Psychotherapy

CHAPTER IX

HYPNOTISM

Hypnotism is popularly supposed to be a mysterious psychological process by which susceptible subjects are brought under the influence of a person possessing some marvelous power over others' minds and wills. According to this supposition, during the periods in which the subjects are under this influence, they either have some new source of energy transferred to them from the operator's strong personality, or else they share to some extent in the will power possessed by him. In the midst of the sub-consciousness which characterizes the hypnotic condition, then, they are in some way endowed with new strength, which enables them to overcome obstacles to physical or mental health, some of which seemed at least quite insurmountable under their normal condition.

As a matter of fact, hypnotism is much simpler than this, consisting merely of a state of mental absorption in which all distracting thoughts are for the moment warded off, and only such thoughts as are suggested by the hypnotist reach the consciousness of the patient. The essence of hypnotism is the concentration of mind on one idea or only a few ideas dictated by the hypnotist. This mental concentration produces the effect of greater strength, whether apparent or real, to carry out the purposes connected with those thoughts. It is usually considered that hypnotism involves sleep, and in some cases it does. This is often undesirable. True, therapeutic hypnosis leaves at least certain senses of the subject open to perceive such things as are presented by the hypnotist's suggestion though these senses may be, and usually are, quite closed to all other perceptions. In a great many cases, though there is a real hypnotic condition, a state resembling true sleep does not occur. There is only a more or less complete concentration of attention on the suggestions of the operator, and a complete cessation of all spontaneous thought, or of all suggestions that might come in ordinary ways from the subject's own senses.

Effects of Hypnotism.—Most people have a very erroneous notion with regard to the effects of hypnotism. Some expect that the hypnotic sleep will work miracles. Nothing is more common in the experience of one who is known to employ hypnotism, even occasionally, than to have a patient who is addicted to some habit, alcoholic, drug, or sexual, ask, "Do you hypnotize?" If an affirmative answer is given, the patient proceeds to say that he has heard that one can be hypnotized, and then all the tendency to fall back into the old habit is immediately lost, and he has no further bother from it. This supposed miraculous effect of hypnotism in supplanting the necessity for using the human will has been cultivated very sedulously in the public mind by quacks and charlatans of various kinds and even exploiters of hypnotism who belong to the medical profession. But there is nothing in it. Hypnotism will not change character unless it be for the worse, since the habit of it sometimes leads to dependence on suggestion rather than spontaneous motives. Hypnotism cannot be substituted for weakness of will. The suggestions given in the hypnotic state are practically no stronger than those given in the waking state, if the patient would only equally concentrate his mind to receive them, and would be as ready in response. It is the readiness of response which comes in cumulative fashion, in the midst of the utter abstraction from other thoughts, that characterizes the hypnotic condition.

This is, of course, quite a different valuation of hypnotism from the very strong expressions, with regard to the power of hypnotists to influence the human will, which have at various times been made. These exaggerated claims have been no stronger than those often made for remedies of various kinds that have been long since discredited. I have heard a serious though young professor of psychology declare that he was not sure whether he was justified in using all the power that he possessed by hypnotism to influence men's wills to keep them from indulging in liquor to excess, because after all men had a right to their free will, even in a matter of this kind, and it would be wrong to take it away from them. He added very philosophically that no human being had the right to play the role of Providence in directing others' actions even for good, unless they themselves were perfectly satisfied. If there was any such force in hypnotism as is thus suggested, the reformation of the world, or still more its deformation, at the hands of some of the strong-minded practicers of hypnotism, would be a comparatively easy process. As a matter of fact, however, the hypnotizer has, except as regards abnormally suggestible people, only as much influence over the person hypnotized as the subject permits, and the subject retains all his personality as an individual with all his weaknesses. After he has been helped away from his weaknesses by hypnotism, he is just as likely as ever to yield to them again, unless, during the interval of conquest, he has succeeded in bracing up his will to resist them.

FORMER METHODS OF HYPNOTIZATION

All the methods of hypnotizing, then, are directed to securing this state of concentration of the patient's mind. The hypnotic state is brought about in different ways by different operators, and even the same operator must employ quite different methods to secure hypnotic influence over different subjects. In the old times, mysterious passes and strokings and rubbings of various kinds, and instruments that flashed light, or that made special sounds, were employed. Among the pioneers, each worker invented methods of his own. A review of these will bring out the fact that none of them represents essentials, and that they are only auxiliaries to secure concentration of the patient's mind.

