The Nervous Housewife Part 12

Naturally she did not of her own accord speak of her unfaithfulness,--largely because no one knew of it. Her husband did not in the least suspect her; he thought she needed a rest, a change, little realizing how "change" had broken her down. (For after all, the most of infidelity is based on a sort of curiosity, a seeking of a new stimulus, rather than true pa.s.sion.) The truth was forced out of her when it was evident to me that something was obsessing her.

When she had confessed her difficulty the question arose as to her husband. She was no longer dissatisfied, no longer eager for romance; but could she live with him if she had been unfaithful? Ought she not to tell him; and yet she feared to do this, feared the result to him, for she felt sure he would forgive her. In reality the conflict in her mind arose first from self-depreciation and second from indecision as to confession.

As to the self-accusation, I told her that though she had been very foolish she had punished herself severely enough; that her reaction was that of an _essentially moral_ person; that an essentially immoral woman would have continued in her career, and at least would not have been so remorseful. As to confessing, I told her that I believed that if she came to peace without such a confession wisdom would dictate not to make it, and that perhaps a little romanticism was still present in the quixotic idea of confession. Discretion is sometimes the better part of veracity, and I felt sure that she would not find it difficult to forget her pain.

It may be questioned whether such advice was ethical. I am sure no two professors of ethics could agree on the matter, and where they would disagree I chose the policy of expediency. Moreover, I felt certain that Mrs. R.'s remorse did not need the purge of confession to her husband, that she was not of that deeply fixed nature which requires heroic measures. Her confession to me was sufficient, and since it was apparent that she would not repeat her folly it was not necessary to go to extremes.

The last two cases make pertinent some further remarks on s.e.x. It has previously been stated that the s.e.x field is the one in which arise many of the difficulties which breed the psychoneuroses. It would not be the place here to give details of cases, though every neurologist of experience is well aware of the neuroses that arise in marriage, among both men and women. Some day society will reach the plane where matters relating to the great function by which the world is perpetuated can be discussed with the freedom allowed to the discussion of the details of nutrition.

No one seriously doubts that women are breaking away from traditional ideas in these matters. There was a time (the Victorian Age) in the United States and England when prudery ruled supreme in the manners and dress of women. That this has largely disappeared is a good thing, but whether there is a tendency to another extreme is a matter where division of opinion will occur. A transition from long skirts to dress that will permit complete freedom of movement and resembling in a feminine way the garments of men would be unqualifiedly good. It would remove undue emphasis of s.e.x and accentuate the essential human-ness of woman. But a transition from long skirts to short tight ones, impeding movement, is the transition from prudery to pruriency and is by no means a clear gain. Plenty of scope for art and beauty might be found in a costume of which pantalettes of some kind are the basis. I doubt if women will ever be regarded quite as human beings so long as they paint, wear fantastic coiffures, hobble along on foolish heels, and are clad in over tight short skirts.

Similarly with the literature of the period. The so-called s.e.x story, the s.e.x problem, obsesses the writers. Nor are these frank, free discussions of the essential difficulties in the relation between man and woman. Usually the stories deal with the difficulties of the idle rich woman without children, or concern themselves with trivial triangles. In the type of interminable continued stories that every newspaper now carries, the woman's difficulties range around the most absurd petty jealousies, and she never seems to cook or sew or have any responsibility, and they always end so "sweetly." On the stage the epidemic of girl and music shows has quite displaced the drama. Here s.e.x is exploited to the point of the risque and sometimes beyond it.

s.e.x is overemphasized by our civilization on its distracting side, its spicy and condimental values, and underemphasized so far as its realities go. The aim seems to be to t.i.tillate s.e.x feeling constantly, and a precocious acquaintance with this form of stimulation is the lot of most city children. Such things would have no serious results to the housewife if they did not arouse expectations that marriage does not fulfill at all. This is the great harm of prurient clothes, literature, art, and stage,--it unfits people for s.e.x reality.

In how far the delayed marriages of men and women are good or bad it is almost impossible to decide. That unchast.i.ty increases with delay is a certainty, that fewer children are born is without doubt. Whether the fixation of habit makes it harder for the wife to settle down to the household, and the man less domestic, cannot be answered with yes or no. There seems to be no greater wisdom of choice shown in mature than in early marriages, though this would be best answered by an a.n.a.lysis of divorce records.

