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Christopher D. Green
York University, Toronto, Ontario
ISSN 1492-3173
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By William H.R. Rivers (1920)
Posted May 2000
CHAPTER XVIII
REGRESSION
In dealing with the various means by which the human organism seeks to solve the conflict between instinctive tendencies and the forces by which they are controlled, I have so far been considering the psycho-neuroses only as examples of failure of equilibrium and of various modes of attempting to redress the balance. In this chapter I propose to treat the psycho-neuroses from another point of view and see how far they may be regarded as examples of regression, as processes which enable us to study the general course of mental development on the assumption that in disease the organism tends to retrace the steps through which it has passed in its development. This aspect of disease is one to which special attention was paid by Hughlings Jackson, whose "devolution" corresponds closely with the "regression" of present-day students of nervous and mental disorder.
I will begin by considering the modes of solution considered in the last three chapters as examples of regression. I have regarded hysteria as a state dependent upon the coming into activity, in a modified form, of a mode of reaction which dates back to a very early stage of animal development. If I am right in looking upon this morbid state as due to the substitution of the instinct of immobility for other forms of reaction to dangerous or unpleasant situations, we have in it not merely an example of regression, but of regression to a very primitive form of reaction. There will be not merely regression to a character of the infancy of the individual, but to a character which must go very far back in the process of development by which Man has become what he is. [p. 149]
The mimetic nature of hysteria provides another characteristic indication of regression. The mimesis of hysteria may be regarded as a throw-back, partly to the dramatic character of the activity of early life, partly to the mimetic aspect of the activity of the gregarious instinct.[1] According to the view put forward in this book hysteria depends on the recrudescence of a very early form of reaction to danger modified by factors arising out of gregarious needs, and both the original activity and the force by which it is modified provide characteristic examples of regression.
In anxiety- or repression-neurosis the regression is less complete, but since in this case the regressive features are of a kind with which we are acquainted in the individual life, the process is more obvious and presents a feature which is now widely recognised. One of the most striking features of this regression is presented by the strength and urgency of emotional reactions. Expressions of affective activity which are frequent in infancy, but have been brought under complete control in later life, are apt to reassert themselves in the state of anxiety-neurosis. Some of the most frequent and distressing symptoms of this state are due to the reawakening of these affective reactions. In slight cases the change may be limited to irritability and undue liability to lose the temper, while in more severe cases the patient may with difficulty restrain himself from violence on slight provocation. There is little doubt that this regression to states in which the primitive emotional impulses have escaped from control has been a definite factor in producing the increase in the frequency of crimes of violence which exists at the present time. In another direction the regression may show itself in great increase of the tendency to give way to grief. One of the most trying of the symptoms of the anxiety-neurosis following warfare is the liability to give way to grief on occasions which would not have moved at all in health, and here the regression to a character of infancy is obvious. In this case it is not so much that emotions occur in greater strength, but they are accompanied by a mode of expression, natural in childhood, to the control of which the [p. 150] influence of parents, teachers and tradition is directed from the earliest years.
A striking manifestation of regression is to be found in dreams. The nightmares of anxiety-neurosis are of exactly the same order as the night-terrors which are so frequent in childhood. In many cases which have come under my own observation they have even been exact reproductions of these childhood states. Thus, one of my patients after an aeroplane crash had dreams in which a Chinaman figured prominently. He remembered having been frightened by a recurrent dream in childhood in which the Chinaman appeared in exactly the same surroundings as those of the adult dream, and similar examples of regression to the dreams and night-terrors of childhood are frequent. The terrifying animals which appear so often in the nightmares of war-neurosis may be regarded as the result of regression to a character especially frequent in the dreams of children.
Another frequent feature of anxiety-neurosis may be an example of regression to a more deeply-seated instinct. One of the most frequent symptoms of war-neurosis is a desire for solitude and inability to mix in the usual way with one's fellows. In many cases this may be explained by feelings of shame which are apt to trouble sufferers from neurosis as the result of their failure to understand that their excessive reactions or other troubles are the natural results of their morbid state and give no real ground for self-reproach. Often, however, it would seem that the desire for solitude and inability to mix with others cannot be explained by such conscious process, but is an instinctive reaction of the same kind as that which leads animals, when ill, to withdraw from their fellows in order to die in solitude. This view may be regarded as fanciful, but the desire for solitude in sufferers from war-neurosis is often so strong and so devoid of rational grounds that I am inclined to regard it as an example of regression to an instinctive reaction dating far back in the history of the race.
