Abnormal Behavior Abnormal Behavior 
Tifalls of Our dMlinds 
An Introduction to the Study of 
Abnormal and Anti-Social Behavior 
BY 
Irving J. Sands, M.D. 
Instructor in Neurology, Columbia University Medical School; 
Assistant Alienist, Bellevue Hospital; Associate Neurologist, 
Montefiore Hospital; Associate Neurologist Brooklyn Jewish 
Hospital; Attending Neurologist, Brownsville 
and E. N. Y. Hospital. 
'And 
Phyllis Blanchard, Ph.D. 
Formerly Psychologist, Bellevue Hospital Psychopathic Service; 
Psychologist, Monmouth County Mental Hygiene Clinic. 
Author of “The Adolescent Girl,” and Co-Author 
“Taboo and Genties.” 
New York 
Moffat, Yard and Company 
1923 COPYRIGHT, 1923 
BY MOFFAT, YARD & COMPANY 
THE PLIMPTON PRE88 • NOB W O OD • M ASSA CH UB ETT8 
PRINTED IN THE UNITED STATES OP AMERICA INTRODUCTION 
UNTIL a comparatively recent period, the indi- 
vidual who showed aberrant behavior traits 
was looked upon as an outcast from the social 
group and was made to pay a heavy penalty for 
being different from his fellows. Within the last 
two decades, however, a radical change has taken 
place in the attitude of the community toward the 
individual who does not conform to its customs 
and standards of conduct. Two factors have con- 
tributed more than any others to bring about this 
change. The first was the recognition of insanity 
as a form of disease and the equipment of hos- 
pitals for the care of the mentally sick. The 
second was the development of modern psychol- 
ogy, with its refutation of the old philosophical 
doctrine of freedom of the will and its conception 
of the human individual as an organism able to 
react only within the limits of instinctive, emo- 
tional and intellectual equipment. 
The scientific knowledge from both these 
sources was gradually disseminated through the 
community, and by a slow process of education 
built up a change in the attitude of the group 
toward its aberrant members. In place of the 
old tendency to condemn and punish the psychotic, 
the psychoneurotic, the social radical, the laggard 
in school, the delinquent, or any other individual 
who did not strictly adhere to social standards, 
V vi 
INTRODUCTION 
there came a questioning attitude, a conviction 
that this atypical personality was ill or mentally 
deranged, and a desire to know the cause of his 
peculiar behavior. 
This new attitude of the community has placed 
upon certain professional groups increasing re- 
sponsibilities. It is, of course, to the neuropsy- 
chiatrist that the community looks for guidance in 
the treatment of conduct disorders. But the 
psychologist has also been called upon to assist in 
the diagnosis of certain types of behavior difficul- 
ties, and, particularly in cases of educational mal- 
adjustment, to aid in mapping out a plan for cor- 
rection. More recently still, the social worker and 
the probation officer have found some knowledge 
of human conduct a necessary part of their equip- 
ment, since they are constantly being called upon 
to assist the neuropsychiatrist in becoming ac- 
quainted with the environmental situation of the 
patient who shows some behavior abnormality and 
to carry out his instructions as to the manipulation 
of that situation in harmony with the patient’s 
needs. 
In view of this general focussing of attention 
upon the scientific treatment of abnormal and anti- 
social conduct of all kinds, there is a growing need 
for literature upon the subject. A knowledge of 
the causation and treatment of conduct disorders 
and of methods for their prevention is an essential 
part of the training of the medical student of 
to-day. The student of psychology has equal need 
of this information, while the social worker and INTRODUCTION 
vii 
those engaged in probation work must understand 
the fundamental principles involved in order to be 
successful. Moreover, the intelligent layman is 
also anxious to learn something of the matter, 
since he is constantly being requested to tax him- 
self for the support of clinics in connection with 
the courts and schools of his city or town, and 
would like to cast his vote intelligently. 
It is not the conviction of the authors of the 
present volume that they are contributing anything 
strikingly new and original to the problems of 
human conduct. It has appeared to them, how- 
ever, that while there is now a fair accumulation 
of specialized books and articles in this field, there 
is a conspicuous absence of any well-rounded ac- 
count which gives an accurate summary of our 
data up to date, without over-emphasis upon one 
aspect at the expense of others. Therefore they 
have attempted to present a clear and inclusive 
statement such as seems warranted in the light of 
our present scientific knowledge and in the test 
of practical experience. We have undoubtedly 
reached that stage where students who expect to 
enter upon some profession which involves the in- 
timate dealing with human Individuals need some 
such general discussion as a classroom text and as 
a guide to further reading.1 But it is our hope that 
1 Hence our bibliographies at the end of each chapter 
will not attempt to include many references which although 
extraneous to the specific subject matter have indirectly 
contributed to our general formulations and viewpoint. 
Instead, we shall take particular pains to limit our bibli- 
ographies to books and articles which the student will find 
extremely valuable as supplementary reading to the text. viii 
INTRODUCTION 
this book may serve a broader purpose than this in 
being sufficiently non-technical to be intelligible 
to the lay reader who wishes to gain some insight 
into the subject of conduct disorders. 
As Professor E. C. Lindeman said not long ago,1 
the specialist too often fails to pass on to the com- 
munity the knowledge which has come into his 
possession by virtue of his technical training and 
capacity for research. It is a part of his obligation 
to present to the community sufficient data to en- 
able the average citizen to at least have some 
understanding of the value of the services which 
the specialist is capable of rendering if called upon 
to do so. When the specialist fails to do this, he 
soon finds himself in a community which has no in- 
terest in assisting him in further research. Further- 
more, he loses his opportunity to accelerate social 
progress by not creating a demand for what he has 
to offer to the welfare of the group. It is our hope 
that this book may serve in some degree to form a 
link between the specialist in the field of human 
conduct and the community members who are eager 
to know a little of what he has discovered. In this 
way, we may be able to feel the satisfaction which 
comes from constructive effort, for in so far as 
the community understands such problems as 
delinquency, etc., in like measure will it be pre- 
pared to further those movements which look 
toward correction and prevention. 
The Authors 
1 In his address at the National Conference of Social 
Work at Providence last June. CONTENTS 
PAGE 
Introduction v 
I. The Instinctive and Emotional Basis of 
Behavior i 
II. Emotional Conflicts in the Causation 
of Conduct Disorders 31 
III. Intellectual Capacities and Their 
Relation to Behavior 67 
IV. The Physical Basis for Behavior and the 
Influence of Somatic Diseases upon 
Conduct 98 
V. The Relation of Personality Types to 
Behavior 141 
VI. The Role of the Psychoses in the 
Causation of Anti-social Conduct. ... 167 
VII. Borderline Mental Disorders as Causes 
of Abnormal Conduct 229 
VIII. Epileptic Manifestations in Behavior 
Difficulties 265 
IX. The Problem of Drug Addiction 291 
X. The Unbiological Behavior of the 
Suicide 332 
XI. Educational Maladjustments 373 
XII. Vocational’ and Industrial Maladjust- 
ments 414 
XIII. Modern Methods for the Prevention 
and Correction of Conduct Dis- 
orders 440 
Lx ABNORMAL BEHAVIOR 
PITFALLS OF OUR MINDS 
Chapter I 
THE INSTINCTIVE AND EMOTIONAL 
BASIS OF BEHAVIOR 
Complexity of human behavior. 
Academic controversy concerning the number of instincts. 
Enumeration of the eight chief instincts and emotions. 
Gradual growth of instincts from simple to complex 
activities. 
Development of the food-getting instinct in the child. 
Economic and sociological aspects of food-getting activities. 
Development of fear in the child. 
Anger reactions and their modifications. 
Fear as a motive in the social history of man. 
Ambivalent relationship of fear and anger. 
Feeling of inferiority and compensatory will to power as 
related to fearful and aggressive behavior. 
Development of the sex life. 
Role of sex in the cultural history of man. 
Possibility of injurious results to the individual from sex 
repressions. 
Parental instincts and emotions. 
Effect of the parental attitude on the child’s personality. 
The herd impulse in the individual. 
Gregariousness as accelerating and retarding social progress. 
Instinct of manipulation in infants. 
Curiosity as a motive of social and scientific progress. 
Instinctive nature of play. 
Play as a repetition of racial experience and as preparation 
for the duties of life. 
I 2 
ABNORMAL BEHAVIOR 
The compensatory function of make-believe play. 
Similar compensatory mechanisms in connection with other 
instincts. 
Sublimation and the flight from reality. 
The pain-pleasure principle as a motive of human conduct. 
Instincts and emotions function in interaction with one 
another. 
Antagonistic instincts and emotions. 
Synchronous action of reinforcing instincts and emotions. 
The unconscious nature of emotional reactions. 
The mechanisms of repression and sublimation. 
Dream psychology in relation to the unconscious emotional 
life. 
HUMAN behavior is the outcome of an infinite 
complexity of interacting factors. The con- 
duct of an individual could only be completely in- 
telligible if we possessed a full knowledge of his 
inherited tendencies, his instinctive and emotional 
equipment, his intellectual capacities, his general 
physical condition, etc. In addition to this infor- 
mation, we should also have to obtain a detailed 
life history of the individual, in order to under- 
stand the various habits and inhibitions which had 
been built up on the foundations of his physical, 
intellectual and emotional endowments. The most 
difficult subject which we should have to study in 
our search for an understanding of human behavior, 
is probably that of the instinctive and emotional 
life, yet in the final analysis we should undoubtedly 
find that these factors outweighed all others in 
the causation of the conduct of an individual, so 
that we should be well repaid for our effort. 
From the academic standpoint, the study of the 
instincts and emotions is rendered obscure by the PITFALLS OF OUR MINDS 
3 
difficulty with which experimental data are obtain- 
able. Thorndike, Watson, McDougall and many 
others have spent much time in research for the 
purpose of determining the number and nature of 
instinctive and emotional reactions which are in- 
nate in the human individual as distinguished 
from those which are acquired during the early 
life history. The term instinct is, of course, by 
definition to be accurately applied only to those 
mechanisms which are known to be innate and 
inherited,1 but at the present time there is some 
controversy as to whether some of the so-called 
instinctive tendencies are really instincts in the 
true sense at all, or if they are not rather woven 
into the mental makeup at some time after birth 
by the forces of the physical and social environ- 
ment into which the infant is born. 
In view of all the data accumulated up to the 
present, we may well leave this academic discussion 
concerning the instincts without going into details, 
and for practical purposes enumerate the principal 
instinctive and emotional activities as follows: 
1. The instinctive tendency to seek food and the 
feeling of hunger. 
2. The instinctive tendency to flee from the 
1 An instinct may be briefly defined as a native tend- 
ency to reaction which involves the whole or considerable 
part of the organism. It is a mechanism for responding 
to external stimuli, yet this response is dependent also 
upon the condition of the organism. (For example, a 
nest of eggs will not call forth the response of sitting 
unless the hen is “broody.”) Instinctive reactions are 
unlearned, but are capable of a great deal of modification 
by learning. 4 
ABNORMAL BEHAVIOR 
dangerous situation and the emotion of fear. 
3. The instinctive tendency to fight and the 
emotion of anger. 
4. The reproductive or sexual instincts and 
emotions. 
5. The parental instincts and emotions. 
6. The gregarious tendencies (the impulse to 
act like the other members of the group) or the 
instincts and emotions of the herd. 
7. The innate tendency to manipulation of ob- 
jects present in the environment and the feeling 
of curiosity. 
8. The instinctive and emotional activities 
which are included under the term play. 
It is generally agreed that the tendencies in- 
cluded in this list are a part of the native equip- 
ment of the new-born infant, and that they mani- 
fest themselves without previous experience and 
training. They are not acquired characteristics; as 
Thorndike expresses it, they are part of the “ orig- 
inal nature of man.” Watson, to be sure, would 
question the existence of a parental instinct, and 
would consider parental behavior to be an ac- 
quired mode of reaction, but the majority of psy- 
chologists would disagree with him, so that we are 
justified in leaving it on our list despite his opin- 
ion. Thorndike, while agreeing to the parental 
instincts, would rule out play, but the consensus 
of opinion would include it as we do. 
McDougall and some other workers in this field 
would add to the category of instincts and emo- 
tions given above three other sets: PITFALLS OF OUR MINDS 
5 
1. The instinct of repulsion and the emotion of 
disgust. 
2. The instinct of self-abasement or subjection 
and the emotion of negative self-feeling. 
3. The instinct of self-display or self-assertion 
and the emotion of positive self-feeling or elation. 
From the viewpoint of our study, these are rela- 
tively of less importance than the others which we 
have enumerated, so that we shall not enter into 
the controversy regarding them nor describe them 
in detail. 
Of the various instinctive and emotional tend- 
encies, it may be generally stated that from their 
relatively simple and rudimentary manifestations 
in the early life of the child, they gradually grow 
into more complex activities. Originally called 
forth by only one or two stimuli, as the child’s 
experience broadens the number of stimuli which 
become attached to any instinctive and emotional 
response increases. Inhibitions and modifications 
are gradually built up, and substitute reactions 
replace the primitive ones which it becomes neces- 
sary to repress. In time, the emotional tone 
which accompanies these substitute reactions be- 
comes almost as intense as that which accompanied 
the original response. These principles, abstruse 
when set forth as generalizations, become clear 
enough when described in connection with the 
development of the specific instincts and emotions. 
The food-getting instinct, for example, is the 
first to manifest itself in the life of the individual. 
The infant comes into the world with this mechan- 6 
ABNORMAL BEHAVIOR 
ism ready to function, and aside from breathing 
and the other vegetative functions of the organ- 
ism, it is the earliest activity which appears. In 
its primary stages it consists simply of a sucking 
reflex, for which the only stimulus necessary is 
contact with the mother’s breast. Gradually other 
things become an adequate stimulus for this reflex, 
such as the sight of the mother unfastening her 
dress, or the presentation of the bottle (in place 
of contact with the nipple), in cases in which the 
infant is not breast-fed. Later, it is necessary to 
replace the sucking activity with other quite dif- 
ferent responses, such as eating and drinking. In 
due season, these latter reaction-patterns replace 
the earlier sucking reflex almost entirely, so that 
it is repressed in favor of these more elaborate 
activities except when we visit the soda fountain 
or upon other suitable occasions. 
As for the economic and sociological aspects of 
the food-getting activities of man, they are mani- 
fold. Hunting, fishing, agriculture, and the system 
of barter and exchange, with all its modern elabo- 
rations, originated in the necessity of obtaining 
food. The feeling of hunger was so powerful a 
motive in the life of primitive man that it even 
played a part in the molding of his religious 
rites and ceremonies. The primitive conception of 
God was in harmony with man’s own emotions and 
desires, therefore he pictured his deities as de- 
manding sacrifices in the form of food. Even 
to-day the strength of the hunger motive is evi- 
dent in the attitude of the conquered European PITFALLS OF OUR MINDS 
7 
countries toward their more prosperous victors. 
The necessity of obtaining food from the former 
enemy proved stronger than hatred, and hastened 
the resumption of commercial relations more than 
anything else. 
Aside from hunger, fear and rage are the next 
earliest emotions which appear in the life of the 
child. Here, too, the rule of development is from 
the simple to the complex. Watson’s observations 
on infants indicate that there are only two types 
of stimuli which evoke fear reactions in early in- 
fancy, namely, the sudden removal of support and 
a loud sound. The response to these fear stimuli 
consists of a catching of the breath, random clutch- 
ing with the hands, closing the eyes, and in some 
cases crying. Fear of other things than these, as 
fear of the dark, of animals, etc., develops in the 
child as a result of experience, Watson discovered 
in the course of his laboratory work. Almost any- 
thing can become a fear stimulus in the life of the 
individual if his experiences are such as to make 
it so. As the child grows older, his activities in 
response to these stimuli become more elaborate 
and more effectual. When he is able to walk, his 
reaction to the terrifying situation is that of run- 
ning away from it. Since this is the most biologi- 
cally useful of the early activities accompanying 
fear, in that it assists in the preservation of the 
organism, McDougall and others usually speak of 
the instinct of flight in connection with the emotion 
of fear. 
Anger produces opposite activities to those of 8 
ABNORMAL BEHAVIOR 
fear. In anger, the reactions of the individual are 
aggressive rather than avoiding. Watson found 
that the original anger-producing stimulus is 
hampering the movements of the infant, where- 
upon the child cries, moves its arms violently and 
kicks. Later, of course, anger is aroused by many 
other stimuli, and the response becomes more 
forceful as the strength of the individual increases 
and new resources are acquired. The traditional 
instinctive activity accompanying anger is fighting. 
In the social history of mankind, fear has prob- 
ably been a more influential motive than anger. 
The taboo control of primitive groups was based 
almost entirely upon fear. Religion, in its earliest 
stages, had its genesis in this emotion. Primitive 
man had a spiritistic interpretation of all phe- 
nomena which he did not understand, and his de- 
sire to propitiate these spirit forces was born of 
terror. The laws and religious beliefs which grew 
out of the primitive taboos and superstitions were 
no less free from this element. Modern society 
still depends to a large extent upon fear control. 
Fear of punishment was for a long time the only 
motive utilized in controlling the criminal pas- 
sions of mankind. 
Fear has played an important part in social 
progress in other ways. The fear of destruction 
has prompted the manipulation of the environ- 
ment to make it more suited to men’s needs. But 
although it has thus been an incentive to human 
progress, it has also held in check the inventive 
genius of mankind, since group conservatism has PITFALLS OF OUR MINDS 
9 
often been slow to appreciate new departures from 
the customary ways and methods, and the inventor 
has more than once suffered ridicule or actual 
punishment at the hands of his fellows. 
As the anger and fear reactions develop in the 
life of the individual, they tend to become ambiv- 
alent to each other, in that one may readily 
change into the other. The original fearful re- 
sponse to a given situation, and the initial impulse 
to flee may be replaced by attempts to master the 
difficult situation. Similarly, aggressive behavior 
may be abandoned, if the odds appear to be too 
great, in favor of fear and flight. 
Whether the individual responds to dangerous 
stimuli by fear reactions or by aggressive behavior 
is in part due to minute variations in the situation, 
and in part is dependent upon the physiological 
condition and previous experience. The child who 
is born with some organic deficiency is apt to be 
fearful in attitude because of the feeling of in- 
feriority which his biological insufficiency natu- 
rally induces. This sense of inferiority is increased 
or decreased according to the treatment which the 
child receives at the hands of parents and other 
associates. If parents and teachers prove critical 
of all his efforts, the feeling of inferiority is deep- 
ened and there is a tendency to become afraid in 
all difficult situations. On the other hand, if par- 
ents and teachers encourage wisely, the feeling of 
inferiority may be somewhat overcome and the 
child may learn to attempt to master the difficul- 
ties which he meets. 10 
ABNORMAL BEHAVIOR 
Very often the feeling of inferiority carries with 
it its own antidote, for there is a tendency to at- 
tempt to rid oneself of this unpleasant feeling by 
making every effort to demonstrate one’s supe- 
riority over one’s fellows and over environmental 
difficulties. The ambivalent quality of fear and 
anger readily permits the building up of this com- 
pensatory mechanism. The individual compen- 
sates for his fearfulness and sense of inferiority 
by the development of a superimposed aggressive 
attitude. This psychological trait has been de- 
scribed in detail by Adler as the feeling of inferi- 
ority and the compensatory “ will to power.” 
The will to power may become so strong in an 
individual as to dominate the behavior almost 
entirely. It is frequently seen in individuals who 
are in authority in political, educational or indus- 
trial fields, being manifest not only in their strug- 
gles to obtain such positions, but also in their 
attitude toward their subordinates and even 
toward those who have been instrumental in se- 
curing them their authority. 
Under extreme stress of circumstances, however, 
these compensatory functions tend to break down 
and the individual reverts to a type of conduct in 
which there is complete fear control. Popular 
observation has voiced this in the saying that the 
bully is a coward at heart. It was best demon- 
strated in many of the war neuroses, in which the 
fear of impending danger could no longer be re- 
pressed, and the reaction became such as to insure 
the individual’s removal to a safer place. PITFALLS OF OUR MINDS 
II 
The instincts and emotions which serve the ends 
of racial continuance are quite as powerful as those 
which tend to preserve the individual. We have 
only recently learned that the sex instincts and 
emotions are present in the life of the infant, and 
that they undergo as many changes and modifi- 
cations as hunger or fear before they reach their 
final biological expression in the life of the adult. 
Watson found activities which were obviously the 
forerunners of the love activities of later life in 
the infants studied in his laboratory. He describes 
the responses to such stimuli as stroking the skin, 
gentle tickling, etc., as smiling, gurgling and cooing, 
and an extension of the arms which is a faint begin- 
ning of the adult embrace to grow out of it. As 
the child grows older, the number of stimuli 
evoking erotic responses increases, and the child 
turns to one love-object after another, until it 
reaches its final fixation on the opposite sex at 
adolescence. Arrested development of this activ- 
ity results in the fixing of the love-life at one of the 
infantile levels, and is frequently a cause of the 
sex perversions and abnormalities which some- 
times appear in the adult. Freud’s study of the 
polymorphous-perverse tendencies of the child’s 
sex life offers a thorough treatment of this subject. 
The sexual instincts and emotions have played 
an important part in the cultural history of the 
race. Social customs and religious observances 
have always united to enforce the repression of the 
sex life at its biological level to a great extent, per- 
mitting its operation only within certain sanctioned 12 
ABNORMAL BEHAVIOR 
limits. Many of the primitive taboos grew up in 
the attempt to subordinate the sexual desires of 
the individual to the demands of the group. The 
energy thus prevented from taking its natural out- 
let found substitute expressions in reinforcing the 
activities of individuals along other lines. In those 
gifted with special abilities, the repressed sexual 
cravings found expression in the arts. Musical 
rhythm, picture-making, dancing, folk-lore, all re- 
ceived a strong impetus from repressed erotic de- 
sires which found a partial fulfilment in these 
vicarious activities. Modern art and literature 
offer no less a means of gratification for repressed 
sexuality. 
While repression of the sex tendencies has thus 
been of some advantage to the race in that it sub- 
served the interests of art and culture, it is only 
fair to admit that in the life of the individual it 
has sometimes proven injurious. From mere day- 
dreaming and fantasy-weaving to incapacitating 
neuroses, the repressed sexual desires may impair 
the physical and mental efficiency of those who 
lack special abilities that would enable them to 
sublimate their cravings along more useful lines. 
Many anti-social traits, from mere perversion of 
the natural biological instinct of sex to conversion 
of its energy into pathological lying and stealing 
or into sadistic outbreaks which sometimes end in 
murder, may be traced to abnormal development 
of this instinct or to its failure to find normal or 
sublimated expressions. 
The parental activities are by their very nature PITFALLS OF OUR MINDS 
13 
closely connected with the reproductive instincts. 
Home-building grew out of the necessity of pro- 
viding shelter for the mate and the child. As the 
infancy period increased in length, and the off- 
spring needed the protection of its parents for a 
longer period of time, so the parental emotions 
became stronger and deeper. The parental instinct 
is naturally stronger in the mother than in the 
father, because her associations with the child are 
more intimate than his. It is by its very charac- 
ter, one of the latest instincts to appear, yet it may 
be seen in the girl child who cares for a baby 
brother or sister, or in the boy who assumes a 
protecting attitude toward one of his younger and 
weaker playmates. 
The parental instincts and emotions lead the 
individual to make endless sacrifices for the sake 
of his children. These sacrifices are facilitated 
by the very nature of the instinct. The parent 
unconsciously identifies himself with the child, 
longing to see fulfilled through it the hopes and 
aspirations which he failed to achieve in his own 
life. This identification with the child is useful 
in so far as it causes the parent to subserve per- 
sonal interests to those of the offspring. It is 
detrimental when the parent forgets that the child 
has a separate individuality of its own and at- 
tempts to interfere with the natural development 
of its personality. Therefore, although this self- 
identification of the parent is advantageous ih 
infancy and early childhood, it is often handicap- 
ping at adolescence, when the child should be per- 14 
ABNORMAL BEHAVIOR 
mitted to work out its own vocational interests, 
friendships and emotional attachments. 
There is indeed no other single factor which has 
so much influence on the development of the per- 
sonality as the parental environment. On the 
basis of the attitude of the parents, the child 
models not only his reactions to them but to the 
rest of the world. The father who assumes a 
dominating attitude toward the child may inspire 
a fearful attitude, or he may cause the develop- 
ment of an antagonism not only to himself but to 
all forms of authority, so that the child’s attitude 
toward the school, the church, and the whole social 
organization may come to be decidedly negativ- 
istic. On the other hand, the father who is too 
tender with his daughters may develop in them a 
fixation on himself which will prevent the trans- 
ference of their love impulses at the proper time 
for mating, or will cause them to select a mate 
possessing traits like the father’s regardless of 
suitability in other respects. So, too, the mother 
who lavishes an undue amount of love and caresses 
on her son binds him to her with ties which prevent 
a normal functioning of his mating activities in 
later years. Too much maternal affection is harm- 
ful to both sons and daughters in another respect, 
in that it is liable to prevent the development of 
self-reliance and render them unfit to meet the 
situations of adult life upon their own initiative 
and responsibility. 
The wise parent is called upon to check the 
emotions that would prompt him to love his chil- PITFALLS OF OUR MINDS 
i5 
dren too intensely, or to manifest his affection in 
ways that protect the child for the present moment 
but leave him more open to injury at some later 
date when he is confronted with situations that call 
for training in independent judgment and self- 
reliance. Moreover, the parent must forego the 
joy of seeing his children accomplish those things 
which he hoped to do himself, and permit them 
to seek out for themselves the vocations and avoca- 
tions to which they are best adapted. These are 
the real sacrifices imposed by the fufilment of 
parental duties. 
The herd impulse is the desire to be with one’s 
fellows, to act and even to think as they do. One 
of the chief causes of unhappiness is the feeling 
that one is set apart from one’s companions by 
some peculiar characteristic. It is to the desire to 
conform to the group standards that we owe obe- 
dience to social laws and customs as much as to 
fear. Exclusion from the group has long been an 
accepted mode of punishment for those who trans- 
gress its laws, and solitary confinement has long 
been considered one of the most severe penalties 
which the group could inflict on the criminal. 
Although gregariousness has been of much im- 
portance in the history of the race in this fashion, 
in other ways it has tended to impede progress by 
suppressing individual differences and forcing the 
genius to conform to the group average. Not only 
were criminal tendencies suppressed by the group, 
but creative tendencies were also regarded with 
suspicion because they deviated from the average 16 
ABNORMAL BEHAVIOR 
and implied a change or modification of social 
customs and traditions. The great leaders of re- 
ligion and science were alike persecuted because 
they roused the hostility of the herd by reason of 
their deviation from the mass. 
The development of the hand in the higher 
primates and in man has been accompanied by an 
instinctive tendency to handle the objects of the 
environment, to twist them into new shapes and 
to put different objects together to form others. 
This manipulative tendency is apparent in the 
infant. Watson finds that from the 150th day on 
children begin to reach for, play with and manipu- 
late objects. He also states that there are marked 
individual differences in the materials selected, the 
length of time that any type of material will be 
utilized, and in the early constructive habits which 
will develop in various infants. One child of 18 
months will work with blocks by the hour, building 
a neat wall, with one color always facing her. 
Another child cannot be made to play with blocks 
at all, but will voluntarily play with twigs and 
sticks for long periods of time. Watson suggests 
that a careful observation and record of the natu- 
ral manipulative activities manifested in early 
childhood might possibly prove of value for pur- 
poses of vocational advice to the individual in 
later years. 
The emotional impulse back of the manipulative 
activities is curiosity.1 It was the manipulative 
1 With many authors, curiosity is considered the 
instinct, and the emotion is called wonder. We consider PITFALLS OF OUR MINDS 
17 
activity acting in the service of curiosity which was 
the source of the earliest inventions of mankind, 
and it is a more complex expression of this instinct 
which has produced the mechanical miracles of 
modern civilisation. The desire to discover new 
principles and new methods of control is the spirit 
of scientific research. The physical and chemical 
knowledge which has aided man in obtaining con- 
trol of many environmental forces, and the devel- 
opment of modern scientific medicine which has 
given him power over disease, are also the out- 
growth of the workings of curiosity. 
Whether play can be placed among the category 
of instincts as a separate entity is perhaps open to 
question. Thorndike says the same original tend- 
ency of manipulation is at the root of both the 
useful activity of work and the activity of play 
which is not specifically useful. He holds to the 
view that there is no definite play instinct in the 
original nature of man, but that the manifesta- 
tion of any of the original tendencies may be 
grouped as play activities when they appear with- 
out serving a utilitarian end. Woodworth describes 
the instinctive activities of man as of two types, 
those which have to do with the preservation of 
life and those which have no survival value but are 
connected rather with the joy of living. These 
latter activities have a play value. 
the terms instinct of manipulation and emotion of curiosity 
to be more descriptive of what actually exists. We cer- 
tainly have a feeling of curiosity about things, but our 
satisfaction of this feeling depends upon activities of a 
manipulative nature, to a large extent. 18 
ABNORMAL BEHAVIOR 
Woodworth believes that in addition to these 
general play activities, which may only be a useless 
expression of various innate tendencies, as Thorn- 
dike intimates, there is a definite group of play 
instincts. He refers to the kicking and throwing 
the arms about that is characteristic of the well- 
rested baby as the first manifestation of the play 
instinct. These movements appear to be random, 
and do not involve manipulation; their only pur- 
pose is in giving personal satisfaction. These 
original play activities probably appear in response 
to internal stimuli; they tend to disappear during 
fatigue. Certain of these random movements, such 
as drumming the floor with his heels, become hab- 
itual play habits during the first year or so of the 
child’s life. Later, the play impulse becomes con- 
nected with external stimuli and adapts to its pur- 
poses other activities such as manipulation, etc., 
until finally the gregarious types of play are de- 
veloped in the form of games in which two or more 
individuals participate. This elaboration of the 
first simple play response is similar to the acquire- 
ment of new fears in addition to the original ones 
under the influence of various experiences. 
Many play activities have been considered by 
observers as a repetition of racial activities. The 
boy who goes hunting and fishing, for example, is 
repeating the story of his ancestors, except that 
activities which were useful to them from the 
standpoint of survival are merely contributing to 
the personal joy of living in his case. At the same 
time that play recapitulates ancestral experience, PITFALLS OF OUR MINDS 
19 
it provides practice for the serious duties of life. 
The girl playing with her doll is not only mother- 
ing it as mothers have their children from time 
immemorial; she is also developing tendencies 
which will be useful when she actually becomes 
a mother herself. 
A characteristic of play which must not be over- 
looked is its employment of make-believe. The 
surplus energies of the child naturally tend to run 
over into such activities as hunting, fighting, home- 
making, etc., But the child’s environment seldom 
offers opportunity for the actual carrying out of 
these activities. Instead of building a hut, he is 
obliged to content himself with a blanket stretched 
across two chairs. Or his gun is a toy one, and his 
steed a rocking horse. Thus a part of the child’s 
play is left to the exercise of his imagination, by 
which he is forced to compensate for the deficien- 
cies of his environment for the satisfaction of his 
play instinct. 
The ability to compensate for deficiencies in the 
environmental situation by means of the imagi- 
nation is found in connection with other impulses 
than that of play, and ranges all the way from idle 
day dreaming to organized artistic or literary 
effort. The fulfilment of many of the instinctive 
desires must often be by means of this fantasy 
mechanism, since social requirements enforce the 
repression of the original manifestations of such 
impulses as sex and anger except in certain pre- 
scribed situations. The energy which is prevented 
from finding expression along its natural motor 20 
ABNORMAL BEHAVIOR 
paths flows over into other channels. It may find 
an outlet in various overt activities which become 
infused with an affective tone such as accompanies 
the inhibited instinctive act in its original expres- 
sion. This process is known as the sublimation 
of the instinctive and emotional cravings, and 
has already been referred to in describing the 
transmutation of sexual cravings into artistic en- 
deavor, etc. 
In other instances, the individual may seek sat- 
isfaction for his repressed desires by means of 
day-dreaming and imagination which never goes 
over into overt expression in any useful activity 
such as artistic or literary composition. This type 
of wish-fulfilment may involve a flight from 
reality, in which the actual external situation is 
distorted or replaced by fictitious creations more 
in harmony with the desires of the personality. 
This flight from reality is seen in its extreme form 
in the mental mechanisms of psychoneurotics and 
in some of the delusional and hallucinatory expe- 
riences of the psychotics. It is probable that some 
form of the flight from reality exists in the mental 
mechanisms of most people. The wife who refuses 
to see her husband’s waning interest, the man who 
insists that he can play tennis better than the 
other fellow and that he was beaten by an un- 
lucky accident, the workman who believes his dis- 
charge was due to personal enmity on the part of 
his employer rather than his own inefficiency, are 
common illustrations. It may be that this type 
of flight from reality is a protective mechanism. PITFALLS OF OUR MINDS 
21 
It is quite possible that were the individual to 
visualize himself with all his limitations as clearly 
at all times as he does in those rare moments of 
self-revelation and self-appraisal which occasion- 
ally come to most of us, he would soon lose the 
courage to “ carry on ” in the business of life. 
The source of the flight from reality is the desire 
to avoid pain and achieve pleasure. Biologically, 
the expression of the instinctive tendencies gives 
pleasure to the organism while the thwarting of 
the instinctive desires causes pain. The individual 
soon learns, however, that while the biological ex- 
pression of the instinctive tendencies may give an 
initial feeling of satisfaction and well-being, the 
associations of the group may be such that painful 
consequences will ensue. In order to escape the 
unpleasantness either of complete inhibition or 
painful after-effects, he takes refuge in some form 
of substitute activity or sublimation or in the flight 
from reality by means of his imagination. 
It must be reiterated that the above discussion 
of the instincts and emotions should not be re- 
garded as final in any sense, but should only be 
taken as an entirely inadequate introduction to the 
subject. The student should undertake a great 
deal of supplementary reading along this line, in 
order to formulate his own conclusions. Many 
authors separate curiosity from the instinct of 
manipulation and class it as an instinct in itself. 
It is our opinion at the present time that these 
two impulses are inextricably interwoven. Before 
we can be sure of our ground at this point we need 22 
ABNORMAL BEHAVIOR 
further studies in infant psychology to round out 
the work already begun by Watson. It is left to 
the student to argue the debated points in the light 
of further reading. 
In any case, the instinctive and emotional tend- 
encies which we have described are by far the most 
universal and powerful motives of human conduct, 
and are most frequently concerned in the causation 
of abnormal and anti-social behavior. We shall 
find in our study of concrete cases that disordered 
conduct can often be traced to the abnormal de- 
velopment or perverted expression of some of these 
tendencies or to conflicts between two or more 
instinctive tendencies or emotional cravings. It 
must be remembered that these tendencies do not 
function separately, but rather in antagonism to 
or reinforcement of one another. It is obvious 
that in situations of a nature to rouse both fear 
and anger one mode of response must be sup- 
pressed in favor of the other. It is impossible to 
flee and to fight at the same time. Fear is also in- 
hibitory to sexual expressions to a marked degree. 
Again, in civil wars, the fighting activity triumphs 
over gregariousness. To cite an example more inti- 
mately related to our general theme, the abnormal 
will to power which makes a parent cruel to a child 
is wholly incompatible with the parental instincts 
and emotions which we would expect to govern 
such a relationship. 
On the other hand, many of the complex 
activities of man are the result of the synchronous 
operation of two or more of these instinctive and PITFALLS OF OUR MINDS 
23 
emotional tendencies. If we analyze such an activ- 
ity as homebuilding we shall find an interaction of 
the mating and parental instincts plus fear (in the 
desire for shelter and protection against the hostile 
forces of the environment) and manipulative activ- 
ities. In that ordinary social activity the dance, 
there is opportunity for the exercise of play and 
gregariousness and of sublimated sexual impulses. 
In war, the instincts and emotions of the herd hold 
sway, together with fear and anger in an ambiv- 
alent relationship in which first one and then the 
other finds expression in overt action. The fear 
of group destruction is a powerful incentive in 
rousing the instinct to fight. A more remote motive 
in war is that of food-getting in its economic as- 
pects. Economists and sociologists have repeatedly 
stated that scarcity of food supply is one of the 
causes of war. To turn again to an illustration 
nearer our general subject, stealing may be 
prompted in the case of a girl both by the desire 
to possess beautiful clothing wherewith to attract 
men and satisfy the erotic impulses and by the 
desire to be as well dressed as her companions, 
since to be different from them is not in harmony 
with the gregarious nature. 
The study of the emotional and instinctive 
reactions of the individual is not an easy matter 
for other reasons than those already considered. 
Many of these motives are unconscious, and may 
appear in behavior only in a disguised form. We 
have already given incidental examples of this. 
The feeling of inferiority and compensatory will 24 
ABNORMAL BEHAVIOR 
to power to which we have referred previously is 
an exceptionally clear illustration. This mechan- 
ism is built up in the early character formation and 
personality development and is not at all a con- 
scious motive in the life of the individual. 
Perhaps a certain boy is of delicate physique 
and is unable to master his companions on the 
playground. This breeds a feeling of inferiority 
toward them and a longing to surpass them. Now 
if this same boy happens to possess a keen intel- 
ligence which makes it easy for him to outshine 
these same schoolmates in the classroom, he is go- 
ing to find a satisfaction in achievement along the 
lines of scholarship out of all proportion to normal 
boyish ambition. Indeed, these emotional reac- 
tions may continue into adult life and furnish an 
incentive for the choice of some intellectual pro- 
fession as a life work. Undoubtedly he will never 
recognize this as one of the motives determining 
his selection of a vocation (unless it is sometime 
explained to him) but will be sure his reasons were 
such entirely commendable ones as scientific curi- 
osity or capacity to render service. 
Another illustration of the unconscious oper- 
ation of instinctive and emotional motives is found 
in the cases of war neuroses already mentioned in 
another connection. In many of these the primi- 
tive fear of death masqueraded as “ shell shock.” 
The sufferers were quite sincere in their protes- 
tations of illness and incapacity. There had been 
a “ conversion downwards ” of the emotional block- 
ing into physical symptoms, and the resulting PITFALLS OF OUR MINDS 
25 
paralyses, loss of speech, etc., which seemed en- 
tirely irrelevant to the emotional life, were in 
reality an expression of its deepest trends. 
The substitution of language expression for 
overt action when this is deliberately inhibited or 
impossible offers a wide variety of guises for the 
instinctive and emotional impulses which are thus 
turned aside from their original motor outlets. 
The young woman bereft of her sweetheart was 
actuated by other than artistic interest and literary 
skill when she wrote: 
“ You are not very far from me, 
Though mile on mile may stretch between; 
Across the lands that intervene 
I joy in your dear company. 
11 The red line of the sunset sky, 
The moonlight on the crannied tower, 
The piercing of the silent hour 
Suddenly, by a night-bird’s cry, 
“ Eternally with me abide, 
In changing beauty; and their fire 
Thrills through me with the old desire, 
Feeling your presence at my side.” 
This was fortunately not written in the idea of 
producing poetry of literary merit. It was simply 
an expression for pent-up emotions which could no 
longer find an outlet in lover’s caresses and kisses. 
It furnishes an excellent example of the scope 
which language expression offers to the affective 26 
ABNORMAL BEHAVIOR 
life. The modern politician who attacks his oppo- 
nent through the press is also an excellent illustra- 
tion of this, as he converts his pugnacious impulses 
into language form. 
The unconscious nature of the instinctive and 
emotional impulses and their appearance in dis- 
guised activities, is dependent on the mechanisms 
of repression and sublimation. These mechanisms 
have been referred to frequently, and by context 
their meaning should have become fairly clear. 
They are not merely convenient terms utilized by 
the pschoanalysts; they are actual functions ap- 
parent in the patterns of human behavior. 
Repression of an instinctive and emotional im- 
pulse occurs when it is antagonistic to the demands 
of society. The innate gregariousness of the indi- 
vidual impels him to conform to group standards 
and to inhibit activities which are not in harmony 
with these. When to the inhibition of the overt 
expression of an impulse is added a refusal to rec- 
ognize its existence it is repressed or barred out of 
the field of consciousness. Relegation to the un- 
conscious is usually accorded to those impulses 
which in the light of our social heritage have come 
to have an immoral or unethical connotation. For 
example, a conscientious husband would repress an 
interest in some other woman than his wife because 
society expects monogamy and censures any other 
relationship. Similarly, the good soldier would 
never admit even to himself that he felt any fear 
as he faced the enemy, because the group has only 
contempt for the coward. PITFALLS OF OUR MINDS 
27 
Repression may also take place when a situation 
arises in which reality is too painful to be accepted 
by the personality. When it becomes impossible 
to satisfy intense emotional cravings because of 
environmental deprivation the feeling-tone thus 
created is often so unpleasant that the individual 
seeks to be rid of it by banishing his desires from 
the field of consciousness and forgetting their ex- 
istence. Thus the young man who finds his sweet- 
heart unresponsive may succeed in convincing him- 
self that he does not love her anyway. 
The mechanism of sublimation depends on what 
Watson describes as the capacity for diffusion 
which is one of the qualities of emotional activities. 
There is apparently a natural tendency for the 
emotional energy of the organism to diffuse into 
other channels when the natural original motor 
outlet is blocked for any reason. The conversion 
of this suppressed energy into vicarious activi- 
ties is known as the process of sublimation in psy- 
choanalytic terminology. We have already given 
many incidental examples of this mechanism. To 
add another we might continue our account of the 
young man described in the preceding paragraph, 
who turns the repressed affective energy away 
from his erstwhile sweetheart into channels of 
work, and redoubles his endeavors along vocational 
lines. Working hard and fast is a common and 
fairly effective way of utilizing the energy roused 
by the love object, and is recognized as a fairly 
successful method of recovering from an unfortu- 
nate love affair. This recovery is evidently ac- 28 
ABNORMAL BEHAVIOR 
complished by the processes of repression and 
sublimation. 
In addition to the many sublimated outlets for 
repressed desires, the unconscious impulses of the 
instinctive and emotional life find a means of ex- 
pression in dreams. In the dream the individual 
realizes the longings which are denied fulfilment 
in his waking hours. This is most easily seen in the 
case of a small child who is refused a baseball out- 
fit with which he might satisfy his play instincts. 
At night he dreams of playing ball with a bat, mit, 
and suit which are facsimiles of those which he 
coveted in the shop window. 
Many dreams, particularly of adults, are not 
such direct and simple expressions of the uncon- 
scious desires of the personality, although they are 
very often wish fulfilments along this line. Just as 
certain impulses which are open to social censure 
are repressed from the waking thoughts, so they 
are also refused admission to consciousness even 
in the dream life, except when they make their ap- 
pearance in disguised forms. The disguises em- 
ployed by the unconscious wishes of the affective 
nature in order to find expression in dreams are 
ingenious and elaborate. Very often all the figures 
and activities involved in a whole dream or series 
of dreams are simply symbolic of the unconscious 
longings of the instinctive and emotional life which 
have been sternly repressed from consciousness. 
Through the study of the dream life and the in- 
terpretation of its symbols we arrive at a knowl- 
edge of the unconscious motives underlying PITFALLS OF OUR MINDS 
29 
behavior. This is one of the essentials of the psy- 
choanalytic method, and is often of much assist- 
ance in discovering the causes of abnormal con- 
duct in cases which have previously remained 
enigmatic. In spite of the importance which it 
thus assumes, the psychology of dreams and their 
symbolisms is far too involved to receive presenta- 
tion within the scope of this chapter. The inter- 
ested reader should study it from the original 
sources in the works of Freud and Maeder, where 
it has received masterly treatment. For the 
present purpose, we must content ourselves with 
the statement that the dream reflects in symbolic 
form the hopes and fears which play a dominant 
part in the unconscious affective life of the indi- 
vidual, and which become the underlying motives 
of behavior which would otherwise appear obscure. 
SUPPLEMENTARY READINGS 
Adler, Alfred. The Neurotic Constitution. Moffat, 
Yard, N. Y., 1917. An account of the feeling of infe- 
riority and its compensatory will to power will be found 
in Chapters I and II. 
Brill, A. A. Fundamental Conceptions of Psychoanalysis. 
Harcourt, Brace, N. Y., 1921. Chapter III, The Psy- 
chology of Forgetting, describes the repression of un- 
pleasant thoughts and feelings into the unconscious. 
Freud, Sigmund. Introductory Lectures on Psychoanal- 
ysis. Allen and Unwin. London, 1922. Lecture XX, 
The Sexual Life of Man, contains same material on in- 
fantile sexuality and sex perversions. Read also Lec- 
tures V to XV inclusive, which present Freud’s interpreta- 
tion of dream psychology. Incidental material on re- 
pression and sublimation will be found in this book. 
Maeder, Alphonse. The Dream Problem. Jour. Nerv. 30 
ABNORMAL BEHAVIOR 
and Ment. Disease Pub. Co., N. Y., 1916. This presents 
the psychology of dreams according to Jung and the 
Zurich School of Psychoanalysis. It is the most im- 
portant monograph on this subject and should be read 
in its entirety. 
McDougal, Wm. An Introduction to Social Psychology. 
Methuen, London, 1920. An elaborate treatise on the 
instincts and emotions which should be read in its en- 
tirety. It shows how complex feelings are built up on 
the basis of the primary tendencies. 
Robinson, E. S. The Compensatory Function of Make- 
Believe Play. Pedagogical Review, Vol. 27, No. 6, Nov., 
1920. An interesting presentation of this subject, with 
much originality. 
Thorndike, E. L. Educational Psychology, Vol. I, The 
Original Nature of Man, Teachers College Publication, 
N. Y., 1913. Chapters VI, VII and X contain an 
account of the native instinctive tendencies. 
Watson, J. B. Psychology from The Standpoint of a 
Behaviorist. Lippincott. Philadelphia and London, 
1919. Chapters VI and VII deal with the instincts and 
emotions, giving an account of the way in which the 
original responses are elaborated and modified. 
Watson, J. B. and R, R. Studies in Infant Psychology. 
Scientific Monthly, Dec., 1921. An important resume 
of experimental data on infant psychology from the 
Johns Hopkins Laboratory. 
Woodworth, R. S. Psychology, A Study of the Mental 
Life. Holt, N. Y., 1921. Chapter VIII treats of in- 
stinctive activities. Chapters VI and VII also contain 
valuable material on the instincts and emotions. Chapter II 
EMOTIONAL CONFLICTS IN THE CAUSA- 
TION OF CONDUCT DISORDERS 
Instinctive and emotional cravings a frequent source of 
misconduct. 
Sex perversions as a cause of anti-social behavior; typical 
case. 
Indirect connection of the sex instincts with pathological 
lying and stealing. 
Case of a woman who stole in order to retain her lover’s 
affection. 
A case in which fear proved to be the motive underlying 
crime. 
The feeling of inferiority as a cause of anti-social conduct; 
the western desperado. 
Dissatisfaction with the self for having failed to live up 
to social ideas as a basis for erratic behavior, and a 
case illustrating this principle. 
Cases which show the origin of conduct disorders in the 
family situation and conflicts caused thereby. 
Adolescent conflicts as a source of malbehavior; the ado- 
lescent longing for independence. 
The case of Mary Brown as an example of diverse forms 
of behavior produced by the same emotional conflicts. 
Mary’s development of sex perversions. 
Mary’s use of drugs as a relief from emotional conflict. 
A language expression of Mary’s emotions. 
The outcome in Mary’s case. 
Necessity of furnishing substitute outlets to replace delin- 
quent conduct. 
IN trying to analyze the causes of abnormal 
and anti-social behavior, we shall find that 
there are innumerable ways in which the emo- 
3i 32 
ABNORMAL BEHAVIOR 
tional and instinctive cravings of the individual, 
when not satisfied in the natural biological fashion, 
can operate to produce various conduct disorders. 
Freudian psychology has shown that the dynamic 
force back of human activity is the search for grat- 
ification of the primordial desires of the organism, 
and that in one way or another a certain amount 
of satisfaction for these fundamental longings 
must be obtained. Modern social organization 
makes it impossible for the innate instinctive and 
emotional tendencies to find their original expres- 
sion in such ways as fighting, running away, or 
entering into sexual relationships with every one 
who arouses erotic feelings. The ideals of the 
group demand that the individual restrain the im- 
pulse to strike the person who arouses him to mo- 
mentary anger; they require that fear be sup- 
pressed, and courage and fortitude be shown under 
difficulties; they insist upon definite limitations of 
sex activity. 
In making these demands upon the individual, 
the group is insuring its own survival and welfare. 
In war, for example, the individual overcomes 
the greatest fear of all, the dread of destruction, 
and willingly lays down his life for the community. 
The social standards are not entirely disadvan- 
tageous to the individual, however, for they make 
it possible for men to live together in a harmonious 
fashion which would be impossible were each mem- 
ber of the group to disregard the rights and priv- 
ileges of his fellow-members and consider only his 
own feelings and desires. In the final analysis, PITFALLS OF OUR MINDS 
33 
therefore, the sacrifices of the individual are 
prompted by his own gregariousness, which makes 
him want to be with and be approved by his fel- 
lows. From this point of view, we can only see in 
the repression of individualistic tendencies the in- 
teraction of antagonistic motives innate within the 
personality, in which sometimes one motive and 
sometimes another passes over into overt action. 
What usually happens in the case of these con- 
flicting emotions, is that the socially disapproved 
mode of behavior is repressed in the form in which 
it would meet with censure, but finds some 
substitute outlet or “ sublimation.” Sometimes 
these vicarious expressions are themselves anti- 
social. There are numerous studies which show 
how the repressed sex desires find some gratifica- 
tion in erotic fantasies and daydreams, in love 
poems and love songs, in psychoneurotic symp- 
toms, or in actual biological perversions of the in- 
stinct. It is in the last mentioned, of course, that 
they fall within the classification of conduct dis- 
orders, and as such need some further description. 
Case i 
We might cite in this connection the case of a man 
who had been widowed, had not remarried, and had 
failed to find an adequate normal outlet for his sexual 
cravings. He lacked sufficient intelligence to find a 
socially adapted sublimated outlet of his sex energy. 
(The psychometric examination showed that he was 
below average intelligence.1) He was not of the im- 
1 The measurement of the intellectual capacities and 
their relation to conduct disorders will be described in 34 
ABNORMAL BEHAVIOR 
aginative type which can find satisfaction in erotic fan- 
tasies and daydreams, nor was he sufficiently neurotic 
to develop a psychoneurosis based on his sex repres- 
sions. Instead, he sought a means of gratification 
of his sex desires in a perverted fashion, by means of 
committing sodomy on various members of his own sex. 
Having once begun to obtain satisfaction in this ab- 
normal fashion, he began to go to all lengths to secure 
it. His favorite method was to induce some boy of io 
or 12 to accompany him to a secluded spot, and 
secure the child’s submission to his perverted practice 
by threats of mutilation. There was one boy who 
finally became his constant partner, being thoroughly 
terrified, and living too near to be able to avoid his 
tyrant. When this boy was about 15 years of age, he 
came into the hands of the Society for Prevention of 
Cruelty to Children, and was sent to a summer camp. 
Soon after the boy was sent away, the Society began 
receiving anonymous letters about him, followed by 
telephone calls from a man who gave his name as 
“ McCarthy,” and whose one inquiry was whether the 
boy had been returned to his home. On being an- 
swered in the negative, the so-called “ McCarthy ” 
would demand that this be done immediately. His re- 
fusal to give an address of his own, and certain 
remarks which he made to the effect that the boy had a 
habit of carrying on degenerate practices, aroused sus- 
picion. The boy was brought back from camp, and 
the story of his victimization by a man whom he knew 
was elicited. The police were put on the trail of the 
man whom the boy accused, and following him to a 
telephone booth found that he was the mysterious 
Chapter III, and the student is referred to that chapter in 
regard to the meaning of the term “ psychometric exami- 
nation.” PITFALLS OF OUR MINDS 
35 
“ McCarthy ” who had manifested such interest in 
the boy’s whereabouts. Investigation of the case 
revealed some evidence pointing to his connection with 
the murder of a boy which had occurred several years 
previously. The body of this child had been found 
mutilated in the same fashion as the so-called “ Mc- 
Carthy ” habitually threatened his victims, and there 
were other circumstances sufficient to warrant sus- 
picion although the evidence was not conclusive. 
“ McCarthy ” was sent from court to Bellevue Hospital 
Psychopathic Ward for observation. He was not defi- 
nitely psychotic; he was simply one of those consti- 
tutionally inferior personalities whose mental dullness 
and emotional peculiarities prevent them from find- 
ing a socially adapted outlet for their activities. 
To the average person, the details of such a case 
as this are shockingly revolting. Yet we must 
know of the existence of these perverted tendencies 
if we are to guard against their development and 
expression. The individual who takes such 
methods of gratification is a menace to the happi- 
ness of others than himself, and it is particularly 
unfortunate that so many perverts practice their 
abnormalities upon children. This is often done 
because the child can be terrified into keeping 
secret what has occurred. With our new under- 
standing of the emotional life, we cannot censure 
these perverts too severely, but on the other hand 
it is essential that their existence be recognized 
and that they be prevented from building up in the 
youth with whom they come in contact habits 
similar to their own. 
The sex instinct is less directly involved in cer- 36 
ABNORMAL BEHAVIOR 
tain other types of misconduct, particularly in 
stealing and pathological lying. Healy has de- 
scribed innumerable cases in which stealing in chil- 
dren was associated with sex behavior. He cites 
cases in which sex curiosity was satisfied by infor- 
mation furnished by some childish companion, who 
at the same time initiated his pupil into lying and 
stealing. Even if the sex conversations or prac- 
tices are broken off with the original friendship, 
the habit of lying and stealing often persists for 
a much longer period, and becomes the occasion of 
much juvenile delinquency. This subject has been 
so amply treated by Dr. Healy in several of his 
books that it is unnecessary to continue its discus- 
sion in detail. The points to be remembered are 
the necessity for seeking for such an explanation 
in cases of juvenile lying and stealing, and for 
eradicating the habits thus formed. Sometimes 
the latter is accomplished by the child’s realization 
of the process of habit-formation which he has 
undergone; sometimes it is only necessary to sat- 
isfy remaining elements of curiosity so that his 
thoughts will no longer revert to the bad compan- 
ion and his influences; sometimes a substitute 
activity can be made to replace the delinquency. 
There can be no prescribed general rule; each case 
involves an individual with a personality and ex- 
perience peculiarly his own, and must be dealt with 
from this point of view. 
Women will often revert to stealing if this is 
demanded of them by the man who is the object 
of their affections. The case of Jane Grey is well PITFALLS OF OUR MINDS 
37 
illustrative of this. A girl of 27 who had been 
working for eight years as a maid, and whose repu- 
tation for virtuous conduct and honesty was ex- 
cellent, she finally fell in love with a man who 
induced her to live with him as his wife, promising 
marriage at a future date. At his instigation, she 
stole from three different families with whom she 
had been employed, only to be rewarded by having 
her lover desert her and marry another woman. 
Jane was a girl of fairly normal intelligence; her 
habits had been good; she was not of a particularly 
unstable make-up. Her conduct was motivated by 
the age-old sex longing of the woman to please the 
man she loved. After his marriage to another girl, 
Jane became remorseful and bitter against him, 
and confessed the whole story. 
The role of sex in the etiology of conduct dis- 
orders has been recognized in its full implications 
by many students in this field. The manner in 
which the individual goaded by fear can be driven 
to abnormal and anti-social behavior has not been 
so well appreciated. The ragged street urchin 
who steals from the vendor’s wagon rather than 
return empty-handed to the cruel parent is a 
familiar figure in the movies, but this conception 
is not so far from real life, after all. The fear 
motive is equally well shown in the following case, 
and could be duplicated in others: 
Case 2 
A young man of 25, of average intelligence, and 
without psychotic traits or evidence of other abnormal 38 
ABNORMAL BEHAVIOR 
make-up is sent to the hospital for mental examination. 
He is charged with forgery, but aside from the fact 
that he has always been rather irresponsible in his 
attitude to his mother and that she found him rather 
difficult to manage, his previous record bears scrutiny 
very well. This sudden breaking into crime in a 
serious fashion after a history of harmonious mar- 
ried life and a clear work record led the court to re- 
quest observation of the patient for some form of 
mental disease, but as stated above he was found to be 
entirely sane. 
At the age of 19 he had contracted syphilis. He 
had received treatment for this but there always re- 
mains a fear lest the cure be not complete in the minds 
of those who have suffered from this disease. More 
recently, the patient had received treatment for an 
intestinal abscess due to gonorrhoea. He had not pos- 
sessed sufficient money to pay for this treatment, and 
had forged a check in order to secure the necessary 
funds for this purpose. When one considers the de- 
gree of dread which venereal infection usually creates 
in the person who has any knowledge of its effects, 
it is not to be wondered at that the patient succumbed 
to his overwhelming anxiety, and allowed himself to 
be persuaded to take the solution which a forged 
check offered. The suggestion, as a matter of fact, 
originated with a fellow employee, who as treasurer 
of the company offered to cover up the matter after 
cashing the check, his only stipulation being that the 
sum should be large enough for him to receive his 
share. It may seem surprising that the patient did 
not seek treatment for his disease at one of the free 
clinics, but when one recollects that those who are 
suffering from venereal infection are usually morbidly 
afraid of being discovered, and that the charity clinic PITFALLS OF OUR MINDS 
39 
is less secretive concerning its records, this, too, be- 
comes clear. 
At the present time we have paid less attention 
to the fear motive than to almost any other in our 
attempt to understand anti-social conduct. We 
shall probably find many forms of this motive op- 
erating to produce delinquency once our attention 
is turned to this possibility. We have already 
learned a great deal along this line, but we have yet 
to understand fully its more complicated aspects, 
such as its operation in connection with the sex 
life, etc., in reference to abnormal behavior. 
Although fear in its open expression has not 
been given full recognition as a factor in the caus- 
ation of anti-social behavior, the feeling of inferi- 
ority (which after all may be conceived to have 
its origin in the fear aroused by a sense of inability 
to cope with one’s fellows and one’s environment), 
and its compensatory will to power has been cred- 
ited with causing misconduct in many cases. A 
striking example was given by Dr. Frankwood 
Williams not long ago,1 and may well be quoted 
here. 
It is the story of a western desperado, who 
had terrorized the country, and whose exploits 
were famous over a broad territory. When finally 
captured, instead of the imposing mass of brawn 
and muscle which the stories of his deeds would 
have led one to expect, there was brought to the 
1 In an address at the National Conference of Social 
Work, June, 1922. 40 
ABNORMAL BEHAVIOR 
jail a puny little man, insignificant in both size 
and bearing. The psychiatrist, by virtue of his 
insight into mental mechanisms, was soon able to 
obtain a light on this strange phenomenon. The 
boyhood history of the desperado was that of the 
undersized boy, who was tormented by his fellows 
until he longed for some method of evidencing his 
superiority. Out of the fear that he might always 
find himself thus at the mercy of others was bred 
the desire to have them at his mercy, in order to 
attain the certainty of his own ability to command 
the situation. And so he chose the career of a 
terrorizing bandit in order to satisfy this irrepres- 
sible desire. 
Another motive underlying certain conduct dis- 
orders, is the dissatisfaction with the self caused 
by the failure to live up to the ideals which are 
woven into the life of the individual by reason of 
his susceptibility to the influence of social tradi- 
tions. At bottom, of course, this implies that some 
other motive has been satisfied at the expense of 
the gregarious tendency which is an innate part of 
the personality. The relation of this dissatisfac- 
tion, which is productive of restlessness and erratic 
behavior, to actual misdemeanors is shown in the 
following case: 
Case 3 
A young man of 21 was brought to the hospital by 
his father, who complained that his son had undergone 
such a noticeable change in the past few years that he 
felt convinced he was suffering from some mental de- PITFALLS OF OUR MINDS 
41 
rangement. The boy had been in college in Montreal, 
when an adventurous impulse led him to join the army 
at the age of 17. He soon found that the army life was 
one of hardship and restrictions rather than romance, 
and his disobedience of rules, etc., soon led to his re- 
ceiving a dishonorable discharge on account of his bad 
record. Later, when the war came about, and the boy 
desired to enlist in the service of his country, he found 
his patriotic spirit of no avail in the face of that old dis- 
honorable discharge. Thenceforward dated his actual 
misconduct. He began to go out late nights, and when 
his father commanded that he be in by midnight, he 
simply left home altogether. He then found difficulty 
in supporting himself, and returned home to steal 
things which he pawned, thinking to return them when 
he should find a job. He finally did get work as a 
chauffer, for a time, but was located by his family, 
who coaxed him to enter the hospital for observation. 
This boy was of average intelligence, and had 
good insight into his personality make-up. He 
frankly admitted that he had been spoiled by his 
parents, and that he had been unable to remain 
self-supporting as he had planned. The real 
source of his trouble was revealed by contrasting 
the truth concerning his army experience with his 
own story of this part of his career. At one time 
he would tell extravagant tales of having been 
overseas. He finally admitted that he had been in 
the army but did not get across, but he shrank 
from the voluntary confession of his discharge, 
and his whole attitude toward the situation showed 
that his feeling of having failed to do the thing 
which group emotion demanded was the biggest 42 
ABNORMAL BEHAVIOR 
part of his difficulties. That this should be the 
case is not strange when we recall how great a 
pressure was exerted by the group to instil a 
powerful feeling of patriotism into its members. 
Perhaps the most frequent source of emotional 
disturbances leading to conduct disorders is found 
in the relationship of the individual to the parents 
and other members of his family. We find case 
after case in which antagonism to the father or 
mother, the brother or sister, lies at the root of 
anti-social behavior. 
Case 4 
Take the case of Tommy B, a boy of n years, who 
was brought to the hospital for observation with a 
record of stealing, retardation in school, truancy, and 
uncontrollable episodes of excitement when he would 
jump up and down and scream wildly. It must be 
stated at the outset that Tommy was a neurotic child, 
and hence more susceptible to emotional conflicts than 
an individual with a better balanced nervous system. 
Tom’s troubles began in an antagonism between him- 
self and his older sister. He tells a rambling story of 
their relations as follows: “ My oldest sister is awful 
mean. She is mean to my other sister and she is mean 
to me. She took my other sister’s fellow away from 
her and went out with him herself. When she got a 
box of candy from anyone the big fat slob ate it all 
herself. She wouldn’t give me the little tiniest piece. 
She hated me and said she wished I would get runned 
over and I did. I never would have been runned over 
if she hadn’t wished it on me.” PITFALLS OF OUR MINDS 
43 
The being “ runned over ” to which Tommy re- 
ferred occurred when he was struck by an auto at 
the age of 8, causing a hernia. With a childish in- 
terpretation of cause and effect similar to that of 
primitive peoples, who attribute the cause of any 
phenomenon to anything which becomes associated 
with it and work out systems of magic and religious 
superstitions on these false premises, Tommy 
ascribed his accident to the wish of his sister. 
This mental process of his was not much different 
from the savage’s fear of the “ death-wish ” and 
his belief in its efficacy when pronounced upon him. 
“ My sister said she wished I’d break my neck,” 
Tommy’s story continued, “ and right after that I had 
a fall. I hate her. She was always being mean to 
me.” 
Whether or not he believed implicitly in his sister’s 
wishes being the real cause of his troubles, there is no 
doubt of the fact that he returned her dislike with in- 
terest, and began plotting ways and means of “ getting 
even ” with her. He began to “ hook ” money from 
her, and taught his other brothers and sisters to help 
him. Besides taking money and candy, he attempted 
to steal a liberty bond from her. Gradually he began 
to extend his depredations from the property of his 
sister to stealing from other people. He began to play 
truant from school and to take things from the push 
carts and street stands. Along with this development 
of the situation, went a tendency to be troublesome in 
school. His teachers found that the only method of 
control was petting him and showing him affection; 
harshness only aggravated his naughtiness. This, of 
course, is also attributable to his antagonism to his 44 
ABNORMAL BEHAVIOR 
sister, which was transferred to his teacher when her. 
behavior became such as to remind him of his sister’s 
attitude. 
These minor delinquencies of Tommy’s finally got 
him into court, whence he was sent to a clinic for ob- 
servation. The psychiatrist in charge of this clinic 
attempted to use fear as a form of therapy, and threat- 
ened Tommy with being beheaded if he did not take 
the medicine given him and behave himself properly 
in general. To this fear motive Tommy reacted in 
as over-exaggerated a manner as he had to his sister. 
He now refused to go to school, was afraid of other 
boys and would not play with them; he became ob- 
sessed with the idea that a fat man from whom he had 
once stolen was after him, and the sight of a fat man 
was sufficient to bring on an attack of weeping and 
excitement. In this condition, he was brought to the 
hospital for observation and treatment. 
At the hospital, his conduct approximated its usual 
type as far as the circumscribed environment of the 
ward would permit. Tommy would steal candy from 
the other children, and if harsh discipline seemed to 
threaten, would become excited, stubborn, and un- 
manageable. He refused to talk with the male physi- 
cians, because they frightened him “ with their deep 
voices,” as he expressed it to the psychologist, who 
was a woman and who became his confidante, because 
he did not fear her and because her attitude never 
became such as to remind him of his sister and rouse 
the antagonism connected with her. It is not to be 
supposed, however, that the full understanding of 
Tommy’s emotional reactions was easy to acquire. 
The boy, although not mentally defective, was below 
average intelligence and in the beginning showed little 
insight into his condition or little realization of its PITFALLS OF OUR MINDS 
45 
origin. The real story came out by means of dream 
analysis, which proved to be an easy matter in his 
case, as his dreams were still at times on the childish 
level of simple and direct wish-fulfilments without any 
of the distortion and symbolism which requires an 
involved analysis. 
One of Tommy’s dreams ran as follows: He 
dreamed that he was watching a submarine full of 
people among whom he distinguished his sister. As 
it came up out of the water, he fired at it, “ bang! ” 
and it sank with all its occupants including his sister. 
When asked if he felt frightened or sorry, he said that 
on the contrary he was glad. Then he went on to 
explain that he hated his sister, anyway, and finally 
gave the complete story as recounted above. 
The family situation and its role in the life of the 
individual is often revealed in some such indirect 
way as this. It is seldom recognized by the indi- 
vidual as the direct origin of his difficulties, 
although he usually includes at some point in his 
story as he recounts his life history a tale of dis- 
like and disharmony within the family circle. This 
is often casually mentioned, although sometimes 
the person will voluntarily make the statement 
that the father or mother or someone else in the 
family is to be blamed for his behavior. More 
often this has to be ascertained by asking the 
patient about his relations with various members 
of his family, or by searching his dreams for a clue 
to his misconduct, etc. 
The lack of sufficient parental affection is often 
the starting point for anti-social behavior. The 46 
ABNORMAL BEHAVIOR 
girl who receives little understanding and love in 
the home is apt to seek for it elsewhere, with grave 
consequences. Annie B’s history well illustrates 
this statement: 
Case 5 
At the age of 12 she was the household drudge. Her 
mother got her up at 5 o’clock in the morning to do 
the work. Whenever the mother went anywhere, 
Annie was left at home to mind the baby, while her 
sister, who was about Annie’s age, but was a sickly 
child, was taken with the mother. As Annie grew up 
conditions did not improve for her. She was always 
obliged to work, and was never permitted to bring her 
playmates and friends to her home. When she was 
only 16 she ran away from home with a man named 
Jack, with whom she lived for a time, until rescued 
by the Neighborhood Association. The 
word “ rescued ” is used advisedly in this connection, 
for Jack had been trying to coerce the girl into becom- 
ing an inmate of a disorderly house, promising her 
$50 a week if she would consent to this arrangement. 
She was taken away from this man and brought to 
court, from whence she was consigned to the care of 
the Protestant Big Sisters. 
Annie’s experience with Jack had developed bad 
habits in her, so that she was not found to be an easy 
charge. She constantly picked up men on the street, 
a habit which does not seem peculiar in view of the 
fact that she had never been permitted to bring friends 
to her home and must always have made her friends 
in this fashion or at least have met them away from 
the house. Finally she went to live with a man named 
Fred S. with whom she had become acquainted in this PITFALLS OF OUR MINDS 
47 
fashion. When she was about to have a child by this 
man, she presented herself at the S Hospital, 
claiming that she was married but that her husband 
had deserted her. When the baby was a little more 
than a week old, it was found dead in the hospital 
nursery under circumstances which roused suspicions 
concerning its death. Annie could not be induced to 
admit any guilt in the matter, however. A year later, 
she returned to the same hospital once more about to 
give birth to a child. After the birth of this second 
baby, she began to act rather queerly, and in view of 
her previous history on the ward, it was thought best 
to transfer her to the psychopathic service of Bellevue 
Hospital for observation. 
At Bellevue, Annie laid no claim to being married, 
but said that this was her second illegitimate child. 
She explained that she had planned to marry its father, 
but that he was “ no good ” and she had decided not 
to do so. Her story ran that even while she was preg- 
nant, he would do no work, but depended upon her 
efforts to support both him and herself. Her conduct 
on the ward was entirely normal. She had a friendly 
attitude toward the other patients, and manifested 
proper maternal solicitude for her child. She showed 
no symptoms of mental disease or mental defect, al- 
though her intelligence according to the rating of the 
psychometric examination was somewhat below aver- 
age. To all appearances her search for an object for 
her affection had finally resolved itself into love for her 
child. She was therefore discharged into the care of 
a social service worker whose task it was to find work 
for her in order that she might support herself and 
her baby. Up to date, no further difficulties have 
been reported. 48 
ABNORMAL BEHAVIOR 
There are more unwanted children in the world 
than we suppose. In hospital clinics we realize 
this keenly when parents bring children who are 
fairly intelligent in the hope of getting them ad- 
judged feeble-minded and sent to an institution 
for mental defectives. Sometimes the child in 
question has sufficient insight into the situation to 
realize that its parents are anxious to dispose of 
it. Then it becomes so terrified that its condition 
may closely simulate mental deficiency or some 
type of mental disorder for the time being. 
Case 6 
One day a girl named Fannie D. was brought to the 
mental clinic by a cousin who claimed she was men- 
tally deficient and requested commitment papers to 
an institution for the feeble-minded. Fannie did not 
appear stupid; she would not talk to the doctors, but 
only begged to be taken back home to her mother. 
Her school record did not harmonize with this extreme 
stupidity, so that mental disorder was suspected rather 
than simple mental defect, and the cousin was asked 
to leave Fannie at the hospital until her cooperation 
could be secured for psychiatric and psychometric 
examinations. 
On the ward, Fannie showed some symptoms char- 
acteristic of the mental disease known as dementia 
praecox. She sat by herself, did not mingle with the 
other patients, and her one response to all remarks 
addressed to her was a mumbled “ I want my 
mother.” It was a long time before she could be in- 
duced to cooperate on the psychological examination. 
One day, however, a new approach was made to ob- PITFALLS OF OUR MINDS 
49 
tain her cooperation by explaining to her that the 
quickest way to get home was to do her best on this 
test. After this was repeatedly told her, Fannie finally 
consented to go into the examining room, and pulled 
herself together sufficiently to answer certain parts of 
the psychometric examination in a way that would 
have been supposedly impossible from the impression 
given by her conduct on the ward. She was assured 
that the rating on this examination, although not ex- 
ceedingly high, was good enough to preclude the pos- 
sibility of her being sent to an institution for mental 
defectives. Upon receiving this information, Fannie 
became more animated, and was finally induced little 
by little to admit that she had refused to talk to any- 
one because she was afraid that anything she might 
say would be used against her to prove that she was 
either “ crazy or foolish.” Her mother was sent for, 
and Fannie was sent home with her with orders to re- 
port back to the clinic occasionally in order that the 
home situation might be kept under supervision for a 
time. As she came back to the clinic, she gradually 
lost her furtive expression, and became cooperative and 
trustful with the doctors. Her whole difficulty had 
been simply the reaction to the excessive terror of 
finding herself unwanted at home. 
While in Fannie’s case the feeling of being a 
burden to her people and the realization that they 
wanted to get rid of her produced a state of mind 
in which fear paralyzed her mental functions and 
made her temporarily appear to be defective or 
mentally deranged, in most cases it results in some 
form of misconduct. Take the following case of 
a boy whose step-father drove him away from 
home. 50 
ABNORMAL BEHAVIOR 
Case 7 
This boy’s childhood had been normal enough, but 
with his mother’s second marriage he became sensi- 
tive, antagonistic to correction, and frequently quar- 
relled with his step-father, until the latter finally drove 
him away, as has been stated. Then he drifted into 
bad company, and having nothing to hold him to his 
ideals now that his father was dead and his mother 
apparently had ceased to care for him, he drifted from 
bad to worse rapidly. At the age of 18 he was arrested 
for grand larceny, his whole record having been one of 
increasing delinquency. As the boy himself expressed 
it, after leaving home he did not care what he did or 
what became of him. He admitted that he did not 
have to steal, as his parents were willing to pay his 
expenses at a boarding home. But what he had wanted 
was affection rather than economic protection. Even 
now, after having spent four years at a reformatory, 
and with a prison sentence to be anticipated for his 
last charge of larceny, since he could not be excused 
on the ground of mental disease or mental defect, his 
attitude was one of recklessness. “ Let them send me 
to jail, I don’t care,” he reiterated. The loss of 
his mother’s love had touched him so deeply that these 
later misfortunes had little power to move him. 
At no time of life are emotional conflicts more 
apt to be present than during the period of ado- 
lescence, which involves as many psychological as 
physiological changes. If we contrast the life of 
the child with that of the adult we shall have a 
clear conception of the necessity of transferring the 
instinctive and emotional cravings from the in- PITFALLS OF OUR MINDS 
51 
fantile to the adult level. In infancy, the wants 
of the child are satisfied not by any adequate 
effort on his own part, but by the administrations 
of an attentive mother (or nurse). The feeblest 
cry is sufficient to bring this devoted slave to his 
side. As the child grows older, more and more 
effort is necessary for the satisfaction of his needs. 
In time he finds that the act of crying is not so 
effectual as it originally proved to be, and that 
other movements are necessary to secure the de- 
sired ends. But the gradual change from a par- 
asitic mode of existence to one of increasing in- 
dependence is not made without reluctance. In- 
deed, it is not until the time of adolescence that the 
child begins to actually desire to meet situations 
upon his own responsibility and wishes to escape 
from the parental guidance and protection. 
At adolescence, unless there is a pathological 
refusal to make the transition to adulthood and 
abnormal clinging to the parental shelter, comes 
a strong desire to throw off the rulings of the par- 
ents, to try things for one’s self, to make one’s own 
decisions. The popular interpretation of these 
longings is that the boy or girl wants to appear 
“ grown-up.” In following out this motive the 
youthful lack of experience may cause some wrong 
decisions. Therefore the position of the parent 
becomes one of confidante and adviser. This re- 
quires much tact and the suppression of the natural 
longing of the father and mother to use their au- 
thority when they perceive that their advice is not 
to be taken. When the parents unwisely attempt 52 
ABNORMAL BEHAVIOR 
to subdue the budding independence of their ado- 
lescent sons and daughters, misconduct is apt to 
result. 
A dramatic example of a daughter’s rebellion 
against maternal authority and her attempt to 
achieve a freer life is given by Judge Hoyt in his 
book “ Quicksands of Youth.” It is the story of 
a quarrel between Helen Burns and her mother 
over the style of hair-dressing suitable for a young 
girl in her teens. 
Case 8 
While in school, Helen had been content to arrange 
her hair in the prescribed fashion, but when she went 
to work and the other girls taught her a new and rav- 
ishing coiffure like their own, she could no longer 
endure the plain style which met with her mother’s 
approval. Helen’s mother called her a hussy when 
she appeared with her hair done in the prevailing 
mode, and ordered her to put it back the way she had 
always worn it. Helen refused, and her mother de- 
delivered the ultimatum that she could either do her 
hair in a respectable fashion or clear out for good. 
Helen chose the latter alternative. She had saved $2 5, 
and with this in her purse she started out to have a 
fling at life. 
After work, Helen persuaded one of the girls to 
help her “ do up ” her hair in the desired way, and 
then she proceeded to a well known hotel in New 
York, where she engaged a room, explaining that 
she was a motion picture actress. At first the clerk 
was suspicious of a fifteen-year-old girl who appeared 
unaccompanied, but Helen glibly explained that her 
mother would arrive in a day or two, and offered to PITFALLS OF OUR MINDS 
53 
pay in advance. She spent an incredible day and 
night in the hotel, then she realized that her money 
was gone and her game was up. She sat in the lobby 
at evening, wondering what she should do next, when 
a man came up to her and invited her to go to a show 
with him. At the theatre Helen became frightened 
by the attitude of her escort, and sought the protec- 
tion of a policeman who referred her to the Society 
for the Prevention of Cruelty to Children. Next morn- 
ing Helen and her mother met at the children’s court, 
where Judge Hoyt attempted to reconcile them. This 
time it was Helen who delivered the ultimatum in the 
following letter to the Judge: 
“ Dear Judge: 
“ I want to be a good girl and I am willing to 
go home to my mother. But I want you to tell 
her that I can go out to dances and shows once in 
a while, and that I can go around with my friends 
more. 
“ Yours truly, 
“ Helen Burns. 
“ P.S. — I think one dance every week will be 
enough.” 
Case 9 
Jennie E. was another girl who did not have ideas 
similar to those of her mother and father. Jennie was 
ambitious; the poverty of her home was a trial to her; 
she was eager to train herself in some vocation which 
would tend to raise her in the social scale. She was 
almost 16 when her case came to our attention. She 
had quarreled with her father because he wanted her 
to go to work, while she was determined to go to 
business school. Jennie was an intelligent girl, and 54 
ABNORMAL BEHAVIOR 
quite capable of acquiring the training she desired. 
Her temper was rather violent, however, and the con- 
stant opposition of her parents did not improve it. 
In one of their arguments, she finally attacked her 
mother with the broom. As a result of this, she was 
taken to the children’s society by her parents, who 
charged her with ungovernable temper and attempted 
assault. She was sent to the hospital for psychiatric 
observation where she was found to be neither defec- 
tive nor suffering from mental disease. The source 
of her difficulties was simply the usual conflict between 
the wishes of the parents and the child. 
The adolescent desire for independence can 
carry the boy or girl to almost any lengths. 
Case 10 
Jimmy L. was a boy whose father had died when he 
was very small, after which his mother transferred all 
her affection to his small person, and never let him 
out of her sight night or day. This was all very well 
until Jimmy began to feel that it was time for him 
to have some of the privileges due to his age. At the 
beginning of adolescence he changed from a loving, 
tractable son, into a stubborn and wilful creature who 
opposed everything his mother suggested. When he 
was 14, and had finished the eighth grade, he asserted 
his independence by refusing to return to school, nor 
could he be persuaded to do so. When his mother 
attempted to control him he would display violent 
temper, strike her, break the furniture, etc. Still his 
mother insisted on keeping him with her, never letting 
him go anywhere alone. One day when they were 
out together Jimmy stole $5 from the pocket of an PITFALLS OF OUR MINDS 
55 
overcoat and slipped away from his mother, to spend 
a glorious, unchaperoned afternoon at Coney Island. 
When he returned, a tearful mother could not under- 
stand why he should do such a thing. “ If he had only 
asked for the money, I would gladly have given it to 
him.” But she also admitted that she would not have 
permitted him to go alone, but would have accom- 
panied him herself. 
Jimmy’s favorite reading matter became the stories 
of gunmen and thieves. Theirs was an enchanted 
career to him, for it seemed free from all the 
restraint which he had grown to hate so much. He 
allowed his mother to get him a job, but his dreams 
were of being a crook, where he could be his own boss. 
He stole from his employers, was arrested, and put 
on parole. His period of probation was unsatisfac- 
tory; he began to stay out all night to write letters to 
the newspapers describing himself as a desperate gun- 
man and warning the public to take care. He was 
arrested again and sent to the House of Refuge. He 
was so much of a problem there on account of his 
rebellion against authority, which had long since be- 
come habitual, that he was sent to the hospital for 
observation. 
He was tractable under the mild discipline of the 
ward, because he was trying to make a good im- 
pression. He showed some insight into his difficulties 
when the situation was discussed with him, and as his 
story was gradually elicited and the conflicts he had 
undergone brought home to him, he seemed to appre- 
ciate the significance of his conduct. His mother, 
however, did not grasp the situation so well. She 
never seemed to realize that she had tried to keep 
her son from becoming a man, and had thus driven 
him to assert his independence in unfortunate ways. 56 
ABNORMAL BEHAVIOR 
That the above discussion is inclusive of all 
types of emotional conflicts is not for a moment 
to be supposed. It does give a fair picture of some 
of the different motives operating in conduct dis- 
orders and demonstrates that various methods of 
reaction may be the result of these motives. The 
human organism is a complex one, and the individ- 
ual is swayed now by one motive now by another, 
and seeks satisfaction in first one and then another 
form of activity. In analyzing human behavior, 
whether normal or abnormal, we must always keep 
this in mind, and not overevaluate one motive at 
the expense of another. We must also bear in 
mind the fact that the same motives may act to 
produce various types of behavior, both socially 
adapted and anti-social in nature. We may well 
present a case history in illustration of this point, 
in which the emotional conflict was variously ex- 
pressed in attempts at literary composition, drug- 
taking, sex perversions, and delinquent conduct 
including prostitution and attempted murder.1 
Case 11 
Mary Brown was a colored girl of 23 or 24 who had 
had as pathological a childhood and adolescence as 
could be well imagined, hence her development of ab- 
normal reactions and emotional conflicts need not 
be considered extraordinary. It would have required 
an unusual degree of nervous stability to have under- 
1 This girl was studied during her stay at the N. Y. 
State Reformatory for Women at Bedford. Her subsequent 
career has been followed up. PITFALLS OF OUR MINDS 
57 
gone her experiences and preserve the emotional bal- 
ance. It is not surprising that she had been variously 
diagnosed as a borderline defective of excitable tem- 
perament, an emotionally unstable personality, and 
even suspected of psychopathic tendencies. Only a long 
analysis could have revealed the fundamental motives 
underlying her erratic behavior. 
