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However this may be, there is struggle, conflict in every human breast and especially difficult and undecided struggles in the case of the neurasthenic. Literally, secretly or otherwise, he is a house divided against himself, de?nergized by fear, disgust, revolt, and conflict.

And the housewife we are trying to understand is particularly such a creature, with a host of de?nergizing 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. These are not so definitely related to the happenings of life as to the inborn disposition of the patient. Nor are they quite so common in the housewife as the neurasthenic, de?nergized state. However, they are usually of more serious nature, and as such merit a description.

These mental symptoms are of three main types. There is a tendency to recurring fears,--fears of open places, fears of closed places, fear of leaving home, of being alone, fear of eating or sleeping, fear of dirt, so that the victim is impelled continually to wash the hands, fear of disease--especially such as syphilis--and a host of other fears, all of which are recognized as unreasonable, against which the victim struggles but vainly. Sometimes the fear is nameless, vague, undifferentiated, and comes on like a cloud with rapid heartbeat, faint feelings, and a sense of impending death. Sometimes the fear is related to something that has actually happened, as, fear of anything hot after a sunstroke; or fear of any vehicle after an automobile accident.

There is also a tendency to obsessive ideas and doubts; that is, ideas and doubts that persist in coming against the will of the patient, such as the obscene word or phrase that continually obtrudes itself on a chaste woman, or the doubt whether one has shut the door or properly turned off the gas. Of course, everybody has such obsessions and doubts occasionally, but to be psychasthenic about it is to have them continually and to have them obtrude themselves into every action. 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. A restless anxiety results, a fear of insanity, an inefficiency, and an incapacity for sustained effort that results in the name that is often applied,--"anxiety neurosis."

Of all the forms of nervousness proper, the psychoneuroses, hysteria is probably the one having its source mainly in the character of the patient. That is to say, outward happenings play a part which is secondary to the personality defect. Hysteria is one of the oldest of diseases and has probably played a very important r?le in the history of man. Unquestionably many of the religions have depended upon hysteria, for it is in this field that "miracle cures" occur. All founders of religions have based part of their claim on the belief of others in their healing power. Nothing is so spectacular as when the hysterical blind see, the hysterical dumb talk, the hysterical cripple throws away his crutches and walks. In every age and in every country, in every faith, there have been the equivalents of Lourdes and St. Anne de Beaupr?.

In hysteria four important groups of symptoms occur in the housewife as well as in her single sisters and brothers.

There is first of all an emotional instability, with a tendency to prolonged and freakish manifestations,--the well-known hysterics with laughing, crying, etc. Fundamental in the personality of the hysterics is this instability, this emotionality, which is however secondary to an egotistic, easily wounded nature, craving sympathy and respect and often unable legitimately to earn them.

A group of symptoms that seem hard to explain are the so-called paralyses. These paralyses may affect almost any part, may come in a moment and go as suddenly, or last for years. They may concern arm, leg, face, hands, feet, speech, etc. They seem very severe, but are due to worry, to misdirected ideas and emotions and not at all to injury to the nervous system. They are manifestations of what the neurologists call "dissociations of the personality." That is, conflicts of emotions, ideas, and purposes of the type previously described have occurred, and a paralysis has resulted. These paralyses yield remarkably to any energizing influence like good fortune, the compelling personality of a physician or clergyman or healer , or a serious danger. The latter is exemplified in the cases now and then reported of people who have not been out of bed for years, but are aroused by threat of some danger, like a fire, reach safety, and thereafter are well.

Similar in type to the paralyses are losses of sensation in various parts of the body,--losses so complete that one may thrust a needle deep into the flesh without pain to the patient. In the days of witch-hunting the witch-hunters would test the women suspected with a pin, and if they found places where pain was not felt, considered they had proof of witchcraft or diabolic possession, so that many a hysteric was hanged or drowned. The history of man is full of psychopathic characters and happenings; insane men have changed the course of human events by their ideas and delusions, and on the other hand society has continually mistaken the insane and the nervously afflicted for criminals or wretches deserving severest punishment.

