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Chapter 27 Hypnotism.
Modes of Operating, and Susceptibility.
THE 'hypnotic,' 'mesmeric,' or 'magnetic' trance can be induced in various ways, each operator having his pet method. The simplest one is to leave the subject seated by himself, telling him that if he close his eyes and relax his muscles and, as far as possible, think of vacancy, in a few minutes he will 'go off.' On returning in ten minutes you may find him effectually hypnotized. Braid used to make his subjects look at a bright button held near their forehead until their eyes spontaneously closed. The older mesmerists made 'passes' in a downward direction over the face and body, but without contact. Stroking the skin of the head, face, arms and hands, especially that of the region round the brews and eyes, will have the same effect. Staring into the eyes of the subject until the latter droop; making him listen to a watch's ticking; or simply making him close his eyes for a minute whilst you describe to him the feeling of falling into sleep, 'talk sleep' to him, are equally efficacious methods in the hands of some operators; whilst with trained subjects any method whatever from which they have been led by previous suggestion to expect results will be successful. 1 The touching of an object which they are told has been 'magnetized,' the drinking of 'magnetized' water, the reception of a letter ordering them to sleep, etc., are means which have been frequently employed. Recently M. Liégeois has hypnotized some of his subjects at a distance of 1 ½ kilometres by giving them an intimation to that effect through a telephone. With some subjects, if you tell them in advance that at a certain hour of a certain day they will become entranced, the prophecy is fulfilled. Certain hysterical patients are immediately thrown into hypnotic catalepsy by any violent sensation, such as a blow on a gong or the flashing of an intense light in their eyes. Pressure on certain parts of the body (called zones hypnognes by M. Pitres) rapidly produces hypnotic sleep in some hysterics. These regions, which differ in different subjects, are oftenest found on the forehead and about the root of the thumbs. Finally, persons in ordinary sleep may be transferred into the hypnotic condition by verbal intimation or contact, performed so gently as not to wake them up.
Some operators appear to be more successful than others in getting control of their subjects. I am informed that Mr.Gurney (who made valuable contributions to the theory of hypnotism) was never able himself to hypnotize, and had to use for his observations the subjects of others. On the other hand, Liébault claims that he hypnotizes 92 per cent of all comers, and Wetterstrand in Stockholm says that amongst 718 persons there proved to be only 18 whom he failed to influence. Some of this disparity is unquestionably due to differences in the personal 'authority' of the operator, for the prime condition of success is that the subject should confidently expect to be entranced. Much also depends on the operator's tact in interpreting the physiognomy of his subjects, so as to give the right commands, and 'crowd it on' to the subject, at just the propitious moments. These conditions account for the fact that operators grow more successful the more they operate. Bernheim says that whoever does not hypnotize 80 per cent of the persons whom he tries has not yet learned to operate as he should. Whether certain operators have over and above this a peculiar 'magnetic power' is a question which I leave at present undecided. 2 Children under three or four, and insane persons, especially idiots, are unusually hard to hypnotize. This seems due to the impossibility of getting them to focus their attention continuously on the idea of the coming trance. All ages above infancy are probably equally hypotizable, as are all races and both sexes. A certain amount of mental training, sufficient to aid concentration of the attention, seems a favorable condition, and so does a certain momentary indifference or passivity as to the result. Native strength or weakness of 'will' have absolutely nothing to do with the matter. Frequent trances enormously increase the susceptibility of a subject, and many who resist at first succumb after several trials. Dr. Moll says he has more than once succeeded after forty fruitless attempts. Some experts are of the opinion that every one is hypnotizable essentially, the only difficulty being the more habitual presence in some individuals of hindering mental preoccupations, which, however, may suddenly at some moment be removed.
The trance may be dispelled instantaneously by saying in a rousing voice, 'All right, wake up!' or words of similar purport. At the Saléptrière they awaken subjects by blowing on their eyelids. Upward passes have an awakening effect; sprinkling cold water ditto. Anything will awaken a patient who expects to be awakened by that thing. Tell him that he will wake after counting five, and he will do so. Tell him to waken in five minutes, and he is very likely to do so punctually, even though he interrupt thereby some exciting histrionic performance which you may have suggested. -- As Dr. Moll says, any theory which pretends to explain the physiology of the hypnotic state must keep account of the fact that so simple a thing as hearing the word 'wake!' will end it.
Theories About the Hypnotic State.
The intimate nature of the hypnotic condition, when once induced, can hardly be said to be understood. Without entering into details of controversy, one may say that three main opinions have been held concerning it, which we may call respectively the theories of
1. Animal magnetism;
2. of Neurosis; and finally of
3. Suggestion.
According to the animal-magnetism theory there is a direct passage of force from the operator to the subject, whereby the latter becomes the former's puppet. This theory is nowadays given up as regards all the ordinary hypnotic phenomena, and is only held to by some persons as an explanation of a few effects exceptionally met with.
