CHAPTER IV.. Morbid Pleasures and Pains.

MORBID PLEASURES AND PAINS.

Utility of the pathological method—Search for a criterion of the morbid state; abnormal reaction through excess or defect; apparent disproportion between cause and effect; chronicity—I. Morbid pleasures, not peculiar to advanced civilisation—Different attempts at explanation—This state cannot be explained by normal psychology: it is the rudimentary form of the suicidal tendency—Classification—Semi-pathological pleasures: those destructive of the individual, those destructive of the social order—II. Abnormal pains—Melancholic type—Whence does the painful state arise in its permanent form? from an organic disposition? or from a fixed idea?—Examples of the two cases.

The title of this chapter may seem paradoxical, pleasure being as a rule the expression of health, and even of exuberant life, and pain, by its very definition, a diseased state. It must be admitted that, for the latter, the expression abnormal would be preferable. However, the facts we are about to study are not rare, and deserve separate examination, because the deviations and anomalies of pleasure and pain serve to make the nature of each better understood.

Taking our subject, for the first time, on the pathological side, a proceeding to be applied later on to each of the simple or complex emotions in turn, certain preliminary remarks are indispensable.

The application of the pathological method to psychology needs no justification; its efficacy has been proved. The results obtained are too numerous and too well known to need enumeration. This method, in fact, has two principal advantages—(1) it is a magnifying instrument, amplifying the normal phenomenon; hallucination explains the part played by the image, and hypnotic suggestion throws light on the suggestion met with in ordinary life; (2) it is a valuable instrument of analysis. Pathology, it has justly been remarked, is only physiology out of order, and nothing leads better to the understanding of a machine than the elimination or the deviation of one of its wheels. Aphasia produces a decomposition of memory and its different signs, which the subtlest psychological analysis could not attempt or even suspect.

The principal difficulty of this method lies in determining the precise moment when it can be applied. The distinction between the healthy and the morbid is often extremely difficult to establish. No doubt there are cases where no hesitation is possible; but there are also debatable zones lying between the territories of health and disease. Claude Bernard ventured to write, “What is called the normal state is purely a conception of the mind, a typical ideal form entirely disengaged from the thousand divergences among which the organism is incessantly floating, amid its alternating and intermittent functions.” If this is the case with regard to bodily health, we may expect to find it still more so with regard to mental. The dilemma: Either this man is mad or he is not, is, in many cases, says Griesinger, meaningless. The psychical organism, being more complex and less stable than the physical, makes it still more difficult to fix a norm. Finally, this difficulty attains its maximum in our subject, because the emotional—the most mobile among all the forms of psychic life—oscillates incessantly around one point of equilibrium, always ready to sink too low or rise too high.

As, however, it is necessary to adopt some definite characteristics which may serve as pathological signs, as criteria for distinguishing the healthy from the morbid in the emotional order, we shall accept those proposed by Féré. According to him, an emotion may be considered as morbid—

1. When its physiological concomitants present themselves with extraordinary intensity (I think we should add, or an extraordinary depression).

2. When it takes place without sufficient determining cause.

3. When its effects are unreasonably prolonged.

Footnote 41:

Féré, Pathologie des Émotions, p. 223.

These three signs, which I shall call respectively abnormal reaction by excess or defect, disproportion (apparent) between cause and effect, and chronicity, will frequently be of service to us in the study of the emotions. For the moment we are only treating of pleasure and pain.

Beginning with pleasure, I shall first examine a typical case studied by several physiologists, who have not furnished any, to me, satisfactory explanation. I mean the special state which has been called “the luxury of pity” (Spencer), pleasure in pain (Bouillier), and which it would be more accurate to call “the pleasure of pain.” It consists in being pleased with one’s own suffering and tasting it like a pleasure.

This disposition of the mind is not, as one might think, peculiar to blasé persons and to epochs of refined civilisation; it seems inherent in humanity the moment it emerges from barbarism. Bouillier has quoted from the ancient writers passages referring to it, not only in Lucretius, Seneca, and other moralists, but in the Homeric poems, which reflect a very primitive civilisation, yet in which a man “rejoices in his tears.” Parallel passages might have been found in the Bible, and also, I suppose, in the epics of ancient India. We have not, therefore, to deal with a rare phenomenon, though it becomes more frequent as we advance in civilisation.

