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MODERN civilization would not last long if human beings lost their conscien tious regard for the sanctity of their pledges and lapsed into indifference regarding personal, social, and moral obligations. Modern business is transacted largely on the basis of mutual confidence, and it is worth a great deal to have it said of us, “His word is as good as his bond.” Nevertheless, every physician who has much to do with nervous troubles and emotional disorders soon comes to recognize that thousands of well-meaning individuals are suffering from mental torture and various nervous disorders as the result of overworking the conscience.
I am very sure we could not get along without conscience, but at the same time it seems a pity that so many splendid men and women should make themselves ill by overscrupulousness. Certainly it is possible to find out how to live conscientiously without having to suffer the tortures of what we have come to regard as the conscience complex.
“Doctor, this thing is just driving me wild. I simply can’t make things go. I have tried my best, but I have made a perfect failure of it.” This is the way a middle-aged woman of hyperconscientious temperament introduced her story to me the other day. This good lady, a few years ago, had heard a sermon on the Scripture text, “But I say unto you, That every idle word that men shall speak, they shall give account thereof in the day of judgment.” She took it seriously, literally, and began to think of all the social palaver, the frivolous chit-chat, and the various other ways in which we loosely use words-not to mention our humor and jokes—and made up her mind that her social circle folks would have much to account for on the day of judgment. She decided to reform her own communications in this respect, and so she largely lost humor out of her life, ceased to tell funny stories, and could not make a social call without condemnation by her own conscience because of the use of idle words.
You can imagine her condition after one month of trying to live this artificial and unnatural life. Her digestion became affected, her sleep was disturbed, her religion was all but ruined, and her happiness had vanished. Her husband became so alarmed that he took her to see a doctor.
And this is but an introduction to the story I want to tell you about conscience in relation to health. I am meeting people all the time who are sick because of conscientious worries, and I want to discuss some of these cases with a view to helping thousands of others who may be in needless trouble with their consciences.
I can do no better than to outline here the method I had to use in the case of this poor soul who had gotten into such a jam with her conscience. In the first place I had to explain to her that conscience was not what she thought it was—“The voice of God to the soul.” I [p. 153] don’t know just where that definition of conscience had origin, but it must have been at the hands of one of the poets. It may, in a way, embody a beautiful sentiment, but it is not true, and in this respect it recalls the quip of the humorist who said that it was “better not to know so much than to know so much that ain’t so.” Conscience is nothing more nor less than the inward sense of our inherited and acquired standards of right and wrong. Conscience is dependent upon education and training, and is tremendously influenced by our associates and environment.
Conscience is a state of mind that tells us always to do right; it never tells us what is right. I tried to make it clear to the woman in question that other mental powers must be brought into service to find out what is right—judgment, reason, idea discrimination, and choicethat it is the part of the other mental powers to determine what is right in the circumstances, and that conscience is merely the monitor which admonishes us to do the right thing after we have thus determined it. I had to explain to her that it was wrong to offend her neighbors by not visiting with them; that the second great commandment of Jesus was to “love your neighbor as yourself.” I had to remind her of the doctrine that Christ came that our “joy might be full”; that we were to “cast our burdens on the Lord” and “rejoice evermore.” I had to look up a lot of texts for this woman, such as “A merry heart doeth good like a medicine.”
I found her religion was all soured and mildewed, and it was no small job to get it sweetened up, but we succeeded. She is getting back into normal ways of living, and is regaining her health; but six months or a year of this sort of foolish living had about spoiled her disposition. I had to remind her that it was conscience that led the zealous Hindu mother to throw her helpless babe into the jaws of the crocodile-until the British authorities put a stop to it. Conscience has led many people, in times of ignorance, to commit acts that we now call crimes. Conscience has been behind many a fanatical and horrible persecution, and to-day we see that it still leads its willing victims into paths of disease and ill health.
Different races have different conscientious reactions in the presence of the same situations. In this connection we must remember that we are all confronted with the problem of adapting our primitive instincts and emotions to the demands of civilization, and that conscience is not equal to the task of sitting as sole judge and arbiter of the conflicts which this problem entails.
