The Nature Of Hypnotism
( Originally Published 1908 )
THE words hypnotism and hypnosis were first suggested by Braid of Manchester in 1843, although many of the phenomena had been recognized from remote antiquity. The words are derived from a Greek root signifying sleep, in spite of the fact that there is a distinct difference between hypnotic and natural sleep, and furthermore that some hypnotic states do not resemble sleep at all, being rather conditions of intense abstraction or absent-mindedness. Hypnosis, however, designates a group of very complex phenomena, whose analysis is not fully completed, but whose importance for therapeutic and psychological purposes is daily becoming more manifest. Hypnosis is as old as the human race, but it is only within the last twenty-five years that it has been scientifically investigated and its nature understood. Animals, too, may be hypnotized and in them may be observed some of the phenomena that occur in human beings. Max Verworn, has given us a very pertinent account of hypnosis in animals and has illustrated it by some interesting photo-graphs.' "It may suffice to recall a few well-known phenomena. The ancient experiments of the Egyptian snake charmers, which Moses and Aaron performed before the Egyptian Pharaoh more than three thousand years ago, belong to this category (i.e., hypnosis in animals). By slight pressure in the neck region, it is possible to make a wildly excited, hissing, erect asp (hooded snake) suddenly motion-less, so that the dangerous creature can be put into any desired position without fear of its fatal bite. The well-known experiment of Father Kircher depends upon the same causes. If any excited fowl be seized suddenly with a firm grip and laid carefully upon its back, after a few brief attempts to escape it lies motionless. Guinea pigs, rabbits, frogs, lizards, crabs, and numerous other animals behave similarly." According to Verworn, the hypnosis of human beings depends upon the same physiological mechanism, that is, an inhibition of the will.
Like all new movements in medicine, hypnosis was compelled to pass through an era of skepticism before it became firmly rooted as one of the most important methods of treatment and investigation possessed by medical science. In fact hypnosis, or some other form of psychotherapy, is the only rational treatment of the functional as distinguished from the organic nervous diseases. Hypnosis is quite popularly known, but its unfortunate use by traveling charlatans and mountebanks for public exhibition purposes has made it the subject of wide-spread misconception, fear, and even ridicule. Even from the trained physician, the word hypnotism proposed as a therapeutic agent for some functional disorder of the nervous system causes the patient almost instinctively to shrink when the term is mentioned, to ask what it means, if it will make them unconscious, destroy their will power and even their personality. When an explanation is given and the treatment begun, there still remains at first the conscious or unconscious resistance. If this short chapter helps to dispel the popular illusion and ignorance and places hypnotism on the sound scientific basis to which it rightfully belongs, its purpose will not have been in vain. The beginning of the scientific investigation of hypnotism occupied a position analogous to the kite in the hands of Franklin or the dead frog in Galvani's laboratory. But as from these arose modern electro physics and electro chemistry, so hypnotism evolved until it developed into one of the important features of modern abnormal psychology.
But we know to-day that we are dealing with one of the most valuable and penetrating therapeutic and experimental agents. Stripped of all its mystery, hypnotism stands out as one of the triumphs of modern science, whose laws are fairly well known and whose mechanism is far removed from the occult. From the standpoint of therapeutics, many of the functional disorders of the nervous system, particularly that protean disease called hysteria, have been greatly ameliorated and in many cases absolutely cured by hypnotic suggestion. On the other hand, experimental hypnosis has enabled us to penetrate deeply into the workings of consciousness, especially the baffling states of double personality and subconscious phenomena.
