The Seline Mind
The Psychological Clinic Copyright, 1918, by Lightner Witmer, Editor. Vol. XI. No. 9 February 15, 1918 :Author: Elmer E. Jones, Northwestern University, Evanston, III.
It was my privilege recently to have charge of an old gentleman on a long and tiresome journey in a Pullman car. He is eighty-five years of age, and appears to be in excellent physical condition, though his mental powers are considerably disintegrated. As a youth he was a great athlete, being the champion wrestler and jumper in a whole township in central Indiana. He has lived an active, vigorous life in a rural community in the Middle West, and was at one time a fairly successful farmer. He was also a fine workman with carpenter’s tools, and for many years built elevators in the western states. At the carpenter’s trade he was regarded as an expert joiner, and was in great demand for laj ing hardwood floors, such as were frequently used twenty-five or thirty years ago.
He is the father of six children, was a soldier in the Civil War, and was a pioneer in the state of Nebraska in the early seventies. His ancestors were Quakers who migrated from the State of Pennsylvania in the early thirties and settled in central Indiana. His boyhood days were spent in the rugged activities of clearing the forests, draining the swamps, and many other arduous tasks which fell to the pioneers of Indiana. His schooling was meagre, but through the favorable recommendation of a county superintendent who had been his teacher, he taught school for two or three years.
In recent years he has not been actively employed, but has lived at his own home with very little responsibility. Two years ago his wife died, and since then he has spent his time chiefly with two daughters, one living in Ohio and the other in Nebraska. He has not been able to transact business for several years, and two years ago a guardian was appointed to look after his financial affairs. This action was taken because his children recognized his mental incapacity.
Having known for several days that I should be his escort on this long journey, I naturally thought of various schemes by which I could entertain him en route. It struck me that since his mind has disintegrated so considerably, and is now about the equivalent of a six or seven year old child, he might respond to some very childish entertainment and treatment. Incidentally I desired to measure his mental age at the present time by some such scale as the Binet, if it could be done without arousing any suspicion on his part that he was being tested for mentality. By careful planning and some ingenuity, it was possible to measure his mental age approximately and, at the same time, afford him no little entertainment. The first approach toward measuring his mental ability was through spelling. This was easily accomplished, because in his boyhood days he was regarded as a phenomenal speller, having committed to memory every word in several of the spellers of his day. It was easy, therefore, to enlist his attention in spelling. I had provided myself with a copy of Ayres’ Spelling Scale, and he very arduously entered into the “match,” though he was the only competitor. I encouraged him in his efforts and somewhat over two hundred words were pronounced to him. On the basis of bis correct spellings he should be ranked somewhere in the latter part of the third school year, according to the Ayres’ scale. This would make his mental age in spelling approximately eight and one-half years.
From spelling it was easy to proceed to vocabulary. I was provided with the vocabulary scale used by Terman in his Stanford Revision of the Binet Scale. My subject had great difficulty in defining twenty words from the list, and the result of this test entitles him to a mental age of eight years.
In the tests for the fifth year of the Binet Scale my subject named the colors correctly, was successful in aesthetic comparisons, gave the correct definitions of terms, but failed on the “game of patience,” and could not give his correct age. In the sixth year he passed all the tests with the exception of “forenoon and afternoon.” In the seventh year he failed in his description of the pictures, in repeating five digits, in tying a bow-knot and in naming the days of the week. He could name the days from memory, but when asked what day comes before Thursday, Tuesday, etc., he could not decide. He could not tell the day of the week, the month, or the year.
Beyond the sixth year there was little integrity to his answers and he could not be given a full score for a single question. There are several mental characteristics in his senile mind which may be of interest. In the first place, it seemed impossible for him to comprehend the mechanical character of the Pullman train. He regarded the series of sleepers and the diner as one large building, somehow connected. The movement of the train, both forward and sidewise, he regarded with some fear, as if the veryfoundations were being shaken under us. In some instances he attributed the swayings of the train to his own lack of motor ability, and complained of being “old and no good.” It is needless to say that I took great pains to explain to him that we were being drawn along a railroad by an engine, but it all seemed incomprehensible. To me it seemed that he had about the comprehension of a three year old child for the whole procedure. In making the trip forward and backward to the diner, his poor vision only permitted him to get rather rough kinesthetic impressions, and these were not associated with any past experiences. Consequently, there were aroused in his consciousness vague ideas of the meaning of the series of cars, the diner, and the journey forward and backward three times a day. It should be said that he has not been a traveler on Pullman trains, and only a few times in his life has he taken his meals in a dining car or slept in a berth in a sleeper. This accounts for the fact that the new experience was practically isolated from all others and he found much difficulty in making che mental adjustments.
Another observation indicated quite clearly that his mental activity is like that of a very small child. Upon one occasion I found him scrutinizing the head of a nail in the Pullman seat. He investigated it from every angle, and seemed to get a great deal of pleasure from the visual perception of this bright object, and from twisting it with his finger nail. It occupied his attention for a distance of twenty or thirty miles.
At another time I found him busy studying and tracing the blue figures in the upholstering on the Pullman seats. He was apparently trying to analyze them and when asked what he was doing replied: “The picture looks like a field with a river running through it.”
