And what proof has Dr. Coriat given us for his conclusions? Here and there scattered through his paper one finds a few conclusions or explanations of a concrete nature, but they are his interpretations of the facts and not the facts. No real, in fact not a vestige of proof is offered. The few dreams which he presents do not, to the inquiring and demanding reader, show anything which permit of the conclusions which Dr. Coriat draws with reference to their meaning or significance. He seems to have interpretated (rather than analyzed) them in typical Freudian fashion. And, furthermore, even if his interpretations of the few dreams which he presents and which were taken from different cases were true, of what significance would that be? What right would we thus have of drawing conclusions which apply to all cases of stuttering (and, as mentioned earlier in this paper, to many other related states of a normal and abnormal nature)? Not the slightest.
Not a single case has been presented in proof of the conclusions drawn in the paper. Surely this is not what we have been accustomed to expect in other fields of medicine, especially when the conception newly put forth is entirely novel, sensational, revolutionary, contrary to all former beliefs, and based on theories and conclusions which have been for some time and still are a centre of storm, of wordy argumentation, and even of insult and abuse-at any rate sub judice,
Has the science and practice of psychopathology come to the stage when theories of any sort can be given to the reading public as fact, and no actual proof therefor presented?
I venture to say that in no other department of medicine or in fact in no other aspect of life would scientific men tolerate such presentation and promulgation, despite opposition and disproof and with no tangible or definite evidence or proof. Nor would men come forward to offer revolutionary, let alone dangerous theories, for general consumption, with so little proof, as is being laid on the platter for psychopathologists.
I find no evidence offered by Dr. Coriat to bolster up the conclusions of his paper.
In response to a question asked by one of those who discussed his paper in which he was requested to explain how he knew that stammering begins by concealing something, Dr. Coriat stated: "I have had an opportunity of examining a number of stammerers and subjecting them to a complete psychoanalysis, studying all the paradoxical mental reactions and in nearly every case this concealment of some sexual secret of childhood came up. It is easy to establish a certain relationship between the speech embarrassment and the concealed sexuality."
There is, as is seen, no other proof for this theory (that is all that one call it) of Dr. Coriat and the Freudian school in general, than his or their say-so. Those who are acquainted with the method of arriving at conclusions adopted by the Freudian school will demand more than this as proof of either the "concealment" of some "sexual secret" of childhood (and where lives there a man or woman that has not sexual memories, not necessarily secrets, of some sort or other, related to the period of puberty or antedating it by a certain varying period?) or the establishment of a relationship other than co-existence or coincidence, between the speech embarrassment and the "concealed sexuality" (just as if even proof of the existence of this relationship was sufficient testimony of the causative operating influence of the latter).
I could discuss Dr. Coriat's paper from many angles, and in each case show that its conclusions were not only unsupported but impossible.[11] But in the above remarks I have presented sufficient evidence, I believe, to carry out the objects of this criticism.
[11] The ideas in the paper are, in fact, absurd. If definite, practical, clinical issues were not involved matters might be different. But the situation is serious yes, dangerously antisocial, since the practical application of these theories to human beings is the point of greatest interest.
The reader should not lose sight of the cold but important fact that the application of Freud's sexual theories to stammering in children is, in my humble opinion, fraught with the greatest danger. I cannot do otherwise than look upon this as positively anti-social. It would, it is my belief, be a glaring and rife source of danger to the community and to society in general for these ideas to be spread broadcast. Freud himself has shown that the child, before puberty, with his more or less undifferentiated sexual impulse, may be swept along into any one or more of the sexual aberrations or to intrafamilial sexuality. These goals exist only as POSSIBILITIES and should not, I contend, be referred to as predispositions or tendencies (almost as if they were instincts). The direction of the child's thought along this line before or at or after puberty may prove disastrous in one or more of many different ways.
