Definite Dreads





Besides these rather vague dreads, however, there are certain special

disquietudes peculiar to individuals, even more groundless, if

possible, than the generic apprehension just spoken of and that have

been dignified in recent years by the name of phobias. Phobia means

only "fear" in Greek, but the term is much more satisfying to nervous

people than the shorter but too definite English term, dread, or fear.

There is acrophobia, or the fear of looking down from a height;

claustrophobia, or the fear of narrow places, as the dread of walking

through a narrow street because of the sense of oppression that comes

with the shut-inness of it. Then there is agoraphobia, market-place

dread, or the fear to cross an open space because one has, as it were,

grown accustomed to be near buildings and misses their presence. There

are many others, indeed as many as there are dislikes in human nature,

for any dislike apparently may be exaggerated into a dread. I mention

a few at the beginning of the alphabet and some of special

significance. There is aerophobia, dread of the air, a symptom

sometimes mentioned in connection with hydrophobia; aichmophobia, the

dread of pointed tools; ailurophobia, the dread of cats; anthrophobia

or the dread of men; pathophobia or the fear of disease, microbophobia

or bacillophobia; kenophobia or the dread of emptiness; phthisiophobia

or the dread of consumption; zoophobia or the dread of animals;

sitophobia or the dread of food, and even phobophobia, the dread of

dreading. Neuropsychologists seem to take a special pleasure in

inventing some new phobia or at least giving us a fine long Greek name

for a set of symptoms by no means new and that might well be explained

in simpler terms. The most familiar examples are: the fear of

lightning, which is more frequently brontophobia, the fear of thunder.



These learned words are all formed on the same etymological principle

as hydrophobia, but they are entirely psychic in origin, while

hydrophobia, as it is well to explain to patients who think of the

word phobia in connection with their symptoms, is, of course, a

misnomer for an infectious disease--rabies--which develops as the

consequence of a bite of a rabid animal, and the principal symptom of

which is not fear of water, but the impossibility of swallowing any

liquid because of spasm of the esophageal muscles.



Almost any function of the body may become the subject of a dread or

phobia that may interfere even seriously with it. Any disturbance of

any function is likely to be emphasized by such dreads. The French

have described the basophobia, which makes the patients suffering from

beginning tabes dread so much walking that it becomes a much greater

effort than it would otherwise be and often interferes with walking

rather seriously. Then there is the fear of tremor which exaggerates a

tremor due to some organic cause, but yet not necessarily of grave

import, nor likely to increase rapidly. Many of the hysterical palsies

are really due to dreads, consequent upon some incident, motor or

sensory, which produced a profound effect upon the patient's mind. A

patient who has been surprised by a digestive vertigo while descending

a stairs, even though nothing more happened than the dizziness which

required him to grasp the balustrade, will sometimes develop a fear of

vertigo that will actually make it difficult for him to go down stairs

without such an effort of will as is very exhausting. Even the

slightest functions may be thus disturbed. Pitres and Regis described

some ten years ago what they called the obsession of blushing, or

erythrophobia, the fear of turning red. Patients make themselves

extremely miserable in this way. Only training and self-control will

help them.



These names are long and mouth-filling and consequently satisfying,

and most people who are suffering from a particular phobia are almost

sure to think that they have a very special affliction. When the word

dread is used instead of the word phobia they are less likely to

misunderstand the character of their affection and to realize that it

is not a disease but only an unfortunate mental peculiarity that needs

control and discipline, and not fostering care. Neurasthenia only

means nervous weakness, as we have pointed out, but most people are

rather rejoiced when informed that they have so high-sounding a

disease as neurasthenia, while to be told that they are nervously weak

or suffer from nervous weakness seems quite a come-down from their

interesting Greek-designated affection. Most psychiatrists feel that

it is better not to give the long Greek term, but to state in simple

short Saxon words just what is the matter with the patient. They are

suffering from the dread of a height, or the dread of a narrow street,

or the dread of open spaces, or the dread of dirt, or of cats, or of

whatever else it may be. This makes it easier for them to begin to

discipline themselves against the state of mind into which they allow

themselves to fall with regard to these various objects, and mental

discipline is the only therapeutic adjuvant that is of any avail in

lessening these conditions. With reasonable perseverance most

people can, if not cure themselves of these affections, at least

greatly lessen the discomfort due to them. A consideration of

particular dreads brings out the specific suggestions that may be made

with regard to each and the directions that may be helpful to the

patients. Probably the commonest is acrophobia, so that the detailed

consideration of it shows the indications for other dreads.





