GENERAL ARTICLES

NERVES!

A note on the Jitters—What they are, whence they come and what to do about them

HUGH GRANT ROWELL, M.D. February 15 1937
GENERAL ARTICLES

NERVES!

A note on the Jitters—What they are, whence they come and what to do about them

HUGH GRANT ROWELL, M.D. February 15 1937

NERVES!

A note on the Jitters—What they are, whence they come and what to do about them

HUGH GRANT ROWELL, M.D.

JITTERS and blues are, of course, none other than the ups and downs of our old friend and enemy "nerves” —or, as technical-minded doctors put it, our “nervous constitution.”

Nerves, it seems, are turning everything upside down today. Physicians have had to make a drastic revision of their services—preventive, curative, diagnostic and research —to meet what is commonly described as man’s inability to meet the “slings and arrows of outrageous fortune.” 1937 • style. Physical fa-

tigue used to be the big problem ; now it’s nervous fatigue. For confirmation ask any modem doctor, personnel manager, social worker, clergyman, or anyone else dealing with humanity and nerves in the raw.

You could write a book on the different ways cracking nerves reveal themselves — temperamental acts highly personalized, nervous breakdowns, disappearance for voluntary or compulsory stays in institutions for the mentally ill, behavior distinctly in conflict with the law and our general standards of how the well-living human will act, physical crack-ups of all sorts, wrecked homes and careers. No group or age is spared. It’s nothing at all new to find parents, in meeting assembled, discussing "my child’s nerves” and reading the numerous books on the nervous child. Nor are grandparents exempt. As a matter of fact it doesn’t make much difference how nerves show upprovided you recognize them for what they are.

Upsetting Factors

OUR NERVES, at any time, represent the result of the molding of life, plus certain other definite factors. Supposing we list the major factors.

Factor one: Body type. The psychiatrist will tell you that there is a definite relation between your body type and the functioning of your nervous system. If you are tall and slender, you are probably a dreamer and a person who isn’t very willing to face realities. When circumstances necessitate the facing of not too pleasant realities, your nerves are likely to take a beating. If you’re short and broad, you’re likely to be a realist. People may consider you hard-boiled, but you know that, inside, you‘are sometimes very cheerful and sometimes way down in the dumps. You are an extremist. And the variations of emotions that are characteristic of your type are much harder on your nerves than if you were placid and more evenly balanced.

Factor two: The endocrine glands—the thyroid, the

pituitary, the adrenals, and others. These are supposed to work in a sort of balance, pouring their products into the

blood in amounts that make for the even functioning of We, Us and Company. However, should any one predominate, the results are anything but desirable in terms of temperament, physical functioning, etc.

Factor three: General health.

Factor four: Temperament—probably an effect rather than a cause.

Factor five: The ego; our estimate of ourselves. The ego may be strong or weak. Furthermore, we may desire power or we may prefer prestige.

Factor six: Experiences or lack of them. Jack may be sorry as a result of a spanking, and Jill turn rebellious. Some of us are protected. Some of us have had to "cut our own bait.”

Factor seven: Mental horsepower. A bright child or adult goes through Hades worrying about things that a less endowed person never knew existed. I deal with this type constantly. Take it from me, being bright is not all beer and skittles. I often think' that what you don’t know doesn’t hurt you.

Factor eight: Heredity. Some of these ancestral in-

fluences are part of the hazards already listed. We may inherit so many things besides wealth from our forebears that there’s no use trying to list them here. And even wealth may affect the nervous situation.

Factor nine: Modernity. Many believe that man has erected in modern civilization a monster that will wreck him.

Like the cat, then, we have nine lives, for each factor or hazard represents a life in itself. All of them can’t be wrong or go wrong. Furthermore, in attacking jitters and blues, the first move is an analysis of the individual on a basis of the hazard situation. Put another way, the first answer to "nerves” lies in a thorough study of the “whole individual” —physical, mental, moral, social and all the rest.

One queer element enters the picture. For years we have been treating certain diseases with the idea they were wholly or principally physical in origin.

Now we find we may attribute them, basically, to nervous constitutions gone wrong; not in every case, but often enough to give us thought. A person develops heart disease; and in certain types we are willing to admit today that such circulatory difficulties are due to the pressure of modem times, with resulting bad health habits, and physical and nervous crash. Take your own pulse some time when you are excited or get bad news and see how it goes up, adding to the burdens

of the situation. Imagine what could happen if this excite* ment was constant.

Or consider arthritis, which you may know as rheumatism. Here again it’s the same story, only it’s metabolism gone wrong. Or stomach ulcer—which clinicians now agree may have as primary cause, not the simple chemical difficulty previously credited, but a nervous constitution gone haywire. Or consider that common thing, nervous indigestion—a queer sort of thing which you can get temporarily if you eat a heavy meal when nervously exhausted.