Especially striking in hysteria are the curious changes in consciousness that take place. These range from what seem to be fainting spells to long trances lasting perhaps for months, in which animation is apparently suspended and the body seems on the brink of death. In olden days the Delphian oracles were people who had the power voluntarily of throwing themselves into these hysteric states and their vague statements were taken to be heaven-inspired. To-day, their descendants in hysteria are the crystal gazers, the mediums, the automatic writers that by a mixture of hysteria and faking deceive the simple and credulous.

For, in the last analysis, all hysterics are deceivers both of themselves and of others. Their symptoms, real enough at bottom, are theatrical and designed for effect. As I shall later show, they are weapons, used to gain an end, which is the whim or will of the patient.

In order to clinch our understanding of the above conditions we must now consider in more detail certain phases of emotion.

Fear curdles the blood, anger floods the body with passion, sorrow flexes the proud head to earth and stifles the heartbeat; joy opens the floodgates of strength, and hope lifts up the head and braces man's soul.

We are accustomed to thinking of emotion as a thing purely psychical,--purely of the mind, despite the fact that all the great descriptions and all the homely sayings portray it as bodily. "My heart thumped like a steam engine," or "I could not catch my breath"; "a cold chill played up and down my back"; "I swallowed hard, because my mouth was so dry I could not speak." And the Bible repeatedly says of the man stricken by fear, "His bowels turned to water," with a graphic force only equaled by its truth.

William James, nearly simultaneously with Lange, pointed out that emotion cannot be separated from its physical concomitants and maintain its identity. That is, if we separate in our minds the weak, chilly feeling, the dry mouth, the racing heart, the sharp, harsh breathing, and the tension of the muscles getting ready for flight from the feeling of fear, nothing tangible is left. Similarly with sorrow or joy or anger. Take the latter emotion; imagine yourself angry,--immediately the jaw becomes set and the lips draw back in a semi-snarl, the fists clench and the muscles tighten, while the head and body are thrust forward in what is, as Darwin pointed out, the preparation for pouncing on the foe. Even if you mimic anger without any especial reason, there steals over you a feeling not unlike anger.

In a famous paragraph James essentially states that instead of crying because we are sorry, it is fully as likely that we are sorry because we cry. So with every emotion; we are afraid because we run away, and happy because we dance and shout. In other words he reversed the order of things as the everyday person would see it; makes primary and of fundamental importance the physical response rather than the feeling itself.

This has been widely disagreed with, and is not at all an acceptable theory in its entirety. Yet modern physiology has shown that emotion is largely a physical matter, largely a thing of blood vessels, heartbeat, lungs, glands, and digestive organs. This physical foundation of emotion is a very important matter in our study of the housewife as of every other living person. For it is especially in the emotional disturbance that the origin of much of nervousness is to be found, and that on what may be called the physical basis of emotion.

What can emotion produce that is pathological, detrimental to well-being? We may start with the grossest, simplest manifestations. It may entirely upset digestion, as in the vomiting of disgust and excitement. Or, in lesser measure, it may completely destroy the appetite, as occurs when a disturbing emotion arises at mealtime. This is probably brought about by the checking of the gastric secretions.

It may check the secretion of milk in the nursing mother, or it may change the quality of the milk so that it almost poisons the infant. It may cause the bladder and bowels to be evacuated, or it may prevent their evacuation.

It may completely abolish sex power in the male, or it may bring about sex manifestations which the victim would almost rather die than show.

It may completely de?nergize so that neither interest, enthusiasm, or power remains. This is a familiar effect of sorrow but occurs in lesser degree with the form of fear called worry.

The fact is that emotion is an intense bodily response to a situation which when perceived is the state of feeling. This intense bodily response, involving the very minutest tissues of the body, may increase the available energy, may help the bodily functioning, may stimulate the "psychical" processes, but also it may de?nergize to an extraordinary degree, it may interfere with every function, including thought and action. It may surely produce acute illness, and it may, though rarely, produce death.

The spread of emotion from person to person by sympathetic feeling or the reverse is a social fact of incalculable importance. The problem of the nervous housewife is a problem of society because she gives her mood over to her family or else intensely dissatisfies its members so that the home ties are greatly weakened.

This spread of emotion was happily portrayed by a motion picture I recently saw. Old Grouchy Moneybags, wealthy beyond measure and afflicted with gout, is seated at his breakfast table. In the next room, seen with the all-seeing eye of the movie, the butler makes love to the very willing maid. In the kitchen the fat cook is feeding the ever hungry butcher's boy with gingerbread and cake, and on the back steps the household cat is purring gently in contentment. Happiness is the predominant note.

