Psychotherapy, Hugo Münsterberg [dar e dil novel online reading txt] 📗

a particular person. All the manipulations, passes, fixation, monotonous speaking, and so on narrow the contents of consciousness but hold the idea of the hypnotizing person steadily in the center of attention. The awakened expectation of sleep, the associated feeling of tiredness all help to cut off attention from the remainder of the world, but as no real sleep sets in, this cutting off from the remainder reënforces the focusing of attention on the one central idea of the hypnotizing personality. Every word and every movement of this personality become therefore absorbed with that over-attention which leads at once from a mere perceiving and grasping to a complete sinking into the suggested idea with the suppression of all opposites, and thus to a blind acceptance and belief. We saw before that such belief is indeed nothing else but a motor setting in which certain ways of action are prepared. We are to think in accordance with the belief in the suggested idea and the channels for discharge in the opposite direction are closed. Even the ordinary life shows us everywhere that the step from attention to belief is a short one. The effort to grasp the object clearly works as a suggestion to accept that which we are seeking as really existing, and that from which we are to abstract and which we are to rule out through our attention, we believe to be non-existent. The prestidigitator does his tricks in order to sidetrack our attention, but he succeeds in making us believe that we see or do not see whatever he wishes.

That the motor setting alone determines those changes and that a real sleeplike inability of the centers does not set in, can also be demonstrated by the results of later hypnotizations. I ask my hypnotized subject not to perceive the friend in the room; he is indeed unable to see him or to hear him. Yet his visual and acoustic centers are not impaired, the defect is only selective, inasmuch as he sees me, the hypnotizer, and not the friend. But even this selection inhibits only the attitude and not the sensorial excitement. If I hypnotize him again to-morrow and suggest to him now to remember all that the friend did and said during yesterday's meeting, he is able to report correctly the sense impressions which he got, which were inhibited only as long as they contradicted the suggestion, but now rush to consciousness as soon as the suggestion is reversed. As a matter of course, he must therefore have received impressions through eye and ear in his hypnotic sleep of yesterday from all that happened, only he was not aware of it because the channels of the accepting attitude were blocked.

As soon as the over-attention has produced the acceptance of the belief, all further effects are automatic and necessary. If I tell the hypnotized person that he cannot speak and he absorbs this proposition, with that completeness in which he accepts it as a fact, not speaking itself unavoidably results. The motor ideas with which the speech movement has to start are cut off and the subject yields passively to the fate that he cannot intonate his voice. Thus a special influence on the will is in no way involved. If the idea is accepted, and that means, if the preparatory setting for the action has been completed, the ideas of opposite activity must remain ineffective; the suggested idea must discharge itself in action without resistance. As a matter of course the new line of action will then surround itself with its own associations and will thus give to the subject the impression that he is acting from his own motives. As soon as the psychophysical principles are understood, there is indeed no difficulty in going from the simplest experience to those spectacular ones where we may suggest to the profoundly hypnotized person that he is a little child or that he is George Washington. In the one case, he will speak and cry and play and write as in his present imagination a child would behave; in the other case, he will pose in an attitude which he may have seen in a picture of Washington. There is nothing mysterious and his utterances are completely dependent upon his own ideas, which may be very different from the real wisdom of a Washington and the real unwisdom of a child. I may suggest to him to be the Czar, by that he will not become able to speak Russian. In the same way I may suggest changes of the surroundings; he may take my room for the river upon which he paddles his canoe, or for the orchard in which he picks apples from my bookshelves.

Finally there is no new principle involved, if the action which is prepared by any belief has to set in after the awaking from hypnotic sleep, the so-called post-hypnotic suggestion. As a matter of course, just these have an eminent value for psychotherapy. I may suggest to-day that the subject will overcome to-morrow his desire for the morphine injection, or that he will feel to-night the restfulness which will overcome his insomnia. But if the suggestion of an idea means belief, and if belief means a preparation for action, we have indeed no new factor before us if the action for which we prepare the subject is from the start related to a definite time. If we do not link it with the consciousness of a special time or of a special occasion which will occur later, the suggestion soon fades away. That my library is an orchard is forgotten perhaps within ten minutes, if I have not come back to it in the conversation. But if I say that after awaking as soon as I shall knock on my desk three times, you will be in the orchard again, the psychophysical apparatus is prepared, a new setting has set in, the three knocks will bring about the complete transformation. In short the difficulties disappear as soon as we are consistent in interpreting all suggestive influences as changes in the motor setting and as the result of the antagonistic character of all of our motor paths.

