CHAPTER XIV HYPNOIDAL PSYCHOTHERAPY

Once the hypnoidal state is induced by any of the various methods of hypnoidization, we can either attempt to follow up the history of the development of the malady, or we may chiefly work for therapeutic effects. It is, however, advisable, from a purely practical, therapeutic purpose to combine the two procedures; the cure is then effective and far more stable. When the history of the origin and development of the disease can not be traced, on account of the age or unintelligence of the patient, the therapeutic effects alone of the hypnoidal states have been utilized.

The getting access to subconscious experiences, lost to the patient’s personal consciousness, makes the hypnoidal state a valuable instrument in the tracing of the origin and development of the symptoms of the psychopathic malady.

From a practical standpoint, however, the therapeutic value of the hypnoidal state is most important. Our experiments have revealed to us the significant fact that the hypnoidal state is the primordial[102] rest-state; sleep is but a derivative form. In many conditions of disease it is advisable to have the patient revert to a simple and primitive mode of life. Similarly, in psychopathic diseases a reversion to a simple, primitive state proves to be of material help to the patient.

In plunging the patient into the hypnoidal state, we have him revert to a primitive rest-state with its consequent beneficial results. The suggestibility of the state, if skillfully handled, is apt to increase the therapeutic efficacy. Relaxation of nervous strain, rest from worry, abatement of emotional excitement are known to be of great help in the treatment of nervous troubles of the neurasthenic, or of the so-called “psychoasthenic” variety. That is what we precisely observe in the treatment of psychopathic or neurotic diseases by means of the agency of the hypnoidal state, the efficacy of which is all the greater on account of the presence of the important trait of suggestibility.

The most important fact, however, is the access gained through the hypnoidal state to the patient’s stores of subconscious reserve neuron energy, thus helping to bring about an association of disintegrated, dissociated mental-systems.

Dr. John Donley in his article, “The Clinical Use of Hypnoidization” (Journal of Abnormal Psychology for August-September, 1908), gives the following account of the method of hypnoidization:

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“The treatment of that large group of disorders, forgotten memories, and emotions is operative in the production of mental disaggregation, but also in those numerous instances where the experience causing the obsessive idea or emotion is well known to the upper consciousness.

“In hypnoidal states they were made to reproduce their obsessive thoughts and images and then to describe them in words. When this had been accomplished and they had received further assurance and persuasion from the experimenter, although the purely intellectual content of their obsessions remained known to them, the insistent automatic character and disturbing emotional factors had disappeared. In this metamorphosis of emotional reaction we may observe one of the most interesting and useful attributes of the hypnoidal state.”

Dr. Donley gives a series of cases which he treated successfully from psychognostic and psychotherapeutic standpoints. The reader is referred to the original article.

“The value of hypnoidization,” says Dr. T. W. Mitchell, “in the resurrection of dissociated memories is that which is perhaps best established. And this applies not only to the restoration of the forgotten experiences of ordinary amnesia, but to the recovery of dissociated memories that are of pathogenic significance.... Sidis himself has insistently[104] taught that the reassociation of dissociated complexes effects a cure of psychopathic disease.... My own experience, so far as it goes, tends to corroborate in every respect the claims put forward by Sidis....”

While in the hypnoidal state the patient hovers between the conscious and the subconscious, somewhat in the same way as in the half-drowsy condition one hovers between wakefulness and sleep. The patient keeps on fluctuating from moment to moment, now falling more deeply into a subconscious condition in which outlived experiences are easily aroused, and again rising to the level of the waking state. Experiences long submerged and forgotten rise to the full light of consciousness. They come in bits, in chips, in fragments, which may gradually coalesce and form a connected series of interrelated systems of experiences apparently long dead and buried. The resurrected experiences then stand out clear and distinct in the patient’s mind. The recognition is fresh, vivid, and instinct with life, as if the experiences had occurred the day before.

It cannot be insisted too much that the hypnoidal state is not a slight hypnosis. The hypnoidal state is a light sleep state, a twilight state. The hypnoidal state is the anabolic state of repose, characteristic of primitive life.

The hypnoidal state is an intermediary state between waking and sleep. Subwaking is an appropriate[105] descriptive term of the character of the hypnoidal state.

The subwaking hypnoidal state, like sleep and hypnosis, may be of various depth and duration; it may range from the fully waking consciousness and again may closely approach and even merge into sleep or hypnosis. The same patient may at various times reach different levels, and hence subconscious experiences which are inaccessible at one time may become revealed at some subsequent time, when the patient happens to go into a deeper hypnoidal state.

