance quite beyond that which ought to be

attributed to them. Everyone knows how qualmy may be the feeling

produced by being told that something eaten with a relish contained

some unusual material, or was cooked under unclean conditions. Food

that agrees quite well with people, so long as they do not know too

much about it, often fails to be beneficial after they see how it has

been prepared. It is often said that people would not relish the food

placed before them if they were aware how lacking in cleanliness

was the place of its preparation, and how negligent those who had

charge of it. Occasionally a peep at the kitchen of a boarding house

effectually takes away appetite, or disturbs the equanimity with which

food must be taken, if there is to be that undisturbed digestion which

makes for healthy nutrition.



It is, indeed, with regard to digestion that the influence of the mind

on the body, favorable as well as unfavorable is, perhaps, most

effectively exercised. Unfortunately the unfavorable influence is even

more pronounced than its opposite. Some people are much more sensitive

than others in this respect, and even the thought of certain defects

in the preparation of their food seriously disturbs them. Everyone has

had the experience of seeing sensitive persons leave the table because

some one insisted on telling a nauseating tale. Anyone who has seen

the effect of talking of blood sausage or fried brains with black

butter sauce at a table on shipboard, when some practical joker was

exercising his supposed wit, knows how much the imagination can

disturb, not only appetite but digestion. The attitude of mind means

much, and especially are such unfavorable suggestions likely to

produce serious effects in inhibiting digestion.





Suggestion and Seasickness.--Seasickness illustrates the place of

unfavorable suggestion in digestion. The nausea, consequent upon the

movement of a vessel at sea, is due to a disturbance of the

circulation within the skull, and particularly of the circulation in

the semi-circular canals. The organ of direction of the body is

disturbed by the over-function demanded of it, consequent upon the

continuous movement of the vessel. This is, however, only a

predisposing element. A strong additional factor is the firm

persuasion many people have that they will suffer from nausea and

seasickness, and the unfavorable expectancy thus aroused. Most people

have to give their dole to Neptune. Those who for weeks before have

been expecting and dreading it usually pay a heavy tribute. Probably

the best remedy for seasickness is the suggestion that there is no

necessity for losing more than a meal or two, if even that much,

provided there is simplicity of diet and proper predisposition of body

by gentle opening of the bowels, and lack of the over-feeding that

sometimes comes from dinners given before departure. I have known many

people who, after suffering severely not in one but in many voyages,

have, by means as simple as this, been saved from days of seasickness

even in rough weather.



Most of the cures for seasickness that have been suggested have

depended principally on the suggestive element. For instance, there is

no doubt that many people are relieved by wearing dark glasses, and

this remedy does good for train sickness and other afflictions of a

similar kind. There is, however, no good physical reason why wearing

dark glasses should help except through their constant physical

suggestion. A simple remedy that has helped many through seasickness

is the wearing of a sheet of glazed paper, usually some heavy

writing-paper, immediately over the skin of the abdominal region. This

of itself has no physical effect, but the sensation of its presence

constantly obtrudes itself, and by making people feel that they must

be better because a great many other people have declared that they

were bettered by this remedy, they actually suffer less from nausea

and vomiting. Many of the internal remedies employed for seasickness

are directed to the stomach and intestines. As the seat of the

difficulty is not here but within the skull, the reputation which

these remedies have acquired has been due largely to the suggestive

effect of taking them rather than to any physical qualities they

possessed, though of course they have served to set at rest stomachs

disturbed by unfavorable expectancy.





Disease Groups and Suggestion.--Labeling groups of ailments with a

single term gives rise to many unfortunate conclusions and dreads with

regard to what a particular condition really is. The word

"indigestion" is commonly used for any stomach discomfort or

disturbance, especially that occurring after eating, from the slight

distress because too much has been eaten, or the uncomfortable feeling

of fullness because too much liquid has been taken, or the discomfort

due to an unsuitable mixture of food materials, to such serious

conditions as develop when there is motor insufficiency of the

stomach, followed by dilatation, with delay of the food for long

periods and with consequent fermentation, distress and bad breath.

Whenever the word "indigestion" is mentioned, the patient may think of

the worst cases that he has seen or heard of with this label, and

concludes that while his ailment may not be very serious just now, it

is only a question of time until it becomes so, and that unless he can

get rid of his uncomfortable feeling he is destined to have one of the

forms of "indigestion" that are productive of such serious discomfort,

with probably ever increasing torment, until some fatal complication

develops. The initial symptoms of gastric ulcer and cancer have been

labeled indigestion, and people, often recalling the serious

consequences that followed in such cases, fear for themselves.





