"Spectator" Conference for Personal Problems
Health—III.
[The SeEcrAron Conference offers to readers a service of advice on personal problems in which they would like impartial help. The Editor has appointed a committee, the members of which are themselves engaged in the practical work of life ; in one way or another they have met, and are meeting, a great variety of problems in their own experience. They do not wish to be regarded as authorities ; but they give their good will and their knowledge to all questions which are referred to them. Readers' inquiries are dealt with in strict confidence ; they are seen only by members of the Conference, and they are answered by private correspondence. Letters should be addressed to the Conference on Personal , Problems, clo The SPECTATOR, 13 York Street, Covent Garden, W.C. 2.]
Ix the previous articles on health I have been occupied mainly with those of us who are able to correct our own attitudes and assume responsibility for our traits of character. The articles should not be pressed too far or interpreted as a moral judgment on other people's illnesses. We are all of us apt, under the strain of dealing with invalids, to show our annoyance, and to assume that we should know better than they how to deal with their difficulties. We are all tempted to improve their fortitude and to recommend them to pay less attention to their misfortunes. If we could ensure a change of attitude on their part it would no doubt aid them considerably ; but we cannot ensure it by brusqueness or lack of sympathy.
There are almost universal psychological repercussions in organic diseases. Indeed, as we know, some diseases may produce profound alterations of character. Every disease presents added difficulties in adaptation to the man who suffers from it. If we treat his reactions as if they sprang entirely from his own free will, we shall never succeed in helping him. It often happens, however, that people feel irritated or hurt by the irritability of an invalid, by his exacting demands, or by his self-pity. To be able to bear -without strain the society of an invalid we must know some- thing of the psychology of disease. No one can be called capable of meeting the common crises of human life unless he is capable of treating an invalid in an objective and helpful manner.
One thing applies to almost all diseases. The sufferer is forced to live a much more subjective life than his fellows. His interests and activities are limited'; he is turned more upon his interior perceptions. The pleasure, for example, that a healthy man can obtain from the enjoyment of work and from a free social life is taken from him, or gravely restricted. Naturally he tends to seek for interests in his own person, his symptoms and pains, his prospects of recovery or his fears of a set-back, the reactions of other people to himself, and his immediate mental and physical surroundings.
It is for this reason that invalids so often make excessive calls for sympathy, are petty and egocentric, grow vain and cause far more trouble than they need. They feel it as their only way of proving their importance. Most people have probably experienced in childhood signs of this " negativism." They can remember times when they wished to reassure themselves of their power by calling in the night for their parents to bring them unnecessary glasses of water. A good deal of the exacting character of invalids comes from the same cause. They wish to feel that they still have influence in the world, and their condition of weakness has made them doubt it. We should never respond to an invalid's querulousness with impatience; nor should we encourage it by excessive atten- tion. Both are equally bad, and equally tend to encourage still more frequent complaints. If we can find a new objective interest for a 'patient we shall have done much to help him ;
and at the same time we shall have relieved our own burden. The psychology of consumptives is easily recognizable. They are generally full of an artificial optimism. They try to persuade themselves of their vitality, make grandiose plans for their future, and live in an intoxication of hope. This over-buoyancy can be quite as irritating as its opposite.
Moreover, consumptives show the underlying fear of failure in their tender regard for their own health. Often they seem to be incessantly taking the temperatures of their souls ; looking for signs that their ambitions are about to be realized and that unique success is before them.
The restriction of their interests and their growing ego- centricity are shown by the devotion they give to their physical symptoms. It is true that they take an interest in the physi- cal ailments of other people, too ; but this is mainly an illustration of their own. They are emotionally unstable and excitable, and often suffer from jealousy. We may suspect that they feel consumption as a wasting disease ; and much of their effort is designed to convince themselves of their virility. There is probably less personal strain in attend- ing to a consumptive than to most other invalids. They are bright and intelligent ; and they are pleased with every attention shown to them.
The opposite picture to the spes phthisica is presented in digestive maladies. Here we frequently have deep gloom and irritation ; moods of depression, spitefulness, and anger. The invalid may be hypercritical ; and he may take pains to prove that everything we do for him is awkward and out of place. A considerable deal of forbearance is necessary in dealing with dyspeptics : their irritability must be seen as part of the disease, and we must recognize that no personal reaction is necessary. Their complaints are not in fact caused by our conduct or directed against us. The striving for power is often very manifest in dyspeptics. It is not without significance that many millionaires have suffered from digestive troubles. Being unable to enjoy the natural satisfactions of appetite and food, they have attempted, with great tenacity, to secure the highest abstract symbol for satisfaction, the power of money.
Diseases of the heart lead to anxiety and timidity. These invalids desire a regular and tranquil life, and seem unable to bear the prospect of any disturbance. Thus they flutter in alarm at the smallest risks, dislike meeting new circum- stances, wish to be spared from all acute experiences, bother and worry over their own health and the health of anyone of whom they have charge. They are involved, of course, in a vicious circle ; their anxiety will often produce the palpitations which they are so intent on avoiding. Sometimes they cultivate an extraordinary degree of absent-mindedness ; they withdraw from the life that is around them in order to have a territory of thought in which they are secure from external stimuli.
There are two conditions which call for special considera- tion, although neither of them is to be regarded as a malady. Everyone knows that in old age abnormalities often develop ; and many old people are particularly difficult to treat with sympathy. It is painful to see men and women who keep up aggressiveness of character in their old age. They appear to be unable to adapt themselves to the limitations of their bodies. Instead of becoming more tranquil and contemplative, instead of enjoying the fruits of their past activity, they cannot abandon the stress of their early lives. They wish to prove that they are still young and forceful. We can gather from their behaviour that they are dissatisfied with their success in the past ; the more they feel that their tenure of life is decreasing, the more intently they strive for prestige. It is an ungracious picture ; but even the shortcomings of age must not be made the basis for a moral judgment.
Another factor which is often given too little allowance is the natural variability in the moods of women. There are times in every woman's life when she feels an unusual need for affection and consideration. Her body puts her to stresses which frequently are entirely misunderstood by men. It is particularly in pregnancy that women may appear irrational, fractious, or openly hostile ; and any husband who takes umbrage at his wife's conduct in these circumstances or even feels them as unaccountable is proving himself unfitted for married life. It is in the strains of married life that the highest opportunity occurs for building up a mutual affection and a mutual feeling of trustworthiness.
ALAN PORTER. [The article in our next issue will deal with some of the personal problems raised by our correspondents.]
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