Mary had never received the parental care and af- 
fection which she in common with every other child 
yearned for and bitterly resented being denied. She 
never knew who her father was, and until the age of 
8 she was separated from her mother, being cared for 
by a maternal aunt. This aunt was not demonstrative 
or affectionate; as Mary herself described her rec- 
ollections of this early childhood period, she was 
dependent for what signs of love she did receive upon 
her pet dog. After her aunt’s death, Mary was re- 
turned to her mother, to whom she looked forward in 
the hope that at last she would be cared for as other 
children were. In this she was doomed to disappoint- 
ment, for her mother was living the life of a prostitute, 
and did not want any such encumbrance to her 
professional activities as was represented in Mary’s 
small person. She bundled Mary off to an orphan 
asylum after a few months, but the child ran away 
and found her way back home. Then she was sent to 
a school for incorrigible children, where she remained 
until the age of 14. 
The years spent at this school increased Mary’s 
sense of loneliness and consciousness of lack of affec- 
tion, and this was reflected in her conduct. Twice she 
became so depressed that she attempted suicide. The 
one bright episode in her stay at the school was her 
affection for the school physician, who to some extent 
became a mother substitute and received the clinging, 58 
ABNORMAL BEHAVIOR 
dependent affection which Mary would normally have 
felt for her mother. It was a sad day in the child’s life 
when this doctor left her position at the school, and 
only the realization that her term of imprisonment had 
almost expired saved Mary from another suicidal at- 
tempt after this loss. The first sublimation of her 
emotional cravings into language expression in versi- 
fication took place when she was bereft of this love 
object. Because this was an important step in the de- 
velopment of her emotional life, this maiden literary 
effort of Mary’s is reproduced in all its imperfection: 
“ Oh, songster, take this message to the woman I 
love for me, 
She is just across the river, and she took my heart 
away. 
Go, tell her how I miss her, how dreary is the' 
day; 
Tell her I can’t do without her longer, the days 
are too dreary. 
“ Her eyes were brown as the squirrel’s fur, 
Her eyes as the chestnut burr. 
She was as sweet as sweet could be, 
And love shone in her eye. 
Go, tell her if she doesn’t come 
I’ll lay me down and die.” 
After five years of absence, during which she had 
changed from a child to an adolescent, with all of the 
adolescent’s sensitiveness to environmental impres- 
sions, Mary returned once more to her mother. Now 
all that she had seen but not understood during her PITFALLS OF OUR MINDS 
59 
previous brief companionship with her mother and her 
friends was borne in upon her consciousness with all 
its implications. She had already seen women with 
blackened eyes and bruised bodies complaining of 
maltreatment by their “ men,” so that she had received 
the childish impression that these masculine creatures 
were to be regarded with fear and terror. She now 
understood the relations between these dominant males 
and the women who were their slaves, furnishing them 
with money gained from the illicit trade in sex. Ab- 
horrence was added to fear in the category of her 
reactions to men, and she fled from them to her 
mother’s women friends. 
She was received into disorderly houses because her 
mother was well known there without herself becoming 
a part of their system for some time, but although she 
did not immediately enter upon a career similar to her 
mother’s she entered upon a new phase of her emo- 
tional life. The adolescent sex awakening was strong 
within her, but her fear and hatred of men, the out- 
growth of her early experiences, prevented her from 
an emotional fixation upon the opposite sex. She fell 
in with a group of sex perverts and learned homosexual 
practices from them. Through this connection she 
entered into the trade in sex, being sent out on the 
street as a decoy for a less attractive woman who was 
her own companion in a perverted relationship. 
This state of affairs did not last long, however, and 
Mary was finally forced into actual prostitution. In 
order to escape from this, she married a man who had 
fallen in love with her, and tried to become a good 
wife to him. Unfortunately, the habit of her perver- 
sions prevented a transference of her affection to her 
husband, and she finally left him to return to a life of 
prostitution again, since in this she could find satis- 60 
ABNORMAL BEHAVIOR 
faction of her distorted love life with others like her- 
self, and could at least reduce her relations with men 
to a business basis without the necessity for simulating 
an affection which she did not feel. 
This period of Mary’s life was one of exceeding 
stress and strain. There was always the fear of arrest 
and the need of constant vigilance to escape this fate. 
Indeed, the girl was twice arrested and placed on pro- 
bation. With the addition of this new anxiety to the 
emotional conflict caused by the nature of her pro- 
fession, which demanded that she submit to the men 
whom she feared and loathed, life became almost un- 
endurable to Mary. When she quarreled with the 
woman who had become her companion in perverse 
practices, it was more than she could face, and Mary 
now sought relief in drugs, since under their influence 
she could escape the realization of the horrible situation 
in which she was entangled. 
Of course, Mary did not recognize the motive of her 
beginning the drug habit as a flight from reality which 
had become too painful to face. She only knew that 
she was getting into a nervous condition in which she 
could not rest, and she had heard the girls say that 
drugs would restore the ability to sleep. But her ex- 
planation as to why the drugs proved satisfactory and 
why she continued their use was that they “ stopped 
her from thinking.” In other words, they meant a tem- 
porary cessation of the mental conflict which was tor- 
turing her waking hours. Thus Mary’s affective life 
was at the bottom of a new type of behavior, just as 
it had previously been the source of literary endeavor 
and of perverted sexuality. 
The next matter of significance in Mary’s emotional 
development was her arrest and sentencing to the state 
reformatory at Bedford. At this institution she was PITFALLS OF OUR MINDS 
61 
cut off from drugs, for the most part, and there was 
little opportunity for the satisfaction of her perverted 
tendencies. At first the emotional energy blocked 
along these lines found expression in a general irritabil- 
ity, and Mary became the leader in “ smashouts ” and 
other rebellions against the institutional regime. Grad- 
ually, however, the old familiar expression of emotional 
cravings through language came into force and Mary 
entered into a phase of steady writing of poetry, drama 
and stories. 
From the viewpoint of literary criticism, we shall 
have to admit that Mary’s efforts were lamentable. 
But from the psychological angle they were exceed- 
ingly interesting, since they were an obvious expression 
of the emotional dissatisfactions of her life and a 
direct fulfilment of her suppressed desires. For in- 
stance, the news of Mary’s mother’s death came to her 
in the institution, and in her writing she immediately 
began to create for herself the picture of a mother 
type which she had always longed for but never found 
in real life. Witness the following poem: 
“ God bless you, dear Mother, my dark life’s sun, 
For of all God’s blessings, you were the greatest 
one, 
Your light of love so tender, so patient, so sweet, 
Will shine ever brightly until we meet. 
“ God bless you, dear Mother, my life’s only light, 
May he give you Heaven’s pleasures, day and 
night, 
Forgotten life’s trials, may all be sunshine, 
God bless you, dear Mother, sweetheart of mine.” 62 
ABNORMAL BEHAVIOR 
The sentiment of this poem, and many similar ones, 
could scarcely have been inspired by the picture of 
Mary’s mother which has been drawn in the foregoing 
pages except for the tendency of human nature to re- 
mold things nearer to the heart’s desire and to tincture 
reality with the lights of the imagination whenever 
possible. The last line is also worthy of note. It is 
more usual for a son to address his mother as “ sweet- 
heart ” than for a daughter to do so. In this connec- 
tion we must remember the peculiar perversions of 
Mary’s love life, which made her assume many mascu- 
line characteristics. Thus the poem represented 
Mary’s longing for motherly love and furnished an 
imaginary fulfilment for this desire which had re- 
mained ungratified by reality, and also held a faint 
implication of the distortions of her erotic nature. 
There were other poems in which this latter factor was 
even more apparent, as in the following, which was 
dedicated to a former woman friend: 
“ Somewhere, my darling, somewhere to-night, 
,4 s the pain in my heart begins to hurt and tear, 
Somewhere, my darling, somewhere as I fight, 
Would you care if you knew, would you care? 
“ Somewhere, my darling, somewhere in this vast 
universe, 
Will our love still be beautiful as on the day' 
’twas given? 
Somewhere when we meet, will our love be a 
curse, 
Or will it be the charm to turn my Hell into 
Heaven? ” PITFALLS OF OUR MINDS 
63 
The last lines of the foregoing verse, in which per- 
verted love is called a curse, express an emotional re- 
action which is apt to accompany any expression of 
the sex life which is not in harmony with social ap- 
proval. The pervert always feels himself a social out- 
cast, and this feeling itself involves emotional conflict 
to no small degree. Now that this conflict could no 
longer be drowned in the haziness of drugs, there was 
born in Mary an ardent desire for social rehabili- 
tation. She developed a dependent attitude toward 
one of the workers at the reformatory, and asked for 
advice concerning her line of conduct when she should 
go out on parole. This mood was also put into poetry, 
of which we cite one example: 
“ I wonder if the bridge of time is strong enough 
for me to cross, 
I wonder if ’twill hold me to pass to the other 
side? 
I wonder if it’s strong enough to help me reach 
the years I lost? 
For the waves test its strength with Life’s rest- 
less, swelling tide. 
• 
“ I wonder if the bridge of time is long enough for 
me? 
I wonder and I wonder till my heart sinks with 
fear. 
I wonder will it stand the waves of life’s tempes- 
tuous sea, 
That are trying hard its frail strength to tear? ” 
When Mary had reached this stage, came the time 
of her parole. Unfortunately, she was not kept under 64 
ABNORMAL BEHAVIOR 
close supervision after leaving the institution and in 
spite of her high resolves of reform, she went back to 
the old life and to drugs. More bitter than ever by 
reason of her failure to live up to her new ideals, she 
speedily got into new difficulties, and was arrested 
for attempted murder and sent to prison, where she 
is confined at the present time. Here she has been 
repeating the history of her reactions at Bedford, go- 
ing through the same stages of writing and making 
new plans for her rehabilitation once she shall be free. 
She has made one advance in that she has devoted the 
time of this last imprisonment to the study of stenog- 
raphy, so that she may possibly find a legitimate means 
of livelihood after her release unless her habitual emo- 
tional instability leads her into fresh misconduct. 
To fully describe and analyze a case as compli- 
cated as Mary’s would require a chapter to itself, 
just as it takes hours of intimate self-revelation to 
learn the emotional conflicts back of her career of 
delinquency. In the limited space which can be 
devoted to her story here it has been impossible to 
touch upon the details of her life or to recount the 
many interesting situations which occurred in the 
course of her analysis. 
It is possible to point out several facts in con- 
nection with the brief history which we have re- 
lated, however. It has already been suggested 
that Mary’s life illustrates to a remarkable degree 
the capacity of emotions to find substitute chan- 
nels of widely divergent types when the original 
expression is denied. It also implies a factor of 
supreme importance for the rehabilitation of the PITFALLS OF OUR MINDS 
65 
delinquent, i.e., the necessity for a vocational pur- 
suit into which his energies can be turned. Had 
Mary been trained in some means of self-support 
and been given constant guidance by someone she 
could have regarded as a friend and whom she 
liked well enough to desire to please (a sublimation 
of her sex perversions) her history subsequent to 
her discharge from the reformatory might have 
been different. She might have become an ac- 
cepted member of the community instead of ending 
in prison. Our study of conduct disorders is not 
ended when we have outlined the causes in each 
case; we must also be able to map out a line of 
activity for the individual which shall provide an 
adequate outlet for the energies that have hitherto 
been turned into anti-social forms of behavior. 
SUPPLEMENTARY READINGS 
Blanchard, Phyllis. The Adolescent Girl. Moffat, Yard. 
N. Y. 1920. Read the account of adolescent conflicts 
given in Chapter IV. 
Healy, William. Mental Conflicts and Misconduct. 
Little, Brown. Boston. 1917. This book is a classic on 
the subject and should be carefully read by the student. 
Healy, William. The Individual Delinquent. Little, 
Brown. Boston. 1915. Chapter X gives some excellent 
case histories of mental conflicts causing misconduct. 
Hoyt, Franklin C. Quicksands of Youth. Scribner’s 
Sons. N. Y. 1921. Read the sections entitled “Path- 
ological Liars ” and “ Homes That Are Bad.” 
Taft, Jessie. Some Problems in Delinquency. Publica- 
tions of the American Sociological Society, Vol. XVI: 
Factors in Social Evolution. University of Chicago Press. 
Chicago. 1922. Excellent studies of two adolescent girls 
which should be read by the student. 66 
ABNORMAL BEHAVIOR 
Williams, F. E. Anxiety and Fear. Mental Hygiene, Vol. 
IV, No. i. Jan. 1920. An excellent article giving a 
general statement of emotional conflicts and their influ- 
ence on behavior. Although it does not directly apply 
to conduct disorders, it treats the subject of conflict 
with such clarity that it is advisable to read it. Chapter III 
INTELLECTUAL CAPACITIES AND THEIR 
RELATION TO BEHAVIOR 
Individual differences in intellectual development. 
Graphical representation of the typical distribution of in- 
telligence in the general population. 
Meaning of “ innate intellectual capacity.” 
Tests for the measurement of intelligence. 
The Stanford-Binet. 
The Performance Scale. 
Group Tests. 
Individual differences in special abilities and disabilities. 
The relation of intelligence to behavior. 
Mental defectives who are self-supporting: data from 
Fernald’s studies. 
Mental deficiency as a contributing factor in the production 
of conduct disorders. 
Cases in which mental deficiency and its accompanying 
tendency to suggestibility rendered the influence of bad 
companions disastrous. 
Feeble-minded girls who are unmarried mothers or prosti- 
tutes: case histories. 
Cases in which conduct disorders can be traced to the child- 
ish irresponsibility of the defective. 
The unruly type of mental defective: case study. 
The mental defective with episodes of excitement: case 
histories. 
Superimposition of mental disease upon mentally defective 
basis. 
Necessity for careful diagnosis of mental deficiency in the 
high grade and borderline cases. 
Institutional care of defectives. 
The Special Class in the public schools. 
67 68 
ABNORMAL BEHAVIOR 
IT is a matter of common observation that the 
various individuals of a community differ 
vastly from one another in physical appearance 
and characteristics. Even the members of the 
same family differ in height, weight, color of eyes 
and hair, and many other details. These individual 
differences are so obvious that they do not even 
create any comment. On the other hand, the 
knowledge of similar individual differences in men- 
tal make-up, because it was so long unrecognized 
in its full significance, has recently been the sub- 
ject of much popular and scientific discussion. It 
is a subject of importance not only to academic 
psychology, but of innumerable practical implica- 
tions for educational methods and vocational guid- 
ance. Moreover, it is one of the factors to be 
considered in a study of human behavior and one 
of the elements to be thought of in connection with 
the causation of conduct disorders. 
The existence of such marked intellectual dif- 
ferences as are apparent in contrasting the imbe- 
cile, the average man and the genius are fairly 
obvious. The elaboration of objective methods for 
estimating the intellectual capacity has shown that 
between these well-known differences of mentality 
there exists an infinite series of gradations, extend- 
ing from the idiot up through the imbeciles and 
still higher grade defectives known as morons, 
through a borderline group and a still higher class 
who are only dull, into the great mass of individ- 
uals who represent the average and are therefore 
termed the intellectually normal, and even above PITFALLS OF OUR MINDS 
69 
these into the levels of superior and very superior 
intelligence until we reach the smaller group of 
geniuses, whose intellectual processes defy meas- 
urement by our yet imperfect scales. This distri- 
bution of intelligence is graphically represented in 
the following diagram, which was constructed on 
the basis of examinations of over 93,000 enlisted 
men of the army draft. In this figure, the C- and C 
groups represent the average or normal group, 
while the ranges to the left and right represent the 
deviations below and above this norm. 
The distribution of intelligence depicted in this 
diagram is fairly representative of society as a 
whole. It is not based upon advantages of edu- 
cation or environment, but is indicative of innate 
differences in intellectual capacity which are ex- 
istent in the individual from birth, and which de- 
termine to what extent that particular individual 
will be able to profit by educational and environ- 
mental opportunities. Just what we mean by the 
term “ innate intellectual capacity ” may best be 
conveyed by a hypothetical illustration. If we 
imagine two children of approximately the same 
native intelligence, one of whom is brought up in 
isolation from infancy, the other having the best 
educational advantages, we can picture the latter 
as learning to read and write, etc., while the other 
child grows up in ignorance of these accomplish- 
ments. Yet if the first child should be removed 
from his isolation, he, too, would learn these things, 
and after a time would be able to read and write as 
well as the child who had always been in school. 70 
ABNORMAL BEHAVIOR 
Moreover, could we measure the intellectual ca- 
pacity of these two children by means of tests 
Percentage of distribution of intelligence of 
93,937 enlisted men in 15 camps. (Figure con- 
structed on basis of data given in Table 199, page 
679, Vol. XV, of Memoirs of The National Acad- 
emy of Sciences, Psychological Examining in the 
United, States Army.) PITFALLS OF OUR MINDS 
7i 
entirely independent of educational material, we 
should find them achieving almost identical ratings 
upon such a purely objective scale, although the 
child who had been deprived of environmental ad- 
vantages might appear stupid to ordinary observa- 
tion in comparison with the developed abilities of 
his more fortunate brother. 
In so far as possible, the various psychometric 
scales in use for the estimation of intelligence do 
aim to measure innate differences in capacity 
rather than differences due to educational and 
environmental advantages. The earliest intelli- 
gence test of this type was devised by Binet. It 
consisted of a series of tests, which by 1908 were 
classified into groups according to mental age. The 
grouping was determined by actual experimention 
and the collection of statistical data. The three- 
year tests were those which the majority of three- 
year-old children were found capable of answering 
correctly; the four-year tests were those which the 
majority of four-year-old children were able to 
answer, and so on up the scale. Thus, a child with 
a chronological age of eight, who could answer 
correctly only such tests as were in the five-year 
group, was considered to have an intelligence equal 
only to that of the average five-year-old child, 
which was expressed by saying that he had a 
mental age of five years.1 This Binet scale was 
1 The typical achievement on the test is not an abrupt 
cessation at a certain year, but a gradual tapering off in 
which more and more failures occur in successive year 
groupings, until finally no more correct responses are se- 
cured. This necessitates the rating being made in years 
and months of mental age, instead of in years alone. 72 
ABNORMAL BEHAVIOR 
revised by the author several times, and was also 
revised by Goddard and later by Terman. 
Terman’s revision of the Binet scale, which is 
known as the Stanford Revision, or the Stanford- 
Binet, is the form most generally in use at the pres- 
ent time. 
In order to estimate the intellectual capacity of 
individuals who were illiterate, unable to speak 
English fluently, or who were deaf and dumb, some 
other measuring scale had to be devised than the 
Stanford-Binet, which depends for the most part 
upon language expression. Pintner and Patterson 
constructed a series of performance tests for use 
in such cases. These were modified in the army 
examining to a flexible scale including as many or 
as few tests as time and the exigencies of the case 
warranted. These tests are quite independent of 
language; they can be given by pantomime, and 
involve only the manipulation of concrete mate- 
rials. The rating on the performance scale, which 
can be translated into terms of mental age for com- 
parison with the Binet, does not offer so accurate 
an estimate of general intelligence as the latter. 
The reaction-patterns to these tests, however, as 
interpreted by the expert technician, give a fairly 
accurate estimate of the intelligence level of the 
individual. The mental processes of memory and 
apperception (ability to grasp a situation) are 
particularly well brought out by some of the per- 
formance tests. 
In order to reduce the time required for the esti- 
mation of the intellectual capacity the so-called PITFALLS OF OUR MINDS 
73 
“ group-tests ” were devised. These can be given 
to ioo or more individuals at a time, so that by 
their use a number of individuals can be tested in 
the same length of time required for a single per- 
son on the Binet. Group testing was first used ex- 
tensively in making psychometric examinations in 
the army for the determination of the intelligence 
levels of the enlisted men and officers, in order 
that this information might be available in decid- 
ing on promotions, etc. The Army Alpha was the 
first group test perfected for use in this connection. 
Later the Beta examination was made for use with 
illiterates and foreigners. This was a test in pic- 
torial form, for which the instructions were given 
by pantomime. Group testing proved so success- 
ful in the army that afterward similar tests were 
issued for colleges, vocational guidance bureaus, 
etc. Less difficult group examinations, such as the 
National Intelligence Test and the Terman Group 
Test, were prepared for school children.1 
The rating on the group tests is usually ex- 
pressed by a numerical score (on the Alpha this 
score is translated into a letter grade ranging from 
A to E), but it can also be expressed in an equiv- 
alent mental age which makes comparison with the 
rating on the Stanford-Binet possible. Generally 
speaking, the rating on group tests such as the 
1 The World Book Company, Yonkers-on-the-Hudson, 
N. Y., publishes a large number of tests for use with school 
children, including both group tests for the estimation of 
general intelligence and special tests for the detection of 
vocational aptitudes. This publishing house also issues a 
catalogue of test materials and a bibliography of tests. 74 
ABNORMAL BEHAVIOR 
Army Alpha or National Intelligence Test corre- 
lates very well with achievement on the Stanford- 
Binet. There is more possibility of error on the 
group tests, however, so that in cases where the 
score on these does not agree with the subject’s 
school record or with the estimate of his associates 
it is always necessary to check up the group tests 
by individual testing with the Binet. In the clin- 
ical diagnosis of mental deficiency, individual test- 
ing with the Binet and Performance Scales is im- 
perative. 
Even in the use of individual tests, a blind ac- 
ceptance of the rating must be avoided. Affective 
disturbances of all kinds can so impair the mental 
efficiency of the individual by interfering with the 
attentive and associative processes as to lower the 
achievement on the examination materially. The 
expert clinician is often able to recognize the exist- 
ence of emotional blocking, and to interpret his 
results accordingly. In doubtful cases, or in in- 
stances in which the ranking on the psychometric 
examination does not harmonize with the subject’s 
school and vocational record, repeated examin- 
ing may be necessary. 
In addition to variations in general intelligence, 
there are individual differences in the way of spe- 
cial abilities and disabilities. Persons of average 
or inferior intelligence in general may be endowed 
with superior manual dexterity, exceedingly vivid 
auditory or visual imagery, etc. By these special 
qualifications they are enabled to attain heights 
of achievement along some one particular line PITFALLS OF OUR MINDS 
75 
which would otherwise lie beyond their reach. On 
the other hand, there may be special disabilities 
inherent in the mental make-up which prevent the 
individual from utilizing his general ability to the 
full capacity. Defective visual or auditory per- 
ception and memory, paucity of associative proc- 
esses, etc., causing special disabilities in reading 
and spelling or in arithmetic, are a great handicap 
to a child in the present educational system, for 
instance. These and other disabilities limit the 
vocational possibilities for the individual to a con- 
siderable extent.1 
After we have succeeded in measuring the intel- 
ligence of the individual, we are still confronted 
with the problem of determining to what extent 
this becomes a factor in behavior. There was at 
one time an attempt to correlate the degree of in- 
telligence positively with certain behavior traits. 
Because a certain number of mental defectives 
were found among the criminal and delinquent 
classes, it was believed for a time that mental de- 
ficiency was one of the chief causes of immoral 
and criminal conduct. Of 608 criminals examined 
at Sing Sing, Dr. Glueck found 171 cases of mental 
deficiency, or 28%. Of 647 prostitutes examined 
at the Social Hygiene Laboratory at the Bedford 
State Reformatory for Women 193 were found 
to be mentally defective, or 29.8% of the 
total population of the institution. Similar figures 
1 For further discussion of the relation between general 
intelligence and special abilities and disabilities to occupa- 
tional pursuits see Chapter XII. 76 
ABNORMAL BEHAVIOR 
were quoted as a result of studies made in other 
penal and correctional institutions. As a result, 
the chief reason given for advocating institutional 
care for the feeble-minded was that they were 
potential delinquents. 
At present, the pendulum is beginning to swing 
in the other direction, and leaders in the work with 
mental defectives consider institutional care neces- 
sary only for such low grade types as the idiots 
and imbeciles who are incapable of an independent 
existence because of their helplessness. A great 
many of the higher grade defectives, who fall 
within the moron and borderline classes, if given 
proper training are quite able to become adapted 
to the community life. The over-crowding of in- 
stitutions for the mentally deficient made it nec- 
essary to try the experiment of returning the prom- 
ising inmates to the community with a view to hav- 
ing them become self-supporting. An idea of the 
success of the experiment may be obtained by 
glancing at the following figures from the Mass- 
achusetts State School for the Feeble-Minded. 
During the 25-year period from 1890 to 1914 
(inclusive), 646 mental defectives — 470 males 
and 176 females — were returned to the com- 
munity. In 1916 Dr. Fernald made the following 
report concerning their adjustment to life outside 
the institution: PITFALLS OF OUR MINDS 
77 
Males 
Earning a living without supervision 28 
Working for wages, supervised at home 86 
Working at home, no wages 77 
Living at home, not able to work 59 
Arrested, but not sentenced 23 
Sentenced to penal insitutions 32 
Committed to other institutions 43 
Readmitted to Waverley 68 
Died 54 
Total 470 
Females 
Married (u doing well) 27 
Self-supporting and self-controlling 
(unmarried) 8 
Working at home under supervision 32 
Living at home, not able to do much work. ... 23 
Committed to other institutions 29 
Readmitted to Waverley 33 
Died 24 
Total 176 
Thus 250 of the 470 males and 52 1 of the 176 
females could not be considered to constitute a 
menace to the community, since they have shown 
no delinquent tendencies and have adapted them- 
selves to the home or work situation fairly well. 
Dr. Helen B. Woolley has contributed a some- 
what similar study of 177 mentally defective indi- 
1 Only 20 of the women working at home and 13 of 
those living at home but not working have adjusted them- 
selves satisfactorily; the others are considered troublesome. 
Hence the summary of 52 doing well. 78 
ABNORMAL BEHAVIOR 
viduals who had passed through the special classes 
in Cincinnati. All of these defectives had been 
out of school at least four years or longer when the 
follow-up study was made (in 1918). A glance 
at the following table will show with what degree 
of success these mentally defective boys and girls 
adapted themselves to community life. 
Occupation 
Num- 
ber 
men 
Per 
cent 
men 
Num- 
ber 
wom- 
en 
Per 
cent 
women 
Total 
num- 
ber 
Total 
per 
cent 
In institutions 
9 
8.0 
6 
9-4 
IS 
8-5 
At home, never worked.... 
5 
4-4 
21 
32.8 
26 
14-7 
At home, previously working 
15 
13 - 3 
26 
40.6 
41 
23.2 
Working for relatives 
11 
9-7 
0 
0.0 
II 
6.2 
In industry 
65 
57-5 
11 
17.2 
76 
42.9 
Army or Navy 
8 
7-i 
0 
0.0 
8 
4-5 
Totals 
113 
100.0 
64 
100.0 
177 
100.0 
(Reproduced from the Report of The Mental Hygiene Survey of 
Cincinnati, page 109, Table 1.) 
The salient figures of the above table might be 
summarized as follows: 
53.6% of the 177 defectives included in the fol- 
low-up study were gainfully employed either in 
industry, in the Army or Navy, or working for 
relatives. 
Only 17.7% of the men were unemployed and 
living at home. 
Although 73.4% of the women were not em- 
ployed outside their homes, 57.8% of the women 
had been in industry at one time or another after 
leaving school. PITFALLS OF OUR MINDS 
79 
The wages per week varied from $4.00 or less 
to $25.00 or more. This indicates that some 
feeble-minded individuals are capable of earning a 
living for themselves in the community. 
In order to be convinced that the mental defec- 
tive is capable of self-support when trained in 
habits of regularity and industry, we need only to 
consider further data reported by Dr. Fernald con- 
cerning some of the “ boys ” who are on parole 
from the State School at Waverley, Massachusetts. 
The following is only a partial table reproduced 
from Dr. Fernald’s study: 
Age 
Mental 
Age 
Years 
at 
School 
Occupation 
Wages 
per 
Week 
IS 
9-6 
2 
Errand boy 
#9-00 
28 
IO-3 
6^ 
Fireman 
24.64 
24 
9-2 
14 
Machinist’s helper 
24.50 
33 
II-I 
9 
Stock-keeper 
28.00 
25 
6-2 
8 
Roofer 
24.OO 
17 
7-2 
5 
Carpenter’s helper 
30.00 
27 
7-4 
8 
Laborer 
25.50 
17 
6-8 
2 
Errand boy 
7SO 
20 
8-3 
5 
Fruit handler 
30.40 
17 
8-1 
7 
Cutlery factory 
12.00 
21 
9-3 
10 
Packer 
23.28 
32 
9-2 
10 
Porter 
11.00 
ft 
(Per mo.) 
18 
7-2 
6 
Farm helper 
35.00 
(Mental age is expressed in years and months. Thus, 9-6 would 
be 9 years 6 months; 10-3, 10 years 3 months, etc.) 
Probably the most accurate statement of the 
situation would be that while mental deficiency 80 
ABNORMAL BEHAVIOR 
is not in itself a primary cause of anti-social con- 
duct, under certain conditions it does become a 
contributing factor in the production of conduct 
disorders. The characteristics of suggestibility, 
inadequate judgment, defective foresight, etc., 
which are typical of the mental defective predis- 
pose him to easily drift into delinquency under the 
influence of bad associates. If his mental defect 
is combined with an excitable and emotionally un- 
stable personality make-up his potentiality for 
anti-social behavior is enhanced, for he is liable 
to outbursts of temper which his defective mental- 
ity sees no necessity of controlling. A more intel- 
ligent individual with the same emotional make-up 
would be more apt to realize the necessity of in- 
hibiting his impulses. 
Since we cannot expect all of the mental defec- 
tives in a community to be brought up in a good 
environment and to be endowed with a docile per- 
sonality, we shall find that our description of con- 
duct disorders will include many cases in which 
mental deficiency is the outstanding feature. The 
following case histories present various types of 
conduct disorders in which mental defect can be 
considered the principal factor, either through per- 
mitting the individual to yield too readily to the 
suggestions of bad companions, through failure to 
understand the need for inhibition and control of 
emotional impulses, or mere irresponsibility due 
to inability to foresee the consequences of certain 
acts. PITFALLS OF OUR MINDS 
81 
Case 12 
Harry S. was sent to the hospital from the Children’s 
Court for observation as to his mental condition. He 
was charged with robbery, and this was his fourth 
offense of that type. He was a boy of 15. He had 
always been dull in school and had been a chronic 
grade repeater, but had always been obedient and 
well-behaved until four years ago. Then he began to 
go around with some boys who taught him to steal. 
Through their influence, he became implicated in a 
robbery, was arrested and sent to the reformatory. 
Since his return from that institution he had fallen 
under the influence of these same companions, and 
was again in trouble. 
The boy’s physical examination showed nothing of 
significance. The mental examination revealed no 
evidence of mental disease, but indicated mental de- 
fect. On the Stanford-Binet the patient was only able 
to achieve a mental age of 5 years 10 months. On the 
Performance Scale his score was equivalent to a men- 
tal age of 6 years 7 months. His attitude was child- 
like; his attention was easily distracted; he did not 
comprehend instructions readily, and his memory and 
apperception were poor. He had a tendency to play 
childishly and somewhat destructively with the test 
materials. These reactions, in connection with his 
history of backwardness in school, and his suggesti- 
bility and tendency to fall under the dominance of his 
associates, are typical of the mentally defective indi- 
vidual. Harry was therefore committed to an institu- 
tion for the feeble-minded where he might receive 
training in habit formation and be taught some useful 
type of work. 82 
ABNORMAL BEHAVIOR 
Case 13 
Another boy of 15, Joseph C., was sent to the hos- 
pital for observation from the Children’s Court. The 
charge against this boy was burglary. The family 
history and physical examination were negative. Men- 
tally, there was no evidence of psychosis or active 
mental disease. His mental age of 12 years 5 months 
on the Stanford-Binet placed him in the class of bor- 
derline intelligence. He had lost his job as an errand 
boy, and needed money to buy himself some clothes. 
Two fellows whom he knew suggested robbing a store, 
and he fell in with the suggestion. He readily ad- 
mitted this, and said that he had taken a suit of cloth- 
ing and a tie pin. He did not seem to realize the 
seriousness of his behavior nor the consequences likely 
to follow. 
Case 14 
Lena Z. was the oldest of six children. Her family 
lived in a tenement house in a congested neighbor- 
hood. Mrs. Z. was sick much of the time, and could 
not supervise the children sufficiently. Mr. Z. was 
out of work and could not give them the things he 
would have liked to see them have. Lena began to go 
around with a group of vicious girls and men. She 
met an Italian who owned a fruit store on Third 
Avenue. This man’s family was still in Italy. Lena 
allowed him to persuade her to become his partner in 
a sex relationship. She received 15 cents each time 
she visited him, with which she bought candy and 
cake. She was arrested on the charge of a disorderly 
child, and placed on probation. She now discontinued 
her visits to the Italian, but took up petty thieving. PITFALLS OF OUR MINDS 
83 
She was considered to have broken her probation by 
this conduct, and was committed to a reform school. 
She gave a great deal of trouble at this institution by 
her constant attempts to run away. She was finally 
brought to Bellevue for observation by one of the 
officers of the school. 
At the hospital, Lena showed no psychotic symptoms 
or vicious tendencies. She adapted herself to the rou- 
tine of the ward, and was helpful with the work. She 
frankly admitted her past misconduct. Her physical 
examination showed nothing of note. The psycho- 
metric examination gave her a mental age of io years 
4 months on the Stanford-Binet, in contrast to her 
chronological age of 16. Her school record showed 
that she had repeated two grades and had often been 
truant. She was diagnosed as a high grade moron 
and returned to the reform school in the hope that she 
might acquire better habits through the discipline 
there. 
The suggestibility of the feeble-minded girl, plus 
her inability to realize remote consequences of her 
acts, renders her particularly liable to be seduced 
by unscrupulous men. After this experience, she 
often continues her sexual activity until she drifts 
into prostitution or becomes the mother of illegiti- 
mate children (or both). This does not mean 
that the mentally deficient girl is any more prone 
to irregular sex life than her better endowed sis- 
ters. It is simply that she has not the same inhib- 
itory forces at work in her make-up since she does 
not foresee the results of her conduct. Nor has she 
the intelligence to avoid unpleasant consequences 84 
ABNORMAL BEHAVIOR 
by methods adopted by more clever women who 
even when they allow their inhibitions to be 
broken down quite as completely assure their im- 
munity from social censure by caution and con- 
cealment. 
Case 15 
Mary M., who was brought to the hospital from the 
Municipal Lodging House in a condition of pregnancy, 
gives a typical mental defective history. Her mother 
is herself somewhat defective. Mary was retarded in 
physical and mental development in infancy and child- 
hood. She did not walk and talk until she was over 
two years of age. In school she continually repeated 
grades, and had only reached the sixth grade at the 
age of 16. Her mother had placed her for a time in 
an institution for mental defectives. After a period of 
training at this institution she was released on parole 
for a time. At the end of her parole period she ran 
away from home, and when found by her mother at 
the Municipal Lodging House was in a pregnant con- 
dition. She was 21 years of age at the time of her 
examination at the hospital, but her mental age was 
only 7 years 6 months. Her memory was poor and 
her judgment entirely inadequate. She was able to 
read some, but appeared to have no conception of the 
meaning of anything which she read. Her attitude on 
the ward was simple and childish. There was no 
doubt that her mental defect was at the root of her 
difficulties. 
Case i 6 
Sadie S. is a similar case. She was brought to the 
hospital by the Friendly Aid Society after having given 
birth illegitimately to twins. Sadie had been em- PITFALLS OF OUR MINDS 
85 
ployed as a domestic, but was now practically home- 
less. Her parents were separated, and her mother 
was dependent on one of the other children and un- 
able to assist Sadie. Mrs. S. said that Sadie had 
always been different from the other children. She 
was backward in physical and mental development, 
and was unable to learn readily at school. At the age 
of 25 she had reached a mental age of only 6 years 
8 months, according to the rating on the psychometric 
examination. Besides having had two illegitimate 
children, she had contracted syphilis as a result of her 
irregular sex habits. 
Case 17 
Jennie W. was brought to the hospital for observa- 
tion by another organization. Like Sadie, she was an 
unmarried mother. She was a girl of 24, who had lived 
in Russia the first 10 years of her life. She had never 
been able to get on in school, and when she left at 16 
was only in the third grade. Since leaving school she 
had been employed at housework and in a factory. 
While working in the latter place she met a man who 
became her lover. He promised to marry her, but 
when she became pregnant he left her and began to 
go around with one of the other girls. Jennie’s mental 
age on the Stanford-Binet was 6 years 8 months. Her 
attitude on the ward was docile and obedient, but she 
was unable to do anything except simple tasks. She 
was a low grade moron, who would not have gotten 
into trouble had she been properly supervised and 
guarded from the influence of bad company. 
Very often these defective girls, after having 
one illegitimate child, find that the easiest way to 86 
ABNORMAL BEHAVIOR 
live is to use their sex functions to induce some 
man to take care of them. In this frame of mind, 
they live with first one man and then another, or 
else become prostitutes. 
Case 18 
Annie B. was sent to Bellevue for observation after 
being arrested on a charge of incorrigibility preferred 
by her mother. At the age of 23 Annie was the mother 
of three illegitimate children. The first child was born 
when Annie was only 15 years of age. After its birth, 
the father was induced to marry Annie, but did not 
live with her. Annie’s mother was constantly reproach- 
ing the girl for her mistake, and Annie finally left 
home, and began living with different men. Occasion- 
ally she would go home to her mother when she was 
unable to find a man to care for her. At the birth of 
the third child her mother lost patience and had the 
girl arrested. A psychometric examination showed 
that she had a mental age of 10 years 10 months. Her 
attitude was childish and her judgment was defective. 
She seemed to have no realization of her wrong-doing, 
could not understand why her mother should find fault 
with her continually, and was only mildly disturbed 
by the fact that her two children had been taken away 
from her. 
Case 19 
Rose G. was a girl of 23, who had been in the United 
States only 7 years. She, too, had been seduced by a 
lover, had given birth to an illegitimate child, been dis- 
charged from her place of employment and had drifted 
into prostitution. She was arrested on the charge of PITFALLS OF OUR MINDS 
87 
vagrancy and sent to the hospital for observation as 
to her mental condition. Examination showed that she 
was not suffering from any physical or mental disease, 
but that she was a mental defective, with a mental 
age of about 8 years. She was committed to an insti- 
tution for mental defectives. 
Many defectives become delinquents because 
they have a childish irresponsibility which is a part 
of their deficiency. With their limited mentality, 
the full implications of such abstract terms as good 
and evil are beyond their comprehension. They 
may know a certain act is wrong because they have 
been repeatedly told so, but they can give no better 
reason for their belief than some such statement as 
“ father said so.” Between right and wrong as 
separate entities they make no clear demarcation 
in their thinking. They commit anti-social acts 
without any idea of the seriousness of their 
offenses, and confess their misdemeanors readily 
without comprehending the penalties certain to 
ensue. 
Case 20 
Mark L. was such a type. He was always backward 
in mental development. He had not begun to talk 
until he was four years old, and had never gotten on 
well at school. He left at the age of 15, and had not 
gotten beyond the primary grades even then. He was 
never able to keep a job on account of his inability 
to learn to do the work required of him in various 
places where he sought employment. He finally began 
to peddle powder puffs. At one of the houses where 
he was trying to sell his wares he saw a diamond ring 88 
ABNORMAL BEHAVIOR 
lying on the table, and attempted to steal it. He was 
seen by the janitor, who called a policeman. The boy 
readily admitted his act. He appeared so irresponsible 
that he was sent to Bellevue for observation. On the 
ward he appeared exceedingly dull and stupid. He 
said that he liked the hospital — “it was such a nice 
place.” He showed no insight into his situation, and 
did not in the least comprehend the gravity of having 
a charge of burglary pending against him. His mental 
age on the Stanford-Binet was 8 years 8 months while 
his actual chronological age was 27. He was recom- 
mended for commitment to the state institution for 
defective delinquents. 
Case 21 
William L. was a mental defective with a penchant 
for stealing pigeons. He had never given his parents 
or teachers much trouble until he began keeping 
pigeons at the age of 13. He spent all his spare time 
with his pets, and began stealing others from his 
neighbors to increase his flock. He was arrested 
five times, each time for bird stealing. After the 
third offense of this nature, he was sent to the New 
York Juvenile Asylum for three months. After his 
release, his mother tried to keep him from having 
pigeons. He went to work as an errand boy, but 
stole a cage of canaries from a bird store. He was 
arrested for this, but was released when he offered 
to return the birds. The craving for birds caused 
another crime and arrest, however, and the case was 
considered so peculiar in some of its aspects that he 
was sent to the hospital for observation. He showed 
no evidence of active mental disease, but appeared to 
be a mental defective, of high grade moron type, with PITFALLS OF OUR MINDS 
89 
a mental age of 10 years 4 months in contrast to his 
chronological age of 17 years. 
Case 22 
Florence F. was the type of defective who adds un- 
ruliness and disobedience to irresponsibility. This 
combination of traits almost always leads to mis- 
conduct. Florence was no exception to this general- 
ization. Her developmental history was typically that 
of the mental defective; she did not get her first tooth 
until the age of io months, and was 3 years old before 
she began to walk and talk. In school she was back- 
ward and repeated several grades. She reached the 
seventh grade at the age of 16, and then left school 
and went to work. After she began to work she be- 
came entirely unmanageable. She began to go around 
with men, and sometimes stayed away from home for 
several days at a time without letting her parents 
know where she was. Remonstrances were of no 
avail. The parents finally had her arrested, and she 
was sent to the hospital for observation as to her men- 
tality. She was found to have a mental age of approx- 
imately 11 years. She was diagnosed as a high grade 
defective and on account of her bad sex habits insti- 
tutional care was recommended. Her parents refused 
to commit her to an institution, however. 
The type of mental defective described in the 
preceding cases is delinquent because of his sug- 
gestibility and irresponsible attitude. Under 
proper supervision, he can be expected to perform 
simple routine labor and can be left at large in the 
community without serious mishap. A different 90 
ABNORMAL BEHAVIOR 
type of mentally deficient individual represents a 
menace to the community under almost any cir- 
cumstances, and can only be safeguarded by the 
strict discipline of an institution. The type re- 
ferred to in this statement are the feeble-minded 
who combine emotional instability with their un- 
developed mentality, and who are subject to out- 
bursts of temper or actual episodes of excitement. 
Mental defectives of this type become destructive 
when such episodes occur, and may attempt to do 
injury to themselves or others. 
Case 23 
Frank M. was such a type. There was some defect 
in the family stock; he had a feeble-minded maternal 
uncle, and one of his sisters had had chorea. Frank 
himself showed the typical retardation of development 
in early childhood. He did not walk until 2 years of 
age, and did not talk until 3 years old. He never 
showed any interest in books, was continually running 
away from school, and had only reached the fifth grade 
ait the age of 16. He was always stubborn and quarrel- 
some. He did not get on well at home or at school, 
and later had trouble with various employers. When 
he was 19 he wrote a letter to the man for whom he was 
working, asking for a loan of $1.00 and forging his 
step-mother’s signature to the request. When ques- 
tioned about the letter he became so irascible and 
threatening that his employer sent for the police. At 
this the boy became very much upset, and tried to 
hang himself by a necktie tied around his neck. 
Frank was sent to Bellevue for observation after 
this exploit. He readily confessed the whole story of PITFALLS OF OUR MINDS 
91 
his misdeeds and attempted suicide, but his manner 
in discussing them was silly and superficial. On the 
psychometric examination his mental age was 9 years 
10 months. When told he was to be sent to a school 
for defectives he became upset again, threatened to 
kill himself, and actually did attack one of the other 
patients on the ward. He was committed to one of the 
state institutions for mental defectives as a high grade 
moron. 
Case 24 
Millie B. was another excitable moron. She was a 
24-year-old girl, who in addition to her generally low 
grade of intelligence had the handicap of being deaf 
and dumb. Her mental defect was probably due to 
the effects of meningitis, which she had had when 4 
years old. Previous to that time she had appeared 
normal enough in her development, and had learned 
to walk and talk. She had a history of being subject 
to violent attacks of excitement in which she would 
become very noisy and destructive, screaming and 
tearing her clothes. She lost her mother while still a 
small child, and lived first with a grandmother, then 
with her father, and later with an aunt. None of 
these were able to keep her because of her violence 
and excitability. At her aunt’s she would kick and 
strike the children, break their toys, etc. Her brother 
was a lawyer and also lived with this aunt. Millie 
would go into his office and drive the clients away. 
At last this state of affairs became unendurable, and 
the brother and aunt sent her to Bellevue for observa- 
tion. Here she showed her usual emotional insta- 
bility, becoming excited at times, screaming and tear- 
ing her clothing, etc. On the Performance Scale she 92 
ABNORMAL BEHAVIOR 
achieved a score which was equivalent to a mental age 
of 9 years 9 months. She was diagnosed as a case of 
mental deficiency following meningitis. 
Sometimes the type of mental defective de- 
scribed above becomes chronically restless and 
excitable to a degree which borders on insanity. 
Case 25 
Izzy M. is a typical case of this kind. He was a 
boy of 20, with a mental age of 8 years i month. His 
history at school was typical of the mental defective; 
he had never been able to learn and had been put in 
a special class for feeble-minded children. He was 
always of a restless, unstable make-up, a constant 
source of trouble to parents, teachers and the police. 
Whenever he could get any money from his father or 
by doing odd jobs he would run away from home and 
stay until it was gone. He was arrested several times 
for minor delinquencies, and finally was sent to Belle- 
vue for examination. In addition to the mental age 
reported above, the patient was found to have an epi- 
sode of excitement which warranted his being diag- 
nosed as insane. He was restless, overactive, 
boisterous, irritable and constantly in trouble with 
the other patients. His conversation was rambling 
and flighty, as the following sample shows: 
“ Just because I came here once the doctors will 
send me away. Where is this Central Islip anyway? 
On land or water? Here is one that bothers me all the 
time. (Referring to the nurse.) I read a piece in the 
paper by Mr. O’Brien. I am a good hand at writing. 
I came out of school with two medals and I don’t know 
what else to tell you.” PITFALLS OF OUR MINDS 
93 
He was sent to a state hospital for the insane, as he 
was too excited and restless to be amenable to the dis- 
cipline of an institution for the feeble-minded. 
Cases such as this, in which there is a combina- 
tion of active mental disease and mental defect, 
are not so rare as might be expected. Psychoses 
of the manic-depressive or dementia praecox 
types, psychoneurotic symptoms, and other mental 
abnormalities, may be superimposed upon primary 
mental defect as well as upon normal brain tissue. 
Conduct disorders which result in these cases are 
motivated by multiple factors. It is best to de- 
scribe these types in connection with the psy- 
choses, however, as they will be more intelligible 
at that point.1 
The diagnosis of mental deficiency is not always 
so simple a matter as one might at first suppose. 
This is particularly true in cases of the high grade 
or borderline type. There is often a tendency to 
place too much dependence on the results of the 
psychometric examination, without reference to 
other factors in the case. The danger of such a 
course of procedure is clear when we realize the 
possibilities for error in the use of these scales for 
the measurement of intelligence. Incipient forms 
of such psychoses as dementia praecox and manic- 
depressive insanity may cause a disorder of atten- 
tion and association which materially lowers the 
achievement on intelligence tests, and makes the 
1 See Chapter VI, in which these cases of psychotic ten- 
dencies in combination with mental defect are discussed in 
detail. 94 
ABNORMAL BEHAVIOR 
rating far below the actual mental level of the 
subject. Certain diseases of the nervous system, 
such as epidemic encephalitis, may be followed by 
a condition which simulates mental deficiency but 
is only temporary. Almost any emotional dis- 
turbance may cause an affective blocking of the 
mental processes which interferes with intellectual 
efficiency and prevents the individual from doing 
his best on the psychometric examination. Any 
of these or several other factors may cause a low- 
ering of the rating on the Stanford Binet of from 
one to three years, according to a study made by 
Dr. Jewett and Dr. Blanchard. 
In view of the fact that a mental test cannot be 
accepted as in itself an incontrovertible proof of 
the subject’s lack of innate intellectual capacity, 
other substantiating circumstances must be ob- 
tained. A study of the family and personal his- 
tory, the school and work record, and the general 
conduct of the individual in respect to ability to 
adapt himself to the demands of his environment, 
etc., must be taken into consideration as well as 
the physical and mental condition at the time of 
the examination. It is on the basis of evidence 
along all these lines that we can safely differenti- 
ate between the borderline defective and the 
merely dull or subnormal. 
The problem of mental deficiency as a cause of 
conduct disorders is no small one. Already the 
state institutions for mental defectives are almost 
everywhere filled to the limit of their capacity. 
This necessitates returning to the community such PITFALLS OF OUR MINDS 
95 
members of the institutional population as seem to 
have benefited by their training sufficiently to be 
trusted to earn a living and stay out of trouble. 
This they can often do, especially if a certain 
amount of supervision is maintained either by 
relatives or parole officers and field workers from 
the institution. This parole system enables the 
institution to make room for new inmates who are 
either incapable of caring for themselves or have 
developed habits of misconduct. 
The public schools are helping to handle the 
problem by establishing special classes for defec- 
tive children in which they are trained along man- 
ual and pre-vocational lines. In these classes, the 
mental defective is taught to form habits of obe- 
dience and industry instead of being allowed to 
play truant from the regular classes of the school 
(where he was an unmitigated nuisance to a har- 
assed teacher who never succeeded in interesting 
him in work for which he had no mental capacity) 
and learning all sorts of delinquent activities. The 
importance of a special curriculum for the defec- 
tive child and of supervision by the school of his 
first few years in industry cannot be overestimated 
as a measure for the early inculcation of proper 
habits which will tend to prevent the development 
of conduct disorders which often occur in the case 
of mental defectives who are permitted to fall 
under less stabilizing influences. 96 
ABNORMAL BEHAVIOR 
SUPPLEMENTARY READINGS 
Anderson, V. V. Education of Mental Defectives in State 
and Private Institutions and in Special Classes in Public 
Schools in the United States. Mental Hygiene, Vol V, 
No. 1, Jan., 1921. This article gives the facts con- 
cerning the problem of mental deficiency, and presents 
this material in the light of the modern attitude toward 
this subject. It should be read by every student. 
Fernald, Walter. After-Care Study of The Patients Dis- 
charged from Waverley for a Period of Twenty-five 
Years. A small pamphlet which analyzes the tables 
quoted in this chapter. 
Fernald, Walter. The Diagnosis of The Higher Grades 
of Mental Defect. American Journal of Insanity, Vol. 
LXX, No. 3, Jan., 1914. This is a pertinent article and 
should be read carefully. 
Jewett and Blanchard. Influence of Affective Disturb- 
ances on Responses to The Stanford-Binet Test. Mental 
Hygiene, Vol. VI, No. 1, Jan., 1922. 
Tredgold, A. F. Mental Deficiency (Amentia). Wm. 
Wood, N. Y., 1915. This is still to be considered an 
excellent reference book. It discusses the causes and 
types of feeblemindedness. Is somewhat medical in 
viewpoint, and although some addenda would be profit- 
able, is undoubtedly of much value in its present form. 
REFERENCES ON PSYCHOMETRIC 
EXAMINATIONS 
Pintner and Patterson. A Scale of Performance Tests. 
Appleton, N. Y., 1917. Descriptions of tests, directions 
for giving, norms, etc., for tests of performance series. 
Terman, Lewis M. The Measurement of Intelligence. 
Houghton Mifflin, 1916. A treatise on the Stanford 
Revision of the Binet. 
Yerkes, R. M. Psychological Examining in The United 
States Army. Vol. XV of Memoirs of The National PITFALLS OF OUR MINDS 
97 
Academy of Sciences. This was edited by Dr. Yerkes 
in collaboration with other noted psychologists. Chapter 
5, Part I, gives reproductions of the tests used in the 
army, including Alpha and Beta, with directions for 
giving, scoring, etc. Chapter IV 
THE PHYSICAL BASIS FOR BEHAVIOR 
AND THE INFLUENCE OF SOMATIC 
DISEASE UPON CONDUCT 
The cell as a unit of structure. 
The skeleton of the body, bones, cartilage, ligaments and 
joints. 
Types of muscle tissue. 
Energy-creating mechanism of the body. 
Food used for fuel. 
Teeth in relation to mental diseases. 
Digestion of various elements of foodstuffs. 
Digestive juices in the mouth, stomach and intestines. 
The absorption of the various foodstuffs. 
Physiology of the lungs. 
The personality of tuberculous and asthmatic patients. 
Definition of glands of internal secretion. 
Relationship of endocrinology to normal conduct. 
The thymus gland and its bearing upon conduct. 
The pineal gland. 
The internal secretion of the sex glands, and its influence 
upon conduct. 
The importance of the parathyroids. 
The adrenals and their influence upon conduct in health 
and in disease. 
Discussion of the pituitary gland, and its disorders. 
The internal secretion of the sex glands, and their influence 
on the formation of secondary sex characteristics. 
Discussion of the liver, pancreas, mammary glands and the 
spleen. 
The interaction of the various glands of internal secretion. 
The energy distributing mechanism of the body. 
98 PITFALLS OF OUR MINDS 
99 
The function of the blood, heart and arteries. 
Diseases of the heart and arteries causing abnormal be- 
havior. 
Reproduction. 
Menstruation. 
Psychosexual phase of sex relationship. 
Protective mechanisms of the body, — skin, mucous mem- 
branes, blood and nervous system. 
The cerebro-spinal nervous system. 
The sense organs. 
Voluntary and involuntary nervous system. 
The divisions of the autonomic nervous system and their 
special functions. 
The activities of the autonomic nervous system in time of 
safety and in time of danger. 
The changes in the nerve cell in times of danger. 
Influence of physical disease upon conduct. 
The mind, as an organ for adaptation. 
DURING the past decade, great strides have 
been made in the study of psychological 
mechanisms in normal as well as in abnormal be- 
havior. The utilization of well established psy- 
chological laws and principles, especially those of 
the Freudian school, has given a dynamic value to 
the interpretation of the oddities of conduct of the 
neurotic and insane. The employment of these 
principles has proven efficacious for the prevention 
of mental disease. 
In the interest evoked by the study of the va- 
rious psychological mechanism, there was a gen- 
eral tendency to neglect the various anatomical 
and physiological factors that play important roles 
in normal behavior. It is appropriate for a work 
of this kind to discuss briefly these different ana- 100 
ABNORMAL BEHAVIOR 
tomical, pathological and physiological facts and 
call attention to the part they play in abnormal 
conduct. This has a most important and practical 
bearing. In the management of abnormal be- 
havior manifestations it is imperative that we take 
cognizance of these factors, and evaluate the role 
which they play in a particular case. Failure to do 
so has resulted in serious blunders. We have seen 
patients sent to us with a diagnosis of hysteria, 
etc., who were suffering from pulmonary tuber- 
culosis, serious forms of heart disease, pleurisy, 
etc. We know of instances where the family re- 
garded the person as lazy, the “ nerve specialist ” 
called him neurotic, and the patient submitted 
to all sorts of mental analyses, only to be found, 
on proper examination, to be suffering from a se- 
rious physical disease. 
In this chapter, we shall therefore discuss the 
human organism from a mechanistic viewpoint, 
and indicate the manner in which the different 
parts of this remarkable machine influence normal 
and abnormal behavior. We shall briefly outline 
the structure of the body, its energy creating 
mechanism, its energy distributing mechanism, 
waste disposal, defensive methods, its correlating 
and integrating mechanism, and the part they 
play in both normal and abnormal reactions. 
The human organism is composed of a multitude 
of cells which are so grouped as to form special- 
ized tissues and organs. The cells of a specialized 
tissue are characterized by uniformity of structure 
and function. Each organ subserves a definite PITFALLS OF OUR MINDS 
IOI 
function and all are working for the ultimate bene- 
fit of the organism. The functions of most of the 
organs are fairly well known to the physiologist 
but those of some organs are still in doubt. 
The skeleton of the body is formed by bone and 
cartilage tissues and is united in part by firm rope- 
like structures known as ligaments. Bone tissue 
also serves an additional purpose in affording pro- 
tection for more delicate tissues and organs, such 
as the brain, the eye, pituitary gland, blood ves- 
sels, etc. Its marrow forms blood cells. The 
bones of the female are more delicate than those of 
the male, and the trained observer may tell the sex 
by studying certain bones, especially those of the 
pelvis. The proper skeletal development is es- 
sential for the normal personality. An undersized 
male, especially if the musculature development is 
poor, is apt to be laboring under an inferiority com- 
plex, and react in several ways as described by 
Adler. Well developed skeletal and muscle struc- 
tures inspire confidence and aggressiveness. It 
must be remembered, however, that there are cer- 
tain disorders of the glands of internal secretion 
that may be associated with gigantism, very 
large skeletal development, and the personality 
of the individual may be of inferior type. There 
are other disturbances of the endocrine glands, 
especially of the thyroid gland, that are associated 
with small skeletal development. Diseases of the 
bones associated with changes in behavior are rare. 
Where two bones come together, a joint results. 
The joint may be immobile, or may permit all de- 102 
ABNORMAL BEHAVIOR 
grees of motion. Diseases of the joints or ar- 
thritis, especially when of a chronic nature, are con- 
ducive towards an irritable and ugly personality. 
Muscle tissue is characterized by its power to 
contract and thereby alter its size and shape, 
causing movements of itself and of the parts to 
which it may be attached. There are three types 
of muscle tissue: 
1. The heart or cardiac muscle; 
2. The smooth or unstriated muscles, lining the 
gastro-intestinal tract, uterus, glands, blood ves- 
sels, and 
3. The striated or skeletal muscles. 
The striated muscles cause voluntary motion at 
the joints, and also give contour to the body. They 
are more powerfully developed in the male than in 
the female. When adequately developed they in- 
duce a feeling of aggressiveness and confidence 
in the owner. It is a matter of common observa- 
tion that every male is proud to display well de- 
veloped muscles of the arm, especially the biceps 
muscles. There are a few definite, though rare, 
muscle diseases, which incapacitate the individual, 
and make him dependent upon the community for 
support. 
The energy creating mechanism of the body is 
the alimentary tract, the lungs and the glands of 
internal secretion. They furnish the energy neces- 
sary for the proper functioning of the body. The 
fuel used is the various foodstuffs, salts and water. 
The ordinary diet consists of fat, carbohydrates 
and proteids, together with different salts and 
water. PITFALLS OF OUR MINDS 
103 
Food is taken into the mouth where it is broken 
up into smaller particles by the teeth. The teeth 
have lately been receiving considerable attention 
from those interested in mental diseases. It is a 
well-known fact that the insane, because of the 
very nature of the disease from which they are 
suffering, are unable to care for their teeth prop- 
erly. It was also found that many of them were 
suffering from pyorrhoea, which is an infection of 
the gums. They frequently suffer from an infec- 
tion of the roots of the teeth also. These so-called 
focal infections of the teeth were regarded by 
many psychiatrists as the cause for mental disease. 
Further research revealed the fact that many of 
the teeth of the insane had not erupted or had 
become impacted, and were causing reflex pain 
which was considered by a few observers to play 
an important part in the mental breakdown. 
Much has been written about this subject. 
It is true that the toxin or poisonous substances 
from pyorrhoea or root abscesses may so exhaust an 
individual and lessen his general power of control 
as to be indirectly an additional factor in precipi- 
tating a psychosis. We cannot agree, however, 
with those who maintain that infected gums or 
impacted teeth are responsible for an attack of 
insanity. We have met many patients not mental 
patients who have had these disorders of the teeth, 
and who are mentally sound. Furthermore, 
there are many mentally sick people whose teeth 
are in excellent condition. It is true, however, 
that infections of the teeth may cause an exhaus- 104 
ABNORMAL BEHAVIOR 
tive state, and an impacted tooth may cause reflex 
pain which may act as additional factors in the 
many that have precipitated a nervous breakdown. 
In the mouth cavity, the food comes into contact 
with the saliva, which contains a ferment known 
as ptyalin. The latter acts on the carbohydrate 
element of the food and changes it into a simpler 
compound so as to be more readily assimilated by 
the body. The food is then swallowed and passes 
along the oesophagus into the stomach. 
In the stomach the ptyalin continues to digest 
the carbohydrate element of the food for one half 
to three quarters of an hour. The hydrochloric 
acid of the stomach continues to digest the carbo- 
hydrate changing it still further into simpler chem- 
ical compounds. 
The proteid element of the food is being di- 
gested by a ferment known as pepsin which breaks 
up proteid into simpler and more soluble mole- 
cules. The proteid compound of milk, caseinogen, 
is digested by a ferment called renin. The fat com- 
ponent of the food is attacked in the stomach by a 
ferment known as lipase which breaks up fat into 
glycerol and fatty acids. 
The food is then passed on into the small in- 
testines. Into the latter are poured the juices of 
an important organ, the pancreas. The pan- 
creatic juice still further breaks down the carbo- 
hydrate component of the food into still simpler 
compounds, through a ferment called amylase. 
The final result is the change of the carbohydrates 
into glucose, chemically a monosaccharide, which PITFALLS OF OUR MINDS 
105 
is assimilated by the body. The action of amylase 
is enhanced by similar ferments present in the 
juices of the small intestines. 
Trypsin, a ferment of the pancreatic juice, and 
erepsin, a ferment of the intestinal juice, still 
further change the proteid component of the food 
into simpler compounds and leave it in the shape 
of amino acids which are then absorbed by the 
body. Lipase, a fat splitting ferment of the pan- 
creatic juice, continues to convert the fats into 
glycerol and fatty acids. The bile is poured into 
the small intestines and by virtue of its salts as- 
sists the pancreatic juice in its function, and pro- 
motes digestion. Bile brings fatty acids and soaps 
into solution and renders it absorbable. 
The final results of the action of the juices on the 
foodstuffs is, therefore, their conversion into mono- 
saccharides (from carbohydrates), amino acids 
(from proteids) and fatty acids, and glycerol 
(from fats). The product of digestion is absorbed 
by the epithelial cells of the lining of the intestines, 
aided by the physical processes of diffusion and 
osmosis. 
The foodstuffs are thus digested, absorbed into 
the blood and carried to the tissues of the body. 
The series of chemical changes which the food- 
stuffs undergo and their absorption into the tis- 
sues, and the elimination of the end product by the 
lungs and kidneys are spoken of as metabolism. 
Metabolism may result in the building up of fresh 
tissues from the material carried by the blood and 
is then spoken of as anabolism, or the tissues un- 106 
ABNORMAL BEHAVIOR 
dergoing constant changes are broken down in 
parts and removed from the body and this process 
is called catabolism. 
About 90 to 95 per cent, of food consumed in the 
ordinary diet is absorbed into the blood stream, 
conveyed to the tissues of the body and turned 
into energy in the form of heat, gland activity 
and muscle work. The remainder of the food is 
expelled in the feces. Fat and carbohydrates and 
part of the proteids are converted into water and 
carbonic acid; the nitrogen is excreted as urea 
and other partially oxidized substances; water is 
removed by the skin, kidneys and lungs; carbonic 
acid by the lungs, and urea by the kidneys. 
Fatty acids and glycerol are combined in the 
walls of the small intestines to form fats, are ab- 
sorbed by the blood, and stored in the fat layer 
under the skin; and in the omentum (an apron 
like structure in front of the intestines) to be 
called upon by the body in time of need. 
Carbohydrates are absorbed from the intestines 
and enter the blood stream chiefly in the form of 
glucose. This passes to the liver where it is con- 
verted into a compound called glycogen. Muscle 
also contains considerable glycogen. Whenever 
there is an immediate need for energy the body 
calls upon this glycogen which it changes into glu- 
cose and uses the latter for energy. Some sugar 
is changed to fat and used as stored potential 
energy. 
The proteids are absorbed into the blood as 
amino acids. Some of it is built up into the tissues PITFALLS OF OUR MINDS 
107 
into living substance; and part of it is burnt up 
by the tissues in the form of carbonic acid and 
water furnishing energy to the body. Some of it 
is excreted as urea and other incompletely oxidized 
substances. 
The residual material passing from the small 
intestines into the large intestine is in the form 
of a jelly, colored by the presence of coloring mat- 
ter from the bile. Water is absorbed from the 
large intestine, and the residuum passes to the 
rectum forming feces. The latter is expelled from 
the body in response to the stimulus caused by its 
presence in the rectum. 
As a rule, diseases of the stomach and intestines 
are not accompanied by any marked conduct dis- 
orders. However, many of the patients suffering 
from mental disorders refer their trouble to the 
stomach and intestines. The depressed patients 
usually complain that their stomach is not func- 
tioning properly, that their intestines are clogged, 
etc. The psychoneurotic patient frequently refers 
his symptoms to the stomach and intestines. Need- 
less to say, thorough examination of these organs 
fail to reveal any evidence of disease. 
It is opportune to speak here of the claims made 
by a group of psychiatrists of the role played by 
ulcerations of the lining of the large intestine in the 
causation of insanity. These observers claim that 
in a fairly large group of insane patients, they 
found infection and ulceration of the lining of the 
large intestines. They maintain that the toxin or 
poison from these infected areas causes mental dis- 108 
ABNORMAL BEHAVIOR 
ease. Such claims are unwarranted in the face of 
present day knowledge of the nature of insanity. 
Furthermore, their claim is not substantiated by 
other authentic workers in psychiatry. 
The lungs are two elastic sacs in the chest cav- 
ity, which allow oxygen of the inspired air to be 
taken up by the blood circulating in its capillaries 
and also permit the circulating blood to expel the 
carbonic acid of the tissues to the exhaled air. The 
process of transference of oxygen from the air to 
the tissues of the body and of carbonic acid from 
the body tissues to the atmospheric air is called 
respiration. Oxygen is essential to the activities 
of the body tissues and indispensable in carrying 
out life’s processes. Oxidation is the process of 
combination of oxygen with other substances. 
Oxygen is an essential element in metabolism. 
It is carried by the red cells of the blood in the 
form of a compound with hemoglobin (the coloring 
element of the red blood cells). 
Tuberculosis of the lungs, consumption, is asso- 
ciated with a peculiar change in the personality of 
the patient suffering from the disease. The tuber- 
culous patient may have a feeling of well being, 
or euphoria, which is entirely unjustified by cir- 
cumstances. The patient is apt to be rather selfish 
and self-centered. He often makes plans for the 
future which are obviously unachievable. We 
have met tuberculosis patients who on the very 
day of their death, were planning trips to the 
woods and seashore, were confiding their plans 
for securing funds of money, etc. They would PITFALLS OF OUR MINDS 
109 
never admit the seriousness of their ailment. This 
peculiar euphoria of the tuberculosis patient is a 
phenomenon which has baffled many a student of 
medicine. 
Asthma, a disease of the lungs which is charac- 
terized by difficulty in breathing, due to changes in 
the lung tissue itself, is often accompanied by 
nervous symptoms such as anxiety, fear, and a 
sense of impending death. The asthmatic patients 
suffer from periodic attacks of difficulty in breath- 
ing and are therefore constantly in dread of im- 
pending death. 
The glands of internal secretion, ductless glands, 
or endocrine glands, are organs which secrete a 
specific chemical substance into the blood circulat- 
ing through the gland. The blood carries this sub- 
stance secreted by the gland, and other tissues and 
organs of the body are affected by it. The chem- 
ical substance secreted by these glands are usually 
referred to as the active principle of the gland, 
hormone, or autocoid substance. The thymus, 
pineal thyroid, parathyroid, adrenal, pituitary, 
testicles and ovaries, are usually dealt with in 
endocrinology — that branch of the medical sci- 
ence which deals with the glands of internal 
secretion. These glands secrete their active prin- 
ciple directly into the blood and not through a 
duct; hence the names ductless glands and glands 
of internal secretion. These glands play important 
roles in the development of physical and mental 
characteristics of the individual, in the mainte- 
nance of physiological balance in the body, in meta- no 
ABNORMAL BEHAVIOR 
bolic processes, in the emotional and instinctive 
responses of the individual, and in his general 
method of adaptation to his surroundings. The 
science of endocrinology is attempting to critically 
analyze these different roles assumed by the endo- 
crine glands, the changes that they undergo in 
disease processes, and the influence they exert both 
in health and in disease upon other organs and 
tissues. 
It must be admitted that while definite progress 
has been made in the field of endocrinology, the 
subject is still in the experimental stages. Much 
has been learned about the thyroid and adrenals, 
but still more information is desired about these or- 
gans and especially about the other glands of in- 
ternal secretion. Experts in the field of endocri- 
nology are reluctant to say much about these glands 
and do not make many positive statements refer- 
able to their physiology and pathology. On the 
other hand, there has been a tendency on the part 
of a few unscrupulous men, to flood the lay press, 
and, to a lesser degree, the semi-medical journals, 
with unwarranted claims and unjustified inferences 
about these organs. The “ monkey gland ” ac- 
counts are filling the front pages of the newspapers. 
Unwarranted statements as to the causation of 
delinquency, criminality and insanity by dis- 
ordered functioning of these glands are flooding 
the semi-scientific publication. Lately we read a 
book published by an international reputable 
house, in which the importance of the endocrines 
in conduct has been so pictured as to make the PITFALLS OF OUR MINDS 
Ill 
critical reader stop and wonder how even a gul- 
lible public would believe such claims! 
We do know, however, that the different glands 
of internal secretion have an important part in 
human life, especially in the field of conduct. 
The thymus has been a source of controversy 
amongst the authentic workers in medicine. It 
does not appear to be glandular in structure when 
examined under the microscope and resembles 
more the lymphatic tissue of the body. How- 
ever, experimental evidence seems to indicate that 
the thymus contributes to the growth of the body 
and to checking excessive development of the sex 
glands. In the human, the gland reaches its max- 
imum size during the first two years of life. It 
then becomes smaller and disappears about 
puberty. Whenever the thymus gland fails to 
undergo a reduction in its size at the proper time, 
there results a condition known as subinvolution of 
the thymus. 
In people thus afflicted the skin is very soft 
and smooth, with very little hair, so that the 
male need hardly shave; the bones of the body 
are very long, the blood pressure is low and the 
genitals are poorly developed. These people are 
quite tall. Their general resistance to all forms 
of stress is lowered. They are apt to die suddenly, 
especially during anaesthesia or following some 
shock. Their personality is characterized by an 
infantile attitude towards life, and dependency 
upon others. They lack aggressiveness and are 
handicapped in meeting the various problems of 112 
ABNORMAL BEHAVIOR 
life. Whenever there is a precocious involution 
(degenerative changes) of the thymus gland there 
results an individual rather stockily built with an 
unlimited amount of energy, rather irritable, im- 
pulsive and unreasonable in behavior, and of very 
intense sex activities. 
The pineal gland is another gland whose func- 
tions are not as yet definitely established. Tumors 
of the pineal gland in the young are accompanied 
by precocious sex development. Deficiency in 
function of this gland is therefore said to be fol- 
lowed by marked and precocious sexual develop- 
ment, and by a rapid body growth. Excessive 
activity of this gland is apt to be accompanied by 
retardation in sexual development. This gland 
normally undergoes regressive changes in puberty. 
The thyroid gland was the first of the endocrine 
organs to interest medical men, and clinical mani- 
festations of diseases of this gland have been rec- 
ognized by physicians for a long time. The active 
principle is thyroxin, a chemical combination of 
thyroid secretion with iodine. Undersecretion of 
the thyroid gland results in the infant in a con- 
dition called cretinism, and in the adult, myxe- 
dema. Cretinism and myxedema are thus caused 
by insufficient supply of the active principle of the 
thyroid gland. In the cretin, there is small stature, 
the nails are brittle, the skin is dry, rough and 
thrown into folds; the metabolism rate is very low; 
the temperature is below normal; the pulse is slow, 
and blood pressure is diminished. Mentally the 
patient shows a retarded development in the in- PITFALLS OF OUR MINDS 
113 
tellectual and emotional fields. Whenever there is 
in the adult a diminished supply of the active prin- 
ciple of the thyroid gland, there results a condition 
known as myxedema. Such condition may result 
from disease of the thyroid, or from a new growth 
in it. The patient becomes sluggish in his mental 
activities, loses interest, is retarded and irritable. 
The skin becomes thickened and edematous. The 
hair falls out and the nails become brittle. The 
pulse is slowed, the rate of metabolism lowered and 
the patient becomes an uninteresting, dull and 
stupid individual. Both cretinism and myxedema 
are amenable to proper medical treatment, which 
consists in administering to the patient thyroid 
gland or its active principle. 
Overactivity of the thyroid gland results in in- 
crease in the heart beat, a slight rise in tempera- 
ture and an increase in all secretions of the body. 
The skin becomes very soft and warm and moist. 
The rate of metabolism is markedly increased. 
There is a loss of weight. The mental activities of 
the patient are enhanced and their ideation is rapid. 
There are tremors in the fingers. The eyes appear 
very bright and sparkling, and there may be a 
moderate bulging of the eyeballs. 
In Graves’ Disease, or exopthalmic goitre, we 
have a condition in which there is abnormal in- 
crease in the secretion of the thyroid gland. In 
this condition the thyroid gland is enlarged. The 
heart beats rapidly; the skin is flushed and moist. 
The eyeballs are bulging from their sockets and 
there appears to be visible an undue amount of the 114 
ABNORMAL BEHAVIOR 
white of the eye. The breathing is rapid and shal- 
low. There is a fine tremor of the extended 
fingers. There is a moderate muscle weakness. 
Insomnia is apt to supervene. Emotional control 
is lacking. There are frequent outbreaks of laugh- 
ing and crying caused by emotional instability. 
Due to increased rate of metabolism, the appetite 
may be ravenous, and yet there is a consistent loss 
of weight. There is diarrhoea. The blood shows 
an increase in its lymphocytic elements. 
It is not common to have insanity associated 
with disturbances of the thyroid gland. Deficiency 
of the thyroid gland causing cretinism and myxe- 
dema results in definite retardation of physical and 
mental processes with a tendency to stubbornness, 
and ugliness. Hyperthyroidism is usually accom- 
panied by fear and anxiety and emotional instabil- 
ity. Rarely does one one see real psychoses 
develop in hyperthyroid cases, and then they are 
characterized by delusions, illusions, visual and 
auditory hallucinations of a persecutory nature. 
Delirium also occurs in these types of psychoses. 
In cases of extreme hyperthyroid activity, there 
are profound changes in the brain cells, and mani- 
fested in the solution of the chromophilic or stain- 
ing substances of the cell. 
Activity of the thyroid is increased during men- 
struation and pregnancy. It is also increased 
during periods of stress and intense emotion. 
It will be observed from what has been said 
before that the thyroid gland secretes a substance 
which is essential to proper metabolism and which PITFALLS OF OUR MINDS 
115 
influences many other glands and organs in their 
proper functioning. It regulates the rate of oxi- 
dation of the body. 
The parathyroids are glands secreting a sub- 
stance which in some manner tends to check exces- 
sive excitation of the nerve cells. Their function 
is best understood by studying the conditions fol- 
lowing their removal from the body. When these 
glands are extirpated, tremors and convulsions oc- 
cur, followed by death. The condition following 
complete removal of the parathyroids is spoken of 
as tetany. There are no known clinical picture 
types resulting from excessive activity of the 
parathyroids. 
The adrenal glands are really of dual structure, 
i.e., (i) the cortex and (2) the medulla. The 
cortex is developed from the mesodermic layer of 
the original embryonic layers, and from the very 
same tissue which later causes development of the 
sex glands. The medulla is derived from the ecto- 
dermic layer of the original embryologic layers, 
and is in reality a modified nerve structure. The 
function of the adrenal cortex is not clearly under- 
stood. It seems to bear some relation to the func- 
tion of the sex glands, but its exact nature is 
unknown. Tumors of the cortex of the adrenals 
are often associated with abnormally precocious 
sexual development. 
The medullary portion secretes a substance 
which is known as adrenalin. When injected into 
the blood, adrenalin causes liberation of sugar 
from the liver, it relaxes the smooth muscles of the 116 
ABNORMAL BEHAVIOR 
bronchials leading to the lungs, it accelerates the 
heart beat, it raises the blood pressure, it checks 
secretions of the digestive glands and inhibits the 
movements of the gastro-intestinal canal, increases 
the rate of metabolism and diminishes muscular 
fatigue. It also is capable of reproducing the va- 
rious changes of the viscera which are character- 
istic of emotional reactions. It aids in coagula- 
tion of the blood. It also enhances the activity of 
the sympathetic nervous system. Diminished ac- 
tivity of the medulla resulting in adrenal insuffi- 
ciency makes the individual unable to cope with the 
problems of life. It results in extreme exhaus- 
tion and fatigability, diminished rate of metabo- 
lism, slow pulse, and tendency toward haemor- 
rhages. 
The pituitary gland is composed of three parts: 
(i) anterior lobe, which is developed from the same 
very primitive tissue that gives rise to the root of 
the pharynx; (2) posterior lobe, which is derived 
from a primitive tissue which gives rise to nerve 
structure, and (3) a middle lobe, commonly re- 
ferred to as pars intermedia. The secretion of the 
anterior lobe is poured directly into the blood ves- 
sels and lymphatic, while the secretions of the 
middle and posterior lobes are supposed to be 
poured into the cerebro-spinal fluid. The anterior 
lobe is essential to life because its removal is fol- 
lowed by death within a few days while removal 
of the posterior lobe alone does not cause death. 
The anterior lobe produces a substance which pro- 
duces growth and sexual development. The pos- PITFALLS OF OUR MINDS 
117 
terior lobe raises the blood pressure, influences the 
vessels supplying the heart, increases the contrac- 
tion of the smooth muscles of the bladder, uterus 
and intestines, causes increased urine secretion, 
increases spinal fluid secretion and milk secretion, 
increases metabolism, and constricts the bronchioles 
of the lungs. There has been isolated an active 
principal of the posterior lobe of this gland known 
as pituitrin which is extensively used as a medicinal 
agent especially in the practice of obstetrics 
and surgery. No active principle as yet has been 
isolated from the anterior lobe. Since the middle 
lobe is so intimately connected with the posterior 
lobe it is usually removed with the latter on dis- 
section. Several authorities maintain that it is 
the middle lobe that is responsible for the function 
usually attributed to the posterior lobe, and that 
the latter has no secretion of its own. (However, 
this is more of academic than practical interest.) 
In visiting neuro-psychiatric clinics, one is apt 
to gain the impression, judging from the number of 
X-rays of the skull that are usually taken, that the 
functions and anatomical boundaries of this gland 
are definitely and clearly understood and their in- 
terpretation is a simple procedure. Such a condi- 
tion is far from being true. X-rays of the skull 
reveal certain changes in the bone that will cast a 
definite shadow upon the X-ray plate. There are 
only relatively few pathological conditions of the 
pituitary gland that will cause changes in its bony 
envelope demonstrable by X-ray examination. 
In hypopituitarism we have a condition with a 118 
ABNORMAL BEHAVIOR 
definite deficiency in the secretion of the pituitary 
glands. There is an accumulation of fat and an 
increase of body weight. The skin is very dry and 
cool, the hair is very thin and sparse, the genitals 
remain infantile in their development. There is 
a lack of desire for sexual intercourse, and there is 
a diminution in potency in the male; menstruation 
is very irregular and often absent in the female. 
There is is a generally lowered metabolism. Often 
there is frequency of urination. The mental state 
of the individual is one of sluggishness and moder- 
ate intellectual impairment. Occasionally an X- 
ray examination of the skull may reveal a rather 
small bony envelope which encloses the gland and 
prevents its proper growth (small sella tursica). 
Hyperpituitarism is a condition resulting from 
increased activity of the gland. Clinically, it re- 
sults in rapid growth of the skeleton bones, an in- 
crease in the psychosexual and physicosexual de- 
velopment, an increase of growth of hair and a low 
sugar tolerance. When this condition occurs in 
childhood, real gigantism results. When hyper- 
pituitarism occurs in an individual in whom body 
growth has already reached its maximum and ossi- 
fication has become complete, there results a con- 
dition in which the skeletal growth is limited more 
or less to the skull and the small bones of the hands 
and feet. We then have an individual who pre- 
sents a markedly protruding lower jaw, protruding 
forehead, widely spaced teeth and very broad toes 
and fingers. 
Acromegaly is a condition usually attributed to PITFALLS OF OUR MINDS 
119 
an increased function of the anterior lobe of this 
gland and most frequently it results from a new 
growth. The individual presents a slow but steady 
increase in the size of his hands and feet, his fore- 
head becomes more or less protruding, especially 
the upper part of the orbital cavity, his lower jaw 
becomes prominent and his upper teeth become 
separated. The upper jaw appears broad and thick- 
ened. He then presents a definite change in his 
facial appearance that attracts the attention of 
his family. He may then complain of increasing 
headache and of difficulties in vision. An X-ray 
examination of the skull will usually reveal an en- 
larged sella tursica. This condition is best man- 
aged by a surgeon skilled in neurosurgery. Usu- 
ally excision of the tumor is resorted to in order 
to secure a cure. 
The sex glands, besides producing a definite 
specific secretion for procreative purposes, also se- 
crete a substance which enters directly into the 
blood circulating through these glands, and which 
influences the physical and mental development of 
the individuals. At the time of puberty in the 
male a definite change in the contour of the body 
takes place, there is a change in the voice, and a 
definite distribution of the growth of the hair on 
the body. Furthermore, there is a definite change 
in attitude towards members of the opposite sex 
and to a lesser degree towards those of the same 
sex. A feeling of aggressiveness and a pugnacious 
attitude develops. 
In the female at the time of puberty there oc- 120 
ABNORMAL BEHAVIOR 
curs development of the mammary glands, a dep- 
osition of fat around the hips and buttocks, a 
characteristic change in the contour of the body, 
a modification in the voice, and a definite altera- 
tion in mental attitude giving her the characteristic 
feminine traits. 
These changes are known as secondary sex char- 
acteristics. In the so-called normal male and 
female, these changes are definite and evident to 
any observer. Unfortunately, however, there are 
all grades of imperfections in development of these 
characteristics which not only cause an imperfect 
physical development but an incomplete psychic 
development as well. Many observers have met 
this so-called indifferent or neutral sex which is 
composed of members of both sexes in whom the 
primary as well as the secondary sex characteris- 
tics are incompletely developed. An understanding 
of normal and abnormal development of primary 
and secondary sex-characteristic will enable one 
to explain such phenomena as men using cosmetics, 
homosexuality, female prize-fighters, etc. 
