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Applied Psychology for Nurses
by Mary F. Porter
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Transcriber's Note: Italics have been rendered using underscores and bold using equals signs. A number of printer's errors have been corrected, and are listed at the end.

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Applied Psychology for Nurses By Mary F. Porter, A. B. Graduate Nurse; Teacher of Applied Psychology, Highland Hospital, Asheville, N. C. Philadelphia and London W. B. Saunders Company 1921

Copyright, 1921, by W. B. Saunders Company



PRINTED IN AMERICA PRESS OF W. B. SAUNDERS COMPANY PHILADELPHIA



TO THE MEMORY OF MY FATHER



FOREWORD

This little book is the outgrowth of a conviction, strengthened by some years of experience with hundreds of supposedly normal young people in schools and colleges, confirmed by my years of training in a neurological hospital and months of work in a big city general hospital, that it is of little value to help some people back to physical health if they are to carry with them through a prolonged life the miseries of a sick attitude. As nurses I believe it is our privilege and our duty to work for health of body and health of mind as inseparable. Experience has proved that too often the physically ill patient (hitherto nervously well) returns from hospital care addicted to the illness-accepting attitude for which the nurse must be held responsible.

I conceive of it as possible that every well trained nurse in our country shall consider it an essential to her professional success to leave her patient imbued with the will to health and better equipped to attain it because the sick attitude has been averted, or if already present, has been treated as really and intelligently as the sick body. To this end I have dealt with the simple principles of psychology only as the nurse can immediately apply them.

The writer wishes to acknowledge her indebtedness for criticism of this work and for several definitions better than her own, in the chapters The Normal Mind and Variations From Normal Mental Processes, to Dr. Robert S. Carroll, who through the years of hospital training helped her to translate her collegiate psychology from fascinating abstract principles into the sustaining bread of daily life.

MARY F. PORTER.

ASHEVILLE, N. C., August, 1921.



CONTENTS

PAGE CHAPTER I

WHAT IS PSYCHOLOGY? 11

CHAPTER II

CONSCIOUSNESS 20 The Unconscious 23 Consciousness is Complex 29 Consciousness in Sleep 31 Consciousness in Delirium 32

CHAPTER III

ORGANS OF CONSCIOUSNESS 34 The Central and Peripheral Nervous Systems in Action 35 The Sympathetic Nervous System 37

CHAPTER IV

RELATION OF MIND AND BODY 40 The Cerebrum or Forebrain 43

CHAPTER V

THE NORMAL MIND 47

CHAPTER VI

THE NORMAL MIND (Continued) 59 Instinct 59 Memory 62 The Place of Emotion 67 The Beginning of Reason 69 Development of Reason and Will 71 Judgment 72 Reaction Proportioned to Stimuli 75 Normal Emotional Reactions 77 The Normal Mind 77

CHAPTER VII

PSYCHOLOGY AND HEALTH 79 Necessity of Adaptability 80 The Power of Suggestion 84 One Thought Can Be Replaced by Another 89 Habit is a Conserver of Effort 90 The Saving Power of Will 93

CHAPTER VIII

VARIATIONS FROM NORMAL MENTAL PROCESSES 95 Disorders and Perversions 95

CHAPTER IX

VARIATIONS FROM NORMAL MENTAL PROCESSES (Continued) 101 Factors Causing Variations from Normal Mental Processes 108 Heredity 108 Environment 109 Personal Reactions 110

CHAPTER X

ATTENTION THE ROOT OF DISEASE OR HEALTH ATTITUDE 112 The Attention of Interest 112 The Attention of Reason and Will 118

CHAPTER XI

GETTING THE PATIENT'S POINT OF VIEW 124 What Determines the Point of View 124 Getting the Other Man's Point of View 126 The Deluded Patient 133 Nursing the Deluded Patient 135 The Obsessed Patient 136 The Mind a Prey to False Associations 137

CHAPTER XII

THE PSYCHOLOGY OF THE NURSE 139 Accuracy of Perception 141 Training Perception 142 Association of Ideas 143 Concentration 146 Self-training in Memory 150

CHAPTER XIII

THE PSYCHOLOGY OF THE NURSE (Continued) 152 Emotional Equilibrium 152 Self-correction 160 Training the Will 161

CHAPTER XIV

THE NURSE OF THE FUTURE 164

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INDEX 169



Applied Psychology for Nurses



CHAPTER I

WHAT IS PSYCHOLOGY?

Wise men study the sciences which deal with the origins and development of animal life, with the structure of the cells, with the effect of various diseases upon the tissues and fluids of the body; they study the causes of the reactions of the body cells to disease germs, and search for the origin and means of extermination of these enemies to health. They study the laws of physical well-being. They seek for the chemical principles governing the reactions of digestive fluids to the foods they must transform into heat and energy. So the doctor learns to combat disease with science, and at the same time to apply scientific laws of health that he may fortify the human body against the invasion of harmful germs. Thus, eventually, he makes medicine itself less necessary.

But another science must walk hand in hand today with that of medicine; for doctors and nurses are realizing as never before the power of mind over body, and the hopelessness of trying to cure the one without considering the other. Hence psychology has come into her own as a recognized science of the mind, just as biology, histology, chemistry, pathology, and medicine are recognized sciences governing the body. As these are concerned with the "how" and "why" of life, and of the body reactions, so psychology is concerned with the "how" and "why" of conduct and of thinking. For as truly as every infectious disease is caused by a definite germ, just as truly has every action of man its adequate explanation, and every thought its definite origin. As we would know the laws of the sciences governing man's physical well-being that we might have body health, so we would know the laws of the mind and of its response to its world in order to attain and hold fast to mind health. Experience with patients soon proves to us nurses that the weal and woe of the one vitally affects the other.

"Psychology is the science of mental life, both of its phenomena and their conditions."

So William James took up the burden of proof some thirty years ago, and assured a doubting world of men and women that there were laws in the realm of mind as certain and dependable as those applying to the world of matter—men and women who were not at all sure they had any right to get near enough the center of things to see the wheels go round. But today thousands of people are trying to find out something of the way the mind is conceived, and to understand its workings. And many of us have in our impatient, hasty investigation, self-analytically taken our mental machines all to pieces and are trying effortfully to put them together again. Some of us have made a pretty bad mess of it, for we tore out the screws and pulled apart the adjustments so hastily and carelessly that we cannot now find how they fit. And millions of other machines are working wrong because the engineers do not know how to keep them in order, put them in repair, or even what levers operate them. So books must be written—books of directions.

If you can glibly recite the definition above, know and explain the meaning of "mental life," describe "its phenomena and their conditions," illustrating from real life; if you can do this, and prove that psychology is a science, i. e., an organized system of knowledge on the workings of the mind—not mere speculation or plausible theory—then you are a psychologist, and can make your own definitions. Indeed, the test of the value of a course such as this should be your ability, at its end, to tell clearly, in a few words of your own, what psychology is.

The word science comes from a Latin root, scir, the infinitive form, scire, meaning to know. So a science is simply the accumulated, tested knowledge, the proved group of facts about a subject, all that is known of that subject to date. Hence, if psychology is a science, it is no longer a thing of guesses or theories, but is a grouping of confirmed facts about the mind, facts proved in the psychology laboratory even as chemical facts are demonstrated in the chemical laboratory. Wherein psychology departs from facts which can be proved by actual experience or by accurate tests, it becomes metaphysics, and is beyond the realm of science; for metaphysics deals with the realities of the supermind, or the soul, and its relations to life, and death, and God. Physics, chemistry, biology have all in their day been merely speculative. They were bodies of theory which might prove true or might not. When they worked, by actually being tried out, they became bodies of accepted facts, and are today called sciences. In the same way the laws of the working of the mind have been tested, and a body of assured facts about it has taken its place with other sciences.

It must be admitted that no psychologist is willing to stop with the known and proved, but, when he has presented that, dips into the fascinations of the yet unknown, and works with promising theory, which tomorrow may prove to be science also. But we will first find what they have verified, and make that the safe foundation for our own understanding of ourselves and others.

What do we mean by "mental life"?—or, we might say, the science of the life of the mind. And what is mind?