Dread of Heights.--Almost without exception men have a sort of

instinctive dread of looking down from a height. In most people this

can be conquered to such a degree that almost anyone, if compelled by

necessity, can learn to work on a skyscraper and continue to do good

work without much bother about the height, though he may have to go up

ten to twenty stories, or even more. When he takes up the work at

first every workman finds it difficult. It gives most of us a trembly

feeling even to sit in our chair and think of looking down from such a

height. To see pictures of men standing on the iron frames of

skyscrapers twenty or thirty stories up in the air looking down 300 to

500 feet below them gives one a series of little chilly feelings in

the back and in many people a goneness or sense of constriction around

the abdomen that is almost a girdle feeling. To sit at a window

opposite where a skyscraper is going up and to see the men lean over

the edge of a beam calling directions of various kinds to workmen

below will give most people, even those who are not nervous or

especially sensitive, creepy feelings with sometimes a little catch in

the breath and an iciness in the hypochondria. It would seem

absolutely impossible that we should ever be able to perform these

feats of looking from a height, yet experience shows that most of us,

after a little training, learn to do it without difficulty.



Even the men who work most confidently have some creepy feelings

return to them whenever they stop and think about this and let their

eyes wander to the distance below them. It is not difficult for us to

walk across a plank raised a foot or two from the ground, though to

walk across the same plank at a height of ten feet may be quite a

trial and at thirty feet may become quite impossible. This is all due

to lack of confidence on our part and there is no reason in the world

why, if the plank is amply wide for us at two feet from the ground, it

should not be just as wide and safe at 30 or 60 or even 100 feet. This

is what the men who have learned to work on skyscrapers have

disciplined themselves to. They have learned to disregard the wide

vacant space around them and the yawning chasm beneath their feet;

they keep their eyes fixed on something in the immediate vicinity,

excluding thoughts of all that might happen if they should lose their

balance.





Physical Basis.--There is a physical basis in many of these cases

that constitutes the underlying occasion, at least, for the

development of the psychic dread. Our eyes have grown accustomed to

being fixed on near objects. Whenever they are not so fixed we get a

feeling of trepidation. Even those who have done a little day-dreaming

know that sometimes when they have been looking into space, objects

around them have suddenly seemed to be transferred to a long distance

and at the same time a curious sense of insecurity came over them.

Anyone can get this feeling experimentally by making two large dots on

a piece of paper about two inches apart and then gazing between the

dots into vacancy beyond the paper as it were, until the dots have a

tendency to become four because of the fact that each eye sees

each of the dots on a part of the retina not corresponding to that on

which the other eye sees it (see Fig. 25).






diameter and 4 inches apart.)]





When the experiment is successfully performed the dots begin to float

before the eyes, then they may coalesce into one or become three, but

any number up to four may readily be seen. This will give the sense of

insecurity that comes from the eyes not having any fixed object to

look at and illustrates the discipline of the eyes that must be

learned in order that looking down from a height may not be productive

of the usual dread.





Dread of Small Heights.--It is often thought that acrophobia, or the

fear of a height, concerns only great heights and that ordinary

elevations produce no discomfort. I have had patients, however, who,

when compelled by circumstances over which they had no control or at

least by social obligations that were hard to break, to sit on the

front row of even a low balcony, have been extremely uncomfortable.

There was a sense of tightness and oppression about the chest that

made it difficult for them to breathe, that disturbed their heart

action and gave them a general sense of ill-feeling. I have had a

curiously interesting series of cases in clergymen who found it trying

to say Mass or conduct services or to preach from the step of a high

altar. One would be inclined at first to make little of their

description of their utter discomfort. There is no doubt at all,

however, of their real torture of mind and of the extreme effort

required to enable them to support themselves in the trying ordeal.

