e of a dead aunt
calling her; that she had thought her family were dead, again that the
baby (who was born just before the psychosis) was dead. The formulation
is therefore less one of fact than of something prospective, something
which is coming--the _going_ to die. Correlated, perhaps, with this
anticipation were slight modifications of the usual apathy. The patient
often had an expression of bewilderment. She was also more in contact
with her environment than many stuporous patients are, for, not
infrequently, she would look at what was going on about her. Her apathy
was also broken into in a marked degree by her active resistiveness,
which was sometimes accompanied by plain anger. It seems that a prospect
of death may occur in other instances in a totally affectless state. We
have recently seen it in a partial stupor during which the patient spoke
and had this persistent idea in a setting of complete apathy. We see
here also, as in one of the former cases, the idea of other members of
the family being dead.

More difficult and deserving more discussion are the two remaining
cases, Rosie K. (Case 11) and Charlotte W. (Case 12). Rosie K. showed a
peculiar condition. She said, retrospectively, that during the stupor
she had the desire to die and that for this purpose she refused food.
Moreover, she was repeatedly seen to hold her breath with great
insistence, though without affect. This is worth noting. We are in the
habit in psychiatry to say in a case like this that "there is no
affect," and yet there is evidently a considerable "push" behind the
action. We shall later have to mention in detail a patient whom we
regard as belonging in the group of stupor reactions, and who for a time
made insistent, impulsive and most determined suicidal attempts, yet
with a peculiar blank affectless facial expression and with shouting
which was more like that of a huckster than one in despair. Here also,
then, there was a great deal of "push," yet not associated with that
which we call in psychiatry an affect. In both instances we see acts
which we are in the habit of calling for this very reason "impulsive."
Evidently this is an important psychological problem which leads
directly into the psychology of affects and deserves further study. For
the present it is enough to say that with a different formulation--that
of wishing to die--there is here not, as in other psychoses, a definite
affect, such as sadness or despair, but no affec