Add up the story so far and we find ourselves, on the farm or in the factory or office or home, living a speeded-up life with a nervous constitution, built for fifty years ago, which is still in a state of adjustment to the newer order of affairs and has never, in many cases, been able to catch up.

Prevention is Best Cure

CURE, of course, is necessary, if we go down under the pressure. More important, however, is prevention. And that prevention, today, goes even into the prenatal periods of life.

Cure, as far as it goes, is a matter of rest. The earlier you know what is happening, the quicker you’re going to straighten things out. The difficulty with most people turning jittery is that they are so jittery they refuse to do anything about it. As for the “glooms” or blues, the answer seems to lie in trying to swing the emotional pendulum toward the more active ends of the arc—but try and do it. Half the recent ballyhoo about hobbies was based on the idea of getting your mind off your own troubles. A game of baseball or horseshoes will do it—if you happen to like the game. So will a good story or a talkie. Yet I have always found, with myself, that it is only a question of time until a hobby turns out to be an octopus, possibly because my own mind runs to the intricate.

The real answer lies in finding some way which, for you, lets down the tension on the springs. Some crass individuals, who of course must be utterly wrong, have advocated an occasional Saturday night spree. The only standard I would set up is this: the way you relax must fit you, not the good wife or the neighbors.

Stabilized manner of living is both cure and prevention. Go to a spa, whether here or in Europe, and the first thing you get is a regular routine of living, including a simple, easily digested diet, plus regular though not necessarily vigorous exercise. To this must be added any kind of interest that takes your mind off the growing crops or the long face the boss puts on, or the

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Nerves

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fact that you are doing a roaring business but collections are listed among the missing. Yet, because routine gets on anyone’s nerves, you’ve get to break away from this once in a while and kick up your heels. Charlie Chaplin told this story clearly enough in “Modern Times.”

Much is being written today of neuromuscular tension and its apparent cure— “relaxation.” The terms are technical. “Tensions” may be illustrated by “making a muscle.” That, the patient is informed, is exactly what not to allow. Imagine, if you can, what your arm would be like if you let it drop lazily on a pillow and allowed it to stay there without further effort. That is what we mean technically by relaxation. With it goes a sort of mental, “What do I care.” Physiotherapists are using this technique now. I have seen it work very nicely on tense children and adults. It is both preventive and curative, as part of a method for fighting jitters and blues. We are, in both instances, all tightened up. The answer lies in getting untightened.

If you were at a hospital or retreat of the right sort, you’d learn about cool packs. You’re all wrapped up and just can’t help resting. At home, a tepid tub, with a good story to read, is wonderful. There should be, in my opinion, proper lighting for every bathtub. Singing in the tub may be a little hard on the rest of the family, and soundproofing is expensive. W"e may come to it.

We are taught to rest our eyes regularly during reading, but what do you think those trips of yours, if in an office, mean when you go to see Joe or visit the water cooler? Nerves demanding a rest. The only way to beat out brain fag, if you work mentally, is a respite of from minutes to days. Many a book is delayed for months from this cause.

The Value of Hobbies

"DATING and drinking figure importantly. When tired, the one best bet is crackers and milk. When you have to work after a meal, make it a light one or both nerves and digestion will pay. As for alcohol, if you are one of those who favor it, remember that it was meant for amusement and not to whip up tired minds and bodies. Party cocktails to make tired minds and stupid tongues pep up, somehow suggest that the party must be banal and you should not be there.

Sleep is, of course, the natural form of rest. It started, supposedly, as man’s way of filling in unlighted hours of terror when blackness seized upon the earth. It became man’s asset. Civilization has broken into this rest period more and more, what with late hours and night jobs. That good tepid tub we mentioned, followed by a nice clean soft bed, can defeat almost any known form of temporary fatigue. On the other hand, if fatigue is purely mental, it’s a good idea to get physically tired too. Physical exhaustion requires physical quiet. That’s why the quiet evening around the lamp on the old-time farm in the pre-radio days got results.

These things are easy, if you can get them done or will do them, as the case may be. But humans are stubborn. They will not give in; it is difficult to break down their mental resistance.

Sometimes you find the way out yourself. A friend of mine, after trying doctors galore and almost everything else, found an answer in making ship models. Others have walked it off. I myself, when things get a bit high pressure, may walk, or more likely 1 will turn to my little shop in the cellar and work on my circus model or old clocks. Movies of the right kind, usually the funny ones, if you can let them carry you, may tide things over.

There’s one thing today that has got to i be remedied before nerves get back to nor-

malcy. That is the eternal feeling of insecurity. Yet it is logical, in crises, that we should not be able to see far ahead. We have turned to religion through the ages. “Simply to Thy Cross I cling,” is the underlying thought. A little child asks innumerable questions. Those who have studied him most, tell us that he wants answers that give him a relief from a sense of uncertainty about things. People on relief are jittery. They wonder if the funds will come; how long they will be available. To many, it’s the same story in regard to the job. Most people haven’t the nervous constitution to stand up under gambling. They can’t stand losing and they can’t stand winning. Security must return or we may expect man to continue jittery. For we haven’t been trained for the present sort of life—barring certain old-timers who seem to be holding things together; firetempered men, knowing from earlier experience that things usually work out.