They are often so exhausted because of the effort required that only

with difficulty can they do anything else during the day.



To most people such a state of mind is inexplicable. There are deeply

intellectual men who, in my experience, are quite disturbed by

apparently so simple a thing as having to say Mass on an altar that

has three or four steps to it and is elevated five or six feet above

the surrounding floor. As for higher altars, like the main altar of a

cathedral, they usually find it quite impossible to conduct services

unless they are in company with others, when their feelings are much

relieved. This same thing is true of agoraphobia in some people. To go

alone across an open place or square is agony, but even the company of

a little child is sufficient to relieve them to a great degree. I told

a distinguished American prelate of this curious dread in priests so

often called to the physician's attention, and he said that he had

never heard of it. To his surprise some of his clergymen present at

the table told him that there were two examples of it in brothers in

his own diocese.





Mental Discipline.--The lesson of the many men who, by discipline,

have succeeded in conquering the aversion and the dread of heights

that everyone has to some extent at least, shows the possibility there

is for even those who are extremely sensitive in this matter to so

lessen their timidity and the uncomfortable oppression that comes over

them, as to make it possible to accomplish whatever is in their line

of duty. It is no more difficult for the sensitive clergyman to learn

by practice and discipline to walk with confidence on a reasonably

high altar or platform, than it is for the workman to learn to

walk a beam on the top of a twenty-story building without a thought of

the dangers of his position, or at least putting the thought away from

him so that it does not interfere with his work. At the beginning he

cannot do it, but he disciplines himself to form a habit that makes it

easy. Yielding to his feelings makes it difficult to withstand the

discomforts that come to him. After an accident on a high building, as

a rule, men have to be sent home for the day to get their nerves

settled by the night's sleep before they can work with sufficient

confidence, and yet accomplish their usual amount of work.





So-called Misophobia--Dread of Dirt.--Misophobia, or the fear of dirt,

has grown much more common in recent years, and the spread of the

knowledge of the wide diffusion of bacteria has added to the

unreasoning dread that possesses these people. Some of them wash their

hands forty to fifty times a day, and one young man who was brought to

me with the worst looking hands, because of irritation from soap and

water, that I have ever seen, seemed to be always either just plunging

his hands into water or wiping them dry. These people make themselves

supremely miserable. They do not care to shake hands with friends and,

above all, with physicians, and they invent all sorts of excuses so as

to wait outside of doors till someone else opens them so as to avoid

touching the knob or door pull, "which" with a poignant expression of

repugnance they tell you "is handled by so many people." When the

patients are women, getting on and off cars becomes a nightmare to

them, because they do not want to touch the handle bars and unless

they do they find it difficult to ascend and descend. The curious

excuses they offer for their peculiar actions in avoiding the touch of

objects around them are interesting.





Claustrophobia.--This sort of dread seems quite irrational to most

people and many would probably conclude that individuals thus affected

could not possibly be quite in their right minds, or must surely be

rather weak-minded. On the contrary, many of the people who are

affected by these curious dreads are above the average in intelligence

and sometimes also in their power to do intellectual work. A typical

example, for instance, of claustrophobia, or the fear of closed

spaces, is found in the life of Philip Gilbert Hamerton. He was a

distinguished painter and essayist, editor and novelist. Few men of

his generation were able to do better intellectual work than he. His

book on "The Intellectual Life" was more read perhaps than any work of

its kind in the last generation. He was not a profound thinker, but he

was a very talented practical man. The fact that besides being a

writer whose books sold he was a painter whose works were in demand,

shows a breadth of artistic quality that is quite unusual. His was not

the sort of genius, however, that is so often supposed to be allied to

insanity, for he was rather a worker who obtained his effects by

plodding, than a brilliant genius that got his thoughts by intuition.



