Integration Course

Download:  MS DOC

A Case of Catatonic Schizophrenia
(The Incredible Power of Beliefs)

Dr. Brian Campbell

The Man Who Thought He Caused the Bombing of Pearl Harbor

One of the first cases I was assigned as a predoctoral intern in the Veteran’s Administration Hospital, was that of a fascinating older man who was a veteran of the second world war.  I will give him the pseudonym of “Frank.”

Frank was a black man, who served on a carrier that was docked in Pearl Harbor.  Some of you may not know, but the military was very prejudiced at that point in American history (as was most of Caucasian society, in general).  I am sure that Frank received a lot of emotional abuse, and he was assigned to the menial task of working in the kitchen and serving the other soldiers (who were mostly White).

When I met Frank, he did not talk at all.  I sat down with him for our first treatment session, and all he did was grimace and make faint whispering noises with his mouth.  These whispers appeared to be speech, but it was impossible to hear what he was saying (a condition termed, elective mutism).  It is hard to describe his facial expression, but it looked like he had seen something horrible and was in total shock.

With regard to motoric functioning, Frank’s body was fixed and appeared rigid.  If you were to pick up his hand and move it somewhere, it would “get stuck” wherever you placed it.  This condition is termed “waxy flexibility,” and it is a common symptom of catatonic schizophrenia.  My first thoughts when I met Frank were:  “What could have happened to this man to have caused him so much pain and suffering?”

Apparently, based on a review of Frank’s case records, he was able to speak at one point in time during therapy, and it was discovered that, as a result of his continuous abuse, he had wished that everyone on the carrier would be killed.  Unfortunately, he had these thoughts on Dec. 7, 1941.  Most of you will recognize this as “Pearl Harbor Day.”

Well, virtually everyone on his carrier was killed that infamous day.  Frank apparently was found floating near the ship and was rescued.  He was injured and in shock, but he survived.  However, the majority of the men he had wished would die, did not survive the bombing.  This information is the key to understanding Frank’s psychopathology.

The logical fallacy of post hoc ergo propter hoc (after which, because of which) came into play.  This maxim refers to the tendency of human beings to “jump to conclusions” and to attribute causality to events that may or may not be related.  In this instance, Frank erroneously believed that his thoughts (wishing his fellow soldiers dead) had actually caused the bombing of Pearl Harbor and the death of the men who were abusing him. 

Unfortunately, the guilt associated with Frank’s erroneous belief was more than his brain could handle.  In a very real sense, he believed that he was a murderer.  He felt personally responsible for carnage on the morning of Dec. 7th.

Let me stop the story for a moment to make a comment about the nervous system.  In the nervous system, there are actually three reactions associated with the sympathetic side of the autonomic nervous system.  Most people are familiar with two of them:  fight or flight.  However, there is a third response:  freeze.

When the amount of fear that someone experiences is overwhelming, the body tends to freeze.  For example, if you opened your front door and there was a lion there, your first inclination would be to run, but you would probably freeze in fear.  Interestingly, some theorists feel that this response may be adaptive in certain instances because animals of prey (such as lions), are stimulated by movement.  Also, if you don’t move and “play dead,” most animals of prey do not eat carrion (dead animals).

Therefore, part of Frank’s reaction may represent a psycho-physiological reaction to the belief that he had been responsible for killing his fellow soldiers.  Although there was no longer any immediate threat in his environment, the threat of exposure of this belief (i.e., if someone found out he had committed murder) appeared to be sufficient to freeze him (physically and psychologically) and pull him away from world around him.

By “shutting out” stimuli from the world, he was protecting himself to some extent—that is, from being exposed as a murderer.  By not moving—literally—and not speaking, his brain was protecting him from the possibility of his “secret” being exposed.  Basically, the “strategy” of his brain was:  shut off everything—shut out everything.

Unfortunately, the world to which he retreated was a living Hell.  Over the next several months, I would sit with Frank and speak softly, while at the same time trying to hear any words that he might speak during his grimacing and whispering.  At times, I would hear a word or two and then repeat them—speaking very softly and imitating his own voice quality.  During these sessions, Frank would also, at times, imitate my words (echolalia).

Over time, on rare occasions, we almost had a fragment of a conversation.  However, after such times, Frank would suddenly “pull back” and stop interacting—as if shocked that he had allowed himself to be so vulnerable.  Time passed, and it eventually came time for the annual Christmas party at the Veteran’s hospital.

After the party had been underway for quite a while, Frank suddenly stood up.  When people saw this happen, everyone stopped what they were doing and the room went completely quiet.  You see, Frank had to be led from place to place, and he almost never did anything on his own volition.  We all stared intently at him as he said, in a loud voice:

“My God!  There’s no hope.  There’s nothing out there.”

Frank then sat down quickly.  He once again assumed a rigid position and the grimace returned to his face.

I believe that my work with Frank allowed him to start to trust “the world” a little more.  After all, he had ventured out of his own world on occasion with me, and nothing terrible had happened.   Unfortunately, during the Christmas party, Frank’s journey into the “real world,” did not turn out very well.  I believe his brief excursion led him to the conclusion that there was nothing that made sense to him, and it was safer to remain in his self-imposed hell.

Frank never spoke again from that time until I finished my internship, about six months later.  As far as I am aware, Frank never spoke again.

Comment:  This case vividly illustrates the power of beliefs, and the influence that faulty beliefs can have on a person’s life.  It also shows the how God designed our bodies to cope with stress.  Frank’s body literally shut out the external world in order to protect him from a world that threatened to condemn him for “murderous thoughts” and the resultant punishment he believed he would receive if exposed.  

Unfortunately, although Frank partially blocked stimuli from the "outside" world, he could not completely numb himself to the conclusion of his inner thoughts--that he was a murderer who had caused the bombing of Pearl Harbor and the death of his fellow soldiers.  This conclusion left him in a self-imposed Hell.  

Finally, this case occurred in a setting (the Veteran's Hospital) where I could not explicitly introduce God into my treatment.  Of course, I was able to pray "silently" for Frank, but I was restricted from introducing my Christian faith.  If this had been a different setting, I would have been gently whispering to Frank about God's love for him and about Christ's redeeming sacrifice on the cross for Frank's sins (whether imagined, or real).  Frank is probably deceased by now; I pray that he will be in heaven and that we will someday be able to freely rejoice in Christ's sacrificial love.