But let us start our quest by asking first what reasons we have for being sure mind exists. We find the proof of it in consciousness, although we shall learn later that the activities of the mind may at times be unconscious. So where consciousness is, we know there is mind; but where consciousness is not, we must find whether it has been, and is only temporarily withdrawn, before we say "Mind is not here." And consciousness we might call awareness, or our personal recognition of being—awareness of me, and thee, and it. So we recognize mind by its evidences of awareness, i. e., by the body's reaction to stimuli; and we find mind at the very dawn of animal life.

Consciousness is evidenced in the protozooen, the simplest form in which animal life is known to exist, by what we call its response to stimuli. The protozooen has a limited power of self-movement, and will accept or reject certain environments. But while we see that mind expresses itself in consciousness as vague, as dubious as that of the protozooen, we find it also as clear, as definite, as far reaching as that of the statesman, the chemist, the philosopher. Hence, the "phenomena of mental life" embrace the entire realms of feeling, knowing, willing—not of man alone, but of all creatures.

In our study, however, we shall limit ourselves to the psychology of the human mind, since that concerns us vitally as nurses. Animal psychology, race psychology, comparative psychology are not within the realm of our practical needs in hospital life. We would know the workings of man's mind in disease and health. What are the instinctive responses to fear, as shown by babies and children and primitive races? What are the normal expressions of joy, of anger, or desire? What external conditions call forth these evidences? What are the acquired responses to the things which originally caused fear, or joy, or anger? How do grown-ups differ in their reactions to the same stimuli? Why do they differ? Why does one man walk firmly, with stern, set face, to meet danger? Why does another quake and run? Why does a third man approach it with a swagger, face it with a confident, reckless smile of defiance?

All these are legitimate questions for the psychologist. He will approach the study of man's mind by finding how his body acts—that is, by watching the phenomena of mental life—under various conditions; then he will seek for the "why" of the action. For we can only conclude what is in the mind of another by interpreting his expression of his thinking and feeling. We cannot see within his mind. But experience with ourselves and others has taught us that certain attitudes of body, certain shades of countenance, certain gestures, tones of voice, spontaneous or willed actions, represent anger or joy, impatience or irritability, stern control or poise of mind. We realize that the average man has learned to conceal his mental reactions from the casual observer at will. But if we see him at an unguarded moment, we can very often get a fair idea of his mental attitude. Through these outward expressions we are able to judge to some extent of the phenomena of his mental life. But let us list them from our own minds as they occur to us this work-a-day moment, then, later on, find what elements go to make up the present consciousness.

As I turn my thoughts inward at this instant I am aware of these mental impressions passing in review:

You nurses for whom I am writing.

The hospitals you represent.

What you already know or do not know along these lines.

A child calling on the street some distance away.

A brilliant sunshine bringing out the sheen of the green grass.

The unmelodious call of a flicker in the pine-tree, and a towhee singing in the distance.

A whistling wind bending the pines.

A desire to throw work aside and go for a long tramp.

A patient moving about overhead (she is supposed to be out for her walk, and I'm wondering why she is not).

The face and voice of an old friend whom I was just now called from my work to see.

The plan and details of my writing.

The face and gestures of my old psychology professor and the assembled class engaged in a tangling metaphysic discussion.

A cramped position.

Some loose hair about my face distracting me.

An engagement at 7.30.

A sharp resolve to stop wool-gathering and finish this chapter.

And yet, until I stopped to examine my consciousness, I was keenly aware only of the thoughts on psychology I was trying to put on paper.

But how shall we classify these various contents?

Some are emotion, i. e., feelings; others are intellect, i. e., thoughts; still others represent determination, i. e., volition or will.

There is nothing in this varied consciousness that will not be included in one or another of these headings. Let us group the contents for ourselves.

The nurses for whom I am writing:

A result of memory and of imagination (both intellect). A sense of kinship and interest in them (emotion). A determination that they must have my best (will, volition).

And so of the hospitals:

My memory of hospitals I have known, and my mental picture of yours made up from piecing together the memories of various ones, the recollection of the feelings I had in them, etc. (intellect).

What you already know.

Speculation (intellect), the speculation based on my knowledge of other schools (memory which is intellect). A desire (emotion) that all nurses should know psychology.

Child calling on street.

Recognition of sound (intellect) and pleasant perception of his voice (emotion).

Desire to throw work aside and go for a tramp on this gorgeous day.

Emotion, restrained by stronger emotion of interest in work at hand, and intellect, which tells me that this is a work hour—and will, which orders me to pay attention to duties at hand.

So all the phenomena of mental life are included in feelings, thoughts, and volitions which accompany every minute of my waking life, and probably invade secretly every second of my sleeping life.

The conditions of mental life—what are they?

1. In man and the higher animals the central nervous system, which, anatomy teaches us, consists of the brain and spinal cord. (In the lowest forms of animal life, a diffused nervous system located throughout the protoplasm.)

2. An external world.

3. A peripheral nervous system connecting the central nervous system with the outside world.

4. The sympathetic nervous system, provided to assure automatic workings of the vital functions of the body. These organs of the mind will be discussed in a later chapter.



CHAPTER II

CONSCIOUSNESS

We took a glimpse at random into the mental life of an adult consciousness, and found it very complicated, constantly changing. We found it packed with shifting material, which, on the surface, seemed to bear very little relation. We found reason, feeling, and will all interacting. We found nothing to indicate that a consciousness as simple as mere awareness might exist. We believe there might be such in the newborn babe, perhaps even in the baby a month old; but can we prove it? Let us look within again and see if there are not times of mere, bare consciousness in our own experience that give us the proof we need.

I have slept deeply all night. It is my usual waking time. Something from within or from without forces an impression upon my mind, and I stir, and slowly open my eyes. As yet I have really not seen anything. With my eyes open my mind still sleeps—but in a few seconds comes a possessing sense of well-being. Obeying some stimulus, not recognized by the senses as yet, I begin to stretch and yawn, then close my eyes and settle down into my pillows as for another nap. I am not aware that I am I, that I am awake, that I have yawned and stretched. I have a pleasant, half-dreamy feeling, but could not give it a name. For those few seconds this is all my world—a pleasant drowsiness, a being possessed by comfort. My consciousness is mere awareness—a pleasant awareness of uncomplicated existence. In another moment or two it is a consciousness of a day's work or pleasure ahead, the necessity of rising, dressing, planning the day, the alert reaction of pleasure or displeasure to what it is to bring, the effort to recall the dreams of sleep—the complicated consciousness of the mature man or woman. But I started the day with a mental condition close to pure sensation, a vague feeling of something different than what was just before.

Or this bare consciousness may come in the moment of acute shock, when the sense of suffering, quite disconnected from its cause, pervades my entire being; or at the second when I am first "coming back" after a faint, or at the first stepping out from an anesthetic. In these experiences most of us can recall a very simple mental content, and can prove to our own satisfaction that there is such a thing as mere awareness, a consciousness probably close akin to that of the lower levels of animal life, or to that of the newborn babe when he first opens his eyes to life.

Consciousness, then, in its elements, is the simplest mental reaction to what the senses bring.

How shall we determine when consciousness exists? What are its tests?

The response of the mind to stimuli, made evident by the body's reaction, gives the proof of consciousness in man or lower animal.

But what do we mean by a stimulus?

Light stimulates me to close my eyes when first entering its glare from a dark room, or to open them when it plays upon my eyelids as I sleep and the morning sun reaches me. It is a stimulus from without.

The fear-thought, which makes my body tremble, my pupils grow wide, and whitens my cheeks, is a stimulus from within.

An unexpected shot in the woods near-by, which changes the whole trend of my thinking and startles me into investigating its cause, is a stimulus from without causing a change within.

A stimulus, then, is anything within or without the body that arouses awareness; and this is usually evidenced by some physical change, however slight—perhaps only by dilated pupils or an expression of relief. When we see the reaction of the body to the stimulus we know there is consciousness. On the other hand, we cannot say that consciousness is always absent when the usual response does not occur; for there may be injury to organs accounting for the lack of visible reaction, while the mind itself may respond. But with due care, in even such cases, some external symptoms of response can usually be found if consciousness exists.

We have already realized how complex, intricate, and changing is fully developed consciousness.