Footnote 42:

Bouillier, Du plaisir et de la douleur, chap. vii.

A few examples will be of greater value than any opinions I could cite. They may be found of all sorts—pleasure in physical pain, and pleasure in moral pain. Certain patients find intense enjoyment in irritating their sores. Mantegazza says: “I knew an old man who acknowledged to me that he found an extraordinary pleasure, and one which seemed to him equal to any other, in scratching the inflamed surfaces surrounding a senile sore in his leg from which he had suffered for some years.”

Footnote 43:

Mantegazza, Fisiologia del piacere, p. 26.

A celebrated man of the Renaissance, Cardan, says in his autobiography that “he could not do without suffering, and when this happened to him, he felt such an impulse arise in him, that every other pain seemed a relief.” When in this state, he was in the habit of torturing his own body till forced to shed tears by the pain. I might enumerate a long series of these pleasures of physical pain. Of the pleasures of moral pain I will give but one example: melancholy in the ordinary, non-medical sense-the melancholy of lovers, poets, artists, etc. This state may be considered as typical of the deliberate enjoyment of sadness. Any one may be sad, but melancholy is not to be attained by every one. I may mention also, in passing, the pleasures of ugliness in æsthetics, and the taste for sanguinary spectacles and tortures which we shall have to consider in another place.

Footnote 44:

A curious study of pathological psychology might be founded on the De Vila Propria of Cardan, who was evidently what would now be called a neuropath and a déséquilibré.

If we leave the facts and come to the explanations proposed, we shall find that they are not numerous. Bouillier (op. cit.) seems to adopt the opinion of a Cartesian, who said, “If the soul, in all movements of the passions, even the most painful, is in some measure tickled by a secret feeling of pleasure, if it takes pleasure in pain, and does not wish to be consoled, it is because of a consciousness that the state in which it finds itself is the state of heart and mind best suited to its situation.” I fail to understand this pretended explanation. I prefer that of Hamilton, who places the principal cause in the increased activity imparted to our whole being by the sense of our own sufferings. This, at least, is logical, since pleasure is connected with its habitual correlative—an increase of activity. Spencer has examined the problem at greater length. "Here I will draw attention only to another egoistic sentiment, and I do this because of its mysterious nature. It is a pleasurably painful sentiment, of which it is difficult to identify the nature, and still more difficult to trace the genesis. I refer to what is sometimes called ‘the luxury of grief.’... It seems possible that this sentiment, which makes a sufferer wish to be alone with his grief, and makes him resist all distraction from it, may arise from dwelling on the contrast between his own worth, as he estimates it, and the treatment he has received—either from his fellow-beings or from a power which he is prone to think of anthropomorphically. If he feels that he has deserved much while he has received little, and still more if instead of good there has come evil, the consciousness of this evil is qualified by the consciousness of worth, made pleasurably dominant by the contrast.... There is an idea of much withheld, and a feeling of implied superiority to those who withhold it.... That this explanation is the true one I feel by no means clear. I throw it out simply as a suggestion, confessing that this peculiar emotion is one which neither analysis nor synthesis enables me clearly to understand."

Footnote 45:

Principles of Psychology, ii., § 518.

This explanation seems to me only a partial one, and not applicable to all cases. In my opinion, no efforts of this kind can be successful, because the authors remain on the ground of normal psychology. This class of facts ought to be treated by the pathological method. It may be said that this is only the substitution of one word for another. By no means, as we shall see by the result.

The mistake lies in attacking, in the first instance, phenomena of too delicate a nature, and considering them as isolated facts. We must proceed, not by synthesis or analysis, but by the cumulative method—i.e., we must establish a chain of facts, of which the last links, being of overwhelming importance, shall throw light on the first. I indicate the principal stages of this gradation thus—Æsthetic melancholy (transitory and intermittent); spleen, melancholia (in the medical sense); then, advancing a step further, suicidal tendencies, and finally, suicide. This last term makes all the others comprehensible. The first stages are only embryonic, abortive, or modified forms of the tendency to self-destruction, of the desire which makes it seem agreeable. The weaker forms—checked in an immense majority of cases—approximate more or less to destruction, and can only be explained if compared with the extreme case.