Fearing the Worst.--This looseness of terms is noted with regard to

many other forms of disease. Rheumatism calls up the picture of

advanced arthritis deformans, with the awful deformed joints and

bed-riddenness, which should not bear the term rheumatism at all, but

which the patient has heard called so. Catarrh is the simplest of

inflammatory processes, meaning merely an increase of secretion,

functional in character and without any serious disturbance of an

organic character beneath it, but many people have heard the

foul-smelling ozena called catarrh, at least popularly, and so the

mental picture of such a repulsive progressive process as beginning in

them is suggested. It is important, therefore, when using words that

have such wide connotation as these, to explain exactly what is meant,

and perhaps, better still, not to use the words, but to employ some

more specific term that does not carry a cloud of dreads with it.

Indigestion can be a very simple passing set of symptoms, but once

certain people get the notion that they are troubled with indigestion,

their minds dwell on it to such an extent that they are likely to

limit their eating more than they should, and to disturb digestive

processes by thinking about them and using up in worry nervous energy

that should be allowed to flow down to actuate digestion.





So-called Incurability.--Patients are likely to hear entirely too much

of the incurability of disease. To the doctor and patient this word,

incurability, often has an entirely different meaning. The doctor

means only that the diseased tissues cannot be restored to their

previous condition by any of our known remedies, and that the effects

of the deterioration are likely to be felt to some degree for the rest

of the patient's life. To the patient it means, as a rule, not only

that the doctor can do nothing for him, which is usually quite

untrue, for much can be done for his symptoms even though the

underlying disease may be intractable, but also that the symptoms are

to grow constantly worse. This is often quite without foundation, for

nature's compensatory powers are very wonderful and seldom fail to

afford relief. In a great many cases fatal termination comes, not from

the original affection, but through intercurrent disease. Above all,

incurable means to many patients that finally the victim is to become

more and more subject to the pains and ills of his "incurable" ailment

until he becomes perhaps a pitiable object. Incurability, when we

recall that patients are so likely to mistranslate this term in the

way indicated, must be a word little used. Etymologically it is never

true, for cura means care, and we can always care for and relieve

the patient. In every chronic case there is room for hope of much

relief through accustomedness, various remedies, nature's compensatory

methods, and, above all, the modification of the state of mind.



There is probably no incurable disease that is ever quite as serious

as it is pictured by its victim when he first hears this word

pronounced. When we recall the chances of life, and that in any given

case, almost as a rule, the patient will live to hear of the deaths of

men and women who were in perfect good health when his ailment was

pronounced incurable, there is much of consolation to be derived from

conditions as they are. It seldom happens that a physician sees a

sufferer from tuberculosis, whose affection is running a somewhat

chronic course, without being able to find out that since the first

symptoms of the disease manifested itself, one or more of the

patient's near relatives have died because of exposure incident to

their abounding health. Pneumonia, appendicitis, typhoid fever,

accidents of various kinds, take off the healthy relatives, while the

tuberculous patient, constantly obliged to care for his health, lives

on, and often is able to accomplish a good deal of work. It is

important to impress facts of this kind upon these "incurable" cases,

for they represent the light in the desert, or the shout, or the

whistle at sea, that give renewed energy when nature seems about to

give up the struggle.





Thinking Health.--Hudson in "The Law of Mental Medicine" [Footnote 14]

suggests that we should think health and talk health on all suitable

occasions, remembering that under the law of suggestion health, as

well as disease, may be made contagious. This expression probably

represents an important element for the prophylaxis of disease under

all conditions. Under present conditions people talk entirely too much

about disease and have too many suggestions of pathological

possibilities constantly thrown around them by our newspapers, our

magazines and by popular lecturers as well as by our free public

libraries. People have learned to think and talk disease rather than

health. This predisposes them to exaggerate the significance of their

feelings, if it does not actually, on occasion, lower their resistive

vitality because of solicitude. The medical student torments himself

with the thought that he is suffering from the diseases that he

studies, and we cannot expect that the general public will be even as

sensible as he is in this matter. On the contrary, people generally

are much more liable to exaggerate the significance of their feelings,

hence the necessity for healthy suggestions rather than innuendoes of

disease.



[Footnote 14: McClurg, Chicago, 1903.]



In recent years, to paraphrase Plato's expression, people are much

more inclined to educate themselves in disease than in health.

The result has been a storehouse of unfavorable suggestion, from which

ideas are constantly being taken to make whatever symptoms that may be

present seem unduly important. Consequently people look for the worst,

and suggest themselves into conditions where not only are they

exaggerating their symptoms, but they are absolutely preventing the

flowing down of such nervous impulses as will enable them to overcome

affections that are present. Whenever anything turns up that lessens

their tendency to unfavorable auto-suggestion, their health improves.

Hence the taking, with confidence, of any quack medicine, no matter

what its constituents, cures them; hence the success of the numerous

and very varied forms of mental treatment. New Thought, Eddyism,

osteopathy, and the like, attain most of their successes because of

the removal of unfavorable suggestions, and the setting up in their

stead of favorable suggestion. In psychotherapy the first duty of the

physician is to undo all the unfavorable suggestion at work, and, if

successful in that, great therapeutic triumphs are possible.



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