A Case of Pathological Day Dreaming
- Author:
John Louis Horn, /
Stanford University, Cal. * Introduction.
James, aged about eleven and one-half years, was given the Binet-Simon intelligence test in the fall of 1917 and found to be at about mental age. He was brought to the laboratory because he is peculiar and deaf. These characteristics are undoubtedly marked and obvious. One can not be in his presence more than a minute before noticing them. In the course of the Binet test, for example, he rose fourteen times and went about the office examining things.
Clearly the boy is not feebleminded. This being the case, it was decided that observation might be of some assistance in disclosing the source of trouble and possibly help in developing some remedy. Accordingly the writer arranged to meet the boy daily for a period of eight or nine weeks. James called six days a week. By far the greatest number of these meetings were spent in walking about the country around Palo Alto. Occasionally the hour was spent in reading, writing or some such occupation as gathering pepper-berries. The boy was observed at the piano, at the table, and in contact with others. Possibly the most effective description will be one that consists of actual occurrences, grouped under several subheads. The mere reproduction of notes made during the period of observation does not seem feasible on account of repetition and the scattering of the points. In this way it is hoped a picture may be given approaching reality.
The order of discussion will be I. Brief history and appearance. II. Principal characteristics. III. Tests and attempts at correction. IV. Present status. I. History and Appearance. James is now twelve years of age. He and his brother, who is about one year older and apparently normal, are the children of a love match that was opposed by the parents of the mother of these children and ended unhappily. The father is a professional musician, a cellist, and from all accounts, normal, so far as concerns intelligence
The mother met him somewhere abroad while studying music. Apparently she was temperamental and probably highly nervous. They seem to have separated very soon after the birth of the younger child. The mother died some four or five years prior to the observations here reported. The boy was probably born deaf, but, for some reason difficult to understand, this fact appears not have been noticed for several years. It is not possible to say whether the deafness was partial or total. He has some hearing now, as will be shown below. Whether this was present to begin with or brought about by physicians in whose care the child was placed, the writer does not know. At any rate, he never learned to speak in the ordinary way. At about the age of five, he came under the care of a lady in Massachusetts who taught him speech by artificial methods?not lip reading. From about the same time until two or three months prior to the observations here recorded he was brought up in the home of two New England women. Between them and his speech teacher, he has received practically all of the schooling that he has had. There has been no firm masculine hand in the process of his raising. For some little time he attended a private school for boys in Massachusetts but very little of his experience there is known to the writer, except that he was not handled with the classes. He speaks unusually good, though somewhat stilted, English, and is an omniverous reader, apparently consuming anything that comes to hand. While he remembers and can reel off, he by no means comprehends all that he reads.
His having learned to speak in the manner indicated gives him an unusual and disadvantageous appearance. He has a deliberate slow speech, and being very deaf, is in the habit of approaching one quite closely. His attention is wandering and very difficult to hold. Anything distracts him. When he sees something he follows it up with his eyes for minute examination, as a dog would with his sense of smell. His eyes have had to make up in part for his lack of hearing.
Physically noticeable in addition to his deficient hearing are the facts that he has a somewhat shrill, unnatural, but not unpleasant voice; that he holds his head in a peculiar forward position, apparently to hear the better; and that he has a painfully nervous twitching of eyes and mouth and legs.
I made a rough measurement of hearing, testing with a watch. He apparently has no hearing in the right ear and can hear the watch ten or twelve inches distant from the left ear. Ordinary conversation sufficiently loud (not shouted) he does not seem to get at a distance greater than eighty inches?less than the distance between two persons opposite one another at the ordinary family table. When brought to California some little time prior to the beginning of these observations, he was sent to the public school principally with the object of securing him an opportunity to get into a manual training class. He was placed in an ungraded room with one other boy?very dull?and there he spent an hour and a half daily for four days. On the fifth day he went to the manual training class. His teacher told the writer that she did not consider him subnormal. He often made her realize, she said, the fact that in many fields he was better informed than she. He was doing eighth-grade work in every thing but arithmetic, and in that subject, which he detests, he was doing fifth-grade work, practically at age. She considered that it would be practical to handle him in regular class were it not for his very deficient hearing.