Think of hinting at or talking about or harping upon matters of this sort to children, let alone to adults of the usual sort! It would be nothing less than a crime to society, to the family and to the growing child. In this respect I look upon the application of the Freudian theories as a distinct and glaring danger to the individual, to the family and to the community.
Efforts to stem the tide from flowing in this direction should be unfettered. It means much for humanity.
Even hinting (to the children) in a remote way about the various aspects of sexuality described by the Freudian school should not find its place and has no place in treating stammering per se in children.
Think of the effect of continual conversation and thinking of this sort upon a child at or before puberty, or at adolescence, or even upon an individual in adult life! His thoughts are continually drifted to his urogenital organs and the sexual possibilities of all sorts of human relationships, intrafamilial as well as extrafamilial.
The Freudians may object to any statements to the effect that they tell their patients about these sexual theories. I find Jones,[12] for instance, declares that Freud "deliberately withholds from his patients all knowledge of psychoanalyses except what they discover for themselves." Even granting this, the patient doesn't have to wait long or think much before he does discover for himself just what the Freudians mean.
[12] Ernest Jones: Professor Janet on Psychoanalysis; A Rejoinder. Journal of Abnormal Psychology, Feb.-Mar., 1915, p. 407.
But Freud[13] himself contradicts this statement by Jones when he says: "If with my patients I emphasize the frequency of the Oedipus dream-of having sexual intercourse with one's own mother-I get the answer: 'I cannot remember such a dream.' Immediately afterwards, however, there arises recollection of another disguised and indifferent dream, which has been dreamed repeatedly by the patient, and the analysis shows it to be a dream of this same content-that is, another Oedipus dream."
[13] Brill's translation of Freud's Interpretation, p. 242. Italics mine.
Then again, listen to Brill:[14] "With reference to the question of determining that a person is homosexual.
[14] The Conception of Homosexuality, Journal of American Medical Association, August 2, 1913. See Brill's discussion on pages 339-340.
"A patient came to me who was said to have nothing the matter with his sexual life, but who had convulsions. I had seen him not more than three times when I said to him: 'You are homosexual,' and I explained what I meant. He told me that while at college he never indulged in sexual acts, and that for this reason he used to wrestle, during which he would have ejaculation, and he selected his partners. Unquestionably from the beginning of his existence he was homosexual, although he was able to have sexual intercourse with his wife, but he was compelled to marry when quite young; he was 'prodded into it,' as he said. He came to me to be treated for neurosis, but the neurosis was simply the result of homosexual lack of gratification.
"We should be particularly careful not to suggest anything. I never tell a patient that he is homosexual. Be reasonably sure that he is homosexual and you need not hesitate to tell him so."
It all depends on what one means by "reasonably sure" or what kind of and how much evidence one requires or demands to be "reasonably sure."
Furthermore the mass of popular Freudian literature is not by any means hidden from the patient.
In conclusion I may remind the members of the Freudian school that it behooves them to undergo that same self-analysis and self-scrutiny which they justly advise others to have. If they do this in a truly critical and impartial way they will find that the opposition which they have met has not been without foundation. They will find that there are serious and all-pervading flaws in their psychology and sexology, and that this is responsible for their one-sided and distorted analyses and interpretations. Most of the trouble will be found in the method of interpretation, flowing out of their attitude. They will find that they have been advocating a system of theories and conclusions which have been followed as a religion, a cult, a creed. And they will correct the errors which are so patent to so many of the rest of us.
It is or should be evident to him who reads between the lines and surveys this question as from a mountain top, that there is not the slightest proof, not one jot of testimony in support of the ideas which Dr. Coriat has given us in his paper.
As a final word I cannot refrain from remarking that it will be a sad day for humanity and for society when psychoneurotics of whatever sort, stammerers, normal individuals with their psychopathologic acts of everyday life, and all the rest of us, particularly children, shall be subjected to Freudian psychoanalyses, with the numerous sexual theories and sexual implications with regard to everything of vital or human concern, as seen especially in family and social relations. A study of the origin, nature and evolution of these is not only not out of place, but on the other hand finds a distinct place of honor for purely scientific purposes. Theories, however unfounded and untrue, may, not inappropriately, be offered for this purpose. But we come upon a decidedly different situation when we have to deal in a practical sort of way with individuals, particularly children, who are the objects of the experimental application of full-blown theories. Especially is this so in the case of sexual theories.
