cidal acts which occur either as
unexpectedly as the impulsiveness in a true dementia praecox patient, or
in a setting of coarse animal-like excitement that seems quite unrelated
to the personality. One is reminded of the patient who made suicidal
attempts during the period when she shouted like a huckster, giving no
evidence whatever by her expression or the tone of her voice of feeling
anxiety, sorrow or any other normal emotion.
All these queer and larval affective reactions remind one strongly of
dementia praecox. The resemblance of the benign stupor to certain
dementia praecox types is not merely a matter of identity with catatonic
features (catalepsy, negativism). In these anomalous mood reactions it
seems as if there were a definite dissociation of affect, and so there
is. How then can we differentiate these emotional symptoms from the
"dissociation of affect" which is regarded as a cardinal symptom of
dementia praecox? The answer is that this term is used too loosely as
applied to the latter psychosis. It is a particular type of dissociation
which is significant of the schizophrenic reaction, for in it there is
an acceptance of what should be painful ideas evidenced either by
incomplete manifestations of anxiety or depression or actually by
smiling. We never see in dementia praecox the reverse--a painful
interpretation of what would normally be pleasant. It is the pleasurable
interpretation of what is really unpleasant that gives the impression of
queerness in the mood of these deteriorating or chronic cases. In
stupor, on the other hand, although this dissociation takes place, the
mood is never inappropriate, merely incomplete in that all the
components or the full expression of the normal reaction are not seen.
Our description of the mood reactions in stupor would be incomplete if
we omitted to mention the occasional appearance of an emotional attitude
not unlike that seen in many cases of involution melancholia, which
reminds one in turn of the reactions of a spoiled child. The commonest
of these manifestations is resistiveness that may occur when an
examination is attempted, feeding is suggested, or a sanitary routine
insisted upon. One also meets with resentfulness. One patient, who
frequently showed this reaction, explained it retrospectively by saying
that she wanted to be left alone. Quite analogous to this is sulkiness
that occasionally appears. Then we have, particularly as recovery
begins, other ch
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