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VII HYSTERIA IN CHILDHOOD

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a little girl, a pupil in a german school, made her appearance in class one morning with a bandage about her head. in answer to her teacher’s questions, she said she had been operated upon for ear trouble at a local hospital the day before. she described every detail of the operation, which, it seemed, had been exceedingly painful.

for some time she wore the bandage to school every day, and frequently complained that her ear was still troubling her. her teacher was properly sympathetic, and, chancing to meet one of the girl’s relatives, expressed her anxiety for the child, and the hope that she would soon be completely cured.

“cured?” repeated the relative. “cured of what?”

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“why, her ear trouble—the disease that has made it necessary for her to keep her head bandaged.”

“but,” said the other, obviously puzzled, “i do not understand you. i did not know she had any ear trouble, and i have never seen her with a bandage.”

it was the teacher’s turn to be astonished. she could not believe that the girl had been deceiving her; but, to get at the truth, she decided to take her immediately to the hospital where the operation was supposed to have been performed. there the child made her way about as if perfectly familiar with the place, and greeted in a friendly manner the surgeon in charge. he, however, did not seem to recognise her, and when told the circumstances by the teacher, said:

“i can assure you i have never operated upon this girl.”

he then made a thorough examination of her ear, and found it to be quite sound. after which, careful investigation developed the fact that her sole knowl223edge of the hospital was derived from detailed information given her by a friend, a lady who, curiously enough, had been operated upon a little while previously for precisely the trouble that the girl had attributed to herself.

in other words, no doubt remained that she had for weeks been acting a lie, from what motive neither her teacher nor her parents could fathom.

again, a clergyman writing to the society for psychical research from a little english village named ham, urgently requested the despatch of a skilled investigator to look into certain strange occurrences in the house of a mr. turner. this house, the clergyman asserted, was haunted by a “veritable ghost,” which amused itself by playing all sorts of mischievous and annoying pranks.

remaining invisible, it hurled boots, shoes, and other small objects through the air, upset chairs and tables, and on at least one occasion it had pitched the family cat into the fire. all this was done, according to both the clergyman and several other in224telligent eye-witnesses, under circumstances that rendered it impossible that the “manifestations” could be the work of any human agency.

“no one can explain it,” the clergyman declared. “it is quite a mystery, and is causing great excitement through the countryside.”

the task of laying this “poltergeist,” or troublesome ghost, was assigned to mr. ernest westlake, an able psychical researcher. proceeding to ham, he found that the turner family consisted of mr. turner, his wife, one son, and a deformed little daughter, polly, not quite twelve years old. so impressed was he with what he heard that his first report indicated a belief that the phenomena witnessed might be genuine evidences of some mysterious and unknown force. but, after a few hours of watchful scrutiny, he sent word that “the ham ghost is a humbug now, whatever it may have been.” in detail mr. westlake afterward added:

“after posting my first letter, i went to the turners’ and sat on a bench in front of the fire.225 no one else was present besides the child. she sat on a low stool in the chimney on the right of the fire. on the other side of the hearth there was a brick oven in which, much to polly’s interest, i placed a dish of flour, arguing that a power capable of discharging the contents of the oven (one of the first disturbances) might be able to impress the flour. after a time i went to the oven to see how the flour was getting on, stooping slightly to look in; but i kept my eye on the child’s hands, looking at them under my right arm. i saw her hand stealing down toward a stick that was projecting from the fire; i moved slightly, and the hand was withdrawn. next time i was careful to make no movement, and saw her hand jerk the brand out on to the floor. she cried out. i expressed interest and astonishment; and her mother came in and cleared up the debris.

