Psychotherapy, Hugo Münsterberg [dar e dil novel online reading txt] 📗
- Author: Hugo Münsterberg
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The lady came from the South, with her nurse, to Boston and insisted on being hypnotized by me. I cannot say whether a really deep hypnotic state was produced at once as I refrained from testing it. There was certainly no amnesia. Probably it began only with a slight drowsiness but at the fifth treatment I found a relatively deep hypnosis. It was a capricious case in which the improvement was fluctuating but clearly setting in from the first day. I trained her in hearing and seeing words like death and suicide with a reënforced feeling of strength and calmness; I forced her to see and touch scissors with an artificial attitude of strength and indifference. At the same time I reënforced her good mood and her enjoyment in life. When she left for England a few weeks later, she felt herself mentally cured, and throughout the summer her letters testified the wonderful change which the treatment had brought about. Half a year later, as the result of an exhausting physical local treatment, the psychophysiological symptoms came back to a certain degree. She requested me by a letter from England to give her some help by suggestion to suppress again the recurring intrusions. As I had observed her strong suggestibility, I sent her over the ocean a little pencil of mother-of-pearl which she had seen in my hand, and advised her to look at it until she counted twenty slowly and then to close her eyes and simply to sleep. The autosuggestive effect was unusually strong. She writes from London: "When I saw the enclosure of your letter I felt as if it would burn through my hand and the feeling became so overpowering that I locked it away with my jewels, but as the days ran into a week I felt I could not live with it in my apartment any more, and I felt almost ill, until it occurred to me I could seal it and take it to my bankers. I felt as dreamy and absent-minded and paralyzed as if you had just treated me." Nevertheless the effect was on the whole the desired one and she returned to America with a wholesome freedom of mind. I hypnotized her twice again and she writes in her last letter: "I can never repay you for what you have done for me. You have given me back my courage and my love of life in its vividness and interest and color, all that through the last years I had so entirely lost."
Even in cases where the disease itself is inaccessible to psychotherapeutic treatment, the superadded grief and worry brought on by the disease might yield to the mental influence and the whole situation would to a high degree be transformed for the better by it. I have often been asked to hypnotize in such cases, where the depression was wrongly taken as a part of the nervous disease; sometimes I agreed to do it in spite of feeling sure that the disease itself could not be removed. I quote an instance.
A young woman afflicted with epilepsy was brought up in the belief that she had only from time to time fainting attacks from overwork, and with them secondarily neurasthenic symptoms, especially spells of depression colored by a constant fear of the next fainting. She had heard voices all her life and they frightened her in an intolerable way. I produced a very slight hypnotic state. I concentrated my effort entirely on suggestions which were to give her new interest in life, and diminished the emotional character of the voices without even trying to make them disappear. I proceeded for several months. The young woman herself believed that the fainting attacks came less frequently afterwards; yet I am inclined to think that that is an illusion. But there was no doubt that her whole personality became almost a different one with the new share in the world. The epilepsy remained probably unchanged but all the superadded emotions were annihilated and she felt an entirely new courage which allowed her to control herself between her regular attacks. She had been unable to undertake any regular work before for a long while, but all that improved. More than a year afterward, she wrote me: "I have really worked most of the time this past winter and spring and I think I can see a steady though slow gain. I am reading quite a little and doing it for the most part easily. To be sure I have, after I have read, hard times with the voices but their character is usually less determined and fearful than formerly. Several times I have thought I must come again to you but each time I have started again to fight it out for myself, but now, as I am gaining, I can better estimate the great help your influence was to me at a juncture when everything seemed so hopeless and helpless."
Even in slight psychasthenic disturbances, the psychotherapeutic influence is not always successful, especially if there is no time for full treatment. But it is very interesting to see how even in such cases the symptom is somehow changing, almost breaking to pieces. It becomes clear that a protracted effort in the same direction would destroy the trouble completely. Typical is a case like the following.
