HYPNOIDAL TREATMENT
_Psychopathic or neurotic maladies do not depend on the abnormal
action of some one organ or function, but on a general condition
common to all bodily and mental functions,--the fundamental
primitive fear instinct which relates to life in general._
The deranged functions, cardiac, respiratory, or sexual,--fatigue,
conflict, shock, repression and others are only the _occasions_.
To regard any of these occasions as the sources of psychopathic
maladies is like regarding the weather-cock as the cause of the
wind. _Self-preservation and the fear instinct alone form the
source of all psychopathic maladies._
I adduce here a few cases which may be taken as typical:
Mrs. M. C., aged thirty-two years. Family history good; well
developed physically and mentally. A year before the present
trouble set in, patient suffered from a severe attack of
grippe. Menstruation, which was before painless and normal in
amount, became painful and scanty, accompanied by headaches,
indisposition, irritability, crying spells and backache which
lasted long after the menstrual period was over. The family
physician ascribed the symptoms to endometritis, mainly cervical
and treated her with absolute rest, fomentations, injections,
scarification and dilatation of the cervix, and finally curetted
the uterus. As the patient grew worse under the treatment, she was
taken to a gynecologist, who after an examination suggested an
operation. The operation was duly performed, with the result that
the nervous symptoms became intensified, and the attacks increased
in violence and duration. The turn of the nerve specialist
came next. Hysteria, neurasthenia, and the more fashionable
“psychasthenia” have been diagnosed by various neurologists. A
year of psychoanalysis made of the patient a complete wreck, with
depression, introspection and morbid self-analysis. Patient was put
by neurologist under Weir Mitchell’s treatment.
When the patient came under my care, she was in mental agonies, a
complete wreck. I gave up the Weir Mitchell rest treatment, sent
away the nurse, released the patient from solitary bed confinement,
told her to leave the sick room, to give up dieting and medicines,
and to return to a normal, active life. I kept on treating her by
the hypnoidal state. The patient began to improve rapidly, and
finally all her physical and mental symptoms disappeared; she has
continued for over six years in excellent condition of health.
A study of the case traced the fear instinct to experiences of
early childhood, fears accentuated and developed into morbid states
by the deleterious tendencies of the treatment, giving rise to a
_somatopsychosis_, the physical symptoms mainly predominating.
A lady, aged fifty-nine years, suffered from kynophobia. When about
the age of twenty-nine years she was bitten by a dog; since then
she was afraid of hydrophobia. She kept on reading in the papers
about cases of hydrophobia until the fear became developed to an
extraordinary degree and became fixed and uncontrollable. According
to the principles of evolution of psychopathic states, the fear
kept on extending. The fear psychosis included all objects that
might possibly carry the germ of hydrophobia. The neurosis became a
mysophobia.
As in all other cases of psychopathic states the psychosis was
traced to the fear instinct, the germ of which was laid in the
patient’s early history. The patient was a timid child, and was
afraid of strange animals. In the village where she lived there
were a few cases of hydrophobia which impressed her when a child.
This germ was in later life developed by thirty years’ cultivation.
Psychopathic or neurotic symptom complexes I observed in children
whose early training was favorable to the awakening and
development of the fear instinct. In children affected with fear of
animals I traced the fear psychosis to the parents who were afraid
of animals, on account of actual traumas in their life history,
_the child being influenced by imitation, by suggestion, often
subconscious, by the behavior of the parents in the presence of
animals_. Such children are predisposed to recurrent psychopathic
states.
In all such cases the etiology is easy to find, if the patient
is carefully examined. In many cases the fear instinct with its
symptom complex is associated with external objects, giving rise
to the so-called phobias. Instead, however, of being associated
with external objects, the fear instinct is frequently associated
with somatic functions (pathophobia), or with mental activities
(phrenophobia).
Man, aged forty-seven years; actor; family neurotic. Patient
suffered from anorexia, indigestion, choking, vomiting, gagging,
eructation, gastralgia, and occasional pains in the limbs. He led
a rather gay and irregular life up to the age of thirty-two years,
when he had syphilis, for which he was under treatment for two
years. This scared him because he had the opportunity to see the
consequences of syphilis in many of his friends. He had been under
continual fear of the possibility of development of parasyphilitic
diseases.