Propagation of such views concerning the origin and nature of stammering as are presented to us in Dr. Coriat's paper should be sternly discountenanced. Nay more, they should be unflinchingly denied and even severely condemned. I, for one, protest vigorously against the propagation of such views, especially when they represent nothing more than an inflated theory.
The writer wishes to assure Dr. Coriat and the reader that his remarks are intended in a thoroughly impersonal sort of way. He is concerned only with the problems involved. Personalities do not at all enter into the proposition. He hopes that his criticism will be accepted in the same spirit in which it is given. If, to the reader, it may seem at times that the writer has spoken too strongly, he can only say in defense that he has seized upon this occasion as the time and the place to so express himself briefly, frankly but without malice. The situation more than demands such outspoken expression of opinion.
ABSTRACTS
THE PSYCHIC FACTORS IN MENTAL DISORDER. Milton A. Harrington, Am. Jour. of Insanity. Vol. LXXI, No. 4, p. 691.
The writer has taken the scheme of the instincts which William McDougall has given in his book, entitled "An Introduction to Social Psychology" and has attempted to show how it may be used in studying the problems of mental disorder. The paper falls into three parts. In the first part McDougall's conception is presented, modified, however, so that it may be better fitted to the needs of the psychiatrist. Briefly it is as follows:
Man has instincts as well as the animals and all his mental activity is due to impulses coming from these instincts. An instinct may be defined as an innate specific tendency of the mind which is common to all members of any one species and which impels the individual to react to certain definite kinds of stimuli with certain definite types of conduct, without having first learned from experience the need of such conduct. For example, there is an instinct of pugnacity which impels us to attack that which injures us or interferes in any way with the attainment of our desires, an instinct of flight which impels us to seek escape from danger, a parental instinct from which come the impulses that lead us to protect and care for our young. But, beside impelling the individual to react to certain definite kinds of stimuli with certain definite types of conduct, an instinct, when stimulated, gives rise in every case to an emotion which is characteristic of it. For example, with the instinct of pugnacity, we have the emotion of anger; with that of flight, the emotion of fear; with the parental instinct, the emotion of love or tender feeling. An instinct, therefore, is regarded as a mechanism made up of three parts:
First, an afferent or cognitive part, through which it is stimulated.
Second, an affective part through which it gives rise to the emotion which is characteristic of it.
Third, an efferent or conative part through which it gives rise to a characteristic type of conduct.
McDougall gives a list of about twelve instincts, each with its accompanying emotion. These he regards as primary and the source of all thought and action.
Considering the instincts from the standpoint of evolution, one may assume that they first developed in extremely low forms of life in order to produce the few and simple reactions of which animals low in the scale are capable. One might almost say in regard to such primitive organisms, that for each situation an instinct is provided and the situation calls forth its appropriate reaction almost as automatically as the pressing of an electric button causes the ringing of a bell. But, as animals rise higher in the scale, the kinds of conduct required become more varied and complex. For example, an impulse from the flight or fear instinct, in the lower animals, will always produce some simple reaction such as flight or concealment. But, in man, the forms of conduct, to which it gives rise, may be extremely varied. Thus in one case a man may be impelled to run away, in another to work hard at some disagreeable task in order to escape the harm which might result if he failed to do so. This capacity to direct the instinctive forces into various forms of activity, we call the capacity for adjustment and we may assume that it depends upon the operation of certain mechanisms which we may call the mechanisms of adjustment. The mind may, therefore, be regarded as made up of certain instincts from which come the impulses that give rise to all our mental reactions and certain mechanisms of adjustment by which these impulses are directed into the most useful forms of activity.
