PART III

CHAPTER XVI

THE TWILIGHT OF CONSCIOUSNESS, OR DÄMMERZUSTÄNDE

THERE are some current theories which attempt to refer the amnesia of subconscious states or of the so-called “Dämmerzustände” found in epilepsy to changes in visceral coenaesthetic sensibility. Cases are brought to show that such changes of sensibility are really found in epileptic states. In order to reproduce an idea a, reason the representatives of this theory, the idea b with which it is associated and which gives rise to the reproduction of idea a is itself conditioned by the total attitude of consciousness; and should that consciousness be modified, then the idea b cannot rise, and consequently the idea a is arrested and cannot come to the light of consciousness. Now visceral sensibility forms a very important factor in the activity of mental life, and if therefore this sensibility is modified the whole constitution of consciousness becomes changed, and hence the old associations become disturbed and cannot rise; in other words, amnesia results. Epileptic amnesia is supposed to originate in this way, and cases are brought to corroborate this theory. A close examination, however, of the cases adduced in support of this theory brings out fully its doubtful, if not negative character. For the followers of this view have neither proven the supposed change of coenaesthetic sensibility in the epileptic subconscious states as “Dämmerzustände,” nor have they shown, if present at all, to what extent the changes go, so as to justify the amnesia.

            Furthermore, granted that there are important visceral changes in epileptic “Dämmerzustände,” it is highly questionable whether such changes give rise at all to any amnesic conditions. For many organic diseases, such for instance as dyspepsia, enteric fever, typhoid, gastritis, cirrhosis of the liver, nephritis, diabetes, and many other physical ailments, whether acute or chronic, in which organic sensibility is involved to a large extent and greatly changed, do not give rise to amnesic states as their characteristic symptoms. Changes, therefore, in coenaesthetic sensibility do not necessarily give rise to such extensive modifications in the content of consciousness as to disrupt the current of association and produce amnesic states. On the other hand, amnesic states are known to be present without any change of visceral sensibility. It is enough, to mention the whole domain of aphasia, which is really amnesia of an elementary form, referring to the more simple elements of mental life. Elementary, however, as the aphasias are, they are still amnesias, but certainly they stand in no relation to visceral sensibilities.

            In functional amnesias of the more extensive kind, where whole tracts of mental life are seemingly gone and lost, there may be changes in peripheral incoming sensations; there may be anaesthesias, hypoaesthesias, paraesthesias; but they are usually of a peripheral character and of so slight an extent as to be out of all proportion to the amnesic state. Furthermore, while the sensory disturbances in functional cases, if present at all, are found to be fluctuating and fleeting, the concomitant amnesic states are frequently found to be stable; in other words, the two do not show concomitant changes.

            Janet’s law that anaesthesias go with amnesias or that modifications of sensitivity go with memory-changes seems to confirm this peripheral theory of amnesia. Unfortunately the relation here is by no means a causal one. Thus in one of the cases the subconscious state was brought about by the shock of a fall, which also accidentally involved the lower extremities. In another case, the hypoaesthesia of the leg was due to persistent suggestion accidentally associated with the object producing mental or psychic shock. The aura found in the subconscious states of so-called “psychic epilepsy” are in my researches proven to be just such accidentally associated changes of sensitivity. For in one case, whose aura was sensations of red, it was found that the color red happened to be associated with the shock and first attack, while in another case, whose aura was sensations of green, the color green was found to be similarly associated; still another case, in which the aura was a fetid smell and nauseating taste, it was found that the first attack came on when a piece of fetid, nauseating meat happened to be in the patient’s mouth. Whatever may be the connection or association between changes of visceral or of peripheral sensibility, it is certainly not one of a causal, but of a casual or occasional character; stated in other words, it may be said that the connection is purely central or essentially mental in origin.

            The changes in visceral or peripheral sensibility may be casually connected with the subconscious states, or “Dämmerzustände,” as both are the effects of one central process; in either case, the relation is purely central in character. Far from affirming that it is changes of peripheral or visceral sensibility that give rise to subconscious states, with their consequent amnesias, the reverse rather may be affirmed with far more truth; it is the subconscious states that give rise to the change of peripheral or visceral sensitivity.  In typical organic epilepsy, sensory and motor disturbances do not stand in relation of cause and effect; both are effects of one central cause; similarly epileptic subconscious states and peripheral sensory changes, when present at all, are both of them results of one central process.