The methods of hypnotism practiced by those most noted in the history of the art were very different from one another, but not more different than are the methods in vogue to-day among individual hypnotizers. Indeed, the practices of the past have come down as a heritage to our own time. Stroking and touching, of which we have hints in the oldest times in Egypt and Babylonia and Greece, have always been prominent features. Valentine Greatrakes dreamt that he heard a voice in his dream telling him that his right hand should be dead and that stroking it with his left should cause it to recover its power once more. After this had happened three times in succession he began to apply this method to the ills of others. Greatrakes seems really to have come in to replace the touching by the king for the King's Evil at a time when there was no king in England, Pastor Gassner, the next worker who attracted attention by hypnotic procedures, used words of command after attracting the profound attention of his patients. Father Hell employed the touch of magnets. Mesmer used music to predispose the mind, but had many of the methods of modern hypnotists.

Mesmer.—While Mesmer undoubtedly attracted attention to certain phases of hypnotism that were to prove valuable, he was by no means the first to do so, and what he did had such a tincture of charlatanism it is no wonder that he was discredited. There was a little truth, but there was a deal of mere pretense in his work. While he undoubtedly obtained results, he did so mainly because of certain mentally impressive methods that he employed in connection with whatever of hypnotism he used. Binet and Feré, who have given us some details of his work, describe his methods in such a way as to make it clear that they smacked largely of quackery:

Mesmer, wearing a coat of lilac silk, walked up and down amid his agitated throng, accompanied by Dezlon and his associates, whom he chose for their youth and comeliness. Mesmer carried a long iron wand with which he touched the bodies of the patients and especially the diseased parts. Often laying aside the wand, he magnetized the patients with his eyes, fixing his gaze on theirs, or applying his hand to the hypochondriac region and to the abdomen. This application was often applied for hours, and at other times the master made use of passes. He began by placing himself "en rapport" with his subject. Seated opposite to him, foot against foot, knee against knee, Mesmer laid his fingers upon the hypochondriac region and moved them to and fro, lightly touching the ribs. Magnetism, with strong electric currents, was substituted for these manipulations when more energetic results were to be produced. The master, raising his fingers in a pyramidal form, passed his hands all over the patient's body, beginning with the head, and going downward over the shoulders to the feet. He then returned to the head, both back and front, then the belly and the back, and renewed the process again and again until the magnetized person was saturated with the healing fluid and transported with pain or pleasure, both sensations being equally salutary. Young women were so much gratified by the crisis that they wished to be thrown into it anew. They followed Mesmer through the halls and confessed that it was impossible not to be warmly attached to the person of the magnetizer.

De Puysegur and His Successors.—De Puysegur has some definite instructions for hypnotizers, whom he called magnetizers. It is instructive even now to read these, for they emphasize the most important element in all hypnotism, the confidence of the operator in his own power, for this, communicated to the subject, produces the beneficial results:

You are to consider yourself as a magnet; your arms, and particularly your hands, being its poles; and when you touch a patient by laying one of your hands on his back, and the other in direct opposition upon his stomach, you are to imagine that the magnetic fluid has a tendency to circulate from one hand to the other through the body of the patient. You may vary this position by placing one hand on the head and the other on the stomach, still with the same intention, the same desire of doing good. The circulation from one hand to the other will continue, the head and stomach being the parts of the body where the greatest number of nerves converge; these are, therefore, the two centres to which your action ought to be mostly directed. Friction is quite unnecessary; it is sufficient to touch with great attention.

Some of these methods continued to be employed by the successors of Mesmer and De Puysegur, the sense of touch being the principal adjuvant, though Mesmer employed also the sense of hearing. Braid seems to have been the first to realize that the sense of sight could be used effectively, or perhaps that the tiring of the muscle sense might well serve as a point for the concentration of attention. He used the flash of a light from some bright object or tired the eye muscles by having the patient look upward at some object brought near so as to require convergence of vision. His methods were imitated by most of the hypnotizers of the nineteenth century. Liebault and Bernheim, at Nancy, employed them regularly, and they were used in the investigations at the Salpêtrière. It was found, however, that after a patient had been once hypnotized, all that was needed was a word of command or a definite suggestion, and the hypnotic state recurred. Further experience showed also that the original hypnotic phenomena might, in most cases, be secured very simply by word-suggestion to the patient, though some individuals required persistent efforts in the application of several methods to secure the concentration of mind on a single idea or set of ideas that is the essence of hypnotism.

By most serious hypnotists, especially those who use hypnotism for therapeutic purposes, all the rubbings and manipulations are now either completely eliminated, or are used only under special circumstances. The important element of the operator's influence consists in obtaining the complete confidence of the subject in the operator's power to control his intelligence for the time being; getting the subject to resign himself completely, with absolute assurance that his trust will be for his good, and can by no means result in harm. Without this attitude of mind on the part of the subject, anything like real hypnotism is impossible. Even with this, only a slight degree of the hypnotic condition may be secured in certain people, but the majority have a distinct susceptibility to it.

