HISTORIES OF SOME SEVERE CASES
The cases that follow represent mainly
the severe types of nervousness in the housewife.
To every case that comes to the neurologist there are
a hundred that explain their symptoms as “stomach
trouble”, “backache”, etc.,
who remain well enough to carry on, and who think their
pains and aches inevitably wrapped with the lot of
It will be seen, upon reading these
cases, that a rather pessimistic attitude is taken
toward some of them. It would be nice to present
a series of cases all of which recovered, and it would
be easy to do that by picking the cases. Such
a series would be optimistic in its trend; it would
however have the small demerit of being false to life.
Though the majority of women suffering from nervousness
may be relieved or cured, a number cannot be essentially
benefited. Some of them have temperaments utterly
incompatible with matrimony, others have husbands of
the incorrigible type, others have life situations
to change which would make it necessary to change
society. Therefore in these cases all a doctor
can do is to relieve symptoms, relieve some
of the distress and rest content with that.
I am essentially neither pessimist
nor optimist in the presentation of these cases, nor
do I seek to present the man or woman’s case
with prejudice. In life a realistic attitude
is the best, for if we were to remove much of the
sentimental self-deception at present so prevalent,
huge reforms would occur almost overnight. Sentimentality
decorates and disguises all kinds of horridness and
makes us feel kindly toward evil. Strip it away,
and we would immediately break down the evil.
There is always this danger in presenting
“cases” to a lay public, that symptoms
are suggested to a great many people. How deeply
suggestible the mass of people can be is only appreciated
when one sees the result of public health lectures
and books. Many persons tend to develop all the
symptoms they hear of, from pains and aches to mental
failure. Even in the medical schools this is
so, and every medical teacher is consulted each year
by students who feel sure they have the diseases he
So in presenting the following cases
symptoms will be largely omitted. What will be
presented is history and to a certain extent treatment.
That part of treatment which is strictly medical can
only be indicated.
It may be said that in obtaining the
intimate history of a woman a difficulty is met with
in the natural reluctance to telling what often seems
to the patient painful and unnecessary details.
To some people it seems inconceivable that fears,
pains and aches, sleeplessness, etc., can arise
out of difficulties like the monotony of housework,
temperament, or troubles with the husband. Furthermore,
though some women understand well enough the source
of their conflicts, they are ashamed to tell and rest
mainly on the surface of their symptoms. To obtain
the truth it is necessary to see the patient over and
over again, to get somewhat closer to her. This
is especially easy to do after the physician has to
a certain extent relieved the patient. In other
words, except in the cases where the woman is quite
prepared to tell of her intimate difficulties, it
is best to go slowly from the medical to the social-psychological
point of view.
Case I. The overworked, under-rested type of housewife.
Mrs. A.J., thirty years old, is a
woman of American birth and ancestry. Her parents
were poor, her father being a mechanic in a factory
town of Massachusetts. She had several brothers
and sisters, all of whom reached maturity and most
of whom married.
Before marriage she was a salesgirl
in a department store, worked fairly hard for rather
small pay, but was strong, jolly, liked dancing and
amusements, liked men and had her girl friends.
At the age of twenty-two she married
a mechanic of twenty-four, a good, sober, steady man,
devoted to her and very domestic. Unfortunately
he was not very well for some time following a pneumonia
in the third year of their marriage. They drew
upon all their savings and fell seriously in debt.
This meant borrowing and scrimping for several years, a
fact which had great bearing on the wife’s illness
They had three children, born the
twelfth month, the third year, and the fourth year
after marriage. After the first child the mother
was very well, nursed the baby successfully, and the
little family flourished. Then came the unfortunate
illness of the husband, which threw him out of work
for six months, during which time they lived on an
allowance from his union, his savings, and finally
ran into debt. This greatly grieved the man and
depressed the woman, but both bore up well under it
until the birth of the second child, when their circumstances
forced them to move to a poorer apartment. The
wife was delivered by a dispensary physician, who
did his duty well but allowed the woman, who protested
she felt well, to get up and care for her husband and
baby much earlier than she should have done.