Compulsion-neurosis affords an excellent example of regression. There is reason to believe that the acts which are [p. 151] especially prone to be carried out compulsively in this state are frequent in childhood. When they become insistent in adult life, this is only an outcrop of a mode of reaction which is characteristic of infantile mentality.
There is little doubt also that the failure to appreciate reality which is so frequent in psychoses, and also occurs in anxiety-neurosis, is another example of regression. Children often, if not always, pass through a stage of development in which they fail to distinguish the products of their imagination from the features of the real world in which they find themselves. There must be a definite stage of mental development in which the child is learning to distinguish imagination from reality, and there can be little doubt that this stage must be accompanied by some degree of the doubt and discomfort which so often occur as features of the psychoses and psycho-neuroses. I have seen cases in which the regression in childhood in this respect has been very definite. I have seen more than one soldier with a history of having been very imaginative in childhood, when they had amused their relatives by tales of the wonderful adventures in which they had taken part. There had always been some difficulty in distinguishing between imagination and reality, and when they began to suffer from war-strain, this failure became pronounced and they laid themselves open to serious trouble by relating adventures in which they had taken an honourable and distinguished part for which there was no foundation. As in the case of other mental anomalies, all gradations may be met between such a regression and cases of pathological lying and swindling in which the person affected has never learnt properly to distinguish imagination from reality and has utilised this imperfection for the satisfaction of his instinctive tendencies.
The most characteristic form of dementia præcox may be regarded as another example of regression in which the sufferer gives way to day-dreams as a means of escape from conflict. The day-dreams which in this state pass insensibly into definite hallucinatory and delusional states may be regarded as regressions to the fancies which are so habitual in childhood. [p. 152]
Lastly, mania may be regarded as an example of regression to a still more primitive state, but one in which the regression is accompanied by such disorder and disintegration as to make this feature less obvious than in the milder forms of psychosis and in the psycho-neuroses.
It is an interesting question how far the process of suppression which has been found to be of such fundamental importance in psycho-neurosis can be regarded as an example of regression. In this book I have regarded the process of suppression as one which goes far back in the history of the animal kingdom, and corresponding with this antiquity I have regarded it as a process which is especially apt to come into action in the infancy of the human being. There is reason to believe that suppression is especially liable to occur, and when it occurs to be complete, or relatively complete, in the first few years of life. All the characters of anxiety-neurosis, on the other hand, are most satisfactorily explained as due to the attempt to put wittingly into activity in adult life a process which normally takes place unwittingly and instinctively in the first few years of life. Cases in which suppression occurs in adult life may be regarded as examples of regression in which an instinctive process characteristic of infancy persists in its capacity for activity in later years. It may be objected that I have supposed the reinstatement of suppression to be the normal way in which a temporary failure of balance is redressed, and if this is held to be an example of regression, we shall have to accept the situation that a regressive process need not necessarily be pathological, or rather, that in order to get rid of a pathological state, the organism sometimes utilises with success in adult life a process which is especially liable to occur in infancy. When suppression occurs in adult life it more frequently happens that the suppressed experience preserves an independent activity either with or without independent consciousness, and such cases may more fitly be regarded as examples of regression. I have suggested that this independence of activity, and the occurrence of independent consciousness, have come down from an ancestral stage of development when a change was taking place in the [p. 153] environment, and if there be anything in this suggestion, the independent activity of suppressed experience and the process of dissociation would also he examples of regression.