That contraceptive measures have come to stay; that they are increasing in use, the declining birth rate absolutely evidences. I take no stock in the belief that education reduces fertility through some biological effect; where it reduces fertility it does so through a knowledge of cause, effect, and prevention. Some day it will come to pa.s.s that contraceptive measures will be legal, in view of the fact that our jurists and law makers are showing a decline in the size of their own families. When that time comes the discussion of means of this kind consistent with nervous health will be frank, and some part of the neurasthenia of our modern times will disappear. The vaster racial problems that will arise are not material for discussion in this book.

Though not perhaps completely relevant to the nervousness of the housewife, it is not without some point to touch on the "neurosis of the engaged." The freedom of the engaged couple is part of the emanc.i.p.ation of youth in our time. Frankly, a love-making ensues that stops just short of the ultimate relationship, an excitement and a tension are aroused and perpetuated through the frequent and protracted meetings.

Sweet as this period of life is, in many cases it brings about a mild exhaustion, and in other cases, relatively few, a severe neurosis. On the whole the engagement period of the average American couple is not a good preparation for matrimony. How to bring about restraint without interfering with normal love-making is not an easy decision to make. But it would be possible to introduce into the teaching of hygiene the necessity of moderation in the engaged period; it would be especially of service to those whose engagement must be prolonged to be advised concerning the matter. Here is a place for the parents, the family friend, or the family physician.

Men and women as they enter matrimony are only occasionally equipped with real knowledge as to the physiology and psychology of the s.e.x life.

That a great deal of domestic dissatisfaction and unhappiness could be obviated if wisdom and experience instructed the husband and wife in the matter I have not the slightest doubt. The first rift in the domestic lute often dates from difficulties in the intimate life of the pair, difficulties that need not exist if there were knowledge. That reason and love may coexist, that the beauty of life is not dependent on a sentimentalized ignorance are cardinal in my code of beliefs. He who believes that sentiment disappears with enlightenment is the true cynic, the true pessimist. He who believes that intelligence and knowledge should guide instinct and that happiness is thus more certain is better than an optimist; he is a rationalist, a realist.

CHAPTER XII

TREATMENT OF THE INDIVIDUAL CASES

It is obvious that what is largely a problem of the times cannot be wholly considered as an individual problem. Yet individual cases do yield to treatment (to use the slang of medicine) or at least a large proportion do. The minor cases in point of symptoms are very frequently the most stubborn, since neither the patient nor the family are willing to concede that to alter the life situation is as important as the taking of medicine.

Most housewives are nervous, both in their own eyes and in those of their husbands, yet rightly they are not regarded as sick. They are uncomfortable, even unhappy, and the way out seems impossible to find. I believe that even with things as they are, adjustments are possible that can help the average woman. It is conceded that where the life situation involves an unalterable factor, relief or help may be un.o.btainable.

It is necessary first of all to rule out physical disease. To do this means a thorough physical study. By doing this a considerable number of women will be immensely helped. Flat feet, varicose veins, injuries to the organs of generation, eye strain, relaxed gastro-intestinal tract, and the major diseases,--these must be remembered as factors that may determine nervousness.

With this question settled, let us a.s.sume that there is no such difficulty or it has been remedied, and we have next to consider the life situation of the patient. Here we enter into a difficult place, where knowledge of life and understanding of men and women, as well as tact, are the essentials.

It is necessary to remedy whatever bad hygienic habits exist. A rich woman may have settled down to a deenergizing life, with too much time in bed, too many matinees, too many late nights, too many bonbons, etc.

Aside from the psychical injuries that such a life produces, it is bad for "the nerves" in its effects upon digestion, bodily tone, and the sources of mood. On some simple detail of life, some unfortunate habit, the whole structure of misery may rest.

I always keep in mind an incident of some years ago when I lived in a small town in Ma.s.sachusetts. For some reason our furnace threw coal gas into the house in such a way as nearly to poison us. The landlord sent several plumbers down, and one after the other suggested drastic remedies,--a new chimney, a new furnace, etc. Finally the landlord and I investigated for ourselves. At the bottom of the chimney we found an inconspicuous loose brick which allowed air to enter the chimney beneath the entrance of the pipe from the stove. We got ten cents' worth of lime and fastened the brick in firmly. A complete cure, where the specialists had failed.

So there often exists some drain on the energy and strength of the woman which may be simple and easily changed, and yet is critical in its significance and importance.

