Page:EB1911 - Volume 14.djvu/215

Rh has done much to retard the application of hypnotism, is now completely discredited. The workers of the physiological party attached special importance to the fixation of the eyes, or to other forms of long continued and monotonous, or violent, sensory stimulation in the induction of hypnosis. They believed that by acting on the senses in these ways they induced a peculiar condition of the nervous system, which consisted in the temporary abolition of the cerebral functions and the consequent reduction of the subject to machine-like unconscious automatism. The leading exponent of this view was R. Heidenhain, professor of physiology at Breslau, whose experimental investigations played a large part in convincing the scientific world of the genuineness of the leading symptoms of hypnosis. The purely psychological doctrine of hypnosis puts aside all physical and physiological influences and effects as of but little or no importance, and seeks a psychological explanation of the induction of hypnosis and of all the phenomena. This dates from 1884, when H. Bernheim, professor of medicine at Nancy, published his work De la Suggestion (republished in 1887 with a second part on the therapeutics of hypnotism). Bernheim was led to the study of hypnotism by A. A. Liébeault, who for twenty years had used it very largely and successfully in his general practice among the poor of Nancy. Liébeault rediscovered independently, and Bernheim made known to the world the truths, twice previously discovered and twice lost sight of, that expectation is a most important factor in the induction of hypnosis, that increased suggestibility is its essential symptom, and that in general the operator works upon his patient by mental influences. Although they went too far in the direction of ignoring the peculiarity of the state of the brain in hypnosis and the predisposing effect of monotonous sensory stimulation, and in seeking to identify hypnosis with normal sleep, the views of the Nancy investigators have prevailed, and are now in the main generally accepted. Their methods of verbal suggestion have been adopted by leading physicians in almost all civilized countries and have been proved to be efficacious in the relief of many disorders; and as a method of psychological investigation hypnotism has proved, especially in the hands of the late Ed. Gurney, of Dr Pierre Janet and of other investigators, capable of throwing much light on the constitution of the mind, has opened up a number of problems of the deepest interest, and has done more than any other of the many branches of modern psychology to show the limitations and comparative barrenness of the old psychology that relied on introspection alone and figured as a department of general philosophy. In England, “always the last to enter into the general movement of the European mind,” the prejudice, incredulity and ignorant misrepresentation with which hypnotism has everywhere been received have resisted its progress more stubbornly than elsewhere; but even in England its reality and its value as a therapeutic agent have at last been officially recognized. In 1892, just fifty years after Braid clearly demonstrated the facts and published explanations of them almost identical with those now accepted, a committee of the British Medical Association reported favourably upon hypnotism after a searching investigation; it is now regularly employed by a number of physicians of high standing, and the formation in 1907 of “The Medical Society for the Study of Suggestive Therapeutics” shows that the footing it has gained is likely to be made good.

Induction of Hypnosis.—It has now been abundantly proved that hypnosis can be induced in the great majority of normal persons, provided that they willingly submit themselves to the process. Several of the most experienced operators have succeeded in hypnotizing more than 90% of the cases they have attempted, and most of them are agreed that failure to induce hypnosis in any case is due either to lack of skill and tact on the part of the operator, or to some unfavourable mental condition of the subject. It has often been said that some races or peoples are by nature more readily hypnotizable than others; of the French people especially this has been maintained. But there is no sufficient ground for this statement. The differences that undoubtedly obtain between populations of different regions in respect to the ease or difficulty with which a large proportion of all persons can be hypnotized are sufficiently explained by the differences of the attitude of the public towards hypnotism; in France, e.g., and especially in Nancy, hypnotism has been made known to the public chiefly as a recognized auxiliary to the better known methods of medical treatment, whereas in England the medical profession has allowed the public to make acquaintance with hypnotism through the medium of disgusting stage-performances whose only object was to raise a laugh, and has, with few exceptions, joined in the general chorus of condemnation and mistrust. Hence in France patients submit themselves with confidence and goodwill to hypnotic treatment, whereas in England it is still necessary in most cases to remove an ill-based prejudice before the treatment can be undertaken with hope of success. For the confidence and goodwill of the patient are almost essential to success, and even after hypnosis has been induced on several occasions a patient may be so influenced by injudicious friends that he cannot again be hypnotized or, if hypnotized, is much less amenable to the power of suggestion. Various methods of hypnotization are current, but most practitioners combine the methods of Braid and of Bernheim. After asking the patient to resign himself passively into their hands, and after seating him in a comfortable arm-chair, they direct him to fix his eyes upon some small object held generally in such a position that some slight muscular strain is involved in maintaining the fixation; they then suggest to him verbally the idea or expectation of sleep and the sensations that normally accompany the oncoming of sleep, the heaviness of the eyes, the slackness of the limbs and so forth; and when the eyes show signs of fatigue, they either close them by gentle pressure or tell the subject to close them. Many also pass their hands slowly and regularly over the face, with or without contact. The old magnetizers attached great importance to such “passes,” believing that by them the “magnetic fluid” was imparted to the patient; but it seems clear that, in so far as they contribute to induce hypnosis, it is in their character merely of gentle, monotonous, sensory stimulations. A well-disposed subject soon falls into a drowsy state and tends to pass into natural sleep; but by speech, by passes, or by manipulating his limbs the operator keeps in touch with him, keeps his waning attention open to the impressions he himself makes. Most subjects then find it difficult or impossible to open their eyes or to make any other movement which is forbidden or said to be impossible by the operator, although they may be fully conscious of all that goes on about them and may have the conviction that if they did but make an effort they could break the spell. This is a light stage of hypnosis beyond which some subjects can hardly be induced to pass and beyond which few pass at the first attempt. But on successive occasions, or even on the first occasion, a favourable subject passes into deeper stages of hypnosis. Many attempts have been made to distinguish clearly marked and constantly occurring stages. But it seems now clear that the complex of symptoms displayed varies in all cases with the idiosyncrasies of the subject and with the methods adopted by the operator. In many subjects a waxy rigidity of the limbs appears spontaneously or can be induced by suggestion; the limbs then retain for long periods without fatigue any position given them by the operator. The most susceptible subjects pass into the stage known as artificial somnambulism. In this condition they continue to respond to all suggestions made by the operator, but seem as insensitive to all other impressions as a person in profound sleep or in coma; and on awaking from this condition they are usually oblivious of all that they have heard, said or done during the somnambulistic period. When in this last condition patients are usually more profoundly influenced by suggestions, especially post-hypnotic suggestions, than when in the lighter stages; but the lighter stages suffice for the production of many therapeutic effects. When a patient is completely hypnotized, his movements, his senses, his ideas and, to some extent, even the organic processes over which he has no voluntary control become more or less completely subject to the suggestions of the operator; and usually he is responsive to the operator alone (rapport) unless he is instructed by the