A Nerves as a Handicap to Efficiency
- Author:
May Smith, M.A., D.Sc.
(Industrial Health Research Board)
No one doubts that serious intellectual or physical defect handicaps the sufferer in his task of earning a living, just as no one doubts that high intellectual and physical gifts are an advantage. There are, however, examples of people who are lacking neither an adequate intellectual nor physical equipment, but who are nevertheless handicapped. The handicap is due to some inadequacy of functioning on the emotional plane.
If we knew that A and B were equally intelligent?and it is possible now to test for intelligence with reasonable accuracy?and that they were equally equipped physically and practically for a specific occupation, we could not from that knowledge alone predict equal success in life. A might be moody, resentful of all criticism, frightened of all people in authority, selfdistrustful, and so on, whereas B might be joyous, able to adapt to authorities and subordinates, keen on getting on, willing to run risks. These differences which are emotional in character, may be so great as to neutralise the other equalities. A word is needed to stand for emotional organisation, and the Word to hand is ” temperament.” Literally, the word means ” mixture,” and was used by the Ancients to stand for the physiological mixture or the make-up *Based on an address given at the Annual Conference of the Association oft Mental Health Workers, Harrogate, March, 1936.
of the individual, differences in the observed behaviour and character being supposed to be due to differences in the mixture. A person in whom the elements forming the mixture were evenly balanced had a perfect temperament, while any one element in excess resulted in some degree of imperfection. What the elements were varied according to the scientific knowledge of the age, but the importance of the differences, whatever might be the cause, has been recognised by almost all the great physicians and philosophers.
Now we limit the word to the emotional make-up and it is possible to investigate this without committing ourselves to the possible cause. Some years ago the Industrial Health (then Fatigue) Research Board undertook an investigation into Telegraphists’ Cramp, a disability that interferes with the efficiency of telegraphists when sending by the Morse or Baudot systems. A comparison of two groups of people, one suffering from cramp and the other not, showed that there was no evidence in support of the view that muscular defect was the cause. An interview with each person revealed that the majority of the sufferers from cramp had some form of emotional instability, whereas the majority of the others were emotionally more balanced.1 This led to a further study of emotional mal-adjustment, or the “nervous” temperament in other groups, leaving on one side the general question of emotional make-up or temperament.2 The word ” nervous ” is here used without any reference to the organic nerves, merely as a useful phrase which is in general use, although frequently misused: it stands for some form of emotional mal-adjustment which may be reflected in behaviour or in personal unhappiness.
It is necessary to note what is meant by a ” nervous ” symptom. Keeping in mind that ” emotional ” would be really better than ” nervous,” we distinguish a symptom from a normal characteristic or even some idiosyncracy by its consequences. The emotion of fear, for example, ought to be aroused in circumstances where there is some adequate cause, and when experience has shown that the circumstances involve no reason for fear, then fear should cease to be aroused. Sometimes, however, such a fixed association is made between a particular group of circumstances and the emotion of fear, that whenever the circumstances occur, fear is also aroused, although the sufferer recognises that it is irrational. For example, it would be reasonable for a person to fear his chief if the latter had power to dismiss him for a mere whim, or were a bully; if, however, his actual experience of his chief is that he is reasonable, and if he has no power of dismissal, then to experience fear invariably in hisj presence, knowing it to be irrational, is a useless response, and that useless emotional response is called a ” nervous symptom.”
Most people in life have to adjust to superiors, to equals, and subordinates, as well as to themselves and to their environment, and in each of these relationships emotional mal-adjustment can take place. For example, when asked how he would feel if sent for by his chief, A will describe himself as mildly apprehensive at first, but the feeling will pass off; B will experience interested iA study of telegraphists’ cramp. Industrial Health Research Board, Report No. 43. 2 The nervous temperament. Industrial Health Research Board, Report No. 61. wonder and expect a rise; C will feel shaky at the knees; D will prepare for some most impossible worst. Clearly these reactions represent real differences in make-up.
Some people have difficulties in getting into touch with their equals, while others can readily adjust; experience shows that the latter are more likely to be successful than the former.
