Emotion Defeats Reason

The power of reason is formidable. It gives logical grounds for hope; it whips up new activity by revealing new possibilities. Probably this accounted for the days during which the patient showed outward im­provement.
When reason and emotion are locked in battle, however, emotion eventually wins. There was the relapse, for which we physicians had no medical explanation. Coming the day after the patient's fast, the relapse might have been the result of physical exertion. Although through most of his life he had not observed the solemn holiday, this time he had chosen to fast against all the efforts of his physician and his nurse to dissuade him, as though he were preparing himself to meet his Maker. That very choice was a self-destructive act, in unconscious obedience to his triumphing destructive drive.
Later I learned that the holiday was also the anniversary of his father's death. I have observed that, just as a word of reassurance at a critical moment can inspire the creative instinct and raise a man once more to strive in his own behalf, so an alluring mental image can encourage the destructive drive and cause the patient to succumb. Especially when a system has already suffered strain, the thought of one's dead father or mother, of a wife or other beloved person who has gone before, beck­ons one to follow.
The death wish promises peace and surcease from struggle. But it does not rely upon lure alone, nor upon its power over the uncon­scious centers of the body. It pleads its case convincingly to reason too. No man lives forever. Why stretch a burdensome existence for just a few years more? The reward is not worth the effort.
And so a man shuts himself away from the outside world, not to hear the voices of those who love him, not to see the tempting glitter of fame which has already betrayed him, not to falter in his resolution to seek eternal rest.
The strange behavior of the sick, often so perplexing to their families and friends and even to their physicians, thus becomes understandable. When a man on his sick bed apparently fights with all his strength to recover, while his lips reiterate the assurance that he wants to live, the same man commits acts which are aimed directly at his own destruction. We who stand at the sick man's bedside are handicapped in our effort to understand him by the very fact that we ourselves are well. We attempt to evaluate a sick man's subjective experience, his feelings and his desires, with a healthy man's calm and reasonable objectivity and a healthy man's involvement in the work and relationships of living. But it is not what we would feel or desire, but the hidden inner resolution of the sick man which will determine the outcome.