The Journal of Abnormal Psychology, vol 10 | Page 7

by deferring investigation as to its exact nature until the symptoms had practically disappeared, a way was cleared to obtain their complete confidence, and at the same time to overcome any unwillingness to accept a psychical explanation for such palpable physical ills. This latter point is of importance in dealing with uneducated persons. For the most part, they are intensely practical and materialistic, and a mere idea does not seem to them to account for paralysis although, of course, such skepticism is usually accompanied by superstitious credulity along other lines. Moreover, by establishing himself as a sort of miracle worker (for so the cure was regarded), it would be understood that curiosity was not the basis for the investigation into the domestic life of the patient and her husband, but that a desire to do more good inspired it.
The physician started his investigation with the statement that he knew from past experience that some conflict was going on between husband and wife; that there was some source of irritation which caused these outbursts of symptoms on the part of the patient, and that unless they told him what was behind the matter his help would be limited to the relief of the present symptoms. It was firmly stated that any denial of such discord would not be believed, and that only a complete confidence would be helpful.
The patient, who had been listening to this statement with lowered eyes and nervously intertwining fingers, then burst out as follows: There WAS trouble between them and there always would be until it was settled right,--this with much emphasis and emotional manifestation. So long as he insisted on living where they did, just so long would she quarrel with him. She did not like the neighbors, especially the woman downstairs, she did not like the room, she did not like anything about the place or the neighborhood, hated the very sight of it and would never cease attempting to move from there. It came out on further questioning that the woman downstairs, whom the patient particularly disliked, was a storm center in that the wife was jealous of her, although she adduced no very good reasons for her attitude. Moreover, the patient stated that she wished to move to a district where she had friends, though other sources of information showed that these friends were of a rather unsavory character. Her husband was absolutely determined not to move from his house. He stated that he would rather have her go away and stay away than move from there; that the rent was too high in the place where she wanted to move, and that the rent was suitable where they were. Moreover, for his part, he hated his wife's desired neighborhood and would never consent to changing his residence from the present place to the other. It came out that her fainting and vomiting spells and headaches usually followed bitter quarrels, and on other matters these symptoms usually placed the victory on her side. On this particular point, however, her husband had remained obdurate. It was shown that the present attack of paralysis and aphonia, symptoms of an unusually severe character, followed an unusually bitter quarrel which had lasted for a whole day and into the night of the attack.
The question arises at this point, "Why did this attack take the form of a paralysis?" At first this seemed unaccountable, but later it was found that the old woman for whom the patient had been caring had a "stroke" with loss of the power to speak, though no aphonia. The patient had gone to work as a sort of nurse for the old woman under protest, for she did not wish to do anything outside of her own light housekeeping, although the added income was sorely needed since work was slack in her husband's place of employment. The pain in her side caused her to quit work as nurse, much to her husband's dissatisfaction until she convinced him that her pain and disability were marked. It was evident that despite the controversies and quarrels that prevailed in the household, her husband sincerely loved her, for he stayed away from his work during the three weeks of her illness to act as her nurse. Moreover, he spent his earnings quite freely in consulting various physicians in order to cure her.
It was shown from what both the patient and her husband said, and from the whole history of their marital life, that she had used as a weapon, though not with definite conscious purpose, for the gaining of her point in whatever quarrel came up, symptoms that are usually called hysterical; that is to say, vomiting, fainting spells and pains without definite physical cause. This method usually assured her victory by playing upon her husband's alarm