HYPNOIDAL PSYCHOTHERAPY
Once the hypnoidal state is induced by any of the various methods
of hypnoidization, we can either attempt to follow up the history
of the development of the malady, or we may chiefly work for
therapeutic effects. It is, however, advisable, from a purely
practical, therapeutic purpose to combine the two procedures; the
cure is then effective and far more stable. When the history of the
origin and development of the disease can not be traced, on account
of the age or unintelligence of the patient, the therapeutic
effects alone of the hypnoidal states have been utilized.
The getting access to subconscious experiences, lost to the
patient’s personal consciousness, makes the hypnoidal state a
valuable instrument in the tracing of the origin and development of
the symptoms of the psychopathic malady.
From a practical standpoint, however, the therapeutic value of the
hypnoidal state is most important. Our experiments have revealed to
us the significant fact that the hypnoidal state is the primordial
rest-state; sleep is but a derivative form. In many conditions of
disease it is advisable to have the patient revert to a simple
and primitive mode of life. Similarly, in _psychopathic diseases
a reversion to a simple, primitive state proves to be of material
help to the patient_.
In plunging the patient into the hypnoidal state, we have him
revert to a primitive rest-state with its consequent beneficial
results. The suggestibility of the state, if skillfully handled,
is apt to increase the therapeutic efficacy. Relaxation of nervous
strain, rest from worry, abatement of emotional excitement are
known to be of great help in the treatment of nervous troubles of
the neurasthenic, or of the so-called “psychoasthenic” variety.
That is what we precisely observe in the treatment of psychopathic
or neurotic diseases by means of the agency of the hypnoidal state,
the efficacy of which is all the greater on account of the presence
of the important trait of suggestibility.
The most important fact, however, is _the access gained through the
hypnoidal state to the patient’s stores of subconscious reserve
neuron energy, thus helping to bring about an association of
disintegrated, dissociated mental-systems_.
Dr. John Donley in his article, “The Clinical Use of
Hypnoidization” (_Journal of Abnormal Psychology for
August-September, 1908_), gives the following account of the method
of hypnoidization:
“The treatment of that large group of disorders, forgotten
memories, and emotions is operative in the production of mental
disaggregation, but also in those numerous instances where the
experience causing the obsessive idea or emotion is well known to
the upper consciousness.
“In hypnoidal states they were made to reproduce their obsessive
thoughts and images and then to describe them in words. When this
had been accomplished and they had received further assurance
and persuasion from the experimenter, although the purely
intellectual content of their obsessions remained known to them,
the insistent automatic character and disturbing emotional
factors had disappeared. In this metamorphosis of emotional
reaction we may observe one of the most interesting and useful
attributes of the hypnoidal state.”
Dr. Donley gives a series of cases which he treated successfully
from psychognostic and psychotherapeutic standpoints. The reader is
referred to the original article.
“The value of hypnoidization,” says Dr. T. W. Mitchell, “in the
resurrection of dissociated memories is that which is perhaps best
established. And this applies not only to the restoration of the
forgotten experiences of ordinary amnesia, but to the recovery
of dissociated memories that are of pathogenic significance....
Sidis himself has insistently taught that the reassociation of
dissociated complexes effects a cure of psychopathic disease.... My
own experience, so far as it goes, tends to corroborate in every
respect the claims put forward by Sidis....”
While in the hypnoidal state the patient hovers between the
conscious and the subconscious, somewhat in the same way as in
the half-drowsy condition one hovers between wakefulness and
sleep. The patient keeps on fluctuating from moment to moment, now
falling more deeply into a subconscious condition in which outlived
experiences are easily aroused, and again rising to the level of
the waking state. Experiences long submerged and forgotten rise
to the full light of consciousness. They come in bits, in chips,
in fragments, which may gradually coalesce and form a connected
series of interrelated systems of experiences apparently long dead
and buried. The resurrected experiences then stand out clear and
distinct in the patient’s mind. The recognition is fresh, vivid,
and instinct with life, as if the experiences had occurred the day
before.
It cannot be insisted too much that the hypnoidal state is not
a slight hypnosis. _The hypnoidal state is a light sleep state,
a twilight state._ The hypnoidal state is the anabolic state of
repose, characteristic of primitive life.
The hypnoidal state is an intermediary state between waking and
sleep. _Subwaking_ is an appropriate descriptive term of the
character of the hypnoidal state.
The subwaking hypnoidal state, like sleep and hypnosis, may be of
various depth and duration; it may range from the fully waking
consciousness and again may closely approach and even merge into
sleep or hypnosis. The same patient may at various times reach
different levels, and hence subconscious experiences which are
inaccessible at one time may become revealed at some subsequent
time, when the patient happens to go into a deeper hypnoidal state.
