Hypnotist And Analyst
( Originally Published 1920 )
"I suppose suggestion plays a great part in the psychoanalytic treatment," is a statement which every analyst hears frequently and has to deny emphatically. Hypnotism and psychoanalysis not only have nothing in common but are in fact the ex-act opposite of each other: hypnotism introduces something into the subject's mind, psychoanalysis takes something out of it.
The hypnotist takes certain ready-made ideas, generally considered as ethical or practical, and, taking chances with their acceptability, tries to make the subject accept them because they are likely to be beneficial to him.
The psychoanalyst, having slowly and carefully amassed evidence as to certain ideas which are obsessing the subject and are likely to wreck his health, proceeds to disintegrate them and helps the subject to eliminate them.
The charge often made by ill-informed opponents of psychoanalysis, among them Boris Sidis, that people may be wrecked and perverted by the sexual thoughts suggested in the course of an analysis, reveals a profound ignorance of the psychoanalytic procedure.
The Freudian school is the only one to lay much emphasis on the sexual element, but the orthodox Freudian is an almost extinct species. Even he, however, should be cleared of every suspicion of sexual suggestion. The sexual material is present in every subject, normal or abnormal, and comes to the surface very easily. No suggestion is necessary to bring it forth.
The Freudians consider sex as the all-important factor in the neurosis. The other schools are inclined to seek, behind the sexual mask, other factors assuming a sexual complexion for abnormal reasons. Adler has stated many times that imaginary sexuality deceives the subject but should not deceive the analyst. If an analyst of the Adlerian school ever tried to suggest anything to his subjects it would be the belief that sex is not always sex.
But no analyst ever suggests anything. As we shall see at the end of this chapter, as soon as the rapport between analyst and subject is such that the subject is too easily influenced by the analyst, the analysis is likely to prove a failure.
One of the reasons for the widely spread belief that hypnotism and psychoanalysis are related methods of treatment is the fact that several of the best-known analysts originally practised hypnotism.
It was while studying a patient in hypnotic "trances" that Freud suspected the possibility of a study of the unconscious in the waking state. Freud made a deep study of hypnotism under men like Charcot of the Salpétrière and Bernheim and Liébault of Nancy. He soon realized, however, the shortcomings of the hypnotic method and dis-carded it entirely.
Jung, of Zurich, was discouraged from using hynotism by the brilliant and spurious successes he achieved through it. An old woman among others who would call at his office complaining of some excruciating pains, fall asleep in three seconds and before he had time to even suggest anything, wake up, thank him and go away, convinced him that the hypnotist is simply aiding and abetting an unconscious fraud.
It may be, however, that if Freud, Jung, Ferenczi and the many others who started in life as hypnotists and, after a while, became psychoanalysts, had not become familiar with the psychology of suggested sleep, they would have been at pains to understand the mechanism of certain neuroses.
All students of psychoanalysis should glance at a few books on hypnotism for that very reason. It would enable them to convince themselves of the neurotic character of that practice.
There are, briefly speaking, three methods of hypnotizing people: A man of powerful physique and of impressive appearance often succeeds in hypnotizing subjects by ordering them in a stern voice to fall asleep. This method is especially effective with weak, timid, feminine subjects. Some memory of the father's authority is evidently at work in such cases and compels obedience.
Other subjects can only be prevailed to enter the hypnotic state in a quiet, dimly lighted room, when the hypnotist keeps up a flow of soothing, monotonous, often senseless words, spoken in a low, crooning voice and strokes the face and hands of the subject. This is the method employed by every mother singing her infant to sleep and surrounding him with a peace and monotony symbolical of absolute security.
Nervous fatigue is relied upon in other cases to induce artificial sleep, the subject being ,asked to concentrate his gaze on a brilliant object, such as a diamond held in one position or moved about, or to listen to the ticking of a watch, etc.
Between ten and twenty per cent. of all the subjects examined have been found impossible to hypnotize. No conclusion should be drawn from that condition as to their normality. They may be so normal and independent that the idea of submitting to any one else's will is repellent to them. They may be so abnormal that their refusal to be hypnotized is a desperate resistance against the practitioner endeavouring to cure their neurotic symptoms.
That the hypnotic condition verges on a neurose is made evident by several of its characteristics.
The fact that it can be best induced in certain cases by a man of the Svengali type and that fakers have better percentages of success than scientific experimenters points to a childish regression and a father fixation. The mother fixation may explain satisfactorily the second method.
The regression is shown in many cases by the childhood memories which constitute the woof of the subject's talk unless the hypnotist imposes by suggestion a different topic.
All consciousness of time generally disappears in hypnosis and the abolition of time seems to cause the subject a great deal of satisfaction. This reminds us of the epileptic fits so well described by Dostoyevsky and in the course of which Mishkin, the Idiot, exulted in the thought that there would be no more time limitations.
The majority of hypnotized subjects have a feeling of pressure all over their body which is a source of most pleasurable feelings.
The Freudians have come to the plausible con-elusion that this is a memory from the prenatal days when the fetus was submitted in the mother's womb to an even pressure of similar character.