The nursing of this baby was more
difficult. The mother’s breasts did not
seem to be nearly as active as in the previous case.
The baby cried a great deal and needed attention a
good part of the night. The husband was unable
to help as he had previously done and the fatigue of
the care of child and man brought a condition where
the woman was tired all the time. Still she bore
up well, though when the summer came she greatly missed
the little two weeks’ vacation that she and her
husband had yearly taken together from the days of
The husband recovered, but his strength
came back very slowly. He went to work as soon
as possible but worked only part time for six months.
At night he came home utterly exhausted and could
not help his wife at all.
During the next year both children
were sick, first with scarlet fever and then with
whooping cough. The mother did most of the nursing,
though by this time the father was able to help and
did. The necessary expenses so depleted the family
treasury that when the summer came neither could afford
to go away.
Both noticed that the mother was getting
more irritable than was natural to her. She went
out very seldom and her youthful good looks had largely
been replaced by a sharp-featured anxiety. Though
she carried on faithfully she had to rest frequently
and at night tossed restlessly, though greatly fatigued.
She became pregnant again, much to
her dismay and to the great regret of her husband.
At times she thought of abortion, but only in a desperate
way. The last few months of her term were in the
very hot months of the year and she was very uncomfortable.
However, she was delivered safely, got up in a week
to help in the care of her other two children and
to get the house into shape again. Her milk was
fairly plentiful, despite her fatigue and “jumpy
nerves.” Unfortunately at this time, when
they had accumulated a little surplus and she was looking
forward to better clothes for her family and more comforts,
the plant at which her husband was employed suspended
operations because of some “high finance”
mix-up. Coming at this time, the news struck terror
into her heart; she broke down, became “hysterical”
i.e. had an emotional outburst. This passed
away, but now she was sleepless, had no appetite,
complained of headache and great fatigue.
Though she was assured that the plant
would reopen soon (in fact it soon did), she made
little progress. That she was suffering from a
psychoneurosis was evident; what remained was to bring
This was done by enlisting a development
of recent days, the Social Service agencies.
Out of the old-time charity has come a fine successor,
social service; out of the amateurish, self-consciously
gracious and sweet Lady Bountiful has come the social
worker. Unfortunately social service has not
yet dropped the name “Charity”, perhaps
has not been able to do so, largely because the well-to-do
from whom the money must come like to think of themselves
as charitable, rather than as the beneficiaries of
the social system giving to the unfortunates of that
Let me say one more word about social
service and the social worker, though I feel that
a volume of praise would be more fitting. The
social worker has become an indispensable part of
the hospital organization, an investigator to bring
in facts, a social adjuster to bring about cure.
For a hospital to be without a social service department
is to confess itself behind the times and inefficient.
Briefly, this is what was done for this family.
Their prejudices against social aid
were removed by emphasizing that they were not recipients
of charity. The husband was allowed to pay, or
arrange to pay, for a six weeks’ stay in the
country for the mother and the new baby. The
home for this purpose was found by the agency and was
that of a kindly elderly couple who took the woman
into their hearts as well as over their threshold.
The social worker arranged with a nursing organization
to send a worker to the man’s house each day
to clean up the home while the children stayed in
a nursery. One way or another the husband and
children were made comfortable, and the wife came back
from her stay, made over, eager to get back to her
It is obvious that in such a case
as this the physician is largely diagnostician and
director, the actual treatment consisting in getting
a selfish and inert social system to help out one
of its victims. That a sick man should be left
to sink or swim, though he has previously been industrious
and a good member of society, is injustice and social
inefficiency. That a woman, under such circumstances,
should be left with the entire burden on her hands
is part of the stupidity and cruelty of society.
How avert such a thing? For one
thing do away with the name “Charity” in
relief work, and find some system by which
industry will adequately care for its victims.
What system will do that? I fear it may be called
socialistic to suggest that some of the fifteen billions
spent last year on luxuries might better be shifted
to social amelioration. The record in automobile
production would be more pleasing if it did not mean
a shift from real social wealth to individual luxury.
