Whenever the dynamic energy is exhausted and the levels of reserve energy are reached, the individual affected begins to feel restless, and if there is no access to the levels of reserve energy, the individual gets scared. The fear instinct becomes awakened, giving rise, after repeated unavailing attempts, to the states of psychopathic neurosis. In states of depression, such as hypochondria and more especially in states of melancholia, the fear instinct is potent. The fear instinct is brought about in the darkness of the night, when the individual is fatigued from his day’s labor, when the external stimuli are at a minimum, and reserve energy is not available. The fear instinct rises from the subconscious regions to the surface of conscious activities. Convalescent states as well as exhaustion from pain and disease, such as fever or a shock from some accident, war-shock, shell-shock, surgical shock predispose to the manifestation of the fear instinct. Hence the caution of surgeons in the preparation of the patient for a serious operation. For the result We must agree with the French psychologist, Ribot, when he comes to the conclusion that “every lowering of vitality, whether permanent or temporary, predisposes to fear; the physiological conditions which engender or accompany it, are all ready; in a weakened organism fear is always in a nascent condition.” The fear instinct becomes morbid when the individual has to draw on his reserve energy, and finds he is unable to do it. The cure consists in the release of the reserve energy which has become inaccessible. This can be done by various methods, but the best is the method of induction of the hypnoidal state under the control of a competent psychopathologist. The whole process consists in the restitution From our point of view, fear is not necessarily due to pain previously experienced, it may be purely instinctive. The fear instinct may be aroused directly, such for instance is the fear of young children who have never before experienced a fall. In fact we claim that the fear instinct and the restlessness which expresses it antedate and precede pain. The fear of pain is but one of the forms under which the fear instinct is manifested. The fear instinct appears long before pain and pleasure come into existence. This holds true not only of the lower animal life, but also of the vague fear found in many a case of neurasthenia and functional neurosis and psychosis. Ribot also calls attention to pantophobia. “This is a state in which the patient fears everything, where anxiety instead of being riveted on one object, floats as a dream, and only becomes fixed for an instant at a time, passing from one object to another, as circumstances may determine.” It is probably best to classify fears as antecedent and subsequent to experience, or fears as undifferentiated and differentiated. When the dynamic energy is used up in the course of life adaptations, and reserve energy is drawn upon, there may be danger that the energy may be used up until the static energy is reached, and neuropathic This process of degeneration and simplification is characteristic of all forms of psychopathic conditions, though it may be more prominent in some cases than in others. The type of mental life becomes lowered and there is a reversion, a sort of atavism, to simpler and more childish experiences, memories, reactions of earlier and less complex forms of mental life. I have laid special stress on this feature of psychopathic reactions in all my works on the subject. What I emphasize in my present work is the fact that psychopathic reactions are dominated by self and fear, which are laid bare by the process of degeneration. The patient in psychopathic states is tortured by his fears, he is obsessed by wishes which are entirely due to his fear and deranged impulse of self-preservation. As the static energy is reached, and with lack of functional energy of the dynamic character, the energy habitually used in the ordinary relations of Psychopathic individuals are in a state of the wicked “who are like the ocean which never rests.” This misery of ever forming wishes and attempting to assuage the inner suffering, this craving for new pleasures and excitements, in order to still uneasiness, distress, and the pangs of the fear instinct with its gnawing, agonizing anxieties, brings the patient to a state in which he is ready to drink and use The patient needs to be lifted out of the misery of monotony and ennui of life, he needs to be raised from his low level of vitality, to be saved from the listlessness into which he has fallen. The low level of energy makes him feel like a physical, nervous, and mental bankrupt. This bankruptcy is unbearable to him. He is in a state of distraction, distracted with the agony of fear. Something must be done to free himself from the depression of low spirits and from the low level of energy which keeps him in a state devoid of all interest in life, accompanied by physical, mental and moral fatigue. He is like a prisoner doomed to a life long term. This constant craving for stimulation of energy, this reaction to the anxiety of the morbid fear instinct is the expression of exhaustion of available dynamic energy for the purpose of normal life activity. The patient attempts to draw on his latent reserve energy. Since this form of energy is not accessible to the stimulations of common life, he The morbid fear instinct in all cases is brought about by exhaustion of energy, whether sudden or gradual. Fear is due to exhaustion of lower levels of dynamic energy and to the inability of liberation of stored up reserve energy. The more intense this incapacity of utilization of reserve stores of energy be, the more intense is the fear. When this condition is prolonged the psychopathic symptoms become unendurable. The experienced, thinking surgeon has learned the danger of this condition in his operating room. Thus it is told of Porta, the great surgeon of Pavia, when his patients died under an operation, he used to throw his knife and instruments contemptuously to the ground, and shout in a tone of reproach to the corpse: “Cowards die of fear.” The great physiologist Mosso gives a graphic description of the effects of fear in a pathetic case that has come under his personal observation: “As army surgeon, I had once to be present at the execution of some brigands. It was a summary judgment. |