According to the neurosis-theory, the hypnotic state is a peculiar pathological condition into which certain pre-disposed patients fall, and in which special physical agents have the power of provoking special symptoms, quite apart from the subjects mentally expecting the effect. Professor Charcot and his colleagues at the Salpétrière hospital admit that this condition is rarely found in typical form. They call it then le grand hypnotisme, and say that it accompanies the disease hystero-epilepsy. If a patient subject to this sort of hypnotism hear a sudden loud noise, or look at a bright light unexpectedly, she falls into the cataleptic trance. Her limbs and body offer no resistance to movements communicated to them, but retain permanently the attitudes impressed. The eyes are staring, there is insensibility to pain, etc., etc. If the eyelids be forcibly closed, the cataleptic gives place to the lethargic condition, characterized by apparent abolition of consciousness, and absolute muscular relaxation except where the muscles are kneaded or the tendons struck by the operator's hand, or certain nerve-trunks are pressed upon. Then the muscles in question, or those supplied by the same nerve-trunk enter into a more or less steadfast tonic contraction. Charcot calls this symptom by the name of neuro-muscular hyperexcitability. The lethargic state may be primarily brought on by fixedly looking at anything, or by pressure on the closed eyeballs. Friction on the top of the head will make the patient pass from either of the two preceding conditions into the somnambulic state, in which she is alert, talkative, and susceptible to all the suggestions of the operator. The somnambulic state may also be induced primarily, by fixedly looking at a small object. In this state the accurately limited muscular contractions characteristic of lethargy do not follow upon the above-described manipulations, but instead of them there is a tendency to rigidity of entire regions of the body, which may upon occasion develop into general tetanus, and which is brought about by gently touching the skin or blowing upon it. M. Charcot calls this by the name of cutaneo-muscular hyperexcitability.
Many other symptoms, supposed by their observers to be independent of mental expectation, are described, of which I only will mention the more interesting. Opening the eyes of a patient in lethargy causes her to pass into catalepsy. If one eye only be opened, the corresponding half of the body becomes cataleptic, whilst the other half remains in lethargy. Similarly, rubbing one side of the head may result in a patient becoming hemilethargic or hemicataleptic and hemisomnambulic. The approach of a magnet (or certain metals) to the skin causes these half-states (and many others) to be transferred to the opposite sides. Automatic repetition of every sound heard ('echolalia') is said to be produced by pressure on the lower cervical vertebræ or on the epigastrium. Aphasia is brought about by rubbing the head over the region of the speech-centre. Pressure behind the occiput determines movements of imitation. Heidenhain describes a number of curious automatic tendencies to movement, which are brought about by stroking various portions of the vertebral column. Certain other symptoms have been frequently noticed, such as a flushed face and cold hands, brilliant and congested eyes, dilated pupils. Dilated retinal vessels and spasm of the accommodation are also reported.
The theory of Suggestion denies that there is any special hypnotic state worthy of the name of trance or neurosis. All the symptoms above described, as well as those to be described hereafter, are results of that mental susceptibility which we all to some degree possess, of yielding assent to outward suggestion, of affirming what we strongly conceive, and of acting in accordance with what we are made to expect. The bodily symptoms of the Salépêtrière patients are all of them results of expectation and training. The first patients accidentally did certain things which their doctors thought typical and caused to be repeated. The subsequent subjects 'caught on' and followed the established tradition. In proof of this the fact is urged that the classical three stages and their grouped symptoms have only been reported as spontaneously occurring, so far, at the Salpétrière, though they may be superinduced by deliberate suggestion, in patients anywhere found. The ocular symptoms, the flushed face, accelerated breathing, etc., are said not to be symptoms of the passage into the hypnotic state as such, but merely consequences of the strain on the eyes when the method of looking at a bright object is used. They are absent in the subjects at Nancy, where simple verbal suggestion is employed. The various reflex effects (aphasia, echolalia, imitation, etc.) are but habits induced by the influence of the operator, who unconsciously urges the subject into the direction in which he would prefer to have him go. The influence of the magnet, the opposite effects of upward and downward passes, etc., are similarly explained. Even that sleepy and inert condition, the advent of which seems to be the prime condition of farther symptoms being developed, is said to be merely due to the fact that the mind expects it to come; whilst its influence on the other symptoms is not physiological, so to speak, but psychical, its own easy realization by suggestion simply encouraging the subject to expect that ulterior suggestions will be realized with equal ease. The radical defenders of the suggestion-theory are thus led to deny the very exist- ence of the hypnotic state, in the sense of a peculiar trance-like condition which deprives the patient of spontaneity and makes him passive to suggestion from without. The trance itself is only one of the suggestions, and many subjects in fact can be made to exhibit the other hypnotic phenomena without the preliminary induction of this one.