Case II. The over-rich, purposeless woman.
This type is of course the direct
opposite of the woman in Case I and represents the
kind of woman usually held up as most commonly afflicted
with “nervousness.” “If she
really had something to do,” say the critics,
“she would not be nervous.”
This is fundamentally true of her,
though not true of the majority of women whom we have
discussed. It seems difficult to believe that
hard work and worry may bring the same results as
idleness and dissatisfaction, but it is true that
both deënergize the organism, the body and mind, and
so are kindred evils. What’s the matter
with the poor is their poverty, while the matter with
the rich is their wealth.
Mrs. A. De L. is of middle-class people
whose parents lived beyond their means and educated
their only daughter to do the same. Here is one
of the anomalies of life: bitterly aware of their
folly, the extravagant and struggling deliberately
push their children into the same road. Mrs.
De L. learned early that the chief objects of life
in general were to keep up appearances and kill time;
that as a means to success a woman must get a rich
husband and keep beautiful. Being an intelligent
girl and pretty she managed to get the rich husband, and
settled down to the rich housewife’s neurosis.
Her husband was old-fashioned despite
his rather new wealth, and they had two children, a
large modern American family. Though he allowed
her to have servants he insisted that she manage their
household, which she did with rebellion for a short
time, and then rather quickly broke away from it by
turning over the household to a housekeeper. This
brought about the silent disapproval of her husband,
who let her “have her own way”, as he
said, “because it’s the fashion nowadays.”
She became a seeker of pleasure and
sensation, drifting from one type of amusement to
the other in an intricately mixed coöperation and rivalry
with members of her set. She followed every fad
that infests staid old Boston, from the esoteric to
the erotic. She became an accomplished dancer,
ran her own car, followed the races, went to art exhibitions,
subscribed to courses of lectures of which she would
attend the first, dabbled in new religions, became
enthusiastic: about social work for a month or
two, and became a professional at bridge.
Summers she rested by chasing pleasure and flirting
with male habitués of fashionable summer resorts;
part of the winter she recuperated at Palm Beach, where
she vied for the leadership of her set with her dearest
Her husband financed all her ventures
with a disillusioned shrug of his shoulders.
As she entered the thirties she became intensely dissatisfied
with herself and her life, tried to get back to active
supervision of her home but found herself in the way,
though her children were greatly pleased and her husband
sceptical. The need of excitement and change
persisted; gradually an intense boredom came over her.
Her interest in life was dulled and she began a mad
search for some sensation that would take away the
distressing self-reproach and dissatisfaction.
Shortly after this she lost the power to sleep and
had a host of symptoms which need not be detailed
The medical treatment was first to
restore sleep. I may say that this is a first
step of great importance, no matter how the sleeplessness
originates. For even if an idea or a disturbing
emotion is its cause, the sleeplessness may become
a habit and needs energetic attention.
With this done, attention was paid
to the social situation, the life habits. It
was pointed out that all the philosophies of life were
based on simple living and work, and that all the
wise men from the beginning of the written word to
our own times have shown the futility of seeking pleasure.
It was shown that to be a sensation seeker was to court
boredom and apathy, and that these had deënergized
For interest in the world is the great
source of energy and the great marshaler of energy.
From the child bored by lack of playmates, who brightens
up at the sight of a woolly little dog, to the old
and vigorous man who makes the mistake of resigning
from work, this function of interest can be shown.
She was advised to get a fundamental,
nonegoistic purpose, one that would rally both her
emotions and her intelligence into service. Finally
she was told bluntly that on these steps depended her
health and that from now on any breakdown would be
merely a confession of failure in reasonableness and
That she improved greatly and came
back to her normal health I know. Whether she
continued to remain well and how far she followed the
advice given I cannot say. From the earliest
time to this, necessity has been the main spur to
purpose, and probably the lure of social competition
drew the lady back to her old life. Experience,
though the best teacher, seems to have the same need
of repetition that all teaching does.
