o different
levels than we ever see in normal life.

Our psychological hypothesis would be incomplete and probably unsound if
it could not offer as valid explanations for the atypical features in
our stupor reactions as for the typical. The unusual features which one
meets in the benign stupors are ideas or mood reactions occurring
apparently as interruptions to the settled quietude or in more
protracted mild mood reactions, such as vague distress, depression or
incomplete manic symptoms, which have been described in the chapter on
affect. The interruptions are easily explained by the theory of
regression. If stupor represents a complete return to the state of
nothingness, then the descent to the Nirvana or the re-ascent from it
should be characterized by the type of thinking with the appropriate
mood which belongs to less primitive stages of development. A review of
our material seems to indicate that there is a definite relationship
between the type of onset and the character of the succeeding stupor.
For instance, in the cases so far quoted in this book, the onsets
characterized by mere worry and unhappiness and gradual withdrawal of
interest had all of them typical clinical pictures. On the other hand,
of those who began with reactions of definite excitement, anxiety or
psychotic depression, there were interruptions which looked like
miniature manic-depressive psychoses in all but one case. This would
lead one to think that these patients retraced their steps on recovery
or with every lifting of the stupor process, moved slightly upward on
the same path on which they had traveled in the first regression. The
case of Charlotte W. (Case 12), which is fully discussed in the chapter
on Ideational Content, offers excellent examples of these principles.

The next atypical feature is the phenomenon of reduction or dissociation
of affect, the frequency of which is mentioned in Chapter V. As the law
of stupor is apathy, normal emotions should be reduced to indifference
and no abnormal moods, such as elation, anxiety or depression, should
occur. What often happens is that these psychotic affects appear but
incompletely, often in dissociated manifestations. This looks like a
combination of two psychotic tendencies, the stupor reduction process
which inhibits emotional response and the tendency to develop abnormal
affects which characterize other manic-depressive psychoses. There is no
general psychological law which makes thi