A dozen chapters could be filled with true stories of well-meaning men and women, young and old, who have made themselves ill and unhappy by allowing the ir consciences to intrude into unwarranted realms and thus unnecessarily to interfere with their pleasures, decisions, and habits of living; but, fortunately, there is no mental twist or intellectual kink of this kind that the average individual can not straighten out if he goes about it with a will.
Much of our trouble with conscience grows out of the teaching of the Puritans, which rather inclined to the idea that if anything was pleasurable it was sinful. As soon as some overconscientious souls find out that something is enjoyable—that they are having fun—they rein themselves up suddenly and look around to find out what is wrong. They have an idea that they can’t have a good time until they get to heaven—that this world is a “vale of tears,” and that there is no use looking for a good time here below. Of course, this mental attitude [p. 154] fosters and augments the hyperconscientious tendencies which so many people have.
Far be it from me to decry the conscientious tendency in the human species. I merely want to see that it is used and not abused. I want it to be so utilized as to help us enjoy better health and a larger measure of happiness. As a physician, I well know that wrongdoing is at the bottom of a large amount of sickness and suffering. Immorality is the cause of a tremendous amount of modern disease, and the guilty conscience, one that is rightfully guilty, predisposes to worry, nervousness, and even semi-invalidism; but fear is not only the handmaiden of sin; fear comes to be misapplied to a great many innocent and harmless things in life.
We all recognize the value of so living as to have “a conscience void of offense toward God and toward man.” We know that sin is at the bottom of a great deal of human misery; but we should also know that worry and fear, when hooked up with conscience, are able to torment and torture the innocent soul, and through a misunderstanding of conscience, produce ill health and unhappiness.
I have as a patient a woman who was more or less nervous; when she got tired out and worried, her digestion went on a strike; and, as was only natural when she had these stomach-upsets, she would think back and remember what she ate at the last meal. If she had eaten tomatoes, she perhaps would recognize a little of the tomato flavor when belching, and would come to the conclusion that tomatoes had upset her digestion; therefore, she wouldn’t eat tomatoes any more.
After six or eight years of this, she came to the place where there wasn’t anything left but baby food and a few special invalid preparations. From 150 pounds she had gone down to 91 . In the midst of this worry about her digestion she began reading all the books she could find on diet, and soon had a religious twist to her dietetic practises. She decided, rightfully enough, that the laws of health were the laws of God, and thus her dietetic worries were also of a conscientious nature.
I remember well the first time I talked with her. She quoted the text to me that our bodies are “the temple of the Holy Ghost.” That is good Scripture, and I think some careless and conscienceless folks would do well to remember it; but this poor soul needed rather to get hold of that text describing how the early apostles “ate their meat with gladness.” After explaining the difference between diet and religion, and making it clear to her that her stomach trouble was altogether due to her upset nerves, I administered a few months of reeducation along these lines, with definite periods of rest in the middle of each day. She is now learning to manage her conscience when it talks to her in a foolish way about eating, and she is making a steady gain in weight.
This woman still has a standard of right and wrong about eating. Conscience has a domain in which she allows it to function, but she does not allow it to dictate as to whether she shall have her potatoes fried or baked. She has learned that when she is not tired out nervously she can digest fried potatoes just as well as baked potatoes. The eating of fried [p. 155] potatoes, by the way, was one of the dietetic practises she regarded as a sin. She read somewhere that when potatoes are fried the starch becomes smeared over with oil and can’t be digested. I had to explain to her that if it was not digested in the mouth and stomach, farther on in the digestive tract old Mother Nature had provided a means for performing just such digestive feats, and that it was a shame not to make use occasionally of Nature’s provision and thus to keep the machinery limbered up.
Of course, I know that some people should give more conscientious attention to their diet. I have a patient now, a man about fifty years old, who is living on the scavengers of the earth, sea, and sky, and is going to check out of this life ten or twelve years earlier than he would if he would consult his conscience in regard to what he eats and drinks; but I am not discussing that case now; I am talking about the folks who make themselves sick by hyper-conscientious worry.