Many more points of similarity between neurotic and hypnotic states could be mentioned. Every neurose is a form of auto-suggestion. The subject imagines he has a large amount of evidence for certain obsessive thoughts and beliefs. At the end of an analysis, the evidence has been disintegrated and destroyed. The hypnotized subject who carries out some command given by the hypnotist will, if questioned, present excellent and plausible reasons for performing actions he cannot help performing. After being assisted in remembering the beginnings of the hypnotic scene, how-ever, he will gradually regain his consciousness of all that transpired and realize that his "reasons" were an unconscious fabrication.
Just as a neurose creates physical symptoms through auto-suggestion, Charcot and the Nancy hypnotists have shown that almost any hysterical symptom can be induced under hypnose and a comparison of the two processes is extremely illuminating.
In acute neurotic cases there is even a form of refusal to be analysed which can be compared to the refusal to be hypnotized.
It happens sometimes, in the course of an analysis, that when the examination reaches a crucial point, the subject develops a physical ailment which for the time being or for a more or less extended period of time places him beyond the analyst's reach.
A subject may feel suddenly distressed and ask for permission to leave the room, or the appointments are postponed on account of some gastric or abdominal disturbance unconsciously improvised for the occasion.
Shall we then attempt to relieve neurotic symptoms through a procedure which affects so many neurotic traits?
The neurotic who consults a hypnotist is, after all, seeking a quick escape from reality, from effort, from responsibilities.
He sees in the practitioner treating him the parent image and "runs back to father or mother" regressing to the age at which he had all his problems solved and the responsibility never weighed very heavily on his shoulders. He seeks the line of least effort. Too often an analyst has the impression brought to bear forcibly on him that the subject places himself in his hands and will hold him responsible henceforth for all the acts of his life.
Unable to lean upon his parents any longer the neurotic seeks a substitute for them.
Physician and analyst must see at once through the threadbare schemes of the subject and not encourage that attitude. They must bend all their energies to one end, to making the patient entirely independent from them.
Take one subject who feels weak and easily tired and hence unable to perform certain necessary and unpleasant tasks.
The hypnotist will repeat to him during each "trance" that he is strong, strong enough to do his work.
But the weak patient is weakened by complexes which hypnosis does not remove. Hence the probability is that after that form of treatment the patient, unable to really feel strong, because he is not strong, will adopt one of the negative attitudes I have described in a previous chapter, "I will act as though I were strong," after which he will engage, according to his temperament, in boasting or disparaging, bullying or scheming, to prove his in-existent strength to himself and others. He may enter a slightly agitated maniac state, followed by the inevitable reaction, depression.
Many serious experimenters have come to the conclusion that we cannot suggest anything to a subject unless he unconsciously craves to do that very thing. Suggestions of unpleasant actions are either rejected or very ephemeral. Suggesting murder or suicide proves effective mainly in the movies. Lombroso saw his subjects wake up every time he ordered them to perform humiliating tasks or to assume degrading rôles.
Our ethical and social notions, our prejudices and fears dominate the hypnotic state as they do the waking state.
Not only is the hypnotic method dangerous for it encourages forms of regression which are the basis of the neuroses, but it is an inefficient and haphazard procedure.
How can we know what suggestion will be acceptable to the subject because unconsciously he has already accustomed himself to it and is expecting it? Must we make hundreds of experiments, each of which weakens the patient's will a little more, in order to strike by mere chance a suggestion which will be both beneficial and acceptable, hence durable?
This applies not only to the form of hypnotism which implies suggestions from hypnotist to subject but to the hypnotic rest cure devised by Wetterstrand of Upsal. Wetterstrand simply put his patients asleep and kept them in that condition, some-times for days and weeks, in a house especially fitted for that purpose.
Sleepless subjects must have derived some comfort from that treatment, granted, however, that they were not, in the course of that hypnotic sleep, tortured and weakened by anxiety dreams, one thing which could not be prevented or checked. To the average neurotic, on the other hand, that protracted drowsiness must have offered a dangerous 'means of escape from the reality which they should have been trained to face.
In the course of an analysis, the analyst, as I said before, is most careful not to offer any suggestions, for suggestions would be accepted by friendly subjects in order to please the analyst, and by hostile subjects to get rid of the analyst.
When asking the subject for his reactions to the various stimulus words used for that purpose, the analyst simply asks the impersonal question: what comes to your mind when you hear this word?
He avoids forms of examination which would practically dictate the proper answer to the patient, such as: Does not this remind you of?
He listens carefully, patiently, uncritically though sympathetically.
Ife may have certain theories as to the subject's trouble, its cause, origin, character, etc., but he never airs them before the subject.
It may be objected that a certain amount of involuntary suggestion is quite unavoidable. The element designed unscientifically as personal magnetism plays in all human relations a part which cannot be minimized.
A letter to a daily paper which publishes health advice by a very bald physician revealed in an amusing way the illogical effects of personal impressions. The correspondent was anxious to find a tonic for his rapidly thinning hair, but wished to have his inquiry referred to another physician than Dr. X, for the latter's denuded skull made him in his estimation unfit to prescribe for his trouble.