The historical development of hypnosis forms one of the most interesting chapters in modern medicine and it is to this history that we will briefly direct our attention. Here we have a very pertinent example of the evolution from mysticism in medicine to sound scientific theory. The French have been and are to this day among the foremost students of hypnotism, for it was in France that the beginnings of scientific hypnotism arose. The history of hypnotism may be conveniently divided into three periods: that of Mesmerism from 178o to 1788; that of Magnetism from. 1820 to 1850, and finally the period of the scientific study of hypnotism beginning in 1875 and continuing up to the present time. In 178o Friedrich Anton Mesmer, a physician and a student of the occult, first made his appearance. He claimed miraculous powers and clothed his procedures with picturesque and mystic effects. Indeed, to the public, many of his cures appeared miraculous, on account of their ignorance of what constituted suggestion. Mesmer believed in an external, invisible fluid, which was able to penetrate all portions of the body, especially the central nervous system. He thought this fluid could influence and modify in various ways all psychical and physiological reactions. So great was public interest in these phenomena, that the French Government appointed a commission of savants, one of whom was Benjamin Franklin, to investigate the claims of Mesmer. In their report they verified the results, but attributed them to purely physiological causes. Soon after, owing to some unfortunate failures with prominent patients, Mesmer's influence rapidly declined. Except for some sporadic investigators, the subject of hypnotism remained unnoticed and almost forgotten until the so-called "magnetism" began to attract attention in 1820. It would exceed the scope and purpose of this chapter to trace its development in subsequent years. It must suffice to state that gradually the old "magnetism" gave way to the more modem and, so far as we can see, the scientific theory of hypnosis. This may be summed up in a few words, namely, that all the phenomena of the hypnotic sleep are purely the results of suggestion. At first it was believed that hypnosis was due to somatic causes, the fatigue of fixation and attention (Braid), or to the various physical, peripheral stimuli, such as fixation, stroking the forehead, manipulation of the eyelids (Charcot and his school). It was finally due to Liébeault, Bernheim, and the so-called Nancy school, that the fundamental importance played by suggestion was first realized.
Since then hypnotism has attracted the serious attention of all scientific physicians. Among the French investigators may be mentioned Gilles de la Tourette, Charcot, Liébeault, Bernheim, Janet; in England, Braid and Bramwell; in Switzerland, Forel; in Germany and Austria, Moll and Krafft-Ebing; in Sweden, Wetter-strand, and finally, in America, William James, Morton Prince, and Boris Sidis.
Hypnosis, therefore, stripping it of all mysticism, may be defined as an intense form of artificial abstraction (absent-mindedness) brought on by suggestion. This artificial abstraction either narrows or dissociates the consciousness, and to this splitting of consciousness many of the phenomena and therapeutic effects of hypnotism are due. Experimentally, it constitutes one of the methods for "tapping" the subconscious, analogous to the hypnoidal state, or to the state of experimental abstraction or distraction. The three marked characteristics of the hypnotic sleep are amnesia (complete loss of memory), suggestibility, and subconscious phenomena. Whether one or all of these appear, depends partly on the susceptibility of the patient and partly on the depth of the hypnosis induced. The amnesia, of course, comprises only the period occupied by the hypnotic sleep. Instead of a complete amnesia there may be only a slight haziness of memory or even a perfectly clear recollection of the hypnotic state. These, how-ever, do not influence the condition of heightened suggestibility that accompanies all depths of hypnosis. Of course, if the suggestions are not remembered they cannot be antagonized or modified; in other words, when there is complete amnesia the suggestions are dissociated or become subconscious. The suggestibility is likewise subject to variations, dependent on the temperament of the patient and the depth of the hypnosis induced. There may be an intense reaction to hypnotic or post-hypnotic influences with a clock-like precision, or many séances may be necessary to secure the required result. The subconscious phenomena are variable and form a gradually increasing complexity from mere automatisms to complete dissociation of the personality or memory, forming what is known as double or multiple personality.
In a popular book like this, it has been thought desirable to omit technical terms as much as possible, but a few of these are so expressive that some definitions become necessary, in order to avoid repetitions in the future. A short explanation of what constitutes hypnosis has already been given. This will be elaborated upon later, when we shall also briefly discuss the difference between hypnotic and natural sleep. The word "hypnotist" does not require a definition. By some writers this is considered synonymous with dictator. By suggestion we mean the dictation of certain commands or the giving of certain orders and their acceptance to a person either in a state of light hypnosis or in a deep hypnotic sleep. According to the nature of the case, the commands given in hypnosis are to be carried out while in that state, or, as is more frequently the plan, they are given in such a manner that they will react after the person has been awakened from the hypnotic sleep. These latter are known as post-hypnotic suggestions and in this peculiarity lies the great value of hypnotism. Suggestions are usually given verbally by spoken words or by placing the hypnotized person in a certain position, thus calling forth a more complex suggestion through the association of ideas. Auto-hypnosis or auto-suggestion is the mental state produced by the person's mind reacting on itself, either consciously, unconsciously, or subconsciously. Of course, from the very nature of the process, it possesses far less therapeutic value than suggestions given in hypnosis by a second party.