On account of the instability of the hypnoidal state, and because of the continuous fluctuation and variation of its depth, the subconscious dissociated experiences come up in bits and scraps, and often may lack the sense of familiarity and recognition. The patient often loses the train of subconscious association. There is a constant struggle to maintain this highly unstable hypnoidal state.

One has again and again to return to the same subconscious train started into activity for a brief interval of time. One must pick his way among streams of disturbing associations before the dissociated subconscious experiences can be synthesized into a whole, reproducing the original experience that has given rise to the whole train of symptoms.

The hypnoidal state may sometimes reproduce the original experience which, at first struggling up in a broken, distorted form, and finally becoming synthesized,[106] produces a full attack. The symptoms of the malady turn out to be portions, bits and chips of past experiences which have become dissociated, giving rise to a disaggregated subconsciousness.

The method of hypnoidization, and the hypnoidal states induced by it, enable us to trace the history and etiology of the symptoms, and also to effect a synthesis and a cure. The hypnoidal state may not be striking and sensational in its manifestations, but it is a powerful instrument in psychopathology and psychotherapeutics.

For many years my investigations of the hypnoidal state were carried out on subjects and patients, adults and children. Having found that during the hypnoidal state the condition of mental plasticity is quite pronounced for therapeutic purposes, and having effected many cures of severe psychopathic maladies, ranging throughout the whole domain of so-called hysterical affections, neurasthenia, obsessions, drug habits, especially alcoholic ones, the hypnoidal state has become in my practice quite an important therapeutic agent. Lately, others have obtained excellent results with the hypnoidal state in their treatment of various functional, psychopathic or neurotic maladies.

Perhaps it may be opportune here for the sake of further elucidation to give a few extracts from the Presidential address on “The Hypnoidal State[107] of Sidis,” given by Dr. T. W. Mitchell before the Psycho-Medical Society of Great Britain, January 26, 1911.

“The history of science,” says Dr. Mitchell in his address, “affords us many instances in which the neglect of residual phenomena in experimental research has led to the overlooking of important facts, and prevented investigators from making discoveries which, had they paid attention to their residues, they could hardly have missed. The great chemist, Cavendish, probably missed the discovery of argon, because in his estimate of nitrogen of the air he neglected a residue which his experiments showed him could not be more than 1/120 part of the whole. More than a hundred years afterwards this residue was accounted for by the discovery of argon.

“Now in the history of Psychotherapeutics, from its earliest beginning down to our own time, we find many cases where the circumstances under which curative results have been obtained render it difficult for us to range these results under the category of the therapeutics of suggestion.

“Such cases as these may be regarded as the residual phenomena of the therapeutics of suggestion, and just as Cavendish and his successors too readily assumed that all the so-called nitrogen of the air was the same as the nitrogen of nitre, so we may be missing some important truth, if we too readily assume[108] that all these therapeutic results are due solely to suggestion. The value of suggestion during hypnosis is well attested, and the possibility of effecting physiological and psychological changes by its means is supported by a large amount of experimental evidence. But evidence of this kind is lacking in regard to suggestion without hypnosis, and until it is forthcoming, we are justified in receiving with some suspicion the account of the therapeutic efficacy of suggestion in the waking state. We seem bound to consider whether some state of consciousness intermediate between waking and hypnosis may not be artificially induced and utilized for the purpose of giving therapeutic suggestion.

“The scientific investigation of states of consciousness intermediate between waking and hypnosis is a contribution to psychology and psychotherapy which we owe practically to one man—Dr. Sidis. A research into the nature of suggestibility led him to formulate certain laws and conditions of normal and abnormal suggestibility....

“By keeping the patient for a short time under the conditions of normal suggestibility we induce a peculiar mental state which Sidis named Hypnoidal state. The process by which it is induced is what Sidis calls, hypnoidization.

“By the use of various methods a state of consciousness is induced which differs from full waking, but is not hypnosis or ordinary sleep.

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“The hypnoidal state is an intermediary territory, on the borderland of waking, sleep and hypnosis. In the course of a valuable experimental investigation of sleep in man and the lower animals, Sidis discovered that the hypnoidal state is a phase of consciousness which is passed through in every transition from one of these states to another. In passing from the waking state to ordinary sleep or hypnosis, there is always a longer or shorter hypnoidal stage. In the practice of hypnoidization the patient sometimes drops into hypnosis, or he may fall asleep without touching on hypnosis. And so also in awaking from sleep or from hypnosis, the hypnoidal state has to be passed through. Sidis found that the further we descend in the scale of animal life, the more important does the hypnoidal state become in relation to bodily rest and recuperation, and he concludes that it is the primitive rest-state out of which both sleep and hypnosis have been evolved.