Case III. The physically sick
woman who displays nervousness.
Though this is one of the most important
of the types of nervous housewife the subject is essentially
medical. We shall therefore not detail any case,
but it is wise to reemphasize some facts.
There are bodily diseases of which
the early and predominant symptoms are classed as
“nervousness.” Hyperthyroidism, or
Graves’ Disease, a condition in which there
is overactivity of the thyroid gland and which is
particularly prevalent among young women, is one of
those diseases. In this condition excitability,
irritability, emotional outbursts, fatigue, restlessness,
digestive disorders, vasomotor disorders, appear before
the characteristic symptoms do.
Neuro-syphilis is another such disease.
This is an involvement of the nervous system by syphilis.
One of the tragedies that distresses even hardened
doctors is to find some fine woman who has acquired
neuro-syphilis through her husband, though he himself
may remain well. In the early stages this disease
not only has neurasthenic symptoms but is very responsive
to treatment, and thus the early diagnosis is of great
What is known as reflex nervousness
arises as a result of minor local conditions, such
as astigmatism and other eye conditions, trouble with
the nose and throat and trouble with the organs of
generation. The latter is especially important
in any consideration of nervousness in the housewife,
particularly in the woman who has borne children.
Frequently too the existence of hemorrhoids, resulting
from constipation, acts to increase the irritability
of a woman who is perhaps too modest to consult a
physician regarding such trouble. Where such
modesty exists (and it is found in the very women one
would be apt to think were the very last to be swayed
by it), then a competent woman physician should be
consulted. With good women physicians and surgeons
in every large community there is no reason for reluctance
to be examined on the part of any woman.
Further details are not necessary.
Enough has been said to emphasize the fact that the
nervousness of the housewife is first a medical problem
and then a social-psychological one.
Case IV. A case presenting bad
hygiene as the essential factor.
Bad hygiene is something more than
exposure to bad air, poor food, contaminated water,
etc. It includes habits and times of eating,
attention to the bowels, outdoor exercise, sleep, and
in the marital state it includes the sexual indulgence.
The housewife under consideration,
Mrs. T.F., aged twenty-eight, married five years,
two children, complained mainly of headache, occasional
dizziness, great irritability, and fatigue, so that
quarrels with her husband were very common, though
there seemed nothing to quarrel about. The family
was not rich, but lived in a comfortable apartment;
there were no serious financial burdens, the children
were reasonably healthy and good, and the closest
questioning revealed the husband as a kindly man who
never took the initiative in quarrels but who was never
able to keep silent under provocation. The couple
was still in love and there seemed to be no essential
Questioned as to her habits, Mrs.
F. said she did all her own housework except the washing
and ironing and scrubbing. She had a little girl
three times a week to take the baby out. Before
marriage she had been a stenographer, but never earned
high pay and had no love for her work. In fact
she gave it up with relief and found housework with
its disagreeable features much more to her taste than
business. She had been of a placid, pleasant
temperament and could not understand the change in
Since all this did not explain her
symptoms, closer inquiry was made into her habits.
She arose with her husband at seven-thirty, prepared
his breakfast, sent the oldest child off to kindergarten
and then had her own breakfast, which usually consisted
of toast and coffee. At noon she had a very small
piece of meat or an egg and a few potatoes with tea.
At night she ate sparingly of the dinner, which usually
was meat, potatoes, another vegetable, and a dessert.
Her husband here stated that she ate at this meal
less than the boy of four and a half.
Comparing her buxom figure with the
diet a discrepancy was at once apparent. She
then confessed with shame that she was a constant nibbler,
eating a bit of this or that every half hour or so,
and consequently never had an appetite. The food
thus nibbled usually was either spicy or sweet, and
she consumed quite a bit of candy. Her bowels
moved infrequently and she always needed laxatives.
In her spare time she felt rather “logy”,
rarely went out, except now and then at night with
her husband, and spent her leisure hours on the couch
reading or nibbling.