The theory of suggestion may be said to be quite triumphant at the present day over the neurosis-theory as held at the Salpétrière, with its three states, and its definite symptoms supposed to be produced by physical agents apart from co-operation of the subject's mind. But it is one thing to say this, and it is quite another thing to say that there is no peculiar physiological condition whatever worthy of the name of hypnotic trance, no peculiar state of nervous equilibrium, 'hypotaxy,' 'dissociation,' or whatever you please to call it, during which the subject's susceptibility to outward suggestion is greater than at ordinary times. All the facts seem to prove that, until this trance-like state is assumed by the patient, suggestion produces very insignificant results, but that, when it is once assumed, there are no limits to suggestion's power. The state in question has many affinities with ordinary sleep. It is probable, in fact, that we all pass through it transiently whenever we fall asleep; and one might most naturally describe the usual relation of operator and subject by saying that the former keeps the latter suspended between making and sleeping by talking to him enough to beep his slumber from growing profound, and yet not in such a way as to wake him up. A hypnotized patient, left to himself, will either fall sound asleep or wake up entirely. The difficulty in hypnotizing refractory persons is that of catching them at the right moment of transition and making it permanent. Fixing the eyes and relaxing the muscles of the body produce the hypnotic state just as they facilitate the advent of sleep. The first stages of ordinary sleep are characterized by a peculiar dispersed attitude of the attention. Images come before consciousness which are entirely incongruous with our ordinary beliefs and habits of thought. The latter either vanish altogether or withdraw, as it were, inertly into the background of the mind, and let the incongruous images reign alone. These images acquire, more-over, an exceptional vivacity; they become first 'hypnagogic hallucinations,' and then, as the sleep grows deeper, dreams. Now the 'mono-ideism,' or else the impotency and failure to 'rally' on the part of the background-ideas, which thus characterize somnolescence, are unquestionably the result of a special physiological change occurring in the brain at that time. Just so that similar mono-ideism, or dissociation of the reigning fancy from those other thoughts which might possibly act as its 'reductives,' which characterize the hypnotic consciousness, must equally be due to a special cerebral change. The term 'hypnotic trance,' which I employ, tells us nothing of what the change is, but it marks the fact that it exists, and is consequently a useful expression. The great vivacity of the hypnotic images (as gauged by their motor effects), the oblivion of them when normal life is resumed, the abrupt awakening, the recollection of them again in subsequent trances, the anæsthesia and hyperæsthesia which are so frequent, all point away from our simple waking credulity and 'suggestibility' as the type by which the phenomena are to be interpreted, and make us look rather towards sleep and dreaming, or towards those deeper alterations of the personality known as automatism, double consciousness, or 'second' personality for the true analogues of the hypnotic trance. 3 Even the best hypnotic subjects pass through life without anyone suspecting them to possess such a remarkable susceptibility, until by deliberate experiment it is made manifest. The operator fixes their eyes or their attention a short time to develop the propitious phase, holds them in it by his talk, and the state being there, makes them the puppets of all his suggestions. But no ordinary suggestions of waking life ever took such control of their mind.
The suggestion-theory may therefore be approved as correct, provided we grant the trance-state as its prerequisite. The three states of Charcot, the strange reflexes of Heidenhain, and all the other bodily phenomena which have been called direct consequences of the trance-state itself, are not such. They are products of suggestion, the trance-state having no particular outward symptoms of its own; but without the trance-state there, those particular suggestions could never have been successfully made. 4
The Symptoms of the Trance.
This accounts for the altogether indefinite array of symptoms which have been gathered together as characteristic of the hypnotic state. The law of habit dominates hypnotic subjects even more than it does waking ones. Any sort of personal peculiarity, any trick accidentally fallen into in the first instance by some one subject, may, by attracting attention, become stereotyped, serve as a pattern for imitation, and figure as the type of a school. The first subject trains the operator, the operator trains the succeeding subjects, all of them in perfect good faith conspiring together to evolve a perfectly arbitrary result. With the extraordinary perspicacity and subtlety of perception which subjects often display for all that concerns the operator with whom they are en rapport, it is hard to keep them ignorant of anything which he expects. Thus it happens that one easily verifies on new subjects what one has already seen on old ones, or any desired symptom of which one may have heard or read.