“The relation to each other of waking, sleep, hypnosis and the hypnoidal state, may be represented in a diagram in which the primitive hypnoidal state is represented as a nucleus from which the segments of the larger circle, waking, sleep and hypnosis, have arisen. The transition from one of these segments to another can take place through the central territory with which they each have relations. (See diagram on page 110.)

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“The spontaneous occurrence of the hypnoidal state in man is as a rule merely a transitory stage in the alternation of waking and sleep. From the point of view of evolution it is a vestige derived from a long race of ancestors, a rudimentary function which has been superseded by the more highly specialized rest-state, sleep. But it can be artificially induced and maintained by the methods which have been described, and it can be utilized with effect in the treatment of psychopathic disorders.
DIAGRAM III

“The therapeutic use of the hypnoidal state is a somewhat complex subject, for hypnoidization may[111] be employed as an adjunct to other methods or as a curative measure in itself.

“The full record of hypnoidization is in the account of the well known Hanna case, given in his ‘Multiple Personality.’ This was a case of total amnesia, following a severe injury to the head. The patient, a cultured clergyman, was reduced to the mental condition of a new-born child. All his former acquisitions and memories had entirely disappeared, and he had to start learning everything again from the beginning. When he (the patient) was put into the hypnoidal state various fragmentary experiences of his past life emerged into consciousness, demonstrating to his observers that his lost memories were merely dissociated and not destroyed. This same method (hypnoidization) was made use of in other cases of amnesia, and it was found to be of great assistance in effecting the resurrection of dissociated mental material and its reintegration in consciousness.

“With the progress of his studies in Psychopathology, the reintegration of consciousness became, for Sidis, the aim of all therapeutic endeavor in connection with maladies that are associated with, or produced by, mental dissociation. The recurrent psycho-motor states of functional psychosis, insistent ideas, imperative concepts, persistent, or periodically appearing emotional states, so-called psychic epilepsy, and other states of dissociation all lent[112] themselves to treatment by hypnoidization. By its means the dissociated complexes could be recovered, the psychogenesis of the malady could be traced, a synthesis of consciousness effected, and the patient thereby cured. As his confidence in his method increased, Sidis gradually extended its employment, until at the present time he seems to use it in every kind of disorder in which psychotherapy is indicated.

“I have no doubt that Dr. Bramwell induces in his patients a state of consciousness which is identical with the hypnoidal state of Sidis.

“My own experience, so far as it goes, tends to corroborate in every respect the therapeutic claims put forward by Sidis. I have observed the good effects of the hypnoidal state apart from any other measure.

“In his later writings Sidis insistently maintains that the use of hypnoidization alone is sufficient to cure certain morbid conditions. He bases this claim on the fact that he has found the hypnoidal state effective towards this end, and he interprets his results as being due to a release of reserve energy which has been locked up in the inhibited and dissociated systems or complexes.

“The principle of reserve energy is based upon a wide generalization of facts, namely, that far less energy is utilized by the individual than is actually at his disposal. In the struggle for existence, those[113] forms of life which have accumulated a store of reserve energy that can be drawn upon in emergencies have the best chance for survival.”

According to my experimental and clinical work the waking state, sleep, hypnosis, and the hypnoidal state, may be differentiated as follows:

(I) In the waking state the upper, controlling consciousness predominates over the subconscious. In other words, in the waking state the conscious is more responsive and more active than the subconscious which as a rule under such conditions may be regarded as partially dormant.

(II) In sleep both the conscious and the subconscious are reduced in activity, often even inhibited in function. Motor consciousness is arrested; motor control is paralyzed. The personality is disintegrated.

(III) In hypnosis the upper, controlling consciousness is diminished in activity, while the subconscious activities are increased in extensity and intensity. In hypnosis the relationship of the conscious and subconscious is interchanged,—the conscious becomes subconscious, and vice versa. The habitual type of character may become changed by suggestion, giving rise to double and multiple personality, according to the crystallization of various association systems, while the habitual, critical attitude is reduced in intensity.

(IV) In the hypnoidal state both conscious and[114] subconscious functions are lowered in activity with no decrease in the intensity of critical attitude, and with no change of personality.

The hypnoidal state is therefore not a light hypnosis, but rather a light sleeping state, a twilight state. The hypnoidal state is a primitive rest-state out of which sleep and hypnosis have arisen in the course of animal evolution.