In relation to subordinates, some people in authority behave as if the group were a superior of whom they stood in dread, with the result that they have to prove to themselves that they are not afraid, and in doing so they assume a blustering or autocratic manner, or they worry their subordinates widi futile criticism or tactless opposition.
With regard to oneself, there is at one extreme the person who is never emotionally sure he is right even when intellectually he knows he is, and at the other the person who is equally irrationally sure he can never be wrong. The well-adjusted person can see himself in perspective, and can realise without emotional disturbance that as there are people who are taller or shorter than himself, so also there are people who know more and also those who know less than himself, and he suffers no more in the one case than in the other. Other fears in disproportionate strength, such as fear of the dark, fear of observation, or of being alone, need not directly affect the work, but their presence does point to emotional difficulties that may play a part in weakening resistance to whatever stress life may set up. Information with regard to these various attitudes to life was sought in an interview lasting about 20 minutes, and for statistical purposes subjects were graded according to the severity of the symptoms. ” 0 ” meant that within the limitations of a short interview conducted for research purposes no particular emotional difficulties were disclosed. This group comprised a very wide range of people. At one extremity was the emotionally well-poised, sensitive and highly intelligent person, who ” in the mutable haps and sudden chances of fickle fortune is not lightly dismyd nor brought to fear,” as a 17th century writer expresses it; at the other the rather dull person with almost no insight into his own life; it also included some who, while not having psycho-neurotic symptoms, give the impression of not being emotionally well-adjusted, although there is no evidence to justify the impression: it is not unlikely that some at least of these will prove to be psychotics later.
” 1 ” was used for those who had only one symptom and that of such a nature as to affect their lives but little. In adolescents it was sometimes difficult to determine whether a symptom would develop or for practical purposes disappear, for example, adolescent shyness may be merely inexperience of life, or may be symptomatic of some serious instability.
If a subject had definite symptoms he was marked 3, 3, 4 or 5, according to the severity. Obviously, such a classification can have only approximate value. 68 MENTAL WELFARE Showing the Number in Each Group Expressed as a Percentage of the Total Number Firm No. o i 2 3 4 & 5 A 191 43.5 26.7 10.5 15.2 4.2 B 69 60.9 16.0 14.5 8.7 0 C 72 50.0 23.6 16.7 8.3 1.4 D 187 52.4 19.7 11.2 9.6 7.0
In the following table3 a selection is given from the various groups studied merely to show the relative proportions of workers (in these groups mainly clerical workers) with and without nervous symptoms. The range for those with no discoverable symptoms is from about 43% to 61%. All of these organisations had a medical examination for entrants. While it is likely that those whose nervous symptoms have been assessed at no more than 2 will carry on quite well, particularly if their work is of such a nature as not to ” touch up ” their particular symptom, the others are very likely to break down, and they constitute a by no means negligible number in each group. Now the question arises as to whether these symptoms really matter in practical life, i.e., do these emotional mal-adjustments make adjustments to the ordinary economic environment difficult?
Obviously, it is extremely difficult to get evidence; still, while it cannot be claimed that proof was forthcoming, yet there is some data to show the general trend.
In some of the groups it was found possible to have the subjects assessed for efficiency. The estimation of efficiency is not easy, for except in a few highly specialised occupations there is no objective criterion that can be regularly applied. Usually efficiency demands an ability to maintain a certain standard of work, and to adjust without friction to other people. In practice, a fairly wide margin of variability is tolerated.
Where the work was of such a nature as to permit of the assessment, subjects were graded A, B or C for efficiency, A being the most efficient and C the least.
It was found that in each group a higher percentage of those without nervous symptoms were graded A for efficiency and a higher percentage of nervous subjects were graded C. It must not, however, be argued from this that therefore each nervous person is likely to be inefficient. All that can be said is that a group composed exclusively of people without nervous symptoms will, other things being equal, be more efficient than one composed of nervous people.
Possibly some of this inefficiency is related to the problem of working with other people. In a small factory, where everyone is well known to everyone else, and where one person’s behaviour was known to, and could *The full details will be found in ” The nervous temperament,” Industrial Health Research Board, Report No. 61.
affect the others, descriptions of all the subjects, from the point of view of ability to get on with others, were obtained. They were classified into three groups, i.e., those who were recognised as difficult to get on with, those who were easy, and a third about which, in the opinion of the assessor, some doubt existed: these latter were almost all young workers, and although they were not exactly easy, yet it was difficult to be sure about them.
