Mental incapacity

“ Every physician of large experience must have seen cases of self-created, unresisted invalidism end with mysterious abruptness and the return of mental, moral and physical competence, under the influence of some call upon their sense of duty made by calamity, such as an acute illness in the household, financial ruin, or the death of a husband. ”

“ If these two forces are lacking in the body to any considerable extent, we have sickness and infirmity and accidents of every kind. If they are lacking in the mind, we find every degree of mental deficiency, every variety of insanity. ”

“ But it is none the less true that always some disorder results from excess or defect, that it influences every function, bodily and mental, and that it constitutes a lowering of the life for the time being. ”

“ Some cases terminate in a chronic condition which may improve somewhat in time. There may be a persistent emotional and mental enfeeblement with indifference, loss of memory, lack of judgment and impairment of will. ”

“ Here, we have a striking proof of the immediate action of the mind upon the body,—of mental disorder instantaneously producing physical derangement, having the power to corrupt the purest juices of the system, and even to extend its deleterious effects to a second individual,—to communicate disorder and pain to an innocent infant. So powerful and so immediate is moral evil in producing physical. ”

“ While we now know that more than one in five Americans experiences some form of mental illness each year, that many mental disorders are biological, and that they can be treated medically, too many people still believe that mental illness is a personal failure. ”

“ Woe to the man who uses up his surplus stock of brain-inhibition too near the bitter end, or too often!... The physiological word inhibition can be used synonymously with the psychological and ethical expression self-control, or with the will when exercised in certain directions. It is the characteristic of most forms of mental disease for self-control to be lost, but this loss is usually part of a general mental affection with melancholic, maniacal, demented, or delusional symptoms as the chief manifestation of the disease. ”

“ Such work is not only for the mentally disordered and those suffering from mental defect, but for all those who, through mental causes, are unable so to adjust themselves to their environment as to live happy and efficient lives. ”

“ But perhaps we have not sufficiently indicated a diseased state of consciousness, from which most intellectual men have suffered, many have died, and all should be warned,--the disease, namely, of mental disgust, the sign and the result of mental debility. ”

“ It is clear that the intention is to distinguish mental deficiency from senile dementia, from hysteria and from insanity, in which there is a temporary or permanent loss of mental ability rather than a failure to develop. ”

“ Such handicaps, however, are limited to relatively few of a population. The raison d'être of the greater number of minor mental inefficiencies the psychanalyst puts down to handicaps in the unconscious. ”

“ It is a lower degree of the same cause which renders continuous seclusion from society so injurious to both mental and bodily health.”
“Inactivity of intellect and of feeling is a very frequent predisposing cause of every form of nervous disease. For demonstrative evidence of this position, we have only to look at the numerous victims to be found among persons who have no call to exertion in gaining the means of subsistence, and no objects of interest on which to exercise their mental faculties, and who consequently sink into a state of mental sloth and nervous weakness.” ”

“ Their perpetual solicitude for him, acting as a suggestion of irresistible force, tends to engender in him a mental attitude out of which may afterward spring, according to the subsequent circumstances of his life, a cold, heartless, calculating selfishness, or a morbid self-anxiety, perhaps eventuating in all sorts of neurotic symptoms. ”

“ Like the unstable or inert they are not failures because of a lack of intellectual understanding of right and wrong, but because of excess or deficiency of their instinctive tendencies especially in the emotional sphere. Such weakness of will may arise either from abnormality of specific instinctive impulses or inability to organize these impulses so that one impulse may 16be utilized to supplement or inhibit another. We may call all this group of cases socially deficient because of a weakness in the volitional, or conative, aspect of mind. ”

“ Guarding against the propagation of mental deficiency thus seems to be the most direct and hopeful method of attack, while the removal of infecting temptations, and training for greater resistance, should receive hearty, albeit subordinate emphasis. ”

“ It is a noteworthy fact, moreover, that often in the milder forms of affliction, where instead of well-marked convulsions only momentary lapses of consciousness occur, the greatest amount of mental and moral deterioration and fluctuation is sometimes found. ”

“ And it is from a neglect of this principle, that some of the most exemplary and conscientious persons in the world suffer a thousand mental agonies from a diseased state of body, while others ruin the health of the body by neglecting the proper care of the mind.
When the mind is excited by earnest intellectual effort, or by strong passions, the blood rushes to the head and the brain is excited. ”

“ From these and many another supporting observation, easily and everywhere to be had, it is perfectly legitimate to conclude, beyond reasonable doubt, that mental pain and its resulting invalidism is quite naturally the necessary outcome of a great variety of causes, which may be contributed to, usually, by almost every influence that either bad heredity, accident, disease, wrong education, personal over-stress, or failure, or future uncertainty, may happen to afford. ”

“ If this is the case with those suffering only from mental deficiency, it is evidently more likely to occur in those suffering from any form of mental disease, which is often liable to change its character, and to pass from the form of depression to one of excitement. ”

“ Of the persons reported recovered from mental disease, a large proportion fail to recover in the sense of being fully themselves again. There is left some change of character, no matter how slight, some moral perversion, irritability, instability, impaired will, lessened power of self-control, diminished mental capacity—some lowering of the intellectual or moral standard, some deterioration of some kind. ”

“ Then add to defective vision his lack of physical endurance, his liability to various organic affections caused by structural defects, and his abnormal appetites which are constantly demanding for their gratification the things which are injurious to his mental and physical constitution, and we are enabled to judge, to some extent, of the obstacles against which, in the struggle for existence, the future man will find himself obliged to contend. ”