The instructor in manual training reported that James was doing below average work for his age. His great difficulty here seems to be inattention. He will not stay at his work long. He forgets what he is doing. He does not follow instructions. He does not use the tools which he is told to use. He was making an ironing board and getting on fairly well, when one day the instructor found him gouging out a hole. It seemed an utterly unreasonable thing to do. James claimed that he was decorating the ironing board. II. Principal Characteristics.
Some of the more pronounced characteristics are his inability to make social adjustment and his attitude toward food; his living in a world of his own, describable roughly as a constant day dream; his language peculiarities; apparent absence of emotional life; his asking of questions and reciting of the lore with which his mind is stored. Each of these phases will now be taken up in some detail. Relations to Social Environment.
Socially he has troubles without number. The children are pounding him and the teacher hastens to the scene. It appears that he wants to get to the Yictrola first. To do so he makes a direct rush, shoving others out of his way. Naturally they will not stand for this.
He has broken up his Sunday-school class because the boys pinched him, he yelled, and the teacher became so indignant at the bad boys that he refused to continue teaching the class. He went to the Saturday morning class for town boys at the University but the instructor asked to have him withdrawn. The boys mauled him. Just how this came about it is somewhat hard to determine, but probably he failed to hear orders, his neighbors nudged him or otherwise gave him a hint which he misunderstood or resented, and trouble was on.
He takes no notice of anyone. Some youngsters we meet greet him, but he is too busy telling me the unending story of his Gothic palace to notice them. When I remonstrate, he calls out “Hello!” without looking at them and goes on talking. He does not understand the business of greeting people and getting on common ground with them. Apparently they are so many inanimate objects. We go into a shop to have some ice-cream. A lad in the shop about his own age suggests that I ask James how he likes gymnasium, quite taking it for granted that there is something wrong with James. I ask James whether he knows the lad. He does know him, remembers in fact that this boy was one of his rescuers in his gymnasium troubles, but cannot tell me why he did not greet the boy. He forgot. I insist on my rule about greeting. He understands and yet leaves without noticing his friend, probably planning the wonderful organ in his Gothic palace. The boy calls “Good-bye, James,” and James replies “Good-bye, boy.”
James bears on his person evidences of war. A certain boy in the manual training class apparently delights in hurling blocks of wood at unoffending James. I cannot be quite certain of James’s innocence, however.
He does not seem to grasp the need for and significance of the usual amenities. He possesses none of the automatically operating habits of ordinary social intercourse. When he enters our house he rushes past the person who has opened the door and makes for the piano or the magazine he wants.
He does not seem to understand the life actually about him. In the course of his embellishment of the great Gothic palace he devises a motor boat and invites me for a trip around the world. I cannot leave my wife behind. He includes her in the invitation. I tell him she would not go without Dr K.’s baby. He demurs a little but includes the child. I then tell him that the baby cannot go without its mother. He includes the mother. The mother, I then inform him, cannot go without her husband. Finally the husband is included. There is nothing humorous about the conversation. It is all in dead earnest. He reports that he was struck in the manual training class by two German boys. Asked how he knew their nationality, he replies that it was from their names which they disclosed to him on the way to school. One is Karl Wilhelm, the other Eitel Friedrich Wilhelm. He walked up to a house, the owner of which we did not know at all and undertook to carry off a milk bottle because his brother is gathering bottles in a war conservation scheme.
His attitude toward food does not seem quite normal or usual. When anything edible is suggested he can describe the very best and nothing else will do. He demands “juicy” oranges and the “very best large apples that come wrapped in paper.” He has assured himself long in advance that there will be turkey for Thanksgiving dinner. In fact he keeps a close eye on the turkey in the yard and would not for the world do anything to frighten it, because that would keep it from getting “fat.” It seems evident that every time he sees the turkey in the yard he thinks actively of the Thanksgiving dinner. He is not aware of the need for inhibition. When given anything, he grasps it in a way which shows the giver is the merest instrument or means by which he gets anything. When reminded of his failure to thank, as is almost always necessary, he is already far advanced in consuming the orange or cake. Doubtless the nearest thing to agitation or emotion I have seen in my association with him centered around the fear that there would be no turkey for Christmas dinner. He has bad table manners although he has always lived in a superior environment. He takes two apples at once but puts one back on request. He innocently expresses his opinion of anything placed before him, if it does not please him. He was given two apples before we started for our walk one day, with the suggestion that one was for me. He appeared on the scene eating an apple and when he had finished this he drew another and ate that. When I charged him with the offense, he claimed that he had forgotten but that he had not meant to be selfish.
