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Here one might quote Laura A. once more, whose resistiveness when stuporous was intense but who in her manic spells expressed her negativism in a definite idea, “I don’t want my face washed.” To summarize, then, we may say that negativism is apparently the result of a desire to be left alone, and that muscular resistiveness is a larval exhibition of the same tendency.

She claimed to remember the Observation Pavilion and her coming to the hospital, also the incidents during the manic state, when she heard cannon and thought a war was on, and voices she could not recognize nor understand. Then she became stupid, although neither sad nor happy. Then, she claimed, she got stupid, but neither sad nor happy.

For example, there are religious and erotic fancies or ambitious schemes dominating the thoughts of manic patients, fears of aggression and injury met with in anxiety cases, and so on. In stupors, death seems to be a state of non-existence with other meanings lacking or only hinted at occasionally.

Both are forms of the manic reaction. We consequently regard stupor and partial stupor as different degrees of the same psychotic process which we term the stupor reaction. To understand it the symptoms should be separately analyzed and then correlated. The most fundamental characteristic of the stupor symptoms is the change in affect which can be summed up in one word apathy.

They are usually fairly clear and oriented and often with good memory for the attack but with evasive explanations for their symptoms. One cannot make any classification of the ideas he quotes, but it is apparent from all his description that the minds of thesemanic stuporsare not a blank but rather that there is a fairly full mental content.

As the clinical pictures show the relationship of stupor to other psychoses, so there is also a correlation with varying formulations of the death fancy. We are now in a position to define more narrowly what death means in stupor. It is an accepted fact, a Nirvana state. When death means union with God or appears in other religious guise, manic symptoms tend to develop.

On the other hand, deep stupors very frequently are terminated by manic reactions, and if not by such means, recovery seems to occur merely in virtue of a gradual attenuation of the stupor symptoms. Rarely do we see a change to depression or anxiety heralding improvement.

The psychosis, Dagonet says, is not pure but more a mixture of hypochondria and depression. Relationship with mania is next considered. He says that stupor may succeed, alternate with or precede mania. His cases seem mainly to have been what we call absorbed manics or manic stupors. In fact, he uses the last term.

Psychiatrists are more or less aware of there being typical ideational contents in the different manic-depressive psychoses. For instance, every one is familiar with ideas of wickedness and inadequacy in depression, ideas of violence in anxiety, or expansive and erotic fancies in manic states. Quite similarly we have seen that death is a dominant topic in a stupor.

You need to keep away from that TV set, don't you think." She giggled as if manic. "No spells?" "No spells," said Gabriele, "and vegetarian recipes afterward. It is really quite boring." "It is just like any church?" Gabriele thought of the Wicca services. They always reminded her of Catholic masses but without the Eucharist.