Regression and the "all-or-none" principle. -- If the psycho-neuroses are to be looked upon as examples of regression, we should expect them to show definite signs of the "all-or-none" reaction. According to the view put forward in the chapter on "the Nature of Instinct" the "all-or-none" character is the sign of the earlier and cruder forms of instinct which serve the immediate needs of the individual, especially such as manifest themselves in the presence of danger. We should, therefore, expect to find reactions conforming to this type in those varieties of neurosis which depend upon reawakening of the danger-instincts. Thus, if "hysteria" is primarily due to the substitution of the reaction to danger by means of immobility for other forms of reaction, we should expect to find that its symptoms would have the "all-or-none" character, for the reaction by immobility is one for the success of which in its original form this principle is essential. It must be noted, however, that I do not suppose "hysteria" to be a simple manifestation of the reaction to danger by immobility, but that the original instinctive reaction has been greatly modified by needs arising out of the gregarious habit. In other words, I suppose the symptoms of hysteria to be manifestations of the instinct of immobility greatly modified by suggestion, and since suggestion is a graded and discriminative process, we should not expect to find that hysteria would show the "all-or-none" character in a pure form. Nevertheless, in some of the features of hysteria the "all-or-none" character is distinctly present. Thus, the symptom of mutism involves not merely suppression of utterances which tend in some relation to the shock or strain by which the disability has been produced, but it extends to the whole of speech. In order to wipe out manifestations of speech which stand in a relation to the needs by which the mutism has been produced, it is necessary to suppress all expressions of the organ of speech, even those of the most useful and pleasant kind. In general, however, it must be acknowledged that the [p. 154] "all-or-none" principle appears only exceptionally in hysteria, and that the morbid process is largely subject to the processes of discrimination and graduation. According to the scheme of this book the slightness of the activity of the principle indicates how greatly the original instinct, which I suppose to underlie the disease, has been influenced and modified by later changes arising out of gregarious needs. We may fitly regard hysteria as dependent on a process whereby the organism, in response to gregarious needs, has utilised an old instinctive form of reaction, but while so utilising it has, at the same time, modified it greatly in so far as the features of graduation and discrimination are concerned. According to the view put forward in Chapter XV anxiety- or repression-neurosis is due to the ineffective action of the instinctive process of suppression, the ineffectiveness being due to the witting character of the process in which it is employed. We should, in consequence, not expect to find this morbid state exhibiting the "all-or-none" principle in any pronounced degree. The excessive emotional reactions of this disease do, indeed, show the "all-or-none" character and are wholly out of relation to the conditions which call them forth, and this want of relation between cause and effect runs through many features of the behaviour of those suffering from repression-neurosis. But there is no one symptom which can be regarded as a pure example of the "all-or-none" principle, at any rate in the waking state. In sleep, however, the principle is more potent as might indeed be expected, since sleep, by removing the higher controlling factors, will allow any instinctive manifestations to appear in the form natural to them. Thus, the nightmare clearly exemplifies the "all-or-none " principle. This state is characterised by an excess of emotion and emotional reaction. The affect, whether of fear, horror or grief, may be altogether out of proportion to the incident of the dream, which is its immediate occasion, and the emotion occurs with a force and urgency which are never experienced, even in the most acute emotional situations of the waking life. In dealing with sleep in Chapter XIV it was found that the normal process is clearly subject to the principle of graduation, but in the sleep accompanying [p. 155] pathological states such as repression-neurosis, instinctive tendencies with their affective accompaniments are apt to show the working of the "all-or-none" principle in an especially pure form. The process of dissociation is especially interesting and instructive in connection with regression and the "all-or-none" principle. I have considered in Chapter X the relation between the pathological process of dissociation, such as is manifested in the fugue, and several phenomena of the normal mental life. One of the chief differences between the pathological and the normal process is the greater completeness of the barrier between systems of dissociated experience in the pathological examples, and this greater completeness seems to bear a definite relation the "all-or-none" principle. Thus, in a definite fugue the suppression is complete. There is no graduation of memory so that certain incidents of the fugue are remembered and others forgotten, but the memory of experience gained during the fugue is lost as a whole. In the examples taken from the normal life, which were compared with the fugue, there is no such completeness of separation, and there is a power of choice between what shall and what shall not be recalled which is wholly absent in the fugue. Thus, if I switch off my attention from one set of interests and turn it to another, I do not thereby exclude the former from memory, but elements of the first set are readily capable of recall if they should come into associative relation with any of the second set of interests. I have spoken of the two kinds of dissociation as protopathic and epicritic respectively, and the protopathic form shows, at any rate in certain respects, the "all-or-none" character which belongs in general to protopathic manifestations. The "all-or-none" character is also present in the dissociation which exists in insanity between a delusional system and the experience which is in harmony with the beliefs of the society to which the deluded person belongs. It is a definite character of a delusional system that it does not admit of compromise. The subject of a delusional system when under its influence is wholly dominated by it and excludes from attention everything in his environment which conflicts with the system.
Footnotes