Let me tell you about a man, now thirty-five years of age, who has made a religion of physical exercise. He thinks he must go through certain exercises every morning, walk so many miles each day, do just the same number of exercises each evening before he retires. I think he has allowed his conscience to intrude into everything he does of a physical nature, unless it be yawning; he can still yawn as Nature wants him to, I believe; but everything else must be done systematically, by rule; yes, by conscientious rule.
He was greatly bene fited years ago by his devotion to physical exe rcise. It did improve his health and efficiency, but this idea has grown in his mind until he has allowed his physical culture fad to become an annex to his religion. He actually told me not long ago that he went to church one Sunday and didn’t enjoy the service because his conscience told him he had not taken his regular amount of exercise the week before. He thinks exercise, talks exercise, almost eats exercise. His wife and friends think he is becoming a nuisance. His outdoor social life is spoiled because he can’t do anything as other people do-because he must have a certain amount of exercise in a certain way.
What are we doing for him? How are we going to set him straight on this point without upsetting his conscience in moral matters? We are attempting to have him redefine conscience to his own mind, and are explaining to him the value of being more free and spontaneous in health practises; showing him the danger of monotony, pointing out that he should vary his exercises, that he should be able, if the occasion requires, to do without them one day and then return to them the next day. We are trying to show him, in short, that he is a slave to his own system; and already we are beginning to succeed.
I have a patient at the present time, an earnest soul, who thought it was wrong to engage in an innocent pastime that all the rest of her family indulged in; but she did not wish to be queer, so she gave in and did what the rest of her family did. And then her conscience began to worry her. In less than three months her health was wrecked; insomnia, indigestion, and various other ills came to distress and plague her; she was a sick woman, ready to take to her bed, all because her conscience worried her over this simple little matter.
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She is getting well now because we persuaded her to take this pastime out of the realm of conscience; told her that conscience was an intruder, that this was a matter of personal choice. She has come to see that it is far better to play with her family and to keep in touch with them, than to indulge what she now says was her conscientious ego. She now regards her hyperconscientious reaction as Pharisaical.
I know an overconscientious physician, a splendid doctor, who broke down worrying over his patients. In taking care of an accident case, he not only showed ordinary human sympathy, but went through nervous reactions that might make you think he was responsible for the accident. I once asked him, while he was taking care of a patient who had been injured by an automobile, “Did you run over the man?” “Why, no,” he said. In his surgical work he not only took the ordinary precautions, and even extra precautions, but allowed conscience, in an unnecessary and harmful degree, to intrude itself. In spite of warnings, he persisted in this overwork, overworry, overanxiety; the result was a breakdown, and it will probably be a year before he ministers again to ailing humanity. I think he has learned his lesson.
Here is another case: a school teacher, thirty-seven years old, a hyperconscientious woman, easily the best teacher in the group to which she belonged. Not satisfied with being an ordinarily good teacher, even the best in her school, she was so overconscientious (and I think there was an element of personal pride, professional egotism, also) that she worked early and late; put in uncalled—for extra time on two or three backward pupils; attended everything that had to do with teachers and teaching; was the leader and moving spirit of the Parent-Teacher Association; took advanced work every summer for ten or twelve years; never had a real vacation. Result, a sudden breakdown. For a year now she has been resting, and she said to me the other day: “Doctor, I have learned my lesson. I am not going to try to be the best teacher in the world any more. I am going to be among the best teachers. I am going to do an honest day’s work, but I am not going to allow conscience to tyrannize over me any longer. This breakdown has educated my conscience, and told it a few things it didn’t know. Some other things my conscience made me do to be a good teacher, in years gone by, my reeducated conscience will not allow me to do in the future. I have learned that I have a duty to myself and my family as well as to my school and its pupils.”
Experiences by the score could be related which would go to show how the overconscientious mother may ruin her health, break down her constitution, by unduly ministering to a sometimes not altogether appreciative family. When parents have done their duty to their children, why should they worry? Maybe later on the children will not act just as we would like to have them. Maybe they will have a program of their own and will run away from [p. 157] home to carry it out, or skip out to get married. Why should father and mother—particularly mother, for she seems more inclined in this direction—lessen their usefulness, diminish the ir efficiency, jeopardize their health, not to say happiness, by overconscientious worry and useless regret regarding these family episodes, which seem to be a part of life on this planet, and which happen even in the best of families.