PRESENT DAY METHODS OF HYPNOTIZATION

Though various methods of producing the hypnotic sleep are in use, the rule is now that, in the course of a hypnotizer's experience, less and less external auxiliaries of any kind are needed, and more and more dependence is placed on the bringing about of mental rapport between the active and passive agencies in hypnotism by persuasion and command. If the hypnotic sleep has once been obtained, usually all that is necessary is a few gentle words, and then the command to sleep. It is at the initial attempts to hypnotize a particular person somewhat refractory to the condition that auxiliaries are needed. In these cases it is often well to tire the eyes of the patient. This is done by directing them to the fingers of the operator held well above the patient's head. After a minute or two of effort the distinct fatigue which occurs may induce forgetfulness of everything else and cause absorption in the single idea of attending only to the hypnotizer's suggestions. This constitutes the beginning of hypnotism. Occasionally the flash of a bright object, or a revolving mirror, may be used, but these are only adjuncts and may be dispensed with entirely if the operator has the patience and the time to give to the subject.

Accessories.—Some operators use a mirror on which a ray of light is cast for the purpose of concentrating the attention and bringing about tiredness of the eye muscles. In so far as it has a more universal application, sight is certainly the best sense to act upon. Other senses may be appealed to, as I suggest later. Instead of a mirror, a polished match-box or pencil-case may be used, but as a rule the less artificiality enters into it and the simpler the procedure, the better. One of the inconveniences of using the flash of a bright object is that occasionally patients who are very susceptible may, after they have had a number of hypnotic experiences, be thrown into a hypnotic condition by the flash of a light in the street, or by the reflection of light from a mirror in their own homes. These conditions of facile auto-hypnotism constitute one of the serious dangers of the practice on susceptible subjects. Whatever good may be accomplished by hypnotism will probably be reached during the first half dozen seances. To proceed with the treatment beyond this, if it is employed at regular and short intervals, is almost sure to result in harm rather than good.

Sensations.—Besides sight, sounds have sometimes been used for the purpose of inducing hypnotism. The ticks of a watch, for instance, placed at a little distance and listened to very intently, have been known to assist in securing the hypnotic state. Sometimes the sound of a gong, or an imitation of a cathedral chime, have been used in the same way. Soft music has also been used by operators with decided advantage. It is necessary that the sounds should be of a kind that do not disturb, but only attract attention to one sensation, and then, as concentration on this is secured, the hypnotic condition results. Practically any other sensation may be used in the same way. Touch is often employed. Mesmer stroked his patients gently, and others have used the same process with advantage. Some of the French workers in hypnotism have claimed that there were special portions of the body the stroking of which was likely to produce this favorable effect. They have called these regions zones hypnogenes—areas that give rise to hypnotic conditions. Strokings of the forehead, of the cheeks, of the hands, are favorite locations for these auxiliary touches. In this, as with regard to sound, the main thing is to concentrate attention on some one sensation without producing disturbing thoughts.

Stroking.—Stroking seems to affect many people and to easily induce a sort of hypnoidal condition. It is done very naturally to a child when one wants to console or encourage or admonish slightly but kindly. In older people it is a familiar gesture among those who think much of one another, and represents a very natural tendency. Even in the midst of physical discomfort its effect is quite soothing, and it is evident that something resembling hypnotism is at work. Evidently, what really happens is a concentration of attention on the sensation thus produced, which concentration prevents distracting thoughts from making themselves felt and permits the words of the one who does the stroking to produce a deeper effect on the mind than would ordinarily be possible. This seems to be nature's method of making suggestion more effective. It has been adopted, quite spontaneously, by many of the pioneers in hypnotism as the result of their observations upon its efficacy. Lloyd Tuckey calls attention to an illustration of this practice, which makes clear its effectiveness and at the same time shows how naturally it suggests itself as a mode of using mental influence. He says:

Among the medical men who have come to watch some of my cases was a gentleman who seemed much struck at seeing the method I adopted with a rather refractory subject. I held his hand and stroked his forehead while at the same time suggesting the symptoms of sleep. The gentleman told me afterward the reason why he was so interested. It appears that he had a few months previously been in attendance on a very severe and protracted case of delirium tremens. The patient could get no sleep, and the doctor was afraid of death from exhaustion. On the third evening he resolved to make a strong effort to produce sleep, and, if necessary, to sit up all night with the patient. He told the man that he would not leave him until he slept, and sitting down by the bedside, he took his hand in one of his own, and with the other gently stroked the forehead. At the same time he talked quietly and reassuringly to him. In less than half an hour he was rewarded by seeing the restlessness entirely cease and the man drop off into a quiet sleep. That sleep, the doctor told me, lasted fourteen hours, and the patient awoke out of it weak, but cured. Manipulation about the head has in many persons a most soporific effect, and several persons have told me that they always become drowsy under their barber's hands.

