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CHAPTER III

PSYCHOSIS AND INTROSPECTION

        IF from a general scientific standpoint we find that we can penetrate into the nature of psychosis by studying the initial stages of mental dissolution, a closer inspection shows that there is a special reason why this procedure is absolutely indispensable. The phenomena of psychosis are not of the same nature as physical phenomena, and do not lend themselves to immediate observation and still less to direct manipulation and experimentation. Psychic phenomena are not of an objective, but of a subjective nature, and as such must be largely studied by subjective methods of investigation. Sensations, images, ideas, thoughts, judgments, feelings, emotions, the material of the sciences dealing with mental life, can not be touched, handled, cut, fixed, stained, and inspected under a microscope. An idea, a feeling, can not be measured in millimetres, nor weighed in scales, nor dipped into a fixing fluid for further reference. Sensations, feelings, ideas, and emotions do not admit of being touched, seen, smelled, heard, nor tasted, for they have no physical properties. A psychic phenomenon has no resistance, no elasticity, no weight, no extension, nor can it be measured by lines, squares, and cubes. An idea does not sound, nor has it odor, nor taste, nor is it black, blue, green, red, yellow, or violet.

        Being of a subjective character psychic phenomena require subjective methods of investigation, those of introspection. Introspection is the most important instrument of psychological research; it is the microscope of the psychologist and psychopathologist; it is the powerful instrument of mental analysis and synthesis, the scalpel and microtome for psychic dissection and the means for mental fixation and preservation. We can know of what is going on in our mind by our own introspection, and we can find out what is going on in other people's minds by the account of their own introspection, or by what is far less certain, the introspective interpretation of their motor manifestations. In no other way can we possibly gain access to mental phenomena. In the study of perception, conception, and memory, in the investigation of illusions, hallucinations, insistent concepts, fixed ideas, imperative and recurrent but repressed impulses, delusions systematized and unsystematized, amnesia, aphasias, etc., on what else do we fall back ultimately but introspection, the main instrument of psychology and psychopathology? If it were not for the patient's account of his experiences; if it were not for the introspective interpretation of his various actions based on his accounts, statements, and reactions, what could we possibly know of all those experiences the psychologists, the psychopathologists, the psychiatrists tell us? Introspection alone can reveal a psychic fact.

        If we turn to those branches of neurology that are concerned with psychic processes, we find the same truth illustrated―the introspective method is the main guide in the inquiry. Neurological investigations of aphasia are really based on the introspective method of psychological analysis. The percept is resolved into its psychic constituents, into so-called "images," by means of introspection alone. Take the stock example of the "bell images." What are the mental images aroused on hearing a bell ring, on seeing a bell, on hearing the word "bell," on pronouncing or on writing the word "bell"? Introspection alone can give us the answer. Sensations, "memory images," representations can not possibly be measured in microns, nor fixed in hardening fluids; they are essentially psychic in character, gained from an introspective analysis. And still the neurologist does not hesitate a moment to base his scientific work of aphasia on such introspective accounts. Whether the psychophysiological association theory of localized "images" accepted by the neurologist is right or wrong, one thing is sure and clear that there is no possibility, even for people with a strong objective bent in their investigations, such as presented by the neurologist, to get at psychic phenomena by any other method than that of introspection. How else can a psychic fact be reached? A psychic fact can not possibly be magnified by a microscope, nor dissolved out of the brain by means of chemical reagents, nor seen by the light of a Roentgen ray, nor revealed by the aid of spectral analysis. The contents of a psychic state can be reached through introspection alone.

        Turning to the analysis of cases, we find that the neurologist is guided by the patient's introspective account interpreted in the light of the general psychological theory maintained by the neurologist and gained from introspection. The patient suffers from visual apraxia, he is shown a bell and he tells us that he does not know what it is, but he does recognize the bell when it is rung or put in his hand; the neurologist concludes that the visual memory-images are lost. How does the neurologist arrive at this conclusion if not by the method of introspection? The patient gives us to the best of his abilities what the sensations of certain forms, size, and color indicate to him, and the neurologist further interprets this introspective experience as to what the psychic material and factors are for the complete perception of the external object. The patient suffers from auditory aphasia, he can hear sounds but can not understand the meaning of words. The patient experiences the components, the sounds, and syllables, but does not realize their combinations and associations. The neurologist concludes that the patient's memory for auditory word-images is lost; although in the present hypothetical case it is not the auditory word-images that are gone, it is more probable that the manifestations are due to dissociation from the memories relating to the other senses. Whatever the real psychological interpretation be one thing stands out clear and distinct, and that is the necessity: of falling back on the patient's introspective account of his experiences. The neurologist further interprets the psychic deficiency by his own introspective analysis as to what sort of psychic content may be absent to account for the mental symptoms, and puts them down to the failure or loss of auditory memory-images. An autopsy may reveal the fact of degeneration in the convolutions of the temporal lobes, and the neurologist comes to regard these convolutions as the area for auditory memory-images found and analyzed introspectively. Whether the neurologist is right or wrong in his generalization, the method of procedure and the conclusion arrived at are essentially of an introspective character.

        Similarly in visual aphasia, such as alexia, the patient sees words but does not know how' to read them; the patient may even be able to describe the color, size, and form of the letters; he may be able to copy and even write spontaneously, to recall how to read written or printed characters. The neurologist may point out the missing psychic elements necessary to the formation of the comprehension of written or printed words, and refer the "symptoms" to the loss of visual memory-word-images; although here again it may be more correct in this case to refer it to a lesion, or dissociation, organic or functional, between certain groups of visual memories and those derived from other sources. An autopsy may reveal a lesion or degeneration in certain portions of the convolutions of the occipital lobes, and the neurologist arrives at the generalization that the convolutions of the occipital areas contain "visual centres." By what other method is the neurologist guided here if not by that of introspection? Introspection is the main method of all branches of psychological sciences for the simple reason that there is no other way of gaining access to psychic phenomena. Introspection alone can give direct cognizance of mental facts.

        Psychological introspection, however, must by no means be confused with the introspection of the metaphysician. The introspective method of psychology is of a purely scientific character; it simply deals with facts of consciousness, such as sensations, percepts, images, ideas, sentiments, affections, emotions, decisions of will; it investigates their conditions, constitution, and laws. Psychology, in short, deals with the psychic facts and their relations. Psychology uses the methods of observation and experiment; it starts with psychic phenomena and does not leave the ground of mental life; it remains entirely subjective throughout; psychological findings, laws, and theories are concerning mental manifestations, concerning facts, facts of consciousness.

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