This in itself would have quite explained
much of her trouble. It has been pointed out
that body and mind are not separable; that mental
functions are based on the bodily functions, and that
mood may rest on no more exalted cause then the condition
of the bowels. But a more intimate questioning
revealed sexual habits which are easily drifted into
by people of an amorous turn of character and who are
really fond of one another. These both husband
and wife frankly said they had not meant to speak
of, but with their disclosure it was evident that a
good deal of importance was to be attached to them.
The correction of the life habits
was of course the fundamental need. The young
woman was instructed in detail as to diet, the care
of the bowels and outdoor exercise. Since she
was in perfect condition except for stoutness she
could easily look for recovery, and as an added incentive
the restoration of youthful good looks was held out
The sexual life was frankly discussed,
and necessary restrictions were imposed. Both
the husband and wife agreed willingly to the changes
ordered and promised faithfully to carry out instructions.
The patient made a splendid recovery
and very rapidly. Here was a deënergization dependent
solely upon the sedentary life of the housewife and
upon ignorance of sex hygiene. Here were quarreling
and impending marital disaster removed by attention
to details in living. Here was a complete proof
that not only does a sound mind need a sound body,
but that a sound marriage needs one as well.
Case V. The hyperæsthetic woman.
Mrs. J.F. is twenty-seven years of
age. She was born in the United States, of middling
well-to-do people. Her father was a gruff, hearty
man, not in the least bit finicky, who really despised
manners and the like, though he was conventional enough
in his own way. Her mother was an old-fashioned
housewife, fond of her home and family, in fact perhaps
more attached to the former than the latter. She
hated servants and got along without them (except
for a day woman) until she became rather too old to
do the work.
J.’s sister and two brothers
were duplicates of the parents, hearty,
stolid, and remarkably plain looking. J., the
younger sister, though not the youngest in the family,
was as different from her family as if she had sprung
from another stock. She was slender, very pretty,
with a quick, alert mind which jumped at conclusions,
because labored analysis fatigued it. Above all,
from the very start of life she was sensitive to a
degree that perplexed her family, who were however
intensely sympathetic because they adored her.
This adoration arose from the fact that J. was brighter
and prettier than most of her friends, and that her
cleverness in many directions music, writing,
talking, handiwork was the talk of their
This sensitiveness arose from two
main factors. First, an egoism fostered by the
worship of her friends and the leadership of her group, an
egoism which led her to regard as a sort of insult
anything disagreeable. Accustomed to praise,
the least criticism implied or outspoken cut like
a knife; accustomed to being waited upon, she resented
physical discomfort of the slightest kind. Second,
there must also have been an actual physical sensitiveness
to sights, sounds, smells, tastes, etc. that
made her perceive what others failed to notice.
This led to an artistry manifested by her nice work
in music and decoration and also by an excessive displeasure
at the inartistic.
With this training, experience, and
natural temperament she should have married a rich
collector of art products, who would have added her
to his collection and cherished her as his most fragile
possession. Instead, through the working of that
strange law of contraries by which Nature strikes
averages between extremes, she fell in love with a
hulk of a man whose ideas on art were limited to calling
a picture “pretty”, who loved sports and
the pleasures of the table, and whose business motto
was “Beat the other guy to it.” A
successful man, troubled with few subtleties either
of approach or conscience, he viewed the marriage
relationship in the old-fashioned way and the new American
indulgence. A man’s wife was to be given
all the clothes she wanted, servants to help run the
home, ought to bear two or three children, and love
her indulgent husband. As for any real intimacy,
he knew nothing of it. Kindly, self-indulgent,
wife-indulgent, child-indulgent, ruthless in business,
he may stand as something America has produced without
From the very first night J.’s
world was shattered. We need not enter into details
in this matter, but a woman of this type needs finesse
in the initiation into marriage more than at any other
time. Cave-man style outraged her every fiber,
and the man was dumbfounded at her reaction.
Though he tried to make amends his very effort and
lack of understanding complicated matters.
