Put one arm up, down; the other like it.
How would you hold a hand to read from it?
This long series of questions with careful introspection tests upon the content of consciousness constituted then my main research in the field of stuttering. Perhaps further details in explanation of the questions chosen is unnecessary. Three or more questions on introspection were asked at each test.
4. FINAL DETAILED RESULTS are found in the following conclusions as drawn from 1440 answers.
In our average conversation a visual picture is created before we begin utterance. Severe stutterers never visualize at all. In direct proportion that these cases become less severe, does visualization increase in frequency, strength and continuation in consciousness before and during utterance.
When severe stutterers are free from spasms they visualize, and when they stutter they do not visualize.
When mild cases are free from spasms, they visualize, and when they stutter they fail to visualize.
In a word, when visualization is present stuttering is absent; when visualization is absent stuttering is present.
This is true not only of EACH UTTERANCE, in most cases, but is true of severe as well as mild forms as a whole.
Stutterers gain in visualization as they approach cure.
For past, present and future memories: visualization is slightly more frequent for past and future.
Therefore stuttering is an indication of absent or weak visualization either in isolated words, occasional stutterers, mild stutterers or the severest type, either before or during speech, or both.
The slump, then, in personality which I showed last year as the main thing in stuttering as its cause and condition, is thus found by further psychological analysis, to be a slump in the power to consciously visualize.
By personality I mean as mentioned above the composite of collaborative activities that lie between the low sensory repository areas and the low motor expression areas. In other words, personality includes all those collaborative processes that lie between the sensory intake areas and the motor output areas; in a word, any unexpressed use the mind makes of its intake. Conscious visualization is a part of personality processes, then. In my last year's paper([1]) the whole matter was left vague. Here something definite and constant is found. In other words the psychoanalytical method revealed no conscious subconscious cause. Granted there is room here to "interpret" (or create according to Freudian mechanisms) a definite subconscious complex, a step which I could not feel justified in taking; I leave this to better psychoanalysts than I. For me to twist stutter phenomena to comply to a theoretical complex is unscientific to say the least. But the psychological method-as represented by this paper-shows a definite constant cause for all the phenomena of stuttering.
FAULTY VISUALIZATION EXPLAINS ALL PHENOMENA:
Upon this basis of an involved visualization all the intricate phenomena of stuttering may be explained. Let us take some of these up in detail.
THE START. Visualization processes are a matter of growth through exercise and development and use from the sensory area mostly of the eye. If these processes in their early start and evolution receive a setback through the treatment of people in the environment, such as interruptions of their early speech efforts, constant inattention of those to whom they speak, and persistent refusal by older people to answer questions propounded or the allowing of the little one to ask the same question without hopes of answer for a great number of times, these visualization processes receive a setback. This kind of treatment in the home is one of the chief causes of the slump of visualization processes. Another cause is hearing other stutterers interrupt their own visualization processes as they stutter; and still other minor causes may be almost any psychic trauma; these traumata, such as an operation, an accident or a severe illness, are sufficient to bring to the surface or intensify a growing lack of visualization that has been started by bad environment long before.
THE DEVELOPMENT OF STUTTERING. When the habit of visualization is lessened, the action upon speech is the same as the withdrawal of an inhibiting or regulating reflex arc.
It is thus that visualization processes act like reflex inhibition. When visualization is present a higher inhibition arc is functioning and we have a normal speech as a consequent reflex expression. When and in proportion as visualization is absent this higher inhibition arc is not functioning; and the speech thus uncontrolled flies away in spasms which we call stutter. It should be called an exaggerated or uninhibited speech reflex.
The stutter, then, is merely the externalization of an exaggerated reflex of motor speech, exaggerated through the loss of the inhibitory action of a more or less weakened visualization process.
Not only does this explain the phenomena at large but seems to be a satisfactory explanation for all its intricate, minute details. Some examples may, perhaps, be welcome at this point. I say to two stutterers: "Tell your first name." One of them stutters and the other one does not. On furthering questioning, it is found that the one who did not stutter visualized, and the one who did stutter did not visualize.
CONCRETE: These conditions are also seen when stutterers talk about concrete and abstract matters or when they promulgate some important plea that cannot be visualized. On concrete matters that can be easily visualized the stuttering is gone; and on abstract matters where visualization is hard, the stuttering again appears.
ANGER: In anger, when an intense visual picture is presented and occupies the mind, there is then no stuttering, and also in other similar situations there are periods when the individual is abandoned to some visual concept which acts in the same manner.
