III. Sleep and Hypnosis
A person falling asleep has the sleep wish. If this sleep wish
experiences internal resistance, either because of emotions from the field of
normal life, perhaps mourning, anxiety, etc., or by reason of neurotic
adjustments, sleep will not ensue, regardless of whether the individual desires
to be sleepless or not. We must distinguish between a clearly conscious sleep
wish and an instinctive sleep wish. Obviously, the latter is the determining
element. The sleep wish may have its way even against an active decision to
remain awake. The objection may be raised that the instinctive sleep wish is
not approachable psychologically and is merely an organic phenomenon. As
opposed to this formulation, we must adhere to the psychological character of
the instinctive sleep wish, together with Forel. No doubt the relations of this
desire to the bodily state are obvious. The feeling of fatigue before going to
sleep is closely connected with metabolic phenomena and with fatigue
substances. In fact, the sleep wish may—and not without reason—be considered as
the indicator of a specific bodily process.(*)
(*) See v. Economo: Die Pathologie des Schlafes.
This formulation is not intended to reduce in any way the significance
of the psychologically approachable nature of the sleep wish. We must imagine
that every psychic phenomenon has energies at its disposal which originate in
the common reservoir of the body; energies which are in constant interaction
with purely bodily processes. One of the present authors has attempted to
outline these matters more definitely with the aid of the conception of the
effect-value. The effect-value of the instinctive sleep wish is therefore
determined also by bodily factors. Even the conscious sleep wish also has an
effect value; it may, furthermore, depend for support on the instinctive sleep
wish. The psychology of soporifics in their relation to the sleep wish has not
yet been investigated. Does the soporific potion reinforce the instinctive
sleep wish, or does it merely make the purely physical apparatus more
responsive? In the case of encephalitis lethargica, is it the sleep wish
that has been changed, or has the sleep mechanism, in its extra-psychic phase, been altered in its responsiveness? In fact, may we
distinguish at all—psychologically speaking—between these things? At any rate,
we must begin by distinguishing between them conceptually. We must, in any
case, distinguish between the psychic agent, a sleep wish, and the sleep
mechanism, and we have every reason to assume that the sleep effect may vary
though the sleep wish remain the same. To make the matter more clear, we may
recall that even very suggestible persons, who seem to offer no doubt of their
psychic surrender, do not develop scald blisters in response to the
corresponding suggestion, obviously for the reason that the vasovegetative
mechanism is not, from a psychic standpoint, responsive enough in their case.
The sleeper is not completely asleep. According to Landauer's excellent expression, "
sleep vigils " have been posted, which remain attentively on guard over
the situation and see to it that no mishap befalls the sleeper. Nor may we say that the
awaking of a sleeper by the use of a stimulus means that a stimulus of a
certain intensity will interrupt sleep, but rather that the vigilant ego, the
sleep vigil, is observing all stimuli to determine whether it might not be
desirable to abandon the state of sleep. In this sense it is not the intensity of the
stimulus that is the determining factor, but the adjustment to stimuli, or
rather to the event that is transpiring. The well known examples for this situation
are: the mother, who will
awake only when her child cries; the miller, who wakes up when his mill ceases
its noise (cf. also Forel).
An apparent contradiction to this position is afforded by the results of
experiments at waking, which present certain regularities in the degree of
wakeability by a certain stimulus in the various stages of sleep. The same stimulus,
qualitatively, will not result in a waking until reinforced up to a certain
point to let us note that an amplified sensation of sound is—for the
individual—a biologically entirely different thing from a feeble sensation of
sound, and furthermore that the biological significance of a waking stimulus
differs with the hour of the night in which it is applied. In other words, the sleep
curves have, in addition to their merely bodily significance, also a
psychological significance, which can be best understood by assuming that the
individual faces certain unified situations which he deals with through his
sleep vigil. This
would be equivalent toan entirely new use of our biological mode of
considering the question, according to which the physical and the psychical are
by no means opposites.
One phenomenon particularly requires our attention in a consideration of
sleep; namely, the precise time
sense of
the sleeper enabling him to wake up at a definite time.(*) This time
sense is more accurate than the corresponding sense in the individual awake. It
would be difficult to assign a psychological reason for this phenomenon.