“this was repeated several times, and one or two large sticks ready for burning, which stood near the child, was thrown down. then a kettle that was hanging on a hook and chain was jerked off the hook226 on to the coals. this was repeated. as the kettle refused to stay on its hook, the mother placed it on the hearth; but it was soon overturned on to the floor. after this, i was sitting on the bench that stood facing the fire in front of the table. i had placed my hat on the table behind me. the little girl was standing near me on my right hand. presently the hat was thrown down on to the ground. i did not on the first occasion see the girl’s movements; but later, by seeming to look in another direction, i saw her hand sweep the hat off on to the floor. this i saw at least twice. a windsor chair near the girl was then upset more than once, falling away from her. on one occasion i saw her push the chair over with both hands. as she was looking away from me, i got a nearly complete view. after one of these performances, the mother came in and asked the child if she had done it; but the latter denied it.” (proceedings of the society for psychical research, vol. xii.)

unquestionably, mr. westlake concluded, polly227 was the “ghost.” yet he found it difficult to conjecture why she should have assumed so singular a r?le. neither she nor her parents—whom he exonerated from all complicity—had profited a penny’s worth from her exploits. indeed, her parents had been put out of pocket by the damage to the household furniture and utensils.

consider, also, the case of a little chicago boy who had fallen out of a play-wagon and hurt one of his arms. the injury was in reality very slight; but his mother, becoming greatly alarmed, declared her belief that the doctor would say the arm was broken. what the doctor—d’orsay hecht, of northwestern university medical school—did say was that a few applications of witch-hazel would speedily remedy matters.

the mother, nevertheless, insisted on bandaging the arm, talked of having an x-ray examination, and broadly hinted that a wrong diagnosis had been made. within a few days, as doctor hecht had expected, all signs of injury disappeared. but now the boy228 complained that the hand of the injured arm felt stiff; and, in a day or so, his mother reported that both hand and arm were paralysed.

this was the situation when, passing along the street one day, doctor hecht was astonished and amused to see his “paralysed” patient romping with a number of children, quite as if nothing were the matter with him. he used his injured arm freely, pushed and pulled his playmates, and was pushed and pulled around by them.

“ah,” thought the physician, with a feeling of relief, “evidently this youngster is going to give no more trouble.”

he was mistaken. within a week the mother sent for him, reporting that her boy was suffering agonies, that he could not eat, and that his arm had become contracted at the elbow. in fact, on visiting the boy he found that at every attempt to flex the arm the little fellow screamed with pain.

but on his next visit, when the child chanced to be asleep, doctor hecht noticed that there was then no229 contracture of the arm, and that he could move it without disturbing the boy in the slightest. so soon, however, as he awoke, the contracture returned, and he wailed and shrieked when his arm was touched. to the astonished mother, the doctor said:

“i see what the trouble is. your son needs a certain kind of treatment that i can administer only at my office. bring him there as soon as possible.”

the treatment in question consisted in the application of a succession of slight electrical shocks, just painful enough to be felt. these, the doctor assured the boy, would cure him completely.

“if they do not,” said he, “your mother must bring you back, and i will give you a stronger treatment next time. i don’t think, though, that that will be necessary, do you?”

and, in point of fact, no second treatment was needed. from that moment the boy ceased complaining of his arm, the contracture and paralysis entirely disappeared, and he was like any normal, healthy child.

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i have cited these three cases, not because of their singularity, but because they afford concrete illustration of some little known facts with which every parent ought to be acquainted. in each case, it will be observed, an element of deception was present; and, moreover, in each case the deception was seemingly motiveless. the child who pretended that she had been operated upon had apparently nothing to gain from the deceit practised by her; neither had the little girl who played the part of a “poltergeist,” nor the boy with the sham contracture and paralysis. besides which, in two of the three cases the children subjected themselves to considerable inconvenience and even pain; and, in all three cases, they ran the risk of severe punishment. none the less, they systematically and persistently kept up their deceptions until discovery ensued.

now, why did they do it?

they did it, as recent medical and psychological investigation into the inner life of childhood has conclusively demonstrated, because they were so consti231tuted that they could not help doing it. and for the same reason, hundreds—nay, thousands—of children, before and since, have been doing much the same thing. it is not that they are merely “naughty.” the ordinary naughty child will, to be sure, lie and cheat and otherwise deceive; but only from readily ascertainable motives, and never in the way of an elaborately sustained deception. when a child’s “naughtiness” takes this latter form, medical authorities are to-day agreed, it is in reality indicative of the presence of a really serious disease—hysteria.

