Prof. Meyer is to be commended for the very splendid program presented at the opening exercises of the Phipps Psychiatric Clinic.
May it be a lasting inspiration for those who drink at the fountain of psychiatry and psychopathology. MEYER SOLOMON.
BOOKS RECEIVED
SLEEP AND SLEEPLESSNESS. By H. Addington Bruce. Pp. IX + 219. Little, Brown & Co., 1915. $1.00 net.
THE MEANING OF DREAMS. By I. H. Coriat. Pp. XIII + 194. Little, Brown & Co. $1.00 net.
THE JOURNAL OF ABNORMAL PSYCHOLOGY
A PSYCHOLOGICAL ANALYSIS OF STUTTERING[*]
[*] Paper read May 6, 1914, at Albany, New York, before the American Psychopathological Association.
Copyright 1915 by Richard G. Badger. All rights reserved.
BY WALTER B. SWIFT, A.B., S.B., M.D.
Instructor in Neuropathology, Tufts College Medical School, In Charge Voice Clinic, Boston State Hospital, Psychopathic Department.
THE object of this paper is to carry the analysis of stutter phenomena deeper than before. In my last year's paper I showed that chronologically the diagnosis of dyslalia mounted step by step from a material external affair, up through the nerves until we came to the basal ganglia. I showed conclusively that it was an involvement that did not exist in any of these places. I further took steps to demonstrate and present evidence that indicated that dyslalia was in its essence some trouble with the personality. I mean by this: that the trouble was located in the nervous system beyond the lower sensory areas of the sensorium; and also above the lower motor areas on the motor side. By the broad term "personality" I mean the total of the activities and interrelations of mental activities that occur above our lower sensory and motor areas. The paper of last year clearly located the trouble vaguely in this region of the personality.
Since that time I have been interested to ascertain just what the nature of this changed personality is. In order to do so, I have carried on an investigation that has reached interesting conclusions. To me it is new truth. It may not be all the truth, but as far as it goes, and as for what it is, it surely is truth and a new finding! This research is an effort to show not only where it is but WHAT IT IS.
The method was as follows: For the purpose of finding out some of the activities going on in the area of collaboration during speech, I asked my stuttering patients two simple questions. I thus found that their methods of collaboration complied to a certain mental type.
Then I carried this same method into the study of normal individuals in the collaboration of their ideas, just before and during speech in order to establish a norm; and to see whether or not it differed from my preliminary test of stuttering cases just mentioned. It did, and therefore I formulated a series of questions in order to pin the type of collaboration down to certain fields of mental action. To make this clear, let me present an outline of these different steps in tabular form.
1. Orientation tests on stutterers. 2. Orientation tests on normal individuals. 3. The research, its objects and methods. 4. Final detailed results.
Let us now pass to a minuter description of each of these procedures and a tabulation of the data that resulted.
1. PSYCHOLOGICAL ORIENTATION TESTS ON STUTTERERS:
By orientation test I mean simply a vague try-out to see just where the problem lies; an initial step to see what further steps are necessary; or in other words enough of an investigation to know where to look next.
The orientation tests consisted in requesting a series of twenty stuttering cases to answer two questions. Following their answers an immediate inspection was made of the content of their consciousness before, during, and after speech. These two questions were as follows:
1. Where do you live? 2. Say after me "The dog ran across the street."
After these questions I asked the patients to state whether there was any picture in the content of consciousness and how long it lasted; also whether that was detailed, intense or weak. I noted the presence of stuttering in relation to the presence or absence of this mental imagery; and also made a note of any other unusual data that happened. The results of the tests indicated above can be summarized as follows:
Of the twenty stutterers examined, ten made no visualization of their homes, some even after a residence of years; one of these twenty visualized home very faintly; two others visualized home clearly but the picture vanished on speaking; seven others visualized home clearly but these had been under treatment.
On repeating the dog statement, ten stutterers made no visualization whatever; one visualized faintly; four visualized well but the picture vanished on speaking; five others reported visualization, and four of these had been under treatment.
At first I did not know but what this was the norm of average visualization methods; so I tried this same series upon a number of normal individuals for comparison; by normal individuals, I mean, at this time, merely anyone who is free from stuttering, and chosen in a haphazard way from the hospital community; for example, one was our executive secretary, another a typewriter, another a telephone operator and so on.
2. PSYCHOLOGICAL ORIENTATION TESTS ON NORMAL INDIVIDUALS
The results of these orientation tests upon normal individuals were as follows:
The normal individuals examined almost without exception visualized clearly before and during speech. Sometimes this visualization was very marked in detail and resulted in emotional responses, such as pleasures, etc.
From the above two sets of figures were thus obtained a fair norm of visualization for ordinary individuals; and in comparison a marked variation from this in stutterers. This data therefore warranted the tentative conclusion that stutterers have a loss or diminished power of visualization. This assertion may seem a little more than is warranted by such meagre data and perhaps would be better revised pending further data into the following: As compared with the normal, stutterers show a weakness in visualization.
3. THE RESEARCH, ITS OBJECTS AND METHODS:
These general orientation tests for a norm and its pathological variation were the basis upon which I proceeded on broader lines with a further and more exhaustive investigation with the following points in view:
To what extent is visualization weak?
Is it weaker in the worst cases?
Is it less and less weak as cases appear less severe?
Is it the same for past, present and future memories?
Is visualization equally at fault in all sensory areas of the cortex?
Do cases approach normal visualization processes in proportion as they progress in their cure? and
Lastly, numerous other minor queries presented themselves.
All these questions were answered in the following research, which after thus much orientation found a more complete and final form.
In order to answer these questions I formulated the following series of tests to the number of twenty-four in all, and asked them in series to nineteen stutterers, making almost four hundred tests:
1. Speech: Say, Today is sunny.
The dog ran across the street.
Submarines will sink all the steamers.
2. Motor: Do you dance?
Did you ever skate?
Would you sew for a living?
3. General Sensory: How does a pinch feel?
Did you ever get hurt?
What would you like to do if it was very hot next summer?
4. Hearing: (Eyes closed) Do you hear anything?
Did you ever hear a rooster crow?
What sounds would you like to hear next summer?
5. Sight: (Eyes closed) What do you see now?
What did you see yesterday?
What would you like to see next summer?
6. Smell: (Eyes closed) (Pen to nose) Do you smell anything?
What have you told by smell?
What would you like to smell next summer?
7. Taste: (Eyes closed) Do you taste anything?
What have you been able to tell by the taste?
What would you like to taste next summer?
8. Muscle Sense: (Eyes closed) Put one arm up; the other like it.