Obviously the resolution taken by day continues effective during sleep, or, in
other words, the estimating of time is a task of the sleep vigils. The fact
that this task may be carried out with such precision is obviously connected
with the fact that the sleep vigil is by no means to be identified with the
fully developed waking ego, but has only subordinate tasks to perform, which
may accordingly be executed with the greater precision. It should be noted even
at this early stage of our book that a better estimate of time is made even
during hypnotic sleep. Ehenwald has summarized the observations of Bleuler and
Forel in this connection, and has also made new experiments. He believes that
through the alternation of the contents of consciousness with that of the
affects is made possible a discrimination of those alternations which become
accessible to realization owing to the dulling of consciousness in sleep and in
hypnosis. That section of the personality which is asleep (a sleep ego) clings
vigorously and tenaciously to sleep and offers resistance to being awakened, as
is well known.
(*) As is well known, this time
sense is not always—or in all persons— precise. But the proved existence of
cases of this kind are of great importance theoretically.
But the assumptions made thus far by no means exhaust the psychology of
the sleeper. As is well known, the sleeper dreams, and in his dreams infantile
strivings of primitive personality make themselves felt. We call attention, in
this connection, to Freud's interpretation of dreams. The dream contents may be
of various stages of differentiation. The dream contents are an expression of
Freud's work on the mechanism of the unconscious. The various conceptions are
fused together, dislocations and condensations take place, the sum of energy of
one conception is transferred to another, chronological sequence is not
observed, external reality is replaced by internal reality, all of which are
processes which we cannot study specifically at this moment, and concerning
which we refer to Freud (cf. also short account by one of the present
authors in his Medizinische Psychologie). We sometimes encounter dreams
which in their structure correspond rather to the psychic mechanism of what was
previously in consciousness, preconscious or foreconscious, i.e., they
present in more emphatic form the mode of activity of the mechanism of the
everyday thought, with the difference that these
sequences of thought are cut off from consciousness. As a rule, the
motility of the sleeper is precluded. But in some cases, particularly in the
above mentioned dreams of the foreconsciousness type, motility seems quite
accessible and we then are provided with such cases in which the sleepers talk
in their sleep and carry out more or less complicated actions. In other words,
the dream state approaches the state of somnambulism. We are therefore led to
the following crude division in the case of the sleeper: the waking ego, the
sleep ego, and the dream ego; in the latter we may distinguish between an
unconscious and a foreconscious dream ego. The foreconscious dream ego merges
imperceptibly with the sleeper's waking ego. But this presentation should not
lead one to forget that all these varied manifestations of the ego are
ultimately connected and that the total personality is in the background, even
behind the dream and the sleep vigils, retaining in some manner its general
goals and measuring the sleep and the dream by the criteria of these ends.
There remains at least a corner of our soul (*) which knows that we are sleeping and
dreaming.
(*) Soul blight be translated as
psyche, the original being Seele.—Trans.
It is possible to secure contact with any good sleeper during the
progress of his sleep.
Poor sleepers will wake up if they at all
register the call.
In other words, we may secure communication
with the sleep vigil; but it should be noted that the sleeper's attitude
toward the person addressing him in his sleep is similar to that of the
hypnotized person to the hypnotizer. He will receive orders and
ally has amnesia with
regard to the conversation; also
he
carry out post-hypnotic orders. We must therefore assume a
connection between sleep and hypnosis from this point of view
as well. If we think out the problems of
the sleep vigil we are
again brought to the conclusion that the sleep vigil cannot correspond
fully to the
course of thought by day.
It has at its disposal a better
estimate of time; it accepts commands with less resistance than does
the waking personality.
Speeches, and the experiences of the sleep
vigil are frequently subject to amnesia. It might even be assumed
that the sleep vigil is not to be considered, psychologically, as a
complete unit, and that the sleep vigil which receives the commands may
not be identical
with the vigil which takes care of the mechanism of
waking, and it is very probable that this assumption is
not entirely
If I put a
person to sleep by hypnosis, I am producing in him all
those psychic transformations that are found also in the sleeper. In
general, the spontaneous dreaming of the hypnotized individual is not very
prolific; but there is still lack of more detailed investigations on this
point. There is no doubt that external stimuli and suggested conceptions are
subject in hypnosis to dislocation and condensation. One of the present authors
induced a hallucination of a tree in hypnosis and then introduced a vestibular
stimulus. Both impressions were fused together in such manner that the patient
(a woman) cried out that the tree was being cut down. An observation
communicated by Moll is very instructive: Moll blew a bellows at the side of a
hypnotized person, but did not say a word. The hypnotized person believed he
heard the noise of a locomotive. There ensued a complete dream concerning a
railroad train. Whenever Moll drummed with his finger nails on the table the
hypnotized person would dream of a military body with a drum and saw soldiers.