The secondary sex characteristics enumerated 
above are supposed to be developed in response to 
stimulation of the supporting cells of the testi- 
cles in the male and of the interstitial cells and 
corpora lutei of the ovaries in the female. When- 
ever through disease or castration the influence of 
these cells is removed, there results a condition 
which can be best described as that of desexing the 
individual. In the male the voice becomes altered 
and resembles that of the female, the hair falls PITFALLS OF OUR MINDS 
121 
out and both desire and potency for intercourse 
are diminished. He becomes more gentle in his 
manner and loses most of his aggressiveness. In 
the daily routine he displays a definite change in 
his general attitude becoming interested in those 
subjects which are usually relegated to the fem- 
inine domain. In the female, the voice becomes 
harsher, there is a disturbance in menstruation and 
frequently complete loss of this function. There 
is a growth of hair on the upper lip and chin. An 
attitude towards daily activities resembling that 
of the male is apt to be assumed. 
While the above glands are the usual ones dis- 
cussed under the heading of the glands of internal 
secretion, there are others which have the power 
of secreting a substance which is taken up by the 
blood and which plays important roles in the per- 
fect functioning of the human organism. The 
liver, pancreas, mammary glands, and the spleen 
are the most important of these. The stomach 
and intestines, the uterus and even the brain are 
known to produce similar substances. 
The liver plays an important part in metabolism 
of the foodstuffs. It stores sugar in the form of 
glycogen and later changes glycogen into sugar 
whenever there is need for energy. It forms urea, 
which is an important end product in protein 
metabolism. It secretes bile which is an important 
element in the absorption of fat. It converts the 
pigments of the broken down red blood cells into 
bile pigments. 
The pancreas produces a secretion which influ- 122 
ABNORMAL BEHAVIOR 
ences the digestion of starch, proteids and fats, to 
which we have already referred. It also has a 
group of cells arranged more or less in clumps which 
are commonly referred to as the islands of Langer- 
hans and which are supposed to be the chief factor 
in the proper metabolism of carbohydrates. These 
are regarded as capable of producing an internal 
secretion which is poured directly into the blood 
circulating through the gland. 
The mammary glands are primarily for the pur- 
pose of secreting milk to be used as food for the 
new-born. There is sufficient evidence to believe 
that the mammary glands also have an internal 
secretion which plays an important part in the va- 
rious physical changes that occur in the female 
reproductive organs during the period of child- 
birth. 
The spleen is alleged to take part in digestion 
and is apparently intimately connected with the 
functions of the liver and the pancreas. Many 
authorities believe that it has an internal secretion 
the function of which is neither definitely estab- 
lished nor proven. The spleen may be removed 
from the body without any serious after effects. 
Thus far we have considered these glands as 
distinct unit entities. We must remember, how- 
ever, that the working mechanisms of these organs 
are indeed delicate ones and are to a certain point 
interdependent. One gland or a group of these 
glands may increase or diminish the activities of 
another gland or another group of glands. Thus 
the thyroid gland enhances the activity of the sex PITFALLS OF OUR MINDS 
123 
organs, adrenals, thymus and the sympathetic sys- 
tem, and increases nerve irritability; on the other 
hand, it diminishes the internal secretions of the 
pancreas. The adrenals stimulate the activity of 
the sex glands, the liver, and the thyroids, and 
diminish pancreatic activity. The pituitary 
stimulates activities of the adrenal, thyroid and 
sex glands and retards thymus gland activity. The 
pancreas stimulates the parathyroids and checks 
the thyroids. The parathyroid checks the activity 
of the pituitary, adrenal and thyroid glands, and 
lessens nerve irritability. The proper activity of 
the glands of internal secretion results in normal 
balance in function of these glands, and induces a 
normal healthy organism. Improper function in 
one of these organs results in imbalance of activ- 
ities of the other glands so that there is hardly any 
disease of a gland of internal secretion in which the 
other endocrine organs are not affected. 
It will be noticed that in describing the func- 
tions of the endocrine organs, there were a definite 
number in which the functions were not clearly 
understood. There were others, however, in which 
the functions were definitely established. A thor- 
ough knowledge of the physiology of these glands 
is essential to a proper evaluation of the functional 
efficiency of any individual, either in health or in 
disease. Such a procedure necessitates not only a 
physical examination of the person but also an 
analysis of his secretions and excretions as well as 
an understanding of his methods of adaptation to 
different environmental situations. Only then can 124 
ABNORMAL BEHAVIOR 
we arrive at a proper conclusion of the role played 
by the endocrine glands in the behavior of the par- 
ticular individual. We must not allow ourselves 
to make exaggerated claims of the importance of 
these organs in behavior and its disorders, since 
we are still in the experimental stage of obtaining 
information regarding their activities. 
The energy distributing mechanism is the 
cardio-vascular system (heart and blood vessels), 
and the blood. Blood has rightly been called the 
fluid of life. It consists of the fluid part known as 
plasma, and a cellular element known as the red 
and white blood cells, and platelets. The blood 
absorbs the products of digestion from the intes- 
tines, and the active principles of the glands of 
internal secretion and the oxygen from the lungs. 
It also carries these different elements to the 
various organs enabling them to perform their 
respective functions. It likewise carries from the 
different tissues waste products and conveys them 
to the waste disposal apparatus of the body. In 
the blood are formed the many defensive agents 
which the body utilizes in combating the various 
infectious diseases. The red blood cells originate 
from bone marrow, and carry oxygen in combina- 
tion with its iron containing element called hemo- 
globin. The white blood cells originate partly in 
blood marrow and partly from the so-called lym- 
phatic tissues of the body and are more or less the 
standing army of the body in combating infectious 
disease. The plasma contains various agents to 
combat disease, (antibodies). The blood platelets PITFALLS OF OUR MINDS 
125 
are found in recently shed blood and participate 
in clotting of the blood. Besides the antibodies, 
the plasma also contains the foodstuffs which are 
conveyed to the tissues and the waste products 
which are carried to the excretory organs as well 
as the enzymes and hormones of the different 
organs. 
The heart is an organ which is composed of a 
highly specialized muscle tissue, which is charac- 
terized by its power to contract and relax rhyth- 
mically. Each contraction of the heart is called 
a heart beat. With each heart beat the blood is 
sent through the arteries to their smaller divisions, 
(arterioles) and finally into the capillaries. In the 
capillaries various products of digestion and oxy- 
gen are given to the particular tissues, and the 
waste products gathered from them. The capil- 
laries then form small veins which in turn form 
larger veins and are returned to the right side of 
the heart. The chambers of the right side of the 
heart send this blood, which is now rich in waste 
products and carbonic acid, through the lungs, 
where some of the carbonic acid and some of the 
other waste products are given up to the expired air 
and oxygen is taken up from the inspired air. This 
blood, rich in oxygen, is now returned from the 
lungs to the left side of the heart and from there 
sent again to the different organs and tissues of 
the body. The blood passing by way of the arter- 
ies through the kidneys gives off most of its water 
and many of its waste products which are then 
excreted by the kidneys in the urine. The blood 126 
ABNORMAL BEHAVIOR 
in circulating through the different organs and tis- 
sues combats the different infectious diseases by 
virtue of the various defensive agents that it has 
for this purpose. The blood also tends to regulate 
the temperature of the body. 
The arteries are the vessels carrying blood from 
the heart to the different organs and tissues. The 
arteries have the power to dilate and to contract 
as the blood rushes through them. The pulse is 
the force conveyed to the arteries by the circu- 
lating blood. It has been an old dictum that a man 
is as old as his arteries, which indicates that with 
increasing age the arteries lose their elasticity 
and are not as efficient as they were in earlier life. 
The veins return the blood from the different body 
tissues and organs to the heart. 
Diseases of the heart play an important part in 
the personality of the individual. Many different 
types of heart disease are associated with anxiety 
and fear reactions. Others may in their terminal 
stage be associated with marked confusion and 
even delirium, which may result in a frank psy- 
chosis. Poor circulation may result in a poor blood 
supply to the brain, giving a condition known as 
cerebral anaemia, which is characterized mentally 
by irritability, lack of concentration, and inability 
to perform one’s work properly. 
Hardening of the arteries or arteriosclerosis is 
in a mild degree present in the vast majority of 
people reaching old age. The clinical signs and 
symptoms produced by arteriosclerosis will depend 
in a measure upon the organs whose arteries are PITFALLS OF OUR MINDS 
127 
chiefly affected. In hardening of the arteries of 
the brain, a condition called cerebral arterioscle- 
rosis, we have an individual who is quite irritable, 
and somewhat stubborn, who cannot maintain his 
attention for any length of time on any task 
(lowered mental tension) and who is apt to show 
defects in memory, especially of remote events. 
They also are apt to show impairment of the power 
to retain new information. When this condition 
is present in extreme degree, it is apt to be associ- 
ated with a definite outbreak of insanity. This 
type of psychosis is characterized by marked irri- 
tability, impulsive acts, memory and retention 
defects, and may be associated with delusional 
ideas of a persecutory nature. Many of these 
cerebralarteriosclerotic individuals have in their 
prime been men of prominence and have achieved 
considerable success in their various fields of en- 
deavor. As they grew older, their cerebral activ- 
ities became more limited and more or less auto- 
matic. 
Arteriosclerotics are apt to become intolerant of 
opinions of others. They find difficulty in adapt- 
ing themselves to new customs and habits of life. 
They often become cranks and faddists. By vir- 
tue of their recognized authority in their various 
callings, they are apt to gather new followers and 
disciples in various movements which they may 
undertake. Thus several prominent men who have 
in their later years become actively engaged in 
such movements as spiritualism have done so be- 
cause of impaired judgment due to cerebral arte- 128 
ABNORMAL BEHAVIOR 
riosclerosis, and have gathered many disciples be- 
cause of the prominence which they have achieved 
in some field of human endeavor during their prime 
of life. 
The waste disposal mechanism of the body con- 
sists of the lungs, skin, kidneys and rectum. 
Through the lungs are excreted carbonic acid gas 
and some water, which are brought there by the 
blood. The skin through its sweat glands excretes 
considerable water, allows evaporation of exces- 
sive heat of the body, and some of the poisonous 
material resulting from metabolic processes. The 
kidneys are the most important organs excreting 
waste products from the body. The kidneys are 
composed of a system of tubes which are able to 
gather from the blood circulating through the kid- 
neys practically all of the end products of the 
metabolism of the protein element of food and of 
the changed tissue proteids, and water. From the 
kidneys the water containing the different excretory 
elements passes through ureters (or tubes) leading 
to the bladder, which expels it through the urethra 
(a tube leading to the outside of the body) as 
urine. Occasionally in process of disease the urine 
contains different infectious agents. The rectum 
is the reservoir which holds that part of the food 
which has failed to undergo digestion, as well as 
some of the bacteria normally present in the intes- 
tinal tract; also many chemical compounds which 
result from bacterial decomposition of different 
organic substances present in the intestinal tract. 
Diseases of the kidneys result in incomplete PITFALLS OF OUR MINDS 
129 
elimination of the end products of metabolism, and 
cause considerable clouding of the sensorium and 
interfere to some degree with normal mental proc- 
esses. In the more serious types of diseases of 
the kidney, there often results confusion, disorien- 
tation, excitement and delirium. Not infrequently 
a real psychosis may ensue. It is a matter of com- 
mon observation that constipation, especially if 
chronic and protracted, causes considerable slug- 
gishness of mental as well as physical activities. 
This is due to the action of the products of decom- 
position of the different waste materials upon the 
nerve cells of the brain. 
Excepting in the lowest forms of life, there are 
special cells and tissues set aside for the purpose 
of continuing the species. The process by which 
a new being springs from these specialized cells 
is known as reproduction. Those organs which 
participate in reproduction are called the gener- 
ative organs. In the male the testicles produce 
types of cells called spermatozoa while in the fe- 
male the ovaries contain a group of cells called ova. 
From the union of a spermatozoon with an ovum, 
there results the new being. By the process of 
copulation or sexual intercourse these specialized 
cells are able to meet. In man alone, sex congress 
is an end in itself; in all other forms of life, copu- 
lation is merely a means for reproduction. The 
failure to realize that in the human being sexual 
intercourse is not only for the purpose of repro- 
ducing the race but is also an end in itself, in satis- 130 
ABNORMAL BEHAVIOR 
fying an instinctive craving, has led to consider- 
able unhappiness. 
Sex relationship and all its concommitant emo- 
tions has occupied the interest of the world at 
large. Much has been written about it both by- 
trained and untrained observers. The ancients 
surrounded sex with all sorts of taboo and mysti- 
cism which have found expressions in many reli- 
gious and civil ceremonies. 
Physiologically, it may be said that at puberty 
(12 to 14 years of age) the various sex glands be- 
gin to functionate. In the female there is a periodic 
monthly discharge of an ovum from the ovaries. 
This is accompanied by general physical as well 
as mental signs and symptoms in the individual. 
The uterus becomes congested and there is a dis- 
charge of blood from it, which escapes through the 
vagina. The breasts become somewhat enlarged 
and tender. The thyroid becomes somewhat en- 
larged. Mentally, the individual becomes rather 
restless, somewhat irritable and emotionally un- 
stable. For a few days preceding these changes 
and for a number of days following them, the de- 
sire for sex relationship is great. These symptoms 
are characteristic of the general phenomenon 
called menstruation. At about 45 years of age, 
at the so-called period of involution, the ovaries 
fail to expel any more ova and menstruation ceases. 
At this period, there is a rather delicate and tense 
mental state in the individual. She is apt to be- 
come morose, irritable, nervous and emotionally 
unstable. PITFALLS OF OUR MINDS 
131 
In the male, there is no such periodicity in the 
sex function. Furthermore, there is no definite 
cessation of spermatozoa production correspond- 
ing to the cessation of ova formation in the female. 
In both sexes, sex relationship has not only a 
definite physical side to it but a well defined psy- 
chic phase. Disturbances in the psycho-sexual 
field are responsible for most of the psychoneur- 
oses. Disturbances in the physical phase of sex 
relationship are caused by diseases of the nervous 
system especially of the spinal cord. 
The defensive and protective mechanism of the 
body consists of the skin, the lining of the different 
cavities of the body, the blood and the nervous 
system. The skin is protective in nature, and it 
is aided by various appendages such as the hair, 
nails, and sweat glands. The mucous membranes 
lining the various cavities of the body are an aid 
in repelling different disease organisms that gain 
entrance into these cavities. The blood by virtue 
of its power to form antibodies, (substances that 
are able to combat disease producing agents) and 
through the white blood cells which are able to 
ingest certain disease producing germs, is a power- 
ful defensive agent of the body. The part the 
nervous system plays in protecting the organism 
from danger will be discussed later in this chapter. 
Suffice it to say that it enables the individual to 
detect any danger in his environment and to mobi- 
lize all the defensive mechanisms to meet that 
danger. 
We have thus far discussed the different organs 132 
ABNORMAL BEHAVIOR 
of the body, as more or less less distinct entities, 
performing a definite function and serving a dis- 
tinct purpose, and all of which are performed for 
the ultimate benefit of the being as a whole. In 
order for these different organs to work in harmony, 
and in the most efficient manner, nature has pro- 
duced a definite and distinct organ for the purpose 
of correlating and regulating the different organs 
of the body. This organ is the central nervous 
system. The unit of structure of the central nerv- 
ous system is the neuron. It consists of a cell body 
with protoplasmic processes for the reception of 
stimuli which are called dendrites, and a prolonga- 
tion of its protoplasm into an elongated process 
called axis-cylinder, for the purpose of conveying 
the stimulus. The cell body contains a highly 
specialized substance called chromophilic sub- 
stance which gives it its coloring properties, and 
which is used as an index in determining the health 
or diseased state of that particular cell. Where 
the axis-cylinder of one cell meets the dendrites 
of another cell there results a synapse which is the 
unit of function of the central nervous system. 
In the unicellular organisms the particular or- 
ganism responds to danger or to a source of food 
by mere movement of its protoplasm sending out 
processes which enable it to get away from a par- 
ticular danger as well as to ingest the food. It 
does so in response to a stimulus directed to some 
part of its body. In those organisms in which there 
is developed a nervous system the different parts 
of the body and its various organs are adjusted by PITFALLS OF OUR MINDS 
133 
this nervous system. Furthermore, in response to 
stimuli brought to it by means of this nervous 
system, the simplest method of response to the 
stimulus is by means of the reflex action. A stim- 
ulus reaches a central station by means of a recep- 
tor or sense organ and a conductor or afferent 
nerve. The correlation centre or adjustor trans- 
mits this stimulus along a second conductor or ef- 
ferent nerve to the so-called effector operators 
which is a group of muscles or glands. In the 
simpler forms of life most of the nervous activity 
consists of reflex acts. As we ascend in the scale 
of development, the reflex acts are so correlated 
and collaborated as to form a more elaborate 
nervous activity. It is only in the human that the 
nervous system is developed to its final degree, 
and here we have those different mental processes 
such as memory, reasoning, and judgment. 
The sense organs are highly specialized nervous 
tissue which are able to detect certain stimuli com- 
ing to them from the environment. In the skin 
we have specialized nervous structures which are 
enabled to perceive sensations of pain, touch, cold, 
and heat, and convey them by means of the sen- 
sory nerves to the spinal cord through the different 
centres in the cord, the medulla, pons, and mid- 
brain to the thalamus, which sifts all these sensa- 
tions, and finally to the sensory part of the cerebral 
cortex. There the sensation is interpreted, re- 
corded as a memory and associated with previous 
experiences, and the human being is thus enabled 
to respond to these sensations in an appropriate 134 
ABNORMAL BEHAVIOR 
manner. The eye, for the purpose of seeing, the 
ear for the purpose of hearing, the nose for smell- 
ing, the tongue and mouth cavity for the purpose 
of tasting, represent in the human the final stage 
of sensory evolution. These sense organs also 
send by means of the various carnial nerves im- 
pressions to the brain cortex which are interpreted 
in the light of old experience, and responded to 
in appropriate fashion. The response to these 
sensations is performed by way of the efferent or 
motor tracts of the cerebro-spinal system. The 
cortex of the brain has a specialized area for send- 
ing stimuli along the motor pyramidal tract to the 
different voluntary muscles which enables the in- 
dividual to get away from danger or to utilize his 
various apparatus in securing food and nourish- 
ment, etc. 
The type of nervous activity that we have thus 
far discussed is voluntary — that is, one in which 
the individual is fully conscious of his stimuli and 
reacts to them in a deliberate, wilful manner. 
However, there are certain processes such as res- 
piration, heart beat, activities of the sweat glands, 
gastro-intestinal tract, reproductive functions, etc., 
of which the individual is unaware, but which go 
on in a definitely regulated and well controlled 
manner. That part of the nervous sysem which 
controls these unconscious activities of the organ- 
ism is called the autonomic nervous system. This 
system not only controls the activities just enu- 
merated but also regulates the action of the glands 
of internal secretion, and participates in the re- PITFALLS OF OUR MINDS 
135 
sponses of the various emotions such as anger, fear, 
rage, joy, sorrow, etc. The autonomic nervous 
system is composed of two parts; the sympathetic 
and parasympathetic system. 
The sympathetic division of the autonomic 
system causes dilatation of the pupils, increases the 
rate of the heart beat, maintains the tone of the 
arteries, causes secretion of sweat, erects the hair, 
inhibits activities of the digestive organs, contracts 
the muscles of the internal genitals, relaxes the 
bladder, and enables the liver to change glycogen 
into sugar. It has an inhibitory effect on the mus- 
cles of the trachea and the bronchi and on the 
smooth muscles of the gut from the stomach to the 
descending colon; contracts the muscles of the ex- 
ternal generative organs, and stimulates the adre- 
nals, as well as the thyroid glands. 
The parasympathetic division of the autonomic 
system has two divisions, the cranial and sacral 
branches. The cranial autonomic division (vagus) 
contracts the pupils, inhibits the heart action, 
causes secretion of the salivary and gastrointes- 
tinal glands, maintains the tonicity of the gastro- 
intestinal canal wall; the sacral division of the auto- 
nomic nervous system contracts the rectum and the 
distal part of the colon, and causes an erection of 
the generative organs. 
The action of the sympathetic division of the 
autonomic nervous system is best seen in time of 
intense emotions, in combat, in rage, and anger. 
To the cranial division of the sympathetic system 
belongs the duty of building up reserve energy 136 
ABNORMAL BEHAVIOR 
to be utilized by the body in time of need. 
The sacral division of the autonomic nervous sys- 
tem deals especially with the function of waste 
disposal and reproduction, serving therefore the 
species as a whole. 
It has been found by Cannon especially and by 
Crile that the autonomic nervous system plays a 
most important part in the control of the glands 
of internal secretion, and during the major emo- 
tions. The latter observer utilizing these various 
theories for practical application in the surgical 
operating room has shown how fear causes a dis- 
turbance in the glands of internal secretion and 
actual changes in the various cells of the nervous 
system, demonstrable under the microscope. 
Through the various stages of evolution the body 
has acquired a pattern of reaction to meet the dif- 
ferent dangers in its environment. The adrenals, 
the thyroids, and the liver are especially called 
upon to meet dangerous situations in time of fear 
and rage. Adrenalin is poured into the circulation, 
which stimulates the sympathetic nervous system, 
causing a shifting of the blood supply of the body 
to the brain cells, relaxing the smooth muscles of 
the bronchioles and increasing respiration, there- 
fore causing increased oxidation, and liberating 
glycogen from the liver to be utilized by the mus- 
cles and glands in the formation of energy. The 
thyroid gland excretes increased thyroid secretion 
and thereby enhances oxidation. In times of stress 
and danger, the body reacts by the utilization of 
the function of the glands of internal secretion PITFALLS OF OUR MINDS 
137 
through the autonomic nervous system. 
In time of relative peace and freedom from dan- 
ger, the body is constantly storing up energy 
through the parasympathetic division of the auto- 
nomic nervous system and is also enabled by this 
division of the involuntary nervous system to pro- 
create itself. 
Crile has shown that during the major emotions, 
in anger, rage, fear, the cells of the brain show 
definite dissolution of its staining substances indi- 
cating an expenditure of nerve energy. Fatigue 
also causes similar changes. He found that during 
sleep the nerve energy is restored, and the cells 
regain their normal healthy staining properties. 
The foregoing is merely an indication of the 
various changes that occur in the tissues of the 
body during rest and excitement, joy or sor- 
row, fear and anger. It will be noticed that all 
emotions are accompanied by definite physiolog- 
ical and anatomical changes. Furthermore, the 
glands of internal secretion play a prominent part 
in the manifestation of emotions. It is therefore 
logical to assume that in the different types of 
physical and mental activities, the processes are 
not distinct but interdependent. In other words, 
there is no distinctive physical or mental process. 
Each elicits activity of the other. Normal con- 
duct is the result of both physical and mental 
processes, and abnormal behavior is caused by 
a combination of both organic and psychogenic 
factors. 
In disease processes, we have an altered physical 138 
ABNORMAL BEHAVIOR 
as well as psychogenic activity. In the various 
diseases associated with fever, there is a definite 
change in the cells of the nervous system which 
results in a dissolution of its color substances and 
loss of nerve energy. In a person recovering from 
febrile disease, it is very common to see restless- 
ness, sleeplessness, irritability, lack of emotional 
control, and often excitement. This is caused di- 
rectly by the biochemical changes in the nerve 
cells. In chronic wasting diseases, there is a con- 
stant source of stimulation and irritation reaching 
the nerve tissue causing exhaustion and resulting 
in a loss of emotional control in the individual. 
Chronic infections such as results from infections 
from the teeth, tonsils, blood-poisoning, etc., also 
cause irritability, restlessness, fatigability, in- 
ability to concentrate for any length of time, lack 
of emotional control, etc. 
In diseases of the kidney, as mentioned before, 
we have an interference with the excretion of the 
various toxic elements of the end product of 
metabolism which causes clouding of the senso- 
rium, confusion, and delirium which may lead into 
a frank outbreak of insanity. In diseases of the 
heart there are often periods of anxiety, fearful- 
ness, confusion and delirium. In diseases of the 
brain, especially when it involves the frontal lobes 
or those areas which are especially concerned with 
the highest mental faculties, namely, reasoning 
and the passing of judgment, there is commonly 
found definite interference with proper cerebra- 
tion. They have difficulty in retaining new per- PITFALLS OF OUR MINDS 
139 
ceptions, and in recalling old memory, association 
is retarded, and often there may result confusion 
and excitement. 
Many diseases of the nervous system are power- 
ful factors in the causation of abnormal behavior. 
Epidemic Encephalitis, a disease attacking the 
central nervous system, may be followed by 
marked behavior abnormalities and characteristic 
mental disorders. Injuries to the brain tissue 
often result in definite traumatic psychoses. Gen- 
eral paresis, a psychosis resulting from neuro- 
syphilitic conditions, plays a prominent part in 
the production of conduct disorders. These men- 
tal disorders will be fully described in later 
chapters (see Chapters VI and XI). Epilepsy is 
probably more conducive to abnormal behavior 
than almost any other one disease. So varied are 
its manifestations that this subject requires a 
chapter to itself (Chapter VIII) to which the 
reader is accordingly referred. 
The mind is primarily for the purpose of adapt- 
ing the individual to his surroundings. The high- 
est mental processes are dependent upon proper 
functioning of the brain. The glands of internal 
secretion, especially the thyroid, play an important 
part in normal mental life. From what has been 
said before, it is quite evident that adequate adap- 
tation to the environment and normal behavior is 
possible only with a healthy, adequate functioning 
of every organ in the body, and a thorough under- 
standing of the various deviations from normal 
behavior can only be obtained by an appreciation 140 
ABNORMAL BEHAVIOR 
of the part played by pathological changes in 
causing abnormal conduct. One must have a 
knowledge of anatomy, physiology, pathology, 
physiological chemistry, and psychology, and have 
extensive experience with not only mental but also 
physical diseases, in order to fully understand the 
different factors involved in the causation of 
abnormal behavior. 
SUPPLEMENTARY READINGS 
Brown, L. The Sympathetic Nervous System, Oxford 
University Press, 1920. 
Cannon, W. B. Bodily Changes in Pain, Hunger, Fear 
and Rage, Appleton Co., N. Y., 1915. 
Crile, G. and W. The Origin and Nature of the Emotions, 
Saunders Co., 1915. 
Cheney, C. The Endocrine Glands, N. Y. State Hospital 
Quarterly, Feb. 1920. 
Schafer, E. A. The Endocrine Organs, Longmans, Green 
and Co., 1916. 
Timme, W. Clinical Endocrinology, N. Y. Neurological 
Bull. Vol. 3 (Jan., 1921) p. 3. Chapter V 
THE RELATION OF PERSONALITY TYPES 
TO BEHAVIOR 
Variations of response to similar situations in different in- 
dividuals explained by variations in personality make-up. 
Definition of personality. 
The physical, intellectual and emotional factors of the 
personality. 
Various outlines and rating scales for description of 
personality. 
Adaptability as the criterion for normal personality. 
Abnormalities of personality due to emotional imbalance. 
The mood fluctuations of the manic-depressive type. 
The shut-in or seclusive personality. 
The neurotic constitution and its characteristics. 
The personality of the psychoneurotic. 
The emotionally unstable personality. 
The egocentric personality and its relation to criminal 
conduct. 
Physical conditions and personality changes. 
Effect of environmental influences on personality develop- 
ment. 
The father and mother complexes in relation to personality 
and behavior. 
The aggressive and passive personalities. 
The self-confident and self-distrustful types. 
Development of the moral and ethical attributes of 
personality. 
Importance of the environmental factor for personality 
reconstruction. 
IT is a matter of common observation that dif- 
ferent individuals respond differently to the 
same situations. A striking example was afforded 
141 142 
ABNORMAL BEHAVIOR 
in the late war, which called out heroic qualities 
in some participants, but evoked only expressions 
of weakness in others. Of a group of men who 
perhaps fought side by side in the trenches, 
some went on and on from one battle to another, 
while others collapsed under the strain and had 
to be removed from active duty. In civil life we 
see similar variations in individual behavior under 
identical circumstances. One business man who 
sees his enterprises threatened will exert every 
energy to avoid the failure of his schemes, while 
another, similarly situated, will endeavor to close 
up his transactions with as little loss as possible. 
An analogous situation exists in the field of love 
activities. One lover is easily discouraged if he 
meets with rivalry over the object of his affections, 
while another only becomes more determined in 
his pursuit of the love object under competition. 
We might go on indefinitely quoting illustrations 
of like nature from almost every sphere of human 
activity. We may accept a general principle that 
the behavior of different individuals in the same 
or similar situations is as varied as the personalities 
of the individuals concerned. 
In its broadest aspects, personality may be de- 
fined as the aggregate of the physical and mental 
characteristics that enable the individual to re- 
spond in a characteristic fashion to a definite situ- 
ation, that distinguish him from others and give 
him his own peculiar individuality. To make this 
general statement more specific, we may consider 
that differences in personality make-up depend PITFALLS OF OUR MINDS 
143 
upon differences in the following traits: 
1. Differences in intelligence. 
2. Differences in physical make-up. 
3. Differences in the strength of instinctive and 
emotional drives. 
Under these three main headings, it is possible 
to group the various personality traits described 
in most treatments of this subject. As a matter 
of convenience, however, different authors enumer- 
ate certain selected characteristics, which might be 
considered as subdivisions of the three main head- 
ings given above, but which have so predominant 
a role in determining the personality make-up that 
a rating of the individual in respect to these qual- 
ities gives a fairly accurate representation of his 
personality. The Hoch-Amsden guide to the de- 
scriptive study of the personality included an 
inquiry into the following characteristics of the 
individual:1 
1. Traits relating essentially to the intelligence, 
the capacity for acquiring knowledge, the judg- 
ment, etc. 
2. Traits relating essentially to the output of 
energy. 
3. Traits relating essentially to the subject’s 
estimate of himself. 
4. Adaptability toward environment. 
5. Mood. 
6. Instinctive demands, traits which are more 
1 Quoted from “ A Guide to The Descriptive Study of 
The Personality,” by Hoch and Amsden, State Hospital 
Bulletin, November, 1913. 144 
ABNORMAL BEHAVIOR 
or less clearly related to the sexual instinct. 
7. General interests. 
8. Pathological traits. 
Lyman Wells, after a study of the Hoch- 
Amsden outline and of data contributed by 
Heymans and Wiersma, Cattell and Davenport, 
presented a synthetic scheme for the study of the 
personality which consisted of an evaluation based 
on the following points:1 
1. Intellectual processes. 
2. Output of energy. 
3. Self-assertion. 
4. Adaptability. 
5. General habits of work. 
6. Moral sphere. 
7. Recreative activities. 
8. General cast of mood. 
9. Attitude towards self. 
10. Attitude towards others. 
11. Reactions to attitude towards self and 
others. 
12. Position towards reality. 
13. Sexual sphere. 
14. Balancing factors. 
A somewhat later personality rating scale 
evolved by F. H. and G. W. Allport has these 
divisions:2 
1 Quoted from “ The Systematic Observation of The 
Personality — in Its Relation to Hygiene of The Mind,” 
by F. L. Wells. 
2 Quoted from “ Personality Traits; Their Classifica- 
tion and Measurement,” by F. H. and G. W. Allport. PITFALLS OF OUR MINDS 
145 
I. Intelligence. 
II. Temperament. 
1. Emotional breadth. 
2. Emotional strength. 
III. Self-expression (strength). 
3. Extro-version. 
4. Ascendance-submission. 
5. Expansion-reclusion. 
6. Compensation. 
7. Insight and self-evaluation. 
IV. Sociality. 
8. Social participation. 
9. Self-seeking and aggressive self- 
seeking. 
10. Susceptibility to social stimuli. 
Without entering into any detailed discussion of 
these various outlines and rating scales for the 
description of the personality,. we may point out 
that in general their points would all be included 
under one or another of the main headings, intel- 
lectual capacity, physical make-up or instinctive 
and emotional drives. The only case in which this 
is not immediately apparent is perhaps that of 
adaptability to environment, but in a severe 
analysis, we should undoubtedly find that this, too, 
depends upon the interaction of the intellectual, 
physical and emotional factors of the organism. 
The ability to adapt readily to new situations de- 
pends partly upon the degree of intelligence, partly 
upon physical well- or ill-being which renders 
a radical change of conduct comparatively easy or 146 
ABNORMAL BEHAVIOR 
difficult, and in part upon the presence or absence 
of emotional impulses which tend to accelerate or 
retard the newly required response. 
The so-called normal personality is rated as 
such principally upon the ability to make adjust- 
ments to new situations in an adequate and 
socially approved manner. That is, the trait of 
adaptability referred to upon the various rating 
scales is placed at a premium as an indication of 
normalcy. This means that the normal personal- 
ity must have average or even superior intelli- 
gence ; must possess a well-balanced physique, and 
must either be free from emotional conflicts or 
have the emotions well under the control of the 
conscious mental life. Aside from the inadequate 
personality of the mental defective, whose defi- 
cient intelligence renders him ill equipped to meet 
the exigencies of life, most definitely pathological 
personalities are based upon imbalance of the 
emotions. These abnormal personality types are 
well known to the psychiatrist. Their incidence 
as a cause of abnormal behavior and in the pro- 
duction of maladjustments of all kinds is so fre- 
quent that it is relevant to discuss them somewhat 
in detail. 
A rather common type of personality among 
those showing abnormal tendencies is that which 
is characterized by an almost or entirely complete 
absence of the gregarious impulses. This has been 
called the seclusive or shut-in type of personality. 
Individuals of this seclusive nature do not mingle 
with others readily, but prefer to remain aloof7 PITFALLS OF OUR MINDS 
147 
wrapped in their own thoughts and fancies. Very 
often, they are indifferent not only to their asso- 
ciates but to the realities of the external milieu 
in which they live. Thus they appear to have little 
interest in either people or events. As children, 
they are shy and timid, do not play with other 
children, are quiet and reserved. Sometimes they 
are considered model boys or girls because their 
withdrawal from the natural activities of child- 
hood saves them from being involved in the mis- 
chievous pranks of their schoolmates. Their 
dreaminess and their habit of staying by them- 
selves to read, etc., instead of joining in the play 
of the group is often mistaken for studiousness 
and intellectual superiority, which justifies for- 
giveness for slight peculiarities. As a matter of 
fact, this type of personality may be found in con- 
junction with almost any degree of intelligence, 
from actual mental defect to very superior in- 
tellectual endowment. 
Unless these seclusive habits are modified before 
it becomes necessary for the individual to make 
adjustments independently and to rather compli- 
cated social situations, this personality becomes an 
important factor in preventing the proper adap- 
tation to the demands of life in general. It may 
become a source of marital difficulties, of voca- 
tional misfits, etc. In extreme cases, we shall find 
that it becomes so intensified as to obscure all the 
other traits of the personality. The individual is 
then considered to be mentally ill. The type of 
insanity known as Dementia Praecox invariably 148 
ABNORMAL BEHAVIOR 
develops in individuals who have possessed a se- 
clusive or shut-in personality. (See Chapter VI.) 
The converse is not true, however. Not all seclu- 
sive personalities pass over into definitely psy- 
chotic states. Individuals of the shut-in type may 
make a fair adaptation to the community life, 
simply remaining more or less aloof from their 
fellow-men, or developing other eccentricities. 
The hermit and the miser are classical literary 
examples of such mildly seclusive personalities. 
Another abnormal type of personality is that 
which finds its extreme expressions in the Manic- 
Depressive patient of our psychiatric clinics. This 
is the personality which is subject to marked fluc- 
tuations of mood. It swings in alternate cycles of 
elation and depression. In the elated or manic 
mood, the person is talkative, facetious, restless, 
overactive, impatient and perhaps a trifle boister- 
ous. The opposite phase is one of sadness or de- 
pression, in which the patient is quiet, retarded in 
thought and movement, is oppressed by a feeling 
of sorrow and even of guilt, blaming himself for 
all sorts of acts which were in reality innocent 
enough in their intent, and at times inclined to 
be morose or tearful. The Manic-Depressive tem- 
perament is also inclined to irritability and uncer- 
tain temper. In the elated phase, when there is 
a free and active flow of associative processes, it 
may become inventive and original. 
One author of exceedingly clever and witty short 
stories possesses this type of personality. The 
manic tendency to a rapid stream of verbal imagery PITFALLS OF OUR MINDS 
149 
is well adapted to the profession of writing so long 
as the associations are maintained in fairly logical 
form. Many manic-depressive patients write 
plays, poems and stories on the ward while in the 
manic phase, only in these extreme cases the 
associations are disordered and fragmentary so 
that their productions could not be considered to 
possess any literary merit. They may, however, 
choose a striking title, as did one brilliant manic 
who conceived the name of a play as “ Souls.” 
Unfortunately he spent more time describing the 
play and writing press notices than in actual con- 
struction of the acts, so that his scheme fell 
through. 
Certain personalities maintain the elated or 
manic phase indefinitely. They are known as hy- 
permanic or hyperkinetic (hyper- or over-active) 
types. These hypermanics, if mild in degree, are 
capable of incredible expenditure of energy with- 
out exhaustion. They can work and play inces- 
santly. They are the life of any social party. 
They are mischievous and indulge in all sorts of 
pranks. These traits make them pleasant pa- 
tients, if they develop definite psychoses, but it 
also renders them somewhat dangerous, as they 
carry their mischievous impulses to extremes, and 
sometimes become assaultive while intending to 
be merely playful. 
In other instances, the depressed mood predomi- 
nates; the person is subject to frequent attacks 
of “ the blues ” and often develops a pessimistic 
philosophy of life. He reproaches himself for 150 
ABNORMAL BEHAVIOR 
trivial errors. He becomes introspective and 
surly in attitude. He has suicidal obsessions, 
dwells upon the thought of self-destruction, and in 
extreme attacks of melancholy may even attempt 
to take his own life. Often such a depressed per- 
sonality is difficult to “ get along with,” as in this 
mood the person is apt to be sensitive and feel 
himself badly treated by friends and relatives, 
accusing them of not having a proper amount of 
affection and consideration, etc. It is not strange 
that a certain percentage of marital difficulty can 
be traced to this personality type in either the hus- 
band or wife. The thought of coming home to 
such a personality might well drive a would-be 
faithful husband to seek relief in the society of 
other women, while the wife who finds her husband 
wrapped in his imaginary woes may well feel a 
desire to elope with some old flame to whom she 
once preferred her husband. 
As we shall see in later chapters, the manic- 
depressive personalities, when their traits are de- 
veloped in extreme forms, may become involved 
in all types of behavior difficulties, from simple 
peculiarities of habit and vocational maladjust- 
ments to actual delinquent conduct, including even 
some of the major crimes against society, such as 
larceny and assault. On the other hand, this per- 
sonality make-up may become a distinct business 
asset to some individuals. One business man of 
distinctly manic-depressive personality found this 
temperament exceedingly helpful. In the manic 
mood, when his mind was alert and hyperactive, PITFALLS OF OUR MINDS 
151 
he could prophesy changes in the market and use 
this foresight to his own advantage. Occasionally 
he made mistakes, but when he became depressed 
he was dominated by a feeling of inferiority and 
self-accusation which made him review these 
errors. This recurrent tendency to self-analysis 
prevented him from repeating his previous mis- 
takes, so that he constantly remained ahead of the 
market as a result of these alternating phases of 
mental activity and introspection. Many promi- 
nent figures of history have also been of a Manic- 
Depressive temperament. A notable example is 
Abraham Lincoln, whose depressive personality 
has been described by L. Pierce Clark. 
Less definitely pathological, perhaps, yet cer- 
tainly abnormal, is the personality which accom- 
panies the neurotic constitution. The neurotics 
are those fearful, indecisive, constantly complain- 
ing individuals, who show a fundamental weakness 
and lack of stamina. They try to compensate for 
their deficiencies by assuming a set of virtues 
which are not natural to their personality, and are 
therefore overdone and patently artificial. In- 
stead of being punctual they arrive ahead of time; 
instead of being rapid and efficient, they are so 
methodical as to be slow. They replace a whole- 
some regard for cleanliness by over-fastidiousness; 
lacking a wholesome sense of honesty and moral 
integrity, they become the type known in the ver- 
nacular as “ goody-goodys,” and are scrupulous 
about unnecessary details. 
Adler has devoted a whole book to a description 152 
ABNORMAL BEHAVIOR 
of the neurotic and a theory as to the underlying 
causes for the development of this type of person- 
ality. According to this author, the neurotic con- 
stitution is characterised by organic deficiencies 
which impair the general physique of the individ- 
ual. This physical defect gives rise to a feel- 
ing of insufficiency and inability to cope with the 
struggle for existence, and thus produces the fear- 
ful, vacillating type of individual whom we have 
described in the preceding paragraph. This theory 
of the neurotic constitution and personality is con- 
firmed by the fact that the developmental history 
of many neurotics gives a typical picture of a 
delicate and sickly infancy period, with prolonged 
enuresis and other physical symptoms. 
Like the neurotic, the psychoneurotic person- 
ality is lacking in certain fundamental character- 
istics which make for strength and stability. The 
symptoms of the psychoneurotic patient are at 
their source an indication of the inability of the 
individual to face the hardships of reality. Sensi- 
tive, easily discouraged, shrinking from pain, 
these personalities take refuge in day-dreaming, 
in hysterical manifestations, minor “ nervous 
breakdowns,” etc., in order to escape from the un- 
pleasant situations which are often a part of life. 
The wife who secures everything she wants from 
her husband by becoming ill when her wishes are 
not granted is the classical illustration. Her ill- 
ness is often nothing more than a fit of temper 
which appears in hysterical form. This method 
of reaction is as infantile as the crying of the baby PITFALLS OF OUR MINDS 
153 
for its bottle when hungry, since it involves no 
more acceptance of reality and necessitates no 
more strenuous activity on the part of the indi- 
vidual. 
The neurotics and psychoneurotics, although 
unpleasant personalities in many ways, seldom be- 
come definitely anti-social in overt action. They 
develop minor mental disorders, such as phobias 
(abnormal fears), morbid obsessions (irresistible 
impulse to certain habits of behavior), hysterical 
attacks, anxiety neuroses, etc. The abnormal be- 
havior of these two personalities will be discussed 
in detail in a later chapter (Chapter VII) and need 
not detain us at this point. 
There is a certain type of personality which 
may best be described as emotionally unstable. 
This implies that the emotional reactions are set 
off by inadequate or inappropriate stimuli on many 
occasions, or that they are exaggerated out of all 
proportion to the external situation. We consider 
such personalities to be over-suggestible and im- 
pulsive, because their behavior would indicate that 
such is the case. They are easily upset, are sub- 
ject to uncontrollable spells of crying or laughing, 
and often have actual temper tantrums. When 
this emotional instability becomes extreme in 
nature and prevents the individual from making 
a satisfactory social adjustment either by causing 
continued vocational malajustment and inability 
to earn an adequate living, or by resulting in ab- 
normal and anti-social behavior which brings the 
individual into conflict with the law, we have a 154 
ABNORMAL BEHAVIOR 
definitely pathological personality known as the 
psychopathic personality or constitutional psychic 
inferior. (This type will be further discussed 
in Chapter VII). 
It is characteristic of the emotionally unstable 
individual to seek the causes of his maladjustment 
outside himself. Because he is unable to adapt 
himself to the demands of society he wishes to 
change social customs to suit his own unstable per- 
sonality. He seizes upon some social or economic 
theory, and becomes a dangerous leader of his 
group, either as a labor agitator or a radical polit- 
ical leader. That modern society could be recon- 
structed to advantage cannot be denied, but one 
could hardly devise a social system in which the 
constitutional psychopath could find a safe haven. 
Were all the changes demanded by his favorite 
theory to be made, he would still find himself dis- 
contented and dissatisfied, for social regulations 
must be shaped in harmony with the demands of 
the average or normal individuals. Thus, although 
the radical psychopath may inadvertently bring 
about changes of benefit to his confreres, he him- 
self profits little thereby, for he soon becomes as 
ill adjusted as ever to the new environment which 
he has created in the hope of achieving satisfaction. 
The personality types which we have been 
describing are those which are definitely associ- 
ated with some form of mental disorder, although 
their mild characteristics are found in a great 
many individuals who are making more or less 
satisfactory social adaptations, and could not be PITFALLS OF OUR MINDS 
155 
considered in the least verging upon a state of 
mental disease. There is an equally well defined 
personality type which leads more directly to anti- 
social behavior than these others, which produce 
serious misconduct only when they have obtained 
a pathological control over the activities of the 
individual and robbed him of conscious appreci- 
ation of moral and ethical standards. The ego- 
centric personality, on the other hand, is that of 
the natural criminal, if indeed such an anomaly 
exists. 
The egocentric person is characterized by such 
traits as selfishness, aggressiveness, cruelty, stub- 
bornness, etc. He never admits that he is in error, 
but places the blame on his associates, or on so- 
ciety in general. He is entirely lacking in sym- 
pathy, is superficial, and has no well-grounded 
ideals of ethical standards of conduct. He is opin- 
ionated, self-assertive and defiant of authority. 
It is apparent at the outset that these qualities 
are excellent soil for the development of criminal 
tendencies if the individual happens to find himself 
in an environment which is conducive to the fos- 
tering of such impulses. If thrown into associa- 
tion with companions who have habits of delin- 
quency, the egocentric person easily falls into 
such habits himself. Attitudes suggestive of this 
personality make-up are expressed by many pris- 
oners in penal institutions, who show nothing 
otherwise abnormal in their mental life. 
The epileptic often develops certain egocentric 
traits in connection with his disease. He is stub- 156 
ABNORMAL BEHAVIOR 
born, inconsiderate, irritable, selfish and at times 
cruel. It is a striking coincidence that so much 
of the behavior of the epileptic should be anti- 
social and even criminal in nature, when we con- 
sider his egocentric personality make-up. 
It must not be taken from the above discussion 
that these personality types always occur as dis- 
tinct and well marked entities. It is not at all 
unusual for an individual to possess a personality 
makeup combining various characteristics. For 
example, a person may be both emotional and 
neurotic; or emotional instability may be found 
in connection with egocentric characteristics, etc. 
The variations in personality possible by different 
combinations of traits are almost innumerable. 
The genesis of the personality is an absorbing 
question, and one which has many practical im- 
plications. We have stated in the beginning that 
personality differences have their inception in 
variations of the physical make-up and in innate 
differences in the intellectual and emotional en- 
dowment. On the physical side, we speak of dif- 
ferences of energy output, for example, and even 
describe the individual who is markedly lacking 
in physical energy as a hypokinetic or under-active 
personality type. To this hypokinetic type we as- 
cribe such traits as slovenliness, lack of ambition 
and initiative, lack of physical energy, indolence, 
and a tendency to be easily led. We also speak of a 
definite personality make-up, the egocentric, as 
associated intimately with the disease condition of 
epilepsy. PITFALLS OF OUR MINDS 
157 
Other physical conditions give rise to charac- 
teristic personality traits. In some instances of dis- 
turbance of the glands of internal secretion there is 
a concomitant development of emotional instabil- 
ity, while other kinds of endocrine disorders cause 
a picture approximating that of the hypokinetic 
personality. The neurotic constitution is definitely 
associated with physical inferiority. Many phys- 
ical diseases produce changes in the personality, 
as we have seen in the preceding chapter. The 
optimism of the tubercular patient and the anx- 
iety of the patient suffering from cardiac dis- 
order are well known to the medical profession. 
The personality differences which are predom- 
inantly due to emotional reactions have been 
described at length in the preceding pages. The 
variations which are to be attributed to the contrast 
between the person of superior intelligence and per- 
haps gifted with some particular talent and the 
inferior or defective mentality are too obvious to 
need further comment. There remains to be ac- 
counted for the vast mass of habitual attitudes 
and reaction patterns, both emotional and voli- 
tional (for want of a better term), which are 
built up in the early integration of the physical, 
intellectual and emotional life into the definite 
personality and character of the individual. 
Our interpretation of the personality of a given 
individual is after all objective, in large measure, 
and is based upon his behavior as observed by us. 
We cannot be acquainted with the intimate proc- 
esses of his mental life, and even if we should ask 158 
ABNORMAL BEHAVIOR 
him to perform an introspection on these, he would 
be able to give us only conscious motives and feel- 
ings. The inadequacy of such a report is evident 
when we consider the vast extent of unconscious 
impulses which find expression in the conduct of 
the individual in one way or another and which 
warp his personality to suit their needs. There- 
fore, if we would understand the problem of per- 
sonality we must have a certain familiarity with 
these unconscious mechanisms, and must under- 
stand how the habits, ideals, and sentiments are 
built up in the mental life of the individual, until 
they finally become an integral part of the char- 
acter and personality. 
Environmental influences begin to leave indel- 
ible impressions on the personality of the indi- 
vidual as soon as he is born. The reactions of the 
parents to each other and to the child tend to 
create conditioned emotional responses which 
later in life may control the conduct of the indi- 
vidual. The classic example of the Freudians is, 
of course, the mother who demands from her son 
an abnormal degree of affection to replace the 
waning interest of her husband. The boy who is 
thus called upon responds by developing a fixation 
upon the mother which interferes with the trans- 
ference of his affection to the proper love object 
when he becomes of marriageable age. In extreme 
instances, the son who is the victim of this 
“ mother complex ” is never able to divorce his 
love entirely from the mother image. He may 
have an active sex life, involving prostitutes and PITFALLS OF OUR MINDS 
159 
many other women, but he cannot quite reach the 
point of choosing a wife, upon whom he would be 
forced to bestow the same reverence and worship 
that he has reserved for his mother alone. If he 
does marry, it will be on account of a strong re- 
semblance to the mother image which he finds in 
some woman, and the element of sex attraction 
may not be at all prominent in determining his 
selection. 
D. H. Lawrence’s novel, “ Sons and Lovers,” 
presents an excellent study of the mother complex 
in contemporary literature. His hero goes through 
two love affairs, but never succeeds in feeling more 
than a physical passion for his sweethearts. His 
mother always remains the center of his hopes 
and fancies, and when he is robbed of her presence 
by death, he becomes as purposeless in his exist- 
ence as a wrecked ship drifting on the ocean. 
Conversely to the mother-son association is the 
relationship between father and daughter. Upon 
the nature of this relationship, the girl patterns 
her reactions to men in general. If she has a 
father whom she adores, and whose attitude to- 
ward his family is affectionate and considerate, 
she is prone to trust men and idealize them. 
Sometimes, to be sure, her faith is betrayed by 
some man with whom she comes in contact, but 
even in this case her feeling toward the other sex 
does not become so unreservedly bitter as it would 
but for this happy paternal background. 
The daughter whose affection becomes alien- 
ated from her father in childhood or adolescence 160 
ABNORMAL BEHAVIOR 
on account of his misconduct or mistreatment of 
his family, is apt to develop a suspicious and 
antagonistic attitude toward the dominant male 
(as she pictures him). Her antagonism may lead 
to the complete repression of her sexual interest 
in men, and incite her to meet them in the busi- 
ness world on terms of free and equal competition. 
She rebels against the idea of surrendering her 
freedom into the keeping of this ruthless masculine 
creature, and if she does fall in love despite 
her determination, there is a decided ambivalence 
in her emotions concerning her lover. Often she 
is torn between the desire to enter into a perma- 
nent relationship such as marriage and an equally 
strong impulse to escape from a situation which 
in view of her parental experiences can only 
appeal to her as abounding in possibilities for 
suffering. 
In writing “ This Freedom,” Hutchinson has 
given us incidentally a description of a girl who 
has rebelled against the authority of an unpleasant 
father, who has sought to carve out a man’s career 
for herself, and has resolved never to fall in love. 
Although she deviates from this last resolution, 
her rebellion against masculine standards forms 
the keynote to her personality and influences all 
her decisions to the end of the story. In spite of 
her love for her husband and children, she refuses 
to give up her business and assume the subordinate 
position of the woman in the home. While we 
could hardly agree that the family misfortunes 
with which the last chapters are filled are the 
direct outcome of her refusal to follow the tradi- PITFALLS OF OUR MINDS 
161 
tions of her sex, we must give credit to the author 
for his skill in delineating this personality type, 
and showing the influences by which it was 
developed. 
Another trait in which personalities differ tre- 
mendously is in respect to their aggressiveness. 
They vary from the extreme type in whom there 
is a determination to master all people and things 
to the utmost passivity and resignation of circum- 
stances. We all know the blustering individual, 
who attempts to bully those with whom he comes 
into contact, just as we can find among our 
acquaintances the person who is so docile and 
helpless that not even the utmost provocation can 
arouse him to aggressive behavior. The golden 
mean lies between these two types. It is neces- 
sary for a well-balanced personality that the in- 
dividual be sufficiently aggressive to take an active 
participation in affairs, and exert himself in his 
own behalf, else he is apt to be submerged in the 
struggle for existence, which retains its competitive 
elements however carefully camouflaged by the 
niceties of modern society, and places a premium 
on aggression to a certain degree. 
The trait of aggressiveness depends to some ex- 
tent upon the physical and mental make-up of 
the individual and the strength of the emotional 
drives inherent within the organism. It also de- 
pends somewhat upon the environmental circum- 
stances which have contributed their quota to the 
development of the personality. Sometimes the 
child is so repressed and inhibited by stern parents 162 
ABNORMAL BEHAVIOR 
and teachers that he is never able to throw off 
the influence, but always feels the impulse to 
cringe to his fellows instead of reacting with a 
normal amount of aggression. On the other hand, 
the habit of over-aggressive reactions may be de- 
veloped under favorable environmental circum- 
stances or in imitation of some admired older 
person who becomes the child’s model and from 
whom he unconsciously copies his behavior 
patterns. 
The over-aggressive personality and the too pas- 
sive type are both liable to become detrimental 
from the vocational viewpoint. The over-aggres- 
sive, blustering individual arouses an antagonism 
in the prospective employer, while the passive, 
spineless person causes a doubt as to his capacities 
and abilities. 
The degree of confidence which the person feels 
in his own powers is also reflected in his person- 
ality. Self-confidence or the lack of it is almost 
entirely dependent on environmental influences. 
The child who is subjected to constant criticism 
becomes distrustful of his capabilities, while the 
boy or girl who is incessantly flattered and con- 
tinually hears his praises sung by fatuous parents 
may become abnormally vain and fail to realize 
that he has any limitations. The over-confident 
personality is apt to have ambitions beyond the 
possibilities of realization, or it may have so self- 
satisfied an attitude that it is content to stagnate 
upon empty and unmerited praise. On the other 
hand, the person who distrusts himself may not PITFALLS OF OUR MINDS 
163 
aspire to activities which are well within his range 
of potential achievement because of his lack of 
confidence in his own abilities. Here, again, the 
ideal personality is one which has plenty of con- 
fidence to attempt to realize its ambitious dreams, 
but at the same time is not too vain to profit by 
its mistakes. 
We might go on to enumerate the various other 
habits which are woven into the fabric of the 
personality by environmental influences in the 
course of its development. The majority of these 
habits are not directly involved in the causation 
of abnormal behavior, however, although they may 
induce minor idiosyncracies which would otherwise 
seem inexplicable. The examples thus far pre- 
sented are sufficient to show the importance of 
environmental circumstances in the development 
of the personality. It is particularly desirable 
that the social milieu be favorable in the impres- 
sionable years of infancy and childhood, when most 
of the habitual patterns of the personality are 
established. 
Upon every rating scale which attempts to 
evaluate the personality make-up of the individual 
for practical purposes, such as vocational advice 
or placement, psychiatric diagnosis, etc., we shall 
find that attention is bestowed upon the moral 
and ethical attributes. To anyone who is familiar 
with the rudiments of sociology, or who has any 
knowledge of the manners and customs of various 
races, it should be a commonplace that these stand- 
ards are largely a matter of environment. It has 164 
ABNORMAL BEHAVIOR 
been said that “ morals are a matter of geography.” 
To the Anglo-Saxon, monogamy is the only ethical 
form of marriage, but among other races and in 
other lands, polygamy has met with equal ap- 
proval. The morality of an individual depends 
upon the standards of the group into which he 
is born. 
The young child is an unmoral little creature. 
Until the idea of possession is impressed upon his 
mind, he sees no reason for not appropriating any 
article that may chance to strike his fancy. 
Honesty is largely a matter of having parents and 
other associates repeatedly emphasize the fact that 
stealing is wrong. Other ethical and moral traits 
are gradually stamped upon the personality partly 
through the efforts of the parents and teachers, 
and later partly through reading, etc. The grega- 
rious impulses operate to make the individual con- 
form to the moral and ethical ideals of the group. 
Imitation is a big factor here; the child tends to 
emulate those with whom he is most frequently 
associated or whom he admires most ardently. 
Although the moral and ethical attributes are 
thus acquired characteristics, they become so 
deeply ingrained in many personalities that all 
kinds of sacrifices will be made for the sake of 
these ideals. Perhaps this is another aspect of 
the fundamental longing to be actuated by feelings 
bigger than those connected with our puny selves, 
and which is at the basis of religious fervor and 
of martyrdom for any cause. The individual 
seldom realizes that this is simply the surrender PITFALLS OF OUR MINDS 
165 
of the individuality to the emotion of the herd, 
and that the psychology of the mob is involved. 
The intellectual factors of the personality can- 
not be changed to any marked extent, but the 
physical characteristics can be improved under 
proper care, and the emotional drives can be some- 
what modified in accordance with the requirement 
for an adaptable personality. Particularly can 
the personality development be controlled within 
those aspects which depend largely upon environ- 
mental influences for their inception and develop- 
ment. Thus the problem of personality is not so 
hopeless as it might seem upon less careful analysis. 
We are prone to regard the personality make-up 
of a given individual as a fixed characteristic, im- 
possible of change. This is popularly expressed 
in the conception of the “ artistic temperament.” 
By building up a healthy physique, exerting con- 
scious control over the emotional drives, and 
manipulating the environment in harmony with 
personal needs, we may hope to make sufficient 
changes in the personality make-up to bring it 
nearer the standard of normalcy. Such changes 
can be most effectively brought about in child- 
hood, of course. In so far as we can insure a 
normal personality development, we can expect to 
prevent abnormal behavior in the individual, and 
increase his chances of social adaptation. 166 
ABNORMAL BEHAVIOR 
SUPPLEMENTARY READINGS 
Allport, F. H. and G. W. Personality Traits; Their 
Classification and Measurement. Jour. Abnormal Psy- 
chology, April, 1921. A report of some original work 
with valuable practical implications. 
Clark, L. P. Unconscious Motives Underlying the Per- 
sonalities of Great Statesmen and Their Relation to 
Epoch-Making Events. (I., A Psychologic Study of 
Abraham Lincoln). Psychoanalytic Rev., Vol. VIII, No. 
1, Jan., 1921. 
Fernald, Guy G. Character as an Integral Mentality 
Function. Mental Hygiene, Vol. II, No. 3, July, 1918. 
Hoch and Amsden. A Guide to the Descriptive Study 
of the Personality. State Hospital Bulletin, November, 
1913. Written with especial reference to psychotic 
patients. 
Hoch, August. A Study of the Mental Make-up in the 
Fundamental Psychoses. Jour. Nerv. and Mental Dis- 
ease, 1909, Vol. XXXVI. Material which throws some 
light on the problem of personality. 
Sands, I. J. Personality Defects as Neuropsychiatric Prob- 
lems. N. Y. State Journal of Medicine, July, 1922. 
An excellent short treatise. 
Wells, F. L. The Systematic Observation of the Per- 
sonality in Its Relation to the Hygiene of the Mind. 
Psychological Review, Vol. XXI, No. 4, July, 1914. 
Proceedings of the International Conference of Women 
Physicians, Vol. IV, Moral Codes and Personality. 
Woman’s Press, N. Y., 1920. Contains some excellent 
papers on the subject by such authorities as Amsden, 
Gj S. Hall, Kempf, et als. Chapter VI 
THE ROLE OF THE PSYCHOSES IN THE 
CAUSATION OF ANTI-SOCIAL CONDUCT 
Definition of psychoses and allied terms. 
Psychogenic and organic psychoses. 
Description of Dementia Praecox; cases illustrating its 
various forms. 
The Manic-Depressive Psychoses; cases illustrating their 
various forms. 
Description of Involution Melancholia; an illustrative case. 
Paranoia, and its bearing on anti-social conduct. 
Senile Psychoses and their relation to abnormal conduct. 
Description of psychoses with Cerebral Arteriosclerosis, and 
cases illustrating their type of anti-social conduct. 
Description of Traumatic Psychoses. 
Syphilis as a preventable disease. 
General Paralysis of the Insane as a cause for anti-social 
conduct. 
Psychosis with Cerebral Syphilis. 
Juvenile Paresis; a form of maladjustment. 
Alcholic Pyschoses; cases illustrating pathological intoxi- 
cation and delirium tremens. A description of Korsakow 
Psychosis and the acute and chronic hallucinoses. 
Psychoses following drug addiction. 
Psychoses accompanying Epilepsy. 
Psychoses occurring among mental defectives. 
The medico-legal aspect of insanity. 
IT is a well-known fact that insane individuals 
frequently behave in a way that is definitely 
anti-social in nature. It is this fact that first 
prompted society to segregate the mentally 
167 168 
ABNORMAL BEHAVIOR 
sick from the rest of the community. It is 
only recently that the humanitarian element has 
entered into the management of those who are 
mentally afflicted. In considering the role that 
the psychoses play in anti-social conduct, we are 
entering into a discussion of the very factor re- 
sponsible for the scientific attitude that has re- 
cently been assumed in dealing with all forms of 
conduct disorder. It was through the effort at 
solving some of the mental mechanisms under- 
lying the behavior of the insane that scientific 
workers became interested in other fields of human 
conduct, and directed their attention to various 
other manifestations of abnormal behavior. It is 
the insane asylum or the hospital in which the in- 
sane are received, observed and treated, which is 
the cradle for the modern scientific attitude as- 
sumed in dealing with the diverse forms of ab- 
normal behavior. 
What is a psychosis? A psychosis is a disease 
of the mind; more technically it may be defined 
as abnormal behavior in which the personality of 
the individual is completely lost. Usually a psy- 
chosis is referred to as an attack of insanity, a 
mental break or inappropriately, a “ nervous break- 
down.” Strictly speaking, the term insanity 
should be abandoned, or relegated to legal con- 
siderations, as it really implies a legal rather than 
a medical status of an individual. It means that 
a certain individual does not know the nature and 
quality of an act at the time he commits it, or its 
consequences; therefore cannot be held legally PITFALLS OF OUR MINDS 
169 
responsible for it. The term psychosis implies 
that an individual is suffering from a disease of 
the mind in a manner analogous to his suffering 
from a diseased heart, or a diseased lung. It is 
the more scientific term, and hence we shall refer 
to it throughout our discussion. 
Originally, the term psychiatry was defined as 
“ that branch of the medical science which dealt 
with the psychoses.” Owing to the knowledge 
gained from the study of the mentally sick, the 
definition should really be broadened to include all 
forms of abnormal behavior. A psychiatrist is 
a physician who makes a specialty of the study of 
psychiatry. A psychopathic, or more properly, a 
psychiatric hospital, is an institution exclusively 
devoted to the treatment of mental diseases. The 
term observation ward usually refers to a ward in 
a hospital treating general diseases set aside for 
the reception and observation of patients suspected 
of having a psychosis. Since caring for the men- 
tally ill is one of the duties of the state, the term 
“ State Hospital ” is generally used, meaning a 
psychiatric hospital maintained by the state. The 
term “ Insane Asylum ” has with the gaining of 
knowledge of the nature of psychoses, been en- 
tirely replaced by the term “ State Hospital for 
the Insane,” or preferably, “ Psychiatric Hospi- 
tal ” or “ Psychopathic Hospital.” 
In order to appreciate the full significance which 
the role of the psychoses play in the causation of 
anti-social conduct, it will be opportune to outline 
briefly the nature of the various types of mental 170 
ABNORMAL BEHAVIOR 
disorders, and to call attention to the most prev- 
alent types of aberrant behavior in each. While 
we must bear in mind that the physical and mental 
processes are interdependent and not distinct, for 
practical purposes, however, we shall divide the 
psychoses into the organic and the functional; the 
former resulting from definite anatomical altera- 
tions in the brain, consequent upon chemical, bac- 
terial and many as yet unknown toxins, and the 
latter resulting from abnormal psychogenic re- 
actions to which there are at present no known 
pathological changes in the nervous system bearing 
a causal relationship. Because of the greater fre- 
quency of the psychogenic psychoses, we shall 
discuss them first. 
The psychogenic psychoses include those forms 
of abnormal behavior for which at present no ade- 
quate explanations are found in the structural 
alterations in the brain or the other tissues of the 
body. In the vast majority of these cases, upon 
which post-mortem examinations are performed, 
the nervous system is found to be normal, or if any 
changes are noted, they are explained on some 
concomitant disease process. It is true that re- 
cently changes have been described in the glands 
of internal secretion of some of these patients, 
but as yet this has not been substantiated by other 
observers, and furthermore, the exact causal rela- 
tionship which such changes might bear to the 
mental process has not been elucidated. In the 
present state of our information concerning these 
psychoses, they are best explained as reaction PITFALLS OF OUR MINDS 
171 
types, resulting from vicious habit formation 
caused by bad mental hygiene, characterized 
generally either by reversion to an infantile form 
of behavior in the Dementia Praecox group, or by 
the extremes of mood reactions in the Manic 
Depressive type. 
The most serious of all forms of psychoses is 
Dementia Praecox, since recovery from this dis- 
ease of the mind is rare, and, many authorities 
believe, impossible. It constitutes about 60% of 
the total residents of the New York State Hos- 
pitals for the Insane.1 The individuals possessing 
the so-called “ shut-in personality ” described in 
the previous chapter are the ones most susceptible 
to this type of psychosis. This personality will 
be recalled as characterized by sensitiveness, 
stubbornness, reticence, seclusiveness, inability to 
make friends readily, or to participate in whole- 
some forms of diversion, and inability to adapt to 
new situations. Such personalities live in a world 
of dreams and phantasies rather than in one of 
facts and actualities. They are engaged in thought 
rather than in action, are apt to delve into deep 
problems, and attempt to solve the riddles of the 
universe rather than to meet the difficulties in 
their own immediate environment. They do not 
meet new conditions squarely, and constantly pro- 
crastinate. When new situations demanding un- 
usual adjustments are encountered, an actual 
psychosis is apt to be precipitated. The new 
1 Thirty-second Annual Report, New York State Hos- 
pital Commission, 1920, p. 258. 172 
ABNORMAL BEHAVIOR 
situation may be physiological in nature such as 
the advent of puberty or sexual relationship, etc., 
or it may be an incidental situation such as death 
in the family, business worries, etc. These patients 
show defects of interest, gradual blunting of the 
emotions, increasing indifference and apathy, silli- 
ness, serious defects of judgment, development of 
phantastic ideas, odd and impulsive conduct, 
dreamlike states, peculiar feelings of being 
“ forced ” to do things, of being interfered with 
by some mysterious influence, etc. 
The four types usually described are: 
1. The Hebephrenic Form, in which there is a 
tendency toward silliness, grimacing, laughing, 
smiling to one’s self, peculiar mannerisms of speech 
and action; absurd and grotesque mental content; 
uncleanliness and untidiness in person and habit. 
Occasionally may show the impulsive type of 
conduct. This form commonly manifests itself 
in adolescence and even at puberty. The indi- 
vidual is completely absorbed in his own ideas; has 
no interest in the outside world, and lives a life 
governed by his own ideas and fancies. 
2. The Simple Type is the mildest form. It is 
characterized by a definite but steadily increasing 
loss of interest; gradual development of a state of 
indifference; carelessness about personal appear- 
ance, and restricted field of activity. 
Patients suffering from the Simple Form of 
Dementia Praecox are apt to express ideas that 
people are referring to them (ideas of reference); 
that people are making slurring remarks about PITFALLS OF OUR MINDS 
173 
them (ideas of derogation); that they are being 
watched and followed (delusions of persecutory 
type). 
3. The Katatonic Type are those cases charac- 
terized by resistiveness to care and treatment; 
the maintenance of a rigid state of limb and body, 
often breaking into states of excitement silly and 
purposeless in character, and reacting to various 
types of hallucinations (false sense perceptions, 
i.e., react to sensation without any apparent 
stimuli). 
4. The Paranoid Type, in which we have 
marked delusions (gross errors in judgment); ideas 
of persecution, imagining that they are being 
plotted against and followed about, and that their 
lives are in danger. They respond to various types 
of hallucinations, especially those of hearing. Be- 
cause of the fact that the acts of the Dementia 
Praecox patient are apt to be so often of impulsive 
character, and are caused frequently by their 
delusions and hallucinations, and owing to the 
fact that judgment is so markedly impaired, every 
conceivable form of anti-social conduct from 
simple minor delinquency to homicide may be en- 
countered. The following cases illustrate the 
point* 
Case 26 
A young boy (19 years of age) born in the United 
States, of normal infancy and childhood, who got along 
unusually well in school so that he was graduated at 
the top of his class, began to show considerable se- 
clusiveness at the time of puberty. He would not read 174 
ABNORMAL BEHAVIOR 
the types of books that boys of his age liked; he pre- 
ferred to read articles dealing with philosophical prob- 
lems. He became unusually religious; became over- 
scrupulous in his acts, and showed an abnormal sense 
of justice. The parents thought nothing of these mani- 
festations; in fact they encouraged them, saying that 
their boy was rather precocious and gave promise of be- 
coming a big man since he liked to read philosophical 
treatises, and would not run around the street with 
other boys. At the age of 18, this condition became 
accentuated; he became more seclusive than ever; he 
would not shave, or cut his hair; he shunned all com- 
panionship; began to laugh and smile to himself; 
would not change his underwear; and had to be forced 
to keep himself clean. Suddenly he threw some ker- 
osene on his beard and then applied a match to it. 
When examined at the hospital, he was in very good 
physical condition except for the burn of the face; 
he showed no evidences of any neurological disorders; 
mentally, he was dull, indifferent; lay in bed all 
the time showing no interest in patients lying in ad- 
joining beds. He was very untidy about his personal 
appearance; was filthy and unclean in his habits; he 
would not answer when questions were directed at 
him; he lay in bed, laughing and mumbling unintel- 
ligibly. He appeared to be reacting to hallucinations 
of sight and hearing, and lived in a world created from 
his hallucinations. His case was diagnosed as one 
of Dementia Praecox, Hebephrenic Form, and he was 
committed to a state hospital for care and treatment. 
Case 27 
A young female (29 years of age) was sent by a city 
magistrate to the hospital for observation. A long PITFALLS OF OUR MINDS 
175 
record from the Domestic Relations Court showed 
that this patient had frequently appealed for help as 
a destitute person. The patient strongly objected to 
being taken to the hospital. Said she was in good 
physical and mental condition; thought there was 
nothing wrong with her in any way; that it was the 
duty of her husband to provide for her and that she 
was perfectly justified in applying to the Court for 
means of securing sustenance from her husband. Her 
father, in describing the patient, said that she was 
rather studious as a child; would read until late hours 
of the night; and instead of going out with the other 
girls she preferred to remain at home and read books, 
most of them, however, being of a strong sex color. 
She was always quite stubborn and obstinate, had to 
have her own way, and insisted upon having things 
done the way she wanted. She would spend hours 
before the mirror, and would take great pains in the 
care of her person. 
Three years ago she met a man and married him 
after a courtship of only two days. She did not tell 
her parents of this man until after the wedding cere- 
mony. One week after her marriage she became rather 
excited, came to her people and complained of her 
husband’s refusal to support her. She stated that her 
husband was trying to do her physical harm; that he 
was tampering with her food; and he was causing 
peculiar feelings to creep through her body. At that 
time she was rather shabbily dressed; her hair was 
dishevelled and she showed peculiar twitchings of the 
face. She objected to her father looking at her, say- 
ing that it made her very uneasy and fearful. She left 
her father’s home without announcing her departure 
and evidently returned to live with her husband. Two 
years ago she applied to the Domestic Relations Court 176 
ABNORMAL BEHAVIOR 
for support from her husband. The social service 
worker attached to the court investigated home con- 
ditions and was told by the landlady that the 
patient was definitely “ peculiar.” She would sit for 
hours smiling in a silly manner; she would often pour 
water out of the window at passers-by. She would 
often go to a corner of her room and talk away for 
hours; would stuff her ears with cotton. The patient 
would deny these allegations and it was impossible to 
get her to come for examination at the mental clinic. 
Six months ago she was finally brought to the mental 
clinic on the pretext of having her heart examined. 
It was impossible to interview the patient at that 
time, as she immediately became very abusive, saying 
that she was brought there for immoral purposes. She 
ran out of the clinic, and finally it was deemed advis- 
able to have her sent to the observation ward by a city 
magistrate. 
Physically the patient was very well developed; 
rather an attractive individual; very well nourished. 
Heart and lungs were negative. There was no evi- 
dence of any neurological disorder. 
Mentally, the patient was very suspicious; was not 
cooperative; was very evasive. For a period of six 
days it was impossible to get her to admit any of her 
peculiar ideas. When eating, she would cautiously 
taste the food before eating it, refusing most of the 
dishes offered to her. When these acts were brought 
to her attention she would refuse to discuss them, or 
denied them. Finally one of the nurses succeeded in 
gaining her confidence and to her she admitted her 
ideas of strong sexual nature and her hallucinatory ex- 
periences. She informed this nurse that she was being 
followed by men on the street, who desired to have 
immoral relations with her. She believed her food was PITFALLS OF OUR MINDS 
177 
being tampered with and that a plot was on foot to 
have her poisoned. She said “ I went into a restaurant 
and ordered some coffee and apple pie; that made me 
sick. There was a soapy taste to it. Wherever I go now 
that same taste is present in all the food. Here, too, 
there is that taste. I must not sleep nights, because 
men come here and abuse me. Can you blame me for 
being careful? etc.” 
This patient was diagnosed as a case of Dementia 
Praecox, Hebephrenic Form, and was finally com- 
mitted to a state hospital. She represents the type of 
person who so often is a source of trouble not only to 
her immediate family, but also to those with whom 
she comes into contact, as well as the social service 
worker, the court and the physician who might be 
called upon to help her solve her difficulties. It is 
quite obvious that such a person cannot possibly live 
a normal marital life. 
Case 28 
A young boy (16 years old) was brought from the 
City Prison being charged with grand larceny, having 
confessed to stealing a horse and carriage. The boy 
was of normal birth and good development. He was 
graduated from public school at the age of 13 and was 
rated as a superior student. Following his graduation 
he was employed as a messenger boy. At puberty 
he began to show a slight but obvious change in his 
personality; he became rather unsociable, would not 
play with the boys living in the same neigborhood; 
would sit for hours buried in thought. He refused to 
discuss things with other members of the family, so 
that it was quite difficult for him to get along in his 
home and in his place of employment. Two years ago 178 
ABNORMAL BEHAVIOR 
he suddenly became rather excited, stating that life 
had too many riddles and too many difficulties in it; 
that the world was against him; that there was no use 
to go on further in this life. He was taken to the 
observation ward from which he was committed to a 
state hospital. During his entire residence of a period 
of three months he showed a rather silly and impul- 
sive attitude; at times he was very quiet and appar- 
ently absorbed in his own ideas and then again he 
would break out into purposeless overactivity. His 
mood reaction was entirely inadequate to the stimulus. 
He was finally discharged as an improved case. 
On his return to his family he could not secure em- 
ployment readily. His people were quite poor, and 
the boys with whom he was thrown into contact pos- 
sessed delinquent tendencies. Five months ago he was 
thrown in with a group of young boys who suggested 
to him that he go into a store and take something from 
the counter, so as to secure some pocket money. This 
he proceeded to do, but his mode of procedure was of 
such nature as to make his apprehension quite certain. 
He was taken to court, where, however, his case was 
critically studied by the presiding magistrate, and he 
was discharged with a warning as to the consequences 
of such future acts. He was walking along the streets 
about a month ago when a group of men approached 
him and asked him if he would not drive a horse and 
carriage for them, giving him a dollar bill and promis- 
ing him a five dollar bill at the end of the day. This he 
did, but he was arrested and charged with grand lar- 
ceny. A detective asked him to sign a confession which 
he immediately did without knowing the content of the 
paper which he had signed. The exact status of the 
case was that the horse and carriage had been taken 
by these men from a neighboring stable, and used for PITFALLS OF OUR MINDS 
179 
transporting stolen goods. When the case of the pa- 
tient was brought before the presiding justice, its 
very simplicity and the apparent indifference of the 
boy aroused the suspicion of the magistrate as 
to the prisoner’s mental status, and he was sent to 
the hospital for observation. At the hospital the pa- 
tient’s physical examination was negative; he was 
somewhat undernourished but he showed no evidences 
of any neurological disorders. 
Psychometric examination showed that he had an 
Intelligence Quotient of 73 and a mental age of 11 
years and 9 months on the Stanford Scale while he 
had an Intelligence Quotient of 84 and a mental age 
of 13 years and 6 months on the Short Performance 
Series. The psychologist stated that the patient was 
of normal intelligence and the rating on the Binet Test 
was undoubtedly too low to represent his actual in- 
telligence level. It was doubtful if he gave full atten- 
tion to the problems presented on the Binet as his at- 
titude was dull, indifferent and lacking in affective 
reactions. The uneven performance was also indica- 
tive of some interference with attention and associa- 
tion processes. On the Performance Test, which made 
less severe demands on his attention, the patient made 
a higher score. The type of reaction to the psycholog- 
ical examination therefore indicated other conditions 
than primary mental deficiency. 
Psychiatric examination showed an indifferent, in- 
attentive individual, childish and foolish in attitude 
and demeanor. He smiled in a silly fashion while dis- 
cussing the seriousness of his situation, and failed to 
show any insight into his condition. He showed an 
inadequate emotional reaction. Mood was that of in- 
difference, and poverty of affective responses. He was 
returned to court with the recommendation that he be 180 
ABNORMAL BEHAVIOR 
sent to a state hospital, diagnosis being Dementia 
Praecox, Simple Type. 
Case 29 
A young male (32 years old) was sent by his par- 
ents to the Red Cross, asking that he be taken care of 
in a hospital as there was something wrong with his 
mind. He spoke about big things but was unable to 
take care of himself. This boy was born in New York 
City, had a public school education and following his 
graduation from school he worked as an office boy. He 
showed no conduct disorder of any type until his dis- 
charge from the army was insisted upon by his people. 
He was drafted in 1917 and was put in the medical 
corps as an orderly. It was noticed then that this 
orderly was rather officious, disobeyed military rules 
and discipline, paid no attention to warnings of his 
superiors, and disregarded any advice given him. He 
was therefore transferred to another post but there, 
too, he interfered with the other men’s duties, com- 
plained of the treatment he was receiving, was care- 
less about his personal appearance and about the con- 
dition of his clothing. He finally was put in a military 
hospital for observation and there his condition was 
diagnosed as Dementia Praecox, Simple Form, and he 
was discharged on a surgeon’s certificate of disability. 
Following his return to civil life, he could not secure 
employment although at that time there were many 
vacancies in various fields of occupation, for an inter- 
view with any of the managers of the place would 
result in a conviction that the applicant was not in 
full possession of his faculties, and he would not be 
employed. 
He spent his time on street corners discussing with PITFALLS OF OUR MINDS 
181 
anyone willing to listen to him all current historical 
topics; boasting of his own participancy in the war and 
blaming his superiors for not securing any promotion. 
His clothes were shabby and his personal appearance 
was quite uncleanly. At home he was rather meek 
though at times excitable and would fly into fits of 
temper whenever crossed by his parents. He was 
referred to the War Veterans’ Bureau where vocational 
training was recommended. Several types of voca- 
tional guidance were suggested for him but he had 
no particular choice. He was placed at 
but he showed no interest in the work; later he was 
transferred to carpentry, but there too he failed to 
show any interest. His attitude and manner drew the 
attention of the man in charge and was finally 
recommended that he give up training and be placed 
under psychiatric observation. It was quite obvi- 
ous that this man was suffering from a Dementia 
Praecox, Simple Type. His dull, listless attitude and 
manner; his mood indifference; his impulsive traits; 
the emotional inadequacy and his inability to secure 
any employment or to maintain any interest in his 
vocational training were definite symptoms of his 
disordered mind. It was therefore recommended that 
he be committed to a psychiatric hospital maintained 
by the Veterans’ Bureau. 
Case 30 
A man (38 years of age) was brought from the 
police precinct by an ambulance, the arresting officer 
stating that this man had struck an innocent man in 
Wall Street. That this prisoner had never seen this 
man before, and that he could not give any adequate 
explanation for his act. He was brought before a 182 
ABNORMAL BEHAVIOR 
magistrate, but there he acted so peculiarly that the 
magistrate had him sent to the hospital for observation. 
At the hospital, the patient showed a very well-de- 
veloped, well-preserved physical condition. He showed 
no evidences of any disease of the central nervous 
system. He said that for the last eight or nine years 
people had been watching him; they were following 
him wherever he went. He could hear them talking 
about him and making disparaging remarks concerning 
his character. He could not keep any position because 
people would tell his employers that he was an “ in- 
decent individual.” He finally secured a position in 
Wall Street taking care of a building (janitor), but 
here, too, he was being followed by people who pre- 
vented him from doing his work properly. He went out 
of the building and heard a man calling him names. 
A voice within him immediately told him to attack 
that man, and this he did for his own defense. He 
showed a very impulsive, irritable attitude and manner, 
expressed ideas of persecution, and reacted actively 
to hallucinatory experiences. He was committed to a 
state hospital, diagnosed as Dementia Praecox, Par- 
anoid Form. 
Case 31 
A young man (25 years of age) was brought from 
the City Prison being charged with “ unlawful posses- 
sion of firearms.’’ This history of this patient revealed 
that he had been born in Italy and was brought here 
by his parents when he was a boy five years of age. 
