Insufficiency or instability of control

In cases of insufficiency, control exists as a faculty, but either it has not reached full development, or it is defective in some way, or its influence is not adequate. In such cases we can see that some of the ideas or impressions experienced by the patient do not pass through the filter of the conscious brain.

These persons may be able to reason or judge in a normal way, yet remain dominated by ideas or impressions which they know are absurd or exaggerated, but over which their willpower has no control. This is the situation of a typical psychasthenic patient.

In cases of unstable control, the situation is basically the same: here patients shift from a normal state to a diseased state, for no apparent reason. Symptoms appear and disappear in more or less close succession. A period of critical depression may be followed by a period of gaiety, and all aspects of the personality are subject to change - it can affect patients' physical health, their character, or their thought processes.

There are an infinite number of degrees between a total absence and an insufficiency of control, giving each case its particular character.

These differences are of interest when diagnosing and prognosing an illness, but it would be useless to describe them all here since, in practical terms, it is enough to determine whether control is sufficient or insufficient.

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