encircling his head, or to a weight pressing on top of it. He may be giddy, nauseated, have difficulty in expanding his chest to take in a deep breath, feel a heavy soreness around his heart or a sharp pain under it which he sometimes refers to as ‘the dagger’. He may also have recurring ‘funny turns’ such as spells of abnormally slowly beating heart, ‘missed’ heart-beats and weak, trembling turns. He loses interest in everything and in everybody, and mounting tension makes him easily upset by trifles. As one young mother put it, ‘I take it out on the poor kids’.
Sedation
The doctor usually prescribes sedatives at this stage, and there is no doubt that the patient may need them. But with a layman’s distrust of such ‘dope’, his family is probably urging him to ‘Throw the wretched stuff down the sink,’ adding, ‘It is only helping to depress you,’ and ‘That doctor will make an addict out of you yet.’ The sufferer becomes further confused because at the back of his mind he too is afraid of that. Part of a doctor’s problem is to convince the patient – and what is just as important, the patient’s family – that such sedation is not only not harmful but, as a temporary measure, may be very necessary, and that it will not make an addict of him if carefully supervised. Usually, when cured, the last thing these people want to see is one of those wretched capsules or a dose of that pink mixture.
Life is so contrary, it can put so many unexpected obstacles in the way of recovery. In the words of one woman, ‘You would never believe the number of spanners that get thrown into the works’.
For example, it is possible that, just as the doctor is winning his battle over the taking of sedatives, someone chooses that moment to take an overdose of barbiturates and the newspapers will be vociferous on the dangers of taking such drugs. The patient, who probably hasn’t looked at a paper for weeks, somehow never fails to see the report or hear about it, and so the doctor’s battle begins again.
And yet, however sedated this person may be, fear usually finds its way through such sedation. Sedation only softens the blow, but it does do that, and so plays in important part in recovery, as will be discussed later.
Collapse
Finally the day may come when, yielding to some extra burden of fear, the sufferer gives up what he thinks is his last ounce of strength, and ‘collapses’, while the alarmed family stand round helplessly. The words heard murmured in the hall, ‘Doctor, he has collapsed,’ close a chapter for him and act as chains to bind him to the bed. If he could not find his way out of breakdown while on his two feet he wonders how he will find it now that he has collapsed. The fight seems too great, the journey too uphill, so he may spend weeks, even months, on his back, or be taken promptly to hospital for shock treatment.
The Constant Pattern of Fear
No doubt you have recognized some of yourself in this person and it may be a revelation to find that the basis of your mysterious symptoms is, like his, fear.
Whether breakdown be mild or severe, the basic cause is fear. Conflict, sorrow, guilt or disgrace may start a breakdown, but it is not long before fear takes command. Even great sorrow at the loss of a loved one is mixed with fear, the fear of facing the future alone. Sexual problems are most likely to cause breakdown when accompanied by fear or guilt. Guilt opens the door to fear. Anxiety, worry, dread are only variants of fear in different guises.
It could be argued that strain, as distinct from fear, may cause breakdown in certain situations. For example, there is much prolonged strain for a middle-aged woman tending an old, sick parent. However, while she copes from day to day, does not look too far ahead and does not think it too important that she is literally chained to her duties, she can sustain months, years, of such strain. She may ‘bend’ and need help from time to time, but she will not ‘break’.
I once commented on the ability of one woman to carry on for so long in such a situation and was told by her brother, ‘Yes, it is a great strain on Ada, but Ada never did think of herself.’ That was the key to Ada’s endurance. Had Ada listened to her sympathizing friends, begun to feel sorry for herself and come to dread the future, she would have sown the seeds of a nervous breakdown.
Strain may cause severe headaches (Ada had migraine) and physical exhaustion, but unless accompanied by fear it will not cause the incapacity known as nervous breakdown. When work threatens to become beyond our physical strength and our responsibilities demand that we keep going, fear usually comes into the picture and any ensuing breakdown is caused not by the exhaustion, as so many believe, but by the fears it brings.
Afraid to Admit Fear
Sometimes it is difficult for a person to admit even to himself that he is afraid. One woman insisted that it was the ‘stomach shakes’, not fear, that caused her nervousness. So I avoided the word ‘fear’ when talking to her and tried to convince her that it was ‘tension’ causing her stomach shakes. Her stomach had ‘shaken’ for six months; she had eaten and slept little and looked the wreck she felt, and yet when she finally accepted that the shakes depended on the excretion of adrenalin through tension, she was able to relax and lose them within a month. However, she continued to insist that she had not been afraid of them.
Is it possible to explain the disappearance of this woman’s symptoms in any other way than that she had lost her fear of them? I asked her for an explanation and she said, ‘I disliked them. I lost my dislike of them.’ She had disliked them so much that she had let them dominate her life for six months. Surely the difference between such strong dislike and fear is only one of degree? At least we have to admit that strong dislike of physical sensations is so close to fear that it can cause the same nervous reactions.
Camouflage your fear as intense dislike if it makes you feel happier. This is of no importance, as long as you understand that the physical reactions in your body to intense dislike and fear are so similar that any difference is negligible.
The Single Pattern
The breakdown described in this chapter was not complicated by a particular problem. It was caused by no more than fear of the very feelings that fear itself had aroused, and as such is the commonest and most straightforward form of breakdown we know. If yours is this type of breakdown, it is a step towards cure to see your various symptoms as part of a single pattern coming from a single cause, fear. These symptoms are not peculiar to you, but are well known to many like you. And yet, however distressing they may be, I assure you that every unwelcome sensation can be banished and you can regain peace of mind and body.
CHAPTER 5 How to Cure the Simpler Form of Nervous Illness
If you have this type of breakdown you will notice that, as already mentioned, you have certain symptoms as a fairly constant background to your day, while others come from time to time. For example, the churning stomach, sweating hands and rapidly beating heart are more or less always with you, while fear-spasms, palpitations, ‘missed’ heartbeats, pains around the heart, trembling turns, breathlessness, giddiness and vomiting come in attacks, at intervals. The constant symptoms are those of sustained fear, hence their chronicity, while the different recurring attacks are the result of varying intensity in sustained fear, hence their periodicity.
The treatment of all symptoms depends on a few simple rules. When you first read them you may think, ‘This is too simple for me. It will take something more drastic to cure me.’ In spite of this, you will need to be shown how to
