Negativism

NEGATIVISM, a negative attitude toward environmental stimuli, is one of the primary symptoms of catatonia (see), also frequently encountered in other forms of schizophrenia (see), and sometimes in the clinical picture of other psychoses (progressive paralysis, senile dementia, etc.). In a mild form, negativism is often observed as a normal phenomenon in children. The forms of manifestation of negativism, while differing in their extreme external variety, can essentially be reduced to withdrawal from external impressions and to resistance against impulses coming from the outside. Negativistic patients offer the strongest, although almost always passive, resistance to any interference from other persons, not allowing themselves to be dressed, undressed, or washed, stubbornly refusing food, etc. They decisively avoid communication with other people, often not answering questions at all (mutism, or mutacism) or answering with words and phrases that seem intentionally chosen to create an impression of meaninglessness (irrelevant speech, paralogia). They do not answer the greeting of the physician treating them, hide in a corner or cover their head with a blanket upon his approach, stubbornly resist examination, turning away when asked questions, clenching their lips if the physician asks them to show their tongue, squeezing their eyes shut during an examination of the pupils, etc. Often, they hold back urine and feces with great tension, and the more often they are taken to the toilet, the more strongly they do so. Sometimes, negativism leads to the systematic performance of actions directly opposite to those required of the patients. Negativistic acts are for the most part involuntary and unmotivated, but not unconscious. By the nature of their experience by the patients themselves, they are close to, although opposite in the direction of action, the phenomena of passive suggestibility, when patients listlessly carry out any suggestions coming from the people around them. Both these types of behavior actually and frequently directly replace one another in the same patient. Kraepelin explains this by the fact that in both cases, the influence of higher goal-oriented and volitional attitudes on behavior is weakened, which opens the way for the unhindered manifestation of deeper and more primitive layers of the psyche. Kretschmer sees in negativism the result of the action of hypobulic mechanisms (see); Bleuler considers negativism, on the one hand, a consequence of autistic (see Autism) tendencies, and on the other, an expression of ambivalence (see), in which negative attitudes that were hidden in the norm gain dominance. Of course, these psychological interpretations are acceptable only upon the assumption of the presence in the brain (most likely in the subcortical centers) of negativistic patients of certain disturbances analogous to those that lie at the basis of reflex resistances sometimes exerted during the performance of passive movements by persons suffering from various diseases of the nervous system.