In a word, in spite of the fact that he was just the sort of man that

one would not think likely to be affected by a phobia, he had a series

of attacks of claustrophobia, some of which were intensely annoying to

him and seriously disturbing to his friends. His wife has described

some of them in his "Life and Letters." Once after crossing the

English Channel, he had a severe attack in the railroad carriage on

the way up to London. He had not been nervous on the voyage and

had not been seasick. He was returning from a vacation and was in the

best of health and spirits, yet suddenly the feeling of inordinate

dread that he was shut in came over him and he could scarcely control

himself or keep from plunging out of the window in order to get into

the open. His wife says that "His hands became cold, his eyes took on

a far-reaching look, his expression became hard and set and his face

flushed." He seemed "as if ready to overthrow any obstacle in his way;

and indeed it was the case, for, unable to control himself any longer,

he got up and told me hoarsely that he was going to jump out of the

train. I took hold of his hand and said I would follow him, only I

entreated him to wait a short time, as we were near the station. I

placed myself quite close to the door of the railway carriage and

stood between him and it. Happily the railway station was soon

reached, when he rushed from the train and into the fields." His wife

followed him like one dazed, and almost heart-broken. After half an

hour he lessened his pace, turning to her and said, "I think it is

going." For two hours they continued to walk, at the end of which

Gilbert said tenderly in his usual voice, "You must be terribly tired,

poor darling. I think I could bear to rest now. We may try to sit

down."





Dread of Cats.--One of the most interesting of dreads, very frequently

seen and producing much more discomfort than could possibly be

imagined by anyone who had not seen striking cases of it, is the dread

of cats which has been dignified and rendered more suggestively

significant by the Greek designation ailurophobia. While the great

majority of individuals suffering from this unreasoning dread of cats

are women and usually of a delicate nervous organization, it must not

be thought that it is by any means confined to them or has any

necessary connection with hysterical symptoms. One of the most

striking cases of this dread of which I know personally occurs in a

large, rather masculine-looking woman, who cannot abide being in a

room with a cat, and who is quite unable to do anything while one of

these animals is within sight. Yet she is not at all what would be

called timorous and she has more manly than womanly characteristics in

every way. She once proceeded to thrash within an inch of his life a

small burglar who entered her house and she rather prides herself on

being able to protect herself. Nor is this dread necessarily

associated with any other disturbances of mind or nervous system. Some

of the patients I have seen, who confess to suffering from it, were

thoroughly sensible, brave little women, able to stand suffering well,

not at all hysterical in nature, and who in the midst of worries found

time to be thoughtful of others and not to have that selfishness

which, even more than physical symptoms, is so apt to characterize

hysterical patients.



I have had men confess to me their dread of cats, and while, as a

rule, they were of delicate constitution and inclined to be nervous

and did not have the phobia to an inordinate degree, there was no

doubt that they were extremely uncomfortable whenever a cat was near

them. On the other hand, some of them were vigorous, husky men with

strong aversions. One of the most marked cases of ailurophobia that

was ever brought to my attention was in an army officer who had

exhibited bravery in battle on many occasions, and what requires much

more strength of mind, calm fortitude in difficult campaigning, yet

for whom a cat had many more terrors than the battery of an enemy or

even an ambuscade of Filipinos. More cases of this particular

aversion seem to occur in clergymen than in other men, yet one of the

worst cases I ever saw was in a priest of great moral courage, who had

served a pest-house over and over again in smallpox epidemics.



All that can be said about such a dread is that it exists, that it is

unreasoning, that some patients have been known by discipline of mind

to overcome the abhorrence to a great degree but never quite entirely.

In this regard, however, it must not be forgotten that there are many

things abhorrent to human nature that seem impossible to overcome the

aversion for, yet discipline does much to relieve them. For instance,

the handling of dead bodies so familiar to physicians brings with it

an aversion that we never quite get over and which resumes most of its

original strength with disuse, but that can be overcome to such an

extent as to make pathological work produce very little aversion. Even

Virchow, after all his years of occupation with pathological material,

confessed toward the end of his life, that whenever he was away from

his work for a few months his aversion had to be overcome anew.