Seven years ago, at the age of forty years, he had to watch at the
bedside of an intimate friend, who had been suffering from severe
gastric crises of tabes dorsalis. After one specially exhausting
night of vigil, worry and fear, he went to bed for a short nap and
woke up with the idea of general paresis and intense fear. From
that time he began to suffer from symptoms of tabes with fear of
general paresis.
The patient had been an imaginative child; he had his fear instinct
cultivated from early childhood by stories of frights, scares,
and horrible accidents. When ten years old, his grandfather gave
_Faust_ to him to read. Since then the patient was troubled with
the fear of selling his soul to Satan. The patient was religious
in his childhood, prayed much, and was possessed by the fear of
committing sins. “It has now all come back,” he complained. A great
number of fears could be traced to his early childhood. The somatic
symptoms were the manifestations of association of experiences of
parasyphilitic diseases, based on the pathological state of the
fear instinct, a case of pathophobia, a somatopsychosis.
A few hypnoidal treatments effected a cure. The patient returned to
his occupation, free from any distressing symptoms.
H. M. aged twenty-seven years, male, Canadian. Family history
good; looked pale, anemic, and frail; very intelligent, sensitive,
restless, and had a tendency to worry. About a year ago, he began
to feel depressed, to worry about his health; thought he suffered
from tuberculosis. His physician assured him that nothing was the
matter, but he had an uncontrollable fear of consumption; and the
idea kept on recurring. Up to the age of nineteen years he was
perfectly well. He was then laid up with a sore knee for a few
weeks. He had time enough to brood over the knee, and read some
literature on the subject. He thought it was tuberculosis and
worried much. The knee, however, got well, and gradually he forgot
all about it, although the idea of tuberculosis often made him feel
uncomfortable, and the idea of “water in the knee” used to flash
through his mind, to pass away the next moment.
A year ago, however, he happened to lose his work, became
despondent, began to worry and to brood over his financial
troubles, slept restlessly, suffered from anorexia, and began to
lose flesh. The idea of the knee and the fear of tuberculosis
got possession of him. He could not rid himself of the idea of
tuberculosis. If in the clinic the physician assured him that he
was all right, he felt better for a couple of hours; but often it
did not last even as long as that. The least pain, cough, heart
beat, a feeling of chill or heat, and the like, brought the idea
and fear of tuberculosis back to his mind with renewed energy. He
was obsessed by the fear of tuberculosis and felt he was doomed to
certain death, a psychosomatic pathophobia.
Hypnoidal states did good service. The patient’s mental condition
began to improve rapidly. He was no longer troubled with
depression, insomnia, and fears; began to gain in weight, appetite
improved, felt energy flowing in; began to look for work in real
earnest, finally found it, and kept at it.
Man, aged forty-three years, suffered from palpitation of the
heart, fainted easily, especially on physical examination by
physician, or at the beginning of medical treatment. He suffered
from indigestion for which he had been under treatment for a number
of years by physicians who gave him medicine for his bowels and
also from time to time kept on washing his stomach. He had a great
fear of becoming a victim of cardiac troubles, especially of some
unknown, terrible, valvular affection. When under my care he kept
on asking to be taken to heart and stomach specialists, to be
examined, and have some radical operation performed. Frequently
under the influence of the fear states and obsession of heart and
stomach trouble, especially the heart, he would collapse suddenly,
be unable to walk, and be afraid that he suffered from some
paralysis.
On examination the patient revealed a history full of various
traumas which, from his very childhood until he came under my care,
helped to bring about his psychopathic condition, and developed the
fear instinct to an extraordinary degree.
Physicians had the lion’s share in this special case by their
rearing of the fear instinct, and by their favoring the patient’s
phobias by their examinations, by their prescriptions, and by the
diet and treatment. The patient was in such a panic that he kept
on taking his pulse on the least occasion, was feeling his heart,
stomach, and intestines at every opportunity. The hypertrophied
growth of his morbid self and fear instinct had invaded and
dominated the patient’s whole personality, developed a typical
psychosomatic pathophobia with its recurrent states. The patient
was cured by hypnoidal states.