Aside from this matter, which in the
course of time became adjusted, so that though she
rebelled desire arose in her, she found herself at
odds with her husband’s tastes and conduct in
little things. Though his table manners were
good enough, the gusto of his eating annoyed her and
took away her own appetite. When they went to
a play together the coarse jokes and the plainly sensuous
aroused his enthusiasm. He lacked subtlety and
could not understand the “finer” things
of life. As he grew settled in matrimony, which
he enjoyed in spite of her nerves (which he took for
granted as like a woman), he grew stouter and this
irritated and jarred her.
She finally realized she no longer
loved him. It is doubtful if she realized this
before the birth of her first and only child.
She lacked maternal feeling and rebelled with a bitter
rebellion against the distortion of her figure that
came with the pregnancy. The nursing ordered
by the doctor and expected by all around her nearly
drove her “wild”, she said, for she felt
like a “cow”, a “female.”
Indeed she reacted bitterly against the femaleness
that marriage forced on her and hated the essential
maleness of her husband. Her emotional reaction
against nursing took away her milk, and finally the
disgusted family doctor ordered the baby weaned and
he was turned over to a servant.
She went back to her own life, determined
to become a housewife, to see if she could not love
her husband and her home. But everything he did
irritated her, and everything in the house made her
feel as in a “luxurious cage.” Yet
she was by no means a feminist; she detested “noisy
suffragettes”, thought women doctors and lawyers
ridiculous, and had been brought up to regard marriage
Gradually out of the conflict, the
chilling fear that she had made a mistake which could
not be rectified, the constant irritation and annoyances,
the revolt against her own sex feeling and her life
situation, arose the neurosis. It took the form
mainly of sudden unaccountable fears with faint dizzy
feelings. The family physician on the aside told
me that it was “just a case of a damn fool woman
with everybody too good to her.”
What constitutes a “damn fool”
will include every person in the world, according
to some one else. It seemed obvious to me that
J. was not meant by nature to be a housewife or any
kind of wife. Matrimonially she was a misfit,
unless she met some man of a type like herself, though
I doubt if any man could have pleased her. I
doubt if her over-exacting taste would not rebel against
the animal in life itself. For though the animal
of life is essentially as fine as the human, certain
types find it impossible to acknowledge it in themselves.
At any rate I advised separation for
a time, six months at least. I told
the woman her reaction to her husband was abnormal
and finicky. She answered that she knew this
but could not conceive of any change. We discussed
the matter in all its ramifications, and though she
and her husband agreed to the separation, I knew that
he was determined to hold her to her contract.
She improved somewhat but I believe that such a temperament
is incompatible with marriage, at least to such a man.
The outlook is therefore a poor one.
Case VI. The over-conscientious
housewife, the seeker of perfection.
The woman whose history is to be discussed
comes from a family of New England stock, i.e.
the Anglo-Saxon strain modified by New England climate,
diet, history, religion, and tradition into a distinct
type. This type, often traditionally conservative
and often extraordinarily radical, has this prevailing
trait, standards of right and wrong are
set up somehow or other, and a remarkably consistent
effort is made to maintain these inflexibly.
However, the hyperconscientious are not peculiarly
New England alone; I have met Jewish women, Italians,
French, Irish, and Negroes who showed the same loyalty
to a self-imposed ideal.
This lady, Mrs. F.B., thirty-five
years of age, with three children, was brought by
her husband against her will. He declared that
both she and he were on the verge of nervous prostration;
that unless something was done he would start beating
her, this last of course representing a type of humorous
desperation that usually has a wish concealed in it.
She was “worn to a frazzle”, always tired,
sleepless, of capricious appetite, irritable, complaining,
and yet absolutely refused to see a physician.
She had taken tonics by the gallon, been overhauled
by a dozen specialists, all of whom say, “nothing
wrong of any importance yet she is a wreck
and I am getting to be one.”
Her husband was a jolly looking personage
from the Middle West, in a small business which kept
his family comfortably. He looked domestic and
admitted he was, which his wife corroborated.