His learning ability was practically nil. I tried to impress upon him the location of the men’s washroom, and the forward journey to the diner, but each time the route was new to him and I had to direct his course. In the washroom he made no progress in learning the use of faucets and drains, though I led him to the washroom frequently and instructed him carefully each time. So far as I could determine, each experience for him was an absolutely new one. He was bothered very much by the reflections in the mirrors and the windows. In the evening when the lights were first turned on he could see the reflection of the interior of the car outside of the window, which gave the appearance of gliding along on top of the snow. This interested him exceedingly and he commented several times on the fact that there was a room closely adjoining the one we were in. My explanations of the physical phenomenon only seemed to mystify him, and I finally gave up the task and left him to enjoy the floating shadows in very much the same fashion as a little child. His dreams appear to be so vivid that he cannot discriminate between them and the waking experiences. His sleep on the Pullman was doubtless somewhat disturbed and his dreams were very vivid. He awoke at one time and said to me that he had gotten up and dressed and gone out to look around the town. While down town he met a man who told him that he had best go back and get into bed, and he took his advice about it. At another time he awoke in the middle of the night and stated that he thought he was in a place where he ought not to be and wanted to leave the train. I went into great detail in explaining to him that we were sleeping on the train and that he would soon be at his old home, and then we would get off the train, where he would be met by his daughter. This satisfied him and he fell asleep like a child.
This old gentleman’s mental ability in certain lines is quite characteristic of the senile mind. The old associations are the most vivid, and those habits which have been used continuously are still fairly efficient. From the standpoint of mental tests it is here that he excels somewhat the child who would measure about the same psychological age as he. For example, he has always been very particular to carry a good watch and have the correct time. However, on this journey he failed to wind his watch and it stopped at 3:45 a. m. It was 10:30 in the morning before he noticed that his watch had stopped and when given the time he set his watch correctly to the minute. I watched him very closely, thinking that possibly the mental ability to do it would be lacking; but he did not hesitate, and proceeded to move the hands in the most economical manner to the correct position. He succeeded, undoubtedly, in this test because he has had constant practice in the use of the timepiece, though when asked offhand to state whether it was forenoon or afternoon he could not tell, and never thought of consulting his watch for the necessary information.
As was previously stated, he was an expert joiner in middle life, and had had much use for the plane. Recently, while in my home, in order to test his memory, I handed him a plane from which the blade had been removed, and asked him to put it together. In this he failed completely. He was astounded at his own inability and expressed himself thus: “I never thought I would forget how to put a plane together.” It is entirely probable that he had in no way used a plane for fifteen or twenty years, and in this time those habits formerly well established were completely obliterated. This, however, is quite characteristic of the senile mind and points distinctly to an educational possibility of retaining many powers ordinarily lost in old age. If old people can be encouraged to maintain to the end their habitual activities, there seems little doubt that mental and physical disintegration would be materially lessened. This, of course, does not mean that old people should be held to labor arduously throughout the senile period, but they should remain interested in many of the things to which they have given attention during a long lifetime.
The treatment of the senile mind is a problem not well understood by those who have old people in charge. There are a few general principles which would be of value to the administrators of homes for the aged, and might be of value to children who may be given the responsibility of caring for aged parents.
In the first place, it should be remembered that the senile mind is a weakened mind in all its phases of activity. It is impossible for such an individual to have the proper comprehension of much conversation he hears. Modern topics, up^to-date methods of doing things, knowledge of the younger generation and their activities, are subjects in which the senile mind finds no interest, because it has no contact with them. For this reason conversation along such lines may prove extremely irritating to the aged, and may be the cause of much trouble in the home. The same psychic attitude is shown when a little child manifests vexation because it cannot comprehend certain phenomena. Obviously the only sane treatment of the senile mind in matters of conversation is to confine the topics to the period of his youth when his mental powers were normal. This is a difficult task, but it is the only way in which the senile mind can be interestedly engaged. In soldiers’ homes, and other institutions for the aged, this problem is practically solved by the fact that the inmates can always find those of equal mental age with whom to associate, and there is the same mutual pleasure in these associations that are to be found among youth of the same age.
Those who have charge of the aged should study the individuals carefully in order to discover habitual activities which have been retained and in which interest is still alive. Effort should be made to stimulate these activities to the end. To allow one of them to lapse is to reduce the mental capacity so much, and to render the subject so much more like a child without the experience that train270 THE PSYCHOLOGICAL CLINIC. ing brings. Nothing is more pathetic than old age when the individual is incapacitated for service of any sort, and when he has forgotten all the technique of former days. Every effort should be put forth by children, who have the care of aged parents, to keep them interested in some sort of service, active in some pursuits in which they formerly excelled.
There is a wide difference between the senile mind and the child mind. The former has lost its plasticity, its curiosity, its inquisitiveness, its investigative activity. It lives in a remote past of experience, and has a backward look. Youth looks forward with great hope for large achievement as a result of investigation and conquest. Youth has confidence, feels assured of victory, and is ready to race with competitors. Old age shrinks from contest, lacks initiative, and is generally satisfied with its past.
With the distinctions from youth, and the similarities to it, the senile mind should be studied with care, and the life activities of the aged adapted to their mental and physical possibilities.
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