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If they sense that you are afraid they frequently enjoy terrorizing you. When psychotic people know you feel comfortable with them, and probably understand a great deal of what they are experiencing, when they know that you can and intend to control them, they experience a huge sense of relief.
White, I presume he meant to imply that there may have been some organic swing corresponding to the psychotic swing. That of course is quite possible. At the same time the analysis of this case showed that purely psychic factors had a great deal to do with it. His monthly attacks seemed to represent a break in the balance.
A nascent stage of stupor, he thinks, is a common reaction to great exhaustion, “such as hard mental work, prolonged or acute illness, dissipation, etc.” Such conditions, like the grave psychotic forms, he regarded as due to physical exhaustion of the brain cells, but, since he thought psychic stress could produce this exhaustion, this “organic” view did not bias his general formulations.
The first case we wish to present, John McM., is at present thirty-six years of age, unmarried, a Catholic. For at least nine years he has been objectively psychotic, though, according to his own account his delusional habit of thought began seventeen years ago. He was always somewhat distant and did not make friends easily.
Many of our psychotic patients achieve in fancy that for which the Persian poet yearned: “Ah Love! could you and I with Him conspire To grasp this Sorry Scheme of Things entire, Would we not shatter it to bits and then Re-mold it nearer to the Heart’s Desire!”
Stern mentions that acute stupors are found in this group. Wilmanns examined the records for five years in a prison and discovered that there were two forms of psychotic reaction, a paranoid and a stupor type. It is interesting psychologically that the former appeared largely among prisoners in solitary confinement, while the stupors developed preponderantly among those who were not isolated.
May we not hope to find in the content of the psychosis some objective criterion as to the degree in which the sense of reality is lost, with all that it implies? But what takes the place of the sense of reality or what causes it to go? With what tendency of the psychotic individual is it in conflict? The answer is a psychological truism the indulgence in fancies.
During his first attack this was his "prophecy," during his saner intervals there were endless ramifications of this idea which are too tedious to recite. It is important to note as evidence of the purely psychotic character of his ideas that he has never been either religious in his spirit or in action a propagandist.
With any psychotic residing in your home it is foolhardy to become inattentive even for one hour, including what are normally considered sleeping hours. I have found the most profoundly ill mentally ill person still to be very crafty and aware even though they may appear to be unconscious or nonresponsive.
If this be a sound view, similar tendencies should appear in everyday life, the psychotic phenomena being merely the exaggerations of a fundamental type of human and animal behavior. Shamming of death in the face of danger and animal catalepsy come to mind at once, but since we know nothing of the associated affective states we should be chary of using them even as analogies.
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