than this disease—of which most people, unfortunately, have next to no exact knowledge, mistakenly confusing it with, and confining it to, uncontrollable attacks of weeping or laughing—there is no malady more insidious, peculiar, or dangerous in the variety of its possible consequences. its peculiarity lies in the fact—discovered only within recent years—that it is always rooted in an extreme “suggestibility” on the part of its victims; and that232 the symptoms it develops are invariably conditioned by the character of the suggestions received from the environment. hysteria is, to put the case briefly, pre-eminently a mental trouble; and this although, not infrequently, its only outward manifestations are wholly physical.

a child with a hysterical tendency—that is to say, an unusually sensitive, impressionable child, of undisciplined will, and quickly overwhelmed by whatever it sees, hears, or feels—is always liable, when brought into contact with a person suffering from any serious ailment of picturesque symptomatology, to manifest in some degree the symptoms of that particular ailment. or, more commonly, such a child may manifest grave physical disabilities simply as a result of hearing or reading about them.

it does not do this voluntarily; there is no conscious intention to deceive; for the matter of that, the child itself is as much deceived as are its parents and friends. the trouble is that in its state of abnormal suggestibility, it is irresistibly impelled by233 the strange power of self-suggestion to imitate the symptoms of disease.

or, instead of simulating disease symptoms, a hysterical child may enter on a course of seemingly deliberate chicanery like that practised by little “poltergeist” polly turner, whose case is typical of a species of behaviour indulged in by hysterical children in all countries and all ages. here, likewise, abnormal suggestibility is in evidence, the resultant hysterical manifestations differing only because the suggestions received and acted on are different.

in cases like polly turner’s, it has been found, the hysterical child usually lives with people more or less superstitious and credulous. they are people inclined to attribute to some spiritistic agency any occurrence they cannot easily explain. in this environment the child gradually becomes obsessed—though quite unconsciously—with a desire to provide “marvels” for their edification and mystification, and, yielding to the desire, is soon in full career as a “poltergeist,” the hysterical obsession becoming234 intensified in proportion as the gullibility of those deceived increases, and also in proportion to the amount of attention paid to the little deceiver.

for—and this is a point to be borne well in mind—it is not alone abnormal suggestibility that characterises the hysterical child. there is also present an abnormal craving to attract attention, to be a centre of interest. of this craving, as of the deceits carried out to attain its realisation, the child itself is unconscious. but it may be stated with assurance that it invariably exists as a concomitant of hysteria. ordinarily it is the family and intimate friends whose interest and sympathy the child wishes to arouse, though this is not always the case. there may be special reasons for desiring to impress mere acquaintances, or even absolute strangers. then we have the odd spectacle of children, like the pupil in the german school, whose hysterical obsessions appear chiefly or only in the presence of outsiders, while the parents remain in partial or total ignorance of them.

and, speaking of this type of hysteria, i may say235 that i am acquainted with a young new york woman who, since the age of fifteen, has led many an unsuspecting physician a merry dance by reason of her extraordinary hysterical simulations. in early girlhood she began to complain of various ailments, which on examination proved to be of no moment. not unnaturally her family lost patience with her “whims,” as they called them, and regarded her as a wholly imaginary invalid. like most people similarly situated, they utterly failed to appreciate that, as has been well said by doctor pierre janet, one of the world’s foremost authorities on hysteria, “when a person is so ill that he says he is ill when he is not ill at all, then he must be very ill indeed.” they scolded the girl, they argued with her; but they made no attempt to give her the treatment she really needed.

what was the consequence? one day she mysteriously disappeared from home, and some time passed before she was located in a hospital, where preparations were making to perform an operation236 upon her for appendicitis. a little later she wandered off again, and turned up at another hospital with symptoms so closely resembling a tumorous growth that a diagnosis to that effect was made, and an immediate operation advised. still later an eminent specialist was misled into crediting her with a serious spinal disease.

after this it was decided that she was insane, and the family had her committed to an asylum. before her release she developed symptoms of ear trouble so pronounced that the dangerous mastoid operation would have been performed had not the superintendent of the asylum been informed of her previous adventures as a hospital visitant.

