o the darker regions where
the inner evolution leads by necessity to disaster even under favorable
conditions.

We might begin this large group of the constitutional disturbances with
that neurasthenia which develops on the basis of inherited disability.
Lack of energy resulting from a feeling of tiredness, a quick
exhaustion, a mood of depression, an easy irritation, even despair and
self-accusation, sullenness and fits of anger, cranky inclinations and
useless brooding over problems, headache and insomnia characterize the
picture which everyone finds more or less developed in some of his
acquaintances. If we classify symptoms, we may separate from it that
which we nowadays are inclined to call psychasthenia. An abnormal
suggestibility for autosuggestions stands in the foreground. Fixed ideas
and fixed emotions, especially fears, trouble the patient. He may pick
up his obsession by any chance experience and no good-will liberates him
from the intrusion perhaps for years. The patient is perfectly well
aware that his ideas and his emotions are unjustified, he himself does
not believe in them, and yet they come with the strength of an outer
perception and with the vividness of a real attitude, and his whole
mental equilibrium may be upset by the continuous fight against these
involuntary interferences. In the light cases, sometimes the one and
sometimes the other autosuggestion may hold the stage; in the severe
cases, mental life turns more and more around certain definite fears and
yet it may all still be in the limits where the daily work can go on and
the world may not know of the hidden tortures. Here belongs the fear of
open places or the fear of touching certain objects, the fear of doing
harm to others or the fear of deciding actions wrongly, the fear of
destroying valuable things or the fear of being the center of public
attention, the fear of crowds or of closed doors, of altitudes or of
bridges. And in all cases emotional reaction may set in with anxieties,
and bodily symptoms such as palpitation of the heart may result,
whenever an effort is made to disregard the nervous fear. There is
perhaps no group of patients which so much deserves the most careful
efforts of the psychotherapist. Still more than the hysterics they
suffer from the fate of seeing their ills counted as not real. For them
everybody has the good advice that they ought to overcome their fancies;
and yet they feel their life ruined with their end