less fight against the
overpowering enemy. And if anywhere, it is here that the psychotherapist
is successful. Psychasthenic fear can be removed, while the developed
melancholic depression, for instance, is entirely beyond the reach of
psychical influence.

We have after all the same psychasthenic state before us when the
obsession has impulsive character, from the mere abnormal impulse of
lying, or making noise in a quiet place or crying in the dark, or
touching certain places, to that of stealing, indecent speech, arson,
and perhaps even murder. The symptoms might easily be mistaken for those
of graver diseases. Yet the fact that the patient himself really does
not will the effect at which he is aiming separates, mostly without
difficulty, the diagnosis of psychasthenia from that of insanity. Quite
nearly related to it are the manifold variations of abnormal and
perverse sexual tendencies. The psychiatrists are perhaps too much
inclined to bring all these pathological impulses and desires, fears and
anxieties, into the nearest neighborhood to real insanity. The
indisputable success of psychotherapy in these spheres ought to add a
warning against these expansions of the strictly psychiatric domain. The
psychologist will be more inclined to emphasize their relation to simple
neurasthenia which itself imperceptibly shades over into our normal
life.

All neurasthenic and psychasthenic disabilities show a certain emotional
continuity and uniformity. It is the emotional instability and the quick
alternation of symptoms which characterize hysteria or rather the
hysterias. It seems as if science were near to the point of explaining
the hysterical disease by one common principle, but certainly the
symptoms are an inexhaustible manifold. The rapid changes of the intense
moods of the patient usually stand in the center. Torturing obsessions,
abnormal impulses, over-suggestibility, hypochondriac depressions,
paralysis of arms or legs, anaesthesia and paraesthesia, a mental stupor
and confusion, illusions and perceptions of physiological symptoms may
work together in spite of his, or rather her clear intelligence. It is
probably on a hysteric basis also that somnambulic states arise during
the night, and from them a straight way leads to those mental attacks
after which the memory is entirely lost, or for which fundamental
associative connections are cut off. And from here we come to the
exceptional cases of alternating personal