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In extreme psychasthenia the difficulty of "making up the mind", of deciding, becomes so great that a person may suffer agonies of internal debate about crossing the street, putting on his clothes, eating his meals, doing his work, about every detail of his coming, going, doing, and thinking.
Moreover in very frequent cases, for instance, of neurasthenia or hysteria or psychasthenia, such wholesale remedies can form only the background of the treatment, but all the details have to be furnished with reference to a most subtle analysis of the special symptoms, and a particular organic symptom or a particular memory idea or a special inhibition by a well-selected counter-idea will do much more than any great emotional revival.
"Nerves," "neurasthenia," "psychasthenia," and "hysteria," are all the names of symptoms of definite bodily disease.
To-day from a really religious point of view, both groups of diseases must be acknowledged to be natural or with Mrs. Eddy, as the work of the unholy spirit. Christian Science is indeed by far more consistent. If the cure results through the meaning and value of religion, there is no reason whatever why cancer and diphtheria and paralysis should not be cured as well as psychasthenia.
There are some in whose lives the fear of death, injury, illness or loss is in constant operation to prevent activity, to lower energy and effort. One finds the coward very commonly in the clinics for nervous diseases, and in some cases the formidable term of psychasthenia is merely camouflage for the more direct English word.
And the housewife we are trying to understand is particularly such a creature, with a host of deënergizing influences playing on her, buffeting her. Our aim will be to analyze these influences and to discover how they work. I have stated that in medical practice two other types are described, psychasthenia and hysteria.
We shall see what an important rôle belongs to these facts, especially in the treatment of hysteria and psychasthenia, but the interpretation again ought to avoid all playing with the conception of the subconscious.
Psychotherapeutic influence may remove the phobia of a psychasthenic or the obsession of a neurasthenic or the emotion of a hysteric, and thus may bring not only momentary relief but a change which may be favorable for general improvement, but certainly the neurasthenia and psychasthenia and hysteria are not really removed by it.
Such occur conspicuously in the psychopathological syndrome so completely described by Janet under the term psychasthenia. Persons thus afflicted feeling an incapacity and an impediment to their free activity and not recognizing that they are sick, endeavour to interpret their feelings.
"Five years ago William Honeywell Robinson became addicted to a patent headache 'dope. It ended, as such habits do, in insanity. He was confined two years, suffering from psychasthenia, with suicidal melancholia and delusion of persecution. Then he was released, cured, but with a supersensitive mental balance."
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