The Spectator on Dreads.--There might be a tendency to think that

these curious dreads came only as the result of the individualistic

over-occupation with self and the introspective sophistication of the

modern time, but the dread is not confined to our time nor special to

it in any way, for we find Shakespeare talking of those who cannot

bear a harmless, necessary cat. A number of other writers of different

periods refer to it. As in so many other things The Spectator

reflects his time in this and so we have a letter with regard to the

dread of cats. It would not have been a subject for discussion in one

of these popular communications only that the writer felt that a good

many people would realize how like it was to things that they

themselves knew of. In number 609 the following letter, supposed to be

from a correspondent, seems worth giving in full, because it touches

on other subjects in which uncontrollable, unreasoning feeling plays a

role:



I wish you would write a philosophical paper about natural

antipathies, with a word or two concerning the strength of

imagination. ... A story that relates to myself on this subject may

be thought not unentertaining, especially when I assure you that it

is literally true. I had long made love to a lady, in the possession

of whom I am now the happiest of mankind, whose hand I should have

gained with much difficulty without the assistance of a cat. You

must know then that my most dangerous rival had so strong an

aversion to this species, that he infallibly swooned away at the

sight of that harmless creature. My friend, Mrs. Lucy, her maid,

having a greater respect for me and my purse than she had for my

rival, always took care to pin the tail of a cat under the gown of

her mistress, whenever she knew of his coming; which had such an

effect that every time he entered the room, he looked more like one

of the figures in Mrs. Salmon's wax-work than a desirable lover. In

short, he grew sick of her company, which the young lady taking

notice of (who no more knew why than he did), she sent me a

challenge to meet her in Lincoln's Inn Chapel, which I joyfully

accepted; and have, amongst other pleasures, the satisfaction of

being praised by her for my stratagem.





Cat Fear and Furs.--This dread of cats is sometimes exhibited to a

surprising degree under rather unexpected circumstances. For instance,

it is not unusual, since the fashion for the longer-haired furs came

in, to find that some of these patients cannot wear certain supposedly

elegant furs, since they are really dyed catskin. At times this is not

suspected until other possible causes for the discomfort have been

eliminated. Some women cannot even bear to be near catskins in muffs

and other such furs, though the imitation may be so good as to

deceive any but an expert, and they apparently had no suspicion at the

beginning of the presence of cat fur near them. I have been told by a

physician the story of a man, poignantly sensitive to cats, who

purchased a fur-lined coat and found it quite impossible to wear it

because of the sensations it produced in him, though he had no

suspicion of any connection between cats and the fur when he purchased

it.





Recognition of Presence.--Why this dread of cats occurs and, above

all, the reason for the ability to know that a cat is near when the

animal is concealed and others are not at all aware of its presence,

or that its fur should produce a disagreeable sensation, is not easy

to decide. Its discussion is suggestive for other forms of dreads, for

there are probably like refinements of sensation, normal and abnormal,

connected with them. Much has been said about this as a reversion to

powers possessed by man in a savage state when there was necessity for

guarding against animal attacks. Unfortunately for any such

supposition as this, these people, who are most fearful of cats, that

is, of the ordinary domestic animal, have no uneasiness in the

presence of the huge cats in the menageries--the lions and the tigers.

It is with regard to these that such a specialization of scent would

be particularly valuable for men. There seems no doubt but that it is

an odor or a sensation allied to an odor, though perhaps below the

ordinary threshold of recognition as such, that enables these people

to detect the presence of a cat. Dr. Weir Mitchell in his article on

"Ailurophobia and The Power to Be Conscious of the Cat as Near While

Unseen and Unheard," in the Transactions of the Association of

American Physicians, 1905, discusses odor in this connections as

follows:



To be influenced by an olfactory impression of which (as odor) the

subject rests unconscious, may seem an hypothesis worthy of small

respect and beyond power of proof. Nevertheless it seems to me

reasonable. There are sounds beyond the hearing of certain persons.

If they ever cause effects we do not know. There are rays of which

we are not conscious as light or heat, except through the effects to

which they give rise. There may be olfactory emanations

distinguished by some as odors and by others felt, not as odors, but

only in their influential results on nervous systems unusually and

abnormally susceptible. No other explanation seems to me available,

and this gains value from certain contributory facts.



