The psychologic understanding of erroneous actions apparently gains little in clearness when we place it under the head of "ataxia," and especially under "cortical ataxia. To do this I shall again resort to personal observations, the opportunities for which I could not very frequently find in myself.
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When I investigated in what patients' homes this occurred, I had to admit that the faulty action -- taking out my key instead of ringing the bell -- signified paying a certain tribute to the house where the error occurred. It was equivalent to the thought "Here I feel at home," as it happened only where I possessed the patient's regard. Naturally, I never rang my own bell. The faulty action was therefore a symbolic representation of a definite thought which was not accepted consciously as serious; for in reality the neurologist is well aware that the patient seeks him only so long as he expects to be benefited by him and that his own excessively warm interest for his patient is evinced only as a means of psychic treatment.
An almost identical repetition of my experience is described by A. Maeder "Contrib.
Treating the ‘idiot’ child in early 20th‐century Ontario: Disability & Society: Vol 21, No 1
Jones speaks as follows about the use of keys [ 2 ] "The use of keys is a fertile source of occurrences of this kind, of which two examples may be given. If I am disturbed in the midst of some engrossing work at home by having to go to the hospital to carry out some routine work, I am very apt to find myself trying to open the door of my laboratory there with the key of my desk at home, although the two keys are quite unlike each other.
The mistake uncon- [p. On several occasions I found myself making serious attempts to open the door with my house key. Each one of the permanent visiting staff, of which I aspired to be a member, was provided with a key to avoid the trouble of having to wait at the door. My mistake thus expressed the desire to be on a similar footing and to be quite 'at home' there.
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A similar experience is reported by Dr. Hans Sachs of Vienna: "I always carry two keys with me, one for the door of my office and one for my residence. They are not by any means easily interchanged, as the office key is at least three times as big as my house key. Besides, I carry the first in my trouser pocket and the other in my vest pocket. Yet it often happened that I noticed on reaching the door that while ascending the stairs I had taken out the wrong key. I decided to undertake a statistical examination; as I was daily in about the same emotional state when I stood before both doors, I thought that the interchanging of the two keys must show a regular tendency, if they were differently determined psychically.
Observation of later occur- [p. Only on one occasion was this reversed: I came home tired, knowing that I would find there a guest. I made an attempt to unlock the door with the, naturally too big, office key.
On the first of these occasions I was in an ambitious day-dream, which allowed me to "mount always higher and higher. On the other occasion I again went too far "engrossed in thought. One day I hurried off at the close of my office hours, as I wished to catch a certain train, and, despite broad daylight, put the tuning-fork in my coat [p. My attention was called to the mistake through the weight of the object drawing down my pocket.
Any one unaccustomed to reflect on such slight occurrences would without hesitation explain the faulty action by the hurry of the moment, and excuse it. In spite of that, I preferred to ask myself why I took the tuning-fork instead of the hammer.
The haste could just as well have been a motive for carrying out the action properly in order not to waste time over the correction. It happened that only a few days ago an idiotic child, whose attention to sensory impressions I was testing, had been so fascinated by the tuning-fork that I found it difficult to tear it away from him. Could it mean, therefore, that I was an idiot? To be sure, so it would seem, as the next thought which associated itself with the hammer was chamer Hebrew for "ass". But what was the meaning of this abusive language?
We must here inquire into the situation.
I hurried to a consultation at a place on the Western railroad to see a patient who, according to the anamnesis which I received by letter, had fallen from a balcony some months before, and since then had been unable to walk. The physician w ho invited me wrote that he was [p.
That was what I was to decide. This could therefore be a reminder to be particularly careful in this delicate differential diagnosis.
As it is, my colleagues think that hysteria is diagnosed far too carelessly where more serious matters are concerned. But the abuse is not yet justified. Yes, the next association was that the small railroad station is the same place in which, some years previous, I saw a young man who, after a certain emotional experience, could not walk properly.
At that time I diagnosed his malady as hysteria, and later put him under psychic treatment; but it afterward turned out that my diagnosis was neither incorrect nor correct. A large number of the patient's symptoms were hysterical, and they promptly disappeared in the course of treatment. But back of these there was a visible remnant that could not be reached by therapy, and could be referred only to a multiple sclerosis.
Those who saw the patient after me had no difficulty in recognizing the organic affection. I could scarcely have acted or judged differently, still the impression was that of a serious mistake; the promise of a cure which I had given him could naturally not be kept.
The mistake in grasping the tuning-fork instead of the hammer could therefore be trans- [p. We observe that this time it is the voice of self-criticism which makes itself perceptible through the mistake in grasping. The erroneously carried-out action is specially suited to express self-reproach. The present mistake attempts to represent the mistake which was committed elsewhere. Here is a first example: It is very seldom that I break anything.
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I am not particularly dexterous, but by virtue of the anatomic integrity of my nervous and muscular apparatus there are apparently no grounds in me for such awkward movements with undesirable results. I can recall no object in my home the counterpart of which I have ever broken. Owing to the narrowness of my study it has often been necessary for me to work in the most uncomfortable position among my numerous [p.
So much is this true that onlookers have expressed fear lest I topple down something and shatter it. But it never happened. Then why did I brush to the floor the cover of my simple inkwell so that it broke into pieces? My inkstand is made of a flat piece of marble which is hollowed out for the reception of the glass inkwell; the inkwell has a marble cover with a knob of the same stone.
A circle of bronze statuettes with small terra-cotta figures is set behind this inkstand. I seated myself at the desk to write, I made a remarkably awkward outward movement with the hand holding the pen-holder, and so swept the cover of the ink-stand, which already lay on the desk, to the floor. It is not difficult to find the explanation. Some hours before my sister had been in the room to look at some of my new acquisitions.
She found them very pretty, and then remarked: "Now the desk really looks very well, only the inkstand does not match. You must get a prettier one. But then, as it seems, I performed the execution of the condemned inkstand. Did I perhaps conclude from my sister's words that she intended to present me with a prettier inkstand on the next festive occasion, and did [p. If that be so, then my swinging motion was only apparently awkward; in reality it was most skilful and designed, as it understood how to avoid all the valuable objects located near it. I actually believe that we must accept this explanation of the whole series of seemingly accidental awkward movements.
It is true that on the surface these seem to show something violent and irregular, similar to spastic-ataxic movements, but on examination they seem to be dominated by some intention, and they accomplish their aim with a certainty that cannot be generally credited to conscious arbitrary motions. In both characteristics, the force as well as the sure aim, they show besides a resemblance to the motor manifestations of the hysterical neurosis, and in part also to the motor accomplishments of somnambulism, which here as well as there point to the same unfamiliar modification of the functions of innervation.
In latter years, since I have been collecting such observations, it has happened several times that I have shattered and broken objects of some value, but the examination of these cases convinced me that it was never the result of accident or of my unintentional awkwardness. Thus, one morning while in my bath-robe and straw slippers I followed a sudden impulse as I passed a room, [p. As it fell to pieces I recited quite unmoved the following verse from Busch This crazy action and my calmness at the sight of the damage is explained in the then existing situation.