The symptoms earliest observed by writers were all thought to be typical. But with the multiplication of observed phenomena, the importance of most particular symptoms as marks of the state has diminished. This lightens very much our own immediate task. Proceeding to enumerate the symptoms of the hypnotic trance, I may confine myself to those which are intrinsically interesting, or which differ considerably from the normal functions of man.
First of all comes amnesia. In the earlier stages of hypnotism the patient remembers what has happened, but with successive sittings he sinks into a deeper condition, which is commonly followed by complete loss of memory. He may have been led through the liveliest hallucinations and dramatic performances, and have exhibited the intensest apparent emotion, but on waking he can recall nothing at all. The same thing happens on waking from sleep in the midst of a dream -- it quickly eludes recall. But just as we may be reminded of it, or of parts of it, by meeting persons or objects which figured therein, so on being adroitly prompted, the hypnotic patient will often remember what happened in his trance. One cause of the forgetfulness seems to be the disconnection of the trance performances with the sys-tem of waking ideas. Memory requires a continuous train of association. M. Delboeuf, reasoning in this way, woke his subjects in the midst of an action begun during trance (washing the hands, e.g.), and found that they then remembered the trance. The act in question bridged over the two states. But one call often make them remember by merely telling them during the trance that they shall remember. Acts of one trance, moreover, are usually recalled, either spontaneously or at command, during another trance, provided that the contents of the two trances be not mutually incompatible.
Suggestibility. The patient believes everything which his hypnotizer tells him, and does everything which the latter commands. Even results over which the will has normally no control, such as sneezing, secretion, reddening and growing pale, alterations of temperature and heart-beat, menstruation, action of the bowels, etc., may take place in consequence of the operator's firm assertions during the hypnotic trance, and the resulting conviction on the part of the subject, that the effects will occur. Since almost all the phenomena yet to be described are effects of this heightened suggestibility, I will say no more under the general head, but proceed to illustrate the peculiarity in detail.
Effects on, the voluntary muscles seem to be those most easily got; and the ordinary routine of hypnotizing consists in provoking them first. Tell the patient that he cannot open his eyes or his mouth, cannot unclasp his hands or lower his raised arm, cannot rise from his seat, or pickup a certain object from the floor, and he will be immediately smitten with absolute impotence in these regards. The effect here is generally due to the involuntary contraction of antagonizing muscles. But one can equally well suggest paralysis, of an arm for example, in which case it will hang perfectly placid by the subject's side. Cataleptic and tetanic rigidity are easily produced by suggestion, aided by handling the parts. One of the favorite shows at public exhibitions is that of a subject stretched stiff as a board with his head on one chair and his heels on another. The cataleptic retention of impressed attitudes differs from voluntary assumption of the same attitude. An arm voluntarily held out straight will drop from fatigue after a quarter of an hour at the at most, and before it falls the agent's distress will be made manifest by oscillations in the arm, disturbances in the breathing, etc. But Charcot has shown that an arm held out in hypnotic catalepsy, though it may as soon descend, yet does so slowly and with no accompanying vibration, whilst the breathing remains entirely calm. He rightly points out that this shows a profound physiological change, and is proof positive against simulation, as far as this symptom is concerned. A cataleptic attitude, moreover, may be held for many hours. -- Sometimes an expressive attitude, clinching of the fist, contraction of the brows, will gradually set up a sympathetic action of the other muscles of the body, so that at last a tableau vivant of fear, anger, disdain, prayer, or other emotional condition, is produced with rare perfection. This effect would seem to be due to the suggestion of the mental state by the first contraction. Stammering, aphasia, or inability to utter certain words, pronounce certain letters, are readily producible by suggestion.
Hallucinations of all the senses and delusions of every conceivable kind can be easily suggested to good subjects. The emotional effects are then often so lively, and the pantomimic display so expressive, that it is hard not to believe in a certain 'psychic hyper-excitability,' as one of the concomitants of the hypnotic condition. You call make the subject think that he is freezing or burning, itching or covered with dirt, or wet; you can make him eat a potato for a peach, or drink a cup of vinegar for a glass of champagne; 5 ammonia will smell to him like cologne water; a chair will be a lion, a broom-stick a beautiful woman, a noise in the street will be an orchestral music, etc., etc., with no limit except your powers of invention and the patience of the lookers on. 6 Illusions and hallucinations form the pieces de résistance at public exhibitions. The comic effect is at its climax when it is successfully suggested to the subject that his personality is changed into that of a baby, of a street boy, of a young lady dressing for a party, of a stump orator, or of Napoleon the Great. He may even be transformed into a beast, or an inanimate thing like a chair or a carpet, and in every case will act out all the details of the part with a sincerity and intensity seldom seen at the theatre. The excellence of the performance is in these cases the best reply to the suspicion that the subject may be shammi............
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