We must admit that all animals and human beings emit emanations

which are recognizable by many animals and are in wild creatures

protectively valuable.



This delicate recognition is commonly lost in mankind, but some

abnormal beings like Laura Bridgeman and a perfectly normal lad I

once saw, have possessed the power of distinguishing by smell the

handkerchiefs of a family after they had been washed and ironed. In

this lad I made a personal test of his power to pick out by their

odor from a heap of clean handkerchiefs mine and those of others,

the latter two belonging to his father and mother.



I have seen a woman, well known to me, who can distinguish by mere

odor the gloves worn by relatives or friends. This lady, who likes

cats as pets, is able to detect by its odor the presence of a cat

when I and others cannot.



Two French observers believe that they have proved the sense of

olfaction to be nine times more acute in women than in men.



So far as the present paper might serve in evidence, I should be

inclined to say that the sense of smell was keener in women than in

men, but as to this there is extreme diversity of opinion and the

whole question awaits further investigation. [Footnote 48]



[Footnote 48: This question of the varying acuteness of smell in

different people is very interesting to the psychotherapeutist for

diagnosis and therapy. We have a number of striking cases of very

acute olfactory power. This is what might be expected since

animals whose respiratory and smell apparatuses are very like our

own show extreme differences. The extent to which human power to

recognize odors can go is marvelous. In his "Thinking, Feeling,

Doing," Prof. Scripture says: "I have a case--reported by a

perfectly competent witness who lived for years with the person

mentioned--of a woman in charge of a boarding school who always

sorted the boys' linen after the wash by the odor alone."

Personally, I have sometimes wondered whether this power, like

that of feeling in the blind, could not be developed. The blind

are supposed actually to bring about an evolution in their nerves

of feeling. No such thing happens, however. An examination of them

by means of an esthesiometer shows that their nerves are no better

developed than those of other people, though they may be able to

recognize much minuter differences between the "feel" of things

and may be able to read raised type, which the seeing cannot. This

is all due to a training of their attention to note slight

differences in sensation, however, and not to improvement in the

nervous apparatus. ]







Dread of the Dark.--The discipline suggested with regard to overcoming

the dread of heights must be applied to any of these dreads if

patients are to be made comfortable. They can form the opposite habit

and by refusing to yield to their fears can do much to lessen them.

Nearly everyone who is unaccustomed to sleeping in a dark house alone

has dreads that come over him when he first tries to do it. Every

noise is exaggerated in significance and the creaking of stairs and

rattling windows and doors and the wind through the trees are all made

significant of something quite other than what they are. Nearly

everyone knows, however, that this can be overcome simply by refusing

to pay any attention to the idle fears that come over us as a

consequence of the tension due to loneliness, and after a time,

sleeping in a strange room and a strange house in the dark is not a

difficult matter. It is harder for some people to accomplish than

others, but it is impossible for none. Here is the lesson that all the

sufferers from dreads must learn. Gradually, quietly, persistently,

they must resist the dreads that come over them, must deliberately,

without excitement, do the opposite to that suggested by their

apprehension, until habits are formed that enable them to accomplish

without discomfort what was before a source of even serious

ill-feeling.



The dread of darkness that so many people have is usually supposed to

be cowardice. It is not, however, in most cases, but is due to

idiosyncrasy or to certain special physical factors in the

environment. If children have been brought up so that when they were

small a light has been constantly shining in their eyes, even though

only a dim light, it will often be difficult to accustom them to be

quite comfortable in the dark. Much depends on habit in this matter. I

have known men, who, when they came from Ireland, feared the darkness

of the coal mines very much and their dread was increased by the awful

horror of possible ghostly appearances, since so many accidents had

taken place where they worked. After some years, however, they were

quite placid about it and would calmly go into the mine as fire bosses

at three and four in the morning, long before others were to go in,

examining absolutely dark passages by the mile, with no human being

near them and with the creaking of the pillars, the dripping of water,

the rumbling of the sides and the occasional fall of a small particle

from the roof, besides the noises of rats to add to the disturbing

factors. Like going up on a high building, one may get entirely

accustomed to it so as scarcely to notice it at all.