Out of 180 subjects, 106 were described as ” easy,” and of these, about 57% werc frce from nervous symptoms, about 27% had slight symptoms, and 16% more serious.
Fifty-six were ” difficult,” and of these about 31% had no symptoms, 23% slight, and 46% serious symptoms. There does seem to be a tendency for the difficulty in social adjustment to be related to the presence of nervous symptoms.
Not only do workers have to adjust to the conditions of their actual work and to the people around them, but also to the material environment, e.g., lighting, heating, ventilation, noise. It is well known that there are certain people in every organisation who seem to be either extremely sensitive or unduly aware of conditions that are to the rest neutral. In the case of one environmental condition, namely noise, it was possible to study the relation between nervousness as estimated by the presence of symptoms and susceptibility to noise. Each subject was asked in the course of the ordinary investigation how he or she worked in a noise. The answers could be classified roughly into three categories: ?
Those indicating indifference to unavoidable noise.
Those indicating slight dislike.
(3) Those indicating serious susceptibility so that physical symptoms or mental distress were set up.
In a group of 49 girls there were 17 with no nervous symptoms: of these, 12 (i.e., nearly 71%) were able to adjust to noise; 13 had slight symptoms and of these 4 (i.e., about 31%) were able to adjust; 19 had severer symptoms and of these, only 1 could so adjust.
A group of 156 men gave a similar result. Of 51 who were free from symptoms, 42 ( = 82%) were unaffected by noise; of 79 with severe symptoms, only 33 (=42%) were unaffected.
Now, if the nervous person is under greater stress than the not-nervous person, it might be expected that this would be reflected in sickness absenteeism. Where it was possible to compare the sickness absenteeism over a considerable period of time it appeared that the nervous person did tend to be absent more for all kinds of disease, although the nervous breakdown type predominated. This does not mean, however, that all nervous people will break down. In all the groups tested there were a number of people with severe symptoms who had reached late middle age without any break-down. It must be remembered that a nervous symptom is the expression of a relationship between a person and his environment. Let us assume that we have two typists of equal intelligence and equal typing ability, equal physical health, and each
with a fear of observation. Let one work in a room alone, and the other work with others and a supervisor watching. The first typist, being able to work unwatched, will rarely have her particular symptom ” touched up,” and that in itself is an advantage.
But when people with this fear are watched, they are liable to make mistakes, so the second typist will have, in addition to the acute mental discomfort due to her fear, the effect of this expressed in mistakes and also the consequences of these mistakes. The full weight of the latter will depend not on the symptom but on the condition of the work. The practical consequences to the two typists will be very different and the second is more likely to break down than the first. Some environments, particularly those characterised by rigidity of organisation and arbitrary personal criteria of efficiency, are difficult for nervous people. The type of mind can be the same, but if its anxieties receive little stimulation in the ordinary daily routine, there is less likelihood of a breakdown.
From the point of view of health and successful work, the diagnosis and treatment of the nervous person is important. Just as there are some people who are physically unfitted for certain occupations, and are therefore kept out, and some who are too intelligent and other too unintelligent for some work, so there are people temperamentally unsuited for the conditions of specialised work, and these should be diverted into occupations suitable for them.
Experimental Work in the Teaching of Retarded Children
In our next issue, we propose to begin a series of Notes on modem educational developments in work affecting retarded children.
To make this section of value, we ask the co-operation of our readers, specially of those who are teachers or in touch with schools or educational administration. Many experiments of great interest are being made by individual teachers in Special ‘Schools and in classes for Dull and Backward Children; new methods are being tried in many places for dealing with the whole educational problem of the retarded child, and experience of the uttfiost value is continually being gamed in many different directions.
The difficulty is, however, to keep track of all this pioneer work, much of which is carried on in isolation by modest people who hesitate to tell of their adventurings, and we therefore appeal to our readers to send us news of any experiments known to them which should be recorded in this new section of the magazine.
Ed. Mental Welfare.
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