Footnote 46:

Krafft-Ebing remarks: “An abnormal mode of feeling on the part of melancholic patients is found in the enjoyment of pain (Leidseligkeit). In these individuals, ideas which, in a healthy slate, would be provocative of pain, awaken in the diseased consciousness a faint feeling of satisfaction which represents the corresponding affective tone.”

The evolutionists have stated the hypothesis that there must have existed certain animals so constituted that, in them, pleasure was connected with destructive acts, pain with useful ones, and that, as every animal seeks pleasure and shuns pain, they must have perished in virtue of their very constitution, since they sought the destructive and shunned the preservative influences. There is nothing chimerical in this supposition, for we see men find pleasure in acts which, as they very well know, will speedily result in their deaths. A being thus constituted is abnormal, illogical; he contains within himself a contradiction of which he will perish.

But, one may say, if pain and hurtful acts on the one hand, pleasure and serviceable acts on the other, form indissoluble pairs, of such a kind that the painful state in consciousness is the equivalent of destructive acts in the organism, and inversely, we should here have an interversion—pleasure would express disorganisation; pain, reorganisation. This hypothesis is not a very probable one, and scarcely seems necessary. If we admit, as has been said in the preceding chapter, that there always exist two simultaneous and opposite processes whose difference is all that is perceptible to the consciousness, it is sufficient for one of the processes to be accelerated or the other retarded, in an abnormal manner, in order to change the difference in favour of one or the other. No doubt the final result contradicts the rule, since in the above cases the surplus which ought to be negative (pain) is positive (pleasure). But this is a new proof that we are confronted with a deviation, an anomaly, a pathological case to be treated as such.

I have taken by itself and studied a typical case; it now remains, not to enumerate, but to classify pathological pleasures in order to show their frequency. Taking as a guide the excellent definition of Mantegazza, “Morbid pleasure is that which is either the cause or the effect of an evil,” I divide them into three classes.

1. Semi-pathological pleasures, which form the transition from the healthy to the frankly morbid. These require an excessive or prolonged expenditure of vital energy. We know that the pleasures of taste, smell, sight, hearing, touch, muscular exercise, the sexual relations, produce fatigue and exhaustion, or even suddenly become painful. The pleasures of affection, of self-love, of possession, when they become passions—that is to say, when they increase in intensity and stability—cease to be pure pleasures; a painful element is added to them. This phenomenon is natural and logical, since every increase in activity entails losses, and consequently conditions of pain. This class is scarcely morbid, since pain here succeeds pleasure. This is not the case with the other two, in which pleasure rises from the midst of destruction, and dominates the consciousness.

2. Pleasures destructive of the individual. I do not stop to discuss certain anomalies of taste and smell which will be described elsewhere; but the pleasures due to intoxication and narcotics are so widespread that they seem inherent in humanity. At all times, in all places, even in the savage state, man has found artificial means of living—if only for a moment—in an enchanted world. He has himself created this pleasure for his own destruction. But there are still clearer cases—of tendencies not acquired or invented—when pleasure makes and dominates the process of disorganisation. Thus, during a certain period of the general paralysis of the insane, the patient believes himself to possess the supreme degree of strength, health, riches, and power; satisfaction and happiness are expressed in his whole bearing. Thus in certain forms of acute mania, on one side (which we shall pass over for the present) it shows itself in anger; on another, in exuberant spirits, abounding joy—a feeling of energy and vigour. Some patients say, after their recovery, that they never felt so happy as during their illness (Krafft-Ebing). We may also mention the case of consumptive patients, many of whom are never so rich in hopes or so fertile in projects as when at the point of death. Finally, we have the sense of well-being (“euphoria”) of the dying. It has been attempted to explain this by analgesia, as if the suppression of pain were identical with the appearance of joy. Féré, who has examined the question in his Pathologie des Emotions, concludes that this exaltation is due to momentary but positive conditions of the cerebral circulation.

Footnote 47:

Pp. 170 et seq.

Must we admit that, in these cases, by an inconceivable derogation from natural determinism, pleasure becomes the translation into consciousness of a deep and incurable disorganisation? There is no need of this. It is more rational to admit that this pleasure is here, as elsewhere, connected with its natural cause, a superabundance of vital activity. Every pathological pleasure is accompanied by excitability; but the latter is not a normal activity, or the fever-patient and the neuropath would enjoy an excess of health. In reality, we are confronted with a complex case; on the one hand, a perpetual and enormous loss, which goes on rapidly, without becoming perceptible to the consciousness; on the other, a superficial excitement, which is momentary and conscious. The anomaly is in this psychic disproportion, or rather in the short-sighted consciousness, which cannot pass its narrow limits and penetrate into the region of the unconscious.

