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Updated: May 19, 2025
All neurasthenics and psychasthenics are psychics and their diseases can only be fully understood by the psychologist. The scientist has long ago exhausted his knowledge of the cause and cure of these diseases and this is why all branches of metaphysical healing are overcrowded. To understand this abnormal thing called "insanity," one must fully understand the normal, called "sanity."
The question of how to differentiate the diagnosis of insanity from that of the other mental abnormities is not our question at this moment. I select the few illustrations which seem to me desirable for the purpose of making more concrete our abstract discussion of methods, essentially from the class of neurasthenics, psychasthenics, hysterics, and so on.
The groups to which the hidden thoughts of psychasthenics, for instance, belong are not many. As soon as our series of words strikes such a group, the reaction of the mind may be discriminated. The effect may be a general perturbation resulting either in an unusual delay of the fitting association or in an effort to cover the sore spot by an unfitting association.
It is, for instance, extremely difficult to say where the limit is to be set for permissible marriages. There may be no doubt that feeble-mindedness ought not to be transmitted to the next generation, but have we really a right to prevent the marriage of epileptics or psychasthenics? Can we be surprised then that others already begin to demand that neurasthenics shall not marry?
He knows that in the long run, even the psychasthenics are best treated with frankness and sincerity and he will therefore only in exceptional cases resort to such short-cut treatment by making believe. Yet that it is sometimes almost the only way to help the patient cannot be denied.
In the field of insanity, naturally the physician at once goes to an examination on his own account, but in the borderland regions of the psychasthenics and hysterics and neurasthenics, the intellectual clearness of the patient too easily tempts one into trusting the sincerity of his story; and yet the most important ideas clustering perhaps about love or ambition, about vice or crime, about business failure or family secrets, about inherited or acquired diseases may be cunningly withheld and may frustrate every psychotherapeutic influence.
But it turns out that Janet's cases are all what he calls psychasthenics, or victims of a chronic sense of weakness, torpor, lethargy, fatigue, insufficiency, impossibility, unreality and powerlessness of will; and that in each and all of them the particular activity pursued, deleterious though it be, has the temporary result of raising the sense of vitality and making the patient feel alive again.
The whole irritation becomes eliminated, the emotion is relieved from suppression and the source of the cortical uproar is removed forever. Practically still more important seems the other case which refers alike to hysterics and psychasthenics and which is applicable for the forgotten experience not less than for the well-remembered ones.
Science gives all actions a physical basis, but it is time to know that abnormal states of consciousness, that are only changes in the functional side of the mind and which have no apparent physical basis, are found in thousands. Neurasthenics and psychasthenics present the mildest picture of disordered states of mind.
This time two hypnotic sittings were sufficient to remove the disturbance of the equilibrium, which as far as I know has not come back. The same hypnotic treatments were used in a secondary way to remove the digestive trouble. I again quote the case of a teacher, a profession in which the psychasthenics are unusually frequent. It is a case of a young woman from the Middle West.
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