When, instead of going into a shop with him to purchase a cornucopia, I handed him a coin and waited expectantly outside, and he did not appear, I entered and found him seated at a table enjoying his ice-cream from a dish. Asked why he did not purchase a cone, he claimed that they did not sell any. The man in charge assured me that James had not asked for one. I feel certain he knows they serve more ice-cream for the same money in a dish than in a cone. On two occasions I sent him on ahead for some reason. On arriving, he announced that I had instructed him to ask for an apple. When his request was about to be granted he ordered “the largest and juiciest.” Both occasions were without warrant. Charged with the offense he denies having said I instructed him to make the request.
Living in a World of His Own.
Apparently he does day dreaming usually along some definite line which keeps on endlessly developing and having entwined into it everything that comes under his notice. One of these dreams is about the great Gothic palace which he is to build. This is of long duration, possibly of years’ standing. It doubtless originated with his reading of some article on architecture. Almost all of his imaginary world seems to originate in this way. The plans for this palace are never completed. If he reads something in the papers about the dropping of bombs, then the roof of his palace shall be bomb-proof. He will test it by having an aeroplane drop bombs on it. If he reads about torpedo-boat destroyers, then he equips his palace with motor-boat guards. He has a great organ, a picture gallery, a beautiful gray automobile, servants, children, and so on indefinitely without the remotest attention to practical daily life. Forced to reply to the question where he will get money to fulfil his dreams, he replies that he will make it by going to work in a steel mill. Did not all the millionaires make their money in the steel business?
For a little while he abandoned his Gothic palace and dwelt on the Sonora Supreme, the phonograph he wanted, and his plans were worked out in preposterous detail?a rubber cover in case of fire, a drill in letting it out of the window, a sign warning children not to touch it, and what not.
The conflict between imagination so active and reality leads to frequent confusion. He often finds it hard to distinguish between “Good morning” and “How do you do.” When he arrives in the afternoon he sometimes goes so far as to answer “Yes, grandmother,” when speaking to me. He usually corrects himself. He is a poor messenger and cannot seem to deliver a message in an orderly manner, sometimes becoming painfully confused.
To this same living in a world of his own is perhaps due to the fact that it is difficult to hold his attention. He will answer a question and start in again on his Gothic palace.
I asked him to make me a copy of the rules which I had given him but he came repeatedly without them. For eight or nine days he kept on forgetting. Finally it seems he did write out the copy but cannot remember to bring it. He says he forgets and is not disturbed by this. He occasionally arrives bareheaded and does not know where his cap is. He used to cut dead flowers on his grandmother’s lawn for ten cents an hour but he no longer does so as he has mislaid the scissors.
He can keep his attention on a book for an hour if it interests him, but he makes a poor report of what he has read. Apparently he repeats without having understood, although this is not always the case.
Language Peculiarities.
He does not seem satisfied to use ordinary words and delights in employing unusual expressions. He will often ask for the Latin equivalent for some simple word. For example, he reads a Bible stOry for me and in repeating it refers to Joseph, the husband of Mary, as “Jo, as his son used to call him.” He refers to his skating as a “tour on eight wheels.” He commences classifying houses by size and coins the designation “couple” for a two-room cottage. He informs me that his uncle has returned with his “spouse.” Asked whether the turkey has been killed, he replies “Yes, the turkey has been executed.” In the same way, in reply to the question whether his eyes have been tested, he says he has never had an “ocular examination.” He was struck in the manual training class with a block of “Sequoia Washingtoniana.” He talks of the “cord of care” which will be broken for his grandmother when he is twentyone. When I object to his many questions, he replies that questions are the “door to knowledge.” He requested a little child to move out of his way by addressing him as “you young microbe.” He asks for an apple that “has no inmates.” All this deliberately but without any attempt at humor. He has an odd trick of handling figures of speech which he has read, as if they were ordinary idioms, much as one might do who had learned speech out of books in Mars.