He had gone through school and had reached the last 
grade at 14 years of age. He was then taken from 
school in order to help support the family, and he 
was always rather suspicious, somewhat stubborn and 
difficult to manage. He had complained of the neigh- PITFALLS OF OUR MINDS 
183 
boring people because they “ were interfering with 
him ” and on one occasion he had struck one of his 
friends because the latter was forcing women to look 
at the patient in a peculiar way. He was discharged 
from the army because of some mental trouble. 
At the hospital the patient showed a very well-pre- 
served physical condition. There was no evidence of 
any disease of the central nervous system. 
A psychometric examination was performed, but the 
result was unsatisfactory as he showed a suspicious, 
rebellious attitude stating that the examiner was trying 
to influence his mind. He said that the reason for his 
possessing a revolver was that people were persecuting 
him and following him; that wherever he went they 
looked at him in a very peculiar way. The reason for 
their action was that he was very much liked by his 
officers in the army and since then they were all jeal- 
ous of him. Lately the lady with whom he was 
boarding was in the habit of looking at him in a 
peculiar manner. He thought she probably had sexual 
designs on him but that it was an immoral thing to do; 
therefore she was trying to poison him. He believed 
she had influenced all the other men of the neighbor- 
hood so that nobody would now look at him. Further- 
more, they were preventing him from securing any de- 
cent employment. They were making threats and were 
going to harm him; his food was now being tam- 
pered with and electricity was being put into his body. 
He therefore bought a revolver, in order to protect 
himself. He took a trip from New Jersey to New York 
and on the ferryboat people were making disparaging 
remarks about him, and had some secret code as evi- 
denced by the whistling of the boats in the river, all 
of which was with the intention of doing away with 
him. He therefore took the revolver and flashed it 184 
ABNORMAL BEHAVIOR 
before the other passengers, “ to frighten them ” and 
prevent them from possibly harming him. His con- 
dition was diagnosed as that of Dementia Praecox, 
Paranoid Type, and he was sent to the hospital for 
observation and treatment. 
Case 32 
A young man (26 years old) was brought from 
home by an ambulance. His father stated that there 
was no nervous or mental disease in the family or its 
collateral branches; that the boy had a good public 
school education and was apparently quite studious. 
He worked in a tailor shop as a cutter, and was quite 
industrious and of good habits. The patient was 
drafted in 1917, but the father was informed about 
one month after his enlistment that the boy was in a 
base hospital for observation as to his sanity. He was 
discharged from the army and it was necessary to 
have him sent to a state hospital where he made a 
temporary improvement. The father insisted upon the 
boy’s discharge from the state hospital and the boy 
was removed to his home against the advice of the 
physician in charge. He showed a definite seclusive- 
ness. Was unusually quiet, had no friends, refused to 
make the acquaintance of anybody, would not go out 
of the house, grew a beard and said that he was a 
chosen prophet; that God was speaking through him 
and that he was going to solve the difficulties that were 
now confronting the universe. He would do no work 
and maintained a superior, haughty attitude, laughed 
at the rest of the family, and'would not converse with 
anyone except at certain times. A social service 
worker from a neighboring settlement house repeat- 
edly urged the parents of this patient to have him re- PITFALLS OF OUR MINDS 
185 
turned to the state hospital as his condition was be- 
coming accentuated and he might become a menace. 
This his father refused to do claiming that he was will- 
ing to look after his own child. On the day preceding 
admission, patient acted in an irritable fashion, did 
not sleep the night before, said that God was talking 
to him, and prophesied a catastrophe would happen to 
the world. On the day of admission he grabbed his 
sister, a 20-year-old girl, and threw her from a window, 
shouting that he was making this sacrifice in the name 
of the Lord. 
During his residence in the hospital the patient 
showed a definitely deluded state. He actively reacted 
to auditory hallucinations and his entire mood reaction 
was governed by these false sense perceptions. He 
said God had told him to make a sacrifice like he had 
told the prophet Abraham; that he had read the Bible 
recently and that the Lord had told him to make a 
similar sacrifice; that he was chosen to lead the people 
of Israel; that his sister looked at him in a hypnotizing 
way which meant that God gave him the signal to 
make the sacrifice. He said that he was the Jewish 
Messiah, and that no one was going to live, but all 
would perish soon; that those were the sayings of the 
Lord. He was committed to a state hospital as an in- 
sane person, diagnosis being Dementia Praecox, 
Paranoid Form. 
In brief, then, the abnormal behavior and anti- 
social conduct of the Dementia Praecox patient is 
of a very diverse nature, varying from simple dif- 
ficulties encountered in home life or place of occu- 
pation to the widest range of crime. They respond 
actively to their false sense perceptions and are 186 
ABNORMAL BEHAVIOR 
dominated and governed by their hallucinations 
and delusions. 
As in Dementia Praecox, so in the Manic- 
depressive Psychoses there are as yet no definitely 
proven pathological changes found in post-mortem 
examination, nor are there as yet any definitely es- 
tablished pathological findings from other sources 
which bear an undisputed relationship to this dis- 
order. We must bear in mind, however, that there 
is an extensive group of scientifically inclined 
medical workers, who are utilizing every modern 
method of diagnostic procedure in their endeavor 
to solve the causes underlying these disorders. 
However, while we are anticipating results that 
may prove a boon to humanity, yet in the present 
state of our knowledge no data are available that 
could explain the mechanisms involved in these 
cases other than psychogenic ones. We therefore 
must regard this group also as a type of reaction 
to a situation on the part of individuals possessing 
a distinct mental make-up. Individuals of such 
make-up were described in the previous chapter as 
either the manic or the depressive type of person- 
ality; the former manifesting it by being over- 
active, vivacious, high-strung and enthusiastic, in- 
clined to overdo things, participating in many 
fields of endeavor, but finishing few of their under- 
takings, and the latter by displaying a tendency to 
worry over insignificant matters, brooding over 
trifles, being subject to frequent blue spells, 
rather slow and deliberate in their physical activ- 
ities, and hardly ever happy, but rather fault-find- PITFALLS OF OUR MINDS 
187 
ing and discouraging. Whenever any situation 
arises which requires considerable tact, judgment, 
and increased capacity for adjustment, an attack 
of psychosis may result. Such demands for unu- 
sual adjustment may be physiological in nature, 
occurring in such crises as puberty, adolescence, 
puerperal state (child-bearing), menopause 
(change of life), etc. Diminished physical en- 
durance following illness, business troubles, un- 
happy family incidents and at times an unexpected 
happy occurrence, may precipitate an attack. The 
types usually mentioned are: 
1. The Manic Phase: This is characterized by 
elation (extreme happiness), flight of ideas (rapid 
ideation, one idea suggesting another) and marked 
motor activity. (The patient is constantly in a 
state of extreme physical activity.) Occasionally 
he is irritable, rather than happy. Owing to the 
fact that their ideas come so rapidly to them, they 
have no time to select from a group of situations 
the proper mode of reaction, and their judgment 
therefore appears markedly impaired. They lack 
control of their instinctive reactions, which results 
frequently in many anti-social acts such as sexual 
indiscretions, assault, minor crimes and mis- 
demeanors. 
2. The Depressed Phase: In this phase, the 
individual is depressed, ideation is quite retarded 
and his physical activity is inhibited and slow. 
Depressed patients express feelings of insufficiency, 
being unable to cope with any situations. They 
often express ideas of sin and culpability, 188 
ABNORMAL BEHAVIOR 
and commonly express hypochondriacal ideas 
(ideas referring to physical ailments and path- 
ological conditions of their organs for which 
there is no apparent ground). Suicide is the most 
serious danger in this disorder, and suicidal at- 
tempts are very common. Occasionally, because 
of the gloomy attitude these individuals have 
towards the world in general, they inflict serious 
injuries upon members of their immediate family 
in their attempt to relieve them from their imag- 
inary troubles. 
3. The Mixed Phase: In the mixed phase of 
this mental disorder, we have a combination of 
the symptoms exhibited in the manic and in the 
depressive phases. In this condition one must 
guard against homicide. 
In the Manic-depressive Psychoses we really 
have a benign type of psychogenic mental dis- 
order, which is fundamentally marked by emo- 
tional oscillations and a tendency to recurrence of 
attacks. The duration of this disease is apt to be 
anywhere from a few hours to several years. Usu- 
ally, one figures from four to eight months as the 
average duration of attack. In the recurrence of 
the attack, a similar type or reaction may occur, 
(i.e., a manic attack may follow a manic attack, 
or a depression may recur in a patient who has 
already had a depressive phase). On the other 
hand, a depression may occur in one who has pre- 
viously had a manic attack, and vice versa (alter- 
nating type) or a depression may follow immedi- 
ately upon an excitement (circular type). These PITFALLS OF OUR MINDS 
189 
various types of manic depressive patients com- 
prise about io to n per cent of the inmates of 
the state hospitals. 
The following cases represent types of abnormal 
conduct usually encountered in this mental dis- 
order: 
Case 33 
A female (35 years of age) was brought to the ob- 
servation ward from the New York City Prison, being 
charged with forgery. The family history of this pa- 
tient reveals the fact that two sisters have had similar 
attacks and have had residences in state hospitals. 
This patient was born in New York City, was very 
precocious in her development; had a public school 
education; was very lively and cheerful; had many 
friends; liked company; and was greatly admired by 
members of the opposite sex. In social gatherings she 
was very popular because of her wit and physical at- 
traction. She had many admirers and was finally 
married at the age of 19. Immediately following the 
birth of her first child, the patient became overactive, 
overtalkative, could not sleep, talked incessantly and 
would not nurse her child; she went out of the house 
and had to be sent to a private hospital where she 
remained for five months. Following the recovery 
from this attack she apparently got along satisfacto- 
rily, looked after her child and was able to resume her 
former fields of activity. She again became rather 
tractable and manageable, participated in many social 
functions and regained her former reputation of being 
a good wife and a charming hostess. Six years later, 
following an abortion, she became somewhat irritable 
and unreasonable at home; left her husband without 190 
ABNORMAL BEHAVIOR 
any apparent reason, took up with some man and 
was finally located by her family living with that 
man under a different name. She was apprehended 
and at that time was dressed in very expensive gowns 
having bought them with the money that she had 
secured by pawning her jewelry and other household 
furniture. She was quite boastful, talked loudly 
and incessantly, kept on the go all the time, and 
complained that she could not control her mind, words 
and actions. She had no conception of the seriousness 
of her acts, and laughed at them, regarding them 
as merely insignificant and trifling experiences. She 
could see no wrong in going with this man; in fact she 
said that her sexual desires were uncontrollable. She 
was committed to a state hospital where after a 
residence of eighteen months she gained full insight 
into her condition, spoke in a heart-broken fashion 
about her going away with a strange man and of the 
sorrow that she had caused her devoted husband and 
family. She returned home, looked after the house, 
and was apparently in a state of good mental and 
physical health. Three months ago (before her pres- 
ent arrest) one of her sisters was committed to a state 
hospital because of an attack of excitement. The 
patient became rather depressed, worried a great deal, 
and finally disappeared from her home taking her 
jewelry and other valuables. She made the friendship 
of a man who took all her jewelry and valuables and 
pawned them, toured through the United States and 
Canada and finally they were traced to one of the 
hotels in New York City. While in Canada she had 
forged the signature of a prominent society lady and 
was therefore able to cash a check for several hundred 
dollars. PITFALLS OF OUR MINDS 
191 
When apprehended, she spoke very lightly of her 
situation; she was quite elated, overactive, overtalk- 
ative, kept on the go all the time, and was in a happy 
mood in spite of the situation in which she found her- 
self. She spoke very lightly of the sorrow she had 
inflicted upon her husband, saying that he should have 
gone out and made love to some other woman. 
She was finally committed to a private institution 
for the care and treatment of the insane, her mental 
condition being diagnosed as Manic Depressive Psy- 
chosis, Manic Phase. 
Case 34 
A young man (22 years of age) was brought from 
the City Magistrate’s Court being charged with dis- 
orderly conduct. A complaint was lodged against him 
for annoying a young lady. This boy was born in the 
United States, of normal birth and normal develop- 
ment. There were no nervous or mental diseases in 
his immediate or collateral family. He was graduated 
from school and worked as a book-keeper. He has 
always been of a cheerful, enthusiastic, ambitious type, 
and made many friends. He would undertake many 
things but somehow never did produce satisfactory re- 
sults in any of his undertakings. He changed positions 
very frequently but always managed to secure a better 
job. He was popular with the girls because of his 
happy disposition, his wit, and entertaining qualities. 
About six weeks before his arrest, patient com- 
plained of being unable to sleep well. He could not 
stay long in his office, and his erratic acts caused 
his discharge. He did not seem to be much concerned 
over the loss of his position. He called upon every 
one of his friends, talked in the streets, and made him- 192 
ABNORMAL BEHAVIOR 
self a general nuisance. He finally met a young lady 
who was at first attracted by his attitude, as he boasted 
of his achievements and of his bright prospects. She 
encouraged him at first but when it became evident 
that his conduct was definitely peculiar if not ab- 
normal, she rejected his attentions and her parents 
prohibited him from calling on their daughter. This 
seemed to be of little consequence to him and he per- 
sisted in forcing his attentions on the girl. He became 
so annoying that threats of his arrest were made. This 
did not seem to deter him, and a warrant was eventu- 
ally taken out for his arrest. 
At the hospital, the patient was somewhat elated, 
quite overactive — he was very officious, interfered 
with the visitors of the other patients; at times he 
would become rather irritable, and when interfered 
with would threaten to strike the nurses and orderlies. 
On the whole, however, he showed a rather cheerful, 
optimistic attitude; was quite pleasant and agreeable; 
helped the nurses and orderlies occasionally; but slept 
very little, was overtalkative and boasted of his abil- 
ities and at times was quite rambling. He spoke 
lightly of his love for the girl, saying that there were 
others whom he expected to woo and win. He had no 
insight into his condition. He was diagnosed as a case 
of Manic Depressive Psychosis, Manic Phase, and was 
committed to a state hospital for care and treatment. 
Case 35 
A young man (28 years of age) was brought from 
the New York City Prison, committed by the presiding 
justice of the Court of General Sessions, charged with 
forgery. The history of this case revealed the 
following: PITFALLS OF OUR MINDS 
193 
He was born in Austria, of Jewish parentage, and 
was brought to America when four years of age. He 
attended public school and following his graduation 
took a business course in one of the preparatory 
schools. He secured a position as a clerk in 
a business house and was rapidly advanced so that 
he was earning about $75 a week when he was 21 
years of age. He helped to support his family and 
sent his younger brothers and sisters through school. 
He participated in civic activities, and was an officer 
of the local political club. He also joined the police 
reserve. He was very well liked, and participated 
in all sorts of social activities. 
The first difficulty in which this patient found him- 
self was at 22 years of age, while returning from a 
drill of his local police reserve organization. He had 
taken a few drinks and on his way home he happened 
to pass a street car barn and pulled a lever sending 
a car on the wrong track. When the motorman called 
his attention to what he had done, the patient struck 
the motorman in the face. He (patient) was arrested 
and taken to the night court, where he was very rest- 
less and overtalkative, boastful and threatened to 
strike the magistrate. He was sent to the psycho- 
pathic ward for observation. At first he was quite 
overactive, somewhat vivacious, and rather officious, 
but after three days’ residence he quieted down, spoke 
fairly coherently and felt sorry for his act, and he was 
discharged at the end of ten days’ observation with 
the diagnosis of Manic Depressive Psychosis, Manic 
Phase (recovered). He returned to his work, got 
along quite satisfactorily in life, and was on one oc- 
casion nominated for the State Legislature. 
At the outbreak of the world war, he enlisted in the 194 
ABNORMAL BEHAVIOR 
army, falsifying his place of birth, as naturalized citi- 
zens of enemy alien countries were at that time not 
accepted. He apparently got along satisfactorily in 
the army and reached the rank of sergeant major. 
In August, 1918, while overseas, he suddenly felt 
somewhat depressed, could not sleep, found that he 
could not get along with his work, and that he was 
“ not up to the job.” He was reported sick and sent 
to the base hospital for observation. There he felt 
very much worse, said that he had led an unworthy 
life, that he had repeatedly sinned against God and 
society, and that he had committed serious sexual 
offenses. A Red Cross worker gained his confidence 
and after confessing to that officer that he had sworn 
falsely about his birth in the United States, he felt 
somewhat relieved, and continued to improve so that 
at the end of two months’ rest he was able to return 
to his outfit. He could not, however, continue with his 
work, for he soon became very restless, overactive, 
scolded his men, and disregarded all rules of military 
discipline so that he was returned to the United States 
and finally was sent to a state hospital where he came 
under the observation of one of the authors. During 
his residence in the state hospital he showed the charac- 
teristic attitude and manner of the Manic Depressive, 
being flighty, restless, excitable at times and over- 
active, somewhat destructive, annoying patients and 
visitors, and showing the general elation characteristic 
of his disease. After one year’s residence he was 
paroled from the hospital as a recovered case. 
In May, 1921, one year after his discharge from 
the state hospital, he was committed to the psycho- 
pathic ward by the justice of the Court of Special 
Sessions, being charged with “ petit larceny.” He 
then showed a very well developed, well nourished PITFALLS OF OUR MINDS 
195 
physical condition; there were no evidences of 
neurological disorders, nor of syphilitic infection. 
Psychometric examination was unsuccessful as it 
was impossible to estimate his intellectual status 
because cooperation could not be obtained. He paid 
no attention to questions except to retort with counter- 
questions. Continual flight of ideas about the loss of 
democracy in the United States — the question of 
marriage, of rights of women, etc., resulted from the 
many questions asked him. He told all sorts of stories 
about his work as a lawyer, his political affiliations, 
his relations with women attorneys, etc. The re- 
sponses to the stimuli were absolutely irrelevant. 
Each stimulus seemed to start a train of loosely asso- 
ciated ideas which had no reference to the solution of 
the problem. 
Mentally, the patient showed an irritable, disagree- 
able disposition; threatened to blacken one of the 
attendant’s eyes. At times he became elated, talka- 
tive, restless, interfering and fault-finding. He said 
in part: 
“ What do you want? I don’t know what hap- 
pened; I was in the City Prison. What do you 
want me to do? Give you a lecture? I will see 
you in church — good-bye. What do you want 
me to do — commit suicide? I remember you 
from Ward’s Island; you are a good guy. I’ll put 
you up as candidate for senator in my district. 
I am just a little nervous; have headaches. I 
don’t know why they sent me here. They said I 
took something from a store; I never touched 
anything. I am not a thief. I am a law abiding 
citizen. I served my country and was wounded, 
too. I was no slacker; that’s the way they treat 
me.” 196 
ABNORMAL BEHAVIOR 
He was committed to a state hospital, where at the 
end of three months’ residence he regained consider- 
able insight, and was again paroled. Diagnosis, 
Manic Depressive Insanity, Manic Phase. 
Two months following his parole, he was returned 
to the psychopathic service, being sent by the Court 
of General Sessions, charged with “ forgery.” This 
time the patient appeared very quiet, depressed, sat 
apart from the other patients, answered questions very 
slowly, and for about a week would not speak to 
anyone, but asked to be let alone as he was not feeling 
well. At the end of a week he became very playful and 
facetious, indulged in constant witticisms, and was 
in a state of moderate motor activity; insisted upon 
helping the nurses polish the floors, look after the 
other patients, etc. He could not sleep, and had 
to be constantly on the go. He seemed to be under 
constant psychomotor tension. When questioned, he 
would become rather irritable and somewhat ugly, but 
on the whole was quite manageable. He was returned 
to the Tombs with the recommendation that he be re- 
turned to the state hospital. The patient did not seem 
to know anything about the forgery, — he said that 
he had been out with a group of friends and had some 
drink; that he did sign a check he would not deny, 
but he could not tell whether it was his own name or 
somebody else’s that he had signed to it. 
Case 36 
A man (42 years old) was brought to the psycho- 
pathic ward after being rescued from drowning. He 
had jumped into the East River and was rescued by 
a policeman. The history revealed that the patient PITFALLS OF OUR MINDS 
197 
had had a former attack of depression at the age of 
25 years, and was ill for about one year. Since 
then he has been getting along quite satisfactorily, 
was working steadily, had married, and was the father 
of three children. About a week ago he showed some 
uneasiness, complained to his wife that people in the 
neighborhood did not like him; that he was not getting 
a “ square deal ” in the shop where he was employed. 
He felt that he had been a failure in life, that he had 
not given all his attention to his work and that his 
family had not been provided for properly. He re- 
fused to return to his place of employment, left his 
home without telling his wife, and after being absent 
for five days was finally located in the psychopathic 
ward. 
On the ward the patient showed a somewhat under- 
nourished physical condition. His heart and lungs 
were negative. There were no neurological disorders. 
The blood Wassermann was negative. Mentally, he 
was somewhat uneasy, expressed ideas of insufficiency 
and inefficiency, spoke in a low, hardly perceptible 
voice, and moved about in a slow manner. He would 
sit for hours deeply absorbed in thought and often 
he would be seen weeping. He said: 
“ I have been sad and downhearted. I lost my 
job because I was a bad man. I have no money. 
I neglected my wife and my children. My 
stomach does not work; my heart has stopped 
beating. Why did they pull me out of the river? 
I wish I were dead — I want to die.” 
He was committed to the state hospital with a 
diagnosis of Manic Depressive Psychosis, Depressed 
Phase. 198 
ABNORMAL BEHAVIOR 
Case 37 
A man (33 years of age) was brought from the 
New York City Prison being charged with “ unlaw- 
ful possession of firearm.” The patient was appre- 
hended in a city park after drawing his revolver in 
an attempt at suicide. 
Physically, the patient was a well developed and 
well nourished individual. His heart and lungs were 
normal; there were no neurological disorders. There 
were no evidences of any blood disease. Patient said: 
“ I wanted to kill myself. I tell you there is no 
use in living. People don’t like me; they don’t 
want me. Everybody seems to avoid me. They 
shun my company — what is there for me to live 
for? ” 
Mentally the patient was very sad; definitely de- 
pressed; he spoke in a very slow, retarded manner. 
Showed moderate difficulty in concentration. He 
would sit for hours in the same place, and expressed 
ideas of insufficiency. He had no insight into his 
condition. His memory was good. His attention was 
somewhat defective. Orientation was intact. He was 
committed to the state hospital for treatment, diag- 
nosis being Depressed Phase, Manic Depressive 
Insanity. 
Case 38 
A young female (25 years of age) was brought into 
the psychopathic ward in a state of excitement, after 
having thrown two of her nieces out of the window, 
killing one and seriously injuring the other. The his- 
tory showed that she was born in Russia; had but 
little schooling, and was considered generally bright PITFALLS OF OUR MINDS 
199 
and attractive, having many friends, and being quite 
popular with everybody with whom she came into 
contact. During the late war, she had undergone 
many privations, and had witnessed many acts of 
cruelty, for she lived near the fighting zone. She had 
to spend many days in cellars and was forced to go 
without food for long periods. After the peace treaty 
was signed, the family emigrated to America, but they 
experienced unusual hardships in getting here and on 
one occasion while waiting in line to have her pass- 
port viseed, a riot broke out and many people standing 
near her were killed. On reaching this country, she 
found her brothers (who had emigrated to America 
before the war) in very good financial condition, and 
she received a very cordial welcome. For a few 
months she appeared quite content and happy. Then 
she became somewhat dissatisfied with conditions. 
She had secured employment in a clothing factory, but 
she could not keep at it. She also had trouble with 
her teeth and had several of them drawn. While in 
the dentist’s chair she suddenly became ugly, insulted 
the dentist, and returned to her home appearing quite 
excited. She could give no account of her actions. 
She went to the bedroom where the children were 
playing and threw them out of the window. 
On the observation ward she was very impulsive and 
excited. Spoke incoherently and incessantly; bit one 
of the nurses; expectorated on anyone coming near 
her; tore her linen and bit her own fingers. She would 
cry a good deal and appeared to be very depressed. 
She was finally committed to a state hospital where 
for a period of four months she was very excited, 
assaultive, had to be placed in restraint, and was kept 
in the ward for the violent patients. At the end of 
that time she gradually became quieter. Gained in- 200 
ABNORMAL BEHAVIOR 
sight into her condition; spoke relevantly and gained 
considerable weight. She discussed her difficulties 
very freely, and apparently made a complete recovery 
from her psychosis at the end of ten months. She 
was diagnosed as a case of Manic Depressive Psychosis, 
Mixed Phase. 
From these typical cases it may be realized that 
the abnormal behavior of the Manic Depressive 
embraces almost every conceivable form, ranging 
from mild eccentricities to the most serious anti- 
social conduct. 
Related to the Manic-Depressive Psychoses is 
a type of mental disorder called Involution Melan- 
cholia. It occurs about middle life, is charac- 
terized by increasing worry, uneasiness, anxiety, 
agitation, marked ideas of sins and culpability, 
motor overactivity, and suicidal attempts. This 
condition is more common in the female. The 
duration of the attack is much longer than that 
of the Manic Depressive Psychoses, and lasts from 
one to two years. The following case illustrates 
this type of mental disease: 
Case 39 
A female (48 years of age), widowed, suddenly be- 
came very uneasy, complained to her children of her 
inability to sleep; would not take much food; con- 
tinually paced the floor and finally tried to jump out 
of the window. The history of the case revealed that 
she had had a normal childhood and adolescence, was 
considered a rather bright and attractive personality, PITFALLS OF OUR MINDS 
201 
had married at the age of 19, and had two children. 
Her husband died leaving her destitute. She was sup- 
ported by her brother. At the death of her husband 
she was 25 years of age and was still fairly attractive. 
She met a man whom she allowed liberties, finally 
becoming impregnated by him. They were then mar- 
ried. After the birth of the child the second hus- 
band also died. She then went to work as a seam- 
stress, and was able to give her children a good 
education. She spent all her time in raising her 
children, and apparently was making a satisfactory 
adjustment. 
At the onset of her mental trouble, she kept on re- 
ferring to the immoral act that she had committed, 
thought that she was going to be killed, that horrible 
tortures were in store for her and that her children 
were going to be injured. She was very suspicious, 
would not allow any strangers in the house, and finally 
attempted suicide. 
She was committed to a private sanitarium. There 
she was in a continual state of agitation, pacing up 
and down the floor, groaning and moaning, begging for 
protection, stating that her children were being held 
prisoners and were being subjected to all sorts of 
cruelties. She resisted all care and attention and had to 
be watched carefully because of her suicidal attempts. 
She continued in this state of restlessness and agita- 
tion for eight months; she gradually regained her poise, 
and at the end of a year was discharged to the custody 
of her son. At the time of her discharge she was 
rather downhearted, though not actually depressed; 
showed moderate anxiety, kept away from the neigh- 
bors and spent most of the time indoors. She appar- 
ently had fair insight into her condition. 202 
ABNORMAL BEHAVIOR 
Amongst the most interesting types of mental 
disorders are the paranoid conditions commonly 
referred to as paranoia. It is this type of patient 
who impresses the layman as being subjected to 
constant maltreatment, because of the logically 
elaborated and systematized delusional trends 
which appeal to one’s sympathy. Paranoia is a 
rather infrequent type of mental disease, and some 
authorities regard it as being quite rare. It is 
characterized by logically elaborated delusions 
based upon false premises. Paranoid patients are 
logical in thought, and their emotional reactions 
are quite adequate. The train of thought is apt 
to be coherent. They show fixed suspicions, per- 
secutory delusions, and logically elaborated gran- 
diose trends. They are litigating in nature and 
become involved in many legal battles in their 
efforts to avenge the wrongs done by their imagi- 
nary persecutors. It is not always easy to detect 
the nature of this disorder, and one has to observe 
the patient for weeks and months before his psy- 
chosis is detected. It is natural for an individual 
showing logical thought and adequate emotional 
reaction to win the sympathy of those who are 
ready to listen to his narrations of wrongs at the 
hands of his persecutors. The following case will 
illustrate this type of mental disorder: 
Case 40 
A married woman (aged 55 years) was sent to the 
psychopathic service for observation, having annoyed 
many prominent people with letters of complaint PITFALLS OF OUR MINDS 
203 
about her husband and her children and a certain 
physician, who had been her family doctor. Her 
family history revealed no mental or nervous diseases. 
As a young girl she was quite suspicious and very 
sensitive. She admitted several homosexual epi- 
sodes. She married at 22 years of age. Because of 
her suspicious nature her marital life was never happy. 
On one occasion, while visiting a friend, she approached 
this friend with homosexual intent and was strongly 
rebuked by the latter. She then began to make dis- 
paraging remarks about this friend, stating that she 
was very jealous, and that she was an immoral woman. 
When she was about 30 years of age, she burst out 
into a state of excitement, stating that her husband 
was being influenced by this friend, and was making 
efforts to get rid of her (his wife). However, 
she continued to live with him, and raised a family 
of six children. At the menopause, she again be- 
came somewhat excited; stated that her friend was 
again influencing her husband, and that the latter in 
turn was poisoning the minds of her children; that 
the reason why she was not liked by her children was 
due to this friend’s animosity; on one occasion she 
tried to enter a theatre, but as all seats had been taken, 
she was obliged to stand. She then created a dis- 
turbance stating that her friend was back of this. At 
the age of 47 she became quite unmanageable. She 
stated that her food was being poisoned by her hus- 
band; that she was being watched wherever she went. 
She sent a letter to the district attorney. She was 
finally committed to a state hospital. In the state hos- 
pital she was readily adaptable, and at first easily man- 
aged, but later, when she requested a privilege which 
could not be granted, she accused the ward physician of 
being in league with her family and her friend. She 204 
ABNORMAL BEHAVIOR 
said that she was far more attractive than her friend; 
was much more clever than any of the nurses on the 
ward, and that everybody was jealous of her. She kept 
writing to the various state officials voicing her griev- 
ances against the hospital authorities so that the ward 
was subjected to several investigations. She was 
transferred by her family to a private hospital for 
the care and treatment of the insane and from there 
was released to the custody of one of her daughters. 
She secretly, however, kept on sending letters to promi- 
nent citizens so that it was necessary to have her 
recommitted to a state hospital. During her entire 
residence, the patient showed logically arranged 
thought. Her delusions were of a systematized na- 
ture, each event bearing a causal relationship to the 
preceding one. It is quite obvious, however, that the 
friend who repulsed her in early life could not have 
been at the bottom of all her troubles. 
The organic psychoses are those forms of mental 
disorders in which there are definite anatomical 
changes in the brains of the patients. These 
changes may be due to degenerations caused by 
senility, hardening of the arteries, bacterial or drug 
poison, or injury to the brain tissue. 
It is a well known fact that individuals approach- 
ing senescence are expected to show slight lapses 
of memory, poor perceptions, failure of attention, 
irritability and somewhat blunted judgment. 
They are apt to speak of events of their childhood 
laying greater stress on these than to occurrences 
of every-day life, in which they display very little 
interest. The brains of these individuals when 
examined show reduction in weight, and moderate PITFALLS OF OUR MINDS 
205 
atrophy and an increase in the supporting tissues. 
Patients suffering ffom Senile Psychosis show 
increasing impairment of retention, failure of 
memory especially for recent experiences, defec- 
tive orientation, lack of concentration, self- 
centering of interests, irritability, marked stub- 
bornness, and a tendency towards reminiscences 
and falsification of memory. They may even show 
paranoid trends, states of confusion, depressions, 
and periods of agitation. Very frequently these 
patients may show marked states of excitement, 
and express persecutory trends with a deep sexual 
background. Occasionally, they may even make 
an absurd accusation of immoral acts against the 
members of their immediate family. On post- 
mortem examination, the brains present marked 
degeneration of the nerve cells and fibres with the 
formation of small areas of degeneration techni- 
cally referred to as senile claques. Because of 
the age of the patient, they are not often sent to 
hospitals for the insane, although commitment to 
a state hospital is imperative in many instances. 
These patients represent about three and one-half 
per cent of the total population of the New York 
State Hospitals. The following cases represent 
some instances of the abnormal behavior of these 
patients: 
Case 41 
An old woman was found wandering on the street, 
being unable to give her address or the name of any 
relative. She could only mention her own name. She 
asked to be taken to her grandparents whom she 206 
ABNORMAL BEHAVIOR 
said lived around the corner. She was taken to the 
hospital. The physical examination was negative ex- 
cept that her heart showed poor action. Cranial nerves 
were intact. Mentally she was childish, rather playful, 
though irritable, misidentified the doctors and nurses 
claiming them as her relatives; was disoriented for 
time and for place; said she was 18 years of age; that 
she was born in 1850 and that now it was 1870, said 
that Lincoln was President — asked to have her grand- 
parents brought so that they might take her for a 
ride. She would dance, and would go over to the 
piano and sing in a childish manner. She was told the 
name of the physician and also the date, but she im- 
mediately forgot same. Through the Police Depart- 
ment her family finally located her in the hospital. 
The history obtained from her relatives showed that 
for the past three years she had displayed increasing 
forgetfulness, irritability, childishness; had wandered 
away from home on several occasions; was restless at 
night, and would misidentify members of her own 
family. She was allowed to be taken home as the 
family could well take care of her outside of an 
institution. 
Case 42 
An Italian, 70 years of age, was brought from the 
magistrate’s court being charged with felonious 
assault. He attacked his wife with a hatchet and in- 
flicted serious injuries. Family history was negative 
for nervous or mental diseases. His son stated that 
the patient first began to show evidences of mental 
disorder about four years ago. He then complained 
to his children that his wife (who was at that time 
65 years of age) was unfaithful to him. On one oc- 
casion he created a disturbance on the street, openly PITFALLS OF OUR MINDS 
207 
accusing her of having immoral relations with a 
neighbor. He became increasingly irritable, inclined 
to fly into fits of temper and would strike anyone 
coming near him. At the hospital the patient showed 
an emaciated physical condition; pupils were irregular 
and reacted somewhat sluggishly; his teeth were in 
poor condition. His abdominal viscera were negative. 
The blood Wassermann was negative. Mentally the 
patient showed quiet, rather seclusive attitude and 
manner; at times, however, he was easily excited and 
would become assaultive; he expressed a number of 
delusions of a sexual coloring which dominated and 
controlled his conduct and into which he showed no 
insight. His memory was poor, especially for recent 
events, and his judgment was markedly defective. He 
voiced his grievances against his wife, bitterly assert- 
ing her immorality and claiming that he had witnessed 
her acts of infidelity. He was committed to a state 
hospital as a case of Senile Psychosis, Confused and 
Agitated State. 
In the psychosis with cerebral arteriosclerosis 
the condition results from the disease of the ves- 
sels of the brain. Hardening of the arteries is 
frequently found among old people, but in these 
cases, the vessels, especially of the brain, are un- 
duly thickened. In many, the vessels are apt to 
be plugged, causing a softening of that part of the 
brain which is nourished by that particular vessel. 
These patients present, besides their mental condi- 
tion, many physical signs such as dizziness, head- 
aches, fainting spells, paralysis, weakness of one 
or more extremities, thickening of the peripheral 
vessels, occasionally high blood pressure, and 208 
ABNORMAL BEHAVIOR 
tremors of the head and extremities. The mental 
symptoms are characterized especially by their in- 
capacity to think quickly and accurately. They 
lack the power to concentrate and to hold their at- 
tention for any length of time; they become 
readily fatigued. They are unable to control their 
emotions, weeping and laughing alternately. Oc- 
casionally they display marked irritability. They 
are unable to retain newly acquired information, 
and there is a general defect of memory, especially 
for remote events. They may display pronounced 
psychotic symptoms in the form of depression, 
paranoid ideas and episodes of marked excitement 
and confusion. Often this condition may be asso- 
ciated with senile changes in the brain. In many 
cases there are co-existing diseases of the kidneys 
and heart. The following are illustrative cases of 
this disorder: 
Case 43 
An old man (65 years of age) was brought from a 
police precinct where he had complained that he 
knew of a man who had wronged a 17-year-old girl 
and asked for a policeman to help him find that man. 
While in the precinct he telephoned to several people 
and acted irrationally. The wife of the patient stated 
that he had been mentally upset for the past two years. 
He at first confided in her that detectives were fol- 
lowing him and were going to have him arrested for 
no cause whatever. Later he complained of people 
annoying him with electricity. He stated that he was 
getting radio messages calling him bad names. On 
one occasion he caused the arrest of an innocent man, PITFALLS OF OUR MINDS 
209 
accusing him of ruining a young girl. Physically, the 
patient showed markedly thickened arteries, irregular 
pulse, enlarged heart with evidences of disease of the 
valves; senile changes in the eyes. His speech was 
somewhat thick and he often used incorrect words to 
express his ideas. Mentally the patient was definitely 
confused; he wandered aimlessly about the ward; got 
mixed up in his statements, contradicting himself re- 
peatedly; his memory especially for remote events was 
definitely defective; he could not concentrate nor 
could he tell a straightforward story; he would tire 
easily, become irritable and excited when questioned; 
expressed a number of delusions of a persecutory 
nature with a deep sexual coloring; he had no insight 
into his condition and his judgment was impaired. He 
was finally committed to a state hospital with a diag- 
nosis of Psychosis with Cerebral Arteriosclerosis. 
Case 44 
A man 70 years of age was brought by the ambu- 
lance having had a “ fit ” on the street. On examina- 
tion patient showed evidences of an old left hemiplegia 
(paralysis of the left side of the body), thickened 
arteries, an enlarged heart; irregular, unequal and 
sluggish pupils; hemorrhages in the eye-grounds, tre- 
mors of the face and fingers, thickened speech, and 
difficulty in speaking, using incorrect words. Men- 
tally at first he was confused, unable to give any 
account of himself; he was disoriented for time and 
place. Later he cleared somewhat, but showed marked 
speech defect, irritability, and memory defect. He 
expressed ideas of derogation directed against his sons. 
A careful history of the patient’s illness revealed that 
he had always been a hard worker, a faithful husband 210 
ABNORMAL BEHAVIOR 
and father, and a law-abiding citizen. About ten 
years ago he began to show increasing irritability, 
would fly into fits of anger, insisted upon his children 
doing exactly as he dictated, slept very little at night, 
and showed wandering tendencies. Five years ago 
he suddenly fell on the street and it was shown that 
at that time he sustained paralysis of the left side of 
the body. Four years ago he made a will in which he 
disowned members of his family and left an estate 
worth several thousand dollars to a neighbor, who 
had a shady reputation. He then stated that this 
neighbor was the only friend upon whom he could 
depend, although on investigation it was found that 
his children were very loyal to him. He made dis- 
paraging remarks about the morality of his daughters, 
and about the honesty of his sons. This man was 
finally committed to a state hospital with a diagnosis 
of Psychosis and Cerebral Arteriosclerosis. 
From the study of the cases presented under the 
heading of senile and arteriosclerotic psychoses, 
it is apparent that there is a considerable justifica- 
tion for litigation over wills drawn by old people. 
Furthermore, one can easily appreciate the reason 
for many lawyers refusing to accept old people on 
juries, where the safety of their client is in danger. 
Traumatic psychoses are diseases of the mind 
resulting from injury of the brain. Brain injuries 
may occur without any apparent injury to the 
scalp or the skull, though the latter frequently co- 
exists with the former. One must bear in mind 
that an attack of manic-depressive psychosis, de- 
mentia praecox, General Paresis, etc., may be PITFALLS OF OUR MINDS 
211 
precipitated by an injury of the brain. The 
amount of damage done to the brain may vary 
from mere concussion to extensive destruction of 
brain tissue. The clinical types differ in accord- 
ance with the extent of the injury. In traumatic 
delirium, the individual may show confusion, 
disorientation and excitement, which may last for 
only a brief period, and the patient may ultimately 
make a complete recovery but usually with a loss 
of memory for events that have occurred for a day 
or two preceding the injury. 
Frequently the individual is left with a change 
of disposition, described as traumatic constitution 
and characterized by headaches, fatigability, 
emotional instability, hysterical outbreaks, over- 
sensitiveness to alcohol and other stimulants, and 
instability of the vaso-motor system (flashes of 
heat and cold). Occasionally they are left with 
an epileptic condition. In the more serious cases 
there is resultant a real dementia often referred to 
as post-traumatic mental enfeeblement. In this 
condition there is definite loss of concentration, 
memory and retention defects, lack of interest and 
emotional deterioration. The patients presenting 
traumatic conditions are chiefly of medical in- 
terest, and are usually best managed by neuro- 
logical rather than psychiatric treatment. 
Perhaps no other types of mental disorders are 
as readily preventable as those caused by syphilis, 
yet owing to the misguidance of well-meaning 
but narrow-minded individuals, we are daily 
meeting patients who are afflicted with these 212 
ABNORMAL BEHAVIOR 
serious mental diseases, which not only incapaci- 
tate them, but cause indescribable agony to the 
members of their families. Syphilis itself is a pre- 
ventable disease. During the late war, when the 
very existence of the nation was at stake, every 
soldier received definite and explicit instructions 
in the methods for avoiding contraction of vene- 
real disease. At present, it is illegal to teach these 
methods; for the prevention of venereal disease is 
so intricately bound with birth control, that they 
are often confused, and bigoted, hypocritical indi- 
viduals, often themselves subjects of mental dis- 
ease in its broadest psychiatric meaning, persecute 
anyone trying to ameliorate human misery due to 
venereal diseases. 
In General Paralysis of the insane, we have a 
condition in which there is a degeneration of the 
parenchymatous structure of the brain tissue, and 
an inflammation of the interstitial supporting tis- 
sue, resulting from the successful invasion of the 
brain by the treponema pallidum, the organism 
causing syphilis. The symptoms are both physical 
and mental. The physical symptoms are charac- 
terized by tremors in the facial muscles; changes 
in the responses of the pupils to light stimulation; 
irregularity and inequality of the pupils; disturb- 
ances in the reflexes; ataxic gait; defects in speech 
varying from mere slurring to omissions of letters, 
syllables and words; and cranial nerve involve- 
ment such as paralysis of the muscles moving the 
eyeball, drooping of the eyelids, deafness, optic 
atrophy, changes in quality of the voice, difficulty PITFALLS OF OUR MINDS 
213 
in articulation, irregular movements of the tongue, 
and facial asymmetry. Convulsions are frequent in 
the later stages. Disturbances in the control of the 
bladder and rectum are also common in advanced 
stages. Examination of the spinal fluid and of 
the blood give positive Wassermann reactions, and 
other evidences of the presence of syphilis. 
The dementia is characterized by the deteriora- 
tion of the response of the individual to ethical, 
esthetic, intellectual and conventional standards 
which have hitherto governed his conduct. There 
is a failure on his part to curb his aboriginal in- 
stincts and to subordinate his individual desires 
to the demands of society. There is marked 
failure of memory, poor retention, markedly im- 
paired judgment, and absence of insight. 
The paretic is proverbially supposed to be gran- 
diose in his mood, that is, unduly elated to the 
extent of imagining himself to be ruler of the uni- 
verse, owner of boats built from rubies and em- 
eralds, and having at his command unlimited 
wealth and power. On the other hand, there is 
a group of cases who are markedly depressed, but 
the depression is of a silly, demented nature, to the 
extent of making one immediately grasp the de- 
mented and deteriorated background into which 
are woven the patients’ delusions. The course of 
this disease is chronic and progressive and the aver- 
age paretic hardly lives more than five years 
after the onset of distressing symptoms. The dis- 
ease is, however, characterized by remissions, and 
many a paretic is able to return to his former 214 
ABNORMAL BEHAVIOR 
sphere of activity, but sooner or later he again 
shows a relapse. 
With the institution of proper prophylactic 
measures, this disease could be made a medical 
rarity. As stated before, prophylaxis has proven 
efficacious in preventing the occurrence of syphilis 
among the soldiers and sailors during the late 
war. Its efficacy is no longer a matter of specula- 
tion. We have sufficient scientific data at our com- 
mand to enable us to combat the contraction of 
syphilis. The amount of unhappiness and real 
misery it causes is incalculable. It is indeed piti- 
ful to behold a man of standing in his community, 
a faithful husband, a devoted father, a loyal citi- 
zen, suddenly lose all sense of ethics, and enter 
into relations with some designing, immoral 
woman, causing many a heart to break. Many an 
individual who has worked hard all his life will 
suddenly squander away his life’s savings, leaving 
those dependent upon him in dire straits. The 
following cases illustrate some of the types of ab- 
normal behavior caused by this disease: 
Case 45 
A man (35 years of age) was brought to the hospital 
by his wife who stated that the patient became 
depressed one month ago; and showed lack of interest 
in his business, following business reverses. On 
examination patient presented the obvious physical 
signs of general paralysis of the insane. These were 
corroborated by examination of the blood and spinal 
fluid. Mentally he was somewhat confused, dull, un- PITFALLS OF OUR MINDS 
215 
stable emotionally, crying at the least provocation. 
His speech was definitely slurring in character, and 
he would drop many syllables. A careful history re- 
vealed that the patient had known his wife from child- 
hood; that they, were married when he was 19 years 
of age; his wife had miscarried six times. He worked 
his way up from a clerk in an importing house 
to the presidency of a large concern. Six months 
before being brought to the hospital, the patient ex- 
tended his business interests and invested every 
available dollar, borrowing heavily from his banks. 
The investment was made against the advice of the 
other members of the firm, and resulted in the resig- 
nation of a few. The investment proved to be a fail- 
ure and he was completely wiped out. The wife did 
not suspect that the patient was in any way erratic. 
When the nature of the disease was explained to 
her, she protested strongly against such a possibility, 
being at first even insulted by the mere suggestion 
that her husband might suffer from a blood disease. 
She insisted that they had been lovers from the very 
first meeting, and that there was no question as to 
his fidelity. Little did she know that the organism of 
syphilis has no regard for race, creed, sex, color, or 
station of life, and that it may be contracted in other 
ways than by illicit sex relationship. The patient was 
committed to a state hospital, leaving his wife destitute. 
Case 46 
A young woman (30 years of age) was brought 
from a city park where she was found wandering 
late at night and unable to give an account of herself. 
In the hospital she appeared dull, stupid, unable to 
speak clearly, was unable to give any account of 216 
ABNORMAL BEHAVIOR 
herself. She showed definitely irregular and un- 
equal pupils which were fixed to light and accom- 
modation. She had bilateral ptosis of both eyelids. 
There were tremors of the face, tongue and hands. The 
elbow jerks were unequal; the other deep reflexes were 
absent. Her gait was definitely ataxic and her station 
was unsteady; the Wassermann of her blood and 
spinal fluid was strongly positive, and the other tests 
performed on the spinal fluid pointed to undoubted 
syphilis of the brain of the paretic type. In two days 
she became very expansive, saying that she owned the 
Brooklyn Bridge; that the hospital was her palace; 
that she had a carriage made of gold. She could 
not tell the name of her husband nor could she 
tell her residence. Her husband finally traced her to 
the hospital and he insisted that she be discharged to 
his care. Three weeks later she was brought to the 
hospital in a taxicab by a young man who stated that 
she was in his friend’s rooms and that she had given 
herself up to anyone who approached her. This time 
she showed increased signs of syphilitic destruction 
of the brain and it was necessary to commit her to a 
state hospital for the insane. 
Case 47 
A man (45 years of age) was brought to the hospital 
by a worker attached to the Domestic Relations Court. 
The history stated that for the past six months pa- 
tient refused to support his wife, spent his money lav- 
ishly, entered into relations with women of the streets, 
and struck his children without apparent cause. On 
examination the patient showed definite signs pointing 
to syphilitic destruction of the brain. He was un- 
steady on his feet; his speech was definitely slurring PITFALLS OF OUR MINDS 
217 
and he omitted many syllables. His knee jerks were 
markedly accentuated, his pupils were unequal, irreg- 
ular in outline and reacted very sluggishly; he was 
partly deaf in one ear. His blood Wassermann and 
spinal fluid Wassermann were strongly positive, so 
were the other tests of the spinal fluid. Mentally he 
was very elated, said that he was the strongest man 
in New York City, that he owned all the gold mines 
in the world and that all the girls were in love with 
him. He stated that his wife was too old fashioned 
and he decided to take a girl from one of the New York 
musical comedy shows. He admitted having spent all 
the money that he had saved, but said all the banks of 
New York were his and therefore he could spend as 
much as he desired. His wife, he said, was not worthy 
of him and naturally he struck her when she inter- 
fered with him. He admitted having contracted syph- 
ilis 20 years ago. He was committed to a state hos- 
pital, diagnosed as a case of general paralysis of the 
insane. 
Case 48 
A man (40 years of age) was transferred from the 
Tombs Prison, charged with grand larceny in the first 
degree. His brother stated that the patient had had a 
normal infancy and childhood; had had two years col- 
lege training; and was quite successful in his business. 
The patient was quite aggressive sexually, and con- 
tracted syphilis at 25 years of age. Three years ago 
a definite change was noted in the patient’s person- 
ality. He became very careless about his personal 
appearance; he did not work steadily and when re- 
proached by his mother struck her. He then got into 
difficulties with his employer because he drew money 
from the treasury without any reason. He then began 218 
ABNORMAL BEHAVIOR 
to take women into his own home disregarding his 
mother’s presence. He ordered many articles from 
various department stores and ran up bills into the 
thousands. He forged his employer’s name to a check 
and was then arrested and charged with larceny in 
the first degree. Physical examination showed un- 
equal, irregular pupils which reacted sluggishly both 
to light and accommodation. There were tremors of 
the muscles of the face, tongue and fingers. His deep 
reflexes were accentuated but more active on the right 
side than on the left. His speech was indistinct. The 
blood Wassermann was four plus. He refused to 
submit to a spinal fluid examination. He was irritable 
in attitude and somewhat flighty in conversation. Men- 
tally he was very restless, facetious, meddlesome, ex- 
pressed a delusional trend of a changeable character; 
fancied he was wealthy, and was capable of performing 
great deeds. He showed moderate memory defect and 
his judgment was definitely impaired. He had no 
insight into his condition. He was diagnosed as a case 
of general paralysis of the insane. 
Occasionally the syphilitic germ limits its field 
of involvement to the uppermost layer of the 
brain, the membranes lining the brain (meninges) 
and to the vessels nourishing the brain (end- 
arteritis), giving the disease picture commonly 
referred to as cerebral syphilis. The mental 
disorder resulting from it is known as psychosis 
with cerebral syphilis. In this type of men- 
tal disease, we have physical signs in which there 
is involvement of the cranial nerves, and a 
mental picture of dullness or confusion and excite- PITFALLS OF OUR MINDS 
219 
ment. Often there are paralyses and convulsions. 
Frequently there are paranoid trends, blunted 
ethical sense, defective judgment and moderate 
mood variations. In these cases Wassermann ex- 
amination of the blood is positive, and the tests of 
the spinal fluid point toward syphilis. Occasion- 
ally, individuals of a manic depressive nature will 
react very strongly to the knowledge that they are 
victims of syphilitic disease and may become de- 
pressed to the extent of committing suicide. 
Case 49 
A young man (27 years old) was brought from 
the Tombs Prison charged with robbery. Family his- 
tory showed that father had deserted the family 22 
years ago. One brother died in a hospital (suicide). 
Patient was apparently a normal and well adaptable 
individual until discharged from military service in 
October, 1919. He then became very shy, would not 
meet people; he appeared somewhat depressed and 
nervous; he could not get adjusted to things; he 
began to dislike everybody and everything; he would 
wake up his family in the middle of the night for no 
apparent reason. He became very impulsive; he went 
on a subway station and asked for a cigarette, then 
tried to enter the booth, chasing the ticket agent, and 
he was arrested and indicted for robbery. On the 
ward patient was rather sullen and depressed. Phys- 
ically he was well developed and well nourished. 
Elbow and knee jerks were equally exaggerated; pupils 
were equal, irregular; the right reacted promptly and 
the left did not react. Blood Wassermann showed 
3 plus reaction; the spinal fluid Wassermann wras neg- 220 
ABNORMAL BEHAVIOR 
ative but showed 54 cells and 2 plus globulin (path- 
ological fluid). One week after his admission, the 
patient pushed his right hand through a pane of glass 
receiving lacerations of thumb, palm of hand and 
forearm; he said: “I felt something strange in me; 
something loose in me. My head feels dull. I am 
bad in memorizing; I can’t sleep. The strain was 
too much. I gave up work three months ago because 
I lost confidence in myself.” He was committed to 
a state hospital with a diagnosis of Psychosis with 
Cerebal Syphilis. 
Juvenile General Paresis, or General Paralysis 
of the Insane occurring in childhood is perhaps the 
most pitiable of all types of abnormal behavior 
resulting from infection by the syphilis germ. In 
this condition the patient suffers from infection 
either in early infancy or while still in the mother’s 
womb. These children apparently develop very 
well until about five or six years of age, or more, 
when they begin to show changes in their reactions 
as manifested by outbreaks of temper, inability to 
learn at school, sleepiness and convulsions. When 
taken to the psychiatrist, his examination, espe- 
cially when aided by blood examination, will read- 
ily detect this condition. It is one of the causes 
for educational maladjustments at school. This 
condition is a progressive one, and the patient 
hardly ever lives to full maturity. 
Among the most interesting types of mental dis- 
orders are those due to alcohol. While the entire 
problem of alcohol with relation to abnormal con- 
duct will be discussed fully in Chapter IX, it is PITFALLS OF OUR MINDS 
221 
relevant to mention a few of the types of disorders 
of behavior which result from psychoses caused by 
this drug. In its mildest degree, alcohol causes a 
condition known as pathological intoxication which 
is characterized by excitement, confusion, and hal- 
lucinations of sight and hearing. This is the re- 
action of a delicate nervous system to the imbibi- 
tion of alcohol in large or even small amounts. 
The duration is but a few days, and there is a 
complete loss of memory for the events that have 
taken place during the “ drinking spree.” The 
following case illustrates this type of abnormal 
reaction to alcohol: 
Case 50 
A young man (28 years of age) was brought to the 
hospital by a policeman, whom the patient approached 
begging for protection. The history revealed that this 
individual was a rather bright and adaptable person, 
although quite tense emotionally. He had frequently 
had such attacks following several hours’ drinking. 
The present attack was preceded by a drinking spree 
which lasted three hours during which the patient 
imbibed about two quarts of whiskey. He then began 
to accuse his friends of trying to harm him; said that 
they were plotting against him, and struck one of 
them. He then ran out of the house and asked a 
policeman to be taken to a place of safety as his ene- 
mies were going to kill him. On the ward the patient 
showed definite and striking fear reactions; said that 
he knew that his friends were going to harm him; 
that he had seen them talking to each other and heard 
them formulating plans for his execution. His face 222 
ABNORMAL BEHAVIOR 
was flushed; his heart was beating very rapidly; his 
pupils were widely dilated and his reflexes were very 
active. He received the necessary medical attention 
and was given a sedative to induce sleep. On the fol- 
lowing day the patient showed a clear consciousness, 
was correctly oriented and did not express any of the 
hallucinations which had dominated his conduct while 
on the outside of the hospital. He could give no ac- 
count, either of the drinking bout or of the events 
that followed it. 
In delirium tremens, we have a real injury to 
the brain substance by the alcoholic poison. This 
condition results from the prolonged use of alco- 
hol. It is characterized by marked visual hallu- 
cinations in which the individual imagines snakes, 
and peculiarly distorted animals are on the walls 
and ceiling. The pulse is very rapid; the face is 
flushed, and there is a temperature of 103 to 104 
degrees. The durability of this attack is about 
a week and the individual has a complete loss of 
memory for events not only during his delirium 
but also for happenings of several days preceding 
the onset of his sickness. Death occurs in at least 
one-third of the cases. The following case is a 
good example of this type of insanity caused by 
alcohol: 
Case 51 
A young business man (35 years of age) was 
brought to the hospital by his wife who stated that the 
patient was always a heavy drinker and had had one 
former attack of the “ horrors ” (a term commonly 
ysed by the laity to describe delirium tremens). He PITFALLS OF OUR MINDS 
223 
had been drinking heavily for the last four weeks and 
had eaten practically nothing for the past two weeks. 
The preceding night he got out from his bed, got 
his cane and began chasing imaginary things from the 
wall. He acted in an irrational manner; did not an- 
swer questions and did not sleep all night long. Upon 
advice of the physician his wife had him brought to 
the hospital in a taxicab. On the ward patient was 
completely disoriented for time, person and place; he 
talked incessantly to imaginary people; said there were 
snakes creeping all over his bed, and asked for weap- 
ons to chase them and kill them. He addressed the 
nurses and physicians as though they were his friends; 
he showed temperature of 103, pulse of 130; his face 
was flushed; there were fine twitchings in the muscles 
of his face and fingers. He had to be placed in re- 
straining sheets to prevent injury to himself and 
others. At the end of six days the temperature grad- 
ually came down to normal; the pulse became slower, 
he gained considerable lucidity and finally recognized 
that he was in a hospital, that he had been ill. He 
admitted drinking heavily but could not describe, ex- 
cept for a few minor details, his hallucinatory expe- 
riences. 
The most serious type of reaction following the 
indulgence in alcohol is that commonly known as 
Korsakow’s Psychosis. In this type there is a 
serious and permanent injury to the nerve cells 
of the patient, as well as to the nerves going to 
the muscles of the extremities. He is completely 
disoriented as to person, time and place. He 
fabricates, imagining that he has been out a 
moment before, transacting business, etc. He is 224 
ABNORMAL BEHAVIOR 
easily suggestible and misidentifies people. The 
duration of the attack is about eight to ten months 
and recovery is never complete, the patient being 
left with a marked defect of memory and retention 
and possibly with moderate disuse of his ex- 
tremities. 
Among the most distressing types of diseases 
caused by alcohol, are the acute and chronic types 
of hallucinoses which follow the use of this drug. 
In these cases we have a clear sensorium, the pa- 
tient being well oriented, but he shows marked 
fear and a tendency towards systematized perse- 
cutory ideas in which he sees himself plotted 
against and actually pursued by his enemies. In 
order to escape the imaginary tortures in store for 
him he may resort to suicide. 
The conduct disorders that result from psy- 
choses following chronic drug addiction will be 
best described under the chapter dealing with the 
entire drug problem. Suffice it to say that they 
are characterized by emotional deterioration, with 
a tendency towards formation of delusions of per- 
secution in the opium group, by marked visual as 
well as tactile (touch) hallucinations in the co- 
caine group, and by marked confusion and dis- 
orientation in the bromide group. 
Psychoses accompanying epilepsy and the result- 
ant abnormal conduct will be fully discussed in 
the chapter on epilepsy. The general physical 
diseases such as diseases of the heart, kidneys, 
etc., are often accompanied by outbreaks of psy- 
choses but they are so purely medical in nature PITFALLS OF OUR MINDS 
225 
and are so comparatively rare in the causation of 
abnormal behavior that they will not be mentioned 
here; furthermore, reference has already been 
made to them in Chapter IV. 
Inflammation of the brain, or encephalitis, often 
results during the active phase of the disease, in 
confusion, disorientation, various hallucinatory ex- 
periences (especially those of vision) and in excite- 
ment. Following recovery, the patient is usually 
left with moderate memory defect, irritability, and 
diminished power for sustained action. 
Epidemic encephalitis, or sleeping sickness, 
which ravaged the country during 1918 and 1919, 
is characterized by tendency to drowsiness, pro- 
longed lethargy, and various manifestations of 
paralyses of the eye muscles and other cranial 
nerve disturbances. The duration of the active 
period of the disease may be from one week to 
several months. In the acute period, there often 
may be present maniacal excitement and periods 
of confusion. 
Following recovery from the acute phase of the 
illness, there ensues very often a more or less in- 
capacitating stage. This, in the adult is mani- 
fested by restlessness, irritability, lack of concen- 
tration, impulsiveness, and inability to maintain 
sustained action. Often these patients show a 
striking change in their sexual life, becoming 
promiscuous. 
In children who have recovered from this dis- 
ease, there often occurs a most incapacitating 
after-effect. This is characterized by marked 226 
ABNORMAL BEHAVIOR 
irritability, restlessness, emotional instability, pre- 
cocious sexual development and activity, and a 
change from nocturnal to diurnal sleep. These 
symptoms are for the most part due to the me- 
chanical effect of the healing scar tissue upon the 
brain. Specific cases will be cited in Chapter XI 
in connection with the subject of educational mal- 
adjustments, since a great deal of the abnormal 
conduct of school children can be traced directly 
to the after-effects of this disease. 
The mental defective occasionally is subject 
to insanity. Acute, usually transient episodes 
of excitement, irritability, depression, persecutory 
ideas and occasionally hallucinatory trends charac- 
terize the psychoses accompanying mental defi- 
ciency. Because of the general lack of feeling on 
the part of the mental defective, his lack of con- 
trol and his inability to appreciate the conse- 
quences of his acts, many brutal acts may be per- 
petrated during his period of insanity. 
It will be seen that the role played by the psy- 
choses in the causation of abnormal and anti-social 
conduct is an important one. It must be remem- 
bered that while the definitely psychotic states that 
are characterized by marked fluctuations in the 
motor or emotional fields of individuals, or in which 
there are present gross hallucinations, are easily de- 
tected even by the layman, there is a group of 
psychotic conditions which baffle even the expert 
in psychiatry. The legal aspects in these cases 
often necessitate the consultation of the psychi- 
atrist to determine the exact mental status of the PITFALLS OF OUR MINDS 
227 
individual. Since the boundary line between 
health and disease is not a definitely delineated 
one, there is opportunity for marked variation of 
opinion as to the person’s sanity. There should 
be attached to every Court of Justice a group of 
well trained, properly qualified, and adequately 
paid alienists, who would pass an unbiased opin- 
ion as to the sanity of the person brought before 
the Court. 
The authors have met too many so-called ex- 
aminers in lunacy whose sole qualification for 
deciding questions bearing upon a patient’s com- 
mitment to a state hospital, etc., was a period of 
three years elapsing from the date of their grad- 
uation from medical school to the time when they 
applied to a Court of Record for appointment as 
examiner in lunacy. Many of these so-called ex- 
aminers in lunacy openly confess ignorance of the 
finer points of psychiatry which are so essential 
for the determination between normal and psy- 
chotic states. Furthermore, it is the belief of the 
authors that kinship to a judge or political leader, 
or affiliation with a political organization, are, by 
themselves, insufficient qualifications for a physi- 
cian to serve as a medical member of a commission 
appointed for the determination of the sanity of 
an individual charged with a felony. 
SUPPLEMENTARY READING 
Anderson, V. V. Mental Disease and Delinquency, 
Mental Hygiene, Vol. Ill, April, 1919. 
Brooks, G. W. Insanity in American Prisons and the 228 
ABNORMAL BEHAVIOR 
Prison Psychoses, Jour. Abnorm. Psychol., Vol. 12, Oct., 
1917- 
Bowers, P. E. The Criminal Insane and Insane Criminals, 
Am. Jour. Insan., Vol. 74, July, 1917. 
Glueck, Bernard. Concerning Prisoners, Mental Hy- 
giene, Vol. II, April, 1918. Types of Delinquent Careers, 
Idem., Vol. I, April, 1917. Studies in Forensic Psy- 
chiatry, Little, Brown and Co., 1916. Read chapter on 
Litigous Paranoia. 
Hart, Bernard. The Psychology of Insanity, The Mac- 
millan Co., 1920. 
Goldberg, Jacob A. Social Aspects of the Treatment of 
the Insane, Longmans, Green and Co., 1921. Read 
chapter on Insanity as a Community Problem. 
Meyer, Adolph. Fundamental Conceptions of Dementia 
Praecox, British Medical Journal, Sept. 29, 1906. 
Nolan, W. J. Some Characteristics of the Criminal In- 
sane, N. Y. State Hospital Quarterly, May, 1920. 
North, C. H. Insanity Among Adolescent Criminals. 
Am. Jour. Insan., Vol. 67, April, 1911, p. 677. 
Reid, E. C. Literary Genius and Manic Depressive In- 
sanity, Medical Record, Feb. 8, 1913. 
Rosanoff, A. J. Manual of Psychiatry, John Wiley and 
Sons, London, 1920. An excellent reference book to the 
various types of psychoses. 
Sands, I. J. Senile and Presenile Psychoses, N. Y. Neuro- 
logical Bulletin, Vol. I, Oct., 1918, p. 377. General 
Paralysis, Idem., Vol. Ill, Feb., 1921, p. 72. 
Spalding, E. R. Emotional Episodes Among Psycho- 
pathic Delinquent Women, Jour. Nerv. and Ment. Dis., 
Vol. 54, Oct., 1921, p. 298. The Problem of a Psycho- 
pathic Hospital Connected with a Reformatory Institu- 
tion, Medical Record, May 14, 1921. 
White, William A. Outlines of Psychiatry, Nerv. and 
Ment. Dis., Monograph Series No. 1, N. C., 1921. For 
general reference. Chapter VII 
BORDERLINE MENTAL DISORDERS AS 
CAUSES OF ABNORMAL CONDUCT 
Boundary line between normal and abnormal behavior not 
clearly demarcated. 
The problem of the psychoneuroses. 
The personality of the hysterical individual. 
The Freudian conception of hysteria. 
Physical manifestations of hysteria. 
Cases illustrating hysterical conversion mechanism, 
Janet’s conception of hysterical dissociation. 
Suggestion and hysteria. 
Hysteria amongst troops during the World War. 
Various methods of management of shell-shocked soldiers. 
Lessons learned from management of shell-shocked soldiers. 
Spiritualism as applied to hysterical people. 
Auto-suggestion. 
Discussion of psychoanalysis. 
The problem of psychaesthenia, or compulsion neurosis. 
Freud’s classification of the psychoneuroses. 
Neurasthenia and its symptoms. 
Anxiety neurosis and its manifestations. 
The problem of traumatic neurosis. 
Various methods for the management of different psycho- 
neurotic patients. 
The problem of the borderline mental deficiency cases. 
Cases illustrating anti-social behavior in borderline mental 
defectives. 
The constitutional psychic inferiority states. 
Cases illustrating abnormal conduct in the constitutional 
psychic inferior. 
The problem of masturbation. 
Abnormal sex indulgences — sadistic and masochistic traits 
— homosexuality — exhibitionism. 
229 230 
ABNORMAL BEHAVIOR 
IT is fairly easy to appreciate the influence of 
psychoses upon anti-social conduct. The in- 
sane man, because of the disease from which he 
is suffering, is unable to behave in a normal fash- 
ion. His conduct is expected to be abnormal. He 
is suffering from the disease of the very faculty 
which enables him to get along in life, hence in 
diseases of the mind where the malady is of a defi- 
nite psychotic type, abnormal behavior is the 
logical result. 
In passing from definitely psychotic states to 
normal conditions we are confronted by an inter- 
mediate group of individuals whose conduct, while 
not definitely psychotic, is obviously abnormal. 
These are the cases of borderline mental disorders. 
In general, they are individuals who are suffering 
from definitely abnormal mental states, but whose 
personality as a whole is fairly intact. Authori- 
ties differ as to the exact nature of the disorders 
from which they are suffering. These cases form 
the bulk of medico-legal contentions, for there is 
a considerable difference of opinion as to whether 
or not they should be held responsible for some of 
their anti-social conduct. Legal responsibility on 
the part of these individuals often is denied to 
them from a medical viewpoint while the law ex- 
acts a thorough accounting for all their acts. 
There are three definite groups constituting 
borderline mental states. They are the psycho- 
neuroses, constitutional psychic inferiority states 
and borderline mental deficiency. This last named 
class lies between the definitely defective indi- PITFALLS OF OUR MINDS 
231 
viduals and those who are of normal intelligence 
(although possibly rather dull). 
Psychoneuroses is the most interesting of the 
three groups. More has been written about the 
psychoneuroses than about any other group of 
medical conditions. Furthermore, there has been a 
greater difference of opinion about the exact 
nature of this malady than about any other. The 
psychoneurotics have been imposed upon by charla- 
tans and quacks to a greater degree than any other 
group of sick people. The failure of most medical 
men to understand the psychoneurotics has been 
the chief factor in the creation of many sects of 
practitioners such as the Christian Scientists, 
chiropracters, etc. 
What are the psychoneuroses? They are tech- 
nically best described as certain types of abnormal 
behavior in which the personality of the individual 
is retained. This definition is perhaps somewhat 
broad but so are the mental states which we are 
now discussing. Furthermore, we have scanned 
through the literature and have become familiar 
with most of the definitions offered not only by 
outsiders meddling with medical affairs but also 
by physicians who have spent a lifetime on the 
study and management of the psychoneurotics and 
none have offered a more workable definition. 
There are several types of psychoneuroses. 
Hysteria is the most common and the most widely 
known of this group. The ancients fully appreci- 
ated the sexual background into which this mental 
disorder is woven, and attributed it, because of 232 
ABNORMAL BEHAVIOR 
their ignorance of anatomy, to a roving uterus; 
hence its name. Until comparatively recent times, 
hysteria was regarded by most medical men as 
a type of reaction on the part of a peculiarly 
disposed individual whenever confronted with a 
painful situation. In order to avoid it he reacts 
in a classical and characteristic manner well known 
to those who are used to dealing with hysterical 
people. The peculiar personality of these hyster- 
ical may be described as one in which there is 
undue craving for sympathy and attention. They 
are apt to be utterly selfish, disregarding the wel- 
fare of others, and viewing life with an outlook 
which circumscribes only that which will afford 
them the greatest amount of pleasure. They show 
an early tendency to lean upon other members of 
the family, and to avoid anything which requires 
of them an expenditure of energy. 
A perhaps more elaborate theory is offered by 
the Freudian school of psychology. This school 
confines itself primarily to the individual case in- 
stead of dealing in generalities. It traces the 
various hysterical symptoms to mental traumata 
which the patient cannot consciously recall. 
Under proper methods of investigation, these trau- 
mata can be brought to consciousness. These 
mental or psychic traumata, or their memories, act 
on the mind like irritating foreign bodies to a 
wound. Most of these psychic traumata were 
found to be sexual in nature, and to have occurred 
in infancy. The original emotional color tone could 
not be given free play because of its painfulness, PITFALLS OF OUR MINDS 
233 
and hence was strangulated. The Freudian tech- 
nique consisted of recalling to consciousness the 
trauma and the painful affect associated with it, 
and thereby liberating the strangled emotion and 
effecting a cure. 
Freud showed that the psychic trauma which 
these individuals had sustained usually carried 
with it a sense of shame and reproach and a 
feeling of guilt. The patient wished to know noth- 
ing about the experience which caused the trauma, 
and tried to forget it, or, technically, to repress 
it. To completely forget it was impossible, and 
the experience constantly strove to come to con- 
sciousness. The so-called psychic censor, on the 
other hand, tried to repress it still further. This 
resulted in a struggle of two opposing forces which 
finally compromised on the basis of a conversion of 
these forces into an hysterical symptom. Each 
force participating in this mental struggle yields 
some of its original demands, and finds ex- 
pression in the mutually accepted hysterical mani- 
festation. 
These hysterical manifestations may be mani- 
fold in nature, and are of innumerable sensory and 
motor expressions. We find in the hystericals, 
paralyses of one or more extremities, difficulties in 
swallowing, sensory disturbances of various sorts, 
twitchings of various parts of the body and even 
convulsive phenomena. These paralyses and sen- 
sory disturbances are not accounted for by ana- 
tomical changes. They are expressions of the 
compromise between the painful experience striv- 234 
ABNORMAL BEHAVIOR 
ing to come to the surface and the psychic censor 
trying to keep it back. 
The following case offers an illustration of this 
mechanism: 
Case i 
A young girl 25 years of age was brought to the 
hospital complaining of loss of sensation in her lower 
extremities. This girl’s history revealed that she had 
been rather sensitive in her make-up, craved attention 
and always wanted more sympathy than any other 
member of her family. She had left high school at the 
age of seventeen and was employed by a man to whom 
she finally became attached. She permitted him to 
take a few liberties without actual sex indulgences. 
He would frequently show his affection by caresses 
and by expressing great admiration for the shape of 
her legs. Most of his gifts were in the nature of 
hosiery. Their friendship ripened to the extent of 
attracting the attention of the wife of her employer, 
and the patient was obliged to leave her employment. 
On the following morning while dressing she found that 
her legs were insensitive. She could walk perfectly 
well but she could not feel any sensation in her ex- 
tremities. 
The mechanism in this case is quite obvious, 
even to the uninitiated. The experiences with her 
employer were trying to come to the surface, but 
were constantly associated with a feeling of guilt, 
and the psychic censor was trying to repress them. 
A compromise between these two forces resulted 
which found expression in sensory disturbances in 
the extremities, and which was the comolaint PITFALLS OF OUR MINDS 
235 
which brought her to the hospital. It is interest- 
ing to note that the hysterical symptoms affected 
her legs, with which many of her guilty memories 
were associated. Analysis in this case was easily 
accomplished and effective of a cure. 
The conversion of the psychic energy along a 
more acceptable line of expression is elementary in 
people of simple intelligence. The higher we as- 
cend in the intellectual scale, and the greater the 
power of conventions over the individual, the 
more complicated are the methods for conversion 
of this psychic energy. The following cases are 
illustrative. 
Case 2 
A man 35 years of age was sent by the presiding 
officer of the Court of Domestic Relations to determine 
his physical condition, as he claimed that he could 
not work because his arm was paralyzed. The history 
revealed that this man was a Russian, carpenter by 
occupation and had always been of good habits. He 
was eight years in this country and spoke only broken 
English, finding it difficult to express himself clearly. 
He married a Russian who spoke English fluently. 
She was quite immoral in her habits; would drink to 
excess and neglected her home and family. He had 
reproached her on several occasions for her conduct 
but she would not heed his warnings. He then left 
her and she brought action against him for non-sup- 
port. He had no lawyer and he could not express 
himself clearly but had to state his case through an 
interpreter. He was ordered to pay his wife $15 a 
week. Over this he brooded and felt that instead of 236 
ABNORMAL BEHAVIOR 
getting justice he was the victim of the entire trans- 
action. He felt that he had always been faithful to 
his wife and he knew that she was unworthy of him. 
He knew of her misconduct with other men. He then 
began to suffer from various ailments, first a cold in the 
head, then inability to talk, and later he felt that his 
arm, which had been broken when he was a child, was 
now losing strength. He went to a dispensary where 
some electricity was prescribed. After the first treat- 
ment he found that he could no longer move his hand. 
He lost his job and was brought to court for failing to 
pay his wife her weekly allowance. His case was then 
carefully investigated and the social service worker 
found sufficient evidence of his wife’s infidelity and 
of her gross misconduct. The court’s attitude towards 
the man was naturally different from what it had been 
at first and he no longer had to give his wife money. 
His arm, which had previously resisted all sorts of 
treatment, now yielded to therapy, and at the end of 
a month’s treatment, mostly in the nature of sugges- 
tion, was restored to its full function. 
Case 3 
A woman 33 years of age was brought to the ward 
suffering from inability to completely open her eyes. 
The history revealed that she had been married for 
12 years to a man who was rather inconsiderate of 
her feelings and somewhat selfish. She had two chil- 
dren by him. He would neglect her and would stay 
away for several days claiming that his business re- 
quired considerable travel to other cities. On one 
occasion she went to a theatre party with her sister and 
returned home, meeting her husband as he was leav- 
ing a maid’s room. There was no doubt of her having PITFALLS OF OUR MINDS 
237 
been mistaken, although the hallway was rather dark. 
She pretended not to have seen him, however. On 
the following morning she asked him where he had 
spent the previous night and was told that he had 
been playing cards with some of his friends. Immedi- 
ately she complained of headache and found that she 
could not open her eyes widely. 
In both of these cases we have painful affective 
situations in which the memory of the original 
psychic trauma is so distressing that consciousness 
is constantly endeavoring to repress it by means of 
the psychic censor, while the experiences them- 
selves are, on the other hand, endeavoring to 
emerge to the surface. A compromise results in 
each case: in the first, in paralysis of the arm; in 
the second, in the dropping of the eyelids. The 
entire mechanism was a subconscious one. The 
cure in the first case was effected in a subconscious 
fashion purely on a basis of suggestion, the remedy 
itself resulting from the redress which he received 
at the hands of the Court. In the second case, 
in which the patient was highly intelligent, a cure 
was effected after an exhaustive analysis of the 
case. 
While the Freudian mechanism is the one which 
is now being so widely discussed, it must be re- 
membered that hysteria was a manageable con- 
dition even before the days of Freud. Janet and 
his school, utilizing the principle of dissociation of 
personality, obtained remarkable results. Neurol- 
ogists of eminence all over the world fully realized 
the part played by suggestion in these cases. 238 
ABNORMAL BEHAVIOR 
Many of them still maintain that suggestion is the 
basis for this disorder and that all the symptoms of 
which the patients complain have been suggested 
to them either by their friends or by those under 
whom they place themselves for treatment. They 
believe that since these symptoms have been sug- 
gested to the patient, the method employed to 
establish a cure should be based upon suggestion. 
Hypnotism has long played an important role in 
the management of these people, and it is really 
one of the various methods of suggestion. With 
this as a cue, many clever people have undertaken 
to cure hysterics and the literature has been 
flooded by books and articles varying all the way 
from simple charlatan and quack discourses to 
writings bearing a certain semi-scientific stamp in 
the effort to advertise their cures. 
The late war has offered considerable opportu- 
nity to study hysteria in its various manifestations. 
At first this malady received a general appellation 
of “ shell-shock,” a term which later was utilized 
to describe all mental states, not only hysteria 
but also insanity. Careful analysis of these cases, 
however, revealed that these individuals behaved 
in a way that would insure their removal from a 
place of immediate danger to one of relative safety, 
although this motive was subconscious. It was 
found that an hysterical outbreak among these 
soldiers usually showed itself in marked tremors all 
over the body and even in real convulsions, which, 
however, differed from the convulsions ordinarily 
encountered in well-known medical diseases. PITFALLS OF OUR MINDS 
239 
Often a soldier would complain of paralysis of one 
or more extremities; of inability to walk; of speech 
disturbances, etc. 
It was noticed that those soldiers who had an 
actual medical or surgical condition necessitating 
their removal to a place of relative security never 
came down with any of the “ shell-shock ” mani- 
festations. This resulted in a change of attitude 
on the part of most medical men towards the 
hysterical soldier. While at first they were 
sent home, and were granted their discharges and 
petted and cajoled by those doing social service 
work, it was found that the cure was never ac- 
complished. Later, however, when these soldiers 
were sent to the rear of the fighting line, but 
within sounding distance of the cannon, and kept 
under rigid military discipline, cures became rela- 
tively frequent. Reasoning from these experi- 
ments in the management of the hysterical sol- 
diers, a few able neuropsychiatrists effected cures 
by bluntly stating to the soldier the facts under- 
lying his malady, and squarely facing him with 
the alternative of either getting well by assuming 
a manly and soldierly attitude towards his disease 
or to remain an invalid for the rest of his life by 
assuming a childish and cowardly attitude towards 
the danger which was confronting everyone. 
A few, and amongst them very able psychiatrists, 
contended that an analysis of the mechanisms 
governing the conduct of these soldiers led to the 
conclusion that hysteria is not only akin to malin- 
gering but in many instances identical with it. 240 
ABNORMAL BEHAVIOR 
The result was that in dealing with these hysterics 
they assumed a strict military discipline which, in 
their hands, at least, accomplished remarkably 
favorable results. In other words, it was the ex- 
perience of everyone engaged in the problem of 
managing the hysterical (shell-shocked) soldier, 
that too much sympathy and attention not only was 
ineffectual in bringing about a cure but in the vast 
majority of instances tended to intensify and pro- 
long the disease. On the other hand, the various 
methods employed either by frank discussions with 
the patients regarding their ailments, or even by 
the utilization of strict military measures in the 
treatment, gave satisfactory results in the hands 
of the men who had advocated this particular 
method of therapy. All, however, agreed that in 
general the hysterical manifestation is a method, 
conscious or subconscious, utilized by the soldier 
in an effort to secure a place of greater safety. 
Applying the lessons learned from the experi- 
ences with shell-shocked soldiers to every-day 
manifestations of hysteria, our methods of hand- 
ling the hysteric have been somewhat changed. 
It is true that psychoanalysis in the Freudian sense 
is effectual in many of the cases, but the patients 
amenable to such analysis are limited to those of 
fairly high intelligence and comfortable financial 
position. Furthermore, after having intimately 
known the men using psychoanalysis, we are be- 
coming more convinced that it requires a certain 
type of personality to conduct an analysis, and this 
personality type is rather limited in number. We PITFALLS OF OUR MINDS 
241 
have seen effectual results obtained from an under- 
standing of the individual’s instinctive cravings and 
an evaluation of the situational conditions in so far 
as his environment offers opportunity for grati- 
fication of his desires, and open discussion of these 
various factors entering into the patient’s behav- 
ior. In brief, it is essential to make the hysterical 
individual realize that it is expected of him to 
face painful realities of life as readily and openly 
as others. It is imperative for him to appreciate 
that sacrifices are expected of anyone who is to 
lead a biological existence. 
In this connection, it may be opportune to 
digress about the waves of Spiritualism, auto-sug- 
gestion, and lay psychoanalysis that are sweeping 
the country. The late war has disillusioned many. 
Many entertain a feeling of the utter futility of the 
sacrifice of so much human life and the amount of 
unhappiness and misery that this war has brought 
to others. Religion, laying too much stress on 
dogma and ceremonials, has failed to bring conso- 
lation equal to that held out by those who have 
been instrumental in spreading Spiritualism. 
Many who have lost dear ones in the war have been 
enabled to get into such a state of emotional ten- 
sion and credulity as to be absolutely deluded and 
illuded in “ seeing ” their departed ones. To these 
people, Spiritualism perhaps offers greater release 
from painful reveries than anything else. Often, 
a frank and open discussion with these people and 
acceptance by them of the brutal truth would not 
be as helpful and wound healing as these emo- 242 
ABNORMAL BEHAVIOR 
tional states which are induced in them by Spiritu- 
alism. Their spiritualistic belief assumes the 
nature of a protective mechanism, and perhaps 
prevents the development of a frank psychosis. 
However, one must not lose sight of the unscien- 
tific and false attitudes of the Spiritualists, or be 
deceived by the statements of these deluded suf- 
ferers. We have seen many frank psychoses 
precipitated by lectures delivered by well-known 
Spiritualists who have recently toured this country. 