            Furthermore, the subconscious states and the sensory changes may become entirely dissociated, one appearing without the other. Extensive sensori-motor changes appear without any subconscious states, and on the other hand, subconscious states are present, with almost no appreciable sensori-motor disturbances. So noticeable is this independence in many cases that it is a current belief that one is a substitute for the other; that where subconscious states are fully developed the sensori-motor changes are at a minimum, and where the sensori-motor disturbances are at a maximum, the subconscious states are at a minimum. In other words, subconscious states are present where the sensori-motor disturbances are absent; or, as it is sometimes put, epileptic mental disturbances are the “psychic equivalents” of typical epileptic attacks, with their loss of consciousness and sensori-motor disturbances.

            There is another point of view often maintained by psychologists and psychopathologists, a view which attempts to explain the amnesia of the subconscious states or of the “Dämmerzustände” by reduced “mental intensity.” When the activity of consciousness, it is claimed, is weak, then the “Dämmerzustände” take place, and hence subsequently arise retrospective mental gaps or amnesic states. Thus a dream state represents weakened states of mental activity, and it is well known how dreams easily lapse from memory. The subconscious states are taken to be dream states, that is, states of mental activity of low intensity, and hence the resulting amnesic condition. If we closely examine this point of view, we find that it is not quite correct psychologically. A mental state of low intensity is not necessarily a lowered capacity of reproduction. A weak sensation may be very vivid and well remembered, while on the other hand a very intense sensation may be of very low vividness, and its memory may hence be indistinct or possibly lacking altogether. Mental intensity and reproduction do not necessarily stand in relation to each other. Mental states of low intensity may become easily reproduced, while mental states of high intensity may lapse from memory. Memory depends largely on the number and frequency of formed associations. Mental states, with a great number of associations of frequent repetitions, can be more easily revived than states of few associations and of rare occurrence; there are more organized starting-points from which the given state may be brought into consciousness. Should such associations become few and narrowed, then the power of reproduction becomes correspondingly reduced.

            Furthermore, the term “mental intensity” is ambiguous and obscure. Does it mean sensory life of great intensity, intense sensations; does it mean vivid mental states, vivid representations, clear and distinct ideas; does it mean a great number of associations awakened, or does it mean mental states having great affective or emotional elements as constituents?

            The greatest objection, however, to the theory of “mental weakness” is the fact that it does not accord with experience and observation. They who have closely studied subconscious states in hypnosis, especially in its last stages, know that intensity of consciousness is by no means weakened, that, though highly suggestible, it is still very clear and distinct, and if by intensity is meant anything at all, then it may be said that intensity of subconscious life differs but little from the waking states of the upper consciousness. And still the amnesia after emerging from this state is often profound and complete.

            If we turn to cases of amnesia not of the hypnotic type, we find the same truth, namely, that the subconscious states are often clear, distinct, vivid and “intense,” differing but little from the normal state, as far as quality of consciousness is concerned. The changes are in the content and form of mental activity. In fact, in one of the cases of double consciousness, the Hanna case, the secondary state was far more clear, far more distinct, more vivid and receptive than was the original normal primary state. Even the so-called epileptic “Dämmerzustände” are not entirely clouded and confused, and quite many cases are found an examination of which reveals a condition of clear “intense” consciousness; and still they are followed often by a severe form of irretraceable amnesia.

            One great error which people are apt to make is to read the nature of things from the terms by which they are denoted. The very word “subconscious” irresistibly suggests to many minds mental states of low intensity. As a matter of fact, the "subconscious" is by no means identical with mental states of low “intensity”; it includes psychic states ranging from the lowest to the highest tension and vividness of mental activity. It may be that for clearness’ sake it were better to discard this term “subconscious”; unfortunately we have no better term, and, besides, it has taken root in literature and is highly useful, if used in its right sense, to include the phenomena it is meant to cover. Because states are termed “subconscious,” it does not follow that they are of low intensity and vividness. What is meant is the fact that subconscious states fall outside the range of normal consciousness and are dissociated, so that they cannot be reproduced or recognized. In other words, their tendency is toward amnesia in the normal upper consciousness. These subconscious states may be associated and coherent with one another and may thus be enabled to have reproduction and recognition; they may have memory, and that of a very precise and exact character. The subconscious states occurring in epileptic conditions may be of a very low type of moment consciousness and may lack altogether any reproductive or recognitive qualities. In the higher type of subconscious mental life, memory is present for subconscious states, and even for states of the upper consciousness, though the reverse is usually absent; that is, the states of the upper consciousness have no memory for the subconscious states.