As a matter of fact, a man affected by calvities is more likely to have investigated hair restorers than a man with a healthy shock of hair, but the person who wrote the letter I mentioned felt that in such matters he could not trust a bald physician.
An athletic physical instructor will easily impress his pupils with the probable excellence of his method and an analyst who seems unlikely to ever be affected by any nervous ailments will create in his subject's mind a confidence which facilitates his work.
Jung says very frankly somewhere that practitioners who manage to invest themselves with the halo of the medicine man are wise in every respect. Not only do they have a large practice but they also obtain the best results. Dealing with neurotics, the medical exorcist shows to, his subjects his full valuation of the "psychic" element when he gives them an opportunity to fasten their faith to his mysterious personality.
That type of healer generally has a large practice but I disagree with Jung as to the final, not the temporary, results of such cures.
Emotional cures have been observed in thousands of cases, but they are seldom lasting, for they eliminate the symptoms, not the deeper factors causing the symptoms to appear.
Powdering up a red nose will have strikingly good temporary effects but the only way to deal with that symptom is to cure the gastric disturbance which is responsible for it.
Analysis does not powder up red noses. It seeks to determine the line of least resistance for the development of a harmonious personality. It tries to find out what the neurotic's unconscious is striving for and actually doing in an abnormal way. After destroying the absurd reasons which the neurotic advances for his abnormal behaviour, it tries to determine in collaboration with the subject himself a positive, vital, socially beneficial guiding line.
But it does not begin to seek that guiding line until the subject has been made entirely free from his complexes.
And here again we must establish a sharp distinction between psychoanalysis and the talking cures made popular, especially in Europe, by the late Dr. Dubois, and which is little more than an at-tempt at suggestion in the waking state.
Dubois system of therapy, which consists in giving to the subject moral reasons for his recovery and in discussing rationally his case, is temporarily efficient if the subject is deeply impressed with the practitioner's personality and is ready to yield to his arguments.
The Dubois method bans all conversation about the past and tries on every occasion to turn the subject's glance toward the future, which psycho-logically is correct, for the neurosis is a regression to the past and to outworn solutions.
That procedure is really the second part of the psychoanalytic treatment. But the first part of it cannot be skipped. Before erecting a building one must clear the ground of all obstructions and blast the rocks which stand in the way.
Conscious advice is very weak against the positive orders which come from our unconscious, and here again, as in the case of hypnotic commands, only that sort of advice for which the unconscious is prepared will find ready acceptance and be permanently followed.
Complex after complex must be disintegrated and the subject must first be made conscious that most of his unconscious cravings are not representative of the intellectual, social and ethical level on which he should stand but survivals of, or regressions to, conditions obtaining at lower, that is, more archaic levels.
Some of his unconscious cravings will be found to lead him along a straight, positive, path. His dreams prove especially valuable in determining what his aptitudes are as well as his abnormal modes of wishfulfilment.
The task of the analyst, after he has freed the subject from his thraldom to an archaic unconscious, is to select in an unprejudiced way from all the unconscious material brought to the surface that which is positive, which shows beneficial adaptability to the subject's environment, which is capable of gratifying in a socially useful way the various urges struggling for expression.
Both in the clearing of the ground and in the building of the new structure, the analyst proceeds scientifically, according to convincing evidential data.
Both reactions and dreams show him what the subject can actually do and is predisposed to do, what actual help and hindrance the subject may derive from his unconscious; dreams, in particular, registering minutely as they do, the subject's progress in regaining his freedom, reveal accurately the time when advice touching a positive guiding line can be given openly.
If you have to deal for instance with a subject in whom the egotistical trend is strongly marked, you must at first disintegrate the false growths whereby his craving expresses itself indirectly and abnormally. After which, when the subject has acquired full insight into his conduct and is reshaping his attitudes accordingly, the analyst can encourage certain forms of activity offering positive gratification to the subject's egotism and yet fitting perfectly in the environment in which he must live.
A neurotic with a decided talent in some direction can be led from a negative life of disparagement, slander, bitterness, in which he is only reducing others to a lower level, to a positive life of accomplishment, in which a development of his abilities will gain him fame and power.
In other words, hypnotism only offers to sufferers a negative escape from; reality, psychoanalysis a permanent formula for exchanging a negative life for a positive one; hypnotism makes sufferers dependent upon the hypnotist, psychoanalysis makes them independent from the analyst.
And yet, there may be exceptional cases in which hypnotism may he used legitimately. While no physician believes in administering strong narcotics, no physician will hesitate to inject large doses of morphine into an unfortunate person who is, let us say, being crushed to death under a railroad train and cannot be lifted from under the wheels until emergency apparatus has come.
In a case, for instance, when a neurotic is incapacitated by some of his symptoms, such as a sick headache, from performing some important task upon which his livelihood or reputation depends, an analyst would have a sufficient excuse for saving his subject from the added strain which might be caused by failure. But that form of treatment should only be resorted to in a grave emergency with the understanding that the procedure shall not be repeated. For the majority of neurotics would rather sleep than talk and would rather regress to their abnormal ideas than to sub-mit them to the destructive fire of psychoanalytic conversation.