Unfortunately the film did not show what the outraged cat did. Possibly it started a devastation that reached back into Moneybags' career; at any rate the unusual little picture showed how emotion spreads through the world, just as disease does. The infection that starts in the hovel finally strikes down the rich man's child, enthroned in the palace. The mood engendered by the humiliation of poverty or cruelty or any injustice finally shakes a king off his throne.

So when we trace the de?nergizing emotions of the housewife, we are tracing factors that affect her husband, his work, and Society at large; we trace the things that mold her children, and thus we follow her mood, her emotion, into the future, into history.

TYPES OF HOUSEWIFE PREDISPOSED TO NERVOUSNESS

There are three main factors in the production of the nervousness of the housewife, and they weave and interweave in a very complex way to produce a variety of results. All the things of life, no matter how simple in appearance, are a complex combination of action and reaction. Our housewife's symptoms are no exception, whether they are mainly pains, aches, and fatigue, or the deeply motivated doubt or feeling of unreality.

The nature of the housewife, the conditions of her life, and her relations to her husband are these three factors. All enter into each case, though in some only one may be emphasized as of importance. There are cases where the nature of the woman is mainly the essential cause, others where it is the conditions of her life, and still others where the husband stands out as the source of her symptoms.

We are now to consider the nature of the housewife as our first factor. We may preamble this by saying that a woman essentially normal in one relationship in life may be abnormal in some other, may be the traditional square peg in the round hole. Moreover, we are to insist on the essential and increasing individuality of women, which is to a large extent a recent phenomenon. The cynical commonplace is "All women are alike"--and then follows the specific accusation--"in fickleness", "in extravagance", "in unreasonableness", in this trick or that. The chief effort of conservatism is to make them alike, to fit each one for the same life by the same training in habits, knowledge, abilities, and ideals.

Talk about Prussianism! The great Prussianism, with its ideal of uniformity, serviceability, and servility, has been the masculine ideal of woman's life. Man was to be diversified as life itself, was to taste all its experiences, but woman had her sphere, which belied all mathematics by being a narrow groove.

The nineteenth century changed all that,--or started the change which is going on with extraordinary rapidity in the twentieth. There are all kinds of women, at least potentially. It may be true that woman tends less to vary than man, that she follows a conservative middle-of-the-road biologically, while man spreads out, but no one can be sure of this until woman's early training to some extent resembles man's.

All these things--vanity, emotionality, romanticism, courtship--are poor training for the home. They hinder even the strongest woman, they are fetters for the more delicate.

In taking up the special types predisposed to the nervousness of the housewife it is to be emphasized that conditions may bring about the neurosis in the normal housewife. Nevertheless, there are groups of women who, because of their make-up or constitution, acquire the neurosis much more easily and much more intensely than do the normal women. They are the types most commonly seen in the hospital clinic or in the private consulting room of the neurologist.

First comes the hyperaesthetic type. One of the chief marks of advancing civilization is an increasing refinement of taste and desire. The fundamental human needs are food, shelter, clothes, sex relations, and companionship. These the savage has as well as his civilized brother, and he finds them not only necessary but agreeable. What we call progress improves the food and the shelter, modifies the clothes, elaborates the sex relations and the code governing companionship. With each step forward the cruder methods become more actively disagreeable, and only the refined methods prove agreeable. In other words, desire keeps pace with improvement, so that although great advances materially have been made, there has been little advance, if any, in contentment. This is because as we progress in refinement little things come to be important, manner becomes more essential than matter, and we get to the hyperaesthetic stage.

From another angle, to the hyperaesthetic more and more things have become disagreeable. To the man of simple tastes and simple feelings, only the calamities are disagreeable; to the hyperaesthetic every breeze has a sting, and life is full of pin pricks. "The slings and arrows of outrageous fortune" are multiplied in number, and furthermore the reaction to them is intensified. In the "Arabian Nights" the princess boasts that a rose petal bruises her skin, while her competitor in delicacy is made ill by a fiber of cotton in her silken garments. So with the hyperaesthetic; an unintentional overlooking is reacted to as a deadly insult; the thwarting of any desire robs life of its savor; sounds become noises; a bit of litter, dirt; a little reality, intolerable crudity.