This conception of the human mind enables us to form some idea of how a mental disorder may arise from purely mental causes; for it is obvious that conditions may sometimes arise when the mechanisms of adjustment will prove inadequate to the demands made upon them, when they will be unable to control the instinctive forces or find for them satisfactory outlet and, as a result, these impulses will escape by undesirable channels, giving rise to forms of thought and action which we recognize to be abnormal. To show that this theory may be successfully applied to explain the facts of abnormal psychology, the analysis of an illustrative case is presented. This case, which is worked out in considerable detail, forms the second section of the paper. It is the case of a young man who, partly owing to inherited tendencies and partly to environment, developed during early life certain habits and characteristics which, when he approached maturity and the sexual instinct awoke to its full activity, caused the impulses from this instinct to be directed into wrong channels, giving rise to a psychosis which took the form of a catatonic stupor.
The conception of mental disorder here presented inevitably leads to certain views regarding the causes which give rise to it. Since mental health is dependent on capacity for adjustment being equal to the demands made upon it, mental disorder must always be due to failure to maintain this relationship between capacity and needs. The causes of insanity must therefore be of two kinds:
First, those which make the task of adjustment so difficult as to overtax the capacity.
Second, those which lessen the capacity so that it is unequal to the demands made upon it.
The third section of the paper is a brief discussion of what these causes are and how we should deal with them. Author's Abstract.
A STUDY OF SEXUAL TENDENCIES IN MONKEYS AND BABOONS. By G. V. Hamilton. Journal of Animal Behavior, September-October, 1914, vol. 4, No. 5, pp. 295-318.
The writer asserts that the work and problems in sexuality in human beings place upon the animal behaviorist an obligation to lay the necessary foundations for a scientific and thoroughly comprehensive investigation of sexual life. This has led him to formulate the following two problems in animal behavior: (1) Are there any types of infra-human primate behavior which cannot be regarded as expressions of a tendency to seek sexual satisfaction, but which have the essential objective characteristics of sexual activity? (2) Do such sexual reaction-types as homosexual intercourse, efforts to copulate with non-primate animals and masturbation normally occur among any of the primates, and if so, what is their biological significance?
The author presents a list of the subjects (monkeys and baboons) employed in his study; gives a description of the environmental conditions in his laboratory which is in the midst of a live oak woods In Montecito, California, about five miles from Santa Barbara; gives a list of the types of situations that were arranged by the observer or encountered by the subjects in consequence of their spontaneous activities, and under each description of a typical situation one or more detailed descriptions of typical responses thereto; and finally offers the classification of sexual tendencies as expressions of reactive tendencies observed.
The author then enters into a discussion of the use of the term reactive tendency, and explains that this term, according to his definition, is meant to explain something more specific than an inclination to direct activity toward one of a limited number of general ends, and to include both the innate and the acquired features of an individual's reactive mechanism.
He then presents his conclusions which I shall here include in full and verbatim, because of the fact that these findings should prove of great importance, especially in the light of Freud's theories of infantile sexuality. The author states that "At least two, and possibly three, different kinds of hunger, or needs of individual satisfaction, normally impel the macaque toward the manifestation of sexual behavior, viz., hunger for sexual satisfaction, hunger for escape from danger and, possibly, hunger for access to an enemy.
"Homosexual behavior is normally an expression of tendencies which come to expression even when opportunities for heterosexual intercourse are present. Sexually immature male monkeys appear to be normally impelled toward homosexual behavior by sexual hunger. The fact that homosexual tendencies come to less frequent expression in the mature than in the immature male suggests the possibility that in their native habitat these animals may wholly abandon homosexual behavior (except as a defensive measure), on arriving at sexual maturity.
"Homosexual behavior is of relatively frequent occurrence in the female when she is threatened by another female, but it is rarely manifested in response to sexual hunger.
"Masturbation does not seem to occur under normal conditions.