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It was merely a stranger seen acting out his peculiar extemporaneous role from at a distance. Within a nebulous understanding of where he was at and what he was doing and the abnormality of it all, the catatonic was able to recognize the fact that this perennial squatting would seem to others as though he were a homeless and disoriented beggar trying to defecate along the road.
The catatonic was between an edge of sward and pavement leading away from the train station, between sluggish and futile conscious thought with its maelstrom of subconscious feelings, the disconnected randomness of fleeting images underneath, and complete inaction, and perpetually bent toward something when, except for insects, weeds, and dirt, there was nothing there.
His most important point is, perhaps, that these benign stupors showed a definite relationship to manic-depressive insanity in that some patients passed directly from stupor to typical manic excitement, while in others a “catatonic” attack replaced a depression in a circular psychosis.
This was the source of his numb but all pervasive headache. So here he continued to remain alone in this posture of a defecating dog, within this strange catatonic trance, and with a numb aching in his head.
S., however, calls it an hysterical stupor, although he agreed with Moeli that it was hard to differentiate from a catatonic state. Löwenstein reports an interesting case of a dégénéré who had had hysterical attacks. He suddenly developed stupor symptoms, which lasted with interruptions for nearly two years.
He shows how others have found patients with catatonic symptom complexes proceed to recovery and speaks of these symptoms occurring in epilepsy and even in frankly organic conditions, such as brain tumor, general paralysis, trauma and infections. Kirby’s first claim is that there are probably fundamentally different catatonic processes, deteriorating and non-deteriorating.
To that he sensed or understood but not enough to be motivated out of his catatonic state for he had lost sovereignty and restraint of himself. A lack of a history of mental illness meant nothing for, had he been able to consider it, entire foundations of long established cities had fallen under enough visceral shifting of plates so why not his own?
The stupor reaction, then, is a simple regression, with a limitation of energy, emotion and ideational content, the last being confined to notions of death. All functional psychoses are regressions. How do the others differ from this? We need only answer this question in so far as it concerns the clinical states resembling benign stupors. Stupors occur frequently in catatonic dementia præcox.
A drugged person can be controlled when they're in a sort of perpetual sedation but then, they never get genuinely well, either. Another early patient, Elizabeth, gave me a particularly valuable lesson, one that changed the direction of my career away from curing insanity and toward regular medicine. Elizabeth was a catatonic schizophrenic who did not speak or move, except for some waxy posturing.
Boredom was so enervating that it wouldn't have been preposterous to think of one's energy being snatched and diverted elsewhere. Money, ownership, tax loopholes, investments, televised games, tree planting, and this, watching the Tonight Show, were the same recurrent life themes of this man. She sat there as listlessly as a catatonic.
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