Thus one case of Dementia Praecox in a state of 
remission, who was able to lead a fairly satisfactory 
life, was again thrown into active excitement after 
listening to one of the lectures. He there and then 
again began to see his sweetheart who had died 
several years before. It was necessary to have 
this patient committed to a state hospital because 
of his excitement. 
Regarding auto-suggestion, much might be said. 
It must be remembered that mental and physical 
processes are not distinct. They are inter- 
dependent. We have pointed out in Chapter IV 
how psychic processes influence physiological and 
pathological states. By maintaining a spirit of 
optimism and by disregarding painful emotional 
conditions, normal physiological processes are en- 
hanced, and disease conditions more easily com- 
batted. For a long time religion has tended to 
infuse that spirit, and to inculcate these very 
emotions which were conducive towards good 
health. It must be admitted that there is suffi- 
cient evidence to believe that many are going away PITFALLS OF OUR MINDS 
243 
from the influence of religion and are losing much 
of the benefit derived from it. Utilizing the power 
of suggestion, a few people have been instructing 
others in this practice, which to some extent fills 
the gap created by loss of religious faith. It is 
remarkable how many of these people will cleverly 
spread their teachings, through books and pam- 
phlets, and commercialize their wares. 
Psychoanalysis as a method for therapeutics has 
proven efficacious in the hands of those who have 
been properly trained and qualified in its use. 
Psychoanalytic principles are applicable to every 
field of human endeavor. There is no doubt that 
there are trained people who can profitably utilize 
these principles in the vocational pursuits in which 
they are interested. It offers rich rewards in 
scientific research. Its use in the treatment of 
nervous and mentally sick people should be re- 
stricted solely to the medical profession, however. 
Psychoanalysis is a method bearing the same 
relationship to certain types of nervous diseases 
that analysis of the secretions of the gastro- 
intestinal tract bears to diseases of that system, 
and that the Wassermann test bears to syphilis. 
No one would tolerate a state of affairs where 
the analytical chemist would treat gastric ulcers, 
intestinal putrefaction, etc., or where the techni- 
cian performing a Wassermann test would treat 
one suffering from some type of syphilis. We 
must admit that there are a group of lay people 
who are skilled and well trained in the technique 
of psychoanalysis. It is equally admitted that 244 
ABNORMAL BEHAVIOR 
there are but a few medical men who are able to 
conduct an analysis. But it must also be admitted 
that the technicians performing Wassermann tests 
far outnumber those medical men who can properly 
perform such a test. The physician requires 
the technician to interpret his findings, and em- 
ploys these findings in his adequate treatment of 
the disease in question. There is no doubt that 
lay analysts under certain conditions may be 
profitably employed by well-trained psychiatrists 
in managing their neurotic patients. But to allow 
lay analysts to treat the neurotics without the 
supervision of the physician is a gross imposition 
upon the sick. 
Owing to the sex element underlying the 
neuroses, which must be brought out in the process 
of analysis, a group of morbidly inclined people 
are attracted to this phase of human ailment and 
to the methods employed in its treatment, from 
which they derive undue satisfaction and gratifica- 
tion. 
Because of the lucrative rewards offered in deal- 
ing with such morbidly inclined people, there has 
arisen a group of clever individuals who, because 
of skillful tongue and pen, have digested the es- 
sence of psychoanalysis and have been conducting 
lectures, not only in their own homes and offices 
but also in institutions which were erected for the 
purpose of disseminating learning and knowledge. 
They are also giving private treatments, charging 
exorbitant prices. They escape the legal penalty 
prescribed for practicing medicine without a license PITFALLS OF OUR MINDS 
245 
by concealing their acts under the guise of giving 
their victims “ psychological advice.” When one 
closely analyzes not only their writings but also 
the lectures they deliver, one easily finds their 
ignorance of the true nature of psychoanalytic 
technique and the disorders for which it is indi- 
cated. Furthermore, one wonders how these people 
can possibly manage the phase of transference 1 
which the patient must undergo in the process of 
analysis. The physician by virtue of his training 
and by his constant association with the sick is in 
a position to manage that phase. The lay analyst, 
however, must be regarded with extreme suspicion 
because he is not held to the strict code of ethics, 
by which physicians are bound. 
The influx of lay analysts has presented consid- 
erable hindrance to the progress of a method of 
therapy which has relieved many people of mental 
anguish and misery. Analytical principles should 
be utilized in every field of human endeavor by 
those properly trained and interested in them. 
The application of these psychoanalytical prin- 
ciples in the treatment of the medically sick should 
be limited to physicians interested in mental 
diseases. 
Psychaesthenia, or as it is called by the Freudian 
1 In transference the patient transfers all his repressed 
love emotions to the physician. In other words, the patient 
actually falls in love with the analyst. Such state of affairs 
requires considerable tact and skill in guiding the patient 
through to the next state of analysis, in which he is able 
to sublimate this emotion and utilize its energy in socially 
adapted activities. 246 
ABNORMAL BEHAVIOR 
school, Compulsion Neurosis, is characterized by 
peculiar fears (phobias) and fixed ideas and be- 
liefs (obsessions). People suffering from this con- 
dition have difficulty in making up their minds 
to do anything, are afraid to mingle with crowds 
or to walk in vacant spaces, to look out from the 
window, etc. They are never sure whether they 
have locked the doors or barred the windows or 
turned off the light on retiring. They sometimes 
are seized with undue fear of impending death, of 
some harm being done to those in whom they are 
interested, of danger lurking in their vicinity, etc. 
Occasionally they perform all sorts of impulsive 
acts, suffer from various (tics) twitchings or con- 
vulsive movements of certain parts of the body, 
etc. Freud found the genesis of such disorders in 
sexual indulgences in childhood. The obsessions 
he regards as transformed reproaches which re- 
sult from repression. They always refer to 
pleasurable sexual acts performed in childhood. 
Analysis, and an understanding on the part of the 
patient of the psychic factors causing such acts 
are the methods for cure used by the Freudian 
school of psychiatrists. 
Freud regards the neuroses as composed of (i) 
the Psychoneuroses, which are mental disorders 
resulting from pure psychogenic causes primarily 
psychosexual in nature, and (2) Actual Neuroses, 
which are abnormal mental states caused by 
somatic sexual injuries having also a psychosexual 
background. The Psychoneuroses he divides into 
Hysteria and Compulsion Neurosis. The Actual PITFALLS OF OUR MINDS 
247 
Neuroses he subdivides into Neurasthenia and 
Anxiety Neurosis. 
Neurasthenia is an old medical term which has 
been used by most medical men to designate 
and condition which baffles their diagnostic skill 
and for which condition they have no explanation 
to offer on the basis of anatomical pathology. 
Lately there has been a tendency to limit this term 
to exhaustive states of the nervous system follow- 
ing disease processes. The Freudians still further 
limit it to exhaustion following excessive sex 
indulgences, or whenever the adequate sex action 
or unburdening is replaced by a less adequate 
one. In Neurasthenia we have a condition in 
which there is an undue degree of fatigability 
and a lack of emotional control. It is a medical 
condition, and should be managed according to the 
best established medical principles. 
By Anxiety Neurosis we mean a condition in 
which the individual suffers from general irrita- 
bility, periods of anxiety, fear of impending 
danger, feelings of cardiac distress, disturbances 
in respiration, excessive sweating, trembling and 
shaking, peculiar disturbances of sensation, and 
occasional dizziness. This condition results from 
disturbances associated with the completion of the 
sexual act. Coitus interruptus (withdrawal) and 
premature ejaculation are the chief cause for it. 
They are medical conditions, readily recognized 
by the trained psychiatrist, and easily managed 
by him. 
Traumatic Neurosis is a condition resulting 248 
ABNORMAL BEHAVIOR 
whenever an individual has been in an accident 
and has been trying to recover damages but has 
been unsuccessful either in recovering such dam- 
ages or the amount which he thinks is due to him. 
Such people complain of all sorts of physical and 
mental signs and symptoms which are out of pro- 
portion to the amount of damage caused them at 
the time of injury. Usually most of the symptoms 
are gradually built up in the process of litigation. 
The various insurance companies have recognized 
this condition, and because of the fact that most 
of these people present such pitiable sights before 
the juries, the insurance companies and others held 
responsible for such injuries, prefer to settle the 
claims rather than to litigate them. Often some 
other psychological mechanisms play important 
roles in this disorder, and are analyzable in the 
hands of those competent to do so. Much has 
been written about this phase of abnormal be- 
havior. Much medical testimony of conflicting 
nature has been given in trials of people suffering 
from this disorder. To describe this fully would 
require a book in itself. 
It will thus be seen that the various forms of 
psychoneuroses and allied conditions such as 
Traumatic Neurosis, etc., are ingrained in a pecu- 
liarly disposed personality and are expressions of 
methods of adaptation to situations on the part of 
this peculiarly disposed individual. Psycho- 
analysis in the hands of trained psychiatrists is 
the method par excellence in managing these con- 
ditions. It must also be admitted that recognized PITFALLS OF OUR MINDS 
249 
authorities have dealt with these conditions in 
other ways and have obtained equally brilliant re- 
sults. In general, the latter have used methods 
by which they would so manage the patient as to 
make him appreciate his mode of facing a trying 
situation, and to instill in him a spirit of adequacy 
enabling him to manage these painful situations in 
a more frank and efficient manner. They have led 
him from a puerile attitude towards conditions to 
a more mature and manly one. 
It must be remembered that many methods 
must be followed in the management of the psycho- 
neuroses; that no two patients can be handled in 
the same manner. What auto-suggestion will do 
for the one, psychoanalysis will do for the other. 
Religiously inclined individuals can receive great 
benefit from Christian Science, but the highly in- 
tellectual individual, skeptical of religious matters, 
can best be treated by psychoanalysis, or frank 
discussion of his difficulties. Ignorant persons 
might yield to suggestion and hypnotism, but would 
receive no benefit from psychoanalysis. 
Borderline mental deficiency 1 is a condition in 
which the individual cannot be properly called a 
mental defective as judged by the rating obtained 
from the standard psychometric examinations. 
1 Although included in the same chapter, this condition 
must not be confused with psychoneurotic tendencies or 
constitutional psychic inferiority. It is a borderline mental 
disorder, if we make the term inclusive, but it has to do 
primarily with intellectual defects, while the other condi- 
tions described in this chapter are more intimately con- 
nected with the emotional life and its aberrations. 250 
ABNORMAL BEHAVIOR 
These cases usually have a rating under 13 years 
but above 11 years. In these patients, the ability 
to select the proper method of conduct from sev- 
eral alternative possibilities is lacking. Further- 
more, they are unable to exercise sufficient con- 
trol of their instinctive and emotional reactions. 
They are easily influenced by others and cannot 
exercise proper self-reliance. While they are read- 
ily managed by those who are skillful in appeal- 
ing to their instinctive and emotional cravings, 
they are resistive to ordinary discipline. They 
cannot withstand temptations, and they yield to 
them easily. Furthermore, they are not able to 
forego present pleasures for the sake of future 
more valuable ones. Because of their great sug- 
gestibility they are often used by designing persons 
in carrying out their schemes in all sorts of plots. 
Frequently they get into conflict with the law by 
failing to appreciate the finer points of conduct. 
They drift into occupations for which they have 
no special aptitude or ability. If properly guided, 
they become law-abiding citizens. Occasionally, 
however, they fall under the influence of agitators 
and become a real menace. The following cases 
illustrate some of the ways in which such indi- 
viduals may behave in an anti-social manner: 
Case 55 
A young girl (17 years of age) was brought from 
a Magistrate’s Court charged with incorrigibility. Her 
mother stated that the patient was a full term child; PITFALLS OF OUR MINDS 
251 
chicken pox during infancy, but no other illness. At 
school the mother stated that the patient was never 
as bright as the other children, and left the 7A 
grade at the age of 16. As soon as she left school, 
the patient became unruly, would run around with 
men, pick up strangers, and her conduct was such as 
to cause her arrest six months ago. She was then 
placed on probation, but she continued to follow the 
wayward path as she did before her probation. She 
was then arrested and the Magistrate sent her to the 
hospital for observation as to her actual mental state. 
At the hospital the patient showed a well developed, 
rather attractive personality. She showed no evidence 
of any neurological disorders. Her Wassermann re- 
action was negative. Her psychometric examination 
revealed that the patient reached a mental age of n 
years and four months with an I. Q. of 70, which would 
give her a rating as a borderline case intellectually. 
In personality she was rather quiet, pleasant and 
agreeable. She at first denied all the charges brought 
against her by her mother. Later, when her confidence 
was gained, she admitted various immoralities, and 
stated that she had met some young men with whom she 
became quite intimate; that she could not resist temp- 
tations placed in her way, especially along sexual 
lines. She admitted having taken money for inter- 
course “ because her friends wanted her to go with 
the boys.” 
This case represents one of borderline mental 
intelligence where her abnormal behavior mani- 
fested itself along lines of precocious sexual de- 
velopment and immorality. She appeared to be a 
facile, suggestible type, and could not resist the 252 
ABNORMAL BEHAVIOR 
temptation thrown in her way. Furthermore, she 
could not evaluate the consequences of her act, nor 
could she withstand any improper suggestions on 
the part of her friends. Such individuals, if their 
condition is detected early, can be made to follow a 
path of proper conduct and can become industrially 
productive and self-supporting if placed under the 
guidance of one who has an understanding of the 
mental mechanisms of these people. 
Case 56 
A young man (19 years of age) was brought to the 
observation ward being charged with burglary. The 
history of this boy revealed the fact that his mother 
was alcoholic and died in an insane asylum. The pa- 
tient was of normal birth, and developed normally in 
infancy and childhood. Owing to the fact that his 
mother was away from home because of her illness, 
the patient did not receive the proper supervision 
while in his developmental period. He would play 
truant most of the time, and would stay out nights 
without accounting for his absences from home or 
from school. When 12 years of age he was arrested 
on the charge of petit larceny. He was placed in a 
reformatory and allowed to go home after six months’ 
residence. At the age of 14 he was arrested for play- 
ing truant from school and he was then returned to 
the protectory, but was allowed to go home at the age 
of 15. At 16 years of age he was arrested once more, 
being charged with vagrancy, and once again he was 
allowed to return home. For the last two years the 
patient would not work, and would not give an account 
of his whereabouts, but always seemed to have PITFALLS OF OUR MINDS 
253 
sufficient money to keep himself comfortably fed and 
dressed. 
On the observation ward, the patient showed a well 
nourished and well developed condition. His heart 
and lungs were negative; he showed no neurological 
disorders to account for his conduct. On a psycho- 
metric examination he reached a mental age of 12 
years and 2 months with an I. Q. of 76, which would 
give him a rating of borderline intelligence. Mentally 
the patient appeared somewhat indifferent and care- 
less about his future. He was superficial in his gen- 
eral attitude and manner; quite boastful about his 
accomplishments; he did not seem to possess any 
ethical or moral standard. He showed a somewhat 
unstable emotional reaction and would not lend him- 
self to reason. However, he was at times rather sug- 
gestible and would help out those nurses to whom he 
became attached. He admitted that he was a member 
of a group who had robbed several places, but he 
would not give the names of any of his associates. He 
boasted of the manner in which he could outwit the 
police, and of the rapidity with which he could accom- 
plish his job. He stated that he liked the leader of 
his gang and would do anything for him. 
This case illustrates the manner in which people 
of borderline intelligence are apt to commit anti- 
social acts because of the influence which designing 
individuals may exert on them. This patient was 
incorrigible in his childhood, lacked the proper 
supervision of a mother, and committed various 
anti-social acts. Instead of being constantly kept 
under adequate supervision he was allowed to 
leave the protectory after a relatively short resi- 254 
ABNORMAL BEHAVIOR 
dence. If the handicap under which such indi- 
viduals labor is detected early, and they are placed 
in an environment where proper modes of conduct 
may be established, it is quite possible to make 
them law-abiding citizens. Owing to the fact that 
they are unable to discriminate between what is 
right and wrong in the finer points, and because of 
the fact that they are so easily suggestible and led 
by those to whom they become attached, they can 
just as easily be influenced to follow a socially 
approved path of conduct as to pursue a delinquent 
career. 
There are a group of individuals whose conduct 
is definitely anti-social and cannot be explained on 
the basis of deficiency in native intelligence. 
Neither can their behavior be accounted for on 
the basis of a mental disease or physical disorder. 
Analysis of the manifestations of behavior diffi- 
culties of these people reveals their primary defect 
in the emotional and volitional fields of their men- 
tal life. Often these people are even of high in- 
telligence, and may have had excellent schooling. 
Physically they may be attractive, and utilize this 
asset in securing many of their anti-social desires. 
Their anti-social conduct may be manifested in 
every phase of human activity. Their emotional 
instability makes them an easy prey for inebriety 
and drug addiction, and causes unhappy marital 
relationship. Furthermore, they become involved 
in all sorts of sexual offenses and perversions. Be- 
cause of their inability to forego present pleasures 
for more ultimate but greater rewards, they be- PITFALLS OF OUR MINDS 
255 
come involved in all degrees of illegal and even 
criminal acts. Many of them are so untruthful 
as to stamp them as pathological liars. They are 
industrial misfits, and they become a burden upon 
the community. Often these people are revolting 
against the existing social and civic institutions, 
blaming them for their own inadequacy. 
Analysis of the mental mechanisms of these pa- 
tients reveals many deeply seated complexes which 
unconsciously govern their conduct. They may 
become antagonistic to existing laws and customs 
as an expression against a domineering and pos- 
sibly tyrannical parent. A strong mother fixation 
or antipathy may make them marital misfits and 
drive them to form attachments with immoral 
women. 
Many of these people manifest a failure of 
normal development of their instinctive and emo- 
tional tendencies, for example, they may become 
homosexual whenever there is a failure to pass to 
the heterosexual phase of normal sexual develop- 
ment. Occasionally they may develop tendencies 
to exhibitionism. Sometimes they manifest in- 
tense masochistic or sadistic traits, and may find 
sexual expression only along such lines. When 
brought before the court for any of their anti- 
social acts, it is not always easy to determine 
their legal responsibility. While many ethical 
psychiatrists may regard such states as manifesta- 
tions of insanity in its strictest psychiatric mean- 
ing, there are others equally ethical who regard 
them as sane from a legal point of view. 256 
ABNORMAL BEHAVIOR 
For these cases are the purest examples of border- 
line mental conditions where sanity so imper- 
ceptibly merges into insanity as to make the 
marking of a boundary line an almost super- 
human task. 
The technical term for designating the condition 
of emotional instability which results in so many 
varied types of abnormal behavior is Constitutional 
Psychic Inferiority (or, less preferably, Constitu- 
tional Psychopathic Inferiority). The following 
cases are examples of the various manifestations 
of this group of disorders of behavior: 
Case 57 
A young boy (22 years of age) was brought to the 
hospital for nervousness and irritability. The history 
of the case revealed that he was an only child, and 
had been brought up by a governess. Later he at- 
tended school and was graduated from high school 
with honors. Following his graduation from high 
school he entered a military academy, but owing to 
the fact that the financial condition of his parents at 
this time necessitated the removal of the patient from 
school, he entered a business house where he made 
fairly rapid progress. He was somewhat timid, and 
rather backward in his attitude towards members of 
the opposite sex, but he was not of a definitely seclusive 
type, as he had quite a few friends amongst members 
of both sexes. For the last six months he had been 
keeping company with a young lady and plans were 
being made for their wedding. About one month ago 
he began to complain of dizziness, weak spells, and PITFALLS OF OUR MINDS 
257 
irritability. Furthermore, he had been seen mastur- 
bating quite often and it was decided to follow the 
advice of the family physician to send him to the 
psychiatric clinic. 
On examination, the patient showed rather a well- 
developed, fairly well-preserved physical condition, 
and showed no evidences of any physical disease. 
Mentally he was rather quiet, somewhat reticent, but 
as a whole a rather pleasant and agreeable personality. 
At first he was rather reluctant to discuss his diffi- 
culties. Later his confidence was gained and he was 
fairly accessible. He stated that from an early age 
he had acquired the habit of masturbation. This was 
first induced by watching his governess masturbate. 
Furthermore, she would also manipulate his genitals 
which would give him considerable sexual pleasure. 
At time of puberty he began to masturbate very ac- 
tively and continued to do so. He had had intercourse 
with prostitutes and other women, but he would be 
left with a feeling of guilt and reproach so that he 
later confined his sex activity to masturbation. When 
he became engaged to his sweetheart, he would often 
get sex feelings from which he would get relief by 
masturbation. As the time for his marriage was 
approaching, he began to dwell upon his habit, and 
brooded over it to the extent of being unable to get 
proper sleep. He then began to imagine that his 
parents and his sweetheart were aware of his short- 
comings and he began to shun them. At the same 
time he was seized with the feeling that he was going 
to become insane. After the patient’s condition was 
freely discussed with him, and after he had gained in- 
sight into the entire situation, he became composed, 
more cheerful and was able to be discharged from the 
clinic at the end of a month. 258 
ABNORMAL BEHAVIOR 
This case will serve as an introduction to the 
discussion of masturbation. Much has been 
written about this condition, and the evils which 
are supposed to accompany it. The quack litera- 
ture is replete with various imaginary evils and 
tortures to which the victim is supposed to be sub- 
jected as the result of his act. Even general prac- 
titioners in medicine are sometimes apt to regard 
masturbation as a horrible evil. The older text- 
books of psychiatry speak of it as a cause for in- 
sanity. Many a parent will come to the doctor 
terrified, upon having seen his child masturbating. 
As a matter of fact, masturbation may be one of 
the various phases of normal sex development in 
men, and possibly in women. Many eminent 
psychiatrists believe that it is universally prev- 
alent amongst boys, and to a lesser degree amongst 
girls. Frequently it is resorted to by adults when- 
ever opportunities for proper sexual expression are 
unavailable. Masturbation is no more harmful, 
if moderately indulged in, than normal sex rela- 
tionship. If excessively indulged in, it is apt to 
cause a neurasthenic condition. 
The real harm that masturbation is apt 
to cause is its tendency to unconsciously pre- 
vent the individual from seeking normal friend- 
ship amongst members of the opposite sex. It is 
apt to be accompanied by a feeling of remorse, and 
it tends to make the individual rather shy and 
backward. As a whole its dangers are rather 
limited and mild in nature. One must assume a 
sensible and scientific attitude in dealing with PITFALLS OF OUR MINDS 
259 
people brought for treatment for this habit. It 
is important to assure the parents that no real harm 
can result from this condition. It must be remem- 
bered, however, that it is a symptom found 
amongst the more serious types of mental diseases, 
and especially amongst Dementia Praecox patients. 
A normal outlet for the play instinct of children, 
the prevention of manifestation of seclusive traits, 
and a normal hygienic regimen of life are the 
methods usually followed in checking this habit. 
Case 58 
A young woman (18 years of age) was brought to 
the hospital by the worker of one of the charity or- 
ganizations, with a history of incorrigibility. The his- 
tory stated that the patient’s people were of moderate 
means, and law abiding. The father was rather strict 
with his daughters and would prevent them from go- 
ing out. The patient was of normal development; she 
attended school at the age of 6 and was graduated 
at the age of 15. She attended a trade school but 
found nothing attractive or interesting to hold her 
there. She then began to go about with girls of whom 
her parents disapproved and her father whipped her 
when she refused to give up their friendship. She 
had masturbated from the time of puberty. At the 
age of 16 she ran away from home and became a 
member of the chorus of a musical comedy show. Her 
family then had her apprehended and she was placed 
on probation, but ran away on the next day. She was 
then found dancing in a cabaret, and her parents 
caused her arrest for incorrigibility. She was again 
placed on probation and a social service worker was 260 
ABNORMAL BEHAVIOR 
placed on her case. The patient was physically at- 
tractive, and quite pleasant in her manner, but she 
was unable to resist the company of men, and the 
social service worker found it necessary to have her 
sent to the hospital for observation. 
At the hospital the patient was found to be well 
developed, well nourished and physically very attrac- 
tive. A psychometric examination gave her a mental 
age of 12 years but the exact mental age and intelli- 
gence quotient could not be obtained because of the 
emotional instability which the patient showed at the 
various stages of the examination and which influ- 
enced her rating. It was obvious, however, that she 
was not feeble-minded. 
Mentally the patient was very pleasant and agree- 
able, and accessible for examination. She spoke freely 
of her difficulties. She said that her father had been 
strict towards her and she could not receive from him 
the sympathy, attention and petting which she had al- 
ways craved. She said that she often wished she could 
talk with her people freely and pour her troubles out to 
them, but she was prevented from doing so as she knew 
that she would meet with reproach rather than with 
sympathy. She was quite popular amongst her girl 
friends, and they introduced her to men who gave her 
all the attention and petting which she desired. She 
said that she found it impossible to resist the tempta- 
tion of men because she was sexually so tense. She 
realized the seriousness of her act, but she fully ap- 
preciated her inability to cope with the situation. 
Case 59 
A woman (28 years of age) was brought to the 
hospital from the New York City Prison after having PITFALLS OF OUR MINDS 
261 
made an attempt at suicide, following her arrest for 
prostitution. She was native born, and had had a 
high school education. Her parents were very strict 
about her association with other girls and especially 
with boys. She was never allowed to go to the library 
unaccompanied by some other member of the family. 
She was never permitted to be in the company of boys 
of her age. At high school, she was not permitted to 
speak to the boys in her class. She had invited one 
of her classmates to accompany her to the “ Junior 
Prom ” and when he called at her home to escort her 
to the affair he was asked by her father to leave the 
home. When she was graduated from high school 
she wished to enter a university where her other 
friends were planning to go, but her parents insisted 
that she attend the normal school which they had 
selected. 
She always showed a deep emotional reaction, and 
would often go into ecstacies of joy or sorrow, exag- 
gerated in comparison with the situations evoking these 
responses. She craved attention and praise; but she 
never received it in her home. She received strict 
religious training. She was taught to regard every 
man with suspicion. 
When she was sent to normal school she was given 
a weekly allowance. She then found herself sud- 
denly in possession of sufficient funds to enable her 
to leave her parents. She left her school and came 
to New York. She entered a restaurant and there 
made the acquaintance of a man who offered to take 
her to his home, telling her he was single and that he 
would introduce her to his sister. That same evening 
he aroused in her all her sex emotions and she finally 
yielded to him. She frankly admitted that she will- 
ingly offered herself to him and later could not resist 262 
ABNORMAL BEHAVIOR 
temptations offered to her by other men. She then 
began to capitalize her weakness and entered into 
a life of prostitution. 
One of her male friends finally became so infatu- 
ated with her that he offered to marry her, after she 
had promised to reform. When they were married, 
however, she found that she could not get adequate 
sex satisfaction from him. She therefore sought and 
found it in the company of other men. Although mar- 
ried to him for at least six years, she was able to con- 
sort with other men without her husband’s knowledge. 
She was arrested, and in order to escape the shame and 
disgrace which she had brought upon herself and her 
husband she tried to swallow poison. 
These two cases illustrate sexual aberrations in 
emotionally unstable individuals. Both were 
denied proper emotional outlets in the form of 
ordinary parental affection and playmate associa- 
tions. Where sympathy and attention in the home 
might have enabled them to become happy indi- 
viduals, unjustifiable criticism and punishment led 
them to seek emotional outlets elsewhere. Their 
undue desire for sex indulgences was an additional 
factor in leading them into prostitution. 
There are many sexual offenses committed by 
those coming under the caption of Constitutional 
Psychic Inferiority. They are discussed at length 
in most of the books dealing with sex and its 
abnormalities, and need but briefly be referred 
to. Some sadistic individuals can obtain sexual 
gratification only by subjecting the love object to 
all sorts of physical punishment. A few masochis- PITFALLS OF OUR MINDS 
263 
tic people are sexually gratified only by receiving 
physical punishment at the hands of their para- 
mours. Such cases are, however, not as numerous 
as one is led to believe, from reading the different 
books on sex matters. 
Homosexuality results whenever there is a fail- 
ure of the normal sex instinct to develop properly. 
It is a condition in which sex gratification can best 
occur when indulged in with a member of the 
same sex. It is often resorted to whenever there 
is no opportunity for adequate normal sex expres- 
sion. Such practice is frequently acquired in 
boarding schools, in jails and in reformatories, and 
under any other conditions where there are congre- 
gated a group of the same sex, and where there 
are no facilities to meet members of the opposite 
sex. Homosexuality may coexist with heterosex- 
uality; often, however, it is the only method of 
securing sex feeling and sex gratification. The 
danger of homsexuality is that it often initiates 
into its practice the very young and those in whom 
normal sexual feeling might have been developed 
if they were not introduced to this habit. Homo- 
sexuality has played an acknowledged part in the 
different arts and in literature. It may occur as 
one of the manifestations of an attack of insanity, 
especially of the manic-depressive type. 
Exhibitionism, or the desire to display the gen- 
itals in public places, is not a very common sex 
deviation, but it is fairly prevalent amongst the 
insane. Voyeurs, or persons who attain sexual 
gratification by looking at sexual objects, are not 264 
ABNORMAL BEHAVIOR 
as numerous as many others would lead us to be- 
lieve. They do, however, form a rather distinct 
group of sexual perverts. These have been so 
fully discussed in many books of psychopathology 
that we shall not consider them in detail in this 
chapter. 
SUPPLEMENTARY READINGS 
Brill, A. A. Psychoanalysis, W. B. Saunders and Co., 
Phil., 1922. Chapters on Psychoneuroses, Masturba- 
tion, and Compulsion Neuroses. 
Hurst, A. F. Hysteria in the Light of the Experience of 
War. Archives of Neurology and Psychiatry, Vol. 2, 
p. 563, Nov., 1919. 
Freud, S. Selected Papers on Hysteria and Other Psycho- 
neuroses, Nervous and Mental Diseases Monograph 
Series No. 4, N. Y., 1912. 
Janet, P. A Lecture on Hysteria, Boston Medical and 
Surgical Journal, Vol. 155, 1906. 
Karp as, M. J. Constitutional Inferiority, Journal of the 
American Medical Association, Vol. 67, p. 1831, Dec. 16, 
1916. 
Rosanoff, A. J. A Study of Hysteria, Based Mainly on 
Clinical Material Observed in the U. S. Army Hospital 
for War Neuroses at Plattsburg Barracks, N. Y. 
Archives of Neurology and Psychiatry, Vol. 2, p. 419, 
Oct., 1919. Chapter VIII 
EPILEPTIC MANIFESTATIONS IN 
BEHAVIOR DIFFICULTIES 
The epileptic as a social outcast. 
Definition of epilepsy. 
The occurrence of convulsions in other diseases. 
Heredity and epilepsy. 
The role of the glands of internal secretion in epilepsy. 
Researches on epilepsy. 
Epilepsy as a life reaction. 
Pragmatic conception of epilepsy. 
The frequency of epilepsy. 
Feeling of inferiority induced by epilepsy. 
The epileptic make-up. 
Grand Mai 
Petit Mai 
Jacksonian Type 
Epileptic Equivalents. 
Clinical types of epilepsy: 
Psychoses in epileptics. 
Cases illustrating maladjustment in school due to epilepsy. 
Cases illustrating types of sexual offenses committed by 
epileptics. 
Cases illustrating assaultive traits in epileptics. 
Cases illustrating minor anti-social acts, such as indecent 
exposure, and disorderly conduct. 
Case illustrating religious trend. 
Scientific management of epilepsy and cases illustrating 
results obtained. 
Epilepsy as a manageable disease. 
BARRED from the public schools, and thus 
deprived from securing any education; ex- 
cluded from the large majority of vocational pur- 
265 266 
ABNORMAL BEHAVIOR 
suits, and thereby prevented from being self-sup- 
porting; shunned by most people because of the 
horror attached to his illness, and therefore de- 
prived from reaping the advantages obtained from 
social intercourse, and often neglected even by 
the members of his own family because of the 
chronicity of his ailment, the individual suffering 
from epilepsy ought to receive the utmost consid- 
eration whenever presenting any behavior difficul- 
ties. Yet, but for a few glaring exceptions, very 
little is being done for those suffering from this 
disease. There are no special classes in the school 
system that are designed especially for the epilep- 
tics. There are no special places where the epilep- 
tic may be sent to work under proper supervision, 
so that he may be at least partially self-supporting. 
There is absolutely nothing in the nature of di- 
version to which the epileptic may turn and not be 
excluded because he happens to have had a con- 
vulsion. Indeed, there are but few families who 
do not become discouraged and finally apply 
to some civil authority to remove the burden of 
an epileptic member from their hands. It is in- 
deed pitiful to watch the epileptic going from one 
clinic to another trying to secure relief. The so- 
called colonies for epileptics, or the places where 
an epileptic may be sent for care and treatment, 
are too few in number and are too crowded to 
accept all their applicants. 
What is epilepsy? To the layman, it means an 
individual suffering from frequent attacks of con- 
vulsions. The medical profession is divided, as PITFALLS OF OUR MINDS 
267 
to what really constitutes epilepsy. One group 
maintains that epilepsy is a manifestation of sev- 
eral conditions, just as shortness of breath, swell- 
ing of the feet, etc., might be due to any one of 
several physical diseases. On the other hand, 
there is a group which claims that epilepsy is a defi- 
nite disease process, just as pulmonary tuberculosis 
(consumption), or typhoid fever are distinct types 
of disease. 
Picture an individual, who apparently has been 
able to get along fairly satisfactorily for several 
days or weeks, suddenly wake up in the morning 
feeling grouchy, complaining of headache, being 
somewhat irritable, fussy and picking on every- 
thing, and unable to perform his work. His eyes 
are dilated, his face pale, his tongue somewhat 
coated. Suddenly he screams, falls, loses con- 
sciousness, stiffens out and then shakes with every 
muscle in his body, froths at the mouth, bites his 
tongue, and perhaps wets and soils himself. 
Finally, after a few minutes, ceasing to shake, 
he gets up from the floor, wanders aimlessly around 
the room, and finally falls into a sleep from which 
he awakens complaining of a headache and again 
is apparently able to assume his former station 
in his little circle. One cannot help but feel that 
we are dealing here with an accumulation of some 
harmful agent, be it some toxin or other as yet 
unknown noxious agent, which seems to set in 
action the entire motor mechanisms of the body, 
but which appears to be neutralized during the 268 
ABNORMAL BEHAVIOR 
“ fit.” This would seem to stamp it as a definite 
disease entity. 
To the layman, the most distressing symptom is 
the convulsions. In fact, it is the one condition for 
which the majority of the patients and most of 
the family seek medical assistance. It must be 
clearly understood that the convulsion itself is one 
of the many, although perhaps the most distress- 
ing, of the links in the entire disease process. Con- 
vulsions are encountered in many other diseases, 
and are met with in diseases of the kidney, in 
certain forms of heart disease, in cases of harden- 
ing of the arteries of the brain, in many diseases 
of the nervous system, in certain types of syphilis 
of the nervous system and in a few diseases of the 
membranes lining the brain. One often meets 
convulsions in poisoning from strychnine or alcohol 
and in direct injuries to the brain from trauma, 
heat-stroke and sun-stroke and in many other con- 
nections. In epilepsy, however, the convulsion is 
entirely different from that encountered in other 
conditions, and when observed by a trained phy- 
sician, is readily recognizable as distinctly epileptic 
in nature. In fact, the epileptic convulsion can 
hardly be imitated, although epilepsy is the most 
simulated of all diseases. 
There are various theories offered in the en- 
deavor to explain the cause of epilepsy. Heredity 
has invariably occupied a prominent place among 
these theories, especially in the writings of the 
older school of physicians. However, more accu- 
rate data fail to reveal any truth in that claim, and PITFALLS OF OUR MINDS 
269 
direct transmission of the disease from parent to 
the offspring is an exception rather than the rule. 
These accurately gathered statistics, however, do 
seem to show that an unstable nervous system as 
manifested by the presence of other nervous dis- 
eases is usually found in the family of the epileptic. 
This is of tremendous importance from a sociolog- 
ical view-point, in that many workers who are in- 
terested in the field of eugenics are clamoring either 
for the segregation of all female epileptics during 
the child-bearing period, or for the sterilization of 
all epileptics. They insist that epilepsy is directly 
transmissable, and offer ingenious diagrams illus- 
trating the Mendelian law to prove their conten- 
tion. Accurate clinical observation and modern 
scientifically gathered statistics fail to reveal any 
evidence to corroborate their claim other than 
proving that there is some neuropathic strain in 
the families of the epileptics. 
Of late there has been evidence produced by a 
group of medical workers that might tend to direct 
one’s focus of attention to the glands of internal 
secretion as the probable causative factor in pro- 
ducing epilepsy. They have quoted several cases 
in which medication directed to counteract the in- 
ternal gland disturbances was administered with 
apparently beneficial results. Still the group of 
cases in which such treatment has been efficacious 
is entirely too small to justify such deductions. 
Furthermore, there are many cases, in fact the 
greatest majority of all epileptics, in whom the in- 
ternal glands are apparently in normal condition. 270 
ABNORMAL BEHAVIOR 
Recently intensive studies in the chemistry of 
the blood and various secretions and excretions of 
the body conducted by very skilful observers, have 
thrown some light on the metabolism of the epi- 
leptic that might be utilized in the general manage- 
ment of the patient, but so far they have failed to 
give any lead as to conclusive evidence about the 
real cause of this disorder. The structural changes 
in the brain and various other tissues of the body 
as studied on post-mortem examination have failed 
to reveal any uniform findings. Indeed they would 
tend to point to many causes rather than to one as 
responsible for this disease. 
A most fascinating theory is being offered by the 
psychopathologists which regards epilepsy as an ex- 
pression of behavior in an individual of a definite 
mental make-up. To quote from the chief expo- 
nent of this theory: “ There exists a more or less 
definite type of constitutional make-up in epileptics 
which has long been recognized by many able 
neurologists and psychiatrists, and this defect ac- 
counts in no small part for the so-called ‘ predis- 
position ’ to the disease, a term in common use 
to-day. The essential defects of instincts are ego- 
centricity, supersensitiveness and emotional pov- 
erty, and an inherent defect of adaptability to 
normal social life in its broadest significance. The 
main defect is an inheritable one. This make-up 
is the primary or original mental endowment of the 
potentially epileptic individual. It is accentuated 
and made the more obvious by the further advance 
of the disease only when the seizures develop. It PITFALLS OF OUR MINDS 
271 
is then often spoken of as the ‘ mental stigma ’ of 
the disease. The attacks are not solely responsible 
for the epileptic deterioration, but the seizures are 
themselves symptoms and exhibitions of the de- 
teriorating disorder.” 1 
The psychopathologist regards epilepsy as a 
specific life reaction disorder. Even the very 
seizure he regards as a manifestation of the in- 
ability of these patients to subordinate their own 
individualistic tendencies to social demands, and 
considers the loss of consciousness as a representa- 
tive of their withdrawal from reality. This the- 
ory while rather intriguing in its psychological 
implications is hardly practical for general appli- 
cation. 
The truth of the situation is that for the present 
there is no definitely established cause of epilepsy. 
In the light of our present knowledge, it might best 
be regarded as the result of an increased irritabil- 
ity of the cerebral cortex, and the convulsion is 
to be interpreted as the response of this highly 
sensitive cortex to stimuli. These stimuli may 
come from poisonous products of metabolism, emo- 
tional complexes, or from various other sources. 
Such an assumption is the most feasible one and 
for practical purposes the most valuable one in the 
management of these patients. For epilepsy is a 
manageable disease, and the proper application of 
well-established therapeutic principles, and the 
utilization of adequate medicinal agents in the 
hands of a properly trained medical man have 
1 L. Pierce Clark 272 
ABNORMAL BEHAVIOR 
enabled many epileptics to lead a fairly normal 
existence. 
Epilepsy is a rather frequent disease. While 
it is generally estimated that .2% of the popula- 
tion suffer from this disorder, no less an authority 
than Spratling, who for years was the superintend- 
ent of the Craig Colony for Epileptics, states that 
from his studies he has become convinced that if 
all cases of epilepsy could be counted, one would 
find no less than one epileptic to every 300 of the 
population at large. Epilepsy may remain un- 
recognized for years. Many of its victims have 
“ fits ” only during the night. Others have such 
mild attacks that the true nature of the disorder 
is not recognized. It is essentially a disease of 
early life. More than 80% of all cases occur be- 
fore the age of 20 years. The sexes are about 
equally affected. 
In a few individuals, epilepsy induces a feeling 
of inferiority, for which the patients tend to com- 
pensate by increased application and concentration 
in the field of endeavor. Sometimes they attain a 
degree of perfection which makes them very suc- 
cessful individuals. One meets with many rather 
brilliant epileptics who lead normal biological ex- 
istences, are married, have children, conduct their 
businesses successfully, and take active interest in 
civic affairs. Historical evidence even leads us to 
believe that such figures as Mohammed, Caesar 
and even Napoleon were epileptics. It must be 
admitted, however, that the average epileptic is 
working under a great handicap, and his chances PITFALLS OF OUR MINDS 
273 
for success in life are less than those of normal 
persons. Mental deficiency is found in greater 
numbers among epileptics than in the rest of the 
population. The epileptic is apt to become rigid 
in his mental attitudes, restricted in his field of 
interest, and to show with increasing age moderate 
intellectual deterioration. 
In order to appreciate the various forms of 
anti-social behavior caused by epilepsy, it will be 
opportune to describe the different forms of epi- 
lepsy, and to call attention to the most frequent 
types of anti-social conduct apt to occur in the dif- 
ferent periods of this disease process. 
The epileptic makeup is rather unique. From 
early childhood, he shows a stubbornness which is 
apt to bring him into conflict with members of his 
own family and with others with whom he happens 
to come in contact. He is quite obstinate, and in- 
sists upon having his own way, disregarding the 
privileges and rights of others. He is extremely 
self-centred, looking upon life from his own nar- 
row range of vision. He displays a lack of interest 
which narrows him considerably. His emotional 
reaction is exaggerated, considering the stimulus 
eliciting it. He flies into fits of temper at the least 
provocation. Such a personality is indeed a dis- 
agreeable one, and one that is apt to be unsuccess- 
ful at school, unpopular at home and a vocational 
misfit. Epileptics often become fanatics along 
religious and political lines and thus tend to 
incur the enmity and ill-will of the community 
in which they may reside. Freauently they become 274 
ABNORMAL BEHAVIOR 
so unreasonable and objectionable as to get into 
legal difficulties. Their disregard for the opinions 
and welfare of others make their marital lives un- 
happy ones. They are apt to be inconsiderate 
wives and husbands and stern parents. 
There are several clinical types of epilepsy. 
The most common form is the Grand Mai. 
Usually the individual, preceding his attack, shows 
general irritability, peevishness, and uneasiness. 
The attack is generally ushered in by an aura 
(warning), such as a flash of light before the eyes, 
or a sour feeling in the stomach, etc. Immediately 
there is a scream, and the patient loses conscious- 
ness, falls, remains rigid from a few seconds to a 
minute, then shakes with all the muscles of his 
body from two to five minutes or longer, froths at 
the mouth, bites his tongue, often wets and soils 
himself, and breathes irregularly. Then he either 
gets up from the floor and wanders about in an 
aimless manner, finally falling into a heavy sleep, 
or immediately after the convulsion goes into this 
sleep, which lasts for several hours. On awaken- 
ing, the patient complains of a terrific headache, 
but seems, however, generally relieved from that 
feeling of tenseness which has preceded his attack. 
He has no knowledge of events between the warn- 
ing, or aura, and his awakening later. 
The Petit Mai attack is ushered in by a momen- 
tary loss of consciousness with a loss of balance, 
and immediate regaining of consciousness followed 
by moderate headache. Many involuntary acts PITFALLS OF OUR MINDS 
275 
may be committed during this brief lapse of con- 
sciousness. 
The Jacksonian type is one in which there is 
convulsion of some part of the body, but without 
any loss of consciousness. 
The most interesting types of epilepsy are those 
which come under the heading of Epileptic Equiva- 
lents. At these times, the individual may perform 
many peculiar acts, some being of marked anti- 
social nature. He may find himself in a strange 
city, he may have contracted many responsibilities, 
and all this he may have done without being cog- 
nizant of it. When these acts are called to his 
attention he is surprised and unable to account 
for them. He may find himself in the clutches 
of the law, charged with some crime which he has 
committed but of which he has no recollection. 
He may have transacted business without knowing 
it. Sometimes gross sexual iniquities are perpe- 
trated in these states. 
During the confusion following the epileptic con- 
vulsion, the individual is apt to commit various 
criminal acts. Especially he must be guarded 
against committing sexual assaults, or injuries to 
persons. Epileptics seem to possess supernatural 
strength during their period of confusion, and the 
crimes they commit are sometimes of the most 
brutal nature. Often they commit suicide. Occa- 
sionally they develop a paranoid trend, and thus 
become a great menace. 
Outbreaks of insanity in epileptics are charac- 
terized by marked states of excitement, mental 276 
ABNORMAL BEHAVIOR 
dulness, slowness of associattion of thinking, im- 
pairment of memory, mood deterioration, irritabil- 
ity or apathy; often there are many periods of 
confusion, bewilderment and anxiety, violent and 
assaultive outbreaks, hallucinations and delusions. 
Occasionally there may be states of abnormal hap- 
piness in which religious exaltation exists. 
The following are some of the instances of epi- 
leptic manifestations in behavior difficulties: 
Case 60 
A young boy (14 years of age) was brought to the 
hospital from school after having attempted suicide 
by strangulation. The family history revealed that 
the parents were born in this country and were in good 
health. There were nine other children in the 
family. The patient was of normal labor and in- 
fancy. He developed properly and was considered 
very bright. At 12 years of age, he began to lose 
interest in his school work and would play truant. At 
the same time he became somewhat nervous, easily 
irritated and at times somewhat excited. He was 
therefore sent to a truant school. A note from that 
school which accompanied the patient stated that he 
had made several attempts to commit suicide by 
cutting himself with a piece of tin and by strangula- 
tion. He had been irritable, impulsive and depressed. 
On examination, the patient at first appeared 
rather fearful and apprehensive, and somewhat in- 
clined to be reticent and evasive. He would not tell 
his story willingly, and it had to be gotten in several 
interviews. He then said that there was absolutely 
nothing wrong with him. He complained that the PITFALLS OF OUR MINDS 
277 
head-master of the school would whip him and beat 
him with drum-sticks. He also complained that on 
several occasions he was “ put on the line ” by which 
the patient meant that he was subjected to running 
barefooted for several hours on the hot pavement. He 
also complained of being sent to the “ coop,” by which 
he meant a small room in the attic, which was 
used for the purpose of segregation and where the pa- 
tient was fed on nothing but bread and water. 
For the first few days the patient apparently was 
adapting himself readily to the ward routine. At the 
end of a week he suddenly became very restless, began 
to cry, became confused, shouted at the top of his voice 
and wrung his hands, exclaiming, “ Take him away — 
For God’s sake save me — Don’t let him kill me — ” 
At the end of five minutes he became very quiet, mute 
and would answer no questions; appeared dazed and 
definitely bewildered; struck anybody coming near 
him, and it was necessary to place him in partial re- 
straint. On the following morning after having been 
restless the entire night, he was still rather dazed and 
confused, and insisted that the truant officer had been 
near him and had struck him with a rod. He com- 
plained of headache. He gradually cleared and be- 
came more composed, and on the following day seemed 
to have no knowledge of his outbreak. He continued 
to get along fairly satisfactorily for three days, when 
once again he became very suspicious, fearful, could 
not sleep; he stated that he saw the head-master, and 
that he was again being beaten; thought he was at 
school; complained of his head being dizzy. At the 
end of 24 hours he again became quieter and com- 
posed, but once more he had complete amnesia (loss 
of memory) for the outbreak, although he insisted 
that the head-master was in the hospital. 278 
ABNORMAL BEHAVIOR 
The psychometric examination at this time resulted 
in a mental age of 11 years and 3 months with an In- 
telligence Quotient of 76. The patient appeared rather 
indifferent in general attitude and was rather seclusive, 
and not inclined to give much information about 
himself. 
Physically, the patient appeared rather of heavy 
set features; tongue was coated; pupils were widely 
dilated but he showed no evidence of physical dis- 
ease. Blood Wassermann was negative, and X-ray 
examination of the skull revealed nothing pathological. 
At the end of two weeks’ residence the patient was 
discharged as a case of epilepsy of the epileptic equiv- 
alent type. 
He was referred to the mental clinic, to which he 
reported three days later. At this time he appeared 
alert and interested, and a psychometric examination 
then resulted in a mental age of 13 years and 5 months 
with an Intelligence Quotient of 90. One week later 
the patient had a general convulsion; became very 
much excited and assaultive, and had to be readmitted 
to the hospital. 
On admission he was ugly, irritable and excitable 
and had to be placed in partial restraint; he 
was quite confused and apprehensive. He was placed 
under proper medication and gradually cleared so 
that he was able to leave the hospital at the end of a 
week. 
This case illustrates the difficulty in which epi- 
leptics often put others. His complaint against 
the head-master caused extreme uneasiness in his 
family, and his parents were contemplating a law- 
suit. In the hospital, the patient at first gained PITFALLS OF OUR MINDS 
279 
the sympathy of the examiners, until his period of 
excitement, when it became apparent that the al- 
leged mal-treatment to which he had been sub- 
jected was really a product of his mental state. It 
is also of interest that the first psychometric ex- 
amination gave him an Intelligence Quotient of 76, 
which was far below his real intelligence rating, as 
was shown by a later psychometric test performed 
by the same psychologist in which he reached an 
Intelligence Quotient of 90. 
Case 61 
A man (50 years of age) was brought from the 
magistrate’s court for mental examination. Family 
history revealed the fact that his mother had died in 
an insane asylum; one brother had been committed on 
two occasions to state hospitals. The wife stated that 
the patient was of an unusually deep religious nature, 
being almost a fanatic on that subject. He fre- 
quently would get into fits of anger and would often 
strike her and her child. He frequently would 
have spells of wandering away from home and find- 
ing himself in strange cities. Occasionally he would 
get into spells of religious excitement in which he 
would run up and down the floor, drop on his knees 
and pray in a loud tone of voice. Often he would 
have outbreaks of sexual excitement, during which he 
would make his wife submit to abnormal sexual acts. 
He also showed a homosexual trend, and would fre- 
quently bring men to the home feeding them and cloth- 
ing them, and appearing during these periods in a 
state of mental confusion. When regaining his senses, 
he would have no knowledge of his acts. 280 
ABNORMAL BEHAVIOR 
On the ward the patient showed a dull, seclusive 
attitude; would not associate with any of the other 
patients, and showed considerable emotional deteri- 
oration. He appeared slow in comprehension and 
moderate retardation in association of ideas was pres- 
ent. He gave a retrospective account of lapses of 
memory, which suggested states of epileptic equiva- 
lents. He said that he was arrested being charged with 
prostitution, but he did not deny that he had been 
in a compromising situation with another homosexual 
individual. He was committed to a state hospital 
with a diagnosis of episode of excitement accompany- 
ing an epileptic equivalent state. 
Case 62 
A young female (23 years of age) was brought to 
the hospital having taken bichloride of mercury. Pa- 
tient stated that her mother died when she (the patient) 
was only five years of age. She had always been of 
a rather artistic nature; liked music and drawing, and 
took part in all dramatic performances during her 
normal school residence. Following her graduation 
from normal school, she joined a stock company and 
participated in many Shakespearean roles. She stated 
that for the past four years she had frequent periods of 
loss of memory during which she performed many 
acts of which she later had no knowledge. She often 
found several articles in her room for which she could 
not account. She would find herself visiting people 
without knowing how she had ever gotten to their 
homes. On one occasion she found herself reciting 
before an audience in a theatre and could not tell how 
she had ever gotten there. On several occasions she 
found herself in rooms with strange men, and would PITFALLS OF OUR MINDS 
281 
become very much terror stricken at this. She be- 
came engaged and planned to get married, but was 
prevented from doing so because her conscience both- 
ered her, and she could not gather enough courage to 
tell her fiance of her ailment. Several months ago 
she found herself in a room with a strange man and 
she became so depressed that she attempted suicide 
by inhaling illuminating gas and was saved by a friend 
who called on her and found her in a dazed condition. 
On the morning of her admission to the hospital 
she found herself in bed with a stranger, and she be- 
came so depressed and discouraged to find herself with 
a strange man in a strange room that she swallowed 
several tablets of bichloride of mercury. The pa- 
tient showed evidence of bichloride poisoning, mercury 
being recovered from various secretions and excretions 
of the body. All medical help failed and she died at 
the end of five days from bichloride poisoning. 
Case 63 
A man (28 years of age) was brought from the 
Tombs Prison being charged with compulsory prosti- 
tution. He had a general convulsion while in the City 
Prison and was therefore sent to the hospital for ob- 
servation. On the ward the patient showed a well 
developed, well nourished physical condition; he 
showed a rather female type of body development; 
very fair skin and very few hairs on the body. He said 
that from the age of 13 he had been having epileptic 
attacks varying in nature from transitory states of 
forgetfulness to marked generalized convulsions. He 
admitted homosexual traits, and also admitted having 
made several sexual assaults on women. This was 
accounted for by his inability to control his instinctive 282 
ABNORMAL BEHAVIOR 
reactions, by his lack of knowledge of the act, and 
because of the confusion that followed his convulsions. 
These three cases illustrate some of the types of 
sex offenses committed by the epileptics. The 
more obvious type of sex offenses such as assaults 
upon women and young girls are quite common in 
the state of confusion that follows convulsions. 
Case 64 
A man (37 years of age) was brought from the City 
Prison being charged with assault, having struck sev- 
eral people on the street without any apparent provo- 
cation. A physical examination of the patient showed 
an incomplete fracture of one of the bones of his fore- 
arms and scars on his tongue; otherwise his physical 
condition was good. He had several scars on his scalp 
and forehead. 
Mentally the patient was somewhat dull, rather ir- 
ritable and impulsive; said that he had been subject to 
epileptic seizures from childhood, and that he had 
been arrested on several occasions because he had 
struck people. This time he said he had been arrested 
for having a fight with a policeman but he does not 
really recall what had taken place. He said that 
often instead of having a convulsion he would run 
about as if in a dazed condition. 
Case 65 
A colored man (27 years of age) was brought from 
the Tombs Prison charged with murder in the first 
degree. It was alleged that he had brutally killed a 
person. Nothing could be learned of his personal or PITFALLS OF OUR MINDS 
283 
family history. Physically the patient showed un- 
equal and irregular pupils, scars on the tongue, face, 
and scalp. His blood Wassermann was negative. 
Mentally he appeared dull, very evasive and sus- 
picious. He stayed by himself taking no interest in 
his surroundings; associated with no one. He ap- 
peared somewhat confused and showed considerable 
fear reaction. He expressed a paranoid trend of a 
persecutory nature. At times he would become mark- 
edly agitated and excited. He had a general convul- 
sion while under observation. On one occasion he 
complained that his food was being poisoned, that 
every night somebody put something in his stomach to 
poison his stomach; he claimed that a lawyer was re- 
sponsible for that, and tried to choke his lawyer while 
the latter was pleading his case before a judge. He 
was committed to Matteawan State Hospital for the 
Criminal Insane, being diagnosed as an epileptic 
psychosis. 
The last two cases illustrate extremes in the as- 
saultive tendencies of the epileptics. Many an in- 
nocent person is seriously hurt by an epileptic 
without any apparent reason. 
Case 66 
A young woman (28 years of age) was brought 
from a magistrate’s court being charged with inde- 
cent exposure. She was found disrobing in one of 
the city parks. Her history revealed that she had 
been subject to epileptic spells since puberty, having 
convulsions every two or three weeks. She frequently 
would disrobe while coming out from a convulsion. ABNORMAL BEHAVIOR 
284 
She showed the characteristic dulness, emotional in- 
difference and irritability and had two general con- 
vulsions while under observation. 
Case 67 
A man (30 years of age) was brought from a magis- 
trate’s court with a charge of indecent exposure 
pending. He was found on the street exposing himself 
to passers-by. It was found that he had been suffer- 
ing from epilepsy since the age of 20 and that he had 
been arrested on several occasions for indecent ex- 
posure. He carried in his pocket a statement from 
a physician that he was suffering from epilepsy. 
Physically this patient was rather under-nourished, 
pale, and showed scars on his tongue, on his face and 
extremities which indicated healed bruises sustained 
during his attacks. 
Case 68 
A young woman (26 years of age) was brought 
from a magistrate’s court with a charge of disorderly 
conduct pending. This patient had had five previous 
admissions to the same ward, and was diagnosed on 
each occasion as epileptic. Two years ago while in 
a street car she broke a window, was arrested and 
finally committed to a state hospital with diagnosis 
of excitement accompanying epilepsy. This patient 
was known to the police of the neighborhood where 
she resided, and whenever found in a state of excite- 
ment the officers who knew her would return her to 
her home. Whenever she had a convulsion in a 
strange neighborhood, she would invariably get ar- 
rested because of her marked restiveness, irritability PITFALLS OF OUR MINDS 
285 
and impulsiveness. She would throw abuse at the 
policeman or anyone who would try to help her. 
She would express a mild paranoid trend and would 
use the most obscene and profane language. Her 
present attack followed an altercation with a police- 
man whom, she accused of being a robber and a mur- 
derer. 
The patient showed a well-developed, well-nour- 
ished physical condition. Mentally she was very ugly, 
restless, disagreeable, irritable and impulsive. She 
was quite officious, interfering with the nurses, com- 
plaining against the treatment she was receiving at 
the hands of the police, and in the hospital. She had 
several convulsions while under observation and it was 
necessary to have her committed to a state hospital 
for further care and treatment. 
Case 69 
A young man (24 years of age) was brought to the 
hospital from a church where he had become very ex- 
cited, insisted upon becoming a Catholic, and called 
for a priest. The history revealed the fact that the 
patient had been having seizures or fits for the past 
four years; that he had gone to church following a con- 
vulsion and had created a disturbance. He showed 
a well-developed, well-preserved condition; his tongue 
showed several scars. Mentally the patient was rest- 
less, confused, and deluded He said that he had a 
golden touch and that he owned several hospitals in 
New York. He expressed a number of delusions of 
a religious character and of an absurdly fantastic 
nature. He said: “ I am Christ; I own the world. 
I have just been up to the sun where God has been. 
I am a doctor to clean you up. God told me he was 286 
ABNORMAL BEHAVIOR 
going to go home. I feel great. Why am I here? 
Because I own this place, don’t you know — etc.’” 
He was committed to a state hospital for care and 
treatment. 
Case 70 
A young woman (21 years of age) was brought to 
the hospital from a magistrate’s court being charged 
with petty larceny, having taken some articles1 from 
a department store counter. The arresting officer 
stated that the girl showed no emotion when arrested 
and acted in such a fashion as to make him suspect that 
she was in some way mentally affected, and he asked 
the presiding magistrate to have her sent to the hos- 
pital for observation. 
At the hospital the patient appeared dull, somewhat 
uneasy, rather tense emotionally, quite irritable at 
times and showed a moderate mood deterioration. 
She had several convulsions while under observation. 
Her mother stated that the patient had been having 
fits at night for the past three years. For the past six 
months she had had several convulsions during the 
daytime. She would often become inattentive, 
apparently in a state of mental aberration during 
which she would take things from the house and sell 
them for insignificant sums. It was quite obvious 
that this patient, when she took the article from the 
counter in the department store, was in a state of epi- 
leptic confusion. She was diagnosed as a case of 
epilepsy. 
On reading these cases, one is apt to gain the 
impression that the epileptics are hopelessly lost, 
anti-social creatures for whom nothing can be done. 
Nothing is so far from the truth as such a belief, PITFALLS OF OUR MINDS 
287 
for the epileptic lends himself to proper treat- 
ment, but only a very few properly qualified and 
trained physicians are able to successfully manage 
such individuals. To successfully treat epilepsy 
one must have a thorough knowledge of the 
mental mechanisms underlying human conduct, an 
appreciation of the peculiar make-up of the epi- 
leptic, a familiarity with the common types of 
psychoses, and a thorough training in general 
medicine. 
Perhaps one might obtain a more optimistic 
view-point if we were to relate some of our 
own experiences in the management of these 
patients. We have had an opportunity to treat 
the female epileptics at the Manhattan State Hos- 
pital under a modern scientific regime. In May, 
1919, there were recorded 502 convulsions on the 
ward. In May, 1920, after the institution of the 
modern accepted scientific standard of treatment, 
there were only eight recorded seizures, in this 
same ward. Many of these patients were enabled 
to leave the state hospital and to return to their 
families and resume a normal life. The following 
are two of the cases which have come under our 
personal observation: 
Case 71 
A young female was committed to the state hospital 
after having attacked her sister in one of her states of 
confusion following a convulsion. In the hospital, 
the patient showed a rather dull, irritable, sullen 
attitude. She would strike the other patients and 288 
ABNORMAL BEHAVIOR 
would break the furniture. She would talk in a some- 
what disconnected, incoherent manner and occasion- 
ally would express a persecutory idea. She would have 
as many as five to six convulsions a week. With the 
institution of proper therapy, she became clearer in 
her mental processes, became more amenable to care 
and treatment, helped the nurses on the ward and 
finally was paroled to the care of her sister. She was 
properly supervised, and was able to get along and 
make proper adjustments. She met a young man who 
was informed of her ailment, and who still wanted to 
marry her; they finally married, had a child, and the 
patient was free from convulsions for two years fol- 
lowing her discharge from the hospital. She has had 
one attack since, which was precipitated by a family 
disagreement. 
Case 72 
A female epileptic, 30 years of age, who in her 
early life was quite charming and attractive, but who 
was quite stubborn and wilful, married quite a prom- 
inent man and was apparently very happy until two 
years after her marriage when she became subject to 
epileptic fits. On one occasion she was found in the 
house with the gas jet open. She was then in a state 
of coma, partly due to gas inhalation and partly due 
to the stuporous state following her convulsion. She 
was committed to the state hospital for care and treat- 
ment. For three years the patient was having on the 
average of two to three convulsions a week. Preceding 
her attacks she would become very ugly, irritable and 
assaultive, and would have to be placed in full restraint. 
Following her attacks she would become very much 
agitated and excited, and it was dangerous to be near 
her. After a month’s treatment by the modern PITFALLS OF OUR MINDS 
289 
methods she was gradually losing her marked irritabil- 
ity and her assaultive traits; gained a good deal of 
insight into her condition, became easily manageable, 
and it was possible to parole her to the care of her 
mother. She was carefully supervised, and was free 
from convulsions for a period of eight months follow- 
ing her discharge from the hospital until she moved 
into another state and she has not been heard of since. 
The last two cases are cited simply to illustrate 
the possibility of properly managing these cases. 
They could be supplemented by many others of 
similar nature. 
It will be seen that epilepsy is manifested in 
diverse manner in behavior difficulties. Minor acts 
of delinquency, various sex offenses, and major 
crimes of all description may be committed by the 
epileptic. It is a manageable disease, and the utili- 
zation of scientific principles is imperative for the 
successful control of this condition. To properly 
treat epileptics, supervision should be instituted 
very early. They should be given proper school- 
ing in special classes, and opportunity should be 
afforded for suitable vocational training. There 
should be sufficient hospital facilities for those 
cases which cannot be managed outside of an in- 
stitution. 
SUPPLEMENTARY READING 
Burr, C. W. Heredity in Epilepsy, Arch. Neurol, and 
Psychiatry, Vol. 7, p. 721, June, 1922. 
Cheney, C. O. Some Conceptions of Epilepsy, N. Y. 
State Hosp. Quarterly, Vol. 2, p. 105, Feb., 1917. 290 
ABNORMAL BEHAVIOR 
Clark, L. Pierce. Clinical Studies in Epilepsy, State 
Hosp. Press, Utica, N. Y., 1917. 
Davenport, C. B., and Weeks, D. F. A First Study of 
Inheritance of Epilepsy, Jour. Nerv. and Ment. Dis., 
Vol. 38, p. 641, 1911. 
Sands, I. J. Control of Epileptic Seizures, N. Y. State 
Hospital Quarterly, Feb., 1920. Luminal Therapy in the 
Control of Epileptic Seizures, Arch. Neurol, and Psy- 
chiatry, Vol. 5, p. 305, March, 1921. 
Spratling, W. P. Recent Progress in the Treatment of 
Epilepsy, Albany Medical Annals, Vol. 29, p. 172, Feb., 
1908. 
Thom, D. A. Frequency of Epilepsy in the Offspring of 
Epileptics, Bost. Med. and Surg. Jour., Vol. 174, p. 573, 
April 20, 1916. Idem, Vol. 175, p. 599, Oct. 26, 1916. 
Yawger, N. S. A Criminal Epileptic with Consideration 
of Epilepsy as a Medico-legal Problem, Jour, of the Penn. 
State Med. Assn., Vol. 20, p. 332, Feb., 1917. Chapter IX 
THE PROBLEM OF DRUG ADDICTION 
Plants as medicinal agents. 
The poppy plant and its products. 
Opium smoking, and its resultant peculiar mental state. 
Morphine addiction. 
Heroin and its physiological effects. 
The deteriorating effects of opium, morphine and heroin 
addiction. 
Sexual impotency caused by drug addiction. 
Cocaine and its physiological effects. 
Cocaine addiction. 
Withdrawal symptoms. 
Morphine poisoning. 
The relative infrequency of habit-formation resulting from 
legitimate use of drugs. 
The personality types of the drug addicts. 
Sociological implications of the drug addiction problem. 
Mental deficiency and drug addiction. 
Exaggerated reports of sufferings on the part of the addicts. 
Frequency of drug addiction. 
Environmental factors chief cause for drug addiction. 
Legislative measures to check drug addiction. 
Drug pedlers and opium dens. 
Heroin as an unnecessary drug. 
The experience of New York City Board of Health with 
drug addiction. 
Physicians prescribing for drug addicts. 
Cases illustrating various phases of the drug addiction 
problem. 
Veronal as a habit-forming drug. 
Inebriety and the personality of the inebriate. 
Prohibition and its effects. 
The relation of the physician to habit-forming drugs. 
291 292 
ABNORMAL BEHAVIOR 
FROM time immemorial, various forms of plant 
life have been utilized by man in combating 
disease. The ancient Medicine Man would carry 
his herbs about, and feed them to his patients, or 
else make a watery solution of them, and make 
those who were ill drink it. Later, with the intro- 
duction of more accurate and well established 
scientific principles, the chief remedial agent of 
the plants was removed and administered to the 
patient not only by the mouth, but also by inhala- 
tion, by injecting the drug under the skin or di- 
rectly into the muscles, by rubbing it into the skin, 
and by inhaling the smoke of the burning drug. 
Amongst the most valuable plants is the poppy. 
This plant exudes a milky secretion when its un- 
ripe capsule is cut, and this milky fluid is known as 
opium. Modern medicine regards opium as 
amongst its most valuable and indispensable me- 
dicinal agents in its attack upon disease. Very 
few doctors indeed would be willing to give up this 
drug. The most active ingredient of opium is 
morphine. Morphine is used by doctors exten- 
sively, to allay severe pain, and to overcome rest- 
lessness and anxiety associated with sickness. It is 
used in many types of heart disease, several forms 
of lung diseases, in some of the diseases of metab- 
olism, and in surgery. Indeed, there are many 
physicians who regard it as the most important of 
all drugs. Curiously enough, the ancients did not 
use the poppy as a medicinal agent, although Hip- 
pocrates, the father of medicine, speaks of it in his 
earlier teachings. It was used more for smoking, PITFALLS OF OUR MINDS 
293 
in order to obtain a peculiar mental state. 
The poppy plant and its qualities were known 
throughout the Mediterranean Basin at a very 
early period. The use of the pipe and the custom 
of chewing this plant was at first confined to India 
and China. The soil of the former country has 
been peculiarly adapted to the growth of the poppy 
so that most of it is now grown there and the Brit- 
ish Government practically has a monoply on it. 
The Chinese, however, are the ones who are usu- 
ally associated with opium smoking. With the 
spread of commerce, however, other peoples have 
been using this drug in order to obtain a peculiar 
mental state. A most remarkable feature con- 
nected with the use of this drug is the fact that 
whenever an individual uses it a few times, he be- 
comes addicted to it, and finds it very difficult to 
dispense with it. This peculiar characteristic of 
the drug has given rise to the most serious problem 
of drug addiction, for the continuous use of the 
drug so undermines the physical, moral, and eth- 
ical status of the individual as to make him not 
only a burden to himself and society, but also a 
real menace at times. 
In order to fully appreciate the entire problem 
of drug addiction, it will be best to describe the 
different drugs used, and the effect that they have 
upon the individual. The poppy plant itself is 
used only by natives of India and possibly, but to 
a very much lesser extent, in China. In the more 
civilized countries, it is not used. 
Opium, or the crude drug obtained from the 294 
ABNORMAL BEHAVIOR 
poppy, is usually employed in the form of smoking 
through pipes. As a rule, a group of people of 
similar tastes congregate in a specially selected 
place and smoke together. This drug in a semi- 
solid state is placed in a pipe, ignited, and smoked. 
The sensation is that of general relaxation and well- 
being which releases many of the inhibitions, and 
offers relief from stressing states of anxiety and 
tension. This form of drug addiction is perhaps 
the least habit forming. The general atmosphere 
of the place, the sociability which it offers to cer- 
tain peculiarly disposed people and the fascination 
that it holds for them, are often factors in the ad- 
diction besides the physiological and psychological 
effect obtained from the drug itself. Occasionally 
the addiction to its use becomes quite strong, and 
people may becomes real fiends at it. In brief, 
such smoking stimulates the imagination, and 
often infuses in the smoker a spirit of self- 
contentment and euphoria or general well-being in 
which all cares, griefs and sorrows are entirely for- 
gotten. There are many people who for years 
have been “ smoking the pipe ” with apparently no 
bad after effects. In the vast majority of cases, 
however, the continual use of this form of opium 
results in a general weakening of the power of 
control, blunts the judgment, undermines the 
moral and ethical senses, upsets the digestion and 
lessens the physical vitality. 
Morphine, one of the most active constituents 
of opium, is the next in the extent of its habit- 
forming capacity. While it is occasionally taken PITFALLS OF OUR MINDS 
295 
by mouth, it is most commonly employed by means 
of a hypodermic syringe. At first small quantities 
of it are taken. Two or three doses are sufficent 
to establish the habit. By this we mean that after 
the individual has used the drug on two or three 
occasions, he feels quite restless, and uneasy, and 
has a peculiar craving which can only be appeased 
by taking another dose. Furthermore, the more 
frequently the person uses the drug, the more of it 
is required to appease this peculiar craving for it. 
After the drug has been used for several months, 
the skin becomes more or less sallow, the bowels 
become constipated, the appetite is diminished, 
and the general strength impaired. Intellectually 
the patient shows a slowing of his reaction time, 
his interest is lessened, his capacity to accomplish 
work is somewhat reduced. Morally and ethi- 
cally the victim shows increasing deterioration. 
After a while, the entire interest of the patient 
seems to be centered upon ways and means of 
securing sufficient drug to satisfy his peculiar 
craving for it. Everything else is of secondary 
importance to him. If adequate funds are avail- 
able to secure sufficient quantities of the drug and 
the person feels that he will be able to get all that 
he wants of it, he is able to continue to lead an 
otherwise law-abiding and even a productive exist- 
ence. If, however, his earning capacity is limited, 
the prime interest of the individual will be to se- 
cure enough money to enable him to procure the 
desired amount of the drug. 
Heroin, a manufactured product, made from 296 
ABNORMAL BEHAVIOR 
opium, has been introduced on the market only in 
the last dozen years. It is the most potent as a 
habit-forming drug. It is used either by snuffing, 
or by the hypodermic needle. It has a much firmer 
hold on the individual than opium or morphine. 
Its deteriorating effect is more intense and more 
rapid than that of the others. The heroin addict 
is a greater menace than the opium smoker or the 
morphine habitue. When snuffed, heroin is apt to 
discolor the mucous membrane lining the nostrils 
and may cause erosions and ulcerations of the carti- 
lage of the nose. It causes marked wasting of the 
tissues, loss of weight, digestive disturbances and 
general weakness. To the trained eye, this drug 
addict is easily detectable amongst a group of 
people. With the continual use of this drug, there 
is a general loss of moral responsibility. It is 
almost impossible to get a truthful statement from 
heroin addicts. The physical resistance becomes 
so lessened that they readily succumb to wasting 
diseases such as tuberculosis. An acute infection 
carries them off very quickly because of their 
diminished power to fight it. 
It is a well-known fact that the extent of phys- 
ical and mental deterioration differs in the three 
drugs. Opium, if smoked, has the least harmful 
effect. Many individuals indulge in its use for 
years, and are able to retain their physical and 
mental powers. Furthermore, they can stop using 
the drug without great difficulty. Morphine forms 
a stronger habit, causes a greater loss of weight, 
upsets the digestion to a greater degree, and tends PITFALLS OF OUR MINDS 
297 
to impair the moral and ethical senses. To give 
up the use of this drug is rather difficult, and the 
patient suffers from distressing symptoms. Heroin 
is the most deteriorating of the three. It causes a 
rapid loss of weight, undermines the entire person- 
ality of the individual and destroys all sense of 
moral and ethical responsibility. Furthermore, 
heroin so lowers the resistance of the person to 
disease that he readily succumbs to it and life is 
thereby shortened considerably. 
One of the interesting effects of these drugs is 
their disturbing influence on the sexual functions 
of the individual. Heroin especially lessens the 
desire and impairs the power. While under the in- 
fluence of this drug, and to a lesser degree while 
under the effects of morphine or opium, the indi- 
vidual has no desire for sexual congress, and in 
men the physical side becomes impossible. The 
menstrual function in women is markedly impaired, 
so that some may not menstruate for years while 
others are very irregular. 
Another drug which is commonly used, and 
which is habit-forming in nature, is cocaine, which 
is obtained from the coca shrub, cultivated in some 
of the South American countries, Mexico and the 
East and West Indies. Cocaine is extensively used 
in medicine because of its anaesthetic effect when 
injected into the tissues. Furthermore, it is used 
extensively for applications to the mucous mem- 
brane lining the body cavities and in certain dis- 
eases of the eye. It has a remarkable effect on the 
brain of the individual, and when taken in exces- 298 
ABNORMAL BEHAVIOR 
sive doses, it stimulates cerebration causing talk- 
ativeness, excitement and wakefulness, though 
smaller doses frequently cause deep sleep. It 
seems to remove feelings of fatigue and sense of 
exhaustion. When used by the addict it is a most 
vicious drug for it is the most potent of all drugs 
in undermining the intellectual, moral, ethical and 
physical status of the individual. It is taken in the 
form of snuff or it may be injected hypodermically. 
These cocaine habitues are recognized by their 
widely dilated pupils, their shining eyes and 
twitchings and jerkings of the body. 
These drugs are often taken in combination. 
Heroin may be taken in conjuncttion with mor- 
phine and cocaine. Rarely is cocaine taken in 
conjunction with opium. Cocaine may be taken 
in order to counteract the effects of morphine or 
heroin. One hardly meets a drug addict who does 
not smoke cigarettes, and in fact the use of tobacco 
seems to be very prevalent among the addicts. It 
is a very common observation that they will beg 
for a cigarette with the same fervor as they do for 
their drugs. Alcoholism, however, is not very 
common amongst them. In analyzing 3,362 cases, 
Copeland found amongst them six who used co- 
caine only, forty-one who used heroin in conjunc- 
tion with morphine, 42 who used morphine and 
cocaine, 305 who used heroin and cocaine, 690 who 
used morphine alone, while 2,176 used heroin 
alone. 
Whenever the individual is deprived of his drug, 
there results a chain of symptoms commonly PITFALLS OF OUR MINDS 
299 
spoken of as withdrawal symptoms. The with- 
drawal symptoms of the opium group of addicts 
differ from those of the cocaine addicts. In the 
former the individual first becomes restless, un- 
easy, complains of general aches and pains all over 
his body, stating that his muscles are drawing and 
pulling, and complains of great weakness. He 
yawns constantly, and there are tears in his eyes. 
He retches and often vomits yellowish-green fluid. 
Diarrhoea is very common. He complains of 
cramps in his abdomen, and a sense of impending 
death. He constantly runs from one room to an- 
other, in and out of bed, but finds no relief. His 
pulse becomes rather rapid and his blood pressure 
falls. A cold sweat comes over his body. To the 
untrained eye the person appears to be in a state 
of great danger. These symptoms disappear in a 
few minutes after the patient receives a sufficient 
amount of the drug. Despite statements to the 
contrary, however, there is no real authentic case 
reported in medical literature where death resulted 
from sudden withdrawal of the drug from the 
patient. 
It is true, however, that because these drug ad- 
dicts cannot withstand any wasting disease, sud- 
den withdrawal of the drug may thus indirectly 
jeopardize their lives, not because the drug is re- 
moved from them, but because of the general 
weakness that follows such withdrawal, and this 
increased lowered vitality makes the individual an 
easy prey for disease. 
The sudden stopping of cocaine is not apt to 300 
ABNORMAL BEHAVIOR 
cause such symptoms. Persons deprived of this 
drug simply appear somewhat irritable, nervous, 
restless and complain of a sense of fear; they 
jump from one subject to another; they cannot 
concentrate their attention; their muscles twitch; 
they constantly rub their noses, and pick their skin. 
An overdose of cocaine is more serious in its mani- 
festations than is the stopping of the drug. When 
the person takes an excessive amount of cocaine, 
he becomes extremely restless, very overactive and 
is apt to become delirious. He imagines that there 
are distorted figures on the wall and peculiarly 
formed human beings as well as animals. He 
complains of annoying sensations in his skin and 
may even complain of insects crawling out from 
his skin. Often he may have ideas that he is being 
haunted and persecuted. He may climb the fire 
escape or jump from a window in an attempt to 
evade his imaginary persecutors. Several such 
addicts have met an untimely death by jumping 
from the roof or the window. 
Occasionally the opium, morphine and heroin 
addict may take an overdose of that drug. The 
morphine overdose is characterized by markedly 
pin-point pupils, and a very slow respiration (as 
slow as one or two per minute) and a tendency to 
fall asleep. If left alone, these patients will die. 
Besides specific medicine, it is important to keep 
them in action and prevent them from falling 
asleep. By so doing their lives may be saved. 
After reading what has been said about the drug 
addict, one cannot help but pause for a moment, PITFALLS OF OUR MINDS 
301 
and reflect upon the danger that lurks in the use of 
these drugs even as medicinal agents. In other 
words, one perhaps may ask whether or not it is 
dangerous for the physician to administer such a 
drug to a patient, lest that patient contract a drug 
habit. As a matter of fact, the danger of drug ad- 
diction resulting from the legitimate use of such a 
drug is very limited indeed. Despite statements from 
people who ai*e interested in the subject of drug ad- 
diction, physicians in general, especially those who 
are handling drug addicts, agree that the danger 
is very slight indeed. The question of drug addic- 
tion begins primarily with the personality of the 
drug addict, and the cure from drug addiction ends 
with the personality. In other words, there are 
only certain types of individuals who are prone to 
become addicts, and those individuals acquire it 
usually through association and not through a 
physician’s prescription. There are two definite 
types of individuals who are apt to become drug 
addicts. The first is the Manic-Depressive type 
of personality who because of his marked fluctu- 
ations in his mood reaction is apt to fall a victim 
to this habit. The second is the emotionally un- 
stable constitutionally psychic inferior individual 
who is readily influenced by his friends and cronies 
because of his inability to exercise self-control. It 
is remarkable indeed how many of these people 
who apparently are earnest and sincere in their 
intention to be cured of this habit, will take the 
cure and on the very day of their discharge from 
the hospital will resume the habit simply because 302 
ABNORMAL BEHAVIOR 
one of their friends asked them “ to be a good 
fellow ” and to “ take a shot.” These individuals 
are distinct types of personalities, they cannot 
withstand temptation, and are unable to foresee 
the consequences of their acts. 
The sociological implications of the drug addic- 
tion problem are manifold. Industrially, the ad- 
dicts may become a burden, in that they are unable 
to continue at their work; furthermore, they be- 
come increasingly dependent upon others for sup- 
port. In order to obtain funds to secure more 
drugs, they will resort to larceny, assault and rob- 
bery. They are very cunning and deceitful, and 
will resort to all sorts of falsehoods in order to 
obtain their desired end. They seem to have a 
circle of their own, and a code understood only by 
members of their own group. They recognize one 
another when detection would baffle the most skil- 
ful detective. Prostitution is very common among 
the women, as it affords them an easy way for 
securing the necessary funds to buy the drug. 
While their natural sexual desires are diminished 
by the use of the drug, they often resort to all sorts 
of perverted sexual acts that will afford them 
pleasure and gratification. They will constantly 
look for new victims to initiate into their frater- 
nity, offering the first few doses gratis, and 
assuring them that the drug leaves no after effects. 
One often comes across statements in the litera- 
ture to the effect that the drug addict is mentally 
deficient. This is due to failure in properly in- 
terpreting the results obtained from the ordinary PITFALLS OF OUR MINDS 
303 
mental tests employed. Because many of the 
addicts are emotionally unstable individuals, and 
because of the fact that the state of the patient’s 
mental efficiency varies with the amount of drug 
that he has taken, several tests must be per- 
formed before an accurate measurement of the 
intellectual endowment is obtained. This has 
been pointed out by Jewett and Blanchard in their 
paper on “ The Influence of Affective Disturbances 
on Responses to the Stanford-Binet Test.” The 
average drug addict is not below the average in 
intelligence. It is true, however, that a continual 
use of the drug does impair the intellectual 
capacity after a while. Many professional people 
and fairly successful business men are victims of 
this disease. Primarily, there is a definite person- 
ality defect which makes them susceptible to the 
habit, and this defect is not along the line of in- 
herent intellectual endowment, but rather in the 
emotional and volitional spheres. 
