You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In commenting on the chaotic terminology of medical psychology the author explains his use of terms such as Regression, Narcissism, Reality and Pleasure Principle. He discards the term Libido, however, in favour of 'Instinct Interest.'
It is noteworthy that the idea of death is frequently present in the neurotic mind, but absent in the physical illness. The impulse of death in the mind of the melancholiac becomes less pronounced when physical disease occurs. Connell maintains that this impulse is due to affective tension denied conative expression and unable to attach itself through regression to imaginative phantasy. The idea of death varies with the intensity of the excitement suspended between the Reality and Pleasure Principle functions. In discussing the death impulse in Melancholia, the author rejects Freud's theory of projection of hate on to the Ego on the grounds that recovery occurs, and that such projection does not relieve or comfort the melancholiac. He continues to dispute the question of projection in melancholia by comparing this psychosis with paranoia. In melancholia the affect remains unpleasurable and exists as a tension which produces the death impulse. In paranoia the affect invests the Self by projection, regression within the delusion occurring to make it one of grandeur. The absence of the suicidal impulse in paranoia is explained by this mechanism of projection.
Psychoneurotics toy with the idea of death, the most serious attempts occurring in the case of Anxiety Hysteria. The neurotic's idea of death is equivalent to quiescence and is not dealt with objectively. It is part of the pleasure principle and possesses no reality. Discussing physiological changes due to the activity of the endocrine glands, the author observes that the death tendency is absent in Graves' Disease, whereas it is present in Anxiety Hysteria. The hypothesis that hyperactivity of sex gland secretion acts on the vagus and produces vagotonus, which in turn be