The Psychology of Dementia Praecox

and another who heard the voice of God. The mannerisms of one were characterized by a continuous rubbing on the top of his head, while another for hours described certain figures in the air. Are these diversities accidental, or do they have a reason? Is there any difference between Kraepelin’s patient who saw a "blue heart up above, and behind it quivering sunshine and another blue heart, ‘a little woman’s heart’,"original: "Ein blaues Herz oben, dahinter zitternder Sonnenschein und noch ein blaues Herz, ein kleines Frauenherz" and the patient who lived by the word of God, a raven was at the window who wished to eat his flesh; or between the patient who repeated numerous times the same unintelligible sentences “one for all and all for one, and two for all and three for all,” and the patient who speaks about “a poinard with a nuptial note”? The same questions could be asked about the manifold so-called senseless actions of patients. Kraepelin makes no attempt to explain these senseless utterances and actions. In other words, while he gives us an accurate, almost photographic account of the patient’s general behavior, he does not enter into his psychological productions. He contents himself with noting that the patient entertains such and such hallucinations and delusions, and such and such mannerisms, without examining the causal relations. Those who work among the insane know that no two cases of dementia praecox are alike; there is always a difference in the grouping and relationship of the symptoms, every case having its own individuality. Kraepelin, like his predecessors, totally ignores individual psychology—a thing absolutely essential for the understanding of the psychosis, just as the microscope is for pathology. The present difficulties in classification are mainly due to a lack of knowledge of the influence of individuality, without which no real classification is possible.

Bleuler and Jung inaugurated a new epoch in psychiatry by attempting to penetrate into the mysteries of the individual influence of the symptoms. They show conclusively why we have this combination of symptoms here and that combination there. In the cases described by them, we see that the senseless expressions and actions have their reasons.