Thus we have seen that the fundamental characteristic of the hypnotic state is the altered condition of conscious- whereby the normal suggestibility is heightened or greatly intensified. It can be produced by mere verbal suggestion, by various mechanical devices, such as staring at a bright object or listening to a monotonous sound stimulus, thus fatiguing the sense organs and brain by a narrowing of consciousness upon one point. In all hypnotized persons there is a rapport or connection between the hypnotizer and the person hypnotized. This is of great importance, as it enables suggestions to be mentally assimilated and to be carried out as post-hypnotic phenomena. It is this connection that constitutes the great difference between hypnotic and normal sleep. Auto-hypnosis or auto-suggestion, the reaction of the mind upon itself, is interesting from the historic standpoint, as this constitutes the ecstatic state of the Hindu Mystics. The intense abstraction in these cases is produced by the firm fixation of the eyes upon the umbilicus and constantly repeating the sacred syllable Om. From the scientific standpoint, however, the only rational method of inducing hypnosis is through suggestion, by means of the dictation of others, although auto-suggestion is of limited value in the milder types of functional disorders.
According to the best authenticated statistics and also as the result of personal experience, one can safely assume that from 80 per cent to 96 per cent of all persons. are hypnotizable. These figures are not exaggerated, if we consider how many of the human race are suggestible in the waking condition. Some of the French investigators claim that only cases of hysteria can be successfully hypnotized, and this has led one writer to state that the hysterics are the frogs of experimental psychology. However, personal experience and the experience of others leads us to decidedly dissent from this view. We have hypnotized many persons who were certainly not suffering from hysteria. Every mentally healthy person is hypnotizable, especially the strong-willed, contrary to the popular belief. Children, on account of their credulity, are very suggestible and, therefore, very easily hypnotized. Idiots and the insane are very difficult, if not impossible, to hypnotize. Waking suggestion differs in many respects from hypnotic suggestion. In the hypnotized subject there is an annihilation or a lowering of the will power and of the conscious resistance, and therefore the reaction to the commands can be dissociated or split off from the command itself. In the waking subject, however, this waking resistance consciously or unconsciously takes place. Suggestions can act in any depth of hypnosis, with this difference, however, that in the lighter grades a more frequent hypnotization becomes necessary. Therefore, fn hypnosis there is a state of over-credulity produced by the heightened suggestibility, whereas in the waking state this over-credulousness, at least in adult individuals, may be antagonized or neutralized. by counter suggestions. In children, however, mere waking suggestion is often sufficient for therapeutic purposes. Post-hypnotic suggestions act powerfully be-cause of this increased suggestibility in the hypnotic state. For this reason, these suggestions, if remembered, are usually not antagonized. If not remembered, or in other words, if there is an amnesia, they are completely dissociated from the waking consciousness and therefore antagonism or counter-suggestions are impossible. There-fore, as will be easily gathered from the above, when the hypnosis is deep and an amnesia supervenes, in other words, where there arises a state of hypnotic somnambulism, suggestions are more penetrating and effective. When the hypnosis is light and there is no amnesia, the same result can only be secured by more frequent séances.
Before we proceed further to discuss the therapeutic value of hypnotism, it is necessary to inquire into two important questions: first, the relation between ordinary sleep and hypnotic sleep; and second, the various physical and mental phenomena of the hypnotic state.
