Sometimes before the period begins, a girl feels blue and upset for a day or two, a sign that the instinct is getting discouraged.  The whole body is saying, “Get ready, get ready,” but it has gotten ready many times before, and to no purpose.  Unsatisfied striving brings discouragement.  What reaches consciousness is a feeling of pessimism and a general dissatisfaction with life as a whole.  If, instead of giving in to the blues or going to bed and predicting a pain, the girl finds other outlets for her energy, she finds that after all, her instinct may be satisfied in indirect ways and that she has strangely come into a new supply of vim.

=The Purpose of the Pain.= Although suggestion is behind all nervous symptoms, there is a deeper reason for the disturbance.  When an unhealthy suggestion is seized and acted upon, it is because some unsatisfied part of the personality sees in it a chance for accomplishing its own ends.  The pre-menstrual period is the blooming-time, the mating-time, the springtime of the organism.  That means eminently a time for coming into notice, that one’s charms may attract the desired complement.  But if the rightfully insistent instinctive desires are held in check by unnatural repressions and misapplied social restrictions, the starved instinct can obtain expression only by a concealment of purpose.  The disguise assumed is often one of indifference or positive distaste for the allurements of the other sex.  But, as we know, an instinctive desire will not be denied.  In this case, the misguided instinct which has been given the suggestion that menstruation means illness, fits this conception into the scheme of things and obtains notice in a roundabout way by the attention given to the invalid.

=The Treatment.= To find that the symptom has a purpose rather than a cause gives the indication for the treatment.  Judicious neglect causes the symptom to cease by defeating its very purpose,—­that of drawing attention to itself.  The person who never mentions her discomfort, thinks about it as little as possible, and goes about her business as usual, is likely to find her trouble gone before she realizes it.[57]

[Footnote 57:  Violent exercise at this time is unwise, but continuing one’s usual activity helps the circulation and keeps the mind from centering on the affected part.  The physiological congestion is unduly intensified by standing; therefore all employments should afford facilities for the woman to sit at least part of the time while continuing work.]

A little explanation gives the patient insight into the workings of her own mind, and usually causes the pain to disappear in short order.  Astonished, indeed, and filled with gratitude have been some of my young-women patients who had all their lives been unable to plan any work or social engagements for the time of this functioning.  Many of them were the worst kind of doubters when they were told that to go to bed and center their attention on the generative organs only made the muscles tighten up and the circulation congest.  They could not conceive themselves up and around, pursuing their normal life during such a time.  However, as they have found by experience that this point of view is not an optimistic dream, they have broken up the confidence-game which their subconscious had been playing on them, and have gone on their way rejoicing.