manifestly, a disease that both impels and enables its victims to mimic the symptoms of grave organic affections, with such verisimilitude as to deceive even physicians, is an extremely serious affair. and one has only to inquire of doctors with an extensive hospital experience to learn that hysteria, in one form or another, is a widespread trouble among both chil237dren and adults. but it is no longer the bugbear of the medical profession that it used to be. following the discovery of its essentially mental character, methods have been devised and perfected for handling it. some of these seem absurdly simple, but even the simplest have been proved efficacious, especially in the case of children. differing in detail, they have one feature in common. they directly attack the hysterical symptoms by the employment of the same agency that was provocative of them—namely, suggestion.

in the case of the boy with the pseudo paralysis, reported above, it was not any therapeutic virtue inherent in the electrical treatment that brought about his rapid restoration to health. it was simply the suggestive efficacy of the way in which the treatment was administered to him. the truth of this, however, may be made clearer by the citation of one or two other cases, that are also of interest as illustrating the ingenious devices by which hysterical attacks in the period of childhood are nowadays overcome.

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there was brought to a new england neurologist a little girl of ten, suffering from a curious physical abnormality. as long as she was seated, there seemed to be little the matter with her; but the moment she attempted to stand her feet bent under her so that they would not support her weight. when left alone she swayed backward and forward, and then fell on her hands and knees. in addition to this, there was a complete paralysis of the left arm, the child thus being deprived of the use of three of her four limbs.

questioned by the physician, her mother explained that these muscular troubles had first set in six months before, following an attack of measles, and that her condition had grown progressively worse. this pointed to an organic and incurable malady; and, indeed, the mother was firmly convinced that nothing could be done. but, on making some delicate diagnostic tests, no signs of true organic trouble were to be found; whereas there were some indications that the disability might be wholly functional,239 the result of hysteria. in verification of his suspicion the physician made a few experiments which proved that the child was extremely suggestible. turning to her mother, he said:

“you are quite wrong in supposing that your daughter cannot be cured. she is ill, it is true; but her illness is of such a nature that it will quickly respond to the right kind of treatment.”

“but,” protested the mother, incredulous, “she cannot use her legs, she cannot move her arm.”

“no matter. i have something here that will enable her to use her legs and move her arm.”

he took up a large magnet and showed it to the little girl. she watched him with the keenest interest, while he used it to lift several pieces of iron.

“now look,” said he.

holding it over his left hand, he slowly raised that hand until it touched the magnet, pretending that it had been drawn up exactly as the pieces of iron had been.

“you see the power of this instrument,” he said,240 to the wondering child. “it can move your arm, and give strength to your legs and feet, in the very same way.”

for three weeks the magnet was applied to the different muscles, with the suggestion that the limbs would thereby regain their power. nine treatments in all were given. after the ninth treatment the girl walked into the doctor’s office unaided.

“yesterday,” her mother explained, “she told me that she thought her arm felt better, and she found that she could raise it. then she said she believed she could walk; and, getting out of bed, she crossed the room without the least assistance, and without her feet clubbing under her. can it be, doctor, that she is cured?”

in fact, she was cured; although, of course, the magnet itself had had no power to cure her, but was used merely as an agent for an efficient “counter-suggestion” to dislodge and uproot the symptom-producing suggestions in the girl’s own mind.

excellent results have also been obtained in many241 cases of hysterical paralysis among children by the use of what is known as the “method of surprise,” the invention of a german specialist named bruns. as employed by doctor bruns and his followers, this method has undoubtedly a certain aspect of brutality; but this is more than compensated by its effectiveness. having determined, by a searching medical examination, that the paralysis in any given case is functional and not organic, what bruns does is to place the paralysed child in a bath-tub, turn on the cold water faucet, and watch the youngster climb out and scamper off.