When the fear is allowed to take hold of one, however, and no effort

is made to overcome it, it may prove quite seriously disturbing. The

unaccustomed, however, means more than anything else in this matter.

Sometimes, indeed, people have a dread of the dark that seems to

be inborn and that apparently cannot be overcome, that, like the fear

of cats or of lightning, may be quite beyond rational control. Hobbes,

the English philosopher, was so perturbed by darkness that he kept a

light in his bedroom all night. I know this to be the case in a

clergyman who had been quite undisturbed about darkness until he was

awakened one night by a burglar. He demanded "who's there?" and

received as answer without further parley a bullet that fortunately

struck only the head of the bed, but so close that it singed him. The

burglar escaped, but the clergyman was never afterwards able to sleep

without a light. Rousseau, the French philosopher, was also much

afraid of darkness. Ordinarily it is presumed that superstition has

something to do with this fear and that the victim of it has ghosts in

mind or at least dreads spirit manifestations. Neither Hobbes nor

Rousseau, however, was likely to be timorous about ghostly visitants.

It was with them a physical idiosyncrasy.



Associated with dread of darkness is the fear of finding some one in a

dark room whose presence may startle us. Sir Samuel Romilly, famous

for his labors for the reform of the English criminal law, and who

must be considered one of the great humanitarians of the nineteenth

century, had this dread to an acute degree. It went so far that

whenever he slept in a strange place he carefully examined all the

possible hiding-places in the room and in wardrobes or closets

connected with it and, as a last precaution, never failed to look

under the bed. He did this even when he was in his own house.

[Footnote 49] This, however, is not so unusual, even among men, as

might be thought. Most women who sleep alone want to investigate under

the bed and in a hotel closets and wardrobes and even bureau drawers

are likely to be examined. Habit in this regard may make one quite

miserable and over-solicitous. I have had patients whose sleep was

seriously disturbed by the remembrance that they had not looked under

the bed and who feared to get up and light a light to do so lest there

should be someone there. Indeed, the idea of putting their feet on the

floor before the light had come to reassure them seemed quite out of

the question.



[Footnote 49: Curiously enough. Sir Samuel Romilly, in spite of his

dread of the dark, committed suicide and went prematurely into the

darkness of the beyond, apparently without his usual tendency to

precaution.]





Dreads Connected with Water.--Strange as it may seem, water

constitutes a source of dread for some people. We have the records of

it in the peculiarities of great men and it is not unusual to meet it

in common life. Dropping water is a source of disturbance for most

people. It is quite impossible for the majority of men and women to go

on writing or reading with any comfort if water is dropping near them.

Dropping water, when one is trying to go to sleep, is one of the worst

of awakeners. The Chinese are said to put people to death in horrible

torture by having a drop of water fall at regular intervals on their

heads. Robert Boyle, the great father of chemistry and a very sensible

man in many ways, is said to have been thrown into convulsions by the

sound of water dropping from a faucet. The splashing of water on some

people is a poignant source of torture. I have had a woman patient who

could not go to services where there was a sprinkling of water, for it

seriously disturbed her and gave her a sense of depression that would

not be overcome for some time. Peter the Great, though the father of

the Russian navy, and though he passed many years of his life in

Holland, used to shudder at the sight of water, and if, when out

driving, his carriage passed near a stream or over a bridge, he would

close the windows and be overtaken with terror that brought the

perspiration out all over him.





Dread of Death.--The fear of death is one of the dreads that bothers

young as well as old, and, curiously enough, as its inevitable

approach becomes more certain, men are prone to dread it more. Long

ago Sophocles said:



None cleave to life so fondly as the old,



-- and this has remained true for all the centuries since. A young man

is quite ready to throw his life away, but the old man hesitates and

even in the midst of suffering, if it is not absolutely continuous,

craves that death shall not come. Sophocles' great rival, the elder

Greek dramatic poet AEschylus, had said:



How far from just the hate men bear to death

Which comes as safeguard against many ills,



-- but his message was only for those with the character to face the

worst. One may reason with the dread of death, however, and patients

can be given motives from philosophy, literature, religion and

experience that will help to relieve, though it will not entirely cure

them. Shakespeare said in "Julius Caesar":



Cowards die many times before their deaths.