One often hears of the torture which the drug 
addict undergoes either when taking the cure for 
his addiction or when suddenly deprived of his 
drug. As a mattter of fact, the consensus of 
opinion of physicians who have had the responsi- 
bility of administering cures or general treatment 
to drug addicts, is that most of the suffering is 
imaginary rather than real. We have personally 
seen addicts who were pitifully begging for a dose 
of drug, complaining of cramps, diarrhoea, vomit- 
ing and sense of impending death, and who, on re- 
ceiving an injection of sterile water, were immedi- 304 
ABNORMAL BEHAVIOR 
ately relieved of all the distressing symptoms. 
Of course, they thought that the solution which 
they received was the drug. The most reliable and 
best qualified medical men either suddenly take 
the patients off the drug, or else withdraw the drug 
from them gradually so that they no longer receive 
it at the end of two weeks. It must be clearly 
understood that neither the continuous use of the 
drug nor its sudden withdrawal, cause any patho- 
logical change in the tissues of the person which 
would jeopardize his life. 
Another point of interest that must be con- 
stantly borne in mind is that in the vast majority 
of cases the victims of this habit do not really 
want to be cured of it. Most of the cures which 
they take are the result of instigations either on 
the part of friends or others interested in them, 
or because they have gotten into difficulties with 
the law, and prefer to take the cure rather than 
be sent to jail. Various estimates reveal that 
from ninety-five to ninety-eight per cent of the 
addicts who have taken the cure return to the drug 
at the earliest opportunity. 
Authorities differ as to the number of drug ad- 
dicts in the United States. It is variously esti- 
mated that there are from 200,000 to 2,000,000 
people who are victims of this habit. The real 
number probably lies somewhere between the two, 
about 800,000 approximating the correct figure. 
Ninety per cent, of the addicts are under 30 years 
of age because the span of life is much shorter, 
owing to the relatively diminished resistance of PITFALLS OF OUR MINDS 
305 
these people to disease. Pulmonary tuberculosis 
and kidney diseases carry them off at an early age. 
It is very interesting that infants often become 
addicted through the mother’s milk as the drug 
is present in it. 
As to the direct cause for the habit, all authori- 
ties agree that bad association is the greatest fac- 
tor. In other words, environment is the chief 
cause for this habit. The uninitiated receives a 
cordial welcome in the circle of the addicts, and 
in the spirit of sociability participates in taking the 
drug. Any unpleasant after effects resulting from 
the first few doses are minimized by his friends, 
so that he continues to take the drug until the 
habit is established, and he then can no longer 
do without it. 
One often hears of the physician being a cause 
for addiction. When one considers the number 
of diseases in which morphine is given, and the 
relatively few people who acquire a habit from 
the legitimate use of the drug, it is safe to say 
that its prescription during illness is hardly ever 
the cause for a habit. A chronic and incurable 
disease associated with great pain such as cancer, 
etc., will at times make the individual an addict. 
But it is really cruel to designate these chronically 
ill, suffering people as such, because the drug 
makes their remaining few months of life toler- 
able, and they should be given all the drug re- 
quired to deaden the pain regardless whether they 
will become addicted to it or not. Many a drug 
addict, in order to gain sympathy, will claim that 306 
ABNORMAL BEHAVIOR 
his addiction resulted from a dose administered by 
a physician in pursuit of his professional duties. 
As a matter of fact, if his confidence is gained, 
the same addict will admit that he lied, and that 
he really acquired it through association. 
Until 1914, drugs were easily obtainable. In 
an effort to check the spread of this vicious habit, 
and, at the same time to prevent the abuse of 
professional privilege by physicians, the Harrison 
Law was enacted. This law provided for the regis- 
tration of physicians, dentists, veterinary surgeons, 
pharmacists, and chemical houses imposing a cer- 
tain tax for the privilege of prescribing and dealing 
in these narcotic drugs. This law forbade all 
sales, or other disposition of the drugs to con- 
sumers except by a pharmacist when filling a 
physician’s prescription or by a physician in the 
course of his professional practice. This resulted 
in some confusion and misunderstanding among 
physicians when the law first came into effect on 
March 1, 1915. Many of the better type of phy- 
sicians refused to prescribe opium and its deriva- 
tives, and quite a few voiced their indignation 
explaining that their medical ethics had been 
questioned. Furthermore, while they would not 
voice their sentiments openly, many physicians 
resented the registration, the paper work, and the 
so-called additional “ red tape ” which this law 
entailed. A group of unscrupulous physicians, 
however, formed a rather discreet circle and pre- 
scribed freely to all who had sufficient money to 
pay. For a while, this evil was rather serious in PITFALLS OF OUR MINDS 
307 
nature, but it was soon checked by the ruling of 
the United States Supreme Court which limited 
the prescribing of these drugs. 
Many states passed additional legislative meas- 
ures in their effort to restrict the use of narcotics 
and habit-forming drugs to definite medical condi- 
tions, making it more difficult for the addict to 
secure his drug. 
With the introduction of Federal and State legis- 
lation intending to make it impossible for the 
addict to buy his drug openly, there came a vicious 
practice of underworld traffic in these drugs. 
Smuggling the drugs from neighboring countries 
and stealing it from chemical houses, the under- 
world secured a sufficient amount to supply the 
victims. The most vicious element engaged in 
this underworld traffic is commonly known as the 
“ dope peddler.” This person obtains drugs in an 
illegal manner, and sells them to customers who are 
well known to him. The peddler not infrequently 
is himself a victim of this habit. In most in- 
stances, however, he is a cunning individual who 
leads a parasitic existence upon his victims. 
He resorts to all sorts of deceit, cheating and 
defrauding his customers by diluting the drug, 
usually with some sugar or milk powder, and charg- 
ing them most exorbitant prices. Often he drives 
his victims to prostitution, theft and to other 
crimes, knowing full well that they must obey his 
command in order to obtain their drug from him. 
Usually these peddlers are well organized into 
cliques, thereby enhancing the power which they 308 
ABNORMAL BEHAVIOR 
exercise over their victims. 
The activities on the part of the Federal agents 
revealed many specially furnished apartments 
which were real dens where the addicts would con- 
gregate and take their drug. These places were 
conducted by people who “ reaped a harvest.” 
Often these places were luxuriously furnished and 
were frequented by people of wealth and social 
standing. Many a fortune has been squandered 
in these dens. Men and women would congregate 
there, and would disregard all conventional stand- 
ards, participate in all sorts of sexually perverted 
acts, and indulge in their favorite drugs. Occa- 
sionally these dens were found to be meeting places 
for gangsters, where all types of crimes were 
planned. The actual participants in the crime 
would receive extra “ shots ” or “ sniffs ” of the 
drug in order to “ get up their courage.” Informa- 
tion obtained from the gangsters caught in their 
anti-social acts would often result in the raiding 
of such places, where thousands of dollars’ worth 
of drugs would be found. 
There are many instructive reports in medical 
and sociological literature that are of interest. 
They all agree that only ten per cent, of the drugs 
consumed in this country are for legitimate medi- 
cal purposes. The amount of opium imported is 
far in excess of that needed. It is the consensus 
of opinion of the best physicians that there is no 
need for heroin because morphine will replace it 
for any therapeutic measure. Heroin is the most 
vicious habit-forming drug of the opium group. PITFALLS OF OUR MINDS 
309 
Approximately ninety-five per cent, of all addicts 
use heroin. 
While the problem of drug addiction is really an 
international one, stringent Federal laws could 
control it in this country. The poppy plant could 
be grown in this country in sufficient quantity to 
produce all the morphine needed for medical pur- 
poses. It is quite feasible for the Federal Govern- 
ment through the Public Health Service to estab- 
lish stations in different localities where the various 
chemical houses, pharmacists and physicians, could 
secure their necessary supplies, and make it almost 
impossible for those engaged in illegitimate traffic 
to obtain any of it. With the establishment of 
such a procedure, the importation of opium and 
its derivatives could be dispensed with. It is also 
felt by those who are treating drug addicts that 
the only way to cure the drug addict is to make it 
impossible for him to secure the drug. 
An interesting experiment by the New York 
City Board of Health originating in an emergency 
precipitated by a raid by the Federal authorities 
under the Harrison Act gave remarkable and in- 
structive results. Through this narcotic clinic, 
passed, from April, 1919, to March, 1920, more 
than 7,700 registered drug addicts. It was found 
that bad association and vicious environmental 
factors were the chief causes in producing addic- 
tion. Ninety-six and five-tenths per cent, were 
heroin addicts and only three and five-tenths per 
cent, were morphine addicts. Eighty per cent, 
were young men and young women just out of 310 
ABNORMAL BEHAVIOR 
their teens. Those occupations that demanded 
irregular hours and irregular meals and where 
stress and tension and irritations were frequent, 
were conducive to the acquisition of the habit. 
It was found that only 55 out of 8,100 registered 
physicians were in the ring who prescribed for the 
addicts. Ninety per cent, of the cases sent to the 
hospital from the clinic returned to the drug upon 
discharge from the hospital. It was discovered 
that there was no real available institution where 
these addicts could be received and treated, so 
that after the various city hospitals closed their 
doors and refused to take relapsed cases, the work- 
house and penitentiary alone were available for 
their care and treatment. It was proven that the 
clinic per se was a failure, and that confinement 
in a hospital followed by proper after care and 
treatment were the only means for treating these 
addicts. 
The following cases will illustrate the various 
phases of the drug addiction problem, and some 
of the behavior difficulties involved: 
Case 73 
A man 32 years of age was brought to the hospital, 
being found on the street in a state of coma. The 
ambulance surgeon noticed pin-point pupils, very shal- 
low breathing (three per minute), and peculiar small 
hard lumps in the arms of the patient, which immedi- 
ately aroused his suspicion that the patient was a drug 
addict. The patient was immediately admitted to the 
ward and was forcibly moved from one place to an- PITFALLS OF OUR MINDS 
311 
other until he regained consciousness. He then was 
made to walk the floor and was prevented from falling 
asleep by being kept moving about. Besides this he 
was given proper medication, and other treatment. 
At the end of three hours his respiration improved, 
being 12 per minute, and the patient was able to sit up 
without falling asleep. He then admitted that he was 
using morphine and heroin, that he had taken too 
much of the drug by a hypodermic injection, and 
became unconscious. Later the patient gave the 
following history: 
He was born in New York City; attended school 
regularly until twelve years of age, when he began to 
play truant and 'fell back in his studies. He left 
school at the age of fourteen and went to work as an 
errand boy. His people were poor and the home sur- 
roundings were not congenial. He would “ hang 
around the corner ” with his boy friends; kept late 
hours, and was rather a disobedient child at home. 
At the age of 18 years he first used the drug. He 
at that time was in the company of boys who were 
using opium by smoking, and he was asked to partici- 
pate in it. After the first indulgence he felt somewhat 
nauseated and had a headache, but this, he was told 
by his friends, would not happen again. He again 
smoked a pipe on the following night. After four 
days he found that he could get a sense of relaxation 
from the use of the pipe and that he could forget all 
his cares and troubles. 
For two years he used only opium by smoking. He 
then began to use morphine by hypodermic needle. 
At first he got it from the drug store on a doctor’s 
prescription. For the past six years he got it from a 
peddler. For the last four years, he snuffed heroin. 
He stated that heroin had the greatest effect on him, 312 
ABNORMAL BEHAVIOR 
and that he could not do without it. He learned to use 
heroin by hypodermic injection two years ago. He 
said that if he could not get the drug he would feel 
restless, weak, his eyes would water, he would suffer 
from cramps in his abdomen, and he would have 
diarrhoea; his limbs would feel as if they were drawn 
up. One dose of the drug would remove all these 
sensations. 
He spent five dollars a day for the drug. Occa- 
sionally he would resort to petty thefts and petit 
larceny in order to get the money to buy the stuff. 
He was arrested on two previous occasions and in 
order to escape jail he pleaded for a cure, which he 
was given. On discharge from the workhouse, where 
the cure was given, and return to his former circle of 
acquaintances, he again resumed the use of the drug. 
He stated that it deadened his sexual desire and that 
he could not indulge in the act while under its influ- 
ence. On the other hand, following a cure, in fact 
as soon as he was beginning to lose the effect of the 
drug, his sexual desire was very strong. 
He also stated that he could not keep a position 
for any length of time. 
This case illustrates the effect of an over-dose 
of the drug. It also shows the industrial malad- 
justment, the sexual incompetency, and the futility 
of “ a cure ” in drug addiction. This individual 
had an unfavorable environment, and after re- 
ceiving treatment for his addiction, was allowed 
to return to the same unfavorable surroundings, 
without proper after care. He immediately fell 
back into his former habits. PITFALLS OF OUR MINDS 
313 
Case 74 
A young female, 22 years of age, was brought to 
the hospital with a charge of “ Possession of Drugs ” 
registered against her. Her parents were born in this 
country. Her father was a heavy drinker and her 
mother was loose in her morals. She attended school 
until 11 years of age and then went to work in a fac- 
tory. She was physically very attractive, had many 
friends, but was rather unstable in her emotional re- 
actions. Her first sexual experiences were at the age 
of sixteen. At seventeen years of age she was taken 
to New York City by a man with whom she had be- 
come infatuated. She saw him inhaling some powder, 
and she asked to be given some. She experienced a 
nauseous feeling and had a splitting headache, but 
when she saw him indulge in this habit she again 
followed suit. She said: 
“ I was blowing ‘ coke ’ for about six months. I 
then began to ‘ shoot ’ it. When I’d get ‘ dopey ’ I 
would sniff some cocaine. Heroin makes you ‘ dopey.’ 
You kind of like to sleep. You just want to sleep, 
that’s all. Cocaine makes you jumpy — your nerves 
spring-like. When I don’t get my dope, I get sick 
in my stomach. My joints ache. I sweat, and I have 
diarrhoea.” 
She then stated that she was spending eight dollars 
a day for her drug. She admitted having been ar- 
rested on three different occasions; twice for prostitu- 
tion, and once for possession of the drug. On two 
occasions, she was sent to the workhouse, where she 
was given a cure. When getting off the drug she be- 
came sexually very tense and she was initiated into 
homosexual acts by another girl who was in the same 
predicament. She said that she was driven to prosti- 314 
ABNORMAL BEHAVIOR 
tution by the need of money, as she had been left by 
the man who brought her to New York, and she was 
working as a chambermaid in one of the New York 
hotels and her earning capacity was insufficient to pay 
for the drug. 
Case 75 
A woman 34 years of age was sent to the hospital 
by a city magistrate for a cure. She stated that she 
was born in Vermont, had a high school education 
and then came to New York where she was employed 
as a stenographer. She said that she had married at 
the age of twenty. Her husband was a travelling sales- 
man and he would leave her for several weeks while he 
was on the road. She stated that she had been living 
in an apartment house and had been befriended by a 
woman who was a drug addict. She met a few other 
addicts who were friends of this neighbor, and on one 
occasion she was given an injection of morphine. 
She said that she had asked for it because all the others 
seemed so anxious to get that drug, and she wanted 
to experience the sensation. She fell asleep after that, 
and did not think any more of it until a week later 
when she again met the same people, and once more 
took it. She experienced a bursting headache, and 
her friend gave her another injection stating that she 
would be relieved from her headache. 
Soon she began to use the drug regularly and found 
that she could not do without it. She then began to use 
heroin, as that would appease her nerves more than 
morphine. She did not tell her husband of it. She 
would spend eight dollars a day for her drug. As her 
husband’s salary was not enough to supply her with the 
drug, she went back to work as a stenographer. How- 
ever, she found it a more convenient way to get money PITFALLS OF OUR MINDS 
315 
by going with strange men. She was physically very 
attractive and her personality was rather pleasant, so 
that she could command a high fee. It was therefore 
possible for her to meet only a few men during the 
month, and to secure enough money to enable her to 
be comfortably supplied with drugs. She stated that 
she lost her menstrual period two months after she 
began taking the drug. She also added that she had 
no sexual gratification. She said that she had taken 
the cure before, but when her husband left for the 
road she became lonesome and visited her former 
friends, and returned to her habit. She said that when 
she was in the presence of her female friends, she 
would occasionally indulge in homosexual acts, but 
that she would get very little satisfaction from it. 
She stated that her husband was becoming suspicious 
of her fidelity, and that in order to be able to be faith- 
ful to him, she decided to get off the drug and not be 
obliged to be immoral any longer in order to get money 
for the drugs. 
The last two cases illustrate the most common 
method of getting the drug habit — bad com- 
panionship. It also illustrates the fact that many 
of these addicts become prostitutes simply to en- 
able them to secure necessary funds to be supplied 
with drugs. Homosexuality is not infrequently 
indulged in, in order to secure some sexual gratifi- 
cation when the usual heterosexual relationship 
fails to provide it. Furthermore, homosexuality 
is first practiced by these people when they are 
receiving a cure because at that time their sexual 
desire is returning and usually they are in no posi- 
tion to indulge in normal sexual relationship. 316 
ABNORMAL BEHAVIOR 
Drug addiction establishes a vicious circle in which 
the chain of events tends in the end to undermine 
the entire moral and ethical status of the addicts. 
The patients mentioned first took the drug, and 
later resorted to prostitution in order to secure the 
necessary funds to buy the drug. 
Case 76 
A woman 28 years of age was brought to the hos- 
pital by order of commitment signed by a city magis- 
trate for the purpose of securing treatment for drug 
addiction. The history of this case is interesting from 
several angles. She was born in the Middle West of 
native born parents. She was the only child and re- 
ceived an excellent bringing up. She had a collegiate 
training and later taught physical training in one of 
the women’s colleges. During the war she was en- 
gaged in social service work, and there she met a 
young army officer to whom she became engaged and 
married him in 1918, on the day when he was to board 
a liner which was to take him to France. She re- 
mained in New York, and engaged in social service 
work among the troops. Four months later she re- 
ceived word that her husband was killed in action. 
She brooded considerably over that and remained for 
days without going outside of her hotel. She had 
sufficient funds to keep her very comfortable. After 
a month of mourning she finally became resigned to 
her lot and again took an active interest in welfare 
work among the soldiers. 
She was physically very attractive. She was gener- 
ally liked by the other guests of the hotel where she 
resided. She made the acquaintance of an actor who 
was living in the same hotel and became infatuated PITFALLS OF OUR MINDS 
317 
with him. She saw him on one occasion use a hypo- 
dermic needle, and she tried to dissuade him from 
doing so, but she was unsuccessful. Finally he suc- 
ceeded in inducing her to “ take a few shots ” and she 
became addicted to it. 
She regularly went to one of the physicians who 
would prescribe for her daily dosage and she would 
spend about four dollars a day for it. She then con- 
tinued to go from bad to worse. She finally changed 
hotels and would not send her new address to her 
people as she was ashamed to face them. She there- 
fore was unable to get any financial assistance from 
any of her relatives. She was still sufficiently physi- 
cally attractive to be able to secure large sums of 
money through prostitution, and she finally resorted 
to this means in order to earn enough to keep her 
comfortable. 
In 1920, while under the influence of an overdose of 
morphine, which she had received from a doctor, she 
had to fill an appointment with one of her male 
“ friends ” whom, however, she had never met before. 
Her signals were crossed, and she selected from a 
group of men one who happened to be a detective. 
When she escorted him to her favorite room he ex- 
cused himself for a moment and returned in a few 
minutes accompanied by two uniformed members 
of the police force. She was taken to the night court 
and from there was sent to the observation ward 
to be detained for drug addiction. It was found 
that she had contracted both syphilis and gonor- 
rhoea and she was transferred to one of the city in- 
stitutions where treatment for these diseases was ad- 
ministered. While in that hospital she was induced 
to communicate with her relatives in the Middle West, 
who proved to be prominent in civil and social affairs 318 
ABNORMAL BEHAVIOR 
in the community where they resided. She went to 
the West with them when she was finally discharged 
from the hospital. 
Her uncle, who was a physician, supervised the 
treatment of her diseases, and took care of her while 
she was with her family. She, however, was very 
sensitive, and could not face her old friends. She 
would brood continuously, and after remaining with 
her people for two months, left them, leaving a note 
asking them not to look for her, and stating that she 
was well able to care for herself. She returned to 
New York and rented a room in another hotel. She 
learned that during her absence the physician who had 
prescribed to her formerly was under arrest, and she 
finally began to use the drug which her friends had 
purchased from a peddler. She now had to pay as 
much as ten to fifteen dollars a day for the drugs she 
would receive. Furthermore, she was now receiving 
heroin and not morphine. She gradually began to 
lose weight, and her general physical condition became 
such that she no longer could secure sufficient funds 
from consorting with a few men during a month, but 
had to meet several men a day in order to do so. In 
other words, she became an ordinary street walker. 
She was arrested, being charged with prostitution, 
and once again came to the observation ward, being 
sent there by a magistrate from the night court. She 
was again seen by us. She had so deteriorated physi- 
cally that it was impossible to recognize her. On 
her former residence she was rather of an attractive 
personality and in excellent physical state. She then 
weighed about 150 pounds. During her last resi- 
dence (one year later) she weighed 105 pounds; her 
face was sallow; her stomach functioned poorly; her 
bowels were constipated; her skin was drawn and full PITFALLS OF OUR MINDS 
319 
of hypodermic marks, and her general physical con- 
dition was very poor. She was irritable and ugly and 
asked constantly for her drug in a manner unbecoming 
a lady. 
This case illustrates the fate of an individual 
who by virtue of her training and social standing 
should have been a successful and happy indi- 
vidual, but who on account of her drug addiction 
sank to the lowest depths of misery. She was pri- 
marily of a mild manic-depressive make-up. She 
had a mild depression following the death of her 
husband. She then met an actor with whom she 
became infatuated and who used his power over her 
to induce her to take the drug. It is alleged by 
those who are in a position to meet and treat the 
addicts, that drug addiction is rather common 
amongst actors. Other professional people such 
as physicians and nurses who are in a position to 
get the drug easily, and even ministers, are known 
to have contributed to the drug addict population. 
She continued to use the drug after she acquired 
the habit, but she used morphine which was pre- 
scribed for her by a physician. She spent only 
four dollars a day and never got any skin infec- 
tions from the hypodermic needle which was used 
by the physician. She would consort only with a 
few men in order to get her funds. When she 
returned to New York, she no longer could get a 
physician to prescribe for her. At that time she 
had to resort to the underworld traffic for her 
supply. She spent as much as fifteen dollars a 
day for her daily dose. Furthermore, she got 320 
ABNORMAL BEHAVIOR 
several abscesses in her thighs and arms because 
she could not use a sterile hypodermic needle, and 
she now was using heroin, a more deteriorating 
drug than morphine. Heroin undermined her 
health to such a degree that even her earning ca- 
pacity in her miserable way became impaired, so 
that she had to consort with more men in 24 hours 
than she previously had done in a week. 
We might digress at this moment to speak about 
the so-called influence which some physicians have 
in spreading drug addiction. As a matter of fact, 
it was revealed during the experience which the 
New York City Board of Health had in 1919, that 
the greatest majority of medical men shunned the 
drug addict and would not prescribe for him. 
This they did not because they feared the law, 
but because of the ethics which govern their 
relationship to their patients. It was also pointed 
out from that experience that of 8,100 registered 
physicians only 55 were members of the so-called 
ring which was regularly prescribing for the ad- 
dicts. It was also pointed out that this ring mus- 
tered its membership from the foreign physicians 
trained abroad, and furthermore, they were ex- 
cluded from all medical societies. 
When we compare the detriment done by the 
underworld traffic with that done by these un- 
ethical practitioners in medicine, the unbiased 
person would immediately say that it is far safer 
to have the unethical physician prescribe rather 
than force the addict to secure the drug from 
the peddler. The case above illustrates this point PITFALLS OF OUR MINDS 
321 
quite vividly. We must never lose sight of the 
fact that so long as the supply of drugs in the 
United States exceeds the amount necessary for 
legitimate medical consumption, there will be drug 
addicts, and they will secure the drug regardless 
of measures to prevent them. It is far better to 
have a person who has knowledge of surgical and 
medical principles administer the drug to them 
than to have them buy it from the peddler. It is 
the lesser of the two evils. 
To return to our patient, we are immediately 
confronted with the fact that she was an addi- 
tional public menace in that she had acquired both 
syphilis and gonorrhoea and was a potent factor 
in spreading these diseases. It must be borne in 
mind that prostitution is very prevalent among the 
poorer classes of drug addicts, and that they are 
undoubtedly a serious menace to the community 
from this viewpoint. 
Case 77 
A young female (25 years of age) was brought to 
the hospital by the ambulance because she had been 
running up and down the fire escape of her apartment, 
and finally put her hands through the window of a 
neighbor. On admission the patient was very rest- 
less and excited, said that the police were after her, 
tossed about in bed, screamed and shouted in an un- 
intelligible manner, picked her nose and her skin, and 
it was necessary to put her in partial restraint. After 
she was given the proper medication she finally fell 
asleep. When she awoke at the end of four hours 322 
ABNORMAL BEHAVIOR 
she was very restless, and asked for a shot of morphine, 
claiming that she was a drug addict. She stated that 
she usually used heroin, but that in order to prevent 
herself from becoming too drowsy she would also sniff 
some cocaine. She said that she had bought a bottle of 
what she supposed was heroin but evidently it was co- 
caine. She had taken one other dose on the day before, 
and she became very irritable and restless; her nerves 
tingled but she had enough presence of mind to go to 
one of her friends who gave her a shot of morphine 
which quieted her. On her last dose of the drug, she 
again became very irritable and in order to steady 
herself she took some more of the drug. She then 
began to imagine that there were detectives after her; 
that she was being followed and that she was going 
to be killed; and she ran on the fire escape in order 
to avoid her imaginary followers. She tried to enter 
her neighbor’s apartment through the window but in 
her haste thrust her arm through a pane of glass and 
cut her wrist. Further history revealed that she had 
been using drugs from the age of 18; she acquired the 
habit from bad associates. She would often use co- 
caine in order to check some of the undesired effects 
of heroin. She said that the cocaine addict was looked 
down upon by the rest of the members of the under- 
world, and that the morphine addict was the one 
looked up to by these same people. 
This patient illustrates the result of an overdose 
of cocaine. They are usually recognized by their 
widely dilated pupils; extreme restlessness and 
purposeless over-activity. Furthermore, they oc- 
casionally have persecutory ideas. Not infre- 
quently they may meet an untimely death in their PITFALLS OF OUR MINDS 
323 
effort to escape their imaginary enemies. This 
case also illustrates the fact that cocaine is not 
infrequently used by addicts of other drugs in an 
effort to counteract extreme drowsiness resulting 
from those drugs. 
While the above-mentioned drugs are the most 
commonly used and constitute the chief habit- 
forming drugs, during the last few years, owing 
in part to the activity by the Federal agents in 
suppressing drug addiction, and caused in part by 
the popularity of self-medication, there has come 
into prominence a habit-forming group of drugs 
which are a real menace to the community. These 
are trional, sulphonal, luminal, and veronal. These 
drugs are sold by the pharmacist to anybody. No 
prescription is necessary for them. They are ad- 
vertised by several chemical houses as remedies for 
nervousness, restlessness, insomnia, vomiting and 
for many other ailments. One nervous patient 
often recommends it to another. These drugs are 
valuable agents if properly used by qualified physi- 
cians. They are like a knife in the hands of a 
skilled surgeon. When, however, the layman be- 
gins to meddle with drugs, he is in the same posi- 
tion as the child who has in his possession a 
valuable surgeon’s knife. Invariably he injures 
himself and he is apt to inflict injury to those near 
him. 
Veronal, and to a similar degree the other drugs, 
when taken in excessive amounts, cause stupor and 
even coma (loss of consciousness from which the 
individual cannot be aroused). When the effects 324 
ABNORMAL BEHAVIOR 
of the drug begin to wear off the individual regains 
consciousness, is very irritable and complaining 
about all sorts of maltreatment and injustices re- 
ceived at the hands of his friends, nurses and 
physicians, staggers about like a drunken man, 
and has weakened control of the bladder and 
rectum. Usually the same person will deny ever 
having taken veronal. When confronted, how- 
ever, with such evidence as labelled vials contain- 
ing some of that drug he will admit that he has 
taken it but will firmly deny his addiction to it. 
Alcoholism is very common amongst people who 
use veronal. This is not the case in the opium 
group of addicts. The speech of the veronal pa- 
tient is very characteristic, being of a thick, un- 
intelligible sort, in which there are omissions of 
many syllables. It takes several days for the 
effect of the drug to wear off. 
Usually the drug is taken by a peculiarly dis- 
posed individual, in other words by an individual of 
a peculiar mental make-up and personality. This 
individual cannot face situations squarely and 
when an unpleasant situation confronts him he 
becomes irritable and restless and seeks refuge in 
anything that will dull his senses. 
The usual answer to the questions as to why they 
have been taking the drug is “ Oh doctor, I try to 
forget.” To state it in a different way, one pa- 
tient said “ I had been worrying; I did not know 
what path to pursue. I was lonesome; I could 
not get the advice of anyone. I had to solve my 
problem for myself. It was too much for me. PITFALLS OF OUR MINDS 
325 
I tried to forget it all. I could not sleep. I went 
to the druggist who gave me this medicine. I 
took a few tablets as he told me. That gave me 
a little rest. The next day I grew more restless, as 
I had to solve my problem on the following day. 
I therefore took the entire contents of a bottle and 
then I found myself in the hospital.” 
This drug is becoming very prevalent in its 
general use. Many people who have formerly 
been alcoholics are now using it, for they have 
found it to give them the same satisfaction as 
whiskey. This drug should be sold only on pre- 
scription. It should be included amongst the nar- 
cotic drugs as its use is becoming increasingly 
alarming. 
While from time immemorial more has been 
written about alcohol than about any other drug, 
and the average person is well familiar with its 
effects and of the various dangers and evils lurk- 
ing in inebriety, comparatively little has been 
said about the person who drinks to excess. 
When one scans the medical literature, one meets 
such terms as dipsomaniac, periodic drinker, etc., 
but only a few references are made to the per- 
sonality type of the inebriate. As a matter of fact, 
the vast majority of inebriates are individuals 
belonging either to the manic-depressive group of 
personality, or to the emotionally unstable type of 
the constitutional psychic inferiority group. 
The emotional fluctuations of the manic-depres- 
sive individuals drive these people to drink. In 
fact, most of the consumption of alcohol occurs 326 
ABNORMAL BEHAVIOR 
during the extremes of emotional fluctuations. 
Even religion has utilized one or another form of 
alcohol in its various ceremonials. Many psy- 
chiatrists have openly asserted that alcohol in many 
manic-depressive individuals acts as a safety valve 
and may even prevent the precipitation of a frank 
outbreak of insanity. The constitutionally psychic 
inferior individuals who suffer from emotional in- 
stability may also resort to drink because of their 
peculiar mental make-up. They try to forget 
their troubles by clouding their senses with liquor. 
We have observed in the alcoholic wards all 
types of alcoholics both before and after prohibi- 
tion. Much has been written about prohibition 
in general and it need not be further elaborated 
upon. It is indeed painful, however, to behold 
to what extent the truth is being distorted in these 
accounts. Even the reformers who have gone to 
the extreme in enforcing prohibition have not been 
free from this. Much may be said both in favor 
of and against prohibition. We have seen a de- 
cline in the ordinary type of people who used to 
come to the alcoholic wards before prohibition 
and have noticed an increase in number of the 
better type middle-class people who are now 
being brought to our wards. We have seen the 
disappearance of the saloon, but there was the 
simultaneous birth of distilleries and of home 
brews. There was a definite diminution in the 
alcoholic admissions to the state hospitals for the 
insane but at the same time appeared a number 
of instances where blindness and even death re- PITFALLS OF OUR MINDS 
327 
suited from the whiskey that is now being sold. 
One sees relatively few drunken men on the 
streets, but the hip flask is now being changed to a 
rather attractive metallic bottle which is being car- 
ried by college students, successful business men 
and people of prominence. One sees a decline in 
the number of crimes committed by drunkards, but 
reads too many newspaper reports of crimes com- 
mitted by policemen while under the influence of 
liquor. Bootlegging with all its concomitant il- 
legal acts is in its ascendancy. The poor man no 
longer can get his whiskey, and sick and infirm 
people are deprived of its legitimate medicinal use 
because the physician either would not prescribe 
it owing to the red tape it involves, or because he 
could not get a safe alcoholic preparation when it 
was needed for those whom he was treating. 
The police who have tried to enforce pro- 
hibition are not only unpopular but in many 
instances are being regarded as oppressors. The 
antagonism towards the police and all its con- 
comitant emotional reactions are being carried 
over in many other instances so that many juries 
will refuse to take the testimony of the policeman. 
Only recently two prominent jurists reprimanded 
members of the jury who had brought a verdict 
of not guilty in face of strong and otherwise con- 
victing evidence because they would not accept 
the testimony of the police. Thus the safety of 
the community is endangered. We can only say 
that extremes in anything are folly, while modera- 
tion is an expression of wisdom. 328 
ABNORMAL BEHAVIOR 
In concluding this chapter, it is opportune to 
bring up the question of the relationship of the 
physician to these problems. Because of a pe- 
culiarly disposed personality, and by virtue of the 
principles which he imbibes in the process of a 
painstaking and laborious study, the physician is 
instilled with a sense of ethics which is acquired 
from constant association with his teachers and 
with the helpless sick who are looking to him for 
guidance and help. From time immemorial the 
physician has commanded the faith and trust 
of the community. This has tended to enhance 
his ethical relationship towards his patients. 
In this age of commercialism many temptations 
have been thrown in his way and yet with very few 
exceptions he continued to follow that code which 
made his profession so unique and so widely re- 
spected. 
On the other hand, the community has allowed 
many sects to encroach upon his premises, so that 
the sick have not only been deprived of proper 
medical care and treatment, but have been in- 
truded upon and misled by wilfully fraudulent and 
deceitful people. It is really appalling to behold 
how many sects of healers have arisen during the 
last few years, to say nothing of such groups as 
osteopaths, chiropractors, neuropaths, and many 
other “ tommy rot paths.” Even well-established 
churches have allowed some of their members to 
become healers. 
This is in part due to the fact that the 
medical profession as a whole has never re- PITFALLS OF OUR MINDS 
329 
garded itself as a commercial enterprise, and has 
never fought any intrusion upon its rights, leaving 
the protection of its sacred mission in the hands of 
the people themselves. In part it is also due to 
the fact that the average medical man considers 
very active participation in political affairs as a 
matter outside of his calling. When one considers 
the intimacy with which the medical man comes 
into contact with the lay people, and the influence 
that he can use over them, it is really remarkable 
that medical men do not avail themselves of the 
unusual opportunities which participation in civic 
affairs in general and politics in particular offers to 
them. Treating the sick is their chief mission in 
life and they do so according to the teachings and 
ethics of their profession. To designate the amount 
of whiskey a physician may prescribe for his pa- 
tient and to limit the number of days within which 
a certain amount may be given is not only an 
imposition upon the rights of the physician but it is 
also a stupid blunder. The ultimate sufferer is 
neither the physician nor the law, but the sick 
person who wants to get well. 
One cannot legislate ethics. That has to be 
acquired through a process of training and associ- 
ation with acknowledged professional leaders. 
The methods of the reformers have been pri- 
marily directed towards the alleviation of condi- 
tions for those who are constitutionally inferior or 
psychopathically inclined. In so doing they have 
changed established customs and conventions in 
general to suit the needs of these biologically infe- 330 
ABNORMAL BEHAVIOR 
rior individuals. It is interesting to study the pro- 
fessional reformer and some of his followers. One 
often finds in their actions attempts to cover un- 
desirable and repulsive traits of their own person- 
ality. Many of them enter it on a purely commer- 
cial basis. It might be best to check them 
altogether. It would be far safer to have every 
individual actively participate in civic affairs and 
share in the moulding of public opinion and in- 
telligently eliminate all sources of evil, rather than 
allow a group of parasitic reformers to thrive on 
the weaknesses of human nature. The activities 
of the latter are tending towards undermining the 
very foundations upon which democracy is built. 
SUPPLEMENTARY READINGS 
Anderson, V. V., Drug Users in Court; Boston Medical 
and Surgical Journal, Vol. 176, page 755, May 31, 1917. 
Bloedorn, W. A., Studies in Drug Addicts; U. S. Naval 
Medical Bulletin; Vol. II, page 305, July, 1917. 
Collins, C. F., The Drug Evil and the Drug Law; N. Y. C. 
Dept, of Health, Monograph No. 20, Dec., 1918. 
Copeland, R. S., The Narcotic Drug Evil and the N. Y. C. 
Health Dept., Weekly Bulletin, Dept, of Health, Vol. 9, 
p. 57, Feb. 21, 1920. 
Goldberg, J. A., Drug Addiction as an International 
Problem; Nation’s Health, Vol. 3, Nov., 1921. 
Graham-Mulhall, S., Experiences in Narcotic Drug 
Control in State of N. Y., N. Y. Medical Journal, 
January, 1921. 
• The After Care of the Drug Addict; 
Medical Times, July, 1920. 
How to Handle the Narcotic Situation; 
Medical Times, April, 1919. 
Gregory, Menas S., Modern Conception of Inebriety, 
N. Y. Medical Journal, April 7, 1917. PITFALLS OF OUR MINDS 
331 
Hubbard, S. D., Some Fallacies Regarding Narcotic Drug 
Addiction; Journal A. M. A., Vol. 74, page 1439, May, 
22, 1920. 
Leahy, S. R., Some Observations on Heroin Habitues; 
N. Y. State Hospital Bulletin, August, 1915. 
Report of the Special Committee on Nar- 
cotic Drugs, the Narcotic Drug Situation in the U. S. A. 
Issued by the council on Health and Public Instruction 
of the American Medical Association. Chapter X 
THE UNBIOLOGICAL BEHAVIOR OF 
THE SUICIDE 
Definition of suicide. 
Attitude of society towards the suicide. 
Suicide as an expression of mental aberration. 
Suicide as a logical choice of conduct. 
Suicide as an expression of intense emotional outbreak. 
Suicide in the aged. 
Suicide in the young. 
The steady increase in the suicide rate. 
Various causes for suicide: Loneliness — ill-health — panics 
— season of year — wave-like periodicity, etc. 
Tables illustrating number of suicides by months and 
seasons; by age and sex; by method used; by yearly rate. 
Changing attitude towards the suicide. 
An analysis of ioo consecutive suicidal attempts encoun- 
tered in patients brought to psychopathic ward. 
Tables analyzing mental disorders in ioo attempts at 
suicide, the age of these cases, their methods employed, 
and their religion. 
Three cases illustrating depressed phase of Manic-Depres- 
sive Insanity causing suicide. 
Case illustrating manic-phase of Manic-Depressive Insanity 
causing suicide. 
Three cases illustrating suicide in Dementia Praecox 
patients. 
Two cases illustrating alcoholism responsible for suicide. 
Cases illustrating suicide in people suffering from chronic 
physical diseases. 
Three representative cases of suicidal attempts in hysteria. 
Case illustrating child suicide. 
General survey of the problem of suicide. 
332 PITFALLS OF OUR MINDS 
333 
SUICIDE, or self-destruction, is as old as the 
human race itself, and the problem of suicide 
is intimately connected with and as baffling 
as many of the problems connected with the 
very origin of life. When one considers how 
powerful an instinct self-preservation is, we can 
readily understand how suicide has interested 
scientists and philosophers of all ages, and how 
each has endeavored to contribute to the under- 
standing of this almost unbiological form of be- 
havior. Among the difficulties encountered in the 
study of this problem is the fact that the successful 
suicide does not, as a rule, leave behind statements 
or other evidence that assist in making proper 
inferences as to the causes that have led up to his 
act. In fact, many of them even attempt to con- 
ceal anything that might be helpful in understand- 
ing the factors which motivated their conduct. 
The family also tries to conceal any evidence in 
order to avoid the stigma that is attached to them 
on account of the suicide of one of its members. 
The attitude of the community towards the sui- 
cide has been different in various periods of his- 
tory. Many of the ancients have sacrificed them- 
selves in the interest of a principle, or faith, or for 
the benefit of the state. In fact, mythology con- 
tains many instances of gods and heroes who have 
thus taken their own lives. Historical figures like 
Cato, Seneca, and Brutus have voluntarily termi- 
nated their own lives. The Stoics utilized suicide 
as a convenient means for escaping the painful 
realities of life. Even Plato is said to have justi- 334 
ABNORMAL BEHAVIOR 
fied it in case of serious calamity, or in extreme 
poverty. Occasionally, in order to escape the dis- 
grace attached to a death penalty inflicted by the 
state, some of the ancients, notably Socrates, re- 
sorted to self-destruction. In the middle ages, 
many of the religious sects threw themselves from 
high cliffs, or adopted other means of suicide as an 
expression of their devotion and martyrdom. His- 
tory is full of instances where captured generals 
or leaders of unsuccessful revolutions preferred 
self-inflicted death rather than suffer the humilia- 
tion attached to failure. Suicide in these cases not 
only failed to carry with it the stigma of disgrace 
but in many instances immortalized these men, 
and gained adherents to their principles and fol- 
lowers of their ideals. 
Later, however, with the advance of Christian- 
ity, suicide came to be regarded as an impious act, 
indignities were heaped upon the body of the 
deceased, and the family looked upon as social out- 
casts. Even as late as the eighteenth century, the 
body of the suicide, could not be interred in the or- 
dinary cemetery. The Hebraic Law to this day pre- 
scribes the burial for these unfortunate individuals 
in certain restricted places. In many countries 
suicide is still regarded as a crime, and if unsuc- 
cessful subject to punishment. The estate of the 
suicide, however, is no longer confiscated by the 
state. Even in New York City, the metropolis 
of the western hemisphere, suicide was a punish- 
able offense as late as the year 1920. As late as 
this did the popular mind fail to realize that PITFALLS OF OUR MINDS 
335 
people attempting suicide are subjects for sym- 
pathy and charity, rather than for condemnation 
and punishment. 
We must remember that even at present among 
certain people suicide is committed in obedience to 
established principles and customs, and as an ex- 
pression of affection, gratitude and loyalty to a 
dead chief. At the time of the death of the late 
Mikado of Japan, some members of the Samurai 
race of Japan, many of them having figured prom- 
inently in the Russo-Japanese War and in other 
movements that have tended toward the rise of 
Japan as a nation, committed suicide, according to 
customs by hara-kiri. 
With increasing interest in modern psychiatric 
problems, and as the result of the psychiatric at- 
titude assumed in dealing with other problems of 
human behavior, many began to regard suicide as 
an expression of mental aberration. In the face 
of strong emotional conflict, as the result of delu- 
sions and ideas of persecution, in an effort to es- 
cape their imaginary tormentors, and to evade the 
terror resulting from horrifying hallucinatory ex- 
periences, the individual seeks refuge in suicide. 
The Psychoanalytic School would regard it as a 
desire of the individual not to die physically but 
to kill his own personality. On the other hand, 
there are innumerable instances where suicide was 
the result of a well-calculated, logically system- 
atized scheme devised as the most feasible plan of 
action when conditions became unbearable. Thus 
the banker who has misused the people’s funds in 336 
ABNORMAL BEHAVIOR 
speculations, in order to avoid disgracing his family 
as a result of impending conviction and imprison- 
ment, may turn to suicide to escape such disgrace. 
Pilgrim mentions the experience of one insurance 
order whose funds were increasingly being depleted 
as a result of premiums paid to families of their 
members who committed suicide. The committee 
appointed to investigate this problem finally con- 
cluded that these men had selected suicide as a 
means of supplying the economic needs of those de- 
pendent upon them. A clause in the constitution 
of that order was inserted limiting the premiums 
of the suicide and this resulted in a marked and 
immediate diminution in suicide amongst their 
members. These facts would point to the presence 
of a group of individuals who while of sound mind 
plan self-destruction. 
There are many causes for suicide. All author- 
ities agree that a large number of suicides are 
the result of mental aberration. This factor will 
be discussed more fully in analyzing our cases. 
The economic factor has undoubtedly played an 
important role in many instances. We know that 
during business reverses and in panics, there is a 
tendency towards an increase in the suicide rate. 
During wars, there is a gradual decrease of the 
suicide rate because of the great opportunity for 
one type or another of war service, the increased 
prosperity among wage-earners, and the deflection 
along more useful lines of the interests of morbidly 
introspective individuals. 
A factor which has played a prominent part in PITFALLS OF OUR MINDS 
337 
suicide is the feeling of loneliness, from which so 
many people suffer. It is remarkable indeed how 
lonesome one can be in a large city. The rural 
communities seem to have in them a greater 
amount of “ the milk of human kindness.” 
Furthermore, the resources of the country offer so 
many opportunities for one to become interested 
in natural beauties, as to remove any tendency 
towards morbid introspection. The cold, unso- 
ciable atmosphere of the city with its limited op- 
portunity for freedom of movement, tends towards 
increasing morbid introspective tendencies which 
finally lead to despair and suicide. It is remark- 
able how many of such individuals one meets in the 
psychopathic wards. It is incredible how many 
of them have for the first time in their lives met a 
friendly look and encouraging word in the obser- 
vation ward, having been brought there after an 
unsuccessful attempt at self-destruction. 
In the aged, when opportunities for diverting 
one’s interests among fields of activities are limited, 
when life has lost many of its charms and attrac- 
tions, and when some of the fondest hopes have 
been unrealized and the future is hardly bright, 
suicide is not infrequent. Thus G. Stanley Hall, 
in Senescence, quotes Prussian statistics which 
show that people between 50 and 80 commit suicide 
about twice as often as those between 20 and 50. 
In the young, suicide not infrequently represents 
an effort to inflict punishment in return for some 
imaginary wrong at the hands of those interested 
in them. Occasionally they resort to this proce- 338 
ABNORMAL BEHAVIOR 
dure in order to gain more attention and affection. 
This mechanism also holds true in hysterical indi- 
viduals who really do not desire to die, but simply 
make attempts at suicide as a means of gaining 
the desired attention and affection. They usu- 
ally select a means that will not prove efficacious; 
often, however, their plans are miscalculated, and 
they succeed in killing themselves. A young girl, 
for example, who jumped into the river in the pres- 
ence of a group of people drowned because there 
was no one in that group who could swim. Her 
history revealed several previous attempts at 
drowning, always in the presence of a large crowd 
amongst whom fortunately there were a few who 
saved her. 
There has been a steady increase in the suicide 
rates of the community at large excepting for the 
period in which there were great wars. An at- 
tempt has been made to explain this increase on 
the basis of the greater complexities of modern life. 
One can hardly estimate the true value of this 
factor. As a matter of fact, it is not an easy 
matter to decide whether modern man has greater 
difficulties to encounter than his forefathers. 
Surely, physical difficulties of former times have 
been considerably mastered by modern science. 
It is held, however, that there are greater 
tunities for emotional conflicts in modern society 
than there were in the past. Even this last state- 
ment is one on which there is considerable differ- 
ence of opinion. 
One frequently meets statements to the effect PITFALLS OF OUR MINDS 
339 
that physical diseases are causes for suicide. 
As a matter of fact, our experience among the 
chronically and even among the hopelessly ill has 
led us to conclude otherwise. It is indeed most 
remarkable how tenaciously these hopelessly and 
chronically sick cling to life. Repeatedly have we 
discussed this subject in a frank and open manner, 
and on final analysis have concluded that if any- 
thing the desire to live is stronger among these 
physically ill individuals than amongst those men- 
tally diseased. It must be admitted, however, 
that there are instances, where in the face of utter 
hopelessness and despair, these individuals occa- 
sionally do attempt to end their existence. They, 
however, are the exceptions rather than the general 
rule. 
An interesting feature of the suicide problem 
is the relative frequency of suicide in the spring 
of the year. On the other hand, the winter months 
usually have the least number of suicides (see 
Table No. i). A superficial consideration of dif- 
ficulties usually encountered in the various seasons 
would lead one to expect the highest suicide rate 
during the winter months. This, however, is not 
the fact. Perhaps the general feeling of restless- 
ness and mood fluctuation usually present in the 
spring months may in part account for this. 
Stearns speaks of a condition corresponding to 
hibernation followed by a period of low vigor which 
perhaps may play some part in this phenomenon. 
Another interesting phase of the suicide problem 
is its occurrence in wave-like periods. In the olden 340 
ABNORMAL BEHAVIOR 
times many hysterical individuals with psycho- 
pathic leanings frequently committed suicide in 
groups, so that the civil authorities had to resort 
to unusual measures to check it, such as exposing 
the bodies of the suicides to public view, confiscat- 
ing their property, etc. The clergy frequently 
found it necessary to speak from the pulpit in their 
efforts to check the group hysteria. Even in mod- 
ern times there is a tendency for suicide to occur 
in waves. The notoriety which the suicide re- 
ceives from some newspapers is, in a measure, 
responsible for this. The despondent, and mor- 
bidly inclined individual is often impelled to take 
his own life after reading a similar account in 
a newspaper. 
There are many interesting studies of suicide. 
Lowrey made an analysis of suicidal attempts in 
a psychopathic hospital. He studied forty-six 
cases who made unsuccessful suicidal attempts. 
Of these sixteen cases were Dementia Praecox, 
nine were patients suffering from Manic-Depres- 
sive Insanity, five were of psychopathic person- 
ality, three of psychoneurotic nature, and the 
others were variously diagnosed. The relatively 
greater number of Dementia Praecox cases could 
in part be accounted for by the fact that the 
Dementia Praecox type represented the largest 
group of inmates in the institution. 
Hoffman made a statistical study of the suicide 
record of 1917 of 100 leading cities. He says: 
“ The annual loss of life through self-murder is 
approaching 20,000 for the continental United PITFALLS OF OUR MINDS 
341 
States. In ten years, therefore, making allowance 
for an increase in population and a further increase 
in the actual number of suicides, approximately 
half a million adult lives will be sacrificed for 
reasons most trivial or causes largely within the 
social control. Looking backward throughout the 
period of 142 years since America became a nation, 
it may be conservatively estimated that not far 
from a million people have ended their own exist- 
ence, regardless of the fact that no country in the 
world, during the corresponding period of time, 
has experienced a higher degree of material and 
social well-being, and provided more abundant 
opportunities for the pursuit of happiness, indi- 
vidually or collectively considered.” He presents 
highly instructive tables which illustrate many 
important points: 342 
ABNORMAL BEHAVIOR 
TABLE NO. I 
(Reproduced from Hoffman) 
Comparative Number of Suicides by Months and Seasons, 
U. S. Registration Area, 1911-1915 
Per Cent 
Month: 
No. of Suicides: 
Distribution: 
Jan 
Feb 
7-8 
Mar 
4,387 
8.5 
Apr 
4,748 
9-2 
May 
4,794 
93 
June 
4,738 
9-2 
July 
8.5 
Aug 
Sep . 
4,3i9 
8.4 
Oct 
4,444 
Nov 
7-8 
Dec 
7-5 
Winter 
Spring 
Summer 
Autumn PITFALLS OF OUR MINDS 
343 
TABLE NO. II 
Suicide in the United States Registration Area by 
Age and Sex, 1911-1915 
(Reproduced from Hoffman) 
Rate per 
100,000 
popu- 
lation 
Per 
cent 
distri- 
bution 
Males 
Females 
Ages at 
Death 
No. of 
suicides 
No. of 
.suicides 
Rate per 
100,000 
Per 
cent 
distri- 
bution 
No. of 
suicides 
Rate 
per 
xooM 
Per 
cent 
distri- 
bution 
5 to 9 
IO to 14 
2 
151 
■5 
•3 
I 
78 
•s 
. 2 
I 
73 
•S 
.6 
15 to 19 
1898 
6-3 
3-7 
825 
5-5 
2.1 
1073 
7.2 
9.0 
20 tO 24 
4525 
14-3 
8.8 
2898 
18.0 
7-3 
1627 
10.6 
13-7 
25 to 34 
10634 
19.4 
20.7 
8302 
36.0 
21 .O 
2338 
11 -3 
19.6 
35 to 54 
10356 
33-3 
20.1 
8516 
Si-7 
21.6 
1840 
12.6 
15-4 
55 to 64 
7620 
40.9 
14.8 
6398 
66.1 
l6.2 
1222 
13-7 
10.3 
65 to 74 
3886 
36.6 
7.6 
3279 
61.8 
8-3 
607 
ii-S 
S-i 
75 Plus 
1512 
33-8 
2.9 
1287 
60.7 
3-3 
225 
9-5 
i-9 
Unknown 
191 
•4 
174 
•4 
19 
. 1 
All Ages 
5U4I5 
16.3 
100.0 
39,492 
24.2 
100.0 
11,923 
7-8 
100.0 344 
ABNORMAL BEHAVIOR 
TABLE NO. Ill 
(Reproduced from Hoffman) 
Suicide in the United States Registration Area by 
Method Used and Sex, 1911-1915 
Per 
cent 
distri- 
bution 
Males 
Females 
Method of 
suicides 
No. of 
suicides 
Rate per 
100,000 
No. of 
suicides 
Rate per 
100,000 
Per 
cent 
distri- 
bution 
No. of 
suicides 
Rate 
per 
100M 
Per 
cent 
distri- 
bution 
By 
Firearms 
15,479 
4-9 
30.I 
14,120 
8.7 
35-8 
1,359 
•9 
II.4 
Poison... 
14,020 
4-4 
27-3 
8,894 
5-5 
22.5 
5,126 
3-3 
43-0 
Hanging 
or 
strangu- 
lation. . 
7,491 
2.4 
14.6 
6.188 
3-8 
i5-7 
1,303 
0.8 
IO.9 
Asphyxi- 
ation. .. 
6,477 
2.1 
12.6 
4-371 
2.7 
11.1 
2,106 
1.4 
17.7 
Cutting 
or 
piercing 
instru- 
ment. .. 
3,279 
1.0 
6.4 
2.884 
1.8 
7-3 
395 
•3 
3-3 
Drown- 
ing 
2,869 
•9 
5-6 
1,845 
1. X 
4-7 
1,024 
•7 
8.6 
Jumping 
from 
high 
places.. 
956 
•3 
1.9 
602 
•4 
i-5 
354 
.2 
3° 
Crushing 
433 
.2 
.8 
356 
.2 
•9 
67 
.1 
.6 
Other 
methods 
411 
. 1 
.8 
222 
.1 
.6 
189 
. 1 
1.6 
Total.. 
5D4I5 
16.3 
100.0 
39,492 
24.2 
100.0 
11,923 
7.8 
100.0 PITFALLS OF OUR MINDS 
345 
(Reproduced from Hoffman) 
TABLE NO. IV 
Year 
Population 
Suicides 
Rate Per 
100,000 of 
Population 
Business Failures 
Per 1,000 Concerns 
1902 
17,816,991 
3,022 
17.0 
9-3 
1903 
18,313,17s 
3,36i 
18.4 
9-4 
1904 
18,809,507 
3,588 
19.1 
9.2 
I9°S 
19,121,548 
3,623 
18.9 
8-5 
1906 
19,922,617 
3,406 
17.1 
7-7 
1907 
20,511,267 
3,888 
19.0 
8-3 
1908 
21,099,858 
4,569 
21.7 
10.8 
1909 
21,688,520 
4,444 
20.5 
8-7 
1910 
22,263,589 
4,383 
19.7 
8.4 
1911 
22,821,267 
4,673 
20.5 
8.8 
1912 
23,436,355 
4,55i 
19.4 
9.9 
1913 
24,000,858 
4,708 
19.6 
9.9 
1914 
24,553,940 
5,089 
20.7 
11.0 
1915 
25,143,497 
5,084 
20.2 
13.2 
1916 
25,829,127 
4,535 
17.6 
10.0 
1917 
26,377,887 
4,274 
l6.2 
8.0 
Table No. i illustrates the great frequency of 
suicide in the spring of the year. Table No. 2 
shows the increase of suicide in direct proportion 
to the increase of age. Table No. 3 reveals that 
the most common method employed by the suicide 
is firearms, closely followed by poisoning; hanging 
and strangulation come next in line, while asphyxia- 
tion is the next method. Cutting and piercing in- 
struments, drowning and jumping from high places 
follow in order. Table No. 4 shows the steady 
increase of suicide in the one hundred leading 
cities studied. 346 
ABNORMAL BEHAVIOR 
Since the policy of the community has changed 
from regarding the unsuccessful suicide as a sub- 
ject for a penal institution to considering him de- 
serving of sympathy, and attention by a psychi- 
atrist, it has been the custom in New York City to 
send the unsuccessful suicide to the psychopathic 
ward for observation. We have therefore had an 
unusual opportunity to study these cases, not only 
from a purely medical viewpoint, but also from a 
psychological one. For the sake of a clear presen- 
tation of the subject, we have graphically analyzed 
fifty consecutive females and fifty consecutive 
males admitted to the psychopathic ward because 
of attempted suicide. In Table No. 5 are shown 
the types of mental disorders from which these in- 
dividuals suffered. It will be seen that in 38% 
of the men and in 44% of the women, or in 41% 
of both sexes, there was sufficient change in the 
mood to justify grouping them under the Manic- 
Depressive class of psychoses. In other words, 
Manic-Depressive insanity in its broadest meaning 
was responsible for 41% of the cases studied. 
The Dementia Praecox group composed 14% in 
each sex. The alcoholic group was represented by 
18% in men, 8% in the women, or by 13% of both 
sexes. It is indeed surprising to find alcohol re- 
sponsible for 13% of suicides in our cases. The 
Manic-Depressive, the Dementia Praecox psy- 
choses and the alcoholics represented 68% of the 
suicidal attempts. Epilepsy was responsible for 
6% of the men, 4% of the women, and for 5% 
of both sexes. Arteriosclerosis and Senile Psy- PITFALLS OF OUR MINDS 
347 
chosis accounted for only 4% while the Psycho- 
neuroses were responsible for only 2 %. The table 
is shown below: 
TABLE NO. V 
Types or Mental Disorder in ioo Attempted Suicides 
Diagnosis 
Number 
males 
Per cent 
males 
Number 
females 
Per cent 
females 
Per cent 
both sexes 
Manic depressive psychosis.... 
4 
8 
10 
20 
14 
Allied to manic depressive 
4 
8 
7 
14 
II 
Undifferentiated depression.... 
8 
16 
0 
O 
8 
Simple depression 
I 
2 
0 
O 
1 
Agitated depression 
o 
O 
2 
4 
2 
Transitory depression 
I 
2 
O 
0 
1 
Transitory excitement 
o 
O 
3 
6 
3 
Involution psychosis 
I 
2 
0 
0 
1 
Total manic depressive group... 
(19) 
(38) 
(22) 
(44) 
(41) 
Dementia praecox 
7 
14 
3 
6 
10 
Allied to dementia praecox 
0 
O 
4 
8 
4 
Total dementia praecox group.. 
(7) 
(14) 
(7) 
(14) 
(14) 
Paranoia 
0 
O 
1 
2 
1 
Epilepsy 
3 
6 
2 
4 
5 
General paralysis 
2 
4 
0 
0 
2 
Psychosis with arterio-sclerosis.. 
3 
6 
0 
O 
3 
Senile psychosis 
0 
0 
1 
2 
1 
Psychosis with organic nervous 
disorder 
3 
6 
2 
4 
S 
Toxic exhaustive psychosis 
0 
0 
1 
2 
1 
Alcoholism 
7 
14 
2 
4 
9 
Acute alcoholic psychosis 
2 
4 
2 
4 
4 
Total alcoholic group 
(9) 
(18) 
(4) 
(8) 
(13) 
Constitutional psychic inferi- 
ority 
2 
4 
3 
6 
S 
Psychoneurosis 
1 
2 
1 
2 
2 
Drug addiction 
0 
0 
1 
2 
1 
Mental deficiency 
1 
2 
1 
2 
2 
Intoxication from drugs, etc.... 
O 
0 
4 
8 
4 
Totals 
So 
100 
5° 
100 
100 348 
ABNORMAL BEHAVIOR 
Age of ioo Attempted Suicides 
TABLE NO. VI 
Age 
Number 
males 
Per cent 
males 
Number 
females 
Per cent 
females 
Per cent 
both sexes 
Under io 
0 
0 
0 
0 
O 
II to 20 
8 
16 
12 
24 
20 
21 to 25 
3 
6 
8 
16 
II 
26 to 30 
6 
12 
II 
22 
17 
31 to 35 
7 
14 
6 
12 
13 
36 to 40 
S 
10 
4 
8 
9 
41 to 45 
5 
10 
S 
IO 
10 
46 to 50 
5 
10 
2 
4 
7 
Si to 55 
1 
2 
1 
2 
2 
56 to 60 
5 
IO 
0 
0 
S 
61 to 65 
1 
2 
0 
0 
1 
66 to 70 
2 
4 
0 
0 
2 
71 to 75 
0 
0 
1 
2 
1 
Above 75 
0 
0 
0 
0 
0 
Unknown 
2 
4 
0 
0 
2 
Totals 
50 
100 
So 
100 
100 PITFALLS OF OUR MINDS 
349 
TABLE NO. VII 
Methods Employed by ioo Attempted Suicides 
Method 
Number 
males 
Per cent 
males 
Number 
females 
Per cent 
females 
Per cent 
both sexes 
Jump out window, etc... 
12 
24 
17 
34 
29 
Eat broken glass 
I 
. 2 
o 
o 
i 
Beating head 
I 
2 
o 
o 
i 
Drowning 
I 
2 
3 
6 
4 
On subway track 
I 
2 
o 
o 
i 
Inhaling gas 
7 
14 
7 
14 
14 
Hanging 
2 
4 
i 
2 
3 
Shooting 
2 
4 
o 
O 
2 
Cutting throat 
5 
IO 
o 
O 
S 
Stabbing or cutting 
3 
6 
o 
O 
3 
Set fire, whiskers 
X 
. 2 
o 
O 
i 
Poison 
o 
O 
I 
2 
i 
Iodine 
S 
IO 
6 
12 
ii 
Bichloride 
o 
O 
4 
8 
4 
Lysol 
o 
O 
2 
4 
2 
Paris green 
I 
2 
O 
o 
I 
“C N” cleanser 
o 
o 
3 
6 
3 
Carbolic acid 
2 
4 
I 
2 
3 
Strychnine 
O 
o 
I 
2 
i 
Veronal 
O 
o 
I 
2 
i 
Wood alcohol 
I 
2 
o 
O 
i 
Disinfectant 
O 
O 
I 
2 
i 
Method unrecorded 
S 
IO 
2 
4 
7 
Totals 
5° 
IOO 
5° 
IOO 
IOO 
Religion of One Hundred Attempted Suicides 
TABLE NO. VIII 
Religion 
Male 
Female 
Both Sexes 
Catholic 
26 
21 
47 
Protestant... 
9 
15 
24 
Hebrew 
14 
II 
25 
Unknown.... 
1 
__3 
4 
Total 
50 
5° 
100 350 
ABNORMAL BEHAVIOR 
In Table No. VI, the respective ages of these ioo 
cases are given. In Table No. VII, the methods 
employed are given. It will be noticed that jump- 
ing from a window represents the favorite method. 
The inhalation of illuminating gas is next in order, 
closely followed by iodine poisoning. It will be 
noted in analyzing our tables, the results are some- 
what different than those given by Hoffman.1 
Our cases represent suicidal attempts, the vast 
majority of which were unsuccessful. His tables 
represent actual suicides. In Table No. VIII, the 
various religions of these cases are shown. The 
greatest number of these cases, however, admitted 
having lost faith in their religious training. The 
impression that we have gathered from this study 
is that lack of religion is a factor to be considered 
in analyzing the causes of suicide. The faith and 
hope which religion inspires, and the confidence 
that is carried with it, enable people to continue 
the struggle for existence in the face of over- 
whelming odds. 
It will be instructive to analyze in detail some 
of the cases which we have studied: 
Case 78 
A young man, 22 years of age, was brought from 
the magistrate’s court charged with carrying concealed 
weapons. The history of the case revealed that this 
1 Hoffman’s figures undoubtedly include some of un- 
intentional self-destruction, such as accidental poisoning, 
self-inflicted injury while under alcoholic influence, and 
unable to care for oneself, etc. PITFALLS OF OUR MINDS 
351 
boy was of normal birth and labor; had a common 
school education, worked as a fruiterer, and appar- 
ently was getting along well in business. He was 
always of a rather gloomy, despondent nature; seemed 
to always worry about trifles, and never seemed to 
look at the bright side of life. One month ago he 
became rather restless and uneasy; became depressed, 
could not continue his work and at times was seen in 
tears. He left home two days before his arrest, and 
was not heard from until the day he was admitted to 
the hospital. When interviewed the patient presented 
the typical attitude and manner of one suffering from 
the depressed phase of Manic-Depressive insanity. 
He was definitely sad, quite depressed, worried a good 
deal and did not mingle with the other patients. He 
spoke in a low monotonous voice and moved about 
very slowly. When interviewed he said: “ I got dis- 
gusted with life. I could not sleep. Life looked 
gloomy to me. There was nothing to live for. I 
bought a revolver and shot myself. A policeman 
arrested me because I had the revolver in my posses- 
sion.” The patient had a flesh wound in the left side 
of his chest where the bullet passed through. The 
diagnosis of the case was that of Manic-Depressive 
Psychosis, Depressed Phase, and he was sent to a state 
hospital for care and treatment. 
Case 79 
A girl 17 years of age was brought to the hospital 
having taken bichloride of mercury. The history re- 
vealed that she was born in California and received 
a high-school education. She was very attractive and 
was of a cheerful disposition. She was engaged as a 
chorus girl in a show which made a success in the ABNORMAL BEHAVIOR 
352 
West. She then went on the road and finally 
came to New York. In that city the play was a 
failure. She was out of employment and spent all 
her savings, so that she was penniless. For a few 
days she went to some of her friends, who gave 
her food. These friends who assisted her were, 
in her opinion, immoral, as they allowed themselves 
to get into compromising situations with men. This 
idea was revolting to her, and she finally even refused 
to visit them. She became down-hearted, brooded all 
day long; she went to one of her girl friends and 
asked her for bichloride which she pretended to want 
for a douche. She left her friend, went to a theatre 
and at the end of the show swallowed the bichloride 
tablets. 
In the hospital the patient showed a very well de- 
veloped, somewhat under-nourished condition physi- 
cally; showed no neurological disturbances. She 
vomited a bloody greenish fluid which was due to the 
irritation of the mercury on the mucous membrane 
lining the stomach. 
Mentally she was definitely depressed, spoke of her 
sad plight; stated that she was penniless and would 
not lead an immoral life as some of her friends had 
done. She therefore decided to die. She gradually 
grew weaker and died four days after admission. 
Case 80 
A young female 20 years of age was brought from 
her sister’s residence after she had made an un- 
successful attempt to jump from the roof. The his- 
tory of this case revealed the following: She was born 
in Poland, of Jewish parentage, was quite bright and 
likeable, but showed a tendency to brood. During the PITFALLS OF OUR MINDS 
353 
late war, her family was subjected to unusual hard- 
ships. There were many days of starvation. The 
patient herself was in constant dread of being ruined 
by the soldiers, for several of her friends had shared 
such a fate. At the end of the war she waS sent a 
ticket and money by her sister who had emigrated to 
America some years before. On the boat she met a 
young man who had come to Poland in order to bring 
his folks to America. This young man became in- 
fatuated with her, and she allowed him liberties after 
he had promised to marry her. When they arrived in 
New York, the young man at first paid considerable 
attention to her, but later he rather neglected her, 
and showed in many ways that he no longer cared 
for her. Her sister appealed to his sense of honor 
and the young man married her. Their marital life 
was very unpleasant. He had had the advantages de- 
rived from living in America for ten years while she 
was just a simple Polish peasant girl. They had noth- 
ing in common. They quarreled frequently. One 
month after the marriage she suddenly became rest- 
less, could not sleep, went to her sister and complained 
that her husband was making her ill; that she no 
longer cared to live, and threatened suicide. She 
left her sister and returned to her husband. At the 
end of a week she again came to her sister; this time 
she appeared very dejected, wept bitterly and when 
her sister left the room for a moment, the patient ran 
to the roof and was in the act of throwing herself 
from it when her sister came just in time to prevent 
her from so doing. 
On the ward the patient appeared very sad and quite 
down-hearted; she did not speak above a whisper. 
She expressed all sorts of ideas of insufficiency, stating 
that she no longer could do anything; that she was not 354 
ABNORMAL BEHAVIOR 
worth caring for; that life had nothing to offer her and 
that she had ruined her husband’s life as well as her 
own. She wished she were dead. Physically she 
showed nothing of unusual interest. She was put on 
proper treatment and at the end of three weeks’ resi- 
dence in the hospital she gradually improved, and 
stated that she no longer wanted to die. 
In relating her matrimonial difficulties she said that 
she was in a peculiar mental state, and her difficulties 
had assumed enormous magnitude. She said that she 
had felt, for a while, that she was getting into a state 
of depression, but that she could not help it. Finally 
she had gotten herself in such a peculiar state of utter 
hopelessness that she pictured herself being punished 
for sins that she had committed. She therefore decided 
life no longer was worth while and she tried to end it 
by jumping from the roof. In the hospital, however, 
she had gradually lost this feeling and she no longer 
wanted to die. It was therefore possible to discharge 
her to the custody of her sister. 
The above three cases are examples of Manic- 
Depressive Insanity, Depressed Phase. It is this 
type of mental disorder which is responsible for a 
large number of suicides. They represent about 
one-third of suicidal cases reported. In our group 
they were responsible for 41%. Depressed pa- 
tients, as a rule, have a sense of guilt which often 
drives them to suicide. They will secretly plan 
self-destruction and often succeed in carrying out 
their plans in spite of vigilance on the part of their 
attendants. All these people have to be carefully 
watched, and should be under the care of a trained 
psychiatrist. The unfortunate feature is that PITFALLS OF OUR MINDS 
355 
many of these patients are able to keep up with 
their work and many of them are not regarded as 
being in any way sick, so that a suicidal attempt in 
not a few cases is the first sign of the abnormal 
state. Often while in the hospitals for the men- 
tally sick, these patients will complain to their 
relatives and visitors that they are maltreated, 
and will beg to be removed to their homes. This 
is done in spite of the advice of the physician in 
charge. Once in their homes, where the super- 
vision is not strict, they will terminate their exist- 
ence at the first opportunity. The psychiatrists 
who maintain that all suicides are mentally ill 
point to the fact that most of the cases present a 
mood variation from the normal which is distinctly 
that of a depression, and this mood depression 
affects their judgment to the extent of making 
them incompetent. 
Case 81 
A woman 29 years of age was brought to the hos- 
pital after she had repeatedly tried to take her life 
by jumping from the window, by swallowing sharp 
metallic substances and by gas inhalation. Her hus- 
band stated that the patient was always high-strung, 
vivacious, overactive and quite lively. Following 
the birth of a child six years ago she had a definite 
state of depression which lasted five months and from 
which she made a complete recovery. The patient 
gave birth to a second child eight months ago and one 
month later became very depressed, and was in a 
hospital for three months; and was allowed to go home, 356 
ABNORMAL BEHAVIOR 
apparently cured. Three weeks ago she became over- 
active, overtalkative, could not sleep at night; said 
she was very happy and felt real well. She would 
burst into frequent attacks of excitement when she 
would break things, destroying everything she could 
put her hands on. When prevented from so doing she 
would strike her husband or anyone who happened 
to be near her. She tried to jump from the window; 
on another occasion attempted to inhale illuminating 
gas. 
In the hospital, she was overactive, overtalkative, 
she would ramble in her speech; at times it was neces- 
sary to put her in restraint in order to prevent self- 
injury or injury to others. She said: “ I am happy; 
let me go out to a dance; I feel good; why do you keep 
me here. Am I a prisoner? I’ll kill myself. I have 
no baby — I have no husband — leave me alone; 
get away.” 
The patient was finally committed to a state hospital 
as a case of Manic-Depressive Insanity, Manic Phase. 
This case illustrates suicidal attempts in manic 
patients. As a rule, these patients do not try 
suicide except when during their periods of mood 
fluctuations they become depressed, reflect upon 
either their unhappy state or upon some anti-social 
act which they may have committed, and then 
prefer death to their unfortunate lot. Occasion- 
ally, when in stress of excitement and motor over- 
activity, they will try to get away from the people 
who are caring for them, and unwittingly make 
suicidal attempts. PITFALLS OF OUR MINDS 
357 
Case 82 
A female, 32 years of age, was brought to the hos- 
pital after having tried to jump from a window. The 
history revealed that the patient was born in this 
country, had a common school education, went to high 
school and was graduated at the top of the class. At 
the age of 20 there was a definite change in her per- 
sonality. While she had always been somewhat un- 
sociable, and rather obstinate, she had never been very 
insistent upon having her way and never shut herself 
away from her friends. At 20, however, she became 
very seclusive; would not go out with her friends; 
remained at home; did not try to get any employment 
and would remain content with doing the housework 
for the family. In spite of this definite change in her 
personality the family did not suspect that there was 
anything seriously wrong with her, although they ad- 
mitted that she was somewhat queer. At about 25 
years of age she began to complain of the neighbors, 
that they were poking fun at her and that they were 
passing disparaging remarks about her. Later she 
said that almost everyone was looking mysteriously 
at her. Still later she began to complain of feeling 
electricity in her body. She stated that her food was 
being tampered with. One week before admission she 
became greatly upset, saying that there was a plot on 
foot to do away with her, and that all sorts of horrible 
tortures were in store for her. She finally locked her- 
self in her room; insisted that people were coming to 
her home to kill her and refused to admit anyone.. 
Her family tried to pry the door open, and the patient 
jumped from the window in her effort to escape her 
imaginary enemies. 358 
ABNORMAL BEHAVIOR 
On the ward, the patient was very dull, seclusive; 
very suspicious and evasive; she imagined that her 
food was being poisoned by her enemies; she talked 
excitedly about the subject; she said: “ I had to pro- 
tect myself. I suspect someone is putting poisonous 
drugs into my food. I feel it going all through my 
system. They are going to crucify me, that’s what 
they will do. I want to die a natural death. I don’t 
want to be tortured.” 
She was diagnosed as a case of Dementia Praecox 
and was committed to a state hospital for further care 
and treatment. 
Case 83 
A man, 35 years of age was brought to the hospital, 
having attempted suicide by stabbing himself with a 
knife. The patient had had a former residence at the 
Manhattan State Hospital. He had always been un- 
sociable, did not like company, was quarrelsome at 
home, could not keep any job, and neglected his per- 
sonal appearance. For the past five years he had been 
reacting to imaginary voices, most of which, however, 
were of a pleasant nature, the patient being told that 
he was a chosen prophet, and that he was going to 
make people lead better lives. Four years ago while 
preaching to a crowd which gathered in the street, he 
was arrested and sent to a state hospital where he 
remained for two years. 
In the hospital the patient was very quiet and did not 
mingle with the other patients. He paced up and down 
the floor, apparently reacting to imaginary voices, as 
he would frequently stop and talk in an unintelligible 
manner; he did not answer questions relevantly or 
coherently. He expressed a deeply religious trend. 
He said: “ God selected me as a Jewish Messiah. PITFALLS OF OUR MINDS 
359 
He talks to me constantly. He tells me to preach to 
people. I was the one who brought peace to the 
world. There is no more war. God told me to sac- 
rifice myself for the Universe. I could not die. I do 
not want to die. I can never die. I can go to Heaven. 
I am his chosen favorite.” 
Diagnosed as a case of Dementia Praecox and com- 
mitted to a state hospital for further care and 
treatment. 
Case 84 
A young woman (28 years of age) was brought to 
the hospital after having jumped from the ferry boat 
into the river. At first the patient refused to give any 
information about herself and to all questions she 
would reply in a uniform manner asking that a tele- 
gram be sent to a certain movie star. She was quite 
seclusive; at times she appeared depressed and would 
ask to be put into the electric chair to end it all. Her 
ideas were rather meagre and her emotional reaction 
was entirely inadequate to the stimulus eliciting it. 
Later she became more communicative; said that 
everybody was against her. She was going to become 
a very popular actress and therefore the other girls 
were jealous of her and were plotting to injure her. 
Upon investigation it was learned that she had come 
from Detroit to New York in her effort to escape her 
imaginary enemies. She later admitted having had a 
residence in a state hospital in Michigan. She was 
committed to a state hospital for further care and 
treatment with a diagnosis of Dementia Praecox. 
These three cases illustrate attempted suicide in 
Dementia Praecox patients. These individuals 
select self-destruction in an effort to escape from 360 
ABNORMAL BEHAVIOR 
imaginary persecutions. Often they commit sui- 
cide because of delusions due to imaginary voices 
telling them to do it. They react to false sense 
perceptions and are slaves to their morbid ideas. 
Their acts are impulsive, and often are executed 
without any warning, so that in spite of careful 
watching on the part of their nurses and attendants 
they may succeed in terminating their lives. The 
most horrifying types of self-mutiliation have been 
committed by these patients. We have seen a 
patient who had completely torn away his external 
genitals by means of his finger nails, having labored 
under the delusion that it was the Lord’s wish 
that he should do so. Another patient of this 
group poured kerosene on his beard and then set 
fire to it, in response to a similar delusion. In our 
group of attempted suicides, Dementia Praecox 
patients represented fourteen per cent, of the total 
number. 
Case 85 
A woman 31 years of age was brought to the hos- 
pital in a semi-conscious state having been found in 
her room with the gas jets open. The landlady stated 
that the patient had been drinking heavily the night 
before, and that on the morning of admission an odor 
of gas was traced to the patient’s room. On opening 
the door, the patient’s room was filled with illuminating 
gas and the patient was found in a semi-conscious 
condition. 
On admission, the patient was stuporous and had a 
disagreeable, penetrating alcoholic odor to her breath. 
After proper treatment, the patient regained conscious- PITFALLS OF OUR MINDS 
361 
ness, and was able to give a clear account of herself 
and of her acts. She admitted having been a heavy 
drinker, but denied attempt at suicide. In an effort 
to explain her situation she stated that it was quite 
possible that she had turned on the illuminating gas 
without lighting it because of her alcoholic state, but 
it was more likely that she had blown the light out, 
without turning it off. 
Case 86 
A man 35 years of age was brought into the hospital 
after being saved from drowning. He had a very 
heavy odor of alcohol to his breath and had the facial 
appearance of one who had always been drinking 
heavily. The history revealed that the patient had 
always been a heavy drinker; that one week before 
admission he began to complain to his sister that 
people were going to harm him; that he was going to 
be cut up, that he heard the neighbors talking about 
him, and that most everybody was involved in this 
plot. Furthermore, he suspected his own brother-in- 
law, and would leave the room whenever the latter 
entered. On one occasion his brother-in-law brought 
some friends to the house and when the patient 
heard them talk, he hurried out of the room and 
ran to the river, eluded two men who were trying to 
prevent him from jumping into the water, but was 
saved by a sailor from a passing boat. 
In the hospital, the patient at first was very sus- 
picious, reacted to imaginary voices, which were 
threatening him and were calling him all sorts of de- 
grading names, and appeared to be in great fear. At 
the end of three days’ rest and treatment, he lost these 
fears, and no longer heard these voices. He gradually 362 
ABNORMAL BEHAVIOR 
improved so that at the end of the week he appreciated 
that his mind must have been upset and finally ac- 
cepted the explanation that his heavy drinking had 
affected his brain. He was diagnosed as a case of 
Acute Alcoholic Hallucinosis, and was allowed to go 
home after making a complete recovery. 
These two cases represent attempts at suicide 
occurring among alcoholic persons. The first case 
represents an ordinary drunkard who, while under 
the influence of alcohol, is unable to take proper 
care of herself, and because of this, occasionally 
jeopardizes her life. Such a person may fall over- 
board, step in front of a moving vehicle, be- 
come asphyxiated by illuminating gas, or take 
poison mistaking it for some medicine. Suicide 
in such cases is not the result of a premeditated 
act, but of utter carelessness and helplessness re- 
sulting from alcoholic intoxication. 
The second case represents a type of mental 
disease resulting from prolonged use of alcohol 
and which is characterized by the occurrence of 
marked false perceptions of hearing which causes 
great fear. These hallucinations of hearing are 
usually of a threatening nature, the patient imagin- 
ing that he is being haunted and that his very life 
is in danger. In order to avoid being apprehended 
by his imaginary enemies, and in an effort to es- 
cape the imaginary tortures which are in store for 
him, such a patient will occasionally attempt 
suicide. Some of the rather mysterious suicides 
occurring among the apparently wealthy and 
healthy individuals are the result of these acute PITFALLS OF OUR MINDS 
363 
alcoholic hallucinations. The relative frequency 
of suicidal attempts caused by alcohol can be 
judged from the fact that, of our group of cases, 
13% were alcoholics. 
Case 87 
A young man 28 years of age was brought to the 
hospital after having attempted suicide by strangula- 
tion. The patient had three years ago contracted 
gonorrhoea and syphilis. Following his infection with 
the syphilitic germ, he became paralyzed and was under 
constant treatment for two years, the paralysis passing 
off but leaving the individual in a rather poor physical 
condition. He was told by his doctor that although 
he had recovered the function of his limbs he was still 
in danger and it was necessary for him to be under a 
physician’s care for practically the remainder of his 
life. The examination of the blood and of the spinal 
fluid still showed evidences of an active syphilitic dis- 
ease process. The patient was an intelligent man, and 
was aware of the seriousness of the nature of his ill- 
ness. He had formed a friendship with a young girl 
and seriously contemplated marriage. He knew, how- 
ever, that if the girl was informed of his disease she 
never would consent to marry him, furthermore he 
realized that even if she were to marry him, their 
marital life would in all probability be unhappy; he 
began to brood and finally made the unsuccessful 
attempt at suicide. 
Case 88 
A young woman 22 years of age was brought to the 
hospital after having made an unsuccessful attempt 
to jump from the window. Her parents stated that 364 
ABNORMAL BEHAVIOR 
the patient had been suffering from heart disease since 
childhood. This incapacitated her to the extent of 
preventing her from participating in the usual play 
and games of the children of the neighborhood. As 
she grew older she was unable to participate in social 
affairs, as she could not dance, swim or even walk 
more than a few blocks without becoming short of 
breath and suffering from rapid beating of the heart. 
