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Updated: May 5, 2025
In fact, such evidences of affect as do appear in the course of the stupor are apt to be isolated, queer and “dissociated.” It does not seem as if the whole personality reacted in the emotion as it does in the other forms of manic-depressive insanity. For example, we may think of the resistiveness which is so frequently present when the patient seems in other respects to be psychically dead.
She too flinched from pin pricks but not only made no effort to prevent them but would even stick out her tongue to have a pin stuck in it. The relationship of catalepsy to resistiveness is interesting but unfortunately complicated and unclear.
She said, on looking back over her state with impulsive excitement, that she constantly had the idea that she wanted to punish herself, but that she did not know why, and did not think she was sad or worried. Considering only the second phase of the psychosis, this deep stupor showed many interruptions, due not merely to her suicidal efforts but also to her resistiveness.
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.
For instance, Mary G., who said, “Leave me alone,” and covered her head or buried it in the pillows, accompanied her muscular resistiveness with laughter. This shows the affective nature of the apparently purposeless muscular tension.
This resentment against interference again reminds us of the reactions of a spoiled child. For instance, Laura A., in manic spells during which she was still constrained and drooled, said, “I don’t want to have my face washed.” In the intervals she showed an intense muscular resistiveness. Mary G. used to say, “Leave me alone,” and covered her head or buried it in the pillows.
She was also more in contact with her environment than many stuporous patients are, for, not infrequently, she would look at what was going on about her. Her apathy was also broken into in a marked degree by her active resistiveness, which was sometimes accompanied by plain anger. It seems that a prospect of death may occur in other instances in a totally affectless state.
By far the commonest cause of muscular movement in these inactive cases is resistiveness, and as a rule the inactivity is interrupted only by negativistic symptoms. If we look for some explanation or correlation of these symptoms, we find that chance references to conduct seem to point in the same direction, namely, to the desire to be left alone.
Besides from her strong resistiveness and constitutional obstinacy, she is liable every moment to turn short from the main point and spend her whole force upon some little one-side annoyance that might temporarily nettle her. In doing this she might win a single battle, but lose a whole campaign.
By far the commonest manifestation is muscular resistiveness, often spoken of as “resistiveness.” It was present in thirty-two out of thirty-seven of our cases. Usually it takes the form of a contraction of the whole system of voluntary muscles when the patient is touched or the bed approached. Often it appears only when any passive movement of the limb is attempted.
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