Drugs.—A number of drugs and related substances have been used as aids to hypnosis, but in nearly all of these cases it is doubtful whether it is true hypnotism that results and whether the suggestions in these states have much therapeutic value. One of the drugs most frequently administered by hypnotists is cannabis indica, which has long been used in the East for a similar purpose. After this, chloroform is most popular. Schrenck-Notzing even ventured to employ alcohol as an aid in hypnosis, and claims that he has succeeded at times in making intoxication pass into the true hypnotic condition. Bernheim and many others of the French school have used chloral and morphine. These substances are, however, liable to great abuse. Whenever they have to be employed it means that the patient is but little susceptible to hypnotic influence. These aids are employed only because hypnotists do not want to confess that a very considerable portion of humanity is not directly susceptible to the hypnotic influence.

Serious harm may be done by the employment of these drugs. A physician, who hoped that he would be able to overcome a drug addiction that had been the bane of his existence for a long while, went to a well-known hypnotist physician with the idea that perhaps the miracle of hypnotism would be worked in his case. He was one of these flighty mortals whom it is extremely difficult to have fix their minds upon any one idea for a definite time. As it was impossible to bring him into anything like a hypnotic condition by ordinary means, a large dose of chloral was administered. He already had an idea that his heart had been affected by his previous drug-taking habit, but the chloral was administered to him before he realized what it was. When he came out of the sleep it induced, he was in an agony of solicitude and anxiety lest his heart should have been further hurt by the chloral. He went back for no more doses of that kind of hypnotism.

The use of drugs seems to be a confession of failure to secure true hypnotism, so that it is doubtful whether their employment is justified. Suggestions received while in the more or less comatose state induced by drugs, instead of having a strengthening effect on the patient's will, rather tend to produce the idea of the impossibility of effectively using his own will, or even exercising his will when helped, as he supposes, by the will of the operator. The real value of hypnotism consists in the concentration of mind upon a particular idea without any distractions, which enables the subject to make firm resolutions and then to have his mind help his body as much as possible by directing his energy to the accomplishment of one end. When drugs are employed, they have a diffusive rather than a concentrating influence, so that the real purpose of hypnotism is entirely missed.

PRACTICE OF HYPNOTISM

In the ordinary practice of hypnotism now, the patient is placed sitting on a comfortable chair and the operator on one side facing prepares the mind of the subject by proper assurances. The patient must be brought into a thoroughly assured and comfortable state of mind and must be quite ready to submit to hypnotism. Then in most people, if the finger is held rather close to the patient and well above the line of sight, requiring special effort on the part of the superior recti muscles as well as of the power of convergence, a tired feeling will come over the subject with a tendency of the lids to droop. When this happens the subject is asked to allow the lids to drop and to quietly concentrate the attention on the idea of sleep so as to permit the drowsy feeling gradually to increase. On a first seance this may take ten minutes, subsequently much less time will be needed, and, as a rule, in five minutes the subject is quite predisposed to sleep. In more difficult cases a much longer time may be needed, and repeated efforts may have to be made. Great patience is required. The operator soon learns to adjust himself to certain peculiarities of individuals in predisposing them to the hypnotic condition.

Hypnotism Simple, Natural, Not Mysterious.—The most important thing to know about hypnotism is the fact that any one who wishes can hypnotize. There may be need for favoring circumstances, but there is no need for any special faculty in the operator. If he has confidence in himself so as to take up the question of hypnotizing seriously, if the subjects are reasonably susceptible and if they are persuaded that they may be hypnotized, or even if they are not, so long as they take the operator seriously a hypnotic state will result. Nothing is more surprising to the operator himself, the first time he succeeds, than his success. This at once gives him renewed confidence, and future hypnosis becomes a comparatively simple matter. To have this idea widely diffused would do much good, since it would at once strip the charlatans, who abuse hypnotism, of most of the mystery that surrounds them. The general diffusion of such knowledge would also do good in another way. It would expose the supposed wonderful power that some people are presumed to possess. Hypnotism works no wonders; it is a mere natural manifestation not unlike sleep, and probably not a whit more mysterious.

Stages.—A number of divisions of the hypnotic state have been suggested, but probably the simple division into three stages is the best for ordinary teaching purposes, and helps to the understanding both of the conditions themselves and of many things that are written about hypnotism.

The first stage consists of a subdued, dreamy condition, in which the patient is not asleep and yet not thoroughly awake to all that is going on around him. He has his mind so concentrated on certain thoughts that he is preoccupied, and suggestions are much more efficient than under ordinary circumstances. This is really only a state of intense attention to the suggestions that are being made, with the banishment of all distracting thoughts. It is rather difficult for any one to keep from being distracted, and whenever this is accomplished, the ideas that then enter the mind penetrate more deeply and, above all, seem to affect the will more forcibly than when they are merely superficially considered. This first stage of hypnotism would not be considered hypnotic by most people who associate the idea of sleep with hypnotism.