On account of the instability of the hypnoidal state, and because
of the continuous fluctuation and variation of its depth, the
subconscious dissociated experiences come up in bits and scraps,
and often may lack the sense of familiarity and recognition. The
patient often loses the train of subconscious association. There
is a constant struggle to maintain this highly unstable hypnoidal
state.
One has again and again to return to the same subconscious train
started into activity for a brief interval of time. One must
pick his way among streams of disturbing associations before the
dissociated subconscious experiences can be synthesized into a
whole, reproducing the original experience that has given rise to
the whole train of symptoms.
The hypnoidal state may sometimes reproduce the original experience
which, at first struggling up in a broken, distorted form, and
finally becoming synthesized, produces a full attack. The
symptoms of the malady turn out to be portions, bits and chips of
past experiences which have become dissociated, giving rise to a
disaggregated subconsciousness.
The method of hypnoidization, and the hypnoidal states induced by
it, enable us to trace the history and etiology of the symptoms,
and also to effect a synthesis and a cure. The hypnoidal state may
not be striking and sensational in its manifestations, but it is a
powerful instrument in psychopathology and psychotherapeutics.
For many years my investigations of the hypnoidal state were
carried out on subjects and patients, adults and children. Having
found that during the hypnoidal state the condition of mental
plasticity is quite pronounced for therapeutic purposes, and having
effected many cures of severe psychopathic maladies, ranging
throughout the whole domain of so-called hysterical affections,
neurasthenia, obsessions, drug habits, especially alcoholic ones,
the hypnoidal state has become in my practice quite an important
therapeutic agent. Lately, others have obtained excellent results
with the hypnoidal state in their treatment of various functional,
psychopathic or neurotic maladies.
Perhaps it may be opportune here for the sake of further
elucidation to give a few extracts from the Presidential address on
“The Hypnoidal State of Sidis,” given by Dr. T. W. Mitchell before
the Psycho-Medical Society of Great Britain, January 26, 1911.
“The history of science,” says Dr. Mitchell in his address,
“affords us many instances in which the neglect of residual
phenomena in experimental research has led to the overlooking
of important facts, and prevented investigators from making
discoveries which, had they paid attention to their residues, they
could hardly have missed. The great chemist, Cavendish, probably
missed the discovery of argon, because in his estimate of nitrogen
of the air he neglected a residue which his experiments showed him
could not be more than 1/120 part of the whole. More than a hundred
years afterwards this residue was accounted for by the discovery of
argon.
“Now in the history of Psychotherapeutics, from its earliest
beginning down to our own time, we find many cases where the
circumstances under which curative results have been obtained
render it difficult for us to range these results under the
category of the therapeutics of suggestion.
“Such cases as these may be regarded as the residual phenomena
of the therapeutics of suggestion, and just as Cavendish and his
successors too readily assumed that all the so-called nitrogen of
the air was the same as the nitrogen of nitre, so we may be missing
some important truth, if we too readily assume that all these
therapeutic results are due solely to suggestion. The value of
suggestion during hypnosis is well attested, and the possibility of
effecting physiological and psychological changes by its means is
supported by a large amount of experimental evidence. But evidence
of this kind is lacking in regard to suggestion without hypnosis,
and until it is forthcoming, we are justified in receiving
with some suspicion the account of the therapeutic efficacy of
suggestion in the waking state. We seem bound to consider whether
some state of consciousness intermediate between waking and
hypnosis may not be artificially induced and utilized for the
purpose of giving therapeutic suggestion.
“The scientific investigation of states of consciousness
intermediate between waking and hypnosis is a contribution to
psychology and psychotherapy which we owe practically to one
man--Dr. Sidis. A research into the nature of suggestibility led
him to formulate certain laws and conditions of normal and abnormal
suggestibility....
“By keeping the patient for a short time under the conditions of
normal suggestibility we induce a peculiar mental state which Sidis
named _Hypnoidal state_. The process by which it is induced is what
Sidis calls, _hypnoidization_.
“By the use of various methods a state of consciousness is induced
which differs from full waking, but is not hypnosis or ordinary
sleep.
“The hypnoidal state is an intermediary territory, on the
borderland of waking, sleep and hypnosis. In the course of a
valuable experimental investigation of sleep in man and the lower
animals, Sidis discovered that the hypnoidal state is a phase of
consciousness which is passed through in every transition from one
of these states to another. In passing from the waking state to
ordinary sleep or hypnosis, there is always a longer or shorter
hypnoidal stage. In the practice of hypnoidization the patient
sometimes drops into hypnosis, or he may fall asleep without
touching on hypnosis. And so also in awaking from sleep or from
hypnosis, the hypnoidal state has to be passed through. Sidis found
that the further we descend in the scale of animal life, the more
important does the hypnoidal state become in relation to bodily
rest and recuperation, and he concludes that it is the primitive
rest-state out of which both sleep and hypnosis have been evolved.