3. Destructive pleasures of a social character, which are connected, not with the suffering of the individual himself, but with that of others. Such is the pleasure felt in killing and seeing killed—in sanguinary spectacles, bull-fights, fights between animals, and, in a much feebler degree, in hearing or reading tales of bloodshed. These pleasures can be explained; they denote the satisfaction of tendencies to violence and destruction, which, strong or weak, conscious or unconscious, exist in all men. They may be studied under the heading of the pathology of tendencies, which I shall treat later on; let me only remark in passing that these tendencies involve a certain display of energy, which is one of the conditions of active pleasure.

One question in conclusion. Can pleasure, and joy in particular, be the cause of a grave catastrophe, such as madness or death? Some alienists—Bucknill, Tuke, Guislain, etc.—quote cases of madness which they attribute to sudden joy, such as an unforeseen inheritance, or success in obtaining a long-wished-for situation. The same thesis has been maintained in the case of death occurring suddenly, or after syncope. Griesinger maintains that it is extremely rare—if it ever happens—for excessive joy by itself to produce madness. Others absolutely deny the fact. It is certain that joy is seldom seen figuring in any enumeration of the causes of madness. Joy, as a state of consciousness, could not have such effects. The catastrophe can only be explained by sudden and violent organic troubles, which cannot have this effect unless there already exists a predisposition. It is not joy which maddens or kills, but the shock received by a being in an abnormal state. It would be more correct to say that an event which, in the generality of men, ought to cause joy, here produces a peculiar pathological state ending in madness or death.

Footnote 48:

For some facts, which may or may not be well authenticated, see Féré, op. cit., p. 234.

Footnote 49:

Féré, Pathologie des Emotions, pp. 293, 294.

II.

The other side of the subject may be briefly disposed of. We occasionally, though rarely, meet with people who grieve over good fortune when it comes to them; these have the pain of pleasure. I do not think that any psychologist has dwelt on them, and it seems to me useless to make a study of these cases. Though in form the reverse of the pleasure of pain, it fundamentally resembles it. This disposition of mind, found in certain pessimists, is rightly called eccentric or bizarre—i.e., general opinion instinctively looks on it as a deviation, an anomaly. This, moreover, is only a special instance of a general state of mind—morbid or pathologic sadness—which we are about to study. I have remarked above that, as pain and sadness always involve a morbid element, the expression abnormal would be more accurate and less open to criticism.

In order to affirm that a physical or moral pain is outside the usual law, and may be described as abnormal, we shall have recourse to the three distinctive marks given at the opening of this chapter, and we can take, as our one type, that of melancholia in the medical sense. It presents the required characteristics: the long duration, disproportion between the cause and effect experienced, and excessive or insufficient reaction.

It is needless to give a description of the melancholic state; it may be found in all treatises on mental disease. This affection assumes many clinical forms, varying from melancholia attonita, which simulates a stupid apathy, to the agitated form accompanied by incessant groans, from the slight to the profound and incurable forms. It will be sufficient to enumerate the most general features. In comparing melancholy with ordinary sadness, we may follow the cumulative method, because the morbid state is nothing but the normal condition thrown into high relief.

1. We know that the physiological characteristics of normal sadness are reducible to a single formula: lowering of the vital functions. The same is the case with melancholia, where, however, the organic depression is much more accentuated. Constriction of the vaso-motor nerves, resulting in a diminished calibre of the arteries, anæmia, and lowered temperature of the extremities; lowering of the cardiac pressure, which may descend from an average of 800 grammes to 650 and even 600 grammes; a progressive slackening of nutrition, with various resultant manifestations, such as digestive troubles, checked secretions, etc.; slow and rare movements; a dislike of all muscular effort, all work, all physical exercise, unless there are (as sometimes happens in cases of agitated melancholia) moments of disordered reflex movements and attacks of fury. Such is the general condition. It is obvious that this represents pain carried to an extreme degree, and that we find, here too, as well as in normal melancholy, passive and active pains.