“ It arose from his diseased mental condition, and the solution of the problem of his life can be obtained only by tracing back his history to the unfavorable circumstances of his childhood, acting upon a brain in all probability predisposed to disease.
Should such a man be interfered with? Interference could not be made on account of the neglect of his property, or of his mode of life. But, conceding his insanity, would it have been desirable to place him under care? ”

“ But the gist of the whole matter is this: in a neurosis, certain forces of the personality—instincts and their accompanying emotions—which ought to work harmoniously, having become tangled up with some erroneous ideas, have lost their power of coöperation and are working at cross purposes, leaving the individual mis-adapted to his environment, the prey of all sorts of mental and physical disturbances. ”

“ The patient feels discouraged and cast down at his inability to conquer himself and is likely to avoid such exercise and diversion of mind as would make normal healthy function possible.
Mental Disturbances.—It is the custom to say that mental deterioration almost surely follows the habit. Those familiar with mental cases often see self-abuse practiced with serious results by young folks whose mentality is deteriorated. In these cases the practice was indulged in with great frequency and with direct physical consequences, such as loss of sleep, of appetite and the like. ”

“ Man's freedom and rationality being impaired by mental conditions, caused by a disorderly life or by some injury to the mind's instrument, the physical brain, as in the various forms of insanity, spirits can possess and dictate his actions according to their conceits, even in direct opposition to his prevailing character before disease. ”

“ Some such disharmony will, by adequate investigation, be found in a large number of cases to exist in the early states of the illness and will be appreciated by the patient before there occur any obvious signs, any outward manifestations of disability.
But in any disharmony which may occur it must be recognized that the mental mechanisms affected are those with which the patient was originally endowed, which he has gradually trained throughout his past experience and which he has employed more or less successfully up to the time the illness commenced. ”

“ The American Psychiatric Association tells us that "severe mental illness can seriously impair a sufferer's ability rationally to appreciate the wrongfulness of conduct." Brief for American Psychiatric Association et al. ”

“ Though only passing incidents, due to overattention to themselves and their ills, real or fancied, and the consequent lack of concentration of mind on a particular subject, the patients fear serious deterioration of their mental condition, or at least of mental control. The neuroglia theory of mental action throws a light on all these phases of mentality that serves to lessen the solicitude of patients and enable them to understand that, in spite of their fears, there is nothing but functional disturbance. ”

“ The mental depression caused partially incapacitates him for energetic activity, and perhaps brings on ill-health. So that maliciously or carelessly propagating false statements tends both to diminish his life and to diminish his ability to maintain life. ”

“ But these causes are in no other way operative in producing insanity than by unduly exciting the brain. By neglect of moral discipline, a character is formed subject to violent passions, and to extreme emo [310] tions and anxiety from the unavoidable evils and disappointments of life, and thus the brain, by being often and violently agitated, becomes diseased; and by too early exercising and prematurely developing the mental powers, this organ is rendered more susceptible and liable to disease.
"I am confident there is too much mental labor imposed upon youth at our schools and colleges. ”

“ Mental defectives, it is argued, unlike the insane and pathological imbeciles, are not a special class of human beings, and they are chiefly distinguished from other normal persons by their low level of general intelligence. The term mental deficiency, as applied to convicts, as well as connoting a mind of inferior capacity, in many cases implies also an unbalanced mind, i.e., a mind whose equilibrium is easily disturbed by the preponderance of extreme degrees of objectionable and dangerous qualities, such as impulsiveness, excitability, passionate temper, &c. ”

“ The actions of the man throughout, together with the contents of a letter found on his person, were evidence that decided lack of mental balance existed, and search of his effects brought to light numbers of long, rambling, scribbled comments that left no doubt concerning mental decay. ”

“ But while affirming that the disease usually arises in the body, and even frequently in parts far removed from the brain, we must not deny nor ignore the fact that intellectual and protracted worry, or sudden and violent grief, can also be the direct cause of disturbance in the brain. For the brain is the organ not of the imagination alone, which is put to an unhealthy strain by excessive mental labor, but probably also of the passions, whose emotions when excessive may cause even permanent lesion. Hence mental insanity may and does often arise from ill-subdued passions. ”

“ What he needs is to buck up and kick them out himself.” Evidently he referred here to the nervous disorders arising from mental disturbances, for the next day he emphasized the government of physical forces by physical laws. ”

“ But one whose bodily vigor and mental health are undermined by self-sacrifice carried too far, in the first place becomes to those around a cause of depression, and, in the second place, renders himself incapable, or less capable, of actively furthering their welfare. ”

“ Such acts, when really due to mental instability, occur either in depressed or maniacal conditions, and these, as is now well known from carefully collected statistics, inevitably recur, or in weakened toxic conditions in susceptible subjects, and a return to the old mode of life may at any time bring recurrences. ”

“ Perhaps also, but here we speak with greater diffidence on account of the practical difficulties in which such a proposal is involved a remedy is to be found in the confinement of those persons who have shown by their conduct that their inability to refrain from vile excesses arises from actual mental disease. ”

“ In the downward course of mental disease-processes the degeneration is from the complex to the simple, from the stable to the unstable, from the highly organized to the lowly organized. In the different forms of mental diseases first the moral life, then the social instincts become affected, the patient becomes selfish, introspective, morally selfish, then loses all regard for others, becomes careless, wasteful and negligent of his vocations, life-work, and duties ”