THE UNCONSCIOUS

But the mind of man knows two distinct conditions of activity—the conscious and the unconscious. Mind is not always wide awake. We recognize what we call the conscious mind as the ruling force in our lives. But how many things I do without conscious attention; how often I find myself deep in an unexplainable mood; how the fragrance of a flower will sometimes turn the tide of a day for me and make me square my shoulders and go at my task with renewed vigor; or a casual glimpse of a face in the street turn my attention away from my errand and settle my mind into a brown study. Usually I am alert enough to control these errant reactions, but I am keenly aware of their demands upon my mind, and frequently it is only with conscious effort that I am kept upon my way unswerved by them, though not unmoved.

When we realize that nothing that has ever happened in our experience is forgotten; that nothing once in consciousness altogether drops out, but is stored away waiting to be used some day—waiting for a voice from the conscious world to recall it from oblivion—then we grasp the fact that the quality of present thought or reaction is largely determined by the sum of all past thinking and acting. Just as my body is the result of the heritage of many ancestors plus the food I give it and the use to which I subject it, so my mind's capacity is determined by my inheritance plus the mental food I give it, plus everything to which I have subjected it since the day I was born. For it forgets absolutely nothing.

"That is not true," you say, "for I have tried desperately to remember certain incidents, certain lessons learned—and they are gone. Moreover, I cannot remember what happened back there in my babyhood."

Ah, but you are mistaken, my friend. For you react to your task today differently because of the thing which you learned and have "forgotten." Your mind works differently because of what you disregarded then. "You" have forgotten it, but your brain-cells, your nerve-cells have not; and you are not quite the same person you would be without that forgotten experience, or that pressing stimulus, which you never consciously recognized, but allowed your subconsciousness to accept. Some night you have a strange, incomprehensible dream. You cannot find its source, but it is merely the re-enacting of some past sensation or experience of your own, fantastically arrayed. Some day you stop short in your hurried walk with a feeling of compulsion which you cannot resist. You know no reason for it, but some association with this particular spot, or some vague resemblance, haunts you. You cannot "place" it. One day you hit the tennis-ball at a little different angle than you planned because a queer thought came unbidden and directed your attention aside. Again, under terrific stress, with sick body and aching nerves, you go on and do your stint almost mechanically. You do not know where the strength or the skill is derived. But your unconscious or subconscious—as you will—has asserted itself, has usurped the place of the sick conscious, and enabled you automatically to go on. For we react to the storehouse of the unconscious even as we do to the conscious.

Remember that the unconscious is simply the latent conscious—what once was conscious and may be again, but is now buried out of sight.

The mind may be likened to a great sea upon which there are visible a few islands. The islands represent the conscious thoughts—that consciousness we use to calculate, to map out our plans, to form our judgments. This is the mind that for centuries was accepted as all the mind. But we know that the islands are merely the tops of huge mountain-ranges formed by the floor of the sea in mighty, permanent upheaval; that as this sea-floor rises high above its customary level and thrusts its bulk above the waters into the atmosphere, is the island possible.

Just so there can be no consciousness except as that which is already in the mind—the vast subconscious material of all experience—rises into view and relates itself through the senses to an outside world. We speak very glibly of motion, of force, of power. We say "The car is moving now." But how do we know? Away back there in our babyhood there were some things that always remained in the same place, while others changed position. The changing gave our baby minds a queer sensation; it made a definite impression; and sometimes we heard people say "move," when that impression came. Finally, we call the feeling of that change "move," or "movement," or "motion." The word thereafter always brings to our minds a picture of a change from one place to another. The process—the slow comprehending of the baby mind—was buried in forgetfulness even at the time. But had not the subconscious been imprinted with the incident and all its succeeding associations, that particular phenomenon we could not name today. It would be an entirely unique experience. So our recognition of the impression is merely the rising into consciousness of the subconscious material in response to a stimulus from the outside world which appeals through the sense of sight. We can get no response whatever except as the stimulus asking our attention is related by "like" or "not like" something already experienced; that is, it must bear some relation to the known—and perhaps forgotten—just as the island cannot be, except as, from far down below, the sea-floor leaves its bed and raises itself through the deeps. The visible island is but a symbol of the submarine mountain. The present mental impression is but proof of a great bulk of past experiences.

And so we might carry on the figure and compare the birth of consciousness to the instant of appearance of the mountain top above the water's surface. It is not a new bit of land. It is only emerging into a new world.

"But," you ask, "do you mean to assert that the baby's mind is a finished product at birth; that coming into life is simply the last stage of its growth? How unconvincing your theory is."

No, we only now have the soil for consciousness. The island and the submarine mountain are different things. The sea-floor is transformed when it enters into the new element. An entirely different vegetation takes place on this visible island than took place on the floor of the sea before it emerged. But the only new elements added to the hitherto submerged land come from the new atmosphere, and the sea-floor immediately begins to become a very different thing. Nevertheless, what it is as an island is now, and forever will be due, primarily, to its structure as a submarine mountain. In the new atmosphere the soil is changed, new chemical elements enter in, seeds are brought to it by the four winds—and it is changed. But it is still the sea-floor transformed.

Just so the baby brain, complete in parts and mechanism at birth, is a different brain with every day of growth in its new environment, with every contact with the external world. But it is, primarily and in its elements, the brain evolved through thousands of centuries of pushing up to man's level through the sea of animal life, and hundreds of centuries more of the development of man's brain to its present complete mechanism through experience with constantly changing environment.

Hence, when the baby sees light and responds by tightly shutting his eyes, then later by opening them to investigate, his sensation is what it is because through the aeons of the past man has established a certain relation to light through experiencing it. To go further than this, and to find the very beginning, how the first created life came to respond to environment at all, is to go beyond the realm of the actually known. But that he did once first experience his environment, and establish a reaction that is now racial, we know.

So our baby soon shows certain "instinctive" reactions. He reaches out to grasp. He sucks, he cries, he looks at light and bright objects in preference to dark, he is carrying out the history of his race, but is making it personal. He has evolved a new life, but all his ancestors make its foundation. The personal element, added to his heritage, has made him different from any and all of his forebears. But he can have no consciousness except as a bit from the vast inherited accumulation of the past of his ancestors, of all the race, steps forth to meet a new environment.

And again you ask, "How came the first consciousness?"

And again I answer, "It is as far back as the first created or evolved organism which could respond in any way to a material world; and only metaphysics and the God behind metaphysics can say."

We only know that careful laboratory work in psychology—experiments on the unconscious—today prove that our conscious life is what it is, because of: first, what is stored away in the unconscious (i. e., what all our past life and the past life of the race has put there); second, because of what we have accepted from our environment; and this comprises our material, intellectual, social, and spiritual environment.

CONSCIOUSNESS IS COMPLEX

The one fact we want at this stage of our inquiry is simply this: that consciousness, awaking at birth, very soon becomes complex. However single and simple in content immediate consciousness may be, it is so intimately linked with all preceding experience that a pure sensation is probably never known after the first second of life. As the sensation is registered it becomes a basis for comparison. That first sensation, perhaps, was just a feeling of something. The next is a feeling of something that is the same, or is not the same, as the first. So immediately perception is established. The baby consciousness recognizes that the vague feeling is, or is not, that same thing. And from perception to a complex consciousness of perceptions, of ideas, of memories and relations, and judgments, is so short a step that we cannot use our measuring rods to span it.

Thus through the various stages of life, from infancy to maturity, the conscious is passing into the unconscious, only to help form later a new conscious thought. Hence the conscious thought is determined by the great mass of the unconscious, plus the external world.

But every thought, relegated to the unconscious, through its association there—for it is plastic by nature—comes back to consciousness never quite the same, and meets never quite the same stimulus. And as a result a repeated mental experience is never twice exactly the same. So the conscious becomes the unconscious and the unconscious the conscious, and neither can be without the other.

Our problem is to understand the workings of the mind as it exists today, and to try to find some of its most constructive uses; and on that we shall focus attention. To that end we must first examine the various ways in which consciousness expresses itself.

We have recognized two distinct mental states—the conscious and the unconscious—and have found them constantly pressing each on the other's domain. Our study of consciousness reveals the normal in the aspects of sleeping and waking, also various abnormal states. Consciousness may become excited, depressed, confused, delirious, or insane. We shall consider later some of the mental workings that account for these abnormal expressions. At present let us examine the mind's activities in sleep and in delirium.