In the _Trudi_ for 1913 of the University of Moscow, Russia,
Doctor Ribakov made an extensive study of a series of cases of
psychopathic or psychoneurotic asthma, and arrived at a conclusion
similar to my own, although he was no doubt unaware of my work and
publications on the same subject. He came to the same conclusion
as I that the etiology of _neurosis is to be found in fear, which
alone forms the basis of psychopathic neurosis. All other factors,
social, professional, sexual, religious, repressions, conflicts are
only occasions of the disease. It is fear, and fear alone that
forms the pathology of the psychopathic neurotic symptom complex._
A young lady was afflicted with ornithophobia, fear of birds, fear
of chickens. The sight of a chicken set her into a panic. The
patient is very timid, and this timidity can be traced to her early
childhood. When at the age of six, a play-mate threw a live chicken
at her in the dark. The child was terribly frightened, screamed,
and fainted. The mother used to tell her fairy stories full of
adventure, of ghosts, of dragons, and of monsters. This prepared
the patient to react so violently to the sudden attack made by the
flight, struggling, and feel of the chicken in the dark. Since that
time, patient has formed an uncontrollable fear of live birds.
Another patient of mine, a lady of forty-nine years, single,
suffered from potamophobia, a fear of going into rivers, or into
the ocean. When about seven years old she was thrown into water by
one of her elder sisters. She was nearly drowned and was half dead
with fear when rescued. Since then she has been in terror of water,
or rather of rivers and oceans. Several times she made conscious
efforts to get rid of the fear, but the attempts were unsuccessful.
In fact, the more she was forced or forced herself consciously to
get into the water, the greater was the fear. This fear became
all the more intensified, when some of her intimate friends were
drowned in a boat. This fixed the fear which became uncontrollable.
A patient of mine, a man of thirty-five years, was afraid of going
out in the dark. This was traced to early associations of fears of
the dark, to superstitious beliefs in ghosts and spirits cultivated
in the patient’s early childhood. He was afraid to remain alone
in the dark or to go down at night into cellars or other secluded
places. This fear was unfortunately still more intensified by an
accident. At the age of twenty-seven, one night when returning
late from a visit, he was assaulted from behind by foot-pads. This
accident fixed the fear of darkness.
A lady of sixty-seven years, with pronounced arteriosclerosis, had
an attack of hemiplegia of the left side. She suffered from motor
aphasia, but did not lose consciousness. The paralysis cleared up
in a few days, but the sudden attack demoralized her. Since that
time she is in terror of another attack. She watches for symptoms,
and the least sensation of faintness throws her into a panic. The
patient is the wife of a general and was in China during the Boxer
riots, in the Spanish American war, in the Philippines, and other
military engagements. The fear instinct was cultivated in her by
all such conditions.
In her early childhood there were fears and frights of child
character, enough to arouse the fear instinct, which was gradually
developed and cultivated by the circumstances of life and by
worries in the course of the various wars, of which she was a
witness. Finally the fear culminated by the stroke of paralysis.
Similarly, I had patients who suffered from tuberculosis, from
asthma, from heart trouble, and from all kinds of intestinal
affections which specially abound in psychopathic cases. All
such cases can be clearly traced to various somatic symptoms
based on the fear instinct. The etiology is fear, the arousal and
development of the fear instinct in respect to the special symptom
complex.
A patient, aged twenty-six years, suffered from agoraphobia at
various intervals. As a child of nine years, he was attacked by
rough boys. He freed himself and ran in great terror. The boys
threatened him with another “licking” when he appeared again
on the street. He was afraid to go out for several weeks. The
parents forced him to go and buy some things. Living in a rough
neighborhood, on account of his father’s circumstances, he had been
many times subjected to knocks, blows, and assaults by rough boys,
until the fear of the open street became fixed into the well known
form of agoraphobia.
Another case, that of a lady of thirty-eight years, married,
suffers from ailurophobia, or fear of cats. This can be traced to
the patient’s early childhood. When she was a child her brothers
and sisters went through attacks of diphtheria, which was ascribed
to infection caused or transmitted by cats. The patient was
specially impressed with the danger from cats. Under such training
and suggestion given in early childhood, the patient gradually
formed a fear of cats. This fear was still more intensified and
became a panic when she was put into a dark room and a cat was let
loose on the poor victim by her mischievous companions, who knew
of the patient’s fear. When the patient had children of her own,
she was still more affected by the fear of cats, on account of the
subconscious and conscious fear of the possibility of infection
transmitted by cats to her children.