Evidently he was exasperated and worried as he gave
the history of the case, with his wife now and then
putting in a word: “Now, John, you are stretching
things there; don’t believe him, Doctor; not
so bad as all that,” etc.
She was a slender person, rather dowdily
dressed as compared with her husband, with garments
quite a little behind the prevailing mode. Her
hair was unbecomingly put up, and it was evident that
she disdained cosmetics of any kind, even the innocent
rice powder. Her hands were quite unmanicured,
though they were, of course, clean and neat. The
hat was the simplest straw, home trimmed and neat,
but a mere “lid” compared to the creations
most women of her class were at the time wearing.
That clothes were meant to be ornamental as well as
useful was an attitude she completely rejected.
It turned out that life to her was
an eternal housekeeping, from the beginning
of the day to the end she was on the job. Though
she had a maid this did not relieve her much, for
she constantly fretted and fumed over the maid’s
slackness. Everything had to be spotless all
the time; she could not bear the disordered moments
of bedtime, of the early morning hours, of wash day,
of meal preparation, of the children’s room,
etc. She was obsessed by cleanliness and
order, and her exasperated efforts, her reaction to
any untidiness kept her husband and children bound
in a fear like her own, though they rebelled and scolded
her for it.
“She’s always after the
children,” said her husband. “She
is crazy about them, but she has got them so they
don’t dare call their soul their own. They
don’t bring their playmates into the house largely
because they know that mother, though she wants children
to play, goes after them picking up and cleaning.”
This restlessness in the presence
of disorder was accompanied by the effort to eradicate
all vices, all discourtesies, all errors in manners
from the children. She feared “bad habits”
as she feared immorality. She thought that any
rudeness might grow into a habit, must be broken early;
any selfish manifestation might be the beginning of
a gross selfishness, any lying or pilfering might
be the beginning of a career of crime.
Here one might hold forth on the necessity
for trial and error in children’s lives.
They want to try things, they form little habits for
a day, a week, a month which they discard after a
while; they try out words and phrases, playing with
them and then pass on to a new experiment. They
are insatiable seekers of experience, untiring in their
quest for experiment, and they learn thereby.
Not every mickle grows into a muckle, and the supplanting
of habits, the discarding of them as unsatisfactory,
is as marked a phenomenon as the formation of habits.
So our patient allowed nothing for
imperfections, experimental stages, developing tastes
in her children. She was, however, hardest on
herself, self-critical, scolded herself constantly
because her house was never perfect, her work never
done. She never had time to go out; she had become
a veritable slave to a conscience that prodded her
every time she read a book, took a nap, or went to
a picture show.
It was not at first obvious either
to her or her husband that her own ideal of cleanliness
and perfection was responsible for her neurasthenia.
If her “stomach was out of order ought she not
have some stomach remedy; if her nerves were out of
order would the doctor not prescribe a nerve tonic
or a sedative?” The idea of a medicine for everything
is still strong in the community and especially amongst
dwellers in small towns, and represents a latent belief
In addition to such medicines as I
thought the situation demanded, and to such advice
as bore on her attitude to work and play, I hinted
that dressing more fashionably might be of value.
For the poorly dressed always have a feeling of inferiority
in the presence of the better dressed, and this feeling
is seriously disagreeable. To raise the ego-feeling
one must remove feelings of inferiority, and here was
a relatively simple situation. This woman really
cared about clothes, admired them, but had got it
into her head early in life that it was sinful to
be vain about one’s looks. Though she had
discarded the sin idea the notion lingered in the
form of “unworthy of a sensible woman”,
“extravagance”, etc. As she was
painfully self-conscious in the presence of others
as a result, this was a hidden reason for sticking
to her home.
This woman had a really fine intelligence,
wanted to be well and made a gallant effort to change
her attitude. In this she succeeded, became as
she put it more “careless of her things and more
careful of her people.” Of course one cannot
expect her ever to be anything but a fine housekeeper
but she manages to be comfortable and has conquered
an over-zealous conscience.