An overdomestic woman may stick too closely to the house; an underdomestic one may go too often to movies and suffer the fatigue of mind and body that comes from over-indulgence in this most popular indoor sport. Carelessness about the eating and the care of the bowel functions may have started a vicious chain of things leading through irritability and fatigue into neurasthenia. We say human beings are all the same, but the range of individual susceptibility to trouble is such that a difficulty not important to most people will raise havoc with others who are in most ways perfectly normal.

Look then for the bad hygiene! Look for the evils of the sedentary life Look for the root of the trouble in lack of exercise, poor habits of eating, insufficient air, disturbed sleep! Search for physical difficulties before inquiring into the psychical life.

If poverty exists, then one may inquire into the amount of work done, the character of the home, the opportunities for recreation and recuperation. All or any of the factors I have mentioned in previous chapters may be critical, and the moil and turmoil of a crowded tenement home may be responsible. That such conditions do not break all women down does not prove that they do not break _some_ women down, women with finer sensibilities, or lesser endurance (which often go together). The most depressing problems are met among the poor, the cases where one can see no way out because the social machinery is inadequate to care for its victims.

What is one to do when one meets a poor woman with three or four or more children, living in a crowded way, overworked, racked in her nerves by her fears, worries, and the disagreeable in her life, drudging from morning till night, yearning for better things, despairing of getting them, tormented by desires and ambitions that must be thwarted? "What right has a poor woman anyway to desires above her station, and why does not she resign herself to her lot?" ask the comfortable. Unfortunately philosophy and resignation are difficult even for philosophers and saints, and much more so for the aspiring woman. And our American civilization preaches "Strive, Strive!" too constantly for much philosophy and resignation of an effective kind to be found.

One must give tonics, prescribe rest, try to get social agencies interested, obtain vacations and convalescent care, etc. Can one purge a woman of futile longings and strivings, rid her of natural fears and even of absurd fears? It can be done to a limited degree, if the patient has intelligence and if one gives liberally of one's time and sympathy.

But unfortunately the consulting room for the poor is in the crowded clinic, the thronged dispensary, and how is the overworked physician to give the time and energy necessary?

For the time required is the least requirement. To deal adequately with the neurasthenic is to have unending sympathy and patience and an energy that is limitless. Without such energy or endurance the physician either slumps to a prescriber of tonics and sedatives, a dispenser of such stale advice as "Don't worry" and "You need a rest", or else himself gives out.

In dealing with the cases in the better-to-do and the rich, one has more weapons in the armamentarium. The worry is more futile here, more ridiculous, and one can attack it vigorously. Usually it is not overwork in these cases; it is monotony, boredom, discontent with something or other, a vicious circle of depressing thoughts and emotions, some difficulty in the s.e.x life, some reaction against the husband, a rebellion of a weak, futile kind against life, maladjustment of a temperament to a situation.

Some difficulties, even when ascertained and clearly understood, are insurmountable. "The truth shall make ye free" is true only in the very largest sense. Some temperaments are inborn, and are as unchangeable as the nose on one's face. In such cases the ordinary physical therapeutics help the acute symptoms that flare up now and then, and that is as much as one may expect.

But it is certain that in the majority of cases more than this may be accomplished. It is often a great surprise and relief to a woman to realize that her overconscientiousness, her fussiness, her rebellion, and discontent, her reaction to something or other is back of her symptoms. She has feared disease of the brain, tumor, insanity, or has blamed her trouble on some other definite physical basis.

If one deals with intelligence, explanation helps a great deal. The intelligent usually want to be convinced; they do not ask for miracles, they seek counsel as well as treatment.

It is my firm belief that the function of intelligence is to control instinct and emotion, and that temperament, if inborn, is not unchangeable, even at maturity. Once you convince a person that his or her symptoms are due to fear, worry, doubt, and rebellion you enlist the personal efforts to change.

A new philosophy of life must be presented. Less fussiness, less fear, more endurance, less reaction to the trifles of their life are necessary. The aimless drifter must be given a central purpose or taught to seek one; the dissatisfied and impatient must be asked, "Why should life give you all you want?" "What cannot be remedied must be endured!"

What a wealth of wisdom in the proverb! One seeks to establish an ideal of fort.i.tude, of patience, of fidelity to duty,--old-fashioned words, but serenity of spirit is their meaning. Suddenly to come face to face with one's self, to strip away the self-imposed disguise, to see clearly that jealousy, impatience, luxurious, and never satisfied tastes, a selfish and restless spirit, are back of ennui and fatigue, pains and aches of body and mind, is to step into a true self-understanding.