A few years ago I had under my care a splendid young mother, about twenty-six years of age, who had three small children. She went completely to pieces. There was nothing the matter with her except overconscientious attention to her family, particularly the children. She was one of those who get up in the middle of the night and go to the bedside of the children to see if they are breathing all right, are covered, and so on. She was constantly worrying over their feeding, and when she stopped to think that the oldest one would have to go to school in a year or two, it was too much for her. How could she bear to have her children out of sight? Something certainly would go wrong in school—they would get hurt, catch diseases, meet bad companions. As the result of all this she simply went to pieces, and for eighteen months had to stay away from her family. Her children had to be left in the care of a stranger, and the father told me, confidentially, that they did very much better in the hands of the practical nurse; that they developed more character than they did under their mother’s solicitous care. It would crush her, all but kill her, no doubt, if we were to tell her that; yet even she has begun to realize, in the last year, that children have a habit of growing up in spite of everything.
All this is not said to detract from the value of intelligent and faithful parental training. These are necessary; but why ruin your health by overanxiety? When you have done your duty, why not be satisfied? The trouble is that certain people are born with this overanxious tendency. They develop it sometimes to the point where we call it an anxiety neurosis, and when they happen, besides, to be of the overconscientious type, the combination means serious trouble unless these tendencies are recognized and early brought under proper control.
Then there is the case of the overconscientious sons or daughters who devote their lives to taking care of their parents. Their spirit is beautiful, like that of a mother’s devotion to her child; but how disastrous it is, say, for a young woman—maybe the youngest of three or four children, all the rest married and settled down—to devote her life to taking care of father and mother, perhaps going occasionally to help her sisters or sisters-in-law when there is to be an addition to the family, and meanwhile toiling as a teacher or at some other vocation to make a comfortable home for one or both of the parents!
It is beautiful, but it is a sad spectacle when the parents pass on, and this old maid sister is unwelcome in the homes of any of her married brothers and sisters. She is too old to teach school. She can’t enjoy the company and affection of the children of other parents, and so her health fails, and she finds herself somewhere between forty-five and sixty years of age, sitting in a doctor’s office broken in heart and in health. Of course, it is too late then, but she [p. 158] sees clearly that she should have married like her brothers and sisters, and then they all together should have cared for the father and mother; or that the son or daughter most favorably situated should have borne the burden.
Just the other day I saw a man of forty-seven, unhappy and discontented. He has only one satisfaction in life—the knowledge that he has sacrificed everything for his parents. Five brothers and sisters are happily married and have children of their own, and now this lone bachelor is beginning to become cynical and bitter. He is soured on the world. He considers taking care of his parents an unpleasant duty. He is determined to see it through, but life for him is all but ruined.
The obligation to care for parents is real and genuine, but who is going to care for the old bachelor or old maid? Have they no rights in this situation? Children can be selfish, but parents can become very selfish, too, and I believe every parent is selfish who monopolizes the lifetime of a son or a daughter, thus making it impossible for him or her to marry and live a normal life. In cases where for some other reason a son or daughter does not get married, I grant you, it seems only natural that such unmarried children should live with their parents and make a home for them in their old age. I do not have such voluntary associations in mind; I refer not to such cases, but to those in which the son or daughter has definitely refused to marry in order to care for the parents. That, I believe, is both wrong and unnatural, and results in a tragedy in later life.
Even the Saviour, when offering up His life on the cross and beholding His mother, did not suspend His work for the world, but called the attention of His disciple John to His mother and asked John to look out for her. He went on with His life work. I am willing to recognize that this care of parents may be our supreme obligation next to the living of our lives, but I cannot conceive that it is right to allow overconscientious devotion to such a duty utterly to nullify one’s life’s program.