We say the difficulties disappear. Of course, that is meant in a relative sense only. It means essentially that we are able to bring the complex state of hypnotism down to the similar state of attention and motor adjustment, but of course we must not forget that we are far from a satisfactory explanation of the process in attention itself. We know that the opening of motor channels in one direction somewhat closes the channels for discharge in the opposite direction, but what mechanism does that work is still very obscure. Whichever principle of hypothetical explanation we might prefer, it certainly leads to difficulties in view of the extreme complexity of attention in states of suggestion and hypnotism. We might think of a mechanism which through the medium of the finest blood-vessels should produce a localized anæmia in those centers which lead to the antagonistic action. Or we might fancy that by extremely subtle machinery the resistance is increased in those tissues which lie between the various neurons, or we might even think of toxic and antitoxic processes in the cerebral regions; and any day may open entirely new ways of explanation. We may add that even if the mechanism of attention were completely explained, we are also still far from understanding the physiological changes which go on in the sphere of the blood-vessels or of the glands and the internal organs. We understand easily that the idea of the subject that he cannot move his arm keeps the arm stiff; but that his idea to blush really dilates the blood-vessels of his cheek is much less open to our causal understanding; still less that in very exceptional cases perhaps a part of the skin becomes inflamed, if we make believe that we touch it with a glowing iron. And yet here too we see that we move in the same direction and that we have to explain these exceptional and bewildering results by comparing them with the simpler and simpler forms, that the process of attention contains all the germs for the whole development.

In claiming that hypnotism depends upon the over-attention to the hypnotizing person, we admit that the increased suggestibility belongs entirely to suggestions which come from without. Only that which at least takes its starting point from the words or the movements of the hypnotizer finds over-sensitive suggestibility. Ideas which arise merely from the associations of the subject himself have no especially favorable chance for acceptance. But surely we also know states in which the suggestibility for certain of one's own ideas is abnormally increased. Great individual differences exist in that respect in normal life. There are normal hypochondriacs who believe that they feel the symptoms of widely different diseases under the influence of their own ideas, and others who are torturing themselves with fears on account of unjustified beliefs. But the abnormal increase of suggestibility parallel to that of hypnotism for suggestions from without exists for suggestions from within, mainly in nervous diseases, especially in neurasthenic, hysteric, and psychasthenic states. Within certain limits, we might almost say that this increase of suggestibility for autosuggestion is the fundamental characteristic of these diseases, just as increase of suggestibility for heterosuggestions characterizes hypnotism.

Especially in earlier times, the theory was often proposed that hypnosis is an artificial hysteria. Such a view is untenable to-day; but that hysteria too shows abundant effects of increased suggestibility is correctly indicated by such a theory. The hysteric patient may by any chance pick up the idea that her right arm is paralyzed or is anaesthetic and the idea at once transforms itself into a belief and the belief clings to her like an obsession and produces the effect that she is unable to move the arm or that she does not feel a pinprick on the skin. These autosuggestions may take a firmer hold of the mind than any suggestions from without, but surely such openness to selfimplanted beliefs must be acknowledged as symptomatic of disease, while hypnosis with its impositions can be broken off at any moment and thus should no more be classed among the diseases than are sleep and dreams. The hysteric or psychasthenic autosuggestion resists the mere will of breaking it off. Here, therefore, is the classical ground for strong mental counterinfluences, that is, for psychotherapeutic treatment. Experience shows that the strongest chance for the development of such autosuggestive beliefs exists wherever an emotional disposition is favorable to the arriving belief. But emotion too is after all fundamentally a motor reaction. The whole meaning of emotion in the biological sense is that it focuses the actions of man into one channel, cutting off completely all the other impulses and incipient actions. Emotion is therefore for the expressions of man what attention is for the impressions. An emotional disposition means thus in every case a certain motor setting by which transition to certain actions is facilitated. It is thus only natural that a belief can settle the more easily, the more it is favored by an emotional disposition, as the motor setting for the one must prepare the other. Hypnosis and hysteria thus represent the highest degrees of suggestibility, the one artificial, the other pathological; the one for suggestions from without, the other for suggestions from within. But between these two and the normal state there lie numberless steps of transition. The normal variations themselves may go to a limit where they overlap the abnormal artificial product, that is, the suggestibility of many normal persons may reach a degree in which they accept beliefs hardly acceptable to other persons in mild hypnotic condition. Thus there is no sharp demarcation between