“The relation to each other of waking, sleep, hypnosis and the
hypnoidal state, may be represented in a diagram in which the
primitive hypnoidal state is represented as a nucleus from which
the segments of the larger circle, waking, sleep and hypnosis, have
arisen. The transition from one of these segments to another can
take place through the central territory with which they each have
relations. (See diagram on page 110.)
“The spontaneous occurrence of the hypnoidal state in man is as a
rule merely a transitory stage in the alternation of waking and
sleep. From the point of view of evolution it is a vestige derived
from a long race of ancestors, a rudimentary function which has
been superseded by the more highly specialized rest-state, sleep.
But it can be artificially induced and maintained by the methods
which have been described, and it can be utilized with effect in
the treatment of psychopathic disorders.
[Illustration: DIAGRAM III]
“The therapeutic use of the hypnoidal state is a somewhat complex
subject, for hypnoidization may be employed as an adjunct to other
methods or as a curative measure in itself.
“The full record of hypnoidization is in the account of the well
known Hanna case, given in his ‘Multiple Personality.’ This was a
case of total amnesia, following a severe injury to the head. The
patient, a cultured clergyman, was reduced to the mental condition
of a new-born child. All his former acquisitions and memories had
entirely disappeared, and he had to start learning everything
again from the beginning. When he (the patient) was put into the
hypnoidal state various fragmentary experiences of his past life
emerged into consciousness, demonstrating to his observers that his
lost memories were merely dissociated and not destroyed. This same
method (hypnoidization) was made use of in other cases of amnesia,
and it was found to be of great assistance in effecting the
resurrection of dissociated mental material and its reintegration
in consciousness.
“With the progress of his studies in Psychopathology, the
reintegration of consciousness became, for Sidis, the aim of
all therapeutic endeavor in connection with maladies that are
associated with, or produced by, mental dissociation. The
recurrent psycho-motor states of functional psychosis, insistent
ideas, imperative concepts, persistent, or periodically appearing
emotional states, so-called psychic epilepsy, and other states of
dissociation all lent themselves to treatment by hypnoidization.
By its means the dissociated complexes could be recovered, the
psychogenesis of the malady could be traced, a synthesis of
consciousness effected, and the patient thereby cured. As his
confidence in his method increased, Sidis gradually extended its
employment, until at the present time he seems to use it in every
kind of disorder in which psychotherapy is indicated.
“I have no doubt that Dr. Bramwell induces in his patients a state
of consciousness which is identical with the hypnoidal state of
Sidis.
“My own experience, so far as it goes, tends to corroborate in
every respect the therapeutic claims put forward by Sidis. I have
observed the good effects of the hypnoidal state apart from any
other measure.
“In his later writings Sidis insistently maintains that the use
of hypnoidization alone is sufficient to cure certain morbid
conditions. He bases this claim on the fact that he has found the
hypnoidal state effective towards this end, and he interprets his
results as being due to a release of reserve energy which has been
locked up in the inhibited and dissociated systems or complexes.
“The _principle of reserve energy_ is based upon a wide
generalization of facts, namely, that far less energy is utilized
by the individual than is actually at his disposal. In the struggle
for existence, those forms of life which have accumulated a store
of reserve energy that can be drawn upon in emergencies have the
best chance for survival.”
According to my experimental and clinical work the waking state,
sleep, hypnosis, and the hypnoidal state, may be differentiated as
follows:
(I) In the waking state the upper, controlling consciousness
_predominates_ over the subconscious. In other words, in the waking
state the conscious is more responsive and more active than the
subconscious which as a rule under such conditions may be regarded
as partially dormant.
(II) In sleep _both_ the conscious and the subconscious are
_reduced_ in activity, often even _inhibited_ in function. Motor
consciousness is _arrested_; motor control is paralyzed. The
personality is _disintegrated_.
(III) In hypnosis the upper, controlling consciousness is
_diminished_ in activity, while the subconscious activities
are _increased_ in extensity and intensity. In hypnosis
the relationship of the conscious and subconscious is
interchanged,--the conscious becomes subconscious, and _vice
versa_. The habitual type of character may become changed by
suggestion, giving rise to double and multiple personality,
according to the crystallization of various association systems,
while the habitual, critical attitude is reduced in intensity.
(IV) In the hypnoidal state both conscious and subconscious
functions are _lowered_ in activity with no decrease in the
intensity of critical attitude, and with _no change_ of personality.
The hypnoidal state is therefore not a light hypnosis, but rather a
_light sleeping state, a twilight state_. The hypnoidal state is a
primitive rest-state out of which sleep and hypnosis have arisen in
the course of animal evolution.