SINGING: We all know that stutterers can sing without stuttering. The process here is a similar one; only that there is held up over the speech before utterance an auditory image of a melody in place of the visual image as held in normal speech. This auditory image may be more easily applicable as supplying the needed inhibition reflex arc than the visual because it is nearer to the speech area.
PRAYER: For the same reason prayer is uttered without stuttering when there is faith enough in a God to hold an image of Him during utterance. There may also be other images held during prayer.
FAMILIAR SIGHTS: Familiar sights are less stuttered upon than the detailing of situations that are less familiar and therefore can be less well visualized. This is also true of sights that have been recently seen or that have been repeatedly seen, or that in some other way have been made intense as pictures in the visual field.
AS CURE PROCEEDS: In the process of recovery where visualization is seen to increase as the stutter decreases, there is another illustration where this visualization attitude explains the whole situation. I have taken a severe stutterer and told him a story that could be well pictured, got him to work up the pictures properly by several complicated processes (which we will not consider now) and when he had them well in hand, I have seen him stand up and relate the story from beginning to end with little or no stuttering If at any point he would trip up, the inevitable confession would be that at that point he dropped the picture, or, in other words, the visualization could not be held over in its inhibitory action; and therefore the stutter came. On further request to hold it over that point, the same passage would be again expressed smoothly if he succeeded in holding the picture.
This constancy, this presence and absence of the picture, its presence to make smooth talk and its absence to cause stuttering, is so constant at every turn of the situation, that I would offer it as a new interpretation of all these phenomena. I know of no other interpretation that can EXPLAIN EVERYTHING UNDER ONE HEAD as does this absence, weakness or interruption of visualization processes.
TERMINOLOGY. We have found in our orientation tests that in a vague way the visualization was at fault. We have also found in normal individuals that a marked visualization was an automatic process that preceded speech, and lasted during utterance; and we have found in the long series of stutterers that visualization is entirely absent in severe cases; that it is weak in milder forms; that it is intermittent in most cases, and that on words that are smooth it always appears, and in occasional stutter it is as occasionally absent.
We have also found that the form of visualization common in normal speech is the visualization of eye sensations; that in unusual situations we may have visualizations from other sense areas, such as the ear, taste or smell, but these are the RARE EXCEPTION.
From all this data it would naturally follow that some sort of term is needed to designate this condition. Last year I probed to find such a term without much success.
At present I see no reason why it should not be called an Asthenia; it is surely the weakening of a mental process that is strong in normal individuals. The evidence here presented shows that. I doubt whether there is any marked pathological change, since the individual may be educated out of it; but this does not necessarily follow as proven with my dog in Berlin.[2] As a general designation, then, I should consider Asthenia as apropos.
One objection to this is that the weakness is by this terminology lacking in localization. Our data above has shown us that the location of the trouble is visual; that is, it is situated about a centre of sensory registration that deposits data from the eye; this must naturally then be located somewhere in or near the cuneus. We could therefore add to the terminology this idea of a minute localization and call it a Centre Asthenia.
Some may prefer to carry the matter one step farther and add the name of the centre in which this weakness is located, but I fear if I take this step and complete my terminology by the word "Visual Centre Asthenia," it will, as such, not cover quite all the cases, for I find that sometimes the visualization is absent in other areas as well, and also the holding of an emotion of pleasure or pain and of other dominating mental attitudes that are sometimes visualized would not, therefore, be included. I would therefore retract the broader claim in order to place the term on a conservative basis and call the essence of the lesion simply no more or less than a Centre Asthenia. As well as visual Asthenia, the following terms might be considered as applicable: collaborative centre asthenia; imaginative centre asthenia; visual creative centre asthenia; picture producing centre asthenia. We say neurasthenia when the trouble is not in the nerves as such, so much as it is in the collaborative centres. More of this later. Here in stuttering the trouble is also collaborative, and we can be still more definite than that and say the trouble is with the collaboration of visualization. So if I were forced, however, to choose one term from all these, my choice would be "Visual Centre Asthenia." This indicates a new and rational treatment. But of this later.
SUMMARY: Psychoanalysis reveals stuttering as some vague trouble in the personality[1]. Psychological Analysis shows stuttering is an absent or weak visualization at the time of speech. This new concept of stuttering as faulty visualization may be called Visual Centre Asthenia. This lack or weakness in visualization accounts for all the numerous phenomena of stuttering in severe, medium, or mild cases. A new treatment is indicated.
REFERENCES
[1] Swift: Walter B, A Psychoanalysis of the Stutter Complex with Results of Synthesis.
[2] Swift Walter B., demonstration eines Hundes, dem beide Schafenlappen xtirpiert worden Sind. Neurologisches Centralblatt, 1910, no 13.