All those cases were investigated and cured by hypnoidal states.
Mr. D., a young man of twenty-five years, was born in Poland. As
far as can be ascertained, the parents as well as the brothers and
sisters are well. A physical examination of the patient reveals
nothing abnormal. There are no sensory, no motor disturbances.
He complains of severe headaches, preceded by a feeling of
indisposition, depression, vertigo and distress. During the attack
there is hyperesthesia to touch, pressure, temperature, and to
visual and auditory stimulations. _The patient shivers and looks
pale._ The cold experienced during the attack is so intense that
the patient has to wrap himself in many blankets, as if suffering
from a malarial paroxysm.
Fears have strong possession of the patient’s mind. He is afraid to
remain in a closed place in the daytime and especially at night.
When he has to remain alone at night, he is in an agony of fear,
and cannot go to sleep. Every passer-by is regarded as a robber or
murderer, and he quakes at the least noise. When walking in the
house in the dark, he has the feeling as if someone were after him,
and occasionally even experiences the hallucination of some one
tugging at his coat. He is mortally afraid of the dead and shuns
a funeral. The patient has also a fear of dogs, a kynophobia. The
fear is irresistible, and is as involuntary as a reflex.
An investigation, by means of the hypnoidal states, brought out
of the patient’s subconscious life the following data: When a
child of three years, the patient lived with his family in a
small village near a large forest infested with wolves. In one of
the intermediary states a faint memory, rather to say a vision,
struggled up, a vision of wolves and dogs. Some one cried out:
“Run, wolves are coming!” Crazed with fear, he ran into the hut and
fell fainting on the floor. It turned out to be dogs instead of
a pack of wolves. It is that fright in early childhood which has
persisted in the subconscious mind, and, having become associated
with subsequent experiences of attacks of dogs, has found
expression in the patient’s consciousness as an instinctive fear of
dogs.
But why was the patient in such abject terror of dead people? This
found its answer in the experiences and training of his early life.
When a young child, the patient heard all kinds of ghost stories,
and tales of wandering lost souls and of spirits of dead people
hovering about the churchyard and burial grounds; he heard tales
of ghouls and of evil spirits inhabiting deserted places, dwelling
in the graves of sinners and the wicked. He listened to stories of
haunted houses and of apparitions stalking about in the dark. His
social and religious environment has been saturated with the belief
in the supernatural, as is usually the case among the superstitious
populations of Eastern Europe. We cannot wonder, then, that an
impressionable child brought up under such conditions should stand
in mortal fear of the supernatural, especially of the dead.
When the patient was about nine years old, his parents noticed
some prominences on his right chest. It was suggested to them that
the hand of a dead person possessed the property of blighting life
and arresting all growth, and would, therefore, prove a “powerful
medicine” for undesirable growths. It happened that an old woman
in the neighborhood died. The little boy was taken into the room
where the dead body was lying, and the cold hand of the corpse was
put on the child’s naked chest. The little fellow fainted away in
terror. The fear of dead people became subconsciously fixed, and
manifested itself as an insistent fear of the dead, and, in fact,
of anything connected with the dead and the world of spirits.
The patient had hardly recovered from the shock of the “dead hand,”
when he had to pass through a still more severe experience. A party
of drunken soldiers, stationed in the little town, invaded his
house and beat his father unmercifully, almost crippled him: they
knocked down his mother, killed a little brother of his, and he
himself, in the very depth of a winter night, dressed in a little
shirt and coat, made his escape to a deserted barn, where he passed
the whole night. He was nearly frozen when found in the morning,
crouching in a corner of the barn, shivering with fear and cold.
From that time on the headaches manifested themselves in full
severity, with hyperesthesia and death-like paleness and intense
cold of the body. The early cultivation of the fear instinct
resulted in a _neurosis_ with its recurrent states.
Another patient is a man of thirty years; his family history is
good. He is physically well developed, a well known professor
of physics in one of the foremost institutions in this country.