Apparent Absence of Emotional Life
Quite self-centered, one would ordinarily say of him. He mourned the death of Mrs. S , his guardian and friend for five or six years, “for two days” he says. I cannot get emotional responses from him on this or apparently any other point. At the time his friend Mrs. S died (he was past eleven years of age) it appears he unconcernedly placed some flowers near the body as he was told to do. Now he never mentions her. We pick pepper berries for Mrs. H . I cannot get him to look forward with pleasure to presenting them to her because she loves them so. We propose a visit at our house some time and when asked what we shall do, he replies that he will have breakfast, lunch, dinner, and play the piano. He uses the appropriate phrases when questioned but I cannot discover any trace of affection for his grandmother or brother.
Asking Questions and Reeling Off Information.
For final specific reference, has been left the characteristic that is perhaps most marked and, certainly, most readily observed. Any time that James is permitted to take the lead, intercourse with him takes on two principal phases: He is either reeling off information gleaned from reading, varied by an elucidation of his intentions in the matter of his palace or other subject of his day dreaming, or else he is wearing out his companion and testing patience and kindliness to the breaking point by an incessant series of questions. One’s first reaction is surprise at the breadth of knowledge and the intelligent character of the questioning. These feelings, although eventually modified, are by no means extinguished. One learns that frequently James doesn’t understand what he is repeating, apparently doing it automatically, and his questions are not always intelligent. Sometimes he asks about things almost automatically, as if going around in a circle. Sometimes he knows the answers to the questions he is asking.
General Summary.
Finally, it may be of interest to reproduce some actual notes of the first meeting, which will perhaps help to complete the picture: I call at the house Friday evening, make the boy’s acquaintance and arrange to call for him Saturday afternoon. He acknowledges the introduction politely and formally but with an unusual air not easy to define. Something is said about music. He rushes off to the piano to play for me and does not appear again.
I call for him at about 1:15 Saturday afternoon. He is ready but does not know where his cap is. Some one else finds it for him. We start out in a friendly manner and talk of games. He doesn’t play many, but he can run and knows he can run exactly forty yards. He proceeds to do it. I stop him and recall his running to the piano the night before and his rising fourteen times and running away to observe something during the Binet test.
He now proceeds to tell me about mushrooms, evidently repeating what he has read or has been told and doing it well. His command of words even when repeating is really fine. This recital of mushroom lore is typical of one of his two principal mental activities. He is ever telling what he knows, or asking about what he does not know. When the former, he does it well. When the latter, it is like the thirsty desert drinking in the rain. His questions are almost always intelligent if but rarely relevant. He asks about anything and everything regardless of the usual amenities.
We arrive at the house and I seat him comfortably within earshot, and proceed to water the lawn. Our intercourse, not exactly conversation, continues. He does not like the way I neglect my lawn. The lawn should be mowed, rolled and watered. Weeds should be cut and he describes the processes. He does not like my house. It does not compare favorably with his grandmother’s. His own shall be large and of Gothic architecture, like a cathedral. He is naively frank, curious, and wants to wander and woolgather, but I can hold his attention by effort.
I suggest going to the University, where I have a book to get. He prefers to ride, but first he would enjoy an ice-cream cone. He expresses his preference as to flavor. He is impressed with the University Chapel. When I ask him to look at a picture and tell him it is a mosaic, not a painting, he remarks: “How they deceive us, they are so fine.” I take him out in front. He can tell me how many arches there are and how many windows above. He knows that the general architectural scheme is mission. He wants to know why they call it the Campus. At exactly the right place he tells me we are passing Dr Terman’s office. He must have noted this point in relation to the chapel the only time he was here before.1
I give him his choice of riding or walking back. He chooses to ride, then begs to walk and see the trees, but I insist on riding. We go back to the house. He acknowledges the introduction to Mrs. H in his formal manner. They sit down at the piano and his showing is really brilliant. This does not refer to accomplishment, as he has had little instruction, but to innate musical tendency and speed in grasping something new. He never lets a new word pass, demanding explanations.
