Dreads founded on terrifying or seriously disturbing incidents of the past, the details of which at times have gone out of the patient's mind, are not infrequent. It is probable that many of the unreasoning dreads have some such foundation and occasionally, if patients' memories are carefully searched, the whole story can be reconstructed. All that is needed, as a rule, is to get the patients interested in conjunction with the physician in tracing the origin of their affliction and not infrequently an interesting story will turn up. Hypnosis used to be considered of great value for such reconstructions, but unfortunately patients then become so suggestible that it is often difficult to decide how much of what is brought out by questioning is due to the suggestive quality that cannot well be kept out of questions, and how much to a true redintegration of memory. Frights in children may for a time be forgotten and yet the memory of them may come back, or a dread connected with them develop, that will make the patient profoundly miserable. One of my patients slipped and fell on a smooth steel plate at the head of a coal breaker and was only saved by good fortune from falling a long distance. This happened when he was a Various physical manifestations may be due to dreads which are often supposed to be the result of some physical process in the nervous system. Occasional fits of trembling, for instance, are, in sensitive people, due to more or less forgotten memories of dangers or frights. Occasionally even slight convulsive seizures may follow such recurrent dreads. Not a few of the cases of so-called hystero-epilepsy in the borderland between hysteria and epilepsy but always one or the other, are due to such mental states rather than to any physical conditions. Such incomplete memories are sometimes spoken of as subconscious. The word subconscious has been so much abused, however, that I prefer not to use it. The reminiscences have been obscured by an accumulation of other facts but may with an effort of attention and concentration of mind be recalled. Hypnosis, or the milder form of it spoken of as the hypnoidal state, may enable the patient to recall them more vividly by enabling him to concentrate his attention, but there are always risks that suggestion will vitiate the old story in these cases. With care all the details can usually be recalled and the patient is thus given renewed confidence in himself and his own powers and does not learn to lean on someone else in the process. |