“you see,” he then says to him, at this psychological moment, “you can walk very well, after all. now let us hear no more from you about being unable to walk.”

if for any reason he deems the bath-tub device inadvisable, his plan is to put the child to bed, keep it entirely isolated, and deprive it of all food for a day or so. an appetising meal is then brought into the room, and left some distance from the child’s bed.242 frequently this is all that is needed to effect a cure. the suggestion of food overcoming the suggestion of paralysis, the child gets out of bed and starts across the room, being encountered midway by bruns, who—of course by accident—enters the room at that precise instant, and makes use of verbal suggestion to reinforce and maintain the “miraculous” recovery.

in contrast with this method of surprise is the “method of disregard,” also originated by bruns and used by him in cases of hysteria other than those involving muscular paralysis—cases, for example, of obsessions, facial “tics,” spasms, or convulsive seizures. in employing the method of disregard the little patient is carefully watched by doctor and nurses but in such a manner that he is led to believe they are paying scarcely any attention to him. as a result the idea that, despite his own conviction, his malady must be most insignificant, gradually takes increasing possession of him, and in proportion as it does so the hysterical symptoms disappear.

but, the reader may ask, does this truly mean that243 the hysteria itself has been cured? do not these methods, one and all, achieve merely the removal of symptoms? is not the child still suggestible enough to develop a new variety of hysterical disturbances should occasion arise?

such objections are not without force, though in practice it has been observed that the cure of the symptoms by suggestion does actually seem to weaken the tendency to future hysterical outbreaks of any kind. to be on the safe side, however, it is always well to institute environmental changes of a sort that will make for a constantly closer approach by the child to a normal life.

with this, we come to the point that is of supreme interest to parents.

almost without exception it is in the home that the seeds are sown which may afterward bear the bitter fruit of hysteria, whether bearing it in childhood or not until some critical period comes in later years. it is the child who is “spoiled,” or kept by unwise parents in a state of nervous tension and excitement;244 the child whose sense of moral responsibility is not properly developed, and whose natural suggestibility is unduly heightened by the superstitions, fears, and eccentricities of its elders; it is such a child who, soon or late, may be counted on to manifest some hysterical taint, perhaps not of the extreme type illustrated by the cases narrated above, but nevertheless of a sort making against happiness, usefulness, and success in the world of active effort. or, to state the situation in more detail in the words of a physician of my acquaintance:

“hysterical children, it has been my observation, usually have neurotic parents. at first i was disposed to see in this another evidence of the dread workings of heredity. but i am now inclined to the belief that it illustrates rather the influence of environment. all children, as you know, are highly imitative. they tend to copy, with exaggerations, whatever models are placed before them, and instinctively they take their parents as their chief models. if, then, the parents are flighty, excitable, passing245 rapidly from extreme to extreme of mood, it is only natural that the children should be likewise. their minds undisciplined, their will-power undeveloped, they easily fall a prey to the baneful, hysteria-producing suggestions of their unhealthy surroundings.

“to make matters worse, there is often, even among well-educated persons, an amazing disregard of the hygienic and dietetic requirements for neural stability. children are allowed to sit up to unreasonable hours; they are permitted altogether too frequent attendance at parties, theatres, moving-picture shows, and similar places of entertainment, where they receive impressions too vivid and varied for them to absorb easily. then, too, there is a tendency to give them at their meals an undue allowance of meat, and to permit them to drink tea, coffee, and other stimulants making for nerve disturbance.

“all the while they are living in an atmosphere of parental uneasiness and unrest. their mothers—and perhaps their fathers also—fuss and fume over them. they delight, it may be, in ‘showing them off’ to admiring visitors, thus suggesting to the246 already over-impressionable little ones undue ideas of their own importance. presently signs of trouble appear—restless sleep, ‘night terrors,’ facial ‘tics,’ possibly even full-blown attacks of hysterical convulsions, paralysis, deafness, or what not—and the neurologist has another patient on his hands.”

surely the duty of parents is plain. to set before their children from earliest infancy examples of placidity and strength of character, to educate their will no less than their intellect, to guard them as far as possible from all harmful suggestions, to love them without idolising them, to study carefully their physical as well as their mental and moral needs—in this way, and in this way alone, can safety be had against the dread evil of hysteria and allied nervous troubles. especially is such a course indispensable in view of the now well-demonstrated fact that a faulty upbringing may be primarily responsible for mental and nervous maladies, not of childhood but of adult life, and of a character to challenge the utmost skill of the best trained physicians. of this, more in our next chapter.

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