AUTOMATISM

This term is used in several senses. Basically, as English and English (1958) state, it is “an act performed without realization or intent, often without realizing that it is taking place.” Examples are reflex responses, as in lifting our foot when we step on a tack, and thoroughly habitual acts such as repeatedly using the same linguistic expressions.In a more specialized sense, the term is applied to certain acts performed in the absence of normal conscious awareness or attention—for example, automatic writing, keepwalking, or behavior in a fugue state. Still more specialized is Janet’s use of the term: “a system of psychological and physiological phenomena, arising from a traumatic experience that grows by annexing other phenomena, originally independent. These annexed behaviors are the secondary symptoms that mark the neurotic.” An example would be feelings of anxiety and tension which some individuals experience in elevators or subways, and which may be traced to traumatic experiences such as being locked in a closet. In this usage, an automatism is similar to a complex, though more restricted.Automatisms are found in a number of psychiatric and neurological conditions. In the early stages of senile psychosis, some patients mechanically perform certain activities which previously required an act of will—for example, they repeatedly make, unmake, and remake their bed. Such performance of habitual activities is probably associated with another characteristic of these patients, their “misoneism,” or extreme intolerance of anything new or changed. In the senile disorder known as Pick’s disease the ability to think abstractly is impaired, and the patient often falls back on “habitual automatisms or immediate concrete images; as a result, impulsive bizarre actions are performed. At times these automatic impulsive responses may be the expression of a cover-up on the part of the patients for their unwillingness to think, rather than of impairment of abstract attitudes” (Ferraro, 1959). If, for example, the patient is given a jigsaw puzzle, he will merely move the pieces about haphazardly instead of making a rational attack with the picture as a whole in mind. In psychomotor epilepsy, or psychic seizures, the patient does not become unconscious, but he may be afflicted with an attack of “automatic thinking.” After the episode he usually cannot remember much of the thought content but recalls its emotional tone. There is evidence that these patients occasionally experience “panoramic memories” similar to those experienced by a drowning person. In a psychic seizure, such memories tend to be accompanied by vivid sights and sounds as if the patient were actually going through the experience. See HYPERMNESIA. In still other cases the patient goes through a five- or ten-minute “twilight state” during which he is disoriented as to time and place, and performs such automatic acts as mumbling unintelligible sounds, uttering a single word over and over, taking off his clothes, smacking his lips repeatedly, or walking about aimlessly. Other patients continue their normal activity, such as sewing, in a thoroughly mechanical way, or walk down the street until they suddenly “snap out of it.” A few develop “epilepsia cursiva,” a condition in which they run swiftly and automatically while in a state of disturbed consciousness. All these reactions tend to be of short duration, but in rare cases a condition known as “poriomanic fugue” may develop and last one or two days. In this state the patient sometimes has a bad accident or commits a crime but later has no memory at all or only a patchy recollection of what transpired.