A woman with this temperament is a poor candidate for matrimony unless there goes with it a capacity for adjustment, unusual in this type. Most men have their habitual crudities, their daily lapses, and every home is the theater of a constant struggle with the disagreeable. Intensely pleased by the utmost refinements, these are too uncommon to make up for the shortcomings. The hyperaesthetic woman is constantly the prey of the most de?nergizing of emotions,--disgust. "It makes me sick" is not an exaggerated expression of her feeling. And her afflicted household size up the situation with the brief analysis, "Everything makes her nervous." Every one in her household falls under the tyranny of her disposition, mingling their concern with exasperation, their pity with a silent almost subconscious contempt.

Next comes the over-conscientious type. Whatever conscience is, whether implanted by God, or the social code sanctified by training, teaching, and a social nature, there can be no question that, as the Court of Appeals, it does harm as well as good.

There are people whose lack of conscience is back of all manner of crimes, from murder down to careless, slack work; whose cruelty, lust, and selfishness operate unhampered by restraint. On the other hand there are others whose hypertrophied conscience works in one of two directions. If they are zealots, convinced of the righteousness of their own decisions and conclusions, their conscience spurs them on to reforming the world. Since they are more often wrong than right, they become, as it were, a sort of misdirected Providence, raising havoc with the happiness and comfort of others. Whether the conscienceless or those overburdened with this type of conscience have done more harm in the world is perhaps an open question, which I leave to the historians for settlement.

The other type of the overconscientious does definite harm to themselves. This type I have called the "Seekers of Perfection" and it is their affliction that they are miserable with anything less. They are particularly hard on themselves, differing in this wise from the by hyperaesthetic. Constantly they examine and re?xamine what they have done. "Is it the best I can do?" "Should I rest now; have I the right to rest?"

Into every moment of enjoyment they obtrude conscience, or rather conscience obtrudes itself. They become wedded to a purpose, and then that purpose becomes a tyrant allowing no escape, even for a brief pleasure, from its chains. Nothing is right that wastes any time; nothing is good but the best. The sense of humor is conspicuously lacking in this type, for one of the main functions of humor is to season effort and straining purpose with proportion.

Should one of these unfortunates be a housewife, then she is continually "picking up", continually pursuing that household Will-o'-the-Wisp, "finishing the work." For it is the nature of housework that it is never finished, no matter how much is done. This overconscientious person, unless she is made of steel springs and resilient rubber, breathlessly chasing this phantom all day and into the night, gives way under the strain, even though she have a dozen servants to help. For to this type each helper is not at all an aid. At once up goes the standard of what is to be done, and each servant becomes an added care, an added responsibility.

"Why don't you rest if you are tired," is his stock remonstrance; "the house looks all right to me."

But it is futile. She becomes irritated, perhaps cries and says, "Just like a man. It's clean to you if there are no cobwebs on the walls."

Whereupon the debate closes, but the woman is the more de?nergized and the man exasperated at the unreasonableness of women in general and his wife in particular.

It is probably true that woman has more conscience, in so far as detail is concerned, than man. She is more of a lover of order and neatness, more wedded to decorum. Man loves comfort and his interest is more specialized and analytical, and as a rule he hates fussiness.

This hatred of fussiness makes him long for the masculine clubroom, gives him the kind of uneasiness that sends him off on a fishing trip or hunting expedition. Further, and this is of great social importance, many a broken home, many an unexplainable triangle of the Wife, the Husband, and the Other Woman owes its existence, not to the charms of the other woman, but to the overconscientious wife.

The third type predisposed to the neurosis of the housewife is the overemotional woman.

We have already considered the effect of certain types of emotion on health and endurance and may formulate it as follows: Emotion may act as a great bodily disturbance, affecting every organ and every function of the body. What we call nervousness is largely made up of abnormal emotional response, of persistent emotion, of the blocking of energy by emotion.

Now people differ from the very start of life in their response to situations. One baby, if he does not get what he wants, turns his attention to something else, and another will cry for hours or until he gets it. One will manifest anger and strike at being blocked or impeded in his desires, and the other will implore and plead in a baby way for his wish.

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