He suffers from attacks of loss of personality. The attack is
of a periodical character, coming on at intervals of two weeks,
occasionally disappearing for a few months, then reasserting
itself with renewed energy and vigor. During the attack the
patient experiences a void, a panic, which is sudden in its onset,
like _petit mal_. The trouble was diagnosed as larval or psychic
epilepsy; the man was referred to me by Dr. Morton Prince as an
extremely interesting, but puzzling neurological case.
Patient feels that his “self” is gone. He can carry on a
conversation or a lecture during the attack, so that no outsider
can notice any change in him, but his self is gone, and all that he
does and says, even the demonstration of a highly complex problem
in integral calculus is gone through in an automatic way. The
fury of the attack lasts a few moments, but to him it appears of
long duration. He is “beside himself,” as he puts it. He seems to
stand beside himself and watch his body, “the other fellow,” as
he describes it, carry on the conversation or the lecture. He is
“knocked out of his body, which carries on all those complicated
mental processes.” For days after he must keep on thinking of
the attack, feels scared and miserable, thinking insistently, in
great agony, over his awful attack, _a recurrent psychoneurotic
phrenophobia_.
At first the patient could trace this attack only as far back as
his seventh year. Later on, earlier experiences of childhood came
to light, and then it became clear that the _attack developed out
of the primitive instinctive fear of early childhood_, fear of the
unfamiliar, fear of the dark, of the unknown, of the mysterious,
fears to which he had been subjected in his tender years.
This state was further reinforced by the early death of his
parents, it was hammered in and fixed by hard conditions of life,
full of apprehension and anxiety. Life became to the child one
big mysterious fear of the unknown. The fear instinct formed the
pathological focus of the attack. As the patient puts it: “It is
the mystical fear of the attacks which overpowers me.”
With the disintegration of the focus the symptom complex of the
attacks disappeared. The patient is in excellent condition, he is
doing brilliant work in physics and chemistry and is professor in
one of the largest universities in Canada.
I present another case apparently “paranoidal,” a case interesting
from our standpoint. The patient is a man of twenty-seven years;
his parents are neurotic, religious revivalists. As far back as
the age of eight he suffered from agonizing fears of perdition and
scares of tortures in hell, impressed on his sensitive, young mind
during the revivals. He is very religious, obsessed with the fear
of having committed an unpardonable sin. He thinks he is damned to
suffer tortures in hell for all eternity. He keeps on testing any
chance combinations, and if his guesses turn out correct, he is
wrought up to a pitch of excitement and panic. For to him it means
a communication coming from an unseen world of unknown mysterious
powers. With his condition diagnosed as “paranoidal dementia
praecox,” the patient was committed to an insane asylum, from which
he was subsequently released.
The attack comes in pulses of brief duration, followed by long
periods of brooding, depression, and worry. The primitive fear
of pain, of danger and death, and the sense of the mysterious
cultivated by his religious training, reached here an extraordinary
degree of development. Among the earliest memories that have
come up in the hypnoidal state was the memory of a Sunday school
teacher, who cultivated in the patient, then but five years of age,
those virulent germs which, grown on the soil of the primitive
instinctive fear and the highly developed sense of the unknown
and the mysterious, have brought forth poisonous fruits which now
form the curse of his life. The case is a typical _psychoneurotic
phrenophobia_ with its characteristic recurrent states.
“It is difficult,” the patient writes, “to place the beginning
of my abnormal fear. It certainly originated from doctrines of
hell which I heard in early childhood, particularly from a rather
ignorant teacher who taught Sunday school. My early religious
thought was chiefly concerned with the direful eternity of torture
that might be awaiting me, if I was not good enough to be saved.”
After a couple of years of persistent treatment by means of the
hypnoidal state and by methods of association and disintegration of
the active subconscious systems, the patient recovered. He entered
a well known medical school and took the foremost rank among the
medical students.[9]
_In the investigation or psychognosis of psychopathic cases I
invariably find the psychopathology to be a morbid condition
of the fear instinct, rooted in the primordial impulse of
self-preservation._ The psychognosis of this underlying
pathological state and disintegration of the latter are of
the utmost consequence in the domain of psychopathology and
psychotherapeutics.
FOOTNOTE:
[9] A full account of the cases is published in my volume “The
Causation and Treatment of Psychopathic Diseases.”