She often discussed her sad plight with her parents, 
and had insinuated that she would prefer death to such 
an unhappy existence. Her attempt at suicide was 
precipitated by a disappointment. There was a social 
affair in the home of one of her friends to which she 
was invited. She had looked forward to it for several 
weeks. On the evening of the party she had an attack 
of rapid beating of the heart and shortness of breath 
which necessitated her going to bed, and prevented her 
from attending the social affair. She cried bitterly 
that night, and finally expressed her disappointment in 
her suicidal act. 
The last two cases are examples of attempts at 
suicide in people suffering from chronic disease. 
As stated before, the usual reaction of these people 
is one of extreme tenacity and of intense determi- 
nation to make the best out of life in spite of their 
handicap. Even in the face of excruciating pain, 
these patients want to live despite their oft-re- 
peated remarks that death would be welcome. 
When their pains have been alleviated by sedatives 
and the patients have regained their natural poise, 
they will admit upon interrogation that their de- 
sire to die was more apparent than real; that it 
was induced by the pain and often utilized in their PITFALLS OF OUR MINDS 
365 
effort to secure the proper sedative. It will be 
noted that in these two cases there was a strong 
element of emotional reaction, and one is justified 
in questioning whether these people who are physi- 
cally ill and attempt suicide, are not really suffer- 
ing from an acute outbreak of a mental disorder 
of the Manic-Depressive type. 
Case 89 
A young woman 25 years of age was brought to the 
hospital after having attempted suicide by drinking 
lysol. The history revealed that this girl was always 
of an hysterical nature; craved a great deal of atten- 
tion and depended upon the other members of her 
family to get along. She married a rather energetic, 
persevering young man whose time was occupied by 
his work, and who did not lavish as much affection on 
his wife as she desired. He was industrious and faith- 
ful to her; treated her with every consideration, and 
yet she was dissatisfied because his work necessitated 
his remaining in his place of business longer than his 
wife had expected. One month after their marriage 
she tried to jump from a window. A few weeks later 
she ran to the roof threatening to throw herself into the 
street, and on the present occasion, she attempted to 
swallow lysol. 
At the hospital the patient admitted that she really 
did not want to do away with herself. What she had 
planned was to arouse her husband’s sympathy and 
thereby gain her end of having him near her most of 
the time. She admitted that she really was not going 
to throw herself from the roof and that before she 
had tried to jump from the window she made it her 366 
ABNORMAL BEHAVIOR 
business to have most of the members of her family 
in the room so that suicide would be prevented, and 
their sympathies would be aroused. She frankly 
stated that she did not swallow any lysol but put a 
sufficient amount of the drug on her face so as to cause 
discoloration and fulfill her purpose. After a few 
interviews with the patient, during which her entire 
conduct was critically analyzed, she gained some in- 
sight into her abnormal form of reaction and was 
allowed to go home in custody of her husband. 
Case 90 
A young girl 18 years of age was brought from a 
correctional institution after having attempted to 
swallow a commercial disinfectant. The history re- 
vealed that this girl was always somewhat neurotic and 
somewhat unstable emotionally. She showed a 
precocious sexual development and wanted to remain 
out late nights. Her parents had to reprimand her 
on several occasions. Twice she had swallowed tinc- 
ture of iodine after her parents had admonished her 
for staying out late. Her act was precipitated by her 
father reprimanding her in the presence of a young 
man. She no longer would listen to her people and 
her father placed her in a correctional institution where 
she found a rather rigid regime, and she could not 
tolerate the discipline and she therefore attempted 
suicide. 
Case 91 
A young woman 30 years of age was brought to the 
hospital after having swallowed tincture of iodine. 
She was a rather sensitive and unstable woman, who 
had spent most of her time in her home; always craved PITFALLS OF OUR MINDS 
367 
a good deal of attention and was regarded more or less 
as the “ baby of the family.” She had been going out 
with several men and became attached to one of whom 
the family did not approve. On several occasions her 
parents strongly objected to her association with this 
man. On one occasion this man was met by her 
people and was told not to continue in his attention to 
the patient. Her suicidal attempt was precipitated by 
a quarrel which she had with her eldest brother who 
insisted that she give up this man’s friendship. 
In the hospital, the patient spoke freely of her diffi- 
culties; stated that she had been intimate with this 
man; that she really loved him and that she could not 
live any longer without him; that since her parents ob- 
jected so strongly she thought that life was not worth 
while, and therefore took the iodine. After several 
interviews with the patient, she gained considerable 
insight into her case, and decided that she could man- 
age her affairs more successfully, and was finally 
allowed to go home in custody of her parents. 
The last three cases represent suicidal attempts 
in hysterical individuals. As a rule, hysterical 
people do not attempt suicide in order to actually 
terminate their lives, but rather as the result of a 
strong emotional tension which impels them to 
commit the act in an effort either to gain a desired 
end, or to flee from a painful situation. The 
methods usually employed are such as rarely to 
cause death. Most of the hysterics swallow tinc- 
ture of iodine because it is the most available drug 
at hand, and furthermore because it usually results 
in the collection of a crowd among whom invariably 
there will be a few ready to offer misguided sym- 368 
ABNORMAL BEHAVIOR 
pathy. Occasionally they attempt to inhale illumi- 
nating gas, making sure, however, that there are 
others in the room who will detect the odor and 
frustrate their suicidal attempt. Sometimes their 
plans are miscalculated, and their knowledge of 
the action of drugs is nil, and their suicidal at- 
tempts are successful. Thus one hysterical girl 
swallowed a solution of bichloride of mercury 
which caused her death. She made one previous 
attempt at suicide by swallowing a tablet of bi- 
chloride of mercury which she immediately 
vomited. This time she swallowed a solution of 
bichloride of mercury and could not vomit all of 
it. This resulted in her death. Another hysteri- 
cal individual who had on several occasions cut the 
tendons of his wrist finally succeeded in committing 
suicide by severing his jugular vein. His knowl- 
edge of anatomy was quite limited, and he suc- 
ceeded in his suicidal attempt. 
Case 92 
A girl 13 years of age was brought to the hospital 
having swallowed iodine. The history of the case re- 
vealed the fact that she was a rather bright and attrac- 
tive child; got along very nicely and was well liked 
by her teachers and friends. One year ago, she was 
one of the organizers of a club whose leader was a 
well-known Socialist. These young children were 
initiated into the teaching of social inequalities, and 
they were constantly told of the grave injustice done 
to the laboring classes by the capitalists. Because of 
her fluent speech and attractive personality, she was PITFALLS OF OUR MINDS 
369 
the president of the club. She neglected her school 
work, and paid greater attention to the duties that 
were connected with the club. During the local cam- 
paign she would speak on the street corners. Her 
teachers repeatedly warned her that her work was 
becoming very poor in quality and that she would not 
be graduated if she were to continue this low standard 
of work. 
The child misinterpreted the teachers’ warnings 
and defiantly disregarded them. She openly stated 
that the teachers belonged to the capitalistic class 
as they did not work; furthermore she laughed at 
some of the doctrines taught in school and on several 
occasions compared her school teachers with the leader 
of her club who happened to have been a member of 
the State Legislature. She idolized her leader, and 
his teachings were divine inspirations to her. When 
the school term closed, she failed to receive her 
diploma; brooded over it, and swallowed the iodine. 
In the hospital, the patient continued her attitude 
of hostility towards the general organized system of 
society; stated that she swallowed the iodine to show 
them that she was ready to sacrifice herself in behalf 
of her principles; that since she was a Socialist nobody 
really cared for her and that she really cared nothing 
for her teachers’ opinions, and she wanted to show 
them that her own doctrines were much firmer than 
those held by her teachers at school. After several in- 
terviews by different members of the staff, she finally 
was made to see the fallacy of her reasoning, and the 
unhappiness which her acts had caused her teachers, 
her family and herself. She finally acknowledged that 
there was a possibility of her having entertained in- 
correct ideas, although she would not fully admit that 
such was the case. She stated that instead of partici- 370 
ABNORMAL BEHAVIOR 
pating in games and wholesome diversions, she would 
read books and pamphlets in which were depicted the 
injustices done to the working classes by their em- 
ployers. She often in her reveries pictured herself 
participating in reforms that would liberate the work- 
ing masses and she would invariably see herself in 
these reveries as the leader of such movements and 
the heroine admired by millions. 
This case represents an attempt at suicide in a 
child. Prussian statistics compiled in 1910 showed 
that there was on an average one child suicide 
a week. One-fourth of their group of cases was 
caused by mental disease. One-third of the chil- 
dren committed suicide in fear of punishment for 
some offense at school, or insufficient successes at 
school. They concluded that the causes for sui- 
cide lay in situations that had a reason at home 
rather than in school. Often these children would 
in their infantile manner of behavior attempt sui- 
cide in an effort to punish those interested in them 
for an imaginary injustice received at their hands, 
or as an expression of their innocence of an act for 
which they may have been reproved. 
In addition to the people who actually commit 
suicide, there are many more who at one time or 
another are more or less inclined to take their own 
lives. That they do not yield to this impulse is 
due to the strength of the instinct of self-preserva- 
tion, to ethical considerations, such as unwilling- 
ness to leave a dependent family, etc.; and to social 
pressure, which has always been exerted to prevent 
the individual from taking his own life. The psy- PITFALLS OF OUR MINDS 
371 
choanalyst would describe many accidents as 
abortive attempts at suicide in cases in which other 
motives repress the conscious suicidal wish. The 
accident thus becomes an expression of the un- 
conscious desire for death, and is a compromise 
between the conflicting motives of the individual. 
Suicide, then, in the vast majority of cases, is an 
expression of a strong emotional state, in which the 
individual is compelled to take his own life. In 
a large number of cases, this is due to a real condi- 
tion of mental aberration, the Manic-Depressive 
reaction predominating. Occasionally it results 
from responses to false or misinterpreted sense per- 
ceptions resulting from alcoholic indulgence, or ac- 
companying other mental disease processes. Fre- 
quently it may be an expression of a flight from 
reality in which the individual utilizes the most 
extreme form of conduct in his effort to solve a try- 
ing situation. It must be remembered that in the 
face of extreme stress, an individual apparently in 
a normal mental state may calmly plan and execute 
suicide. The application of the generally accepted 
mental hygiene principles in dealing with people 
out of employment, social misfits, and those who 
lack opportunity for expression of their normal in- 
stinctive tendencies for social intercourse will 
materially lessen the number of suicides. 
SUPPLEMENTARY READINGS 
Brend, William A. The Mental Condition Preceding 
Suicide. The Practioner, Vol. 103, page 401, Dec., 1919. 
Hoffman, Fred L. The Suicide Record of 1917. Result 372 
ABNORMAL BEHAVIOR 
in ioo Leading Cities. The Spectator, Oct. 26, 1918, 
page 202. This article contains an excellent statistical 
study of many phases of the suicide problem. 
Lowrey, L. G. An Analysis of Suicidal Attempts. Journal 
of Nervous and Mental Diseases, Vol. 52, page 475, Dec., 
1920. 
Pilgrim, Charles W. Insanity and Suicide. American 
Journal of Insanity, Vol. 63, page 349, Jan., 1907. 
Ring, A. H. Factors in Suicide. Boston Medical and 
Surgical Journal, Vol. 185, page 650, Dec. 1, 1921. 
Stearns, A. W. Suicide in Massachusetts. Mental Hy- 
giene, Vol. V, page 752, Oct., 1921. 
Suicide has Increased in 1921. Metropoli- 
tan Life Insurance Co., Statistical Bulletin, August, 1921, 
page 1. 
Effect of the War upon Suicide and Homi- 
cide Rate. Metropolitan Life Insurance Co., Statistical 
Bulletin, June, 1920, page 2. 
Suicide Waves. Editorial, Journal Ameri- 
can Medical Association, Sept., 1921, page 460. 
Suicide in School Children. Journal 
American Medical Association, Feb. 5, 1910, page 479. Chapter XI 
EDUCATIONAL MALADJUSTMENTS 
Distribution of abnormalities among children and the adult 
population. 
Statistical data concerning pathological school children. 
Comment on these figures. 
The mentally defective child as a problem in school; case 
studies. 
Careful diagnosis necessary in some cases of apparent 
mental defect. 
The epileptic child as a case of educational maladjustment. 
Congenital lues a cause of abnormal behavior in school 
children. 
Post epidemic encephalitis syndromes in school children. 
Mental disease and abnormal conduct in school. 
The psychoneurotic child; his abnormal personality and 
behavior. 
The problem of the neurotic child. 
Adolescence as a factor in educational maladjustments. 
Emotional conflicts, due to pathological home situations, 
in children who show conduct disorders. 
The governess as a source of emotional disturbance. 
The abnormal behavior of the unwanted child. 
A case showing many sources of maladjustment. 
Necessity for careful individual study and treatment of 
school children. 
ANY attempt to outline the causes and condi- 
tions which unite to produce conduct dis- 
orders would be sadly incomplete without a con- 
sideration of maladjustments which appear in the 
school system. The criminals and delinquents in 
373 374 
ABNORMAL BEHAVIOR 
our penal and correctional institutions at one time 
or another passed through the schools of the 
country, and from the children who are now en- 
rolled in the schools will come the next group of 
delinquents and criminals who will fill these same 
institutions. This does not imply that all the chil- 
dren who find it difficult to adapt themselves to the 
requirements of the educational system will inev- 
itably become behavior problems in a more serious 
sense as the time goes on. On the contrary, many 
individuals who never succeed in making a satis- 
factory adjustment during their school history do 
become socially adapted and find their vocational 
level successfully. An investigation of the causes 
of maladjustment in school children, however, 
will show that their behavior difficulties are 
produced by the same factors which operate in the 
causation of more serious conduct disorders of 
later life. 
In the preceding chapters, we have traced a 
great deal of abnormal and anti-social behavior to 
mental and physical diseases, emotional conflicts, 
defective intelligence, abnormalities of person- 
ality make-up, etc. It must not be supposed that 
these are limited to the adult population, for in 
reality they often have their origin in the period 
of childhood. In fact, recent studies of school 
children indicate that approximately 15 or 20% 
may be classed as definitely pathological. Of 
4,839 public school children in Maryland, who were 
given medico-psychological examinations in the 
course of the mental hygiene survey of the state, PITFALLS OF OUR MINDS 
375 
only 79.7% could be considered to fall within the 
range of normalcy. In the recent mental hygiene 
survey of Cincinnati, only 86.8% of the 4,326 
school children examined were diagnosed as nor- 
mal. The diagnostic data included in both these 
studies are illuminating, and the following tables 
are therefore reproduced: 
Percentage Distribution of Mental Diagnoses of 4839 
Public School Children in Maryland. 
Diagnosis 
Per cent 
Superior 
9-i 
Normal 
55-5 
Dull normal 
15.1 
Borderline mental defect 
3-7 
Mental defect 
34 
Character defect 
Psychopathic personality 
19 
Psychoneuroses and neuroses 
0.7 
Mental disease or deterioration 
Epilepsy 
Endocrine disorder 
Total 
(Reproduced from the Report of The Maryland Mental Hygiene 
Survey, page 60, Table XX.) 376 
ABNORMAL BEHAVIOR 
Mental Diagnoses oe 4326 School Children in Cincinnati. 
Diagnosis 
Normal 
Number 
Per cent 
69.4 
17.1 
Dull normal 
741 
Subnormal 
4-3 
Borderline mental defect 
86 
2.0 
Mental defect 
86 
2.0 
Pre-psychopathic 
69 
1.6 
Psychopathic personality 
47 
1.1 
Nervous and neurotic 
36 
0.8 
Question of epilepsy 
3 
Q.I 
Epilepsy 
9 
0.2 
Endocrine 
29 
0.7 
Unascertained 
9 
0.2 
— 
— 
4326 
100.0 
(Reproduced from the Report of The Mental Hygiene Survey of 
Cincinnati, page 62, Table 35.) 
While these figures are startling enough, they 
do not include the whole number of maladjusted 
children in our schools. These are only the gross 
maladaptations. More careful investigation will 
find among the children who appear to be normal 
upon a superficial examination, individuals who 
are suffering from emotional conflicts, pre-delin- 
quents, and other maladjusted types. Thus, 
intensive studies will show a decided increase over 
the figures quoted above in the number of children 
deviating from normalcy, although some of these 
may be less markedly pathological than those in- 
cluded in the preceding tables.1 
1 The research which is being carried on under the 
direction of Dr. V. V. Anderson of the National Mental PITFALLS OF OUR MINDS 
377 
The most easily recognized type of educational 
maladjustment is that due to mental deficiency. 
The feeble-minded child stands out from his class- 
mates at once by reason of his inability to learn 
new material and to keep pace with the other 
pupils of his age. He is known to the teacher as 
a chronic grade repeater, and often as a disciplinary 
problem also. His inability to understand what 
is being taught in the class makes him restless and 
mischievous. He is apt to dislike school intensely 
and is then a frequent truant. Some children of 
this defective type show much improvement in 
conduct when transferred to a class specially 
adapted to their needs, in which they are given a 
minimum of academic work and are allowed to de- 
vote most of their time and energy to manual 
training. 
Case 93 
Jimmie C. was a typical disciplinary problem of this 
kind. He was a fifteen-year-old boy who had been 
tried in one school after another but had never gotten 
along anywhere. He was constantly in fights with 
other children, swore at his teachers, and never applied 
himself to his lessons. His family history was nega- 
tive except for a mother who was a “ nervous ” type. 
The physical examination also showed nothing of sig- 
nificance. There was an account of a bad fall at the 
age of 7, with a severe injury to the head, but an 
X-ray showed no evidence of fracture of the skull. 
Hygiene Committee by the Monmouth County Mental Hy- 
giene Clinic among the public school children of Monmouth 
County, New Jersey, will soon afford interesting statistical 
data on this point. 378 
ABNORMAL BEHAVIOR 
The neurological examination was also negative, except 
for slight exaggeration of elbow, wrist and knee jerks. 
The blood Wassermann was negative. 
The psychometric examination gave more significant 
findings. On the Stanford-Binet,1 Jimmie’s mental 
age was only io years 2 months, while he had a chrono- 
logical age of 15 years 6 months. (This would make 
an I. Q.2 of 65.) This rating was strongly indicative 
of mental deficiency. The school record was in har- 
mony with the evidence of the intelligence test. At 
the age of Jimmie was only in the fifth grade; he 
had repeated every grade up to that time. 
In expressing his desire to leave school and go to 
work this boy showed more wisdom than teachers who 
expected a pupil with his limited capacity to achieve 
the standards of his classmates. Although unable to 
profit by extensive academic training, Jimmie could 
undoubtedly have been taught to do some simple 
manual work and have formed habits of industry which 
would have enabled him to become a self-supporting 
member of the community instead of developing habits 
of idleness and irresponsibility. 
Case 94 
Another boy who came into the children’s court be- 
cause of truancy presented a somewhat similar picture. 
The family history was negative and the physical 
examination practically so. The developmental his- 
tory gave a record of spinal meningitis at the age of 
1 See Chapter III for a description of this test. 
2 I. Q. — Intelligence Quotient. This is simply the 
ratio between the chronological and mental ages. It is ob- 
tained by dividing the mental age by the chronological age. 
In adults, the I. Q. is always calculated on the basis of an 
arbitrarily assigned chronological age of 16. PITFALLS OF OUR MINDS 
379 
13 months. Previous to the onset of this disease, the 
boy had learned to walk, but he now stopped and did 
not begin again for three months. When sent to school 
he was unable to make any progress. He repeated 
grades continually, and when brought to Bellevue was 
only in the third grade, although he was 15 years of 
age. He disliked school, and constantly played truant. 
He would frequently stay away from home until mid- 
night. The father found it impossible to give the 
boy proper supervision. (The mother had died of in- 
fluenza.) The boy was sent to the truant school for 
a period of 7 months, but his conduct did not improve 
after his release. 
The psychometric examination gave this boy a men- 
tal age of 8 years 4 months. His chronological age 
was 15 years 4 months. (I. Q. 54.) He was diag- 
nosed as a case of mental deficiency induced by his 
infantile attack of meningitis. In view of his defective 
intelligence his poor school progress could only be 
considered natural. He was recommended for a 
period of training in a school for the feeble-minded. 
Even when the mentally defective child is placed 
in a special class he does not always adapt himself 
to this simplified routine. 
Case 95 
A boy of ii years io months was brought to the 
hospital from the children’s court. The charge was 
assault. The findings and story of the case were as 
follows: 
A physical examination of the boy revealed charac- 
teristic stigmata often associated with mental defect. 
The upper lip was enlarged and protruding, the upper 380 
ABNORMAL BEHAVIOR 
jaw malformed, and the tongue protruded along the 
midline. The boy’s developmental history was also 
typical of mental deficiency. He was retarded in 
physical and mental development, and had a history 
of convulsions during the infancy period. At school 
he was always backward and was finally placed in an 
“ ungraded ” class, in which the mentally defective 
children of the school were segregated and given a cur- 
riculum suited to their limitations. In this class he 
adjusted himself to the schoolroom routine fairly well 
until he got into a quarrel with another boy over the 
possession of a piece of wood. He was holding a razor 
blade in his hand at the time, and in the course of the 
struggle the other boy was cut on the wrist. The 
charge of assault and arrest followed, and the commit- 
ment to the hospital for observation. The psycho- 
metric examination showed a mental age of 6 years 
2 months. His chronological age, as stated above, was 
11 years 10 months. (This made the I. Q. 52.) In 
view of his obvious mental deficiency he was returned 
to court with a statement to the effect that he could 
not be considered responsible for the act with which 
he was charged. 
There are cases of mental deficiency among 
school children which may be traced to some dis- 
turbance in the glands of internal secretion. In 
these cases, improvement is to be anticipated if 
proper medical treatment is given. 
Case 96 
A boy was sent to the clinic by his teacher because 
of his nervousness and inability to learn. He was re- 
ported to have been restless all his life, moving about PITFALLS OF OUR MINDS 
381 
continually even in his sleep. His muscles twitched 
continually, and he did not sit still but was constantly 
moving about in his chair, even when being examined. 
The psychometric examination gave him a mental age 
of 6 years 4 months. His chronological age was 8 
years 6 months (I. Q. 74). This intelligence rating 
would rank him in the borderline class of mental de- 
fectives. Physically, he showed clinical signs of thy- 
roid insufficiency. He was placed on thyroid extract 
over a six-month period, and showed constant improve- 
ment, becoming less nervous and getting on better with 
his lessons at school. 
Case 97 
In another case of glandular imbalance the pituitary 
gland was involved. This was in a girl who was ex- 
cessively overweight. She also showed other clinical 
signs of endocrine disturbance, and the X-ray revealed 
a typical dyspituitarian skull formation. Her develop- 
mental history gave an account of retardation in physi- 
cal and mental development. She did not begin to 
walk until she was 3 years of age, and did not talk 
until the age of 4. Her teeth did not appear until she 
was 2 years old. There was a history of convulsions 
during the first three years of infancy. Her appetite 
was abnormal, especially her craving for sweets. 
Menstruation was precocious, being established at the 
age of 10. For a long time this girl would not co- 
operate on the psychometric examination. When 
finally persuaded to respond to this test, she made a 
mental age of 4 years 6 months on the Stanford-Binet 
in contrast to her chronological age of n years. (Her 
I. Q. was 40.) She was sent to an institution for men- 
tal defectives, where she could receive treatment for 382 
ABNORMAL BEHAVIOR 
her glandular disturbance and at the same time be 
given proper educational training. 
Occasionally we find a case in which we hesitate 
to make a definite diagnosis of mental deficiency, 
even when the rating on the psychometric exami- 
nation is indicative of feeble-mindedness. This is 
especially applicable in instances when we are con- 
sidering very young children in whom there is hope 
for improvement with change in physical condition 
or environmental circumstances. We quote two 
such cases in which a definite diagnosis of mental 
deficiency was considered unfair: 
Case 98 
A boy of 12 years 4 months, who was brought to the 
hospital for observation, achieved a mental age of 
8 years 6 months on the Stanford-Binet. (I. Q. 68.) 
He was in the ungraded class at school, had fallen in 
with some bad boys in his neighborhood and been 
arrested for stealing. This sounded like a typical case 
of mental deficiency, yet there were other factors which 
caused one to hesitate before making a hard and fast 
diagnosis of innate mental defect. His development 
had been normal during the infancy period. He had 
walked and talked at the usual age. His attendance 
at school had been irregular, and he had never been 
to school until 9 years of age. This brief and inter- 
mittent school attendance would in itself partly ac- 
count for his inability to read and write. The physical 
examination revealed the existence of a chronic heart 
disease, which reacted on his whole personality, caus- 
ing an attitude of listlessness and depression. It was PITFALLS OF OUR MINDS 
383 
obvious that he put forth little effort on the psycho- 
metric examination, and that the Stanford-Binet rating 
quoted above could therefore not be accepted as un- 
questionably accurate. A diagnosis of mental retarda- 
tion was made, and the boy was transferred to the 
medical ward for treatment for his heart condition. 
Case 99 
An eight-year-old boy was committed from the court 
for observation. He had been taken to court by his 
father and stepmother, who complained that he ran 
away from home continually and asked to have him 
committed to some institution. On the psychometric 
examination this boy rated as 5 years mental age. 
With his chronological age of 8 this gave him an I. Q. 
of 62. The physical examination was negative. His 
developmental history showed some retardation in both 
physical and mental development, he was slow in learn- 
ing to walk and talk, etc. There was an unfortunate 
home situation, however, which was to be considered 
as well as these other facts. The boy’s mother had 
died when he was a small child, and the stepmother 
was so cruel that the neighbors often threatened to 
interfere in his behalf. It was not strange that under 
these circumstances the boy often ran away from home. 
He was recommended for institutional care more to 
free him from the intimidating presence of his step- 
mother than because of certainty that he was as defec- 
tive as the tests indicated. 
It is manifestly unfair to any child to make a 
definite diagnosis of mental deficiency if there are 
existent any factors which offer hope of a tem- 
porary condition of mental retardation due to other 384 
ABNORMAL BEHAVIOR 
causes than innate intellectual defect. In such 
doubtful cases no effort should be spared to bring 
about improvement before the child is disposed of 
in the special class for defectives or in an institu- 
tion for the feeble-minded. It is for the avoidance 
of incorrect diagnoses in such doubtful instances 
that we insist upon a consideration of the physical 
condition, home surroundings, etc., of our retarded 
children as well as the rating of the psychometric 
examination. 
A certain number of maladjusted children will 
be found to be suffering from some definite disease 
such as epilepsy. The epileptic child may have 
such a severe form of the disease as to make con- 
tinuation in school impossible, he may be gradu- 
ally deteriorating intellectually as a result of his 
attacks, or he may have the disease only in the 
form of psychic equivalents which are manifest in 
some kind of misbehavior not readily recognizable 
as of epileptic origin.1 It must be borne in mind 
that these cases of epilepsy in both school children 
and adults can be ameliorated to a marked extent 
by proper medical treatment. Under favorable 
conditions, the epileptic child responds to therapy 
very well, and is enabled to go on with his school 
and eventually to enter upon some vocational 
pursuit. 
1 A case of this type has been given in detail in Chapter 
VIII, showing a school maladjustment resulting from epilep- 
tic manifestations, which long remained unrecognized. PITFALLS OF OUR MINDS 
385 
Case too 
One school boy had had epileptic attacks since the 
age of 7. These attacks occurred every six or eight 
weeks, and interfered a great deal with his school 
work. At the age of 16, when he left school, he had 
only reached the fourth grade. His mental age on the 
psychometric examination at this time was only 9 years 
5 months. (I. Q. 58.) He had been in charge of 
the Catholic Guardian Society for some time, as both 
his father and mother were confined to hospitals for 
the insane. His epileptic attacks interfered with his 
adaptation even more after leaving school than had 
previously been the case. He could always go back 
to class after having an attack, but he could not retain 
a job under these circumstances. When his school 
career was over, therefore, it became necessary to 
commit him to a state colony for epileptics. 
Case ioi 
In another case, the result was entirely different. 
This was a bright child who was in the second year 
of high school at the age of 13 years 8 months and 
whose mental age on the Stanford-Binet was 14 years 
8 months (I. Q. 107). He began to have epileptic 
attacks at the age of 12. Previous to this he had been 
one of the best pupils and had skipped one or two 
grades. The epileptic attacks which he developed 
were severe enough to interfere with his school prog- 
ress rather seriously. He came to the clinic and was 
given medical treatment over a period of three months. 
He was first tried on sodium bromide, then on luminal 
and finally thyroid and later pituitary. The pituitary 
was found to be the most effective medication in his 386 
ABNORMAL BEHAVIOR 
case. After this treatment he was able to continue 
his work free from attacks. 
Cases of congenital lues (syphilis) in school 
children may cause a gradual deterioration in the 
quality of the school work, or may be manifest 
in misconduct. The former condition is due to 
gradual development of the disease in which vision, 
hearing, speech, etc., become affected. 
Case 102 
An eleven-year-old boy was sent to the hospital for 
treatment for congenital syphilis. His mother was in 
a hospital for the insane suffering from general paresis. 
The boy rated as of normal intelligence on the psycho- 
metric examination, and although he was only in the 
third grade at school he had never repeated any grades. 
For the past year or two, however, his parents and 
teachers had noticed a gradually progressive deafness 
and increasing impediment of speech. The boy him- 
self made no complaint except for frequent headaches. 
He became irritable and restless, and was unable to 
concentrate on his studies. His eyesight began to give 
him some trouble. The physical examination gave 
him a four plus Wassermann; there was a fine tremor 
of hands and tongue, and a noticeable slowness and 
hesitancy of speech. He was diagnosed as suffering 
from congenital lues and medical treatment was 
recommended. 
Case 103 
Another child whose failure in school could be traced 
to a syphilitic inheritance was a little girl of eleven. 
Her father had been treated for this disease, but had PITFALLS OF OUR MINDS 
387 
considered himself cured, and had never told his wife 
of his infection. The child got on at school very well 
at first, and succeeded in reaching the third grade. 
Then she began to get inattentive, grew dull and 
stupid, and ceased to talk clearly. By the time she was 
brought to the hospital, she was unable to make herself 
understood when she spoke, and her attitude was one 
of extreme dullness and stupidity. Physical examina- 
tion revealed a faint rash on chest and shoulders, 
stiffness of ankle joints, slightly spastic gait. Blood 
Wassermann was four plus. All these clinical signs 
indicated congenital lues. The child was given sal- 
varsan over a period of several months. Her condition 
gradually improved; her speech became clearer, she 
began to take an interest in the games of other chil- 
dren on the ward and was finally permitted to go home 
with her mother. 
Syphilitic infection in children may take the 
form of juvenile General Paresis. When this oc- 
curs, marked conduct disorders are apt to be de- 
veloped, as in the cases of adult General Paresis 
reported in Chapter VI. 
Many cases of conduct disorders in school chil- 
dren may be traced to mental disturbances follow- 
ing attacks of epidemic encephalitis (sleeping 
sickness). Children who return to school after 
having this disease often are restless and trouble- 
some from a disciplinary viewpoint. Sometimes 
they show improvement with the lapse of time, 
and their mental functions are restored. This was 
true of the following case: 388 
ABNORMAL BEHAVIOR 
Case 1041 
A boy, aged nine years. Chief complaint, insomnia 
at night and somnolence during the day. Unable to 
learn well. The family history, both maternal and 
paternal, was good for two generations back. They 
were of German descent. 
The patient was of normal birth; he had had none 
of the other diseases of infancy except measles. He 
was considered an average child, learned easily and 
had acquired a good knowledge of both the German 
and English languages. When the United States en- 
tered the war, in 1917, the father, who, although an 
American citizen, was residing in Germany, was held 
as an alien enemy and the family suffered great priva- 
tions. They lived close to the fighting zone and were 
in several air raids. The greater part of the time 
they were compelled to live in a cellar. 
At the conclusion of the war, the family migrated 
to America. The child got along very well with other 
children and made an excellent adaptation to his new 
country. 
In January, 1920, the patient was taken ill sudj 
denly with fever and restlessness and, later, somno- 
lence. He slept for six continuous weeks. At times 
he was in delirium, in which he would call to his mother 
and point at the ceiling, saying there were aeroplanes 
and Zeppelins around and asking her to remove him 
to a cellar. 
At the end of six weeks the fever gradually declined 
and he began to sit up and his sensorium gradually 
cleared. In March, his mother took him to the Cats- 
1 Reported by Leahy and Sands in New York Medical 
Journal, Aug. 3, 1921. PITFALLS OF OUR MINDS 
389 
kill Mountains, where he remained for two months. 
After his return from the mountains the patient had 
become quite restless; he became rather disobedient, 
would not mind his mother, and had a ravenous appe- 
tite. He could not sleep at night and would prevent 
his mother from sleeping. During the daytime, how- 
ever, he would often go to sleep, even while standing. 
It was impossible for him to learn readily and in talk- 
ing he would frequently interpose English words when 
speaking German and vice versa. He remained in- 
doors the greater part of the day and would not asso- 
ciate with the other children. 
In January, 1921, he was admitted to Bellevue 
Hospital. He was well developed and well nourished, 
and generally in good physical condition. His heart 
and lungs were normal. There was no neurological 
disturbance. 
Mentally, he was at first rather quiet, somewhat for- 
getful, did not know anything about his clothing, ap- 
peared rather restless, and seemed to prefer to be by 
himself. He would frequently interchange his German 
and English when speaking. He did not associate with 
the other children in the ward. He did not seem to be 
pleased with his examination, cooperated very poorly, 
and showed considerable irritability. His mental ten- 
sion was definitely lowered; his memory and retention 
were somewhat impaired. He showed definite attention 
disorder and could not hold his attention on one sub- 
ject for any length of time. Intelligence examination 
by the Stanford-Binet on January 28th showed that 
he had at that time a mental age of 6 years 4 months. 
His chronological age was at this time 9 years 9 
months (I. Q. 67). The psychologist, however, wisely 
added that the patient ought to be retested later, as in 
view of his personal history it was quite possible that 390 
ABNORMAL BEHAVIOR 
his difficulties might be due to some other cause than 
an intellectual defect, and that the mental age and the 
intelligence quotient obtained on this test were prob- 
ably incorrect. 
The patient was immediately placed with the other 
children. He required no sedatives nor any milder 
therapeutic measures. He was kept from sleeping 
during the day, was allowed to attend his school both 
in the morning and afternoon and was placed upon 
occupational therapy. He gradually became brighter, 
liked to associate with the other patients, and slept 
very satisfactorily at night. His condition, though far 
from satisfactory, indicated that he was on the way to 
greater improvement. 
A mental test, done on March nth by the same 
psychologist, placed the mental age of the patient at 
7 years io months. His chronological age was now 9 
years 10 months (I. Q. 80). A supplemental note by 
the psychologist stated that the gain of one year and 
six months in his mental age was accompanied by 
considerable improvement, both in his attitude and 
general conduct. On the ward, he was less timid and 
talked more freely. Shortly after this he was able to 
go home with his parents. 
Case 105 
A girl of 8 was brought to the hospital suffering 
from a post-epidemic encephalitis syndrome. She 
was of normal intelligence, and was in the second grade 
at school. She was a problem to her mother and 
teacher, because of her stubbornness and tendency to 
run away from home and school. Her irritability and 
restlessness developed after an illness which was diag- 
nosed as influenza at the time, but was more probably 
epidemic encephalitis or sleeping sickness, as it had 
the usual symptoms characterizing that malady. PITFALLS OF OUR MINDS 
391 
Case ioo 
One of the boys of the observation ward might have 
been expected to develop some form of post epidemic 
encephalitic disorder, for his heredity indicated a pre- 
disposition to instability. His father and mother were 
both alcoholic. The mother was immoral and sepa- 
rated from the father. One of his brothers was de- 
fective mentally. The boy lived with his father and 
stepmother. The latter was a drug addict, and pro- 
vided a home that was anything but stabilizing for 
the child. His developmental history was negative 
except for an attack of meningitis in early childhood. 
Strangely enough, Joseph seemed to suffer no ill effects 
from this disease, but got on very well in school, reach- 
ing the fourth grade at the age of io years. At this 
time he became ill with epidemic encephalitis. The 
attack lasted three weeks, during which time he was 
delirious for several days, saw double, etc. Since this 
illness he had been unable to get on in school. He 
felt drowsy and had no ambition, although his illness 
had occurred a year and a half ago. In school he 
was not able to get along with other children, but 
teased them and beat them. He also began to steal. 
At the hospital, the physical examination was prac- 
tically negative, and the psychometric examination 
rated him as of normal intelligence. The only ex- 
planation for the change in his personality make-up 
and conduct was that he was suffering from a post- 
encephalitic syndrome. 
Mental diseases of all types also have a share 
in the production of abnormal behavior in school 
children. A sudden failure in the hitherto satis- 
factory pupil, accompanied by a change in per- 392 
ABNORMAL BEHAVIOR 
sonality traits and behavior is always ground for 
the suspicion that the child is developing a mental 
disorder of some sort. Manic-Depressive attacks 
and the early symptoms of Dementia Praecox occur 
to some extent among school children, especially 
in the upper grades and high school. The follow- 
ing case may be cited in this connection: 
Case 107 
A certain boy who had entered school at the age of 
6 made very good progress until the age of n, when 
he failed to pass the fifth-grade work, and was forced 
to repeat that class. For the two years previous, he 
had been growing increasingly irritable, and had de- 
veloped a tendency to temper tantrums. He now be- 
came entirely unmanageable, stayed away from school 
and from home, began to take sums of money from 
his mother and even displayed assaultive tendencies. 
He was finally brought to the hospital after having 
attempted to commit suicide. He was found in his 
room with the gas turned on. He explained that he 
had decided upon this course because he was tired of 
hiding from the truant officer. His attempt to take 
his life was serious enough; he was partially uncon- 
scious when discovered. 
This boy was of normal intelligence, but was suffer- 
ing from a depression. His psychotic state rendered 
him liable to do injury to himself or others. On the 
ward he was unmanageable, would give way to temper 
tantrums without obvious reasons and would attack 
the other children. His heredity probably gave him 
a predisposition to instability. His father had been 
so unstable and bad-tempered that the mother was PITFALLS OF OUR MINDS 
393 
unable to live with him. The boy was diagnosed as 
suffering from an undifferentiated depression. Against 
the advice of the physicians, his mother insisted on 
taking him home. 
Case 108 
A boy of 17 was brought to the hospital by his 
mother. He had a history of petty thieving, and was 
reported to have repeated the eighth grade three times, 
although previously able to get on well in school. He 
refused to work, played only with small children, etc. 
The rating on the Stanford-Binet gave the boy a 
mental age of 12 years 10 months (I. Q. 80). The 
performance ranged from a basic year of seven to a 
group limit of sixteen years, with several failures at 
the twelve year level, almost complete success at the 
fourteen year level, and then a sudden cessation of 
successes with only one correct response at the six- 
teen year level. This uneven distribution of perform- 
ance was not in itself sufficiently erratic to excite 
suspicion, were it not for the fact that it was accom- 
panied by a noticeably indifferent attitude with appar- 
ently no affective reactions. This dreaminess and in- 
difference would make one suspect some incipient 
mental disorder of the dementia praecox type. 
The boy’s history was also suggestive of some men- 
tal trouble. He had always been seclusive and never 
played with other boys, but sat by himself and 
read. Up to the eighth grade he had been fairly 
successful in his school work. When called upon to 
explain why he played only with small children, he 
replied: “ They are not strange children; they are my 
little cousins.” He stated that he stole money from 
his aunt because he “ wanted to sit in a box seat at the 394 
ABNORMAL BEHAVIOR 
theatre.” He appeared not to realize the inadequacy 
of these explanations, which showed a lack of insight 
on his part. He gradually grew worse, and was finally 
diagnosed as Dementia Praecox. 
Some children of unstable mental make-up de- 
velop psychoneurotic symptoms which interfere 
with their school adjustment. Often these pupils 
are bright enough intellectually, and would get on 
very well in school but for their psychoneurotic 
tendencies. 
Case 109 
One psychoneurotic boy found it difficult to adjust 
himself to a new school environment. He had been in 
the Boston schools until 12 years old, and had gotten 
on very well. Just as he was entering the seventh 
grade, his family moved to New York. The boy thus 
had to enter a new school and adapt himself to a new 
group of classmates. He complained that the boys 
teased him because he was Jewish, and that the teacher 
called him a Bolshevik. He began to stay away from 
school, and his parents were unable to make him at- 
tend. He was adjudged a case for the truant school, 
but the school physician intervened in his behalf, and 
asked that he be sent to the hospital for observation. 
The boy was found to be of average intelligence. 
His mental age on the Stanford-Binet was 13 years. 
(Chronological age n years n months, I. Q. 109.) 
The physical examination was negative. He was 
cheerful on the ward, but for a long time refused to 
discuss the subject of school. It was finally found 
that he associated all sorts of fears with his school 
situation. He was afraid of his teacher, was afraid 
that he could not accomplish the work assigned, felt PITFALLS OF OUR MINDS 
395 
that the other boys did not like him, etc. He longed 
to be back in the old familiar places. An attempt was 
made to induce him to rationalize his attitude, and he 
was sent back home to make a second trial at 
adjustment. 
The child who suffers from a manic-depressive 
attack or from psychoneurotic symptoms is often 
only temporarily maladjusted. We may hope for 
his improvement and return to the school environ- 
ment to complete his school work in a satisfactory 
manner. There are other cases of misconduct 
among school children where the outlook is not so 
hopeful. These are the types whom we designate 
as psychopathic personalities, and whose erratic 
behavior is a constant source of difficulty to parents 
and teachers. 
Case iio 
A 12-year-old boy was brought to the hospital for 
examination as to his mentality, with a history of 
truancy, lying, stealing and general incorrigibility. 
He was found to be of normal intelligence. The physi- 
cal examination was negative. There was no history 
of significant hereditary characteristics, and the home 
environment appeared to be a normal one. This child 
had always been unstable and troublesome. He would 
cry easily, but always forgot his promises to do better. 
He took money from his parents and from the teacher’s 
desk. At times he would run away and be gone for 
several days in succession. He had always been rest- 
less and over-active, with a history of talking in his 
sleep. He read a great deal, and seemed to be imagi- 
native. He told of stealing money to go to the country 396 
ABNORMAL BEHAVIOR 
because he wanted to go to work on a farm. In spite 
of his intellectual capacity he had had to repeat three 
grades in school. At the age of 12 he was in the 
sixth grade, having made up the work for one grade 
in summer school. When settled down to work he 
could accomplish his lessons satisfactorily, but his 
peculiar personality seldom permitted him to do this. 
There seemed little indication that he would ever ad- 
just himself to the requirements of the school. He 
appeared to have no realization of the seriousness of 
the habits he was forming. He cheerfully admitted 
various thefts, explaining that he didn’t think the 
things would be missed. He seemed to feel that his 
running away was sufficiently explained by his desire 
to go to the country. 
Case iii 
Allan D. was another psychopathic child. Although 
of average intelligence, his inattention and lack of 
application had caused him to repeat several grades 
so that at the age of 16 he was only in the eighth 
grade, and had just failed to pass this. He had never 
been truant except on one occasion, but was guilty of 
plenty of misconduct along other lines. He was 
known to lie and steal and was suspected of sex as- 
saults on his 6-year-old brother and on a little girl 
in the neighborhood. His mother considered that 
he always had been peculiar. She said that he was 
wilful and disobedient. His father had been untruth- 
ful, headstrong and immoral. His stepfather had been 
very kind to the boy. Allan himself admitted this, 
and confessed that whenever he said other things 
about the stepfather he was not truthful. The boy 
claimed to have a deep affection for his mother, yet PITFALLS OF OUR MINDS 
397 
he did not hesitate to do things to grieve her. He 
seemed entirely lacking in moral responsibility. His 
physical examination was negative. The only ex- 
planation for his conduct was his psychopathic per- 
sonality make-up. 
The neurotic child is often a problem in school, 
although a less serious one than the psychopathic 
type. Neurotic children are apt to be irregular 
in attendance on account of illnesses, and are 
so sensitive and shy in school that it takes an 
exceptional teacher to get them to do themselves 
justice. Out of their poor physique and sensitivity 
develops a lack of self-confidence and a feeling of 
inferiority which interferes with their success in 
class work to a marked degree. 
Case 112 
June F. was 16 years of age. She was a prob- 
lem to her teachers because she was not doing well 
in her school work and because of her peculiar habits. 
She was felt to be a slight disciplinary problem be- 
cause she did not hesitate to disturb the routine of 
the class-room in order to call attention to herself. 
June’s intelligence was found to be only average, while 
she was attending a school in which most of her class- 
mates ranked as decidedly superior in intelligence 
rating. Thus at the outset she was under a heavy 
handicap. She might have overcome this by diligence 
and application but for her sensitive and neurotic 
make-up. 
At the beginning of the examination June was ex- 
ceedingly antagonistic. Unwittingly, she betrayed her 398 
ABNORMAL BEHAVIOR 
sensitiveness and feeling of inferiority at the start by 
inquiring if she were considered a dummy that it was 
felt necessary for her to have an interview with the 
school psychologist. After some discussion of her 
trouble with French and other subjects, she became 
more confidential, and admitted that she had always 
been over-sensitive, that she used to cry at the slightest 
criticism, and that her attempts to overcome this ten- 
dency had resulted in the assumption of the bold and 
indifferent attitude which was criticized by her 
teachers. She went on to explain the peculiarities of 
conduct which her teachers had mentioned by saying 
that she hated to do things just as everyone else did 
because she desired to be original. Her seclusiveness 
and lack of comradeship with the other girls she at- 
tributed to her sensitiveness; she hesitated to make 
advances to the girls in this new school lest they repel 
her friendliness. 
This girl needed to rationalize her attitude to some 
extent. She was led to understand the nature of her 
feeling of inferiority, and to see that it was a tempera- 
mental trait, and that she need not fear that others 
would underestimate her as she did herself. She was 
told that she must give the other girls a chance to know 
her and like her, as they could not help doing once she 
permitted them to become really acquainted with her 
actual self. Her teachers were advised to give her 
praise and encouragement, and to overlook her pecu- 
liarities and avoid calling attention to them as much as 
possible. Private tutoring in French was also advised 
for June until she had caught up to the standards of 
her new school. PITFALLS OF OUR MINDS 
399 
Case 113 
Charlotte S. was another neurotic child. She was 
rather dull intellectually, and her mother brought her 
to the physician as much on account of her backward- 
ness in school as for treatment for her nervous condi- 
tion. Charlotte was exceedingly restless. She could 
not sit still during the examination, and her mother 
said the same thing occurred wherever she was. At 
the theatre she would bite her handkerchief, etc. 
Charlotte’s early developmental history showed little 
of significance. She walked and talked at the usual 
time. There was a history of walking and talking in 
her sleep, however. Menstruation was established at 
the age of 12, but had been very irregular. (The girl 
was now 13 years n months of age.) Charlotte had 
had a great deal of illness. She had diphtheria twice, 
had whooping cough and pneumonia at the same time, 
and had had measles. She had been operated on for 
appendicitis, and had had tonsils and adenoids re- 
moved. She had had a great deal of trouble with her 
nose and throat and frequently had hemorrhages from 
this source. 
On the psychometric examination she achieved a 
mental age of 11 years (I. Q. 79). In view of her 
nervousness and evident hesitancy in responding, this 
rating may not have represented her best effort. She 
had a tendency to become confused when questions 
were put to her, and much tact and patience were 
necessary to persuade her to attempt a solution of 
many of the problems. It was found that she was 
often able to solve problems to which her initial re- 
sponse was “ I don’t know ” when she was encouraged 
to attack them. One might suspect from this that her 
backwardness in school was partly due to her nervous- 400 
ABNORMAL BEHAVIOR 
ness and lack of self-confidence. She certainly ap- 
peared too dependent on her mother for a girl of her 
age, constantly looking to her for advice as to how to 
answer questions, etc. 
Physically, this girl showed some clinical signs in- 
dicating the possibility of glandular imbalance. There 
was also a question of visual defect. It was felt that 
much might be done to overcome her nervous symp- 
toms through attention to her physical condition and 
establishing a more normal relationship with her 
mother. She was sent for a thorough optical examina- 
tion, and was started on medical treatment for her 
nose and throat and for her probable endocrine dis- 
turbance. Her mother was made to realize the neces- 
sity for the development of independence and respon- 
sibility in her daughter, and her cooperation for this 
purpose enlisted. 
In any study of educational maladjustments, the 
factor of adolescence must not be overlooked. 
The adolescent period is normally one of restless- 
ness and thirst for new experiences, and carries 
with it a rebellion against authority which is only 
an expression of the desire to become independent 
and assume responsibility. Without these im- 
pulses the boy and girl would remain too long under 
the parental protection, and seek to avoid the cares 
and responsibilities of adult life. Yet these ado- 
lescent activities, necessary though they may be 
to the development of the personality, are not al- 
ways in harmony with the school routine, and may 
be a source of some trouble to parents and teachers. PITFALLS OF OUR MINDS 
401 
Case 114 
One girl of 13, of superior intelligence, was a prob- 
lem to her teachers because she would not apply her- 
self to her studies. When interviewed she was per- 
fectly frank about the matter. She announced that 
she considered school a bore, that she hated being 
inside studying when she might be out doing something 
every minute. The only kinds of books she enjoyed 
reading were detective stories, because in those “ some- 
thing happened.” She liked to indulge in stunts 
which gave her a thrill of excitement. She thought 
it would be fun to burglarize a house, just to 
see if she could do it, and then return the things she 
had taken, of course. She was proud of the fact that 
none of her elders could restrain her. She boasted 
that she could make things so unendurable for her 
governesses that her parents could not find one who 
would stay long. All this was not conducive to study, 
but was a natural adolescent phase, for youth craves 
excitement and adventure, and is loath to be confined 
to books. There was nothing to do but let her 
naturally outgrow this stage of her adolescence. Her 
failures in school did not worry her, because she was 
fully conscious of her intellectual ability, and knew 
that she could easily maintain the standards of her 
class whenever she tried to do so. 
Case 115 
The desire to escape parental restraint built up a 
love of horseback riding in one girl of 14 so that she 
let this pursuit interfere with her studies. She had 
always had governesses who accompanied her wherever 
she went, except on her rides. As she expressed it, 402 
ABNORMAL BEHAVIOR 
if she came home with a low mark either her mother 
or her governess kept urging her to study every minute 
she was in the house. A recent absence from school 
on account of illness had resulted in poor rank in school 
work for that month, after which the difficulty began. 
In order to escape the nagging of her mother and 
governess, she would get her horse and go riding for 
hours although she realized that she ought to be study- 
ing, and was secretly anxious lest she have to repeat 
her grade. The prodding of her mother and governess 
did not tend to alleviate this anxiety, so that the child’s 
chief motive became a desire to escape from their 
authority. She became very sensitive and easily up- 
set. It was recommended that she be sent to a school 
in the country, where she could have more freedom 
than the city life permitted. Ostensibly, this was sug- 
gested on account of the nervous state which was 
rapidly developing in the girl, but in reality the recom- 
mendation was made in order to give her an oppor- 
tunity to enjoy a normal amount of freedom and 
independence. 
That adolescent ideals are not always those 
which are conducive to high scholarship and as 
such would be approved by teachers, can well be 
imagined. 
Case 116 
One girl of 15, who ranked as of very superior in- 
telligence on the Otis Group Test, was nevertheless 
failing in her school work. Her physical condition 
was good, she had a normal personality make-up, and 
her home environment was excellent. The whole dif- 
ficulty was in her attitude toward school. To her 
mind, school was simply a place to spend the time PITFALLS OF OUR MINDS 
403 
until she should be old enough to “ come out.” Her 
chief topics of conversation were social activities, and 
what all the “ debs ” she knew were doing. She had 
no desire to rank high in her studies. She and her 
chums agreed that study was a waste of time. It was 
their ambition to become clever if superficial conversa- 
tionalists. 
Case 117 
Another girl, 16 years of age, did not see why her 
teachers should expect her to get good marks in her 
studies in view of the fact that her chief interests were 
art and athletics. She really disliked school, because 
it used up so much time when she might have been 
painting. It was endurable only because of the gym 
work. She came down to the examination in her gym- 
nasium suit, and could hardly sit still to talk, she was 
so eager to get back to gym. Her hair was closely 
cropped like a boy’s in order to have it out of the way 
while she was performing athletic stunts. Her dreams 
were concerned with wrestling and fighting. Her day- 
dreams were of the time when she would work out a 
technique of her own, and would be recognized as the 
originator of a new style of painting. It is not easy 
to see how this interest could be transferred to any- 
thing so prosaic as study. Perhaps a thorough psycho- 
analytic study would have revealed a “ masculine pro- 
test ” beneath the surface of this girl’s mental life. 
The influence of an idolized teacher might be utilized to 
change her hopes and aspirations to some other theme. 
Before we turned her energy into other channels, how- 
ever, we should want to be certain that she lacked 
real ability for artistic accomplishment, which might 
be her proper vocation. 404 
ABNORMAL BEHAVIOR 
Probably the largest percentage of school mal- 
adaptations go back to emotional conflicts centered 
around pathological family and home life. These 
conflicts are as many and varied as are the family 
situtions which create them. Some children are 
antagonistic to their parents, and carry their re- 
bellion against parental control over into refusal 
to accept the authority of teachers. This is par- 
ticularly apt to occur at adolescence, as we have 
stated. Perhaps the home atmosphere may be 
such as to develop a timid and shrinking person- 
ality in the child, and to breed a lack of self- 
confidence which interferes with his making the 
best possible showing at school. Unharmonious 
relations between parents may produce a feeling 
of unhappiness in the child, until he broods over 
their difficulties instead of applying himself to his 
work in the classroom. Almost any disturbing 
element in the home may become a source of 
anxiety and emotional disturbance in the mental 
life of the child, and is reflected in his behavior. 
Sometimes the inability to do well in school work 
can be connected with a home situation which 
causes nervous strain and interferes with the child’s 
regular habits of sleeping, etc. 
Case 118 
One girl of 14 who was not keeping up in her school 
work was at first a puzzle to the examiner. She was 
bright intellectually and there was no physical diffi- 
culty to account for her poor effort. Although not a 
neurotic or over-emotional type, this girl did give the PITFALLS OF OUR MINDS 
405 
impression of being rather tense nervously. Her in- 
terest was apparently centered in her school work, 
and she frankly admitted that she wanted to pass her 
examinations and go on with her class more than any- 
thing else in the world. At last it was revealed that 
this child had an invalid mother. In the evening, 
when she should have been doing her home study, she 
was playing cards, etc., with the invalid in order to 
amuse her. Her afternoons were often given over to 
this duty, also. What studying she did manage to do 
at home was accomplished in the late evening hours 
when she should have been sleeping. The combina- 
tion of anxiety about her mother and continual loss 
of sleep were interfering with her school work to a 
marked degree. 
In other homes, the parental attitude builds up 
a fearfulness and timidity in the child which pre- 
vents adjustment to the school routine. 
Case 119 
Adelaide was a 12-year-old girl whose mother be- 
lieved in being the undisputed head of the household. 
Adelaide spent most of her time in school worrying 
about her lessons, not because she was afraid of her 
teachers, but because she dreaded having to carry home 
a poor report to her mother. Her anxiety interfered 
with her efficiency as a student to a marked degree. 
Her dream life reflected her emotional disturbance. 
One of the dreams she recounted was of a girl with 
red hair, whose mother and sisters were unkind to her. 
(Adelaide had red hair. She also had a sister whom 
she felt to be her mother’s favorite child.) In the 
dream, the red-haired girl’s mother died. Then the 406 
ABNORMAL BEHAVIOR 
girl went to live with an aunt in the country where 
she had a glorious time. The natural solution for such 
a type of maladjustment as Adelaide presents is re- 
moval from the unfortunate home situation. In her 
case, transference to a boarding school was recom- 
mended. 
In many well-to-do families, the governess be- 
comes the center of an emotional disturbance. 
The methods employed by governesses to exact 
obedience from their charges are often open to 
criticism. Fear is a favorite method of control, 
but it often reacts disadvantageously on the child. 
Katherine was a small child in the third grade. She 
was restless and mischievous in school to such an ex- 
tent that she became somewhat of a disciplinary prob- 
lem to her teacher. She was in good physical condi- 
tion and her intelligence was distinctly superior. Her 
home situation appeared good at the first inspection. 
There was the not unusual conflict with brothers and 
sisters, with much mutual teasing and fighting, but 
this did not seem sufficient in itself to explain 
Katherine’s restlessness in school. Indeed, one would 
have expected her to use up much of her surplus energy 
in this way. 
A glance at Katherine’s dream life proved illuminat- 
ing. A new governess had recently entered upon the 
home scene. Since her advent, Katherine had been 
having fear dreams. Were they connected with the 
governess? Not openly, at any rate. For instance, 
she had dreamed of being alone in a great forest, when 
suddenly a huge owl swooped down and began to carry 
Case 120 PITFALLS OF OUR MINDS 
407 
her off. Another dream pictured Katherine alone in 
a big, dark hall, when suddenly a frightful woman 
jumped at her, made awful faces at her and seized her, 
whereupon she awoke thoroughly frightened. She re- 
luctantly admits that she did have one dream con- 
cerning the governess in person — when she thought 
the governess had gone away and that she was alone 
with her mother and father. In this dream she felt 
very happy. 
Repeated questioning now elicited the information 
that the new governess was in the habit of punishing 
the children by striking them, and that she had threat- 
ened them with worse punishment if they mentioned 
this fact. This admission was drawn from Katherine 
with difficulty; she always blushed and became uneasy 
whenever the governess was mentioned, an affective 
reaction which in itself was sufficient to excite suspicion 
as to the relations between the two. It now became 
evident that one source of Katherine’s restless and 
mischievous conduct might be undue repression at 
home under the new regime. The recommendation in 
this case was of course to get rid of the governess. 
There is probably no other home situation which 
can cause as much distress in the child as the feel- 
ing that he is not wanted by his parents. 
Case 12 i 
Christine T. was an excellent example of this. She 
had been placed in a boarding school by her mother, 
and had given the teachers much trouble by running 
away. She was slightly below average in intelligence, 
but was not defective. She was a somewhat neurotic 
type, but her chief difficulty is brought out in her own 
account of her situation: 408 
ABNORMAL BEHAVIOR 
“ My mother put me in boarding school when I was 
a little girl, right after my father died. I was there 
nine years. (I am 14 and a half now.) My mother 
never came to see me, not even when I was sick with 
chorea these last five years. This fall, when I got 
well from chorea, they wanted to put me back in the 
sixth grade, where I had left off. I was a lot bigger 
than any of the other children in that class, and I 
didn’t like the school any more. So last week I ran 
away and came home to my mother. She didn’t want 
me, she just tried to send me back to the school, so I 
ran away from her, too. A policeman brought me here 
to the hospital. He found me crying on the street.” 
This child was so bitterly grieved by her mother’s 
attitude that she refused to see her when she came to 
the hospital. What she needed was not to be returned 
to the former school, but to be given to foster parents 
who would supply the affection which she had been 
denied all her life. 
Besides these gross maladjustments which occur 
in school children, there are less flagrant ones which 
are connected more intimately with the method of 
education itself. Cases of special disabilities in 
reading, spelling, or arithmetic are sometimes 
found among the backward groups. These types 
of educational problems have been adequately de- 
scribed by several psychologists, notably by Dr. 
Bronner, Dr. Leta Hollingworth and Dr. Arthur 
Gates. Such specialized types are principally of 
pedagogical concern, and are not directly produc- 
tive of abnormal behavior. Studies have also been 
made of speech disorders among school children. 
Dr. Smiley Blanton and Dr. Margaret Blanton PITFALLS OF OUR MINDS 
409 
have made excellent contributions in this field, 
which is also somewhat apart from that of conduct 
disorders, and will not be discussed in this chapter. 
Often we find a child in school who is 
maladjusted for many reasons, all of which con- 
tribute to the final picture. One such case may 
well be presented at this point, as an illustration 
of the necessity for thorough study of the child 
before making diagnosis and outlining treatment. 
Case 122 
The parents of a certain eleven-year-old girl became 
anxious over her apparent dullness. They complained 
that she could not get on in school, that she could not 
seem to comprehend many things easily grasped by 
the average child, such as plots of motion pictures, etc. 
They were almost convinced that the child was men- 
tally defective, and being intelligent people themselves, 
were very much upset by this idea. 
This child had a very comfortable home. Her 
heredity was good, although her father was a 
somewhat unstable type. Her developmental his- 
tory showed that she had been a delicate child 
from infancy. Shortly before the examination, she 
had been ill with epidemic encephalitis, which as we 
have seen is apt to have a long continued effect on 
the personality. Her vision was very defective, and 
she had a special disability in reading which had be- 
gun on account of uncorrected visual defect, and per- 
sisted in the habit of transposing letters in the words 
being read, which led to frequent mispronounciations. 
Her dullness in school and her inability to follow the 
stories of motion pictures were due to this special dis- 
ability. Her general intelligence, as measured by the 410 
ABNORMAL BEHAVIOR 
Stanford-Binet, was average for her age. She was 
11 years 3 months old chronologically, while her mental 
age on this test was 12 years. (I. Q. 106.) 
A feeling of inferiority had been developed in the 
child’s mental life. Her frequent illnesses formed the 
characteristic background for the growth of such a 
feeling, and it was intensified by her consciousness of 
her inability to read as well as her companions, etc. 
This sense of inferiority made her lacking in self- 
confidence, so that she seldom ventured to attempt 
even the type of work which she could have accom- 
plished in spite of her reading disability. This feeling 
of inferiority and lack of self-confidence was the worst 
aspect of her case, since it was the one most likely to 
lead to personal unhappiness, and interfered with her 
putting forth the effort necessary for rapid improve- 
ment. 
For this child there were many things to correct. 
She needed to be placed in a school where she could 
receive intensified and special instruction in reading. 
She needed a thorough eye examination, to be sure 
that her glasses corrected her marked visual defect 
adequately. She needed medical observation and 
treatment for post-encephalitic symptoms if any such 
existed. Most of all, she needed to have her feeling of 
inferiority removed and her self-confidence restored. 
This could be accomplished by wise parental attitude, 
and insight on the part of her teachers. 
We must always bear in mind the complex na- 
ture of the human organism, and the necessity for 
investigating the child’s life from every possible 
angle in our study of educational maladjustments. 
The source of abnormal behavior may be in the PITFALLS OF OUR MINDS 
411 
physical condition, in the relations with parents 
or other associates, in the personality make-up, the 
intellectual capacity, etc. Or it may be in a com- 
bination of these or other factors. Our medical 
examination must take account of the possibility 
of mental as well as physical disease. Our psycho- 
logical examination should include tests of special 
abilities and disabilities as well as those for the 
measurement of general intelligence. The socio- 
logical study should inquire into heredity, develop- 
mental history, relations in the home and school, 
play activities, type of companions, etc. We must 
also secure an insight into the child’s mental life 
in more intimate ways. We must obtain his con- 
fidence to such an extent that he will reveal his 
feelings and ideation to us in detail. We must 
know his hopes and fears, his ideals or his obses- 
sions with forbidden activities, his emotional re- 
actions in general. 
The cases reported in this chapter are only a few 
of the many types of abnormal behavior found in 
maladjusted school children. We have endeavored 
to cite a sufficient number of concrete instances 
of educational maladjustment to make it evident 
that the school problem is that of the individual 
child. The school system as originally planned 
was not founded on a knowledge of individual 
differences in either intellectual, physical or emo- 
tional make-up. There was a standard curriculum 
and an inflexible discipline, to which every pupil 
was indiscriminately expected to adapt himself. 
With our present knowledge of innate variations 412 
ABNORMAL BEHAVIOR 
in mental capacity and personality make-up, we are 
gradually improving this condition. Little by 
little, the educational system is being modified to 
suit the needs of the child. Special courses for the 
mental defectives, out-door classes for children 
suffering from incipient tuberculosis, rapidly mov- 
ing classes for pupils of superior intelligence, trade 
schools for individuals who are too dull to assimi- 
late the higher branches of academic instruction, 
and many other innovations have marked the prog- 
ress in pedagogical methods during the last decade. 
The adjustment of the pathological child does 
not always mean the transference to a class for 
atypical children, however. In many cases, it 
means intensive treatment of the child along other 
lines. Medical treatment, training in the forma- 
tion of personality habits, remodelling the home 
and other social milieu, are in order as often as 
pedagogical measures. Each child must be studied 
carefully, the causes of his abnormal conduct de- 
termined, and a plan of treatment mapped out in 
the light of our knowledge. No amount of group 
treatment can accomplish our purposes with the 
maladjusted child; he is always an individual, and 
must always be regarded as a separate problem 
needing the attention and care adapted to his own 
peculiar needs. 
SUPPLEMENTARY READINGS 
Blanton, Smiley. Speech Defects in School Children. 
Mental Hygiene, Vol. V, No. 4, October, 1921. This 
treats of a phase which is not entered into in this chapter, 
but which is worthy of reading. PITFALLS OF OUR MINDS 
413 
Bronner, Augusta. Psychology of Special Abilities and 
Disabilities. Little, Brown and Co., Boston, 1921. Dr. 
Bronner is an authority on this subject, and her book 
is invaluable. 
Campbell, C. Macfie. Nervous Children and Their Train- 
ing. Mental Hygiene, Vol. Ill, No. 1, January, 1919. 
Contains some valuable material. 
Idem. The Experiences of the Child: How They Affect 
Character and Behavior. Mental Hygiene, Vol. IV, No. 
2, April, 1920. An excellent article on habit formation 
in early life. 
Kenworthy, Marion E. Extra-Medical Service in the 
Management of Misconduct Problems in Children. Men- 
tal Hygiene, Vol. V, No. 4, October, 1921. An excellent 
article. 
Leahy and Sands. Mental Disorders in Children Follow- 
ing Epidemic Encephalitis. Jour. American Medical 
Assoc., Feb. 5, 1921, Vol. 76. Contains some detailed 
case studies, and should be read. 
Idem. Management of Children Presenting the Post- 
epidemic Encephalitis Syndrome. New York Medical 
Journal, Aug. 3, 1921. A continuation of the preceding 
series. 
Richards, E. L. Some Adaptive Difficulties Found in 
School Children. Mental Hygiene, Vol. IV, No. 2, April, 
1920. Describes the process of readjusting some mal- 
adapted children. 
Idem. The Elementary School and the Individual Child. 
Mental Hygiene, Vol. V, No. 4, October, 1921. Similar 
in nature to the preceding article, and should be read in 
conjunction with it. 
Idem. The Role of Situation in Psychopathological Con- 
ditions. Mental Hygiene, Vol. V, No. 3, July, 1921. 
Also contains some interesting cases of children. 
White, William A. The Mental Hygiene of Childhood. 
Little, Brown and Co., Boston, 1919. Presents the prob- 
lem from the viewpoint of psychoanalytic theory and 
practice. 
Woods, Elizabeth L. Talks with “ Every teacher ” on 
“ Everychild.” Published by the Wisconsin Dept. Public 
Instruction. A readable presentation of the various types 
of educational problems of childhood. Chapter XII 
VOCATIONAL AND INDUSTRIAL 
MALADJUSTMENTS 
Social psychology of labor unrest. 
Contrast between the old and new industrial eras from the 
psychological point of view. 
Present industrial system involves repressions and emotional 
conflicts. 
Relation of intelligence to occupation. 
Vocational maladjustments occasioned by placing the in- 
dividual in a type of work above his level of general 
intelligence. 
Case of the mental defective who was promoted above his 
mental level. 
Healthy unrest induced by the realization of not working 
up to one’s mental equipment. 
Vocational guidance should fit the individual to an occupa- 
tion correlated with his intelligence rating. 
Special abilities and disabilities which make for vocational 
aptitudes. 
Personality make-up as a factor in vocational success. 
Vocational maladjustment due to sensitive and timid per- 
sonality. Two cases which show this factor. 
Incipient mental disease a factor in vocational misfits. 
Some cases of Dementia Praecox showing effect on voca- 
tional adaptation. 
Manic-Depressive attacks in cases of industrial maladjust- 
ment. 
The psychoneurotics and constitutional inferiors as a 
vocational problem. 
Emotional disturbances a source of vocational dissatisfac- 
tion. 
Loss of the love object a cause of vocational failure in one 
case. 
414 PITFALLS OF OUR MINDS 
415 
Emotional conflict rising out of the family life transferred 
to the vocational situation. 
Vocational unrest must be thought of in terms of the 
individual. 
Necessity of securing the emotional drive of interest and 
enthusiasm for success in the chosen vocation. 
IF we interpret abnormal behavior in a broad 
sense as including any form of behavior which 
indicates that the individual is maladjusted and 
that he is tending to become a liability rather 
than an asset to the community, our consideration 
of this subject, however cursory, would certainly 
be incomplete without a brief discussion of voca- 
tional and industrial misfits. Social psychology 
has long been concerned with the problem of labor 
unrest in its group aspects, which involve such 
factors as turnovers, strikes, unionism, and the 
development of various political theories by the 
laboring classes. All these forms of group be- 
havior are indicative of a general and widespread 
unrest among all types of workers usually attrib- 
uted to the fact that the modern industrial system 
is ill adapted to the instinctive and emotional needs 
of human nature. To the ideal of economic 
efficiency all other impulses have been subordi- 
nated, with the result that the workers within the 
system are subjected to an emotional tension which 
breaks over into activities such as strikes, labor 
turnover (i.e., going from one job to another fre- 
quently), and all the other symptoms of restless- 
ness which are characteristic of the organism when 
its fundamental cravings remain ungratified. 416 
ABNORMAL BEHAVIOR 
We have only to contrast the industrial situation 
of earlier centuries with that of to-day in order to 
understand this state of affairs. Before the inven- 
tion of machinery and the establishment of the 
factory system, the various arts and crafts were 
carried on in the home or by means of guilds. 
The workman knew that his skill in his own par- 
ticular handicraft gave him reasonable certainty 
of livelihood, since it could only be rivalled after 
long years of apprenticeship. The modern fac- 
tory employee has no such assurance; he operates 
a comparatively simple piece of machinery which 
anyone else can soon learn to do equally well. 
Hence the feeling of insecurity in his employment 
with the accompanying fearfulness and anxiety 
over “ losing his job ” is a constant source of 
unrest. 
Moreover, the guildsman, as he wrought upon 
his material, knew a taste of the joy that 
comes with the consciousness of having created 
something with one’s own hands, and which 
is rooted in what we have already described as 
the innate tendency “ to manipulate the objects of 
the environment and mold them into new forms.” 
To-day this pleasure is limited to a comparatively 
small class of artists, writers, musicians and scien- 
tists.* The average workman has no such oppor- 
tunity to exercise his skill and ingenuity; his task 
is limited to some one small part of the work which 
is necessary to complete the finished product. 
This automatic and uninspired task holds illimit- 
able vistas of monotony for the worker unless his PITFALLS OF OUR MINDS 
417 
native intelligence is so low that he is incapable of 
feeling the desire to vary his routine and branch 
out into constructive effort. Here again lies a 
source of dissatisfaction. 
Even if the worker succeeds in adapting him- 
self to the new economic situation, with its monot- 
onous labor and its element of uncertainty, he 
finds that his emotional life is affected by it in 
other ways which although indirect are none the 
less an outcome of modern industrial conditions. 
Under the old system, a home, a wife and children 
were an economic asset. At that time a wife was 
necessary for the preparation of food and cloth- 
ing, while the children could help with simple parts 
of the productive process. At present, to own a 
home is far beyond the means of many workmen. 
The women, although they still have much to do 
with the making of clothing and the preparing and 
serving Of food are doing these things in the fac- 
tory and in the restaurant. And children are a 
burden economically which one may well pause 
before assuming. 
The worker of to-day, whether man or woman, 
in many instances finds that the love of the 
mate and offspring together with all the other 
emotional associations of home life must be 
sacrificed in the interest of self-survival. Under 
ordinary circumstances competition for employ- 
ment is so keen and the type of work demands so 
little in the way of training and skill, that the 
worker cannot command sufficient income to en- 
joy normal family life. If he does attempt it, the 418 
ABNORMAL BEHAVIOR 
struggle of maintaining the home and caring for 
the children is so great as to rob it of much of its 
power to give happiness. Often the problem of 
providing for his family becomes in itself the 
greatest possible source of anxiety. 
If we turn aside from the thought of man be- 
coming thus enslaved to the machinery which he 
has created, with the inevitable suppression of his 
own personal wishes to a greater or lesser degree, 
we find that there are many other factors which 
operate in individual cases to increase the chances 
for maladjustment to one’s work. The matter of 
individual variations in general intelligence and 
special abilities and disabilities immediately occurs 
to us in this connection as offering innumerable 
opportunities for vocational misplacement. Psy- 
chometric examinations in the U. S. army showed 
a definite correlation between the level of intelli- 
gence and occupational pursuits. Mfen who 
achieved a high score (A or B) on the Army Alpha 
Intelligence Test were found to represent the pro- 
fessional group, such as engineers, physicians, den- 
tists, etc. The C-f- men were those engaged in 
such occupations as photographer, telegrapher, 
book-keeper, clerk, and the like. The men who 
fell in the C group represented types of employ- 
ment such as cook, baker, plumber, gunsmith, 
carpenter, machinist, telephone operator, etc. 
The C- men were laborers, miners, teamsters, 
barbers, etc. 
A chart giving the distribution of occupations 
in relation to general intelligence as indicated by PITFALLS OF OUR MINDS 
419 
rating on the Army Tests is reproduced on the fol- 
lowing page. This chart is based on the average 
intelligence found in each occupation listed. That 
is, the 25% receiving the lowest ratings and the 
25% receiving the highest ratings on the Army In- 
telligence Examinations are not represented, the 
diagram being based on the achievement of the 
middle 50% for each occupation. 
If we try to place an individual who by virtue 
of his native intellectual capacity would fall within 
the “ C ” group in an occupation which requires 
a “ B ” grade of intelligence we could hardly ex- 
pect him to do well at his work. Indeed, such a 
placement may lead to grave results. Dr. Pratt, 
in an article on “ The Problem of The Mental 
Misfit in Industry,’’ tells of a case which illustrates 
this point. It is the history of a mental defective 
who rated so low on the army intelligence tests 
that he was withdrawn from the ranks and put into 
a position at the dock loading automobiles. He 
did so well at the work that his foreman pro- 
moted him to driving one of the trucks. Even at 
this more complicated occupation he got on pas- 
sably so long as his route was confined to the short 
haul between the works and the loading dock. 
But one day the foreman sent him on a special 
haul across the city, with instructions to make his 
delivery as soon as possible. His judgment proved 
defective in this exacting situation. Obedient to 
the command to hurry, he neglected to calculate 
his time margin correctly in crossing a railroad 
track, was struck by the train and killed. The 420 
ABNORMAL BEHAVIOR 
Chap. XII. 
Page 5. 
Laborer...., 
Gen. miner. 
Teamster..., 
Barber....., 
Rorseshoer........... 
Bricklayer........... 
Cook 
Baker.... 
Painter....... 
Gen. Blacks: 1th 
Gen. carpenter 
Butcher. 
Gen. machinist 
Hand riveter 
Tel. (4j tel. lineman., 
Gen. pipefitter. 
PlumBer..... 
Tool and guage maker. 
Gunsmith. 
Gen. mechanic 
Gen. auto repairman.. 
Auto engine mechanic, 
Auto assembler 
Ship carpenter 
Telephone operator... 
Concrete construction foreman., 
Stock-keeper. 
Photographer. 
Telegrapher. 
R. R. clerk 
Piling olerk 
Gen. clerk 
Army nurse 
Bookkeeper 
Dental officer................. 
Meehanlcal draftsman........... 
Accountant 
Civil engineer. 
Medical officer................ 
Engineer officer. 
(Reproduced from Vol. XV of Memoirs of The National Academy 
of Sciences, Fig. 57, Page 829, Occupational Intelligence Ratings. 
Horizontal bars show range of middle 50% tested in that occupa- 
tion; median is indicated by vertical lines.) PITFALLS OF OUR MINDS 
421 
amount of intelligence which he possessed had 
fitted him for the adequate performance of his 
duties when he was loading automobiles at the 
dock, but was unequal to the more complex ac- 
tivities of truck-driving. 
The opposite situation, in which the individual 
of superior (A or B) intelligence is engaged in a 
type of work which could easily be performed by 
a person of less capacity than himself means that 
the individual is not working at his highest effi- 
ciency. This involves potential social wastage, to 
be sure, but does not predispose to accident and 
actual loss as is often the case when the occupation 
makes demands above the worker’s mentality. 
The realization that his work is too easy may make 
for dissatisfaction of the individual with his job, 
but this is to be considered a “ healthy irritability ” 
which acts as a stimulus in causing the worker to 
seek a more advanced position. 
One of the functions of vocational guidance is to 
assist the individual in determining to what occu- 
pational level he may aspire in view of his native 
intellectual capacity. This is often a situation 
requiring much tact and finesse. When a 19-year- 
old boy with a mental age of expresses the 
ambition to become a doctor, and shows indefat- 
igable industry in school which wins the sympathy 
of his teachers in spite of his obvious dullness, 
it is difficult to tell him that his cherished voca- 
tional ideals can never be achieved. The only 
course is to induce him to make a transfer of his 
interest to some vocation which lies within his 422 
ABNORMAL BEHAVIOR 
reach by picturing its advantages and assuring him 
of his evident aptitude for this line of work. On 
the other hand, it is easier to encourage the su- 
perior type to seek higher training which will fit 
him for a better position more in harmony with his 
real abilities. 
Even within the occupational groups which de- 
mand the same general level of intelligence, the 
individual may be better fitted to succeed in one 
type of work than another by virtue of certain 
special abilities or disabilities which may form a 
part of his mental equipment. Contrast the dif- 
ferent demands of the professions of medicine and 
civil engineering, for example, which both require 
superior intelligence for success, but depend on 
diverse specializations. Or in a somewhat lower 
group, consider the mathematical accuracy de- 
manded of the book-keeper, the faculty of 
visualization of the picture to be obtained neces- 
sary for the good photographer, and the language 
ability which makes the secretary indispensable to 
the business man who must employ someone to 
keep up his correspondence. In view of all the dif- 
ferences between the various occupations, it is not 
strange that in addition to making use of examina- 
tions for determining the approximate intelligence 
level, vocational advice needs to be based on 
further knowledge obtained from such special data 
as can be secured by the use of tests for clerical 
ability, mathematical accuracy, engineering apti- 
tude, etc. As a basis for advice as to further train- 
ing or as a preliminary to vocational placement, PITFALLS OF OUR MINDS 
423 
the various psychological examinations along these 
lines are indispensable. Indeed, we need more of 
these to use in our endeavor to size up the person 
who seeks advice concerning his vocational dif- 
ficulties, for the more we can learn of his mental 
make-up the better choice shall we be able to assist 
him in making. 
The intellectual side is only one aspect of the 
vocational situation, however. Success depends 
quite as much and perhaps far more upon the 
personality make-up of the individual than upon 
his intelligence. The good nurse must not only 
have the mental alertness to carry out the doctor’s 
instructions; she must also have that combination 
of sympathy and tenderness and optimism in her 
personality which in itself is a stimulus to her con- 
valescent patient. The teacher may be a master 
of his subject, but if he is unable to win the affec- 
tion and loyalty of his students, if he is unable to 
enter with them into their hopes and aspirations, 
he may achieve renown in scientific research but 
he will not send out a group of pupils fired with 
the same enthusiasm to continue his work after his 
time is ended. If he cannot accomplish this, he 
is misplaced as a teacher; his place is with an or- 
ganization which cares only for the results worked 
out in his laboratory, and in such a position sooner 
or later he will probably find himself. The execu- 
tive, however shrewd, succeeds best when he has 
in addition the type of personality which inspires 
confidence and loyalty in those working under his 
direction. More than one man or woman of un- 424 
ABNORMAL BEHAVIOR 
doubted intellectual ability has failed to reach the 
level of achievement which might have been pre- 
dicted on the basis of this one factor because their 
personality has been such as to impede their prog- 
ress by keeping them in constant disharmony with 
those with whom they came in contact in the course 
of their work. 
The individual with a timid or sensitive per- 
sonality make-up is especially lacking in ability to 
make the proper vocational adjustments. Not 
only does he tend to underrate his ability and fail 
to arouse a feeling of confidence in his qualifica- 
tions when he seeks employment, but even after 
he is placed in a position he is apt to react to criti- 
cism, if any be forthcoming, in an over-exaggerated 
fashion, and may become discouraged to such an 
extent as to give up his place on that account. 
Lorine Pruette and Douglas Fryer cite two cases 
in which vocational maladjustment was undoubt- 
edly to be attributed to this factor. 
Case 123 
The first case is that of a young man of 22, who had 
partially finished high school and then completed a 
business course. He had had three years’ experience 
as a book-keeper. His rating on the Army Alpha In- 
telligence Examination was A, or superior. A glance 
at the chart showing correlation of intelligence rating 
with occupation will show that a C+ rating is the aver- 
age for this type of work. Nevertheless this particular 
book-keeper had little confidence in his own ability, 
and would probably not have had courage for some PITFALLS OF OUR MINDS 
425 
time to apply for a position on his own initiative. At 
the Placement Bureau it was found necessary to make 
definite appointments for him instead of following the 
usual custom of giving him a list of openings in his 
field, for he was too timid to make contacts with pos- 
sible employers for himself. Once located in a posi- 
tion, he could be trusted to do work of a satisfactory 
character; his difficulty was in his timid and shrinking 
personality make-up which prevented him from making 
his own opportunities. 
Case 124 
Another boy of 18 showed similar personality traits. 
He was a public school graduate with three years’ 
clerical experience. His rating on the Army Alpha 
was B, which again is a much higher intelligence than 
that necessary for clerical work. He was convinced 
of his incapacity for achievement, however, and al- 
though highly conscious of the irrationality O'f his 
attitude, seemed to be suffering from a feeling of in- 
feriority which was beyond his control. Once the 
Placement Bureau had secured the proper contacts 
for him with prospective employers, he lost much of his 
timidity and feeling of inferiority and was able to 
make a fair impression. 
