LITMIR.BIZ

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was 14–½, that is, the age of puberty had just been reached, one must suppose that there was some connection between the disturbances and the physiological character-changes at puberty. "There appears in the consciousness of the individual during this period of life a new group of sensations, together with the feelings and ideas arising therefrom; this continuous pressure of unaccustomed mental states makes itself constantly felt because the cause is always at work; the states are co-ordinated because they arise from one and the same source, and must little by little bring about deep-seated changes in the ego."[67] Vacillating moods are easily recognisable; the confused new, strong feelings, the inclination towards idealism, to exalted religiosity and mysticism, side by side with the falling back into childishness, all this gives to adolescence its prevailing character. At this epoch the human being first makes clumsy attempts at independence in every direction; for the first time uses for his own purposes all that family and school have contributed hitherto; he conceives ideals, constructs far-reaching plans for the future, lives in dreams whose content is ambitious and egotistic. This is all physiological. The puberty of a psychopathic is a crisis of more serious import. Not only do the psychophysical changes run a stormy course, but features of a hereditary degenerate character become fixed. In the child these do not appear at all, or but sporadically. For the explanation of our case we are bound to consider a specific disturbance of puberty. The reasons for this view will appear from a further study of the second personality. (For the sake of brevity we shall call the second personality Ivenes—as the patient baptised her higher ego).

      Ivenes is the exact continuation of the everyday ego. She includes the whole of her conscious content. In the semi-somnambulic state her intercourse with the real external world is analogous to that of the waking state, that is, she is influenced by recurrent hallucinations, but no more than persons who are subject to non-confusional psychotic hallucinations. The continuity of Ivenes obviously extends to the hysterical attack with its dramatic scenes, visionary events, etc. During the attack itself she is generally isolated from the external world; she does not notice what is going on around her, does not know that she is talking loudly, etc. But she has no amnesia for the dream-content of her attack. Amnesia for her motor expressions and for the changes in her surroundings is not always present. That this is dependent upon the degree of intensity of her somnambulic state and that there is sometimes partial paralysis of individual sense organs is proved by the occasion when she did not notice me; her eyes were then open, and most probably she saw the others, although she only perceived me when I spoke to her. This is a case of so-called systematised anæsthesia (negative hallucination) which is often observed in hysterics.

      

      Flournoy,[68] for instance, reports of Helen Smith that during the séances she suddenly ceased to see those taking part, although she still heard their voices and felt their touch; sometimes she no longer heard, although she saw the movements of the lips of the speakers, etc.

      Ivenes is just the continuation of the waking self. She contains the entire consciousness of S. W.'s waking state. Her remarkable behaviour tells decidedly against any analogy with cases of double consciousness. The characteristics of Ivenes contrast favourably with the patient's ordinary self. She is a calmer, more composed personality; her pleasing modesty and accuracy, her uniform intelligence, her confident way of talking must be regarded as an improvement of the whole being; thus far there is analogy with Janet's Léonie. But this is the extent of the similarity. Apart from the amnesia, they are divided by a deep psychological difference. Léonie II. is the healthier, the more normal; she has regained her natural capabilities, she shows remarkable improvement upon her chronic condition of hysteria. Ivenes rather gives the impression of a more artificial product; there is something thought out; despite all her excellences she gives the impression of playing a part excellently; her world-sorrow, her yearning for the other side of things, are not merely piety but the attributes of saintliness. Ivenes is no mere human, but a mystic being who only partly belongs to reality. The mournful features, the attachment to sorrow, her mysterious fate, lead us to the historic prototype of Ivenes—Justinus Kerner's "Prophetess of Prevorst." Kerner's book must be taken as known, and therefore I omit any references to these common traits. But Ivenes is no copy of the prophetess; she lacks the resignation and the saintly piety of the latter. The prophetess is merely used by her as a study for her own original conception. The patient pours her own soul into the rôle of the prophetess, thus seeking to create an ideal of virtue and perfection. She anticipates her future. She incarnates in Ivenes what she wishes to be in twenty years—the assured, influential, wise, gracious, pious lady. It is in the construction of the second person that there lies the far-reaching difference between Léonie II. and Ivenes. Both are psychogenic. But Léonie I. receives in Léonie II. what really belongs to her, while S. W. builds up a person beyond herself. It cannot be said "she deceives herself" into, but that "she dreams herself" into the higher ideal state.[69]

      The realisation of this dream recalls vividly the psychology of the pathological cheat. Delbruck[70] and Forel[71] have indicated the importance of auto-suggestion in the formation of pathological cheating and reverie. Pick[72] regards intense auto-suggestibility as the first symptom of the hysterical dreamer, making possible the realisation of the "day-dream." One of Pick's patients dreamt that she was in a morally dangerous situation, and finally carried out an attempt at rape on herself; she lay on the floor naked and fastened herself to a table and chairs. Or some dramatic person will be created with whom the patient enters into correspondence by letter, as in Bohn's case.[73] The patient dreamt herself into an engagement with a totally imaginary lawyer in Nice, from whom she received letters which she had herself written in disguised handwriting. This pathological dreaming, with auto-suggestive deceptions of memory amounting to real delusions and hallucinations, is pre-eminently to be found in the lives of many saints.[74]

      It is only a step from the dreamlike images strongly stamped by the senses to the true complex hallucinations.[75] In Pick's case, for instance, one sees that the patient, who persuades herself that she is the Empress Elizabeth, gradually loses herself in her dreams to such an extent that her condition must be regarded as a true "twilight" state. Later it passes over into hysterical delirium, when her dream-phantasies become typical hallucinations. The pathological liar, who becomes involved through his phantasies, behaves exactly like a child who loses himself in his play, or like the actor who loses himself in his part.[76] There is here no fundamental distinction from somnambulic dissociation of personality, but only a difference of degree, which rests upon the intensity of the primary auto-suggestibility or disintegration of the psychic elements. The more consciousness becomes dissociated, the greater becomes the plasticity of the dream situation, the less becomes the amount of conscious lying and of consciousness in general. This being carried away by interest in the object is what Freud calls hysterical identification. For instance, to Erler's[77] acutely hysterical patient there appeared hypnagogically little riders made of paper, who so took possession of her imagination that she had the feeling of being herself one of them. Similar phenomena normally occur to us in dreams in general, in which we think like "hysterics."[78]

      The complete abandonment to the interesting image explains also the wonderful naturalness of pseudological or somnambulic representation—a degree unattainable in conscious acting. The less waking consciousness intervenes by reflection and reasoning, the more certain and convincing becomes the objectivation of the dream, e.g. the roof-climbing of somnambulists.

      Our case has another analogy with pseudologia phantastica: The development of the phantasies during the attacks. Many cases are known in the literature where the pathological lying comes on in attacks and during serious hysterical trouble.[79]

      Our patient develops her systems exclusively in the attack. In her normal state she is quite incapable of giving any new ideas or explanations; she must either transpose herself into somnambulism or await its spontaneous appearance. This exhausts the affinity to pseudologia phantastica and to pathological dream-states.

      Our patient's state is even differentiated from pathological dreaming, since it could never be proved that her dream-weavings had at any time previously been the objects of her interest during the day. Her dreams occur explosively, break forth with bewildering completeness from the darkness of the unconscious. Exactly the same was the case in Flournoy's Helen Smith. In many cases (see below), however, links with the perceptions of the normal

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