The after-history of this case is instructive. Almost none of our suggestions were taken when our first diagnosis was made. Two years after we first saw Annie she was placed in an institution for delinquents, then having run away from home, ``picked up'' a man on the street and stayed all night in a hotel with him. At the institution the girl became very nervous and behaved badly and the authorities decided it was a poor place for her. The father, who at first wanted her placed there, very soon decided that she should be removed. It is very likely his attitude had something to do with her behavior there.
About this time Annie worked in a millinery shop where she proved herself quick and skilful. There she told stories again defaming herself. She said she had had a baby and went into complete details, such as giving the name of the nurse who had taken care of her, and so on. On account of this she was discharged. Later she told us she related these stories to get even with her father, for if there was ever a hell on earth it was living with him.
About three years after our first study of Annie, the father himself brought a complaint against her of untruthfulness and general unreliability. This was at one of the times when he was complaining bitterly of other people. It seems he had lately tried to restrain her from leaving the house and she had cut his head open with an umbrella. It was evident she had started downhill again, and she was placed in a Rescue Home. She now repeatedly told people she was pregnant and made charges against some man, but these soon fell through because a little detective work showed she was corresponding with a boy and had very likely been immoral with him and others. She was then making an attempt to lead a dual life, maintaining she wanted to save some of the unfortunates with whom she was placed, while at the same time entering into various escapades with them and others. At this period a suicidal attempt was reported, but we never had satisfactory proof of the genuineness of this. Annie was now regarded as being excessively delinquent.
A few months afterwards, when the young woman was in one of her better moods and wished to do well, we made a few vocational tests on her. We found her quite unfit for the position of telephone operator which had been suggested for her. Psychomotor control appeared then decidedly defective. However, there was great improvement on work done on intellectual tests two or three years previously. Although she had developed physically (she now was a particularly good looking young woman) we felt she was quite unfit for work which demanded steady effort. One trouble all along was the fact that she did not wear her glasses. We advised then, as we had advised at first, a quiet country life for Annie and the other members of the family. The constant stimulus of city conditions was too much for them.
Again our advice was not taken and some months later the father came to us with the story of extreme poverty, some recent attacks of unconsciousness on his part, separation from his third wife, and the information that Annie was about to become a chorus girl.
Even a final consideration of the general diagnosis in this case which has been so long observed by us does not seem to justify our including it among our border-line mental types. Application of the term constitutional inferiority seems a priori warranted by the family history and yet we have no proof that her physical and mental conditions as enumerated above are not the result of her many early illnesses and the excessively erratic environmental conditions, rather than of causes which existed at birth.
On account of the peculiar inhibitory phases which arose nearly always during observation, we never relied merely on the results of laboratory tests for our judgment, and her success in some social situations has proved the wisdom of this. Our earliest feeling that we had to do with a temporary and mild psychosis was perhaps justified, but further observation of her has led us to see clearly that she is not to be considered as a deeply aberrational type. Could she ever have been free from the extraordinarily upsetting home conditions one could have gauged much more accurately her mental capabilities. As time went on, the moral difficulties, which were largely induced by family conditions, led to mental as well as moral upsets which could be considered as little else than normal reactions to the situation. Her conduct lapses, under the circumstances, are no indication of any mental breakdown. On the contrary, it is clear by our own examinations and the accounts of other observers that she gradually has showed greater mental stability.
(Since writing the above, we have had, by chance, the opportunity of getting some important information about this case from an entirely new source. A person who knew the family many years ago corroborates the father's remarkable story of antecedents. The father himself remains in about the same state of social incapacity. Annie, now married to a young man with a long criminal record, has a child. Her word has recently been found absolutely unreliable, and testimony lately given by her in court concerning her husband was grossly false when it would seem that her interests and welfare demanded her testifying the truth concerning his non-support.)