“Good Bringing Up”

C TART WITH the child and you can get ^ the best solution of all. And you can, furthermore, modify the program for a child to your own needs. Some call the program “Mental Hygiene.” You would probably prefer the term “Good bringing up.”

Granting a home in which there is enough of proper food to eat, a quiet happy atmosphere and a sense of stabilization, you can get right down to training in selfcontrol. The youngster with the tantrums today is the man or woman with the jitters tomorrow. I’ve had children nearly tear my office to pieces in front of their parents and come back a week later, alone, behaving perfectly. I’ve even had them laugh with me two years later about the show they had put on. A child will get away with what he can. Don’t fool yourself. You may let him do it, but will the world?

A child has to learn to “take it.” He can’t win all the time. None of us get everything we want. Losing a few times but facing the loss squarely is a good thing for anyone. A good parent ought to be able to teach a child how to be a good loser—by which I do not mean a quitter. Society today and hereafter is going to be complicated. No one is going to be able to live of himself or for himself. In bringing up a child, emphasis should be placed on the gentle art of give and take. In my experience, the fellow who gives most, sanely, is quite likely to have plenty of opportunity for taking. Many professional men have found that when they attempted to stress the financial end of their work, the only result was loss of clientele. You’ve got to be willing to work for what you get.

This isn’t intended as preaching or philosophy. It is merely listing the sort of thing which causes the situations which later crack up nerves. Today, we know that life is one continuous series of little punishments which gradually wear us down unless we can rise above them. One big wallop isn’t anything. You may get the “kayo,” but you’re back on your feet shortly. It’s the old Chinese slow but sure torture that gets you and your nerves. You can’t seem to escape—till you’re a jittery wreck. That’s what’s happening. That’s where a confessor comes in; a friend to whom you can turn and, in confidence, tell all. After such a mental cathartic you feel better. Perhaps the alleged chattery, gossipy habits of the fair sex are an unconscious guard against jitters. I wouldn’t dare more than suggest this possibility. Women claim men are just as gossipy.

Self-Control

AND NOW comes the question: Do

you know yourself? That’s where a doctor comes in, on the preventive side and on the treatment side as well. He is

the fact finder. Fact finding takes time.

I have, in my own office, talked with a patient for as long as three hours, scattered over several visits, before getting the facts in his background which I needed. Then came a very thorough examination.

In one case it all added up to this: another fellow was trying, with unknown success, to get his job. But. oh, what a long series of symptoms and statements you had to vade through before getting at the core!

Someone is sure to ask, “But why no remarks on overwork?” The answer is that there is no such thing. We have in each of us exactly so much work we can do in a day or a week. By developing efficient methods, we can reach a maximum higher than otherwise. There we must stop. Fatigue stops us physically, or we make such a mess that we accomplish little mentally and have to do the job over again. For a short period, in times of great stress and need, we can draw upon our reserves: ve can more nearly approach our danger line. But this ability is most limited. It is found more often in fiction than in life. It’s the steady, balanced work program, day after day, that gets you somewhere— vithout jitters. Put in another way, overtime is not necessarily overwork in terms of things accomplished. Furthermore, people today tend to meter out their time —so much for so much—more than ever before. The prime difficulty is to get so much done, if you’re a boss. Incidentally, metering your time is the answer to overwork, if you accept that term, and to the jitters and upsets and accidents arising from long active periods.

Putting the whole picture together, we

find that two factors can defeat “nerves” —planning and control. To plan we must know our own background, even to ancestry, pretty thoroughly. We must then, from early in life, proceed in well-controlled experiences along lines which are likely to be the most profitable. “Guidance”—

educational, vocational, and what not— has come into the picture to put into more formal and organized action what we used to call “good bringing up.” Guidance recognizes the whole individual.

Logically, guidance can commence at any time in life and under any conditions. Ships do not steer themselves. It is logical for man to turn to persons in his neighborhood and in his confidence, for advice along lines where he feels insecure himself. Such guidance may be in health or illness.

Nerves, in wholesale quantity, are a logical outcome of an era where devastating war cracked many humans through shell-shock and otherwise; where, war being scarcely over, we faced a deceptive prosperity which drove us to other jitters; where the back swing of the pendulum pretty nearly wrecked the world. In a world that has been jittery for over two decades, is it illogical that individual nerves should give way? We are, in a sense, dealing with the old survival of the fittest—this time, of the fittest nerves. The fellow who survives will, above all else, be the fellow who, in the broadest sense of the word—physically, mentally, socially and everything else—has the best self-control, however acquired. He may get the jitters. But if he does, he will, through personal ingenuity and wellsought aid, “snap out of it.”