CONSCIOUSNESS IN SLEEP

Sleep seldom, if ever, is a condition of utter unconsciousness. We so frequently have at least a vague recollection, when we wake, of dreaming—whether or not we remember the dream material—that we are inclined to accept sleep as always a state of some kind of mental activity, though waking so often wipes the slate clean. A new word which serves our purpose well has come into common use these last years, and we describe sleep as a state of rest of the conscious mind made possible as weariness overpowers the censor, and this guard at the gate naps. The censor is merely that mental activity which forces the mind to keen, alert, constructive attention during our waking hours, a guard who censors whatever enters the conscious mind and compares it with reality, forcing back all that is not of immediate use, or that is undesirable, or that contradicts established modes of life or thought. In sleep we might say that the censor, wearied by long vigilance, presses all the material—constantly surging from the unconscious into consciousness, there to meet and establish relations with matter—back into the unconscious realms, and locks the door, and lies and slumbers. Then the half-thoughts, the disregarded material, the unfit, the unexpressed longings or fears, the forbidden thoughts; in fact, the whole accumulation of the disregarded or forgotten, good, bad, and indifferent—for the unconscious has no moral sense—seize their opportunity. The guard has refused to let them pass. He is now asleep. And the more insistent of them pick the lock and slip by, masquerading in false characters, and flit about the realms of the sleeping consciousness as ghosts in the shelter of darkness. If the guard half-wakes he sleepily sees only legitimate forms; for the dreams are well disguised. His waking makes them scurry back, sometimes leaving no trace of their lawless wanderings. So the unconscious thoughts of the day have become sleep-consciousness by play acting.

CONSCIOUSNESS IN DELIRIUM

At this time of our study it will suffice to say that in delirium and in insanity, which we might very broadly call a prolonged delirium, the toxic brain becomes a house in disorder. The censor is sick, and sequence and coherence are lost as the thronging thoughts of the unconscious mind press beyond the portals into consciousness, disordered and confused. We shall later find, however, that this very disorder falls into a sort of order of its own, and a dominant emotion of pain or ecstasy, of depression or fear, of exaltation or depreciation calls steadily upon the stored away incidents and remembered, related feelings of the past and interprets them as present reality. The censor of the sick brain is stupefied by toxins, shock, or exhaustion, and the citadel he is supposed to guard is thronged with besiegers from every side. The strongest—i. e., those equipped with most associations pertinent to the emotional status at the time—win out, occupy the brain by force, and demand recognition and expression from all the senses, deluding them by their guise of the reality of external matter.

We find consciousness, then, determined by all past experience, by an external world, and by its organ of expression—the brain.

Consequently, our psychology leads us into anatomy and physiology, which, probably, we have already fairly mastered. In rapid review, only, in the following chapter we shall consider the organs of man's consciousness, the brain, spinal cord, and the senses, and try to establish some relation between the material body and its mighty propelling force—the mind.



CHAPTER III

ORGANS OF CONSCIOUSNESS

Nothing is known to us until it has been transmitted to the mind by the senses. The nerves of special sense, of sight, hearing, smell, taste, touch, the temperature sense ("hot or cold" sense), the muscular sense (sense of weight and position), these, and the nerves controlling voluntary motion, form the peripheral, or surface, nervous system. This acts as a connecting medium between the outside world and the central nervous system, which is composed of the brain and spinal cord. We might liken the nerves, singly, to wires, and all of them together to a system of wires. The things of the external world tap at the switchboard by using the organs of special sense; the nerves, acting as wires, transmit their messages; at the switchboard is the operator—consciousness—accepting and interpreting the jangle of calls.

The recognition by the brain of the appeals coming by way of the transmitting sense, and its interpretation of these appeals, is the mind's function of consciousness, whether expressed by thinking, feeling, or willing.

THE CENTRAL AND PERIPHERAL NERVOUS SYSTEMS IN ACTION

I am passing the open door of a bake-shop, and a pervading odor fills the air. I think "hot rolls," because my organ of smell—the nose—has received a stimulus which it transmits along my olfactory nerves to the brain; and there the odor is given a name—"hot rolls." The recognition of the stimulus as an odor and of that odor as "hot rolls" is consciousness in the form of thinking. But the odor arouses desire to eat—hunger; and this is consciousness in the form of feeling. The something which makes me walk into the shop and buy the rolls is consciousness in the form of willing. The sensory appeal from the outside world gained admission through the sense of smell; this transmitted the message, and consciousness recognized the stimulus, which immediately appealed to my hunger and incited action to satisfy that hunger.

The ear of the operator in the telegraph office, again, might illustrate consciousness. It must be able to interpret mere clickings into terms of sense. To the operator the sounds say words, and the words are the expression of the object at the other end of the wire. The brain is the receiving operator for all the senses, which bring their messages in code, and which it interprets first as sound, vision, taste, touch, feel, smell, temperature; then more accurately as words, trees, sweet, soft, round, acrid, hot.

The mind can know nothing except as the stimulus is transmitted by sense-channels over the nerves of sense, and received by a conscious brain. A baby born without sight, hearing, taste, smell, or touch would remain a mere bit of clay. He could have no awareness. But so long as any one sense channel remains open the mind may acquire some knowledge.

Suppose I am paralyzed, blind, and deaf, and you put a tennis-ball into my hand. I cannot tell you what it is, not even what it is like. It means nothing whatever to me, for the sense channels of touch, sight, and hearing, through which alone it could be impressed upon my brain, are gone. Suppose I am blind and deaf, but have my sense of touch intact; that I never saw or touched or heard of a tennis-ball before, but I know "apple" and "orange." I can judge that the object is round, that it is about the size of a small orange or apple. It is very light, and has a feel of cloth. I know it to be something new in my experience. You tell me in the language of touch that it is "tennis-ball"; and thereafter I recognize it by its combination of size, feel, and weight, and can soon name it as quickly as you, who see it.

Suppose I am blind and my hands are paralyzed, but I have my hearing. You tell me this is a tennis-ball, and if I have known "tennis-ball" in the past, I can describe it to you. It has been impressed upon my brain through my sense of hearing; and memory immediately supplies the qualities that go with "tennis-ball."

But if none of the senses has ever developed, my brain can receive no impression whatever; it cannot have even the stimulus of memory. Hence conscious mind cannot be, except as some sense-channel or channels have been opened to carry thought material to the brain. So far as we know today, in this world, mind is absolutely dependent upon the sense organs and the brain—upon matter—for existence.

THE SYMPATHETIC NERVOUS SYSTEM

Associated with the central nervous system by connecting nerves—but located outside of it in various parts of the body—are groups of nerve-cells (gray matter) and their fibers, forming what we call the sympathetic nervous system—the direct connecting link between mind and body.

The central nervous system is the director of all conscious action of the body; the sympathetic orders all unconscious action.

The beating of the heart, the contraction of the blood-vessels, hence the flowing of the blood, the processes of digestion, the functioning of the glands, are all directed by the sympathetic. In other words, the central nervous system normally controls the movements of the voluntary muscles; the sympathetic controls those of the involuntary muscles.

The quick blush, the sudden paling of the cheeks, the start of fear, the dilated pupils of fright are the direct result of the action of involuntary muscles under control of the sympathetic system. The stimulus is received by the central nervous system; the fibers connecting the central and the sympathetic systems carry the message quickly to the latter, which immediately respond by ordering contraction or expansion of involuntary muscles. So tears flow, we breathe freely again or we quake and tremble, our pupils widen or contract, the heart beats suffocatingly, or seems almost to stop.

The sympathetic system, as the name implies, is influenced by suggestions from the emotions rather than from the intellect. We might say that it is controlled by the "feeling mind" rather than the thinking mind, for intellect cannot influence it in the least.

The wise nurse, who knows something of the laws of the mind, soon realizes that the sympathetic nervous system, rather than physical disability, causes many indigestions, headaches, diarrheas, dry mouths, chills; is responsible for much nausea, much "exhaustion," etc. When she has had wider experience she finds that almost any known physical disorder can be unconsciously imitated by the suggestible patient, whose sympathetic nervous system causes physical reactions to respond to the feelings of a sick mind. Let the nurse remember, however, that is it not for her to decide whether the disorders from which her patient suffers are of physical or nervous origin. It is for her, on the other hand, to study her patient's mentality and reactions, and to become expert in reporting symptoms of nervous as well as of physical significance.