Then we see this hyperconscientiousness in other family relations. I have in mind two sisters who are trying to live together. As time goes on, their personalities are developing, and each has more and more of a desire to live her own life; but they are always fearful of hurting each other’s feelings. They keep themselves in hot water all the time because one of them can’t do anything without trying to explain it to the other. If they would go right ahead and live their lives and get over this squeamishness about hurting the other’s feelings, it would be much better; but they are overconscientious, and so unhappy. I had to sit down and explain to them not long ago, when they came to me with their troubles, that if each one of them would go about her business, and be natural and normal, and not feel that she had to live as the other lived, within a year’s time they would be fairly happy.
It would be well for all of us to realize that when people in the same family try to live together after growing up, they are going against Nature. It is the plan of Mother Nature to scatter families and thus to work against inbreeding. She seems to want a widespread distribution of the germ plasm of the race, and so she sees to it that the task of living together [p. 159] becomes more and more difficult as we grow older.
All that I have said about hyperconscientiousness in the family applies to husbands and wives in their daily efforts to get along together. I don’t often see cases of this sort; but occasionally a wife becomes overconscientious as to her duties in the home aside from the children. Another thing: I wish especially to warn parents against worrying over their failure wholly to eradicate inherited traits in their children. Remember that children inherit not from their parents but rather through their parents, and that when you have done your duty as parents to overcome defective heredity in your children, you can cease to worry about it. Let them go out into the game of life, and there gain that experience which will admonish them to put forth personal efforts to correct these inherent weaknesses. Parents are responsible only for doing their duty; they can’t make over their diversified children; they have to accept them as they are born and make the best of their hereditary endow ments.
Several years ago I had a city missionary who worried over her religious prospects. After studying her for a number of weeks, I became convinced it was a case of worry, pure and simple. I told her she would have to get another brand of religion. That was a great shocknot only to hear that there was something wrong with her religion, but to have a doctor suggest that her physical troubles were rooted in her religious experience.
I asked her to go home and think the matter over; but before she left the office, I told her the story of a feeble-minded boy, who when he went on his pony to the mill for chop-feed, came riding home with the two-bushel sack on his shoulder. When asked why he didn’t put the sack down on the horse and sit on top of it, he wrinkled his brow, scratched his head, and said, “Well, I reckon if the horse is willing to carry me, I ought to be willing to carry the feed.” I tried to illustrate to this missionary that the good Lord had no more trouble carrying her on top of her burdens than underneath them; He had to carry them all anyway. She came back in a few days to tell me that my efforts had been successful, that my story had turned the trick, that she really had found a new religion, or rather, as she expressed it, “not a new religion, but a new dip in my old religion.” She had come to see a new meaning in “Cast all your care upon Him, for He careth for you,” “Come unto me all ye that are weary and heavy laden, and I will give you rest.” And she recovered.
At the present time I have a very interesting case on my hands; I suppose he would be called a professional reformer. He has worked so hard and so continuously, trying to make the world over, trying to get everybody to do things just as he does them, that he has broken down—gone to pieces trying to save the world. Now, I am willing to subscribe to the idea that every human should try to make the world a better place to live in, but I think the task ought to be handled with some sense of values and proportions. Why should we get sick trying to make everybody do some trifling thing just the way we do it? I know that this is ticklish ground I am treading on, for we all have our pet hobbies, and I have no wish to quarrel with a single reader; but I insist that it is not a wise expenditure of energy to break [p. 160] down your health trying to reform the world. You won’t be a success as a reformer if you are sick, grouchy, and a victim of chronic worry.
If this uplift business is so good, get other people in it with you. Don’t be so egotistic as to think you are the only one who can do it. Share this splendid enterprise with your friends and neighbors, and thus save your own health and contribute to the spiritual edification of your friends.
A number of years ago I met a man who had ruined his life through yielding to the tendency to be overscrupulous. He had been an average, normal boy, and it was not until adolescence, when he was about fourteen years of age, that this tendency to worry, and to worry conscientiously, began to manifest itself in his experience.