Case 125 
A young professional woman, rating A on the Army 
Alpha, seemed unable to continue in any one position 
for long. She, too, was found to have a feeling of 
inferiority and to be over-sensitive to criticism. With- 
in a period of six months she had resigned two positions 
because of criticism which had made her feel dis- 426 
ABNORMAL BEHAVIOR 
couraged and incapable of doing her work properly. 
Her third placement proved successful. She found 
her superiors appreciative and soon developed into a 
valuable and efficient part of the organization in which 
she was serving, making some reputation in her par- 
ticular field. 
A certain percentage of vocational maladjust- 
ment may be traced to the onset of various types 
of mental disease. Incipient psychoses of the 
Manic-Depressive or Dementia Praecox types 
often have their first manifestation in vocational 
failure. 
Case 126 
A certain upholsterer, for example, became unable 
to stay for any prolonged period in the same position. 
Without any apparent reason he would leave one job 
and hunt for another. This went on for months, then 
he also began to move from one place to another, never 
living long in one place. He was finally brought to 
the hospital on complaint of his neighbors. He had 
placed a peculiar notice on his door and was suspected 
of setting fire to the house in which he was living. 
In the hospital it was found that he had developed 
definite delusions of persecution which are typical of 
Dementia Praecox of the paranoid type. He believed 
people were trying to kill him by means of poisonous 
gases. Every place he went to work he fancied he 
could smell these, hence his restlessness and frequent 
changes of positions. This reason for his unrest was 
not discovered, however, until his hallucinations and 
delusions became so marked as to cause him to put a 
notice on his door requesting people not to make such 
bad smells, followed by his attempts to burn the house PITFALLS OF OUR MINDS 
427 
in which he believed his persecutors to be located. 
Sometimes an actual accusation becomes the 
starting point of a delusional system built up 
around the occupation in cases of incipient De- 
mentia Praecox. 
Case 127 
Louis S. was a young man of 25, a Russian Jew 9 
years in the United States, a celluloid worker by trade. 
He was brought to the hospital by his wife who said 
that he had had some trouble in the shop where he was 
employed several months ago and had been unable to 
get work since then. It appeared that the trouble to 
which Mrs. S. referred was a quarrel between Louis 
and his boss in which the latter called him, a thief. 
Louis immediately left his job, and started looking for 
another one. But the chance remark of his previous 
employer had been woven into his delusional trend, 
so that wherever he went to look for work he imagined 
that he was regarded as a crook, and hence did not 
succeed in getting another job. He finally became 
convinced that all the employers whom he had seen 
were in a plot against him, that his wife had become 
unfaithful and that all his relatives were not treating 
him as they should. 
Case 128 
In still another case of Dementia Praecox work was 
given up because it interfered with a form of activity- 
dictated by the patient’s delusional trend. A young 
man of 33, American-born, single, occupation, clerk, 
gave up his job and began to spend all his time in a 
motion-picture theatre. For three weeks his foster- 428 
ABNORMAL BEHAVIOR 
mother tried to get him to go back to work unsuccess- 
fully, then she brought him to the hospital. His ex- 
planation was quite simple. He believed that a certain 
actress was able to communicate with him by her eyes, 
and he was neglecting his work to attend the pictures in 
which she appeared and receive her messages. 
The necessity of recognizing this type of indus- 
trial maladjustment for what it really is and re- 
ferring it to the psychiatric clinic is readily appre- 
ciated when we realize that the individual who is 
reacting to hallucinatory and delusional experi- 
ences is apt to do harm to himself or others. This 
is particularly true in paranoid trends with ideas 
of persecution, when the patient is liable to attack 
the fancied persecutor. 
Case 129 
Take the case of a young man who was arrested 
for assaulting a former employer. At the hospital, 
where he was sent from court for observation, he gave 
the following explanation of his act: 
“ I went to work for this fellow down on Third 
Avenue. He said he would treat me right and I went 
with him. For three months he paid me, then he 
gave me nothing more. I left him but still he would 
not pay me. After that he began influencing me. At 
first he gave me headaches and pains through my 
stomach. Sometimes I would go to bed with my shoes 
and stockings on and wake up with them off. Then 
my food started tasting queer. One day I saw him 
putting something red in my tea. Then I knew he 
was trying to poison me. He gets herbs from a man PITFALLS OF OUR MINDS 
429 
over in Brooklyn with which he influences people. 
His wife is sick by his influence, too. She has a snakes 
or a frog in her. He kept after me so I decided to 
kill him. I am not sorry I stabbed him. Look at all 
he did. If I had only taken the three steps to God 
I would not have done it. If only I had been baptized, 
had my feet washed and taken Communion I would 
have let him go on killing me. The reason I did not 
want to die was because I was afraid of going to Hell.” 
The beginning of a Manic-Depressive attack is 
often manifested in an inability to continue the 
usual routine of work, or in erratic conduct which 
leads to discharge from the position which has 
hitherto been satisfactorily filled. The Manic- 
Depressive type of individual is also apt to be rest- 
less, and to wander from one job to another. 
Case 130 
A young woman of 24, who had been giving satis- 
factory service as a housekeeper, became irritable and 
quarrelsome and finally threw a cup and a pot of tea 
at her employer. This act was the beginning of a 
Manic-Depressive attack which was severe enough to 
necessitate her commitment to the state hospital shortly 
afterward. 
Case 131 
Somewhat similar is the case of a 2 7-year-old 
Greek who was employed as a cook at a restaurant. 
One night he left his work and attempted to arrest a 
gambling party at one of the tables, threatening them 
with a water pistol. He, too, was suffering from a 
Manic-Depressive psychosis. He had been brooding 430 
ABNORMAL BEHAVIOR 
over the death of his brother, who had lost a fortune 
gambling. Out of this grew his belief that he was 
called upon to lead an anti-gambling crusade. 
Sometimes individuals in a mild Manic-Depres- 
sive state will be placed by some agency in one 
position after another, their continual failure to 
adjust themselves to their work remaining a source 
of mystery for some time. 
Case 132 
Hilda F. was a Jewish girl whose father had com- 
mitted suicide when she was a small child, after which 
her mother abandoned her and returned to Russia. 
Hilda grew up in an orphan asylum. When she was 
20, an attempt was made to secure her a position at 
housework in which she could become self-supporting. 
For six months she kept one of the representatives of 
the asylum busy placating one employer after another. 
At her first place she was simply disobedient to her 
mistress. At the next place she began to tell untruths; 
later still she began to steal from her employers. She 
became more and more difficult to manage, and by the 
time the social worker in charge of her industrial place- 
ment had decided to bring her to the doctors for ob- 
servation she was irritable, talked incessantly, and 
showed marked assaultive tendencies. She was sent 
to the state hospital for the insane. Diagnosis, Manic 
Depressive Psychosis. 
Sometimes the Manic-Depressive temperament 
can be alternately a liability and an asset from the 
vocational viewpoint, as the following case illus- 
trates: PITFALLS OF OUR MINDS 
431 
Case 133 
A prominent financier lost a fortune on Wall Street 
during the development of a depression in which his 
mental alertness became impaired to such a degree 
that he could no longer size up the financial situation 
accurately. After this he became depressed to such 
an extent that he was sent to the hospital. With the 
beginning of the opposite or manic phase of his disease, 
he grew eager to go out and build up his fortune again. 
His mind now became overactive along this line, and 
he planned innumerable schemes in which he talked of 
oil wells, etc. What actually did happen was that he 
was released while somewhat in a manic state (although 
mild, of course), and became the best salesman em- 
ployed by the firm with whom he secured a position. 
The manic tendency to think and talk rapidly stood 
him in such good stead in this particular line of work 
that his sales were double those of any other man on 
the road. He might even have been advanced very 
rapidly on the basis of his success, but for the fact 
that he became worse and was obliged to return to the 
hospital after some months in his new business. 
The psychoneurotic is often dissatisfied with his 
work because he blames it for his fancied ills or 
feels his employers are unsympathetic and unfair, 
etc. Just as he drifts from one clinic to another 
because he feels that the doctors previously con- 
sulted are too harsh or do not understand the na- 
ture of his illness, so he seeks work where he can 
obtain consideration and interest in his ailments. 
Just as he is never adapted to life, so he is never 
adapted to his vocational situation. 432 
ABNORMAL BEHAVIOR 
The constitutional inferior, with his defective 
judgment, poor insight, and emotional instability 
is also a case of chronic industrial unrest. He is 
discontented with the world in general, he never 
finds a successful method of adjusting to the de- 
mands of the group, and this characteristic is re- 
flected in his attitude toward his work. If he does 
not advance rapidly, he never thinks of looking for 
any cause of his lack of progress in his own per- 
sonality but considers it the fault of his employers 
or of the industrial system in general. In the latter 
event he may become a labor agitator and disrupt 
the morale of the other employees. 
If we turn from these grosser forms of malad- 
justment to the consideration of the more subtle 
aspects of the affective life of the worker, we shall 
find that almost any type of emotional disturbance 
can react upon the individual to impair his effici- 
ency. Lorine Pruette and Douglas Fryer have de- 
scribed a number of cases in which emotional con- 
flict of one kind or another lay at the source of 
the vocational maladjustment. Emotional dis- 
turbances connected with the home life are re- 
flected in an irritability toward the vocation in 
several cases reported by these authors. One boy 
who was rebellious because he felt that his parents 
gave him insufficient personal freedom carried over 
this antagonism toward his employers by refusing 
to obey the rules of the firm for which he worked. PITFALLS OF OUR MINDS 
433 
Case 134 
This was a boy of 19, with a rating of B on the 
Army Alpha Intelligence Examination, which was su- 
perior to that needed for his work as clerk. He had 
had clerical experience for five years, and was quite 
capable of holding his positions but for his rebellion 
against any semblance of authority, which grew out of 
the adolescent desire to achieve freedom from the 
parental control. His difficulties were adjusted when 
his parents were induced to understand his feelings 
and give him more responsibility and independence. 
The loss of the love object can so lower the 
emotional tone of the individual as to breed a dis- 
taste for life in general and for the vocation in 
particular. 
Case 135 
Miss Pruette and Mr. Fryer cite as an example 
the case of a young man of 28 who for n years pre- 
vious to the death of his wife had been in export work 
making $275 a month. With the loss of his wife’s 
love and encouragement he had given up all interest 
in life, had permitted his physical condition to become 
run down, and finally lost his job. When he came to 
the Placement Bureau he was so discouraged that he 
was willing to accept any kind of position, even that 
of messenger. He was advised to confide the care of 
his two small children to his sister and to seek for him- 
self a complete change of environment in which there 
would be nothing to remind him of his painful 
memories. 
Pruette and Fryer conclude that in many of 
their clients at the Placement Bureau the voca- 434 
ABNORMAL BEHAVIOR 
tional problem becomes not one of finding out what 
is the matter with the job, but of heeding the old 
adage cherchez la femme. Sometimes it will be 
the economic difficulties confronting the engaged 
man who is anxious to marry which cause dissatis- 
faction with his work. In other instances, voca- 
tional interests are sacrificed to a mother who re- 
fuses to move from her accustomed home. Men 
with families dependent upon their efforts cannot 
give up a lucrative position for an opening which 
promises big results in the future but is not im- 
mediately a paying proposition. Sometimes the 
impossibility of earning sufficient income to care 
for the increasing number of children sends men 
in despair to the vocational advisor of the Place- 
ment Bureau. Inability to give the wife and chil- 
dren all that one could wish is an acute source of 
vocational discontent. All of these cases in which 
a woman is concerned are at bottom cases of 
emotional conflict. 
When we think of industrial unrest and voca- 
tional dissatisfaction in terms of the individual, 
we find that there are as many sources of difficulty 
as there are types of individual to adjust to the 
vocational situation. In this sense, the problem 
of vocational adjustment becomes a phase of the 
greater problem of the adjustment to the demands 
of life. Vocational advice and placement must be 
based upon a knowledge of the individual from 
every point of view. It is not so simple a matter 
as was once conceived, — i.e., the mere estimation 
of intelligence and special abilities. We must also PITFALLS OF OUR MINDS 
435 
have some insight into the personality make-up and 
habitual attitudes of the individual, and a knowl- 
edge of his affective life, together with the status 
of his physical and mental condition relative to the 
possibility of health or disease. When our files 
contain some such composite picture of the indi- 
vidual as this, plus a record of his reactions in 
various positions which he has held, we shall be in 
a position to recommend him for training or place- 
ment with a much higher chance of satisfaction. 
Even when we have this extensive material at 
hand, we are still confronted with the necessity 
of tying up the interest and “ emotional drive ” 
with the task for which the individual is best 
adapted. The man of inferior intelligence or de- 
fective personality make-up may be ambitious for 
a vocation which is far beyond his reach. Voca- 
tional choices and ideals are often made with com- 
plete irrationality and without reference to per- 
sonal qualifications for the work selected or desired. 
Family pressure, social situations, desire for econo- 
mic rewards, etc., are generally more potent factors 
in the formation of vocational ambitions than calm 
and impartial self-analysis. Indeed, it is doubtful 
whether the vocational aptitudes of an individual 
could be determined by any amount of introspec- 
tion or subjective method. Psychological exami- 
nations and estimates by associates probably offer 
a much more accurate basis for making decisions 
on this matter. But there must be associated with 
the vocation the interest and enthusiasm for the 
work which is a part of the affective life, and with- 436 
ABNORMAL BEHAVIOR 
out which it is impossible to attain the highest 
point of achievement. 
It is of course an open question to what extent 
the interests of the individual can be changed by 
vocational advice. Psychologists who are working 
in this field are conducting research to determine 
the degree of correlation between the vocational 
ambition or choice and the possession of intellec- 
tual and personality qualifications which make for 
success in the desired or chosen field. The result 
of their studies will be awaited with interest. 
While the existence of a specific talent such as ar- 
tistic ability, or inventive genius, may in rare cases 
become the dominant motive in the selection of the 
life work, we should expect that in less gifted 
individuals the vocational choice may be influenced 
by many extraneous factors, such as the advice of 
parents and other associates, unconscious emo- 
tional trends, etc. 
As representative of the psychoanalytic school, 
we might quote Brill’s opinion that the unconscious 
affective elements are so important that the in- 
dividual can only be successful in some vocation 
which affords a sublimation of the repressed in- 
stinctive and emotional desires of the personality. 
Indeed, his view is so extreme as to rule out the 
possibility of vocational guidance, on the basis of 
intelligence tests, personality ratings, and the 
methods now generally in vogue, ever being advan- 
tageous for the individual. We must maintain, 
in spite of this excellent authority, that these 
methods, in combination with a careful analysis PITFALLS OF OUR MINDS 
437 
of the affective aspects of the case such as is found 
in the material quoted from Miss Pruette and Mr. 
Fryer, offer a vast amount of assistance in many 
instances of vocational maladjustment. Our 
speculations on these debatable points will doubt- 
less be clarified when some of the researches re- 
ferred to in the preceding paragraph are available 
for our use. 
The close relationship between vocational mal- 
adjustment and gross forms of abnormal behavior 
should be fairly apparent. In the final analysis 
we shall find that the same factors underlie both. 
Inferior intelligence, emotional conflicts, abnormal 
personality make-up and incipient mental dis- 
orders may lie at the root of the vocational mal- 
adaptation or abnormal and anti-social behavior. 
In many cases, both misconduct and failure at 
vocational pursuits may be an expression of one 
and the same aspect of the mental life. 
It is of even greater significance to realize that 
the therapy for conduct disorders of various types 
may lie along vocational lines. In some cases, 
vocational adjustment may in itself be sufficient 
to remove the emotional conflict and restore the 
individual to a normal mode of behavior. This is 
especially true when such motives as a feeling of 
inferiority or dissatisfaction with the self are the 
underlying causes of misconduct. Through voca- 
tional success the normal feeling of self-respect 
may be restored and the satisfaction which comes 
from regarding oneself as a useful member of so- 
ciety may be achieved. Repressed emotional 438 
ABNORMAL BEHAVIOR 
energy may be turned into substitute outlets along 
the line of work as well as of anti-social behavior. 
In many cases of juvenile delinquency this pre- 
sents the solution of the problem. Whenever we 
can sublimate the energies of the individual into 
vocational activities, we are establishing a socially 
adapted form of response which will prove to be 
the most successful means for the prevention and 
correction of conduct disorders. 
SUPPLEMENTARY READINGS 
Bingham, Anne T. What Can be Done for the Mal- 
adjusted? Mental Hygiene, Vol. IV, No. 2, April, 1920. 
A study of cases of maladjustment centering around ab- 
normalities of personality and emotional conflicts. 
Brill, A. A. Fundamental Conceptions of Psychoanalysis. 
Harcourt, Brace, N. ¥., 1921. Chapter XIII contains 
a courageous statement of Dr. Brill’s convictions on the 
subject of vocational guidance, to which reference has 
been made in this chapter. 
Cassamajor, L. Neuroses in Business Life. Neurol. 
Bulletin, Vol. Ill, July, 1921. A very lucid and excellent 
article citing cases in which the mechanisms of the 
neuroses are factors in unhappy business pursuits. 
Fryer, H. Douglas. Occupational-Intelligence Standards. 
School and Society, Vol. XVI, No. 401, 1922. An article 
written from the viewpoint of the correlation between 
intelligence and occupation. It is important because it 
includes correctional data for the army material repro- 
duced in this chapter. 
Jarret, Mary C. The Psychopathic Employee, A Problem 
of Industry. Medicine and Surgery, Vol. I, Sept., 1917. 
This discusses cases in which difficulties in places of em- 
ployment were directly traceable to psychoses in the in- 
dividuals described. 
Pratt, George K. The Problem of the Mental Misfit in 
Industry. Mental Hygiene, Vol. VI, No. 3, July, 1922. PITFALLS OF OUR MINDS 
439 
An outline of the various types of mental disorders found 
among industrial misfits. 
Pruette and Fryer. Affective Factors in Vocational Mal- 
adjustment. Mental Hygiene, Vol. VII, No. i, Jan., 
1922. A significant article including many interesting 
and valuable case histories. 
Tead, Ordway. Instincts in Industry. Houghton, Mifflin, 
N. Y., 1918. A study of the psychology of the working 
class which is representative of the literature on the sub- 
ject of industrial unrest as a problem of group behavior. 
Yerkes, R. M. Psychological Examining in the United 
States Army. Vol. XV of Memoirs of the National 
Academy of Sciences. Chapters 15 and 16 of Part III 
contain the data concerning the relation of intelligence 
to occupation, and the use of this material in assigning 
branches of the service in the army. Chapter XIII 
MODERN METHODS FOR THE CORREC- 
TION AND PREVENTION OF CONDUCT 
DISORDERS 
Intolerant attitude of the group toward aberrant members. 
Primitive attitude toward mental disorders. 
Early asylums for the insane. 
Introduction of psychiatric hospitals. 
The development of the mental clinic. 
Primitive attitude toward the criminal. 
Universality of the death penalty. 
The social motive of revenge upon the criminal. 
The motive of preventing repetition of crime and the in- 
timidation by means of torture. 
Exile of criminals. 
Imprisonment as a form of punishment. 
Development of the modern prison system. 
The idea of reforming the criminal. 
Influence of psychiatric knowledge on the treatment of 
delinquency. 
Glueck’s plan for the New York State prison system. 
The modern reformatory plan. 
The dangers of the reformatory system. 
Criticism of trial by jury in its present form. 
Legal errors in the commitment of insane patients. 
Necessity of psychiatric clinics in the courts. 
Personnel and technique employed in clinical service. 
The development of the ideal of prevention of delinquency. 
The mental clinic for school children. 
Functions of the school clinic. 
Actual status of clinical work with delinquents. 
Commonwealth Plan for the Prevention of Delinquency. 
440 PITFALLS OF OUR MINDS 
441 
Psychiatric clinics operating in the schools under this plan. 
Pre-school age and baby clinics. 
Mental hygiene education of parents. 
Mental hygiene education of the community. 
The role of the scientist in the social organization. 
FROM time immemorial, the attitude of the 
group has been one of intolerance toward any 
of its members whose behavior deviated from 
socially approved modes of conduct. It did not 
matter whether the aberrant individual was a 
genius or the most atrocious criminal; he was 
radically different from the rest of the group, and 
as such was regarded with suspicion. Socrates 
drinking the hemlock, Galileo brought to account 
for his scientific inquiries, Jesus upon the cross, 
were all victims of social intolerance and conserva- 
tism. The early Christians were martyrs to their 
convictions until their numbers increased to a point 
where they themselves became the persecutors 
of other faiths. Mediaeval fanaticism even in- 
sisted upon the suppression of all scientific inter- 
ests which might necessitate a modification of 
religious creeds and churchly dogma. From the 
earliest ages, the history of mankind has been one 
of persecution of the individual who dared to think 
or act differently from his fellows. 
In primitive times, individuals afflicted with 
mental disease were often regarded as inspired by 
gods or as possessed by evil spirits. In the former 
instance they were frequently revered as oracles 
and prophets; in the latter, they were shunned or 
turned over to the incantations of the medicine 442 
ABNORMAL BEHAVIOR 
man. At a later period, however, after the Chris- 
tian religion obtained a firm foothold, and the old 
gods were relegated to the status of demons, ab- 
normal behavior due to mental disease was re- 
garded as indicative of communion with these bad 
spirits, and much of the witchcraft persecution 
was levelled at individuals whom modern psy- 
chiatry would class as victims of mental disorders 
of one type or another. In some instances, to be 
sure, in which the disordered mind became warped 
along religious lines, the victim was looked upon 
as a saint, and treated with reverence and respect. 
But these cases were few in number and could not 
begin to balance those whose mental illness re- 
sulted in untold suffering at the hands of their 
superstitious companions. 
Even when superstitious fears did not lead to 
persecution of the insane as witches, they were 
still regarded as a menace. During the 17th and 
18th centuries, they were thrown into dungeons, 
along with paupers and criminals, where they 
languished in chains, with which they were 
bound in order that they might not inflict injury 
on themselves or others. Even the asylums of the 
19th century, although they made some effort to 
provide medical care for the mentally ill, still clung 
to the tradition of chaining. As the physicians in 
charge of these newly established asylums learned 
more and more about their patients, the treatment 
of the insane gradually grew more humane. Other 
methods of restraint replaced chains, but it was a 
long time before the patient suffering from mental PITFALLS OF OUR MINDS 
443 
disease was left comparatively free, as in the psy- 
chiatric hospitals of the present day. The isola- 
tion cell, the strait-jacket, and many other 
methods now obsolete still existed within the 
memory of most medical men. 
With the institution of less rigid treatment, how- 
ever, a few of the insane recovered. This attracted 
the attention of the medical profession, and they 
began to apply the same methods to the study of 
mental disease that they had found efficacious in 
the study of physical maladies. A classification 
of the various forms of mental disorders according 
to their symptomatology resulted, and research for 
pathological conditions or other causes of mental 
disease was undertaken. 
New York was the pioneer state in instituting 
the modern system of management of the 
insane. From 1830 to 1870, county asylums 
were established, and in 1873 a state lunacy com- 
mission was appointed to supervise these institu- 
tions and also the private asylums which had 
sprung up over the state. Not until 1896, how- 
ever, was the county asylum system replaced by 
the state hospitals. At about the same time, the 
Psychiatric Institute was founded. This Institute 
had charge of the training of physicians appointed 
to the state hospital staff, the standardization of 
methods for treatment and management of the in- 
sane, and the encouragement of research along psy- 
chiatric lines. The New York State Hospital 
system as thus organized became the model for 
other states and for foreign countries. Some other 444 
ABNORMAL BEHAVIOR 
states have improved upon the New York system 
by adding to the state hospital plan a psychopathic 
hospital. At the psychopathic hospital, the men- 
tally ill receive a preliminary study, and those 
needing prolonged treatment or permanent care 
are transferred to the state hospitals, while the 
borderline cases, which are capable of fairly rapid 
improvement, are retained until their recovery. 
The final outgrowth of the scientific treatment 
of the insane is the mental clinic, which attempts 
to treat incipient mental disorders, and prevent 
their becoming so severe as to necessitate confine- 
ment in an institution. This type of clinic was 
first conceived as an out-patient department in 
connection with the psychopathic hospital., Its 
scope has extended increasingly, however, until it 
now includes the prevention of mental disease 
through the study of school and vocational mal- 
adjustments, etc., which are often due to the de- 
velopment of abnormal personality traits apt to 
lead to psychotic trends if not handled in season. 
A comparison of the old attitude toward the 
mentally ill with that in vogue to-day is indeed an 
indication of scientific and social progress. The 
modern hospital ward with its cheerful pictures, its 
section for occupational therapy, and its compara- 
tive freedom presents an almost inconceivable con- 
trast to the old system of incarceration and solitary 
confinement. The loss of superstitious fear of the 
insane and the scientific study of mental disorders 
has resulted in an advance along humanitarian lines 
which has had a far-reaching effect in the social PITFALLS OF OUR MINDS 
445 
life of man. Under the modern methods of treat- 
ment, the patient is often permanently cured, or at 
least temporarily improved, so that he can be re- 
turned to the community, and often is able to 
resume the uninterrupted commonplace of daily 
life without mishap. 
Quite as radical as the change in the social atti- 
tude toward the insane is the change in the attitude 
of the group toward the delinquent. Among primi- 
tive peoples, the breaker of social taboos was usu- 
ally sacrificed to the gods whom he was supposed 
to have offended by his act. Violation of taboos, 
sacrilege and treason were the only crimes con- 
sidered to concern the general public, however. 
Private crimes, such as murder, assault or theft 
were settled by the relatives of the injured parties 
by blood-feuds, Later, the church and state took 
over the task of suppressing these crimes, which 
with the growth of the monarchial state came to 
be regarded as an infraction of the “ King’s peace.” 
One of the easiest methods of dealing with the 
criminal was to get rid of him by execution, and 
the death penalty was inflicted for many misde- 
meanors both in primitive society and in the early 
history of civilization. Burning, hanging, break- 
ing on the wheel, beheading, drawing and quarter- 
ing, and many other forms of capital punishment 
are recorded in history. In the early history of 
England we find that slaves were burned for theft. 
The frequency of burnings gave one English queen 
the name of “ Bloody Mary.” Crucifying crimi- 
nals or throwing them to animals in the “ circus ” 446 
ABNORMAL BEHAVIOR 
was customary in the ancient Roman empire. 
Various other methods of capital punishment were 
resorted to at different times and in different 
countries. In France, as late as the sixteenth cen- 
tury, counterfeiters were boiled alive. In China, 
it is traditional for faithless wives to be trampled 
under foot by elephants. 
When less drastic measures than capital punish- 
ment were utilized, there was an attempt to make 
the penalty fit the crime. The old Mosaic law 
meted out retaliation in exact proportion, — “a 
life for a life, an eye for an eye, tooth for tooth, 
foot for foot, burning for burning, wound for 
wound, and stripe for stripe.” The ancient Egyp- 
tians cut off the hands of forgers. Under Henry 
VIII in England, cutting off the right hand was 
the legal penalty for striking another person with 
sufficient force to draw blood. Mutilation was 
employed by the Persians and various Oriental 
peoples as a form of punishment. 
The types of punishment to which we have been 
referring represented an effort on the part of so- 
ciety to take revenge upon the culprit. A later mo- 
tive was that of deterring the criminal from repeat- 
ing his crime and intimidating others from 
following his example. This purpose gave rise to 
the most hideous forms of torture, too harrowing 
to describe in detail. The method of torture was 
practiced for thousands of years. 
Exile was substituted for capital punishment 
as a more humane way of ridding the group of the 
criminal. It was used fairly extensively by the PITFALLS OF OUR MINDS 
447 
ancient Greeks and Romans. The English re- 
sorted to it frequently, and even maintained a 
“ felon fleet ” for the transportation of criminals 
to Australia as late as 1790. At that time the 
English penal code listed 145 offenses for which 
the death penalty was inflicted, but the hangmen 
were kept so busy and the jails were so full that 
the surplus numbers were disposed of in this way, 
the death sentence being commuted to exile for a 
period which varied from a minimum of seven years 
to a maximum of the life of the individual. Many 
of the offenses for which people were executed or 
exiled at that time would now be considered trivial. 
There are records of women and children being 
condemned for the theft of a two-penny pork pie or 
a square of linen. Some of these criminals were 
sent to the American colonies as well as to 
Australia. 
The persistence of the theory of torture was 
evident in the equipment of the English criminal 
transport vessels. Whipping posts, manacles, iron 
strait-jackets, spiked collars, branding irons, and 
numerous other brutal devices were provided for 
the restraint and management of the prisoners 
during the voyage. 
The third concept back of punishment of the 
delinquent was the idea of segregating law-breakers 
for the purpose of social protection. While 
prisons for holding individuals in confinement until 
they could be tried and punished, have existed 
from early times, the prison as an institution for 
the confinement of convicted criminals has only 448 
ABNORMAL BEHAVIOR 
been in existence within the last 150 years. Until 
about 1780, the jails and prisons of both Europe 
and America were used simply for the detention of 
criminals until their trial, after which those con- 
victed were sentenced to death, to corporal punish- 
ment of one kind or another, or to deportation, as 
described above. The use of the prisons for the 
confinement of criminals as a form of punishment 
originated in the efforts of the Quakers to substi- 
tute a more humane penal system for that of cor- 
poral punishment. 
The efforts of the Quakers did not stop here, 
however. Their next move was to reconstruct the 
prisons themselves. In place of the customary 
flinging together of men, women and children into 
one building, the Quakers formulated the plan of 
solitary confinement. Under their influence, the 
prisons were rebuilt so that each prisoner might 
have a single cell to himself. They held that the 
isolation, with its opportunity to meditate upon 
his sins, would be good for the soul of the con- 
fined person. In this fashion, the modern prison 
was produced. 
The system of solitary confinement, first prac- 
ticed in the Pennsylvania prisons, was later re- 
placed by a modified plan, which was first put into 
effect at Auburn (New York). The Auburn plan 
was that of solitary confinement at night and asso- 
ciated labor by day. Economically, it had dis- 
tinct advantages over the Pennsylvania system, 
and by many it was thought to be more humani- 
tarian. It soon became the accepted model for PITFALLS OF OUR MINDS 
449 
American prison institutions. 
With the introduction of these more humani- 
tarian methods of penology, came another change 
in the social mind. Society came to desire not 
only the segregation of the criminal for its own 
protection, but also wished for a method whereby 
he might be reformed and become a useful member 
of the community. This resulted in the establish- 
ment of “ reformatories ” for young delinquents 
who were first offenders. In these institutions, 
the sentence was more or less indeterminate, and 
the aim was the return of the individual to the 
community as soon as he had made sufficient ob- 
servable progress to warrant the expectation of 
his adapting himself to the group life. Unfortu- 
nately, similar methods were not applied simul- 
taneously to institutions for adult criminals. 
The present transition in the social attitude to- 
ward the delinquent is intimately connected with 
the development of modern psychiatry and the 
scientific management of the insane, which we 
have previously mentioned. In our study of men- 
tal disease, we discovered that many insane acts 
were anti-social in nature, and the individual could 
not be held accountable for his behavior on account 
of his psychotic condition. Thus a new aspect of 
anti-social conduct presented itself, namely, the 
responsibility of the individual for his behavior. 
When mental diseases came to be regarded as a 
strictly medical problem, and the sufferer was 
placed in state hospitals instead of being thrown 
into dungeons and prisons, there came about a re- 450 
ABNORMAL BEHAVIOR 
action against the imprisonment of the insane 
criminal under the same regime as his fellow- 
delinquent who was not suffering from any form 
of mental disorder. Thus, the criminal who was 
adjudged to have committed an anti-social act be- 
cause of a psychotic condition was sent to the 
hospital rather than to the prison, while those 
already in prison who developed psychoses were 
transferred to separate institutions. 
The modern prison program is an outgrowth of 
the psychiatric study of the criminal. Glueck 
found in his study of 608 prisoners at Sing Sing 
that 59% of these were suffering from some ner- 
vous or mental abnormality which in one way or 
another had contributed to their anti-social be- 
havior; 12% were frankly insane; 28.1% were 
mentally defective; 18.9% were psychopathic. 
As we have seen in the preceding chapters, in- 
sanity, mental deficiency, emotional instability and 
many other factors enter into the production of 
abnormal and criminal conduct. 
Under the old prison system, a heterogeneous 
group of criminals, some sane, some insane or 
borderline, and some mentally defective, were 
thrown together and forced to submit to the same 
regime. If the prisoner were psychotic to such a 
degree that the untrained eye of the warden recog- 
nized it, he might be placed in solitary confine- 
ment, or even suffer a worse fate. It is a known 
fact that in one state prison not so many years ago, 
an insane prisoner was chained to a stake in the 
prison yard and his food thrown to him by the PITFALLS OF OUR MINDS 
451 
keepers. This state of affairs has of course been 
somewhat remedied by the equipment of separate 
institutions for the criminal insane. 
The ideal plan for the prison is along the lines 
outlined by Glueck. It provides for a classifica- 
tion clinic, which will sort the offenders into vari- 
ous groups, such as normal and capable of learning 
a trade, normal, but only intelligent enough for 
farm work, etc., insane, defectives and psycho- 
paths. These different types should be placed in 
separate institutions where each may receive the 
type of treatment adapted to his needs. This 
means the equipment of separate institutions for 
the criminal insane, and for defective delinquents, 
a farm colony for normal prisoners capable only of 
routine labor, and industrial institutions for those 
who are able to learn various trades. The neces- 
sity for such vocational preparation is emphasized 
when we remember that approximately 66% of 
prisoners as investigated by various psychologists 
are found to be without training for any of the 
skilled occupations. Such training is obviously 
necessary if we aim to rehabilitate the delinquent 
instead of merely inflicting punishment for past 
misdeeds. 
Dr. Glueck’s plan for the administration of the 
New York prison system is so applicable to the 
situation in general that his diagramatic scheme is 
herewith reproduced: 
Not only is the modern aim to remodel the 
prison so that it shall serve primarily as a school 
in which the normal individual can be trained along  <£\ficaVion —— 
Tflew Vlovli ~Pv\$c>n&. 
cmjc* ef" - — 
Mormai 
CAPABLE 
lEARNllJe 
A 
Trade 
Hormal 
ESPECIAL 
Suited 
Jor 
ACRICULT 
GENERA lx 
COMMUNITY 
| .ADMINISTRATIVE j 
I MEDICAL. DEPT I 
i -i ~ i j- —id 
1 PSYCHIATRIC CLINIC 
' i i i i — r~' 
I VOCATIONAL GUIDANCE 
I I I I ~T~ 
|educational Guidance 
* i i i ' i i ' 
I religious guidance 
L I T" I ' I I 
I ADMINISTRATIVE 
RECEPTION 
STATION 
To RE 
INDUSTR 
PRI&OM 
INDUST 
PRISON 
FARM 
PRISON 
CRIMINAL 
insane 
Defective 
DELINOUW ■ 
indeterminate Sentence 
PAROLE AGENCIES 
GENERAL COMMUNITY 
(Reproduced from Mental Hygiene, Vol. I, No. 2, April, 1918: 
Concerning Prisoners, by Bernard Glueck, M.D.) PITFALLS OF OUR MINDS 
453 
industrial and vocational lines and in habits of 
better citizenship (or as a hospital in which he can 
receive proper treatment for mental disease); it 
also includes the purpose of keeping him out of 
prison whenever possible. The probation system 
for first offenders is the official expression of this 
aim. The probation officer has as his duty the 
supervision of the first offender for whom there 
seems hope of adjustment without the intervention 
of the prison or reformatory. As these probation 
officers become better trained, and as they are 
guided by the diagnostic data and recommenda- 
tions of a psychiatric clinic, they will give increas- 
ingly efficient service. There is yet much to be 
accomplished in this line, however, both in the way 
of education for probation work, and in the estab- 
lishment of court psychiatric clinics for the 
examination of social offenders. 
Since reformatories came into existence at a 
later date than prisons, and since they were con- 
cerned with juveniles, they were of course some- 
what less drastic in the beginning. Nevertheless, 
the psychiatric attitude has had no less influence 
upon the character of these institutions. The old 
reformatory had its solitary confinement cells, its 
harsh discipline and its severe punishments. The 
modern “ training school ” abounds in normal ac- 
tivities such as school work, prevocational training, 
trade school instruction, boy scout troops, student 
government, etc. The boys or girls are studied 
from the psychiatric and psychological viewpoint, 
and are given training in harmony with their per- 454 
ABNORMAL BEHAVIOR 
sonality make-up and intellectual abilities. The 
entire scheme is in harmony with modern scientific 
and humane ideals. 
If we must have correctional institutions for 
children, the least we can do is to see that they 
are managed along the lines indicated above. 
The institutional child often suffers as a result 
of the very environment in which we have so 
ruthlessly placed him. From associates more 
hardened in crime than himself he learns of deeds 
he would never have imagined if left to his own 
devices. Unless he has some definite training to 
counteract these influences, his first act upon his 
release is to try out this new knowledge. If he 
is not provided with plenty of recreational activi- 
ties, such as boy scout work, ball games, and other 
sports, he spends his leisure time in perverted prac- 
tices with his companions, and comes out of the 
institution more abnormal as well as more anti- 
social than he was at the time of his admission. 
Such results can hardly be condoned, yet they are 
the inevitable result of institutionalization of the 
child unless every precaution is taken to avert 
them. 
Case 136 
We might cite an instance in which institutional life 
built up distinctly abnormal tendencies in one child. 
This was the case of a i5j-year-old boy, who was ar- 
rested on the charge of sodomy and sent to the hospital 
for observation. The family history was negative ex- 
cept for nervousness in the mother. The physical 
examination was practically negative. The psycho- PITFALLS OF OUR MINDS 
455 
logical examination indicated subnormal intelligence. 
The outstanding characteristic, however, was emo- 
tional instability, and the boy was finally diagnosed as 
a Constitutional Psychic Inferior with sexual perver- 
sions. 
The patient’s personal history was the keynote to 
the whole situation. He had first been committed to 
the Catholic Protectory at the age of io for stealing 
some Buffalo nickels from his father. Twice later 
he was sent to the Protectory by the school authorities, 
once for truancy and again for causing a disturbance 
in the schoolroom. While he was in this institution, 
he witnessed perverted practices between the other 
boys. After his release he remembered these things, 
and began to experiment along similar lines, first mas- 
turbating and later indulging in perversions with a 
five-year-old child. The little five-year-old, not 
realizing the meaning of the act, reported the occur- 
rence to his parents, who caused the older boy’s arrest. 
This boy’s abnormal tendencies were developed 
during his confinement in the institution, to which 
he was committed for seemingly trivial offenses. 
His maladjustments at home and at school were 
undoubtedly due to his psychopathic make-up and 
his intellectual subnormality. Had he been in- 
telligently handled by his parents and teachers, 
he might have been enabled to make an adaptation 
to his environment without any necessity for the 
institutional experience which only made him more 
of a social menace than he had been before. 
Although we have made much progress in our 
treatment of the insane and criminal classes, in 456 
ABNORMAL BEHAVIOR 
respect to our methods of trial and judgment of 
offenders, there is still opportunity for improve- 
ment. As Harry E. Barnes has remarked in his 
article on the evolution of the penal system, the 
trial by jury gives no assurance of an impartial 
administration of justice, for the jurymen are or- 
dinarily average citizens, well-meaning, to be sure, 
but lacking the training which would enable them 
to scrutinize the evidence carefully and come to 
their decisions uninfluenced by the eloquence of 
persuasive attorneys. Modern sociologists would 
have the traditional jury replaced by a permanent 
board of experts, trained along various lines such 
as biology, economics, sociology, etc. The func- 
tion of such a board would be the impartial weigh- 
ing of evidence and formulating conclusions from 
this alone. In Dr. Barnes’ opinion, the fact that 
we are a long way from seeing this plan put into 
actual practice is but an indication of the great 
distance which we have yet to travel before we can 
consider that we are according a scientific and at 
the same time a humane treatment to our delin- 
quent classes. 
Another point which offers itself for criticism, is 
the legal attitude toward those psychotic patients 
whose commitment to the proper medical institu- 
tions depends upon the decision of the court. 
Many such cases, who not only need proper medi- 
cal attention for their mental disorder, but require 
hospital care lest they do injury to themselves or 
others, are able to deceive their relatives and 
others not trained in psychiatry as to their actual PITFALLS OF OUR MINDS 
457 
mental state. It is not strange that judges 
are also sometimes mistaken about these indi- 
viduals, and order their release from custody, in 
spite of the statements of competent medical men 
as to the psychotic condition of these patients. 
Sometimes such legal errors are followed by tragic 
results. We might cite a particularly striking 
example from recent experience. 
Case 137 
A woman of 40 was brought to the hospital from 
court. She had been arrested on the charge of dis- 
orderly conduct. For some time she had been annoy- 
ing a former employer, writing him letters, calling 
him up on the ’phone, and finally threatening him. 
Psychiatric examination showed that this woman was 
suffering from a psychosis closely allied to Manic- 
Depressive, with a marked paranoid trend. She was 
suffering from delusions, would imagine that her em- 
ployer was calling her on the ’phone, and would then 
want to call him, etc. She refused to go to the state 
hospital upon the recommendation of the physicians, 
but demanded a hearing before the judge. She was 
taken before one of the supreme court justices, who 
made the following ruling: 
“ Upon hearing held by me, , 
I find the said to be sane, and 
order her to be discharged from custody.” 
The patient was accordingly discharged. She was 
very much elated at her victory over the physicians, 
and as she was leaving the court room, asserted that 
she was now going to find out what her old employer 
meant by having her arrested. A few days later an 458 
ABNORMAL BEHAVIOR 
article appeared in one of the New York papers, re- 
porting her suicide. She had gone to the office of her 
former employer, who had immediately caused her to 
be arrested again, on the charge of threatening assault, 
A police officer made the arrest, but neglected to search 
his charge for weapons. As she was being placed in 
a taxi for removal to the police station, she shot her- 
self. Evidently, she had brought a pistol with her in- 
tending to kill her old employer, and failing in this, 
had used it for suicidal purposes. 
Enough has now been said to demonstrate the 
necessity for psychiatric clinics in connection with 
courts, where offenders may have the proper study 
before any determination is made as to their dis- 
posal. There are a few such clinics in existence 
in connection with certain courts in various parts 
of the country, but these are all too small a number. 
They are particularly necessary in the juvenile 
courts, since it is here that many first offenders 
are brought, and their treatment at this time may 
mark the decisive step between the development 
of a criminal career and the turning back to a so- 
cially approved line of conduct. It may be well 
to digress from the main thread of our discussion, 
at this point, and to give a brief outline of the 
personnel and methods of study which such clinical 
examination of the delinquent requires. 
The immediate personnel of the psychiatric 
clinic includes the services of well-trained psy- 
chiatrists, psychologists and psychiatric social 
workers. Probation officers should also work in 
close connection with the clinic, since the success PITFALLS OF OUR MINDS 
459 
of their efforts will depend on the insight into the 
probationer which can only be obtained by refer- 
ence to the findings of the clinical study. The 
decisions of the judge must also be made with a 
knowledge of the clinical findings, as well as upon 
the legal presentation of evidence. 
The purpose of the clinical study of the delin- 
quent is to discover the causes of his abnormal 
behavior, and to map out a program for his adjust- 
ment to his environment. We have seen in the 
course of our present discussion, that the causes of 
anti-social behavior may be of many kinds. Physi- 
cal and mental diseases, intellectual inferiority, 
emotional conflicts, personality defects both native 
and acquired, bad environmental influences, and 
many other factors enter into the causation of con- 
duct disorders. To determine the nature of any 
particular case, therefore, requires psychiatric, psy- 
chological and sociological study, as has been sug- 
gested in enumerating the personnel of the clinic. 
The psychiatric study demands a thorough 
physical and medical as well as a complete mental 
examination. In addition to the ordinary medical 
examination, which means the heart, lungs, etc., 
the various neurological tests are made and clinical 
signs of glandular imbalance are taken into ac- 
count. A serological examination is also indispens- 
able. This means simply that a blood Wasser- 
mann test must be performed (and if necessary a 
spinal fluid examination made) to rule out the 
possibility of syphilitic infection as a cause of ab- 
normal conduct. Metabolism studies (in cases 460 
ABNORMAL BEHAVIOR 
which show signs of glandular disturbance), 
X-rays, and other laboratory aids to medical diag- 
nosis are called into assistance whenever the super- 
ficial physical examination indicates the desir- 
ability for such procedure. 
The mental examination consists of the usual 
psychiatric observation for hallucinations, delu- 
sions, disorientation for time or place, and other 
symptoms of mental disorder. It also includes a 
study of the mental life, with more or less utiliza- 
tion of psychoanalytic principles, with a view to 
revealing any possible emotional conflicts, obses- 
sive ideation, etc. 
The psychological study of the aberrant person 
is equally thorough in nature. It includes exami- 
nations for the determination of the general level 
of intelligence (such as the Stanford-Binet or the 
Army Alpha), and all sorts of tests for the estab- 
lishment of the existence of special abilities or 
disabilities which may be utilized in vocational 
guidance. The data of the psychological study 
should offer not only an estimate of the individual’s 
intelligence, which may be a contributory factor 
in the production of his misconduct, but also a 
picture of his potentialities for achievement, since 
the sublimation of energies once used along anti- 
social lines into vocational or other socially ap- 
proved activities is often an important step in the 
adjustment of the individual’s behavior and the 
correction of his difficulties. 
The sociological study should give an account 
of the hereditary and environmental influences PITFALLS OF OUR MINDS 
461 
which have been brought to bear on the personality 
development of the individual. The family his- 
tory must be obtained in detail, with especial in- 
quiry as to the existence of neurotic or psychotic 
taint, intellectual impairment, syphilitic or epilep- 
tic members, etc. The physical condition of the 
home, the economic status of the family, the atti- 
tude of the parents toward the individual as a 
child and his reactions to the father and mother, 
his early companions, his school and vocational 
career, his developmental history through infancy 
and childhood, must all be described as fully as 
possible. This social history gives us innumerable 
sidelights on the personality, and often reveals 
definite causes of abnormal reactions. 
When these studies are completed, the causative 
factors differentiated, and a plan of therapy out- 
lined, it remains to know by whom this treatment 
is carried out. This differs in different instances 
in accordance with the nature of the case. Per- 
sons whose abnormal behavior is the result of some 
physical or mental disease naturally receive medi- 
cal treatment at the hands of a qualified physician 
or in the proper type of hospital. The mentally 
deficient become custodial cases in the institutions 
for the feeble-minded, or are given special training 
in the public schools or placed in training schools 
for mental defectives. The probation officer plays 
an important role in cases whose misconduct, al- 
though flagrant enough to bring them into conflict 
with legal codes, is of a kind to permit their 
being given another trial at large in the community. 462 
ABNORMAL BEHAVIOR 
Given an insight into the personality and capacities 
of his probationer, this officer can often help him 
make a social adjustment and prevent his appear- 
ance in court as a “ repeater.” In cases of emo- 
tional conflict, the remedy lies for the most part 
with the individual himself; outside assistance 
consists chiefly of aiding him in the rationalization 
of his conflict. Whether he can do this success- 
fully will depend in large measure upon his own 
intellectual capacity, his personality make-up and 
his ability to face reality squarely, even though it 
be painful. For the adjustment of behavior dif- 
ficulties in children who are brought to the juve- 
nile court, the cooperation of parents and teachers 
must be depended upon to a large extent. The 
efforts of the social service worker to mold the 
environment must also be taken into account. 
From the ideas of reforming the criminal and of 
curing insanity, it is a short step to the concept of 
preventing mental disease and delinquency. This, 
indeed, is the latest aim in this field. It has been 
mentioned incidentally in remarking upon the de- 
velopment of the mental clinic, but in its full im- 
plications it can be expanded endlessly, for it has 
innumerable possibilities. It is an ideal of recent 
origin, however, and its practical applications are 
still in their infancy. 
In 1918, it was estimated that 500,000 persons 
pass through the penal and correctional institu- 
tions of the United States annually. Each year, 
too, approximately 50,000 new patients are ad- 
mitted to the state hospitals of the country. These PITFALLS OF OUR MINDS 
463 
two groups represent only the gross types of ab- 
normal behavior. There is in addition to these a 
class of individuals at large in the community who, 
although their behavior is not sufficiently abnormal 
to bring them into actual conflict with legal codes 
or to indicate the existence of definitely psychotic 
conditions, are nevertheless more or less malad- 
justed, so that they are unhappy in their personal 
and business relationships. It is not to be con- 
ceived that the vast numbers represented by these 
and by the frankly abnormal and anti-social are 
an irreducible minimum, irretrievably doomed to 
an abnormal mode of existence. 
As a matter of fact, the causes of abnormal 
behavior are manifold, as we have seen in the 
course of this study, and many of them are of a 
nature that would permit of their removal from the 
life of the individual. Aberrations of the instinc- 
tive and emotional life are not necessary in many 
cases, nor are mental conflicts and the formation 
of faulty personality habits inevitable. Many of 
these difficulties could be averted if the child were 
provided with proper environmental influences. 
Moreover, many of the physical and mental dis- 
eases leading to aberrant conduct will yield to 
therapeutic treatment, and the number of malad- 
justed would be still more reduced thereby. The 
proper physical, mental and social hygiene, par- 
ticularly in the impressionable years of infancy, 
childhood and adolescence, would do much to pre- 
vent the development both of minor behavior diffi- 464 
ABNORMAL BEHAVIOR 
culties and more serious conduct disorders (such as 
insanity and delinquency). 
The scientific program for the prevention of 
behavior abnormalities is very largely an extension 
of the methods in vogue for the correction of con- 
duct disorders. It consists of the extension of the 
medico-psychological study of the individual from 
the group already manifesting serious behavior 
difficulties (i.e., the psychotics and delinquents) to 
that in which definitely abnormal conduct has not 
yet appeared except in a rudimentary form. In 
other words, the study of children of school and 
pre-school age in whom there is any indication of 
incipient maladjustment, is the proposed means of 
directly dealing with the problem of prevention. 
The logical outcome of this concept is the estab- 
lishment of psychiatric clinics in connection with 
the schools. The functions of the mental clinics 
in connection with the school system would em- 
brace such activities as the following: 
1. The recognition of somatic disease and in- 
cipient mental disorders, and the institution of 
proper therapeutic measures for these. 
2. The recognition of mental defectives and 
the arrangement of a curriculum suited to their 
needs and capacities. 
3. The recognition of the superior child and 
adequate provision for the development of his 
special abilities. 
4. The recognition of undesirable personality 
traits in the process of formation and the endeavor 
to mold the personality along acceptable lines to PITFALLS OF OUR MINDS 
465 
prevent the possibility of failure in later life 
(either through the development of psychotic 
trends or vocational maladjustment, etc.). 
5. The recognition of vocational aptitudes and 
advice concerning their utilization. 
6. The guidance of play to inculcate the quali- 
ties of fairness and sociability. 
7. The discovery of abnormal emotional re- 
actions or incipient emotional conflict and the 
utilization of proper psychological methods for 
their removal from the mental life. 
8. The study of children showing pre-delin- 
quent tendencies and the transference of their ac- 
tivities into other socially approved types of 
conduct. 
9. The study of the environmental situation, 
and the readjustment of the home and general so- 
cial milieu for the benefit of the child. 
10. The study of problems involved in adoles- 
cent transitions, and advice concerning these 
difficulties. 
Such clinical service, in order to be universally 
effective, should not be limited to the public 
schools, but should be provided in private schools, 
colleges and universities (in connection with the 
department of student health), orphanages and all 
other institutions dealing with children and young 
people. This service should detect abnormal be- 
havior patterns in the process of formation, when 
they can be corrected before they become suffi- 
ciently pronounced to cause serious maladjust- 
ments. In this way, much personal unhappiness 466 
ABNORMAL BEHAVIOR 
and a great deal of social wastage could be 
prevented. 
Although we have come to realize the necessity 
of introducing scientific methods for the correction 
and prevention of conduct disorders into the court 
and school systems, the actual carrying out of this 
project is taking place very slowly. As we have 
seen, the development of the mental clinic as an 
out-patient department of the psychiatric or psy- 
chopathic hospital is comparatively recent. The 
establishment of clinical service for delinquents 
occurred at a still later date. The first clinic for 
the study of adult criminals was that at the Boston 
Municipal Court under the direction of Dr. Ander- 
son, which was initiated unofficially in 1913, while 
Dr. Healy’s famous medico-psychological studies 
of juvenile delinquents were begun in Chicago at 
about the same time. Other court clinics similar 
to these have sprung up sporadically over the 
country, but their numbers are wholly inadequate 
in view of the scope of the field to be covered. 
The Commonwealth Program for the Preven- 
tion of Delinquency is the most ambitious attempt 
to actually meet existing needs along this line. It 
provides for the maintenance of demonstration 
clinics in connection with the juvenile courts and 
public schools. It is believed that when the 
demonstration period is ended, the community in 
which it has been made will have come to appre- 
ciate the value of such work sufficiently to cause 
the institution of permanent clinical service at the 
public expense. As the result of one such demon- PITFALLS OF OUR MINDS 
467 
stration, permanent clinical service has already 
been established in connection with the juvenile 
court at St. Louis. Similar demonstrations are 
under way in other cities, and will soon be placed 
by permanent clinics. 
The school clinics which form another division of 
the Commonwealth demonstration are the first psy- 
chiatric clinics to operate exclusively with school 
children.1 It is true that school children have 
been brought to mental clinics in juvenile courts 
and out-patient departments of hospitals, but these 
have been cases of such marked abnormality as to 
be readily discernible even by the layman. By 
the time they received clinical study they had 
reached a stage requiring corrective rather than 
preventive measures. 
Dr. Glueck’s Bureau of Children’s Guidance, 
which operates in connection with some of the New 
York City schools, and the Mental Hygiene Clinic 
working in the public schools of Monmouth 
County, New Jersey, under the direction of Dr. 
Anderson, are definitely concerned with the pre- 
vention of conduct disorders. They study the 
child as soon as the first signs of maladjustment 
in any form appear, with a view to determining the 
causes of his behavior and outlining a plan for the 
prevention of more serious misconduct. 
The Monmouth County clinic is particularly 
unique in that it deals principally with children 
1 Dr. Fernald has for some time furnished clinical 
service for the public schools of Massachusetts, although 
this has been limited to retarded children for the most part. 468 
ABNORMAL BEHAVIOR 
who live in a rural environment, and who present 
many problems which may be traced specifically 
to this fact. The lack of proper play and recrea- 
tion facilities in rural districts is frequently pro- 
ductive of behavior difficulties. Lacking a whole- 
some outlet for his energies in play activities, the 
child may become precociously concerned with sex 
affairs or may find other means of obtaining excite- 
ment and exhilaration more or less anti-social in 
nature. This is not peculiar to the group of chil- 
dren being studied in Monmouth County, but is a 
general statement, applicable to children placed in 
a rural milieu. The mobile mental hygiene clinic, 
which is the necessary form of clinical service in 
rural districts, presents many difficulties of or- 
ganization and administration, but it is a very 
necessary part of an inclusive preventive program. 
Recent studies in child psychology indicate that 
the pre-school years and infancy are as significant 
for the formation of habits which act as a founda- 
tion for conduct disorders in later life as are the 
years spent in school. Many abnormal reaction 
patterns are built up in the first years of the child’s 
life. Just as baby clinics have already been in- 
augurated to care for the physical welfare of the 
young child and to offer guidance to mothers in 
the care of their babies, so the time will come when 
mental hygiene clinics will also offer their services 
for this period of the child’s life. Just as the 
mother should be taught the proper methods of 
feeding and otherwise caring for the physical needs 
of her child, so she must be given an insight into PITFALLS OF OUR MINDS 
469 
the mental mechanisms of childhood. She must 
learn how easily abnormal emotional reactions, 
such as morbid fears, are set up in the child’s life, 
and how difficult it is to dispel these reactions once 
they have become habitual. She must learn to 
replace the traditional parental discipline of re- 
pressive measures based on mere authority with 
sympathetic guidance of the child’s diverse energies 
into wholesome play and work activities. Only 
through the intelligent cooperation of the home can 
the child be trained in adequate habits of character 
and personality formation. 
While the various types of clinical service will 
do much to eliminate abnormal behavior traits 
from the life of the individual, the community in 
general must have some education along the lines 
of mental hygiene if we are to obtain the highest 
possible success along preventive lines. In its 
broadest aspects, this means that the general pub- 
lic must have some knowledge of the underlying 
principles of modern dynamic psychology, and 
must acquire to a certain extent an impersonal and 
scientific attitude toward such problems as we have 
been discussing. Once there is firmly established 
in the social mind the concept that the aberrant 
individual is urged on by motives beyond his con- 
trol and often beyond even his own understanding, 
that he is seeking, perhaps blindly, for some satis- 
faction for his fundamental human cravings, and 
that he is not hostile to the interests of his fellows 
from mere perversity of volition, then we may ex- 
pect a more tolerant attitude toward the divergent 470 
ABNORMAL BEHAVIOR 
members of the group, and a more intelligent 
treatment of their problems. 
Just as the parent and teacher must face the 
fact that the child has definite affective needs 
which must be given satisfaction by providing ade- 
quate outlets for his emotional energies and per- 
mitting him a reasonable amount of freedom in 
which to develop his own personality, so the group 
as a whole must recognize that each of its in- 
dividual units has his own emotional cravings and 
has similar need for as much personal autonomy as 
can possibly be granted. Fearful for its own safety, 
the community has always been loath to permit 
too much individual liberty, and has always at- 
tempted to suppress the personality which was 
noticeably different from the social norm. As we 
have remarked previously, this unreasoning atti- 
tude of the group has resulted in the loss of con- 
tributions of vast importance to society in many 
instances, and has often materially retarded social 
progress. 
We are still too much the slaves of old traditions 
and conventions which were woven into the mores 
in a day when scientific knowledge was lacking, 
and when taboos and fear inhibitions were neces- 
sary for the protection of the individual and for the 
survival of the group. We have now reached a 
stage of social evolution in which we can safely 
grant more freedom to the individual. The system 
of repression not only involves personal unhappi- 
ness, but also results in the dissipation of energies 
in rebellion against imposed codes of conduct PITFALLS OF OUR MINDS 
471 
when these energies might better be converted into 
a broad sphere of social usefulness, yet the great 
mass of people are still governed by taboos and 
inhibitions built up in ignorance and superstitious 
beliefs. 
It is not compatible with the theory of democ- 
racy to withhold from the masses the knowledge 
which has come into the possession of the upper 
classes, nor is it for the best interest of the group 
to do so. We have no right to place a heavy 
premium on marriage by refusing the popular dis- 
semination of data as to birth control, for example. 
In so doing, we not only place unjust restrictions 
upon the individual, but we also foster the social 
evil of prostitution to some extent. We have no 
right to take away from the working man the 
sociability of the saloon and the relaxation of his 
alcoholic beverages, when it is possible for the 
prosperous citizen to secure his liquor as liberally 
as ever, in spite of the laws we have made. If 
we insist on prohibition, we should at least furnish 
some vicarious means of attaining similar satis- 
factions. We have no right to prevent the spread- 
ing of knowledge concerning prophylactic measures 
for preventing the contraction of venereal disease 
on the sanctimonious and pseudomoral grounds 
that the possession of such knowledge would lead 
to an increase in irregular sex habits among the 
general population. The misery of innocent 
women and children which is caused by venereal 
disease (easily preventable were the social attitude 
toward the problem other than it is) is a more 472 
ABNORMAL BEHAVIOR 
pressing reason for the dissemination of such in- 
formation than all those which unscientific 
moralists can assemble against it. 
The burden of reproach falls to some extent 
upon the scientist, himself. Too often he has re- 
mained absorbed in his research, leaving the public 
to suffer at the hands of charlatans who purveyed 
a distorted and untruthful version of his discov- 
eries. (Some of the popular lecturers on psycho- 
analysis, auto-suggestion, spiritism, etc., are perti- 
nent contemporary examples of this.) The scien- 
tist should feel it a part of his obligation to his 
fellows not to leave society to the management of 
those who are ignorant of the significant facts 
which he could present to assist in a better organiz- 
ation. That he may have difficulty in convincing 
the conservative and intellectually inferior mem- 
bers of the group is true, and these are no small 
number. Yet it is his duty to provide an intel- 
ligible statement of his findings for the purpose of 
educating the public. Moreover, it is still further 
his duty to take an active part in political affairs, 
in order that he may prevent the perpetration of 
such outrages against the common weal as are im- 
posed upon a credulous people by unscrupulous 
politicians. The movement of the age is the appli- 
cation of scientific principles for the welfare of 
mankind, and in this the scientist must become the 
leader unless he would see his life work distorted 
beyond all recognition, and his most cherished 
discoveries made a source of grief to mankind. PITFALLS OF OUR MINDS 
473 
SUPPLEMENTARY READINGS 
Barnes, H. E. Some Leading Phases of the Evolution of 
Modern Penology. Political Science Quarterly, Vol. 
XXXVII, No. 2, June, 1922. An excellent outline of 
the development of penal systems. 
Campbell, C. MacFie. The Mental Health of the Com- 
munity and the Work of the Psychiatric Dispensary. 
Mental Hygiene, Vol. I, No. 4, Oct., 1917. 
Chute, Charles L. Probation in Children’s Courts. 
Gov. Printing Office, Washington, D. C., 1921. An ex- 
cellent article on probation. 
Clark, M. V. Mental Hygiene and the Public Library. 
Mental Hygiene, Vol. V, No. 4, Oct., 1921. A short skit, 
but somewhat suggestive. 
Fernald, W. E. An Out-Patient Clinic in Connection with 
a State Institution for the Feeble-Minded. Am. Jour. 
Insanity, Vol. LXXVII, No. 2, Oct., 1920. 
Glueck, Bernard. Concerning Prisoners. Mental Hy- 
giene, Vol. II, No. 2, April, 1918. A significant account 
of the studies in Sing Sing. 
Glueck, Bernard. Psychiatric Aims in the Field of 
Criminology. Mental Hygiene, Vol. II, No. 4, Oct., 1918. 
Also based on the psychiatric study of Sing Sing prisoners. 
Healy, William. Medico-Psychological Study of Delin- 
quents. Mental Hygiene, Vol. Ill, No. 3, July, 1919. 
Montague, Helen. Report of the Psychopathic Clinic of 
the Children’s Court, 1918. Contains some interesting 
statistical data. 
Singer, H. D. Mental Health Clinics. Mental Hygiene, 
Vol. V, No. 3, July, 1921. 
Singer, H. D. The Need for Instruction in Mental Hy- 
giene in Medical, Law and Theological Schools. Mental 
Hygiene, Vol. Ill, No. 1, Jan., 1919. 
Williams, F. E. Psychopathic Hospitals and Prophylaxis. 
Boston Medical and Surgical Journal, Vol. CLXXII, No. 
25, June 24, 1915. 
Williams, F. E. The State Hospital in Relation to Public 
Health. Mental Hygiene, Vol. IV, No. 4, Oct., 1920. 
Wines, F. H. Punishment and Reformation. Crowell, 
N. Y., 1919. 474 
ABNORMAL BEHAVIOR 
Woodill, Edith E. Public School Clinics in Connection 
with a State School for the Feeble-Minded. Mental 
Hygiene, Vol. IV, No. 4, Oct., 1920. 
Proceedings of the National Conference of 
Social Work (49th Annual Session). University of 
Chicago Press, 1922. Section II, Delinquents and Cor- 
rection, and Section VII, Mental Hygiene, contain valu- 
able papers of further material concerning subjects briefly 
touched upon in this chapter. INDEX 
Abnormal personality, 146 et seq. 
See also Personality 
Acromegaly, 119 
Adlerian theory, 151-15 2 
See also Inferiority, feeling of 
Adolescence, abnormal behavior 
in, 51-56 
desire for independence in, 
51-56 
educational maladjustment in, 
400-403 
emotional conflict in, 50-56 
Adrenal glands, 115 et seq. 
and behavior, 116 
and personality, 116 
Aggressive personality, 161-163 
See also Anger 
Alcoholics, 
See also Delirium Tremens, 
Korsakow Psychosis 
Delirium Tremens, 222-223 
hallucinosis in, 224 
pathological intoxication, 221- 
222 
personality of, 321 
prohibition, 326 et seq. 
suicide in, 360-363 
Alcoholic hallucinosis, 224 
Allport personality scale, 144- 
145 
Ambivalence, of emotions toward 
opposite sex, 160-161 
of fear and anger, 9-10 
Anger, 8 et seq. 
ambivalent to fear, 9 et seq. 
original stimulus for, 8 
Anxiety Neurosis, 247 
Army Alpha Intelligence Test, 
73-74 
Army Beta Intelligence Test, 73- 
74 
Arteriosclerosis, 126-127 
Asthma, 109 
Autonomic nervous system, 134- 
135 
Auto-suggestion, 242-243 
Beta intelligence test, 73-74 
Binet test, 71 
Borderline mental defect, 249- 
254 
abnormal behavior in, 250 et 
seq. 
description of, 249-250 
Borderline mental disease, 230 
et seq. 
See also Anxiety Neurosis, 
borderline defect, constitu- 
tional psychic inferiority, 
Hysteria, Neurasthenia, Psy- 
chaesthenia, Psychoneurosis, 
Traumatic Neurosis 
Caesar as epileptic, 272 
Capital punishment, 446-447 
Cardiac disease and behavior, 
126 
Censor, psychic, 233, 237 
Cerebral arteriosclerosis, psy- 
chosis with, 207 et seq. 
abnormal behavior in, 207 
et seq. 
causes of, 207 
delusions in, 207 
475 476 
INDEX 
symptoms of, 207-208 
Cerebral syphilis, psychosis with, 
218-220 
abnormal behavior in, 219-220 
symptoms of, 218-219 
Children, abnormalities in, 374 
et seq. 
congenital lues in, 386-387 
Dementia Praecox in, 393-394 
educational maladjustment of, 
373 et seq. 
emotional conflicts in, 404-408 
glandular disturbance in, 380- 
382 
maladjusted from many causes, 
409-4x0 
Manic Depressive Psychosis 
in, 391-393 
mental defect in, 377-384 
neurotic, 397-400 
post-encephalitic disorders in, 
387-391 
psychoneurotic, 394-395 
psychopathic, 395-397 
psychotic, 391-394 
suicide in, 368-371 
Clinics, 458 et seq. 
court, 458 et seq. 
function of, 458 et seq. 
methods of study, 459-466 
personnel of, 458-459 
Cocaine, effect of, 298 
overdose of, 300; 321-323 
source of, 297 
Complex 
father, 14; 159-161 
mother, 14; 158-159 
sister, 42-45 
Conflict, see Emotional Conflict 
Compulsion neurosis, 245 
See also Psychaesthenia 
Congenital lues, 386-387 
See also General Paresis and 
Syphilis 
Constitutional psychic inferiority, 
abnormal behavior in, 254 
et seq. 
masturbation in, 256-258 
pathological lying in, 255 
personality in, 153-154 
sexual perversions in, 255 
et seq. 
sexual promiscuity in, 159- 
262 
vocational maladjustment in, 
432 
Conversion, see Hysteria, 235 
Cretinism, 112 
Criminality, see Delinquency 
Curiosity, 16 et seq. 
see also Instinct of manipula- 
tion 
question of being an emo- 
tion, 16-17 
Dancing, 23 
Daydreaming, 19 
See also Flight from Reality 
Delinquency, attitude of com- 
munity toward, 445-450 
juvenile, 453-455 
prevention of, 462 et seq. 
reformatories for, 454-455 
prevention of, 462 et seq. 
Commonwealth program, 
466 
punishment of, 446-450 
Delirium Tremens, 222-223 
Dementia Praecox, 172 et seq. 
abnormal behavior in, 173- 
186 
delinquency in, 177 et seq. 
educational maladjustment in, 
393-394 
frequency of occurrence, 171 
Hebephrenic form, 172 
in children, 393-394 
Katatonic form, 173 
marital difficulties in, 175-177 
Paranoid form, 173 
personality in, 146-148 
self-injury in, 173-174 
Simple form, 172 
suicide in, 357-360 INDEX 
477 
Dreams, 28; 43; 406-407. 
Drug Addiction, 292 et seq. 
abnormal behavior in, 310 
et seq. 
cure of 303-304 
homosexuality in, 313-315 
in emotional conflict, 56-64 
mental deficiency in, 302 
personality in, 301 
prostitution in, 302; 313 
et seq. 
stealing in, 310 et seq. 
Educational Maladjustments, 373 
et seq. 
adolescence, 400-403 
congenital lues in, 386-387 
Dementia Praecox in, 393-394 
emotional conflict in, 404-408 
epilepsy in, 276-278; 384- 
386 
family situation in, 404-408 
glandular disturbance in, 
38o-38r 
management of, 411-412 
Manic Depressive Psychosis in, 
391-393 
Mental defect in, 377-384 
neurotic child, 397-400 
post-encephalitic conditions, 
387-391 
Egocentric personality, 133-136 
Emotional conflict, 32 et seq. 
in educational maladjustments, 
404-408 
in vocational maladjustments, 
432-434 
Emotional instability, 
See also Mental defectives, 
Personality. 
Cases of, 36-64 
Emotions, 3 et seq. 
See also Anger, Curiosity, 
Fear, Foodgetting, Gregari- 
ousness, Parental, Play, Sex 
disgust, s 
elation, 3 
glandular activity and, 136- 
i37 
negative self-feeling, 5 
nervous system and, 136-137 
positive self-feeling, 5 
Endocrine disorders, no et seq. 
See also Adrenals, Glands of 
internal secretion, Parathy- 
roids, Pineal, Pituitary, Sex 
glands, T hymus, T hyroid, 
etc. 
Epidemic encephalitis, 139 
See also Postepidemic enceph- 
alitis disorders 
Epilepsy, 265 et seq. 224; 282- 
283 
abnormal behavior in, 276 
et seq. 
assaultive tendencies in, 282- 
283 
causes of, 268-270 
convulsions in, 267-268 
cure of, 287 et seq. 
educational maladjustments in, 
276-278; 384-386 
equivalents, 275; 2 76-2 78; 
279-280 
frequency of occurrence, 272 
glandular disturbances in, 269 
Grand Mai attacks, 274 
Heredity of, 268-269 
in children, 276-278; 384-386 
insanity in, 224; 273-276; 
282-283 
Jacksonian type, 273 
personality in, 273 
psychoanalytic theory of, 270 
psychoses with, 275-276 
sex delinquency in, 279-282 
suicide in, 280-281 
types of, 274-273 
Fear, 7 et seq. 
Flight from reality, 19 et seq.; 
45 
Focal infections, 103; 107-108 
Foodgetting, 5 et seq. 478 
INDEX 
General Paresis, 139 
See also General Paralysis, Ju- 
venile General Paresis 
General paralysis, 
abnormal behavior in, 214 
et seq. 
cause of, 212 
crime in, 214 et seq. 
marital difficulties in, 214 
et seq. 
syphilitic infection in, 212 
symptoms of, 212-213 
Glands of internal secretion, no 
et seq. 
See also Adrenals, Parathy- 
roids, Pineal, Pituitary, Sex 
glands, Thymus, Thyroids, 
etc. 
Glandular Imbalance, no et seq. 
in children, 380-382 
in educational maladjustments, 
380-382 
in mental defectives, 380-382 
Gregariousness, 15; 40-42 
Group tests 
See Psychometric examination 
Heart diseases, 126 
personality in, 126 
Hebephrenic Dementia Praecox, 
See Dementia Praecox 
Heroin, 295-296 
Hoch-Amsden guide to personal- 
. ity, 
Homebuilding, 23 
Homosexuality, 
See also Sex perversions 
in drug addiction, 313-315 
in epileptics, 279 
Hunger, 
Hypermanic, 
See Manic Depressive Psy- 
chosis, Personality 
Hyperthyroidism, 114 
Hypopituitarism, 118 
Hypnosis, 238 
Hysteria, 232 et seq. 
See also Psychoanalysis, Spirit- 
ualism, Suggestion 
conversion in, 235 
Freudian theory of, 232-234 
in shell shock, 235; 238-240 
personality in, 232 
sexual trauma in, 232; 
234-237 
suicide in, 365-368 
Ideals, development of, 164 
Individual differences, 
in intellectual capacities, 68 
in personality makeup, 142 
Industrial maladjustment, 
See Vocational Maladjustment 
Infantile arrest, 
See Sex 
Inferiority, feeling of, 9-10; 
24; 39-40 
Inhibitions, 
See Repression 
Insanity, 167 et seq. 
See also Psychosis 
definition of, 168-169 
legal term, 168 
Instincts, 3 et seq. 
See also Anger, Fear, Food- 
getting, Gregariousness, Pa- 
rental, Play, Sex, Manipu- 
lation 
Intelligence levels, 69 et seq. 
See also Psychometric exami- 
nations 
and vocational maladjustment, 
418-421 
Intelligence tests, 
See Psychometric examina- 
tion 
Intoxication, pathological, 221- 
222 
Involution melancholia, 200 et 
seq. 
abnormal behavior in, 200 et 
seq. 
Juvenile general paresis, 220 INDEX 
479 
Juvenile delinquency, 453 et seq. 
See also Delinquency, juvenile 
Kidneys, disease of, 129 
Korsakow psychosis, 223-224 
Language expression, 
See Sublimation 
Lincoln as manic depressive, 151 
Lues, congenital, 386-387 
See also General Paralysis, 
Syphilis 
Lung diseases, 108 et seq. 
Lying, pathological, 36 
Manic depressive psychosis, 186 
et seq. 
abnormal behavior in, 189 et 
seq. 
crime in, 189 et seq. 
educational maladjustments in, 
391-393 
in children, 391-393 
personality in, 140-151 
recurrence of, 192-196 
suicide in, 196-198; 350-356 
Manipulation, instinct of, 16 
et seq. 
Masochism, 262 
See also Sex Perversions 
Masturbation, 256-258 
See also Sex Perversions 
Measurement of intelligence, 
See Psychometric Examina- 
tions 
Melancholia, 
See Manic Depressive Psy- 
chosis 
Mental defect, 68 et seq. 
See also Psychometric exami- 
nations 
abnormal behavior in, 75 et 
seq. 
borderline defect, 249-254 
glandular disturbances in, 380- 
382 
in criminals, 75; 83 et seq. 
in educational maladjustments, 
377-38o 
in prostitutes, 75; 86 et seq. 
institutional care for, 77-79 
irresponsibility of, 87 et seq. 
lack of foresight in, 87 et seq. 
psychoses in, 229; 92 et seq. 
sex delinquency in, 83 et seq. 
social adaptation in, 77-79 
special classes for, 95 
suggestibility of, 80 et seq. 
unstable type, 90 et seq. 
Mental disease, 
See also Psychoses 
attitude of community toward, 
441-445 
history of treatment, 441-444 
Mohammed as epileptic, 272 
Morphine, 274-295 
Mother, unmarried, 46-47 
Myxedema, 113 
Napoleon as epileptic, 272 
National Intelligence Test, 73 
See also Psychometric Exam- 
inations 
Nervous system and behavior, 
132 et seq. 
Neurasthenia, 247 
Neuroses, 230 et seq. 
See also Anxiety neurosis, 
Neurasthenia, Psychoneu- 
rosis, Traumatic Neurosis 
War, 24; 235-240 
Neurotic, 
Adlerian theory of, 151-152 
Personality of, 152; 248 
Obsessions, 246 
Opium, 292 et seq. 
See also Heroin, Morphine 
Organic psychoses, 204 et seq. 
Pain pleasure principle, 21 
See also Flight from Reality 
Paranoia, 202 et seq. 
See also Dementia Praecox 480 
INDEX 
Parasympathetic nervous sys- 
tem, 135 
Parathyroids, 115 
Parental instincts and emotions, 
13 et seq. 
Pathological intoxication, 221- 
222 
Pathological lying, 255 
Penal code, history of, 446 et 
seq. 
Performance Tests, 72 
See also Psychometric Exam- 
inations 
Personality, 141 et seq. 
aggressive, 151-163 
Allport rating scale, 144-145 
egocentric, 155-156 
emotionally unstable, 153-154 
epileptic, 155-156; 263 
genesis of, 156 et seq. 
glandular imbalance, no et 
seq. 
Hoch-Amsden guide, 143-144 
Hyperkinetic, 149 
Hypermanic, 149 
Hypokinetic, 156 
of alcoholic, 321 
of constitutional psychic in- 
ferior, 153-154 
of Dementia Praecox, 146- 
148 
of drug addicts, 301 
of Manic Depressive, 148-151 
of neurotic, 151-153 
of psychoneurotic, 15 2-153; 
248 
passive, 161-163 
physical disease and, 99 et. 
seq.; 156 
seclusive, 146-148 
shut-in, 146-148 
unconscious mechanisms of, 
1S8 
Wells outline of, 144 
Perversions, 
See Sex perversions 
Phobias, 246 
Physical basis of behavior, 99 et 
seq. 
Physical disease and behavior, 
ioo et seq. 
arteriosclerosis, 126-127 
arthritis, 102 
asthma, 109 
cardiac diseases, 126 
chronic wasting diseases, 138 
dental diseases, 103 
See also Focal infections 
digestive organs, 127 
endocrine disturbance, no et 
seq. 
epidemic encephalitis, 139; 
epilepsy, 139; 
fevers, 138 
general paresis, 139 
glandular diseases, no et seq. 
joint diseases, 102 
kidney diseases, 129 
heart, 126 
lungs, xo8 et seq. 
nervous system, 139 
tuberculosis, 108 
Pineal gland, 112 
Pintner Patterson Tests, 72 
See also Psychometric exam- 
inations, 
Pituitary gland, 116-1x9 
Play, 17 et seq. 
Postepidemic encephalitis dis- 
orders, 225 
See also Children, Educational 
maladjustment, 
Prevention of delinquency, 462 
et seq. 
Prevention of mental disease, 
462 et seq. 
Prison reform, 448 et seq. 
Prisoners, 
Vocational guidance for, 451 
Prohibition, 326 
Prostitution, 259-264 
See also Mental Defect, drug 
addiction, etc. 
Psychaesthenia, 245 et seq. INDEX 
481 
Freudian theory of, 246- 
247 
Psychoanalysis, 238; 243-245 
Psychometric examinations, 71 
et seq. 
Army Alpha, 73-74 
Army Beta, 73-74 
Binet, 71 
effect of emotions on, 74 
for illiterates, 72-74 
group tests, 73~74 
National Intelligence Tests, 73 
Pintner Patterson Perform- 
ance Tests, 72 
reliability of, 74 
Stanford-Binet, 71 
Terman Group Test, 73 
Psychoneuroses, 231 et seq. 
See also Anxiety Neurosis, 
Hysteria, Neurasthenia, Psy- 
chaesthenia, 
in children, 394-395 
in educational maladjustments, 
394-395 
personality in, 148-151 
treatment of, 249 
vocational maladjustments in, 
43i 
Psychopathic child, 395-397 
Psychopathic personality, 153- 
i54 
Psychoses, 167 et seq. 
See also Dementia Praecox, 
General Paresis, Manic De- 
pressive, etc. 
abnormal behavior in, 207 
et. seq. 
definition of, 168-169 
functional, 170 
in mental defectives, 92 et 
seq.; 226-229 
organic, 170 
psychogenic, 170 
suicide in, 335 et seq. 
types of, 170 
Reformatories, 453 et seq. 
Repression, 22-23; 26; et seq.; 
161; 233 
Reproductive instincts, 11 et 
seq. 
Sadism, 262 
Seclusive Personality, 146-148 
Senile psychosis, 205-207 
Senescence, 205-207 
Sensory nervous system, 133-134 
Sex instincts and emotions, 11 
et seq. 
See also Sex glands, Sex per- 
versions 
Sex glands, 119 et seq. 
Sex perversions, 33-35; 56-64; 
262 et seq. 256-263; 279- 
284 
exhibitionism, 263-264 
homosexuality, 56-64; 263 
in epileptics, 279-284 
masturbation, 256-258 
masochism, 262-263 
sadism, 262 
sodomy, 33-35 
voyeurs, 263-264 
Shell shock, 24; 235-240 
Shut-in personality, 146-148 
Sodomy, 33-35 
Special abilities and disabilities, 
74-75 
Special classes, 95 
Spiritualism, 241-242 
Stanford-Binet, 71 
See also Psychometric exami- 
nation 
Sublimation, 20-21; 25 et seq.; 
56-64 
See also Repression, Flight 
from Reality 
Sucking reflex, 
See Foodgetting 
Suggestion, 237; 242-243 
Suicide, 33 et seq. 
alcoholic hallucinosis in, 360- 
363 
attitude of community to- 482 
INDEX 
ward, 333-336 
causes of, 336 et seq.; 370 
chronic disease in, 363-364 
Dementia Praecox, 357-360 
Manic depressive, 196-198; 
3SO-3S6 
Mental disease in, 346 et seq. 
Psychoanalytic theory of, 335 
Symbolism, 28-29; 406-407 
See also Dreams, 
Sympathetic nervous system, 135 
Syphilis, 37-39! 211-214 
See also General Paralysis 
in children, 386-387 
Terman revision of Binet, 71 
See also Psychometric exam- 
ination 
Terman Group Test, 73 
See also Psychometric exami- 
nation 
Thymus gland, in et seq. 
Thyroid gland, 112 et seq. 
cretinism, 112 
exopthalmic goitre, 113-114 
Graves’ disease, 113-114 
hyperthyroidism, 114 
myxedema, 113 
Torture, 446-447 
Transference, 245 
Traumatic neurosis, 247-248 
Traumatic Psychosis, 210-211 
Tuberculosis, 108 
Veronal, 323-324 
Vocational guidance, 422-424 
Vocational maladjustment, 415 
et seq. 
Dementia Praecox in, 426-429 
emotional conflicts and, 432- 
434 
intelligence levels and, 418- 
421 
Manic Depressive and, 429- 
43i 
Social psychology of, 415-418 
Voyeurs, 263-264 
War, 23 
War neuroses, 24; 235-240 
Will to power, 10 
Wish-fulfilment 
See Flight from Reality, Sub- 
limation