CHAPTER IV

RELATION OF MIND AND BODY

We have found that mind is entirely dependent upon the bodily organs for its existence. Is the body in the same way dependent upon the mind? Can the mind die and the body go on?

Given a perfect body with unblocked sense channels, and put the mind to sleep, paralyze the central nervous system with alcohol in sufficient quantity so that the undamaged peripheral nervous system—the senses—can obtain no response or recognition from it, and that perfect body is as useless for the time as if dead. But here comes proof of the remarkable hold of the body on life. The unconscious mind takes up the burden of directing the sympathetic nerves to stimulate the muscles of breathing. The unconscious sees to the beating of the heart. It directs the contraction of the blood-carrying vessels. It maintains certain vital processes of secretion. Thus automatically life goes on; the body still reacts to a limited field of stimuli, and consciousness recognizes it not. But when the unconscious mind ceases to function, then, indeed, does the body die. Yet the conscious mind may "die" and the body live on, so long as the unconscious continues its activity.

It is possible for the human body to live for years, utterly paralyzed, with many of the senses gone, with no consciousness of being—if cared for by other persons—a merely vegetable existence. The current of power is broken; but the spark is still glowing, though utterly useless because connected with nothing. And it may continue to glow for some time while properly stimulated from outside sources.

We might liken the mind to the boiler in which steam is generated, and the body to the engine which the steam runs. If the boiler bursts, the engine stops; but it may not be otherwise damaged. It simply cannot carry out its main function of motion any longer. The fires under the boiler are still burning and can be kept burning so long as fuel is provided, but the connection is broken and the great bulk of iron is a useless thing in that it can no longer fulfil its purpose.

In just such a way may the mind be paralyzed; but the spark of life, which has through all the years kindled the now lost mind to action, may still remain—a useless thing, which would die away if not tended from without by other bodies whose minds are still intact.

But in the demented mind consciousness still remains, the awareness of the young child or baby stage of life. The connection between the upper or conscious brain centers and the body has been tampered with; it no longer is direct, but breaks off into switch-lines. But the contact still holds between the lower or unconscious mind and the body; so the automatic body functions go on, directed as they were in babyhood before the independent mind assumed control. Hence, when all acute consciousness is finally gone, the unconscious mind, a perfect automaton, may still carry out the simplest vegetative activities of existence.

When body is dead, mind, so far as its reactions to the world we know are concerned, ceases to act. But when the conscious mind is "dead" the body may yet live as a vegetable lives, with all its distinctively human functions lost. Motionless, save for the beating of the heart and the reaction of the lungs to air, the body may still be alive, though the mind long since has ceased all earthly activity.

So we discover that an organ of mind is an essential, here, to life of mind, and that mind only can induce this organ to any action above the vegetative stage. But, on the other hand, we find that life can exist without conscious mind, even if untended by others, for a limited time.

If the direct nerve connections between the brain and the hand, the brain and the foot, or the brain and the trunk are cut off, the mind henceforth realizes nothing of that part except as the sense of sight reports upon it; for the optic nerves relate the hand and mind, through this sense, as truly as the motor nerves which carry the mind's message for motion to the hand, and the sensory nerves which carry back to the mind the hand's pain. But let the optic nerve be inert, the sensory and motor connections broken between brain and hand, or foot and trunk, or brain and trunk, and the hand or foot may be amputated and the mind never sense the fact; the trunk may be severely injured and the mind be serenely unconscious. So the brain in man is "the one immediate bodily condition of the mental operations." Take away all the brain and man's body is a useless mass of protoplasm.

The brain's varied and intricate nerve connections with all parts of the body, through nerves branching from the main trunks in the spinal cord, we shall not discuss, for you know them through your study of anatomy. For the purpose of our psychology we need consider only two of the main divisions of the brain—the cerebrum, which includes what we call the right and left hemispheres, and the cerebellum.

THE CEREBRUM OR FOREBRAIN

For convenience the various lobes of the cerebrum are known as frontal, temporal, parietal, and occipital, according to the parts of the brain referred to: as forehead, temples, crown, or occiput. The cerebellum, or hind brain, is also divided into two hemispheres, and is situated behind and below the hemispheres of the cerebrum.

A system of localization has been roughly mapped out, the result of careful laboratory work on animals and of studying the loss of various functions in human beings as related to the location of brain injuries.

From these experiments it seems proved that consciousness belongs only to the cortex or surface of the upper brain, and that the vast realm of the unconscious belongs to the lower brain centers. Hence the cortex is the organ of consciousness, and the lower centers are the repository of the unconscious until it again becomes conscious.

The motor zone of the cortex we now know to be situated in the convolutions bordering the fissure of Rolando. Vision is evidently excited from the occipital lobes, though not yet conclusively proved. Smell, presumably, is located in the temporal lobes. Considered action is directed from the upper hemispheres only. It is significant that the hemispheres of the cerebrum are also accepted as the seat of memory for man—that intellectual quality which makes him capable of acting from absent stimuli, stimuli only present to memory; which makes it possible for him to reason the present from the experiences of the past.

But in all animal life, except the higher forms, the control of action is from the lower brain centers, centers which respond only to present objects. With them memory, as man knows it, is lacking; but the reactions of the past are indelibly imprinted upon motor nerves and muscles, so that when the present object presses the button, as it were, calling forth the experience of the race, the animal instinctively reacts.

But of what use to man, then, are the lower brain centers?

In man, as in lower animals, they care for the vegetative functions of life, so that our blood continues to circulate, the air enters and leaves our lungs, digestion is carried on, with no assistance from the upper centers, the hemispheres of the cerebrum being thus left free for concentration on the external world of matter, which it can transform into a world of thought.

It is the lower or vegetative brain that may still exist and keep life intact when the functions of the cerebrum are destroyed. We can say, then, of the brain as a whole that it is the organ of the mind, the sine qua non of the mind, the apparatus for the registration of sense impressions. The senses themselves are the rudiments of mind, are the means by which stimuli alighting on sense organs enter consciousness; for the nerves of special sense immediately carry the impetus to the brain, where it is recognized as the "not me," the something definitely affecting the me, and demanding reaction from the me.

The functions of the cerebrum we find grouping themselves in three classes: intellect, emotion, and volition, more simply, thinking, feeling, and willing; and we find no mental activity of the normal or abnormal mind which will not fall into one of these groupings. This does not mean that one part of the brain thinks, another part wills, another part feels; for in the performance of any one of these functions the mind acts as a whole. Our thinking or our willing may be permeated with feeling, but the entire mind is simply reacting simultaneously upon various stimuli.



CHAPTER V

THE NORMAL MIND

Mind, we found, is born in the form of consciousness when the outside world impresses itself upon the brain-cells by way of the senses. This consciousness, observation and experiment prove, is first a feeling one, later a feeling-thinking-willing one. The mind, then, is really the activity of the brain as it feels, as it thinks, as it wills. We express this in descriptive terms when we speak of mind as the flow of consciousness, the sum of all mental associations, conscious and unconscious. For mind is never a final thing. Looking within at our own mental processes we find that always our thought is just becoming something else. We reach a conclusion, but it is not a resting place, only a starting place for another. My thought was that a moment ago, but while it was that it was becoming this, and even now it is becoming something else.

Thinking is mind. Feeling is mind. Willing is mind. But for the sake of clearness we speak of feeling, thinking, and willing as being functions of mind. Mind acts by using these powers. But to what end does it act? What purpose does it serve? For these functions are not the reasons of being for the mind, even as motion—while the immediate purpose of the locomotive—is not its chief end. The steam engine may stand in the same spot while its wheels revolve madly; it may move along the tracks alone, and accomplish nothing; or it may transport a great train of loaded cars. Unless it moves to some definite point and carries merchandise or people there, it is a useless, indeed, a dangerous invention. We find, in fact, that it functions to the very definite end of taking man and his chattels to specified places.

And so it is with the mind. If it is thinking and feeling and willing only for the sake of exercising these mental powers, it might better not be. But what end do we actually find these functions serving?

Mind, with its powers of thinking, feeling, and willing, gives an external world of matter; an internal world of thought, and so relates them to each other as to make them serve man's purposes. Thus these functions exist for accomplishment.