2. The psychic characteristics consist, in the first place, of an emotional state varying from apathetic resignation to despair; some patients are so crushed as to think themselves dead. It has been noted that, in general, persons of a gloomy disposition are inclined to melancholia, while those of a cheerful one rather tend towards mania. In both cases there is an exaggeration of the normal condition. The intellectual disposition consists in the slackening of the association of ideas, in indolence of the mind. Ordinarily, a fixed idea predominates, excluding from the consciousness all that has no relation to it; thus the hypochondriac thinks only of his health; the nostalgic, of his country; the religious melancholiac, of his salvation. Voluntary activity is almost nil; aboulia, “the consciousness of not willing, is the very essence of this disease” (Schüle). Sometimes there are violent and unexpected reflex impulses, which are a new proof of the annihilation of the will. To sum up: while normal sadness has its moments of intermission, the melancholiac is shut up in his grief as if by an impenetrable wall, without the slightest fissure through which a ray of joy might reach him.

Here arises a question we cannot neglect, because it is connected with one of the principal theses of this work, the fundamental part played by the feelings. Passive melancholia, being taken as the type of the painful state under its extreme and permanent form, what is its origin? There are two possible answers. We may admit that a physical pain, or a certain representation, engenders a melancholic disposition, and poisons the affective life. Or we may admit that a vague and general state of depression and disorganisation becomes concrete and fixes itself in an idea. On the first supposition the intellectual state is primary, and the affective state resultant. On the second the affective state is the first moment, and the intellectual state results from it.

This problem, rather psychical than practical, has only occupied a very small number of alienists. Schüle admits the twofold origin. Sometimes the patient, suffering from a painful and causeless depression, which he cannot shake off, inquires no further; but, most frequently, he connects the painful feeling with some incident in his previous or present life. Sometimes, much more rarely, the haunting idea is the first to appear, and forms the pivot of the melancholic state and its consequences. Dr. Dumas, who has devoted a special work to this question, founded on his own observation, comes to the same conclusions as Schüle. One of his patients attributed her incurable sadness, in turn, and without sufficient reason, to her husband, to her son, to expected loss of work. In others, the melancholy is of intellectual origin: the loss of fortune, the idea of irrevocable damnation, etc. He is thus led to admit that a melancholia of organic origin is the most frequent, one of intellectual origin the rarest.

Footnote 50:

Schüle, Traité clinique des maladies mentales, Art. “Mélancolie” (French edition), pp. 21, 28.

Footnote 51:

G. Dumas, Les états intellectuels dans la mélancolie, where may be found several detailed observations.

Can we trace back these two modes of manifestation to a common and deeper cause? This is Krafft-Ebing’s solution: “We must consider psychic pain and the arrest of ideas as co-ordinate phenomena; and there is reason to think of a common cause, of a nutritive trouble of the brain (anæmia?), leading to a diminished expenditure of nervous activity. Taken comprehensively, melancholia may be considered as a morbid condition of the psychic organism founded on nutritive troubles, and characterised on the one hand by the feeling of pain and a particular mode of reaction on the part of the whole consciousness (psychic neuralgia), on the other by the difficulty of psychic movements (instinct, ideas), and finally, by their arrest.”

Footnote 52:

Krafft-Ebing, op. cit., vol. ii., sec. 1, chap. i.

I am unwilling to incur the reproach of inferring more from facts than they contain, and of insisting on unity at any price; but it follows from the preceding that if the element of feeling is not everywhere and always primary, at least it is so in the majority of cases. Besides, it is closely connected with fundamental trophic troubles, so that we arrive at the same conclusion by another road. Dumas (op. cit., pp. 133 et seq.) has insisted on the depressing influences of marshy soil, on the stagnation, the physical and moral apathy of the inhabitants of Sologne, the Dombes, the Maremma, and other regions infested by malaria, a condition which may be summed up in two words, sadness and resignation. These facts are quite in favour of the organic origin of melancholia.

The special study of the anomalies of pleasure and pain is not important for itself alone. The formula generally admitted since Aristotle, which couples pleasure with utility, pain with what is injurious, admits of many exceptions in practice. Perhaps the constitution of a pathological group in the study of pleasure and pain may permit us to solve some difficulties, to prevent the rule and the exceptions being placed on the same plane, and unduly assimilated to one another. We shall see that this is so in one of the following chapters.