He was so overconscientious in his high school work that he would study until 2 o’clock in the morning to try to be absolutely perfect in his lessons, and then he would apply himself to athletic activities with the same religious ardor. He had no fun in any of these; the games were a duty to him, a stern duty to do his best—not his best in the ordinary sense, but in a religious, hyper-conscientious sense. In college this young man broke down after the first year. He took everything, including himself, so seriously. After his collapse at college, his parents sent him west to the ranch of a relative, and out in that country some young woman chanced to lose her heart, became infatuated with him, and then he all but had a second collapse. His conscience wouldn’t let him fall in love with this girl, because he was not in the best of health and not prepared to marry. But he worried over her. He would be everlastingly responsible if anything happened to the girl, if she should break down or go crazy through her love for him; so this young fellow really did the best he could to go crazy himself. He became hysterical, and for months was almost unmanageable. I suppose the only reason he didn’t go insane was that he didn’t have that tendency in the family. What he inherited was the tendency to hyperconscientiousness, not to insanity.
They had to bring him away from the ranch, of course, and then for more than two years he moped and worried over what would happen to this poor girl. He couldn’t write to her; that would encourage her; and if he didn’t write, she might go insane, and then he would be responsible. After two years of careful planning and hard work, we succeeded in directing his mind in other channels, and he was getting along finely when up in his section of the city they started revival meetings; after attending two or three of these meetings, with their emotional appeal and their effort to quicken conscience, he was all astir once more. He made up his mind that his sufferings were due to the fact that he never really had been converted, that he had never been right with God. He heard a sermon one evening on the text, “Whoso covereth his sins shall not prosper.” He looked himself over and decided that he had not prospered, and immediately came to the conclusion that he had been covering his sins. He gave up his position. He spent weeks and weeks trying to get right with God, talking of his sins and confessing them. He prayed and prayed, and of course his parents became alarmed again. I tried to reassure them, but a sister, who was a little bit on the same order, began to [p. 161] worry over him, and the whole household was again thoroughly upset.
This went on all winter and into the spring and summer; he was relieved only by patient effort and by getting him away for the summer to a boy’s camp, where he acted as an instructor in certain activities and otherwise participated in recreations and outings. He came back in the autumn fairly well, and obtained a new position; but within a few weeks a situation arose, a very ordinary one in business, in which he was requested to keep still; it was a sort of commercial confidence, but when he was admonished to say nothing about it, his conscience bothered him. Could it be anything wrong? If everything were all right, why should he be asked not to disclose these secrets? By Christmas time he was in deep water, and his conscience compelled him to resign his position. To make a long story short, there is a list of twenty-five positions which this man held from the time he was twenty-five years of age until he was forty.
And now what has happened? He began to grow more philosophical as he neared forty, and concluded that he had been foolish about this matter of conscience. He looked back over his life and decided that conscience had been a tyrant, a slave-driver, and that he was going to be free of it; but instead of acting on his philosophy, keeping his feet on the ground, and proceeding in a sane and sensible manner, he flopped over to the other extreme. He decided that life was meant to be lived and enjoyed, and so for six or eight months he cut loose to have a good time, and went in for all the amusements and questionable entertainments that he formerly had shunned; and when he failed to get peace of mind and comfort of soul out of this life, he reverted to one of his conscientious spells of depression, and this time he had real trouble. He knew he had done wrong; no question in his mind about the sin of his recent experience. In his efforts to set himself right with God, he encountered the mental difficulty that he had deliberately gone into evil, that he had committed the unpardonable sin, and so on. It took another year of effort on the part of friends, ministers, and doctors, to try to straighten him out. But he then started in to worrying over the fact that he had never married, that he hadn’t done his duty to the world, that he never would be happy now. He had no wife and children to comfort him. Pretty soon he would be an old man.
I could fill a whole chapter with the story of this one man and the way he wrecked his career, making himself a nuisance to himself and all his associates. His aged mother’s chief worry is still this wabbly, unbalanced, hyperconscientious boy. Fortunately, very few of us are born with such a pronounced tendency to over-scrupulousness; and if we have it to a mild degree, we can easily overcome the handicap.
Let us therefore learn to live cheerfully and gracefully; let us become experts in taking ourselves less seriously. Let us master the art of living with ourselves as we are, and with the world as it is, according conscience its legitimate place, but recognizing that reason and judgment have their part to play in relegating conscience to its legitimate sphere of action.