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

more, in spite of the fact that he had during all this winter a bottle with a thousand tablets of morphine, prescribed by an unscrupulous physician, in his writing desk. He was thus at every moment during the day and night in full possession of the deadly poison with which he could have fully satisfied his craving. It was a moral victory when he finally reached the point at which he went for several weeks without any desire for morphine and finally presented the remaining tablets to a hospital. And yet there would not have been the least chance for his winning this ethical victory without the outer help of the hypnotist. We do not eliminate the moral will but we remove some unfair obstacles from its path. We have no mystic power by which our will simply takes hold of the other man's will, but we inhibit and suppress by influence on the imagination those abnormal impulses which resist the sound desires. If that were immoral, we should have to make up our minds that all education and training were perverted with such immoral elements. Every sound respect for authority which makes a child willing to accept the advice and maxims of his elders is just such an influence. If it were really a moral demand that the will be left to its own resources and that no outside influence come to strengthen its power or remove its hindrances or smooth its path, then we ought to let the children grow up as nature created them and ought not to try to suppress from without by discipline and training, by love and encouragement, the willful impulses and the ugly habits. Even every good model for imitation is such a suggestive influence from without and every solemn appeal to loyalty and friendship, to patriotism and religion, increases the degree of suggestibility. That is the glory of life that the suggestive power may belong to moral values instead of mere pleasures, but it is not the aim of life to remain untouched by suggestion. And he who by suggestion helps the weak mind to overcome obstacles which the strong mind can overthrow from its inborn resources works for the good of the individual and of the community in the spirit of truest morality.

Much more justified than such ethical objections are the fears which move entirely in the causal sphere. It must be acknowledged that a method which has such powerful influence over the mind that it can secure ideas and emotions and impulses which the own will of the patient cannot produce, ought to be allowed only to those who are prepared for its skillful use. To hypnotize or to perform any persistent psychotherapeutic treatment may thus be dangerous, if it is done by the unfit. We have discussed before the injuries which might result from the administration of such powerful psychotherapeutic effects through the best meaning minister, but we can extend this fear to anyone who has not systematically studied medicine and to a certain degree normal and abnormal psychology. The possibilities of overlooking symptoms which ought to suggest an entirely different treatment, or of adjusting the treatment badly to the special physical conditions, or of ignoring the desirable physical supplement by drugs, or of creating unintentionally by suggestion injurious effects, are always open when medical amateurs undertake such work. Certainly there is no physician who is not liable to make mistakes, and a physician who has never given any attention to psychology and psychiatry would also be a rather poor agent of psychotherapeutic methods, but the probability is that such a physician would simply abstain by principle from all psychotherapeutic methods; his mistake only begins if from his lack of acquaintance with the subject he draws the conclusion that the method itself is undesirable. That his real preparation ought to include psychological studies we have pointed out before, and the time seems ripe for the community to urge such a reform of the studies.

All that involves the conviction that even the experimental psychologist as such is not prepared to enter into medical treatment; and a "Psychological Clinic," managed by a psychologist who is not a doctor of medicine, is certainly not better than a church clinic. I cannot even acknowledge the right of psychologists to make hypnotic experiments merely for the psychological experiment's sake. Nobody ought to be brought into a hypnotic or otherwise abnormal state of mind if it is not suggested by the interests of the subject himself. Science has the right to make hypnotic experiments, or experiments with abnormal mental states, only under the one condition that a physician has hypnotized the subject in the interests of his health and that the patient has agreed beforehand to allow in the presence of witnesses certain psychological studies. Needless to say that any hypnotization for mere amusement and as a parlor trick ought to be considered as criminal.

On some other objections which interest the community as such we had to touch before, and there is no need of returning to them with any fullness of argument. We spoke of the danger which the mental cures carry with them when they are based on any particular creed, and especially when they are tied up with a semi-religious arbitrary metaphysics. What is gained if some nervous disorders are helped by belief, if the belief itself devastates our intellectual culture and brings the masses down again to a view of the world which has all the earmarks of barbarism? That is indeed one of the central dangers of all non-medical suggestive cures, that while any belief may cure through the mere emotional power of the act of believing, the content of the belief gains an undeserved appearance of truth. Any absurd superstition can become accredited because its curative value may be equal to a truly valuable suggestion. The intellectual life of the community would have to suffer greatly if the way to be freed from bodily suffering had to be the belief in the metaphysical doctrines of Mrs. Eddy's "Science and Health." From a cultural viewpoint, too, suggestive therapeutics must stand the higher, the more sharply it is separated from special philosophical or religious doctrines. No theory of the world and of God ought to gain authority over the mind from such an external motive as a belief in its curative effects. Freest from such implications is certainly the hypnotic method of the physician who does not need the strong religious reënforcement of the suggestion because he reënforces instead the suggestibility of the patient by slight influences on his senses.