In the solving of a problem, for instance, the mind thinks, primarily; in the enjoyment of music it feels, primarily, though its feeling may be determined by the intellectual verdict on the music; in forcing its owner to sit at the piano and practice in the face of strong desire to attend the theater, it wills, primarily. Now one of its functions predominates; now another. But the whole mind, not a feeling section, or a thinking section, or a willing section, operates together to produce action. When I play the piano it calls on all my mind. I think the music. I feel it. I make my fingers play it. But the thinking, the feeling, and the willing act together to result in the fingers playing.

The mind, then, is an instrument of achievement. It fulfils its purpose when it makes matter serve useful ends.

Emotion or feeling is the function of the mind which associates a sense of pleasure or pain with every thought or act.

Feeling is the affective state of mind. By this we mean that it has the power to move us. And this emotion primarily does; for our feeling of pleasure or pain moves us to action, as well as precedes and accompanies and follows action. The word emotion is usually employed to denote an acute feeling state, while the word mood denotes a prolonged feeling condition, i. e., a less acute emotional state. The word feeling, however, is used to cover both; for in each case the sensational element manifests itself in a definite physical affect, pleasurable or painful in some degree.

Thinking is a conscious mental activity exercised to evolve ideas from perceptions, and to combine and compare these ideas to form judgments.

Intellection, or thinking, might be explained as the mental process which converts sensation into percepts, groups percepts to form concepts or ideas, stores away ideas and sensations for future use, and recalls them when needed—the recalling being memory—and by reason combines, compares, and associates ideas to form judgments, then compares judgments to form new judgments. The process of intellect we name by terms denoting activity, such as intellection, thinking, the stream of thought, and the latter describes it most truly.

Volition or will is the function of the mind which compels the expression of thought or feeling in action.

For clarity we might indicate the mind and its functions in the following diagram:

/ Emotion { Pleasure { { Pain } { / Eye } { { Ear } { / Sensation / Nose } { { (impression < Mouth } { { on mind from Skin } { { some organs) { Muscles } { { { Viscera } { { General sensation } { { } { { Perception } } { { (recognition of > of object } / { cause of sensation) } of quality Mind Mind the Stream < { Self / { of Thought { Organic } { { Memory < Inorganic } { { { Percept } { { { Concept } { { } { { { Abstract } { { Ideation < Concrete } { { { Imaginative { Fanciful } { { { Constructive } { { Reason } { Judgment } Will /

The following terms are ones constantly used in psychology, and are briefly defined that there may be no haziness in their application.

Sensation is the uninterpreted response of the mind to stimuli brought by sense organs.

{ hot. Examples: Feeling of { cold. { pain.

Sensation may arouse instinct and cause reflex action, or start a feeling state, or a train of thought.

Perception is the conscious recognition of the cause of a given sensation.

{ fluid—water. Example: { cold—snow. { pain—cut.

Percept is a word often used to denote the mind's immediate image of the thing perceived.

Percepts are of two kinds: object and quality.

Example: { object, as water. { quality, as fluid.

Memory is the mind's faculty of retaining, recognizing, and reproducing sensations, percepts, and concepts.

Organic memory is the mind's reproduction of past bodily sensations.

Example: I recall the physical sensations of a chill, and live it over in my mind, so that I can accurately describe how a chill feels to me, though I can but surmise how one feels to you.

Inorganic memory is the mind's reproduction of its own reactions in the past.

Example: Myself having a chill, how I acted; what I thought and my emotions during that chill.

Ideation is the mind's grouping of percepts by the aid of memory, to form concepts.

Example: I perceive color, form, mouth, eyes, nose, chin, etc. These percepts I combine as a result of past experience (memory) to form my concept, face; and the process of combining is ideation.

Concepts are mental representations of things or qualities, i. e., of object or quality percepts.

We might say that the percept is the mind's immediate image of a thing or quality, and the concept is the result of the storing up and grouping and recombining of percepts. Thus a lasting mental picture is secured; and my idea of horse, for instance, is so clear and definite a thing in my mind that if I should never again see a particular horse, I should yet always be able to think accurately of a horse.

Concepts are of two kinds—concrete and abstract.

A concrete concept, or concrete idea (for concept and idea are interchangeably used), is an idea of a particular object or quality.

Examples: This wine-sap apple (object concept). This sweet orange (quality concept).

An abstract concept, or abstract idea, is a mental reproduction of a quality or an object dissociated from any particular setting or particular experience.

Abstract ideas are of two kinds. We speak of them as abstract object concepts and as abstract quality concepts. An abstract object concept we might call a generalized idea, an idea comprehending all objects having certain things in common.

Example: My idea of animal includes many scores of very different individual animals, but they all have bodies and heads and extremities. They all have some kind of digestive apparatus; they breathe, and can move.

An abstract quality concept is easier to think than to explain. It is as though the mind in considering a multitude of different objects found a certain quality common to many of them, and it "abstracted," i. e., drew this particular quality, and only this, from them all, and then imagined it as a something in itself which it calls redness, or whiteness, or goodness. Thereafter, whenever it finds something like it anywhere else again it says, "That is like my redness." So I call it "red." In other words, consciousness thereafter can determine in a newly discovered object something it knows well merely because that something corresponds to a representation which experience and memory have already formed.

These comprehensive concepts, or universals, as some psychologists term them, the mind, having pieced together from experience and memory, holds as independent realities, not primarily belonging to this or that, but lending themselves to this or that. For example: My mind says "white," and sees white in some object. But I see the white only because my mind has a quality concept, whiteness. This outside object corresponds to my concept. I recognize the likeness and call it "white."

I speak of goodness, or purity, of benevolence; or of fulness, emptiness, scantiness. There is no object or quality in the outside world I can say is goodness, or fulness. But I do see things in the external world through my ideas of goodness or fulness that correspond to these ideas. They have some of the qualities the ideas embrace; and so I point them out and say, "This represents purity; that, impurity"; or, "This is full, that is empty." One satisfies my concept of purity, while the other does not. One fulfils my concept of fulness; the other does not. And because we can never point out any one quality in the outside world and say "This is purity, and all of purity; this is goodness; or this good plus this good plus this makes all of goodness"; because of this impossibility we speak of these concepts as having reality somewhere. They are absolutes, universals, abstract quality concepts—the unfound all of which the things we call pure and good are but the part.

Apperception is the process of comparing the new with all that is in the mind, and of classifying it by its likeness to something already there.

With an abstract idea of an object in mind we very deftly, through the use of memory and constructive imagination, deduce the whole from the part recognized as familiar.

Example: In walking through the field, along the bank of the brook, I glimpse under the low-hanging branches of the weeping willow a restlessly moving hoof. I see a certain kind of hoof and only that. Or I hear a lowing sound. And I say "cow." I have not seen a cow, but only a part which tells me a cow is there; for all the cows I ever saw had hoofs of that general description, and so it fits into my concept cow, and into no others. Or I have heard cows, only, give that lowing sound before. From my perception, then, of hoof or sound I apperceive cow. Memory relates that hoof or that lowing sound to a certain kind of animal known in the past; and constructive imagination draws in all the rest of the picture that belongs with it.

Again, we may apperceive an object or quality from our recognition of something which in our experience has been associated, under those particular circumstances, with only that object or quality. I see smoke on the ocean's far horizon, and I decide instantly, "a steamer." I have not perceived any steamer, but only something that "goes with it," as it were. I see the ship with my mind, not with my eyes; for I know that a cloud of smoke out there always has, in my past experience, represented just that. I compare the newly appearing stimulus—smoke in that particular location—with all that is associated with it in my mind, and classify it with the known. I apperceive "steamer."

In apperception, then, we construct from the known actually perceived by the senses, the unknown. How does the child realize that the moving speck on the distant hillside is his father? There is nothing to indicate it except that it is black and moves in this direction. But experience tells Johnny that father comes home that way just about this time. Moreover, it says that father looks so when at that distance. When Johnny is as sure it is his father as if he could see his face close beside him he has apperceived him. The speck on the hill is the newly arriving stimulus. Johnny compares it with what corresponds to it in his mind's experience and proclaims, as a fact, that he sees his father.

Reason is the mind's comparison and grouping of concepts to form judgments, and its association of judgments to form new judgments.

Example: My concept man includes the eventual certainty of his death. My concept mortal means "subject to death." Therefore my judgment is, "Man is mortal." Reason has compared the concepts and found that the second includes the first.

Judgment is the mind's decision arrived at through comparing concepts or other judgments.