The valiant never taste of death but once,



-- and people may be aroused to appreciate this.





Fear of Early Death.--Many fear that if they have shown symptoms of

delicacy of constitution at some time in life or suffered severely

from some serious disease, that they are not likely to live long and,

above all, that they are almost sure not to be able to accomplish

anything worth while in life. The old proverb is "a healthy mind in a

healthy body." This is, however, the ideal. There are very few ideals

realized in life. Just because a man has a weak body is no argument at

all that his mind may be weak and some of the world's finest work has

been accomplished by men whose bodies were always delicate.

Metchnikoff is the apostle of old age to our generation, but it is he,

also, who has pointed out that many distinguished workers in science,

in poetry, in art, men who have left a precious heritage in succeeding

generations, were delicate all their lives. He cites such typical

examples as Fresnel, the great French physicist; Giacomo Leopardi, the

distinguished Italian poet; Weber and Schumann, the great German

musicians, and Chopin, the Polish composer and pianist, all of whom

did work that the world would not willingly miss, in spite of delicacy

of health and weakness of body which shortened their lives.

Intellectual power is not dependent on bodily energy and

accomplishment is not a question of years of work, but intensity of

work.



It would not be difficult to add many other names to those mentioned

by Metchnikoff. Naturally his thoughts recurred to men of distinction

on the Continent, but in English-speaking countries we have a

number of typical examples of strong minds doing fine work in weak

bodies. Robert Louis Stevenson is the best remembered by our

generation. Elizabeth Barrett Browning, delicate all of her life, a

neurasthenic during the precious adolescent years that are supposed to

mean so much for future accomplishment, always an invalid to some

degree at least, did some of the best work that was given to any woman

to do during the nineteenth century. J. Addington Symonds, the

historian of the Renaissance and of Italian literature, is another

striking example of a man who had to do his work under great physical

difficulties, yet who left a long bookshelf of large volumes after him

as the product of the hours that he could cheat from caring for his

health. Henry Harland, whose recent death all too young was a blow to

the English-speaking world, is another striking example. The names of

such men and women and their stories must be made familiar to people

who are themselves delicate in health and who fear for their future

and, above all, are despondent about the possibility of ever doing

anything worth while.





Dread of Insanity.--People who have relatives who are already

sufferers from such severe forms of insanity as require asylum

treatment are often likely to be much disturbed over the possibility

that they themselves should become insane. Of course, there is no

doubt but that these people are much more liable to suffer from

insanity than others, but their worrying over the matter is sure to do

them harm rather than good. There are quite enough sources of worry in

life without the additional one of dread of a future event that may

not occur, and this must be made as clear to them as possible. The

people who have no obligations on them, who have nothing to do that

they feel they have to do, are especially likely to suffer from such

obsessions. The best possible relief for them is afforded, not by the

effort not to worry about their dread, which usually has exactly the

opposite effect and emphasizes their fear by the constant effort which

they make to put it aside, but by getting something else to interest

them. This must not be merely a passing interest, if possible, but a

serious attraction of some kind that fully occupies the mind. A hobby

is an excellent thing for this, but alas! a hobby must be cultivated

for many years, as a rule, to become powerful enough to bring relief

in such serious matters.



Occasionally the thought of the insane asylum or the sight of an

institution of this kind passed even at a distance in the train is

enough to give some people a fit of depression that may last for some

time. The thought of going to visit their ailing relatives is enough

to make them even more depressed. I have sometimes found that in

chosen cases, especially among women and those of sympathetic

disposition, the apparently heroic remedy of making them visit their

relatives in the asylum was excellent for them. It is the usual rule

for people who are themselves sane to consider that it is the greatest

hardship of asylum confinement for the patients to be associated with

those whom they recognize to be insane. Exactly the opposite effect is

the usual result. To be among people, many of whom are more irrational

than themselves and some of whom are quite beside themselves, proves a

stimulus and an encouragement. Contentment has been defined by a cynic

as the feeling that things might be worse.





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