THE ORIGIN OF SUPERNATURAL EXPLANATIONS[*]
[*] Read at the 7th Annual Meeting of the American Psychopathological Association, New York, May, 1915.
BY TOM A. WILLIAMS, M. B., C. M. (EDINBURGH)
Corresponding Member Neurol. and Psychol. Societies of Paris, etc.
Neurologist to Freedmen's Hospital and Epiphany Dispensary, Lecturer on Nervous and Mental Diseases, Howard University, Washington, D. C.
THERE is a general impression that the explanations of natural phenomena, including human destinies, to which the term superstitious is given are usually attributable to the vestiges of traditional cosmogonies of our tribal ancestors handed down to children at the knees of their parents or guardians. This explanation however, is only true of a portion of the beliefs which we call superstitions. The demand for superstitious explanations depends upon psychophysiological tendencies of the human organism, the root of which is comprised in the affect which we call craving. This theorem I have tried to develop as follows:-
I
Craving is a sign of physiological need. It is a sensory phenomenon, of which, however, explicit awareness cannot always be discovered. It is conspicuously noticed in cases of disturbance of the body secretions, such as occurs in over-function of the thyroid gland. It is regarded as a crude body-consciousness that something is the matter. In motorial organisms it causes visible reaction: this expresses itself in what is termed restlessness. But the unrest may show itself by a fixation more particularly in the muscles of emotional expression, although the manifestation is not confined to these; shallow respirations and restricted amplitude of movement in limbs and trunk may be observed also. In cerebrate animals the reaction of the individual is under the guidance of preceding impressions stored in the pallium and known as memories; whereas in the animals without a pallium all reaction is accomplished through stable mechanisms known as instincts. Both of these types of reaction are tropisms merely; but the former are labile, conditionable; whereas the latter cannot be modified. The science of conditionable reactions of cerebrate animals is called psychology, and the means by which the reactions are influenced are called psychogenetic, whether these are healthy or diseased. It must not be forgotten, however, that the genesis of a psychological disturbance may be purely somatic, although the manner in which the reaction shows itself is contingent mainly upon the features of the individual which have been derived from previous sensory impressions and their resultant motor reactions commonly known as experience. It is the influence of these upon the hereditary dispositions of the individual which constitute what is known as "make-up" or character; and it is this which determines the form which reaction to stimulus must take, whether the stimulus is purely psychological or somatic.
Now physiological discomfort is an experience universal at one time of life or another; but the reaction to it is infinite in variety; and while part of it depends upon the congenital dispositions which are the common property of humanity, a larger part is contingent upon the psychogenetic factors which have stamped the individual.
II
Now an influence which has been of great significance to every human being since the traditional period, at least, has been the concept of the universe regnant at the period of that individual's life. The insistence by its protagonists upon this concept as the ultimate motive of human endeavour made its acceptance almost universal at periods when it was the custom to lean upon the dicta of authority for guidance in life even when blind obedience was not the rule. Now in natural affairs, inconvenient questionings and scepticisms towards dogmatisms would ultimately reach truth. But as inaccessibleness to verification of what was called supernatural made authority, rather than investigation, its criterion, excommunication from the tribe would still all criticism.[1] Thus every act of life became permeated by motives, originated in arbitrary interpretations of a super-nature.
[1] A dramatic study of this occurrence is presented by Grant Allen in "The Story of Why-Why" in his book "The Wrong Paradise."
These influences were specially conspicuous concerning the difficulties of man's almost blind struggle against the uncomprehended astronomical and geodetic phenomena marvelled at and fled from, as well as the pestilences which ravaged him. In his sociological affairs too, every act or thought became embued with relationship to an extraneous power.
It is by these social and physical phenomena that the greatest appeal is made to the states of feeling termed emotions and sentiments. So that it became the custom to invoke, concerning ill states of feeling, the reference to a supernatural influence. Thus, from the cradle up, the ordering of social relationships was made dependent upon the simple expedient of the supernatural extraneous agent, rather than upon the more difficult and elaborate analysis and synthesis which would have been required for a proper investigation of each perturbing circumstance in its relation to life as a whole. The power of this influence was inversely proportional to the resiliency and tenacity as well as the general well-being of the individual.
But not only is reference to the supernatural favoured by traditional cosmogony, but because of certain psychological features of the individual himself there is a tendency towards supernatural explanations of the introspective observations. The Occasions of introspection of this kind are two, and I am not speaking of the inculcated introspection of the moralists. One of these Occasions is the self-examination into his conduct which is a normal character of a thinking being. This may give rise to supernatural explanations even when the introspection is not determined by the tradition of which I have already spoken.