The Collected Clinical Works of Alfred Adler, Volume 10: Case Readings and Demonstrations by Alfred Adler

Author:Alfred Adler [Adler, Alfred]
Language: eng
Format: mobi
Publisher: The Alfred Adler Institute of Northwestern Washington
Published: 2008-04-29T05:00:00+00:00

Part 2

5

The Pattern of Life4

Originally published in 1930 by Cosmopolitan Book Corporation. The lengthy, introductory essay, titled “Adler and our Neurotic World,” by W. Beran Wolfe, has been omitted from this volume. 5 Additional editing and re-formatting by Henry T. Stein, Ph.D., 2005.

Chapter I

A Gesture of the Whole Body

An Adult Woman

This evening we have the problem of Miss Flora, whose chief complaint is that for years she has been subject to attacks of unconsciousness. She lives with her mother, father, two younger and two older brothers, and two young children. The relationships in the home are very congenial, and the patient, who is the only girl, has always had her own way and has been distinctly favored by the father.

Now when we hear of attacks of unconsciousness we think immediately of epilepsy, but epilepsy is a word that is very loosely used to describe a variety of illnesses. The differential diagnosis is sometimes exceedingly hard to make and is entirely the concern of the physician. Usually people who suffer from epilepsy are facing great difficulties in their lives, and, these difficulties being mirrored in their mental attitude, it is sometimes hard to decide where the organic disease leaves off and its mental superstructure begins. Epilepsy has always been called a sickness, because up to the present time epileptics have been taken care of by physicians. It is rather similar to the attitude of laymen toward the neuroses, which were previously always called hysteria.

There are a number of symptoms that are highly significant in the differential diagnosis between a true epilepsy and a simulated epilepsy. In a real epileptic attack the pupils of the eyes are dilated and do not react to light. This is one of the most important signs of an organic epilepsy. So far nothing like this sign is mentioned in the case history of Flora. The second important symptom is the presence of the Babinski reflex during the fainting spells. To test the Babinski reflex we stroke the sole of the foot and find that the great toe rises (toward the dorsum of the foot) instead of moving downward as one would normally expect. The Babinski reflex signifies that an injury has occurred to a certain part of the brain and this injury prevents the passage of the nervous impulse along its usual routes. There are other symptoms that point to the presence of a true epilepsy. Sometimes one finds small hemorrhages below the skin, especially behind the ear; often the epileptic patient bites his tongue during the attack, and we find that his saliva is bloody. Frequently, too, the epileptic falls and hurts himself during his attack.

The epileptic often has a fleeting presentiment that the attack will occur. We call this the aura, which varies in its form but is usually present.

This group of symptoms, which are present in a true epilepsy, distinguishes it from other fainting attacks of an hysterical nature, in which the person feels himself injured, hopeless, and powerless, and expresses his attitude in a gesture of his entire body.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.