Sleep has been defined as the resting time of consciousness, but it is rather a partially conscious mental state and not a complete annihilation. A sound sleep is dreamless just like a complete anaesthesia, and dreams only appear in the half-waking state or at the end of an ether or chloroform anæsthesia. Not only does the imagination run riot in dreams, but also slight external stimuli, such as the position of the bedclothes or the exposure of certain parts of the body, are important factors in making up "such stuff as dreams are made of." Deep hypnosis resembles outwardly normal sleep, — it is somnambulistic and there is amnesia or loss of memory on awakening. There is one important difference, however, — the hypnotic subject is suggestible to a high degree, either in the hypnotic state itself or as a reaction on, awakening, the so-called post-hypnotic suggestion. There is a kind of mental connection between the hypnotized person and the hypnotist; in other words, the subject is en rapport with his hypnotic dictator. In deep natural sleep there is no suggestibility or psychic connection, although in the half-waking, or what is technically known as the hypnagogic state, there is a mental condition closely analogous to the true hypnotic sleep. In this half-waking state, catalepsy or fixation of the limbs into any desired position may be brought about, — the limbs may be manipulated as if made of wax, and peculiar somatic sensations may arise, such as transitory paralysis or numbness, startings of the body and sensations of falling. Hypnotic consciousness and dream consciousness have many points in common, such as hallucinations, peculiar sensations, and dissociations of the personality. No wonder the savage looks upon the dream as a departure of the soul from the body during sleep. Dreams also may be projected into the waking life and cause hysterical symptoms. In a young woman under our care, following a dream of falling down a hill, there developed on awakening a partial hysterical paralysis of the limbs. Forel says, "Normal sleep, like hypnosis, is a condition of heightened suggestibility—i.e., a dissociated condition — only as a rule the condition of exhaustion of the brain is added and the connection with the hypnotist is wanting." Bechterew, however, takes an opposite view,' and believes that hypnosis is nothing but a modification of normal sleep, although he is compelled to admit that ordinary normal sleep in most people reaches such a depth that the influence of suggestion is impossible. The more we study the question, the more we are led to believe that hypnotic sleep, natural sleep, and the sleep from narcosis of ether or chloroform are different phenomena. Hypnosis is purely a psychical state; natural sleep is dependent on changes in the circulation and chemistry of the body, while the narcosis of ether and chloroform is caused by the chemical action of these drugs upon the nerve cells of the brain.
The artificial stages that have been proposed to designate the various depths of hypnosis are of limited value, and this only for purposes of description. This can be easily seen when it is stated that the variations of the hypnotic sleep shade imperceptibly into one another and therefore there is a decided overlapping of types. The only variations in the intensity of hypnosis comprise an almost imperceptible series of changes from light drowsiness, in which the eyes can be opened only with difficulty or not at all, to a deep somnambulism. Recollection may vary from a clear retention or a slight haziness of memory to a complete loss of memory for the hypnotic séance. Of course in all the stages there is an increased suggestibility. When there is an amnesia from the suggestions on awakening, these suggestions are completely dissociated from the consciousness, and therefore cannot be antagonized, corrected, or minimized. When there is a deep somnambulism with amnesia on awakening, the various happenings of the amnesic period can be recalled perfectly in the next hypnosis, according to well-known psychological laws. For descriptive purposes, Forel has given us the best and simplest classification of the degrees of hypnosis. This classification is a vast improvement over the more complex one of Charcot and Bernheim. According to him there are three transitions:
1. Somnolence or sleepiness, in which the influenced person can resist suggestion and open his eyes.
2. Light sleep, in which the eyes cannot be opened, and obedience to suggestions is obligatory, but there is no loss of memory on awakening.