If a situation demands action, even drastic action, "surgical" action, then that action must be forthcoming, even though it hurts. To end doubt, perplexity, to cease being buffeted between hither and yon, is to end an intolerable life situation. I have in mind certain domestic situations, such as the effort to keep up in appearance and activity with those of more means and ability.

s.e.xual difficulties, so important and so common, demand the cooperation of the husband for remedy. He should be seen (for usually the wife consults the physician alone) and the situation gone over with him. Men are usually willing to help, willing to seek a way out. A neurasthenic wife is a sore trial to the patience and endurance of her husband and he is anxious enough to help cure her.

Where there is conflict of other kinds the situation is complicated by the intricacy of the factors. Financial difficulties especially wear down the patience and endurance of the partners, and the physician cannot prescribe a golden cure. In prosperous times there is less neurasthenia than in the unprosperous, just as there is less suicide.

Sometimes it is just one thing, one difficulty, over which the conflict rages. I have in mind two such cases, where one habit of the husband deenergized his wife by outraging her pride and love. When he was induced to yield on this point the wife came back to herself,--a highly strung, very efficient self.

In fact, the basis of treatment is the painstaking study of the individual woman and then the painstaking _adjustment_ of that individual woman. It may mean the adjustment of the whole life situation to that housewife, or conversely the adjustment of the housewife to the life situation.

In many marital difficulties that one sees, not so much in practice as in contact with normal married couples, the trouble reminds one of the orang-outang in Kipling's story who had "too much Ego in his Cosmos."

Marriage, to be successful, is based on a graceful recession of the ego in the cosmos of each of the partners. The prime difficulty is this; people do not like to recede the ego. And the worst offenders are the ones who are determined to stand up for the right, which usually is a disguised way of naming their desire.

One might speak of a thousand and one things that every man and every woman knows. One might speak of the death of love and the growth of irritation, the disappearance of sympathy,--these are the hopeless situations. But far more common and important, though less tragic, is the disappearance of the little attentions, the little love-making, the disappearance of good manners. Men are not the only or the worst offenders in this; the nervous housewife is very apt to be the scold and the nag. Perhaps the neurasthenia of the husband arises from his revolt against the incessant demands of his wife, but that's another story.

At any rate, there is what seems to be a cardinal point of difference between men and women, perhaps arising from some essential difference in make-up, perhaps in part due to difference in training. An essential need of the average American-trained woman is sympathy, constantly expressed, constantly manifested. The average man tends to become matter-of-fact, the average woman finds in matter-of-factness the death of love. She acts as if she believed that the little acts of love and sympathy are the more important as manifesting the real state of feeling, that the major duties were of less importance.

On this point most men and women never seem to agree. The man gets impatient over the constant demand for his attention. He thinks it unreasonable and childish. Intent upon his own struggle he is apt to think her affairs are minor matters. He thinks his wife makes mountains out of molehills and lacks a sense of proportion. He forgets that the devotion of the husband is the woman's anchor to windward, her grip on safety,--that his success and struggle are hers only in so far as he and she are intimate and lover-like. And women, even those who trust their husbands absolutely so far as physical loyalty goes, jealously watch them for the appearance of boredom, or lack of interest, for the falling off of the lover's spirit and feeling.

After marriage the rivalry of men expresses itself in business more than in love. Even where a woman does not fear another woman as a rival she fears the rivalry of business,--and with reason. So she craves attention, sympathy, as well as the dull love of everyday life. She ought to have it; it is her recompense for her lot, for her married life, her smaller interests. Now and then some great man intent upon a great work has some excuse for absorption in that work; for the great majority of men there is no such excuse. Their own affairs are also minor and are no more important than those of their wives. Fair play demands that the women they have immured in a home have a prior claim to their company, in at least the majority of the leisure hours. If in the time to come the home alters and a woman who continues to work marries a man who works, and they meet only at night, then it will be ethical for each to go his or her way. Marriage at present must mean the giving up of freedom for the man as well as for the woman, in the interests of justice and the race.

In medicine we prescribe bitter tonics which have the property of increasing appet.i.te and vigor. For the husband of every woman there is this bit of advice; sympathy and attention const.i.tute a sweet tonic, which if judiciously administered is of incomparable power and efficiency.