He really seems to be as capable as this in everything else. He was recently presented with roller skates and without’further ado, although he had never had skates before, he proceeded to do fancy skating, making figures. He can construct more bridges, towers and so on out of the; Meccano than his older brother. He spurns St. Nicholas and other juvenile magazines and devours popular scientific journals. He reads the Book of Knowledge constantly, but for botanical matters he prefers the encyclopedia. I am sure he could read the dictionary. To give still more clearness to the picture, the following compositions are reproduced. These were written without previous notice or preparation. The topic was dictated in each case:
Why I like to live in California.
1. Because California has less rain & less cold. 2. Because I can go outdoors more. 3. More flowers grow there most of the year & there are less sparrows. 4. Because of the eucaliptus & pepper & sequoia and other California trees. 5. Because of the fig, orange, apricot, persimmon & strawberries & apples. What I want to do when I grow up.
1. Build a fleet consisting of 22 freighters, 29 passenger ships, 24 torpedoes, with mother, 4000 destroyers, 28 mother ships, with contents, 100 mertanks, 300 zeppelins, 30 navy ferrys, 1200 solid build hydroplanes and 2 light ships to lead the way at night, and 25 motor gooses & 28 rams. 2. For my home I want a great Gothic and roman palace.
3. For land defense an army consisting of 1,000,000 footmen, 50 tanks, 12,000 tanklets, 22 zeppelin observation airships, 20,000 monoplanes, 18,000 biplanes & 2,000 military tractorplanes. 4. Commerce. 20 freight u-boats 12000 monorail cars. 1 Interesting because the style of architecture leaves this building indistinguishable from any number of others. ? German. 5. I want 4 children in the fimily, for music, chimes and a Sonora Supereme phonograph. 6. Go to Germany and sell good aeroplanes, and when returning to my home in holland, bring a fine solidly built plane, from Germany. James.
One is tempted to easy explanations of the peculiarities, such as deafness and late speech or the fact that many people recall having indulged in day dreaming during childhood. James himself, however, eventually forces one out of these temporary shelters. After all allowances are made, something queer remains. When things seem most hopeful, if another child of almost any age appears on the scene, the contrast is very bad. Some boys on our block have spotted him. They may be lined up near the house when he is leaving, intently watching, but he does not see them. He cannot hold attention. He breaks into a serious remark with “May I play the piano?” or “I want to skate now.” One feels that the talk has been of no effect. Surely he is better off than people who have no speech or hearing at all, but who are capable of making adjustment.
Tests and Attempts at Correction.
James was given four rules covering some of his principal offenses?talking too loud, interrupting others, failing to observe the amenities at meeting or parting, and asking too many questions. By dint of hard work and constant repetition we made some little headway, particularly in the matter of greeting.
It may be that this indicates that constant attention and vigorous handling have some possibility of hope. With this in view, and bearing in mind the opinion of his teacher above referred to, that the boy could be handled in classes were it not for his defective hearing, the experiment was tried of placing him in a private school, where the classes consist of only four or five pupils. It was thought worth finding out whether a full load of school work, individual attention and association with the boys at the school might help to recall him to the life about him. Unfortunately the school to which he was sent could not handle him for longer than a week, at the end of which time his withdrawal was requested. It appears that the week he was at school was a week totally lost to the rest of the class in which he was placed. His demand for the teacher’s attention was constant. He himself enjoyed his experience immensely and it was a great blow to have to leave the school. However, he required more personal attention than could be given him. Equipped, for example, with a wooden gun, and asked to stand aside and observe the drill, he had to be ordered out of the lines eight times. Finally he kept out, but in his anxiety to see what was happening he stood so close that the company ran him down and in extricating himself he struck three boys with his wooden gun.
In view of the suspicious symptoms, that is to say, of the fact that we had a person who was not feebleminded and yet had decided peculiarities, the writer gave James the Kent-Rosanoff Association test in accordance with the instructions suggested by Whipple in his manual, Vol. II, p. 55. The test was given twice because it was felt that this might produce a clearer idea of the situation. After accounting for the doubtful responses in accordance with the principles laid down by the authors, liberally interpreted, there were left twenty-seven “individual” responses for the first sitting and twenty-four for the second. This data consisting of these fifty-one individual reactions will be treated together. It will be borne in mind that the fact of having given the test twice probably magnifies the individual reactions and their indications unduly and gives a different aspect than would the usual single sitting. At the same time the greater amount of data possibly assists in indicating certain characteristics.