Even where sound religion without superstition and without pseudophilosophy stands behind the therapeutic work, the community will not give up the question whether the church does not necessarily neglect by it the interests which are superior. The community becomes more and more strongly aware that too many factors of our modern society urge the church to undertake non-religious work. Social aid and charity work ought to be filled with religious spirit, but to perform it is not itself religion. Still more that is true of the healing of the sick. Whether or not such expansion of church activity in different directions saps the vital strength of religion itself is indeed a problem for the whole community. The fear suggests itself that the spiritual achievement may become hampered, that in the competition of the church with the other agencies of social life the particular church task may be pushed to the background, and that thus the church in imitating that which others can do just as well or better loses the power to do that which the church alone can do. The final outcome is therefore practically in every way the same. From whatever starting point we may come, we are led to the conviction that the physician alone is called to administer psychotherapeutic work, but that he needs a thorough psychological training besides his medical one.

But the interest of the community is not only a negative one. Society does not only ask where psychical treatment can be dangerous, but asks with not less right whether the scheme and the method might not be fructified for other social ends besides the mere healing of the sick. If psychotherapy demonstrates that for instance hypnotism makes possible the reshaping of a pathological mind, it is a natural thought to use the same power for remodeling perhaps the lazy or the intemperate, the careless or the inattentive, the dishonest or the criminal mind. Both educators and criminologists have indeed often raised such questions, and social reformers have not seldom seen there wide perspectives for social movements in future times.

There can be no doubt that the possibility of such remodeling activity is given, but as far as education is concerned certainly grave misgivings ought to be felt. When we spoke of the treatment of the sick, we had always to emphasize that the suggestion cures symptoms but not diseases. In the same way hypnotic suggestion might reënforce a single trait but would not reform the personality of the child. Yes, the artificial reënforcement of such special features would deprive education of that which is the most essential, namely, the development of the power to overcome difficulties by own energy. Wherever a reasonable amount of own will force and attention can be expected to overcome the antagonistic influence, there artificial hypnotic influence ought to be avoided. Everything ought to be left in that case to suggestions within normal limits, in the form of good example and persuasions, authority and discipline, love and sympathy. That holds true even for very slight abnormalities which seem still within the limits where the own energies can bring about the cure. For instance, I have steadily refused requests of students and others to use hypnotism for the purpose of overcoming merely bad habits, such as the habit of biting the nails. A child who finds some difficulty in sticking seriously to his tasks might learn now this and now that under the influence of hypnotic suggestions but he would remain entirely untrained for mastering the next lesson. In the same way some naughty traits might be artificially removed but the child would not gain anything towards the much more important power of suppressing an ugly tendency by his own effort. All that finds its limits where the inhibitions or obstacles in the brain of the child are too strong possibly to be overcome by the own good will, but in that case we already stand in the field of abnormal mental life and then of course psychotherapy has its right. The feeble-minded and the retarded child, the perverse child and the emotionally unstable child, belong under the care of the physician, and in such a case he ought not to hesitate to use the whole supply of psychotherapeutic methods which are at his disposal.

Still more complex is the criminological problem. It sounds like an easy remedy for the greatest social calamity, if it is proposed simply to hypnotize the criminal and to supplant his antisocial will by a moral one. And if the absurdity of such a proposal is recognized it seems to many justified to demand such an intrusion at least in the case of the born criminal, even if the occasional criminal cannot be reached. But the conception of the born criminal is also only a label which is superficially used for a great variety of minds. That men are born with a brain which necessarily produces criminal actions is not indicated by any facts. The varieties which nature really produces are brains which are more liable than others to produce antisocial actions. We recognized from the start that the abnormal mind never introduces any new elements but is characterized only by a change of proportions. There is too much or too little