Example: Man is mortal is my decision after comparing the concepts man and mortal and finding that the latter really includes the former. Judgment at the same time says that "Mortals are men," is not a true conclusion. For in this case the first concept is not all included in the second. Mortals are all life that is subject to death.

We may assume personal consciousness even as we recognize an individual body. Psychology does not deal with any awareness separated from a person. It knows no central mind of which you partake or I partake, and which is the same for us both. A universal consciousness would simply mean one which is the sum of yours and mine and everybody's who lives today, or who has ever lived. So by personal consciousness the psychologist means his consciousness, or yours, or mine. But they can never be the same; for mine is determined by my entire past and by how things and facts and qualities affect me; and yours, by your past, and by things and facts and qualities, and by how they affect you.

Personal consciousness is the mind's recognition of self; and as the self changes with every added experience, so personal consciousness is modified.

Stream of thought is a term James has brought into common usage to illustrate the fact, already stressed, that thinking, as we know it, is never static, is never one thing, one percept, one concept, one judgment; but is a lot of these all together, just beginning to be or just beginning to change into something else. We never know a concept, for instance, except as it is a part of our entire consciousness, related to all the rest; just as we do not know the drop of water in the brook as it flows with the stream. We can take up one on our finger-tips, however, and separate it from all the rest. But analyzed in the laboratory, this drop will contain all the elements that a pint or gallon or a barrel of the same water contains. The drop is what it is because the stream has a certain composition. We only have a brook as drops of rain combine to make it, but we also have only the drops as we separate them from the steam.

Imagination is the combining by the mind, in a new way, things already known.

This may be either into fantastic groupings divorced from reality, or into new, possible, rational groupings not yet experienced. So imagination is of two kinds, the fantastic and the constructive. Fantastic imagination, or fantasy, gives us gnomes, fairies, giants, and flying horses, and all the delights of fairy tales. Constructive imagination is the basis for invention, for literature, and the arts and sciences.

The word thinking, defined early in this chapter, is broadly used to denote the sum of all the intellectual faculties. Thinking is really the stream of thought.



CHAPTER VI

THE NORMAL MIND (Continued)

INSTINCT

We have found that the mind's chief end is action, of itself, or of its body. But what are its incentives to action?

We see the very young baby giving evidences of an emotional life, living in an affective, or feeling environment, leading a pleasure-pain existence, from the first. He acts as desire indicates. But from the very moment of his birth he performs actions with which he cannot as yet have a sense-memory connection, because he is doing them for the first time. How can he know how to respond to stimuli from the very beginning?

No other possible explanation offers itself than that he is born with certain tendencies to definite action. These we call instincts—man's provision to keep him going, as it were, till reason develops. Instincts are handed down from all the past. Definite tendencies, they are, to certain specific reflex actions in response to certain sensations. These responses, from the very beginning of animal life, have been toward avoiding pain, and toward receiving pleasure. It is as though the stimulus presses the trigger—instinct—and the muscle responds instantly with reflex action. This mechanism is the means of protection and advancement, and takes largely the place of intelligence in all animal life. It is what makes the baby suck and cry, clutch and pull, until a sense memory is established. So instinct is really race memory. We call instinctive those immediate, unthought reactions which are the same with all mankind.

The pugnacious instinct—the desire to fight—is the natural reaction of every human being of sane mind to attack. The inner necessity of avenging is so strong in the child or man of untrained mind or soul that he acts before he thinks. He strikes back, or shoots, or plots against his enemies. Only rare development of spirit or the cautious warning of reason which foresees ill consequences, or a will trained to force control, can later make the instinct inactive.

Where instinct ends and sense memory, imitation, and desire step in is difficult to determine. Later in life probably most of what we consider instinctive action is simply so-called reflex action, depending on sense memory, action learned so young that it is difficult to distinguish it from the true reflex action, which is due only to race memory.

James, in his Talk to Teachers, gives us a partial list of the instincts. Thus:

Fear Ownership Shyness Love Constructiveness Secretiveness Curiosity Love of approbation The ambitious impulses: Imitation, Emulation, Pride, Ambition, Pugnacity

To this partial list we would add self-preservation, reproduction, etc.

But instincts conflict with each other, and man carries about with him in babyhood many of them which may have been very useful to his prehistoric ancestors, but which only complicate things for him. Fear and curiosity urge opposite lines of conduct. Love of approbation and shyness are opposed. Love and pugnacity are apt to be at odds. So, gradually, as intelligence increases, the child refuses to allow such impulses to lead him to action. When fear-instinct and love-instinct are at war, reason is provided to come to the rescue.

Instincts are racial tendencies of sensational or emotional states to determine action.

Instincts are the germs of habit, and when instinct would give rise to a reaction no longer useful, reason, abetted by new habit formation, in the normal mind, weakens instinct's force; and the habit is discarded and the instinct gradually declines.

In prehistoric times when food was scarce, and man had not learned the art of tilling the soil, hunger forced him to fight for what he got to eat. As there was often not enough to go around, he maimed or killed his fellow-man that he might have all he wanted, obeying the instinct to survive. So, now, the baby instinctively clutches for all that appeals to him. But an abundance of food for all, or the intelligent realization that co-operation brings more to the individual than does fighting, and a developed sense of responsibility toward others; or merely the fear of the scorn of fellow beings, or the desire to be protected by the love of his kind; perhaps a genuine love of people, acquired by spiritual development, puts the primitive habit of food-grabbing into the discard. Finally, the very instinct of self-preservation may be transformed into desire to serve others. No better illustration of this can ever be offered than the sacrifices of the World War.

MEMORY

No mind retains consciously everything that has ever impressed it. It is necessary that it put aside what ceases to be of importance or value and make way for new impressions. We found early in our study that the subconscious never forgets, but harbors the apparently forgotten throughout the years, allowing it to modify our thinking, our reactions. But the conscious mind cannot be cluttered with the things of little importance when the more essential is clamoring. So there is a forgetting that is very normal. We forget numberless incidents of our childhood and youth; we may forget the details of much that we have learned to do automatically; but the subconscious mind is attending to them for us.

Do you know how to skate? and if so, do you remember just how you did it the first time? Probably all you recall is that you fell again and again because your feet would slip away from where you meant them to be. When you glide over the ice now it is as natural as walking, and as easy. You cannot remember in detail at all how you first "struck out," nor the position of your feet and arms and legs, which you felt forced to assume. At the time there was very real difficulty with every stroke—each one was an accomplishment to be attempted circumspectly, in a certain definite way. All you remember now is, vaguely, a tumble or two, soreness, and lots of fun.

We forget details we have intrusted to others as not a part of our responsibility. We forget the things which in no way concern us, in which we have no interest and about which we have no curiosity. And it is well that we do so. If it were not for the ability to forget, our minds would be like a room in which we have lived a lifetime, where we have left everything that has been brought into it since our birth. It would be piled ceiling high, with no room for us, and with difficulty only could we find what we want. As we grow from babyhood to childhood, from childhood to youth, from youth to maturity the room changes with us. We put off childish things. They are stored away somewhere, in an attic or basement, or destroyed. And day after day something new is added, displacing something else. In the case of the mind all these things are stored and cataloged in the subconscious, and forgotten, until some need causes us to look into our catalog-index and see the experience again, or some association calls it back, relating it to something new. So our discussion of the subconscious involved also a discussion of memory.

But what of the things we must use frequently and cannot find in our minds? What of absent-mindedness and faulty memory? In such cases our minds might be compared to a cluttered room full of things we need and want to use every day, but in confusion. We know where many of them are, the ones we care most about; but we have to rummage wildly to find the rest. We have no proper system of arrangement of our belongings. You laid down that book somewhere, absent-mindedly, and now you cannot tell where. You were thinking of something else at the time, and inattention proves a most common cause of poor memory. Perhaps you simply have more books than the room can hold in an orderly way, and so you crowded that one in some corner, and now have no recollection of where you put it.

Poor memory is the result of lack of attention, or divided attention at the time the particular attention-stimulus knocked. You asked me to buy a ribbon of a certain shade and a certain width when I went to town. I was thinking of my dentist appointment. However, I heard your request, answered it graciously, took the money you offered, still wondering if the dentist would have to draw that tooth. And the chances are that I forgot your ribbon. I was giving you only a passive and divided attention.