3. Deep sleep or somnambulism, with amnesia and fine post-hypnotic effects.
The various psychic and physiological accompaniments of hypnosis are of great interest as they serve to elucidate many of the suggestive phenomena. Of first importance is what is known as catalepsy, that is, the eyes cannot be opened on command, the limbs can be placed in a strained position or molded like wax and kept in this uncomfortable position for a much longer period than in the waking state, without any signs of fatigue. Anaesthesia or in-sensibility to pain may also take place. Hallucinations 1 of the various senses (sight, hearing, touch, smell, taste) may be experimentally produced. The disturbances of memory, consciousness, and will have already been de-scribed. The breathing usually becomes deeper and the pulse rate increased. From the purely mental stand-point, fixed ideas, obsessions, abnormal impulsions and habits, tendencies to alcoholism and to various drugs, on account of the great proneness to suggestion in the hypnotic state, may be greatly ameliorated or completely removed. Herein lies the great therapeutic value of hypnotic suggestion. When hypnotic suggestion is used for medical treatment, it is impossible and in fact highly impracticable to keep the patient continually in hypnosis. Left to himself, the hypnotized subject will either awaken spontaneously or there will be a gradual transition to. a natural sleep. Both of these are incompatible with suggestion. Fortunately, however, there is another phenomenon, which is perhaps the most important in the whole range of psychotherapy. This is what is known as post-hypnotic suggestion, whereby suggestions given in hypnosis are carried into and obeyed in the waking state. The carrying-out of suggestions in the waking state, whether given in this state per se, by command, persuasion, or argument, or whether preceded by the hypnotic state, furnishes the keystone of suggestive therapeutics in the modern scientific sense.
In any degree of hypnosis there is increased suggestibility and an uncritical and unantagonized acceptance of all commands and requests. These suggestions are given in such a manner that they will act, not in the hypnotic state itself, but are projected into the future as it were, into the waking condition. Sometimes these suggestions are remembered dimly or clearly; some-times there is complete oblivion for the suggestions (amnesia), according to the depth of the hypnosis. In either case, if the suggestions are repeated a sufficient number of times in a series of hypnotic séances, if an insistence on the impossibility of failure be added; in other words, to use a slang phrase, the suggestions are "rubbed in," in the end they will be found to be successful. They have become unified with the personality. In post-hypnotic suggestion there is a condition of absolute obedience or automatism. For instance, if we hypnotize a patient and tell him that at a certain hour the next day he will write a letter, on awakening he may or may not retain a memory of the command. In either case it will not trouble him until the exact hour arrives, when he will feel literally impelled to write the letter without knowing the reason therefor. The suggestion has been there all the time, only it is split off, dissociated, in psychological language, from his waking consciousness. If we hypnotize another patient for the treatment of chronic alcoholism and suggest that he will no longer drink, that he will not only lose the craving for alcohol, but develop a positive distaste for it, this too will be effective when the patient awakens. Of course, in the treatment of drug habits, a number of hypnotic séances are necessary, in order to cure the old habit, to change the current of the patient's thoughts and to strengthen the will power. Another patient may be the victim of fixed ideas or obsessions, and these too in time will yield to post-hypnotic suggestion. The above are not mere fictions, but stern realities that can be found in the practice of anyone who has utilized hypnotic suggestion for therapeutic purposes. The relation of post-hypnotic suggestion to crime would exceed both the limits and the purpose of this chapter.
The dangers of hypnosis have been greatly exaggerated. In fact, in the hands of a properly qualified and trained physician there is absolutely no danger. Personally, we have never seen hypnosis act harmfully. There is no weakening of the will power as is popularly supposed. If the subject be given a few suggestions directed against headache, eye-strain, and dizziness just before being awakened, and if the awakening be gradually accomplished, there are absolutely no bad after effects. The subject will feel the same as if he had awakened from a natural sleep. A patient that has once been hypnotized, however, can be more easily hypnotized subsequently, but any illegal use of this fact in the hands of a disqualified individual can be easily guarded against by suggesting that only a physician will be able to hypnotize him in the future and that only for the purpose of medical treatment.
We must here emphatically denounce as inhuman and barbaric the hypnotizing of persons for purposes of public exhibition by traveling charlatans. Here the real moral danger of hypnosis lies, for hypnosis is not a plaything, but a sound psychological precedure which should be used only for therapeutic purposes or for the analysis of certain abnormal mental states. If a hypnotized patient be left to himself, there will either be a transition into a natural sleep or he will awaken spontaneously after a certain length of time. As the hypnotic state is brought about by suggestion, so suggestion can terminate it at any time.
As today the theory of suggestion is the only accepted one, it may be stated at the outset that the various mechanical methods of hypnotizing are merely devices. The basis of all these is suggestion. Of course, no one method is universal in its application; it varies with the individual and the nature of the disease. Various investigators seem, however, to have a personal preference for certain methods, but this is more the result of habit and individual training than of any special virtue in a particular method.