Kent and Rosanoff divide the individual reactions into normal, pathological, and unclassified. The attempt was made by the writer to exclude all reactions that might be regarded as normal. By this process twenty-three of the fifty-one reactions are excluded, leaving twenty-eight for study here. The data here treated would therefore seem to come under the heads of pathological reactions or unclassified reactions. It is always possible of course that in this last classification there have been included words which to others might be explicable as normal reactions, thereby still further decreasing the total number of words treated.
In the class of pathological reactions, we appear to have one sample of the class which Kent and Rosanoff call “derivatives of stimulus words”?tobacco-backy?and one sample of what they call “sound reactions”?street-stream.
Regarding derivatives of stimulus words, they say “the tendency to give such reactions seems to be dependent upon a suspension or inhibition of the normal process by which the stimulus word excites the production of a new concept, for we have here not the production of a new concept but a mere change in the form of the stimulus word ” In the class, “complete dissociation,” which forms the second division of pathological reactions as analyzed by Kent and Rosanoff, wa seem to have samples of both types referred to, i. e. perseveration and neologisms.
The perseveration is confined to the type which they call “association to preceding reaction.” In other words, the subject is stimulated bjr his own last answer instead of by the new stimulus word. In the following, we give first the stimulus word, then the reaction followed in parentheses by the preceding reaction which in our opinion produced the reaction in question.
dream - red (light) scissors - satellite (sun) music - horse (black) comfort - chicken (beef) eagle - motor-bike (bicycle) Kent and Rosanoff say regarding complete dissociation that “in the case of such reactions the stimulus words seem to act, as Aschaffenburg has pointed out, merely as signals for discharge.” They say further regarding the specific type of perseveration here presented, that “the phenomenon of perseveration occurs in cases in which one may observe an abnormal immobility of attention. To react normally to a series of stimulus words requires on the part of the subject, in the first place, a certain alertness in order that he may grasp quickly and clearly the meaning of each word, and in the second place, a prompt shifting of the mind from one reaction to the next.”
Regarding neologisms, the second type of complete dissociation, samples of which we quote below, Kent and Rosanoff say “here we place the newly coined words so commonly given by the insane,” man - boowhoon citizen - woof trouble - calm-down-ness In connection with this tendency to perseveration and to neologisms we refer to the wandering attention and the peculiar tendency to use big words heretofore described.
Our largest class, as also Kent and Rosanoff’s, consists of “unclassified reactions,” using their terminology of the type, however, which to us would seem fairly classifiable as “incoherent reactions.” An effort has been made to list these somewhat in the order of their incoherency. In view of the fact that placing reactions in this group is to a considerable extent a subjective procedure, it is possible that others may consider that some of these words have some association bases that has escaped the writer and do not belong here.
street-whiz (auto going along?) slow-l’hirondale (swallow-l’hirondelle? *) window-ugh sleep-bang (thinking of someone being wakened?) green-laugh (grin? x) religion-list, cruelty light-death (life? *) needle-horse priest-spectator hard-bicycle citizen-criminal eagle-naughty fruit-coddling moth river-black justice-deviltry long-chubby (contrast?) thirsty-contented (contrast?) soft-black (an S B lead pencil?1) IV. Present Status.
Reviewing, we find a boy testing at normal by the Binet-Simon scale, which excludes the possibility of feeblemindedness. We find, nevertheless, well-marked peculiarities, the principal one being the living in a world of his own, making it impossible for him to adjust himself socially to the life about him. Is it a case for psychopathic examination? The results of the Kent-Rosanoff test make one extremely suspicious. The facts of deafness and unusual up-bringing are far from explaining away conditions. Seemingly it is a case of pathologically exaggerated day dreaming, complicated, perhaps, by other factors. If this diagnosis is approximately correct is there a remedy?
1 These possible associations have been suggested by a student in the Dept. of Psychology, U. of Pa., who read the MS.
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