Or I have more to do than I can possibly accomplish in the next six hours. You ask me to buy the ribbon. I attend accurately for the moment, think distractedly, "How can I do it all?—but I will"—and crowd the intention into an already overburdened corner of my mind, fail to associate it with the other thoughts already there, and return six hours later without the ribbon. My sense of hurry, of stress, of the more important thing to be done, or a reaction of impatience at the request, forced back the ribbon thought and allowed it to be hidden by others. I was really giving you only partial attention, or an emotion interfered with attention; and I forgot.

Hence we find that a faulty memory may exist in an otherwise normal mind when poor attention, or divided attention due to emotional stress or to an overcrowded mind, which makes it impossible to properly assort its material, interferes.

Again, we forget many things because they are unpleasant to remember. We have no desire, no emotional stimulus to make us remember; or because some of the associations with the forgotten incident are undesirable. We forget many things because if we remembered them we would feel called upon to do some unpleasant duty. You forgot your tennis engagement with B, perhaps, because you were so engrossed in a pleasure at hand, or in your work, that anything which interrupted was, under the circumstances, undesirable. You may have wanted very much to play with him, but some more pressing desire—to care well for your patient, or to continue the present amusement—was stronger. Or you forgot because you did not want to play with him and had no excuse to offer at the time. You wished to forget. Perhaps he does not play a good game, or you do not like him, or at least you like some one else much more, and he happened along; so you forgot B. The unconscious mind saw to it that something else was kept so prominently before your attention that it could not return to the less desired.

Thus a forgetting may be purely the result of an emotional interference which makes it, all in all, more pleasant to forget than to remember. If we would help ourselves or our patients whose memories are faulty, and who make them worse by their continual fretting over their disability, we must train ourselves to be willing to forget all that does not in the least concern our interests or those of the people about us, and does not add anything desirable to our knowledge. Thus we may avoid overcrowding the mind. But when we would remember let us give our whole active attention at the moment of presentation of the new stimulus, and immediately tie it up with something in past experience; let us recognize what it is that we should remember, and call the reinforcement of will, which demands that we remember whether we want to or not. Sincere desire to remember will inspire early and frequent recalling, with various associations, or hooks, until the impression becomes permanent. The average patient's poor memory is made worse by his agitation and attention to it, and his conviction that he cannot remember. The fear of forgetting often wastes mental energy which might otherwise provide keenness of memory. If the nurse ties up some pleasant association with the things she wants the sick man to remember, and disregards his painful effort to recall other things, then—unless the mind is disordered—he will often find normal memory reasserting itself.

We shall consider this question of memory in more detail in a later chapter of practical suggestions for the nurse.

THE PLACE OF EMOTION

Feeling Cannot Be Separated from Thinking.—Emotion we found the constant accompaniment of every other mental activity. It is first on the stage of consciousness and, in the normal mind, last to withdraw.

When I am working at a problem in doses or solutions, trying to learn my materia medica, or wrestling with the causes of disease in my medical nursing, or thinking how I can eke out my last ten dollars till I get some more, I am pursued with some vague or well-defined feeling of annoyance or satisfaction, of displeasure or pleasure. If all goes well, the latter; if not, the former.

Feeling Cannot Be Separated from Will.—I cannot will without a feeling accompaniment, pleasant or unpleasant. I may be using my will only in carrying out what intellect advises. But we found that intellect's operations are always affective, i. e., have some feeling of pleasure or pain. And the very act of will itself is a pleasant one and much easier if it is making me do what I want to do; it is a vaguely or actively unpleasant one if it is making me act against desire. In the end, however, if I act against desire in pursuance of reason or a sense of duty, the feeling of pleasure in the victory of my better self is asserted. And feeling cannot be separated from will.

Feeling Cannot Be Separated from Action.—I cannot do anything without a feeling of comfort or discomfort, happiness or unhappiness. Try it for yourself when you are feeding a patient, making a bed, giving a bath or massage, preparing a hypodermic. Other things being normal, if you are performing the task perfectly, the feeling of satisfaction, of pleasure, of the very ability to work effectively, with speed and accuracy and nicety, comes with the doing. If you are bungling, there is a pervading sense of dissatisfaction, of unpleasantness. In the automatic or semi-automatic action a great economy of nature has conservatively put feeling at the absolute minimum; but it has not eradicated it. As you walk across the ward, though your predominating thought and feeling may be elsewhere, there is a sense of pleasure or displeasure in the very movement. If your body is fresh and you are of an energetic type and in happy frame of mind, a pervasive feeling of satisfaction is experienced. If tired or discouraged or sore from unaccustomed exercise, every step registers protest.

Thus we find by experiment that there is no thought we have, no single conscious movement or action, nor any expression of the will, but is accompanied with what the psychologist broadly terms pleasure or pain. So emotion, the first expression of mentality, is never absent from any mental or physical act. It permeates all we do, as well as all we think and will, with the partial exception of automatic action, above indicated.

THE BEGINNING OF REASON

We found feeling by far the strongest factor in producing action in babyhood and childhood. Our instinctive doing, we learned, is the result of a race impulse. Will acts chiefly at emotion's bidding. But very early the baby's experience operates as a partial check to feeling's exclusive sway. It keeps him from touching the fire, no matter how its brightness attracts. It may be merely the sense memory of hurt when fingers and that bright thing came together; and one such impression will probably prevent him from ever again touching it. Or it may be the brain-cell's retention of the painful feeling of slapped hands when the fingers reaching out to the flame had not yet quite touched. These punishment experiences are only effective in many children after more or less repetition has set up an automatic prohibition from brain to motor nerves; but right here intellect begins to assert itself in the form of sense memory. The baby does not reason about the matter. His nerve-cells simply remember pain, and that particular brightness and glow, and finger touch—or that reaching out to the glow—and slapped hands, as occurring together. In the same way he early connects pleasure with the taste of certain forbidden things. He does not know they are sweet. He only knows "I want." Even here his desire to taste may be checked in action by a vivid memory of what happened when he tasted that other time, and was spanked or put in his little room all alone with only milk and bread to eat for a long time.

Later on the child may think, from cause to effect, thus: "Sweet, good, want, taste, spank, hurt (or no dinner, all by self, lonely), spank hurt more than sweets good. Not taste." But long before he can work this out, consciously, two distinct memories, one of pleasure and one of pain, are aroused by the sight of the sweet. And what he will do with it depends upon which memory is stronger. In other words, his action is governed altogether by his feeling, though memory, which is an intellectual factor, supplies the material for feeling.

DEVELOPMENT OF REASON AND WILL

Later still, when the child is older, we may have somewhat the following mechanism: "Sweets, good, want, taste; spank, hurt; don't care, spank not hurt much, maybe never found put, sweets very good."

Now the child is reasoning and choosing between two courses of action, don't and do. His decision will depend upon whether immediate satisfaction of desire is stronger than the deferred satisfaction of being good, and the fear of punishment. He probably prefers to take a chance, and even if the worst comes, weighs it with the other worst, not having the sweet—and takes the "bird in the hand." He has reasoned, and has chosen between two emotions the one which his judgment says is the more desirable; and his will carries out the decision of his reasoning. His chief end in life is still to get the most immediate pleasure. Still later in child-life, much later, perhaps, his decision about the jam is based on neither love of it nor fear of punishment, but—despite his still sweet tooth—on a reasoned conclusion that if he eats jam now he may be sick, or he may spoil his appetite for dinner; or on a consideration that sweets between meals are not best on dietetic principles; and will very readily backs up the result of his reasoning. Though his determination is largely based upon feeling, reason has chosen between feelings, between immediate desire to have, and desire to avoid future discomfort. Reason is triumphant over present desire.

JUDGMENT

The conclusion or decision that reason has reached we call a judgment. The youth who decides against the sweet between meals, we say, has good judgment. And we base our commendation on the proved fact that sweets are real fuel, giving abundantly of heat and energy, and are not to be eaten as mere pastime when the body is already fully supplied with high calorie food not yet burned up; that if sweets are eaten at irregular intervals and at the call of appetite, and not earned by an adequate output of physical work, the digestive apparatus may become clogged, and an overacid condition of the entire intestinal tract threaten. We call judgment good, then, when it is the result of reasoning with correct or logical premises which correspond with the facts of life. We call it bad when it is the conclusion of incorrect or partial or illogic premises.

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