An elderly woman has been troubled her life long by a disproportionate fear of thunderstorms with almost hysterical symptoms. As she had no other complaint, I hardly found it worth while to enter into a systematic treatment and could not expect much of a change from a short treatment, considering that her hysteric response had lasted through half a century. As she begged for some treatment, I brought her into a drowsy state and told her that she would in future enjoy the thunderstorms as noble expressions of nature. The whole procedure took a few minutes. Yet after some summer months she wrote me a letter which clearly indicated this characteristic compromise between the habitual dread and the reënforced counter idea. "I have the same sick dread at the sight of thunder clouds that I have always had, but I seem to have gotten somehow a most desperate determination to control my fear. I have done this to the extent of keeping my eyes open and looking at the storm. Is that hypnotism or pride?"
Another thunderstorm case may lead us to other methods of treatment. Here again in the field of emotional response, we may consider the methods of going back to primary experience, known or forgotten.
A young married woman of the West had suffered always from hysterical attacks in response to any sharp sudden impressions, especially sudden loud noises. The banging of a door, but worst of all a thunderstorm, could produce hours of weeping and crying and desperate mental condition with all expressions of excitement. Her husband wanted me to hypnotize her but I preferred another way. I tried to get her memory back to the earliest case of which she could think of this hysterical response. As long as we were in ordinary conversation, she could not trace it beyond about her twelfth year. But when I brought her into a drowsy state, her memory revived older experiences and finally settled at a school experience in her seventh year of age. She then had an excitable country school-teacher who relied on whipping the children. Once her neighbor in the class did something forbidden. Her teacher mistook her for the culprit and began to whip her most forcibly before she could explain anything; and while the punishment was going on and she began to bleed from a wound, she all the time felt that she wanted to express her innocence and could not speak. After that, evidently the first attack of hysteric character followed. From that time on any sudden impression released the same group of reactions. The suppressed emotion had evidently become a psychophysical "complex." As soon as I had reached this starting point of her pathological history, I asked her to bring back to consciousness as many details as possible of that first incident. She told me all the names and described the classroom and brought herself vividly into the whole situation. Then I asked her to tell me the whole story once more and to express strongly her innocence and the wrongness of the punishment, and when she had completed her account, brought out with fullest indignation, I had her tell the whole thing once more and then a third and a fourth time, until she was quite tired out from it. That was all I did. Very soon after, the husband reported that there was a great improvement in every respect, no hysteric attacks, only slight discomfort. Most of the stimuli which had previously produced strong reactions now passed without any disturbance and even thunderstorms were experienced with relative ease. A year later they came once more to Cambridge, and she simply passed once more through the same process of discharge which seems now to have removed the symptoms still further.
By far more reliable, however, is the method of side-tracking the starting experience into a new associational track.
A gentleman with a decidedly psychasthenic constitution developed a tendency to hesitate in walking on the street. It was not a complete stumbling but a disturbing inhibition, which set in when he was walking alone and his attention was not absorbed by something on the street. He believed that it came on most strongly when he looked down at the pavement. He suffered from it vehemently and avoided going on the street alone. He was unable to connect it with any starting point. He interpreted it as merely a symptom of overwork. But going with him through all kinds of experiences which he had had on the street in previous years, we finally found that once he was running to catch a street car, when he suddenly saw almost immediately before him a big hole dug out for laying gas pipes. He was able to stop himself quickly enough not to fall into the hole but he got a strong emotional shock from the experience. He, himself, did not think that his walking troubles set in immediately after this shock. Yet the hypothesis seemed to me sufficiently justified that there existed a connection, even though some weeks lay between that first experience and the first observation of the abnormal inhibition in walking. On that basis I tried to train a new associative connection. I made him drowsy and asked him to think himself once more into the situation of his run for the car but as soon as he reached the hole to jump over it. He went through this motor feature on ten successive days with new and ever new energy and from that time up to the present the trouble on the street has disappeared entirely.
To mention at least one case of the large group in which suppressed sexual emotion was the evident source of an anxiety-neurosis, I mention the case of a woman who showed very strong symptoms of anxiety and oppression and who was cured by a simple advice.
The woman, aged thirty-two, was a saleswoman in a large store selling gentlemen's gloves and ties. She suffered from time to time by attacks of vague anxiety in which her heart showed vehement palpitation. There were paleness and perspiration and at the height a nervous trembling together with a feeling of despair. These attacks were not frequent, separated sometimes by weeks, sometimes by months, but troubling her exceedingly. She had been assured by a physician that her heart was normal and that she was probably overworked. She could find absolutely no source of the disturbance.
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