We are here dealing with a spontaneous performance of the dream ego of the
hypnotized person, independently of the will of the hypnotizer. The mechanism
of this process is similar to that observed when the hypnotized person begins
to operate independently on a suggested simple visual hallucination, producing
hallucinations of plastic visual scenes that are no longer connected with the
initial hallucination. There is no doubt that dreams may be suggested in
hypnosis. We have no reason for doubting there is no identity between suggested
and spontaneous dreams. On the whole, the dream phenomena within the hypnosis
probably occupy a rather slight place. What is present in the hypnosis in the
way of experience is frequently of a different character merely permitting the
dream dislocations and condensations to gleam through. This is true of any
hypnosis, including hypnosis in which visual hallucinations may be secured. The
experiences as a rule follow the suggestions clearly and distinctly, in so far
as we are not dealing with hypnoses in which the individual is living in
accordance with his own desires. But even then the images and experiences that
ensue are characterized by that relatively clear formulation that may be
observed, let us say, in the experiences of the hysterical state, or, to put
the matter more precisely, they have the mode of appearance of what was
formerly in consciousness. To be sure, the hypnotized person who is induced to
act in the somnambulist state has an appearance of dreamy abstraction; he
produces the impression of being a person more familiar with the dreaming state
than others, though otherwise everything may be in order. He acts as a sleeper would
act, with whom one has
entered into closer contact, in tangible proximity to the dream
experience. It is in this
stratum that the transference with the hypnotizer takes place. It may be said that we are
dealing essentially with a contact with the sleep vigil, concerning whose
psychological character we have already reported above. In the contact with the sleeper
it may be observed that it is possible to strengthen this relation with the
sleep vigil more and more at the expense of those sections of the personality
which are sleeping and
dreaming. In fact, even in normal
sleep, fluctuations between the degree of participation of the sleep vigil and
the sleep ego are constantly taking place. The morning slumber becomes more restless, i.e., the
reaction to the environment is enhanced. When in rapport with sleeping persons, we have the
impression that the sleep becomes lighter and lighter as the contact becomes
more complete. Also, the
remarks of the sleeper, paralleled with his process of waking, become more
orderly, or, to express the matter in psychoanalytic terms, the elements of the
Ubw(*) system fall more and more into the background as compared with the
elements of the Vbw (**)
system, which latter tends more and more to coincide in Its, qualities with the
Bw (***) system. Even in profound hypnosis we have
the impression that as the patient becomes more tractible, as he grasps more
readily, the more does the dream character of the situation disappear and the
state of the consciousness approach more and more the state of consciousness in
ordinary life.
(*) Unconscious mind.
(**) Preconscious or foreconscious mind.
(***) Conscious mind.
The terminal point of such a series is given in the waking suggestion in
which the deviations from the state of consciousness in the normal state have
become quite insignificant.
To be sure, the foregoing description of the state of consciousness of a
hypnotized person is inadequate
inasmuch as we have not sufficiently emphasized the fact that there remains
standing behind all these psychic complications a total personality, which
exercises its control on the one hand over the condition of the sleep ego, on
the other hand over the condition of the dream ego, and finally also over the
sleep vigil with all its relations, including, therefore, also the relation of
suggestability. Precisely this is the problem which is to have our attention in
the next chapter. For
the present, however, we must still dwell on the process of waking out of sleep
and hypnosis. Waking from
sleep maybe a gentle and gradual process. Obviously, beginning with a certain stage of
sleep, the sleep vigils are reinforced, and these,
responding to some insignificant alteration in the situation, waken the
individual. If a sound sleeper is suddenly awakened he will frequently react—as
has been already mentioned—with a short phase of blankness, followed by
headache and dizziness. The case is similar with the hypnotic sleeper. A
suggested sleep may be permitted to run its own course until the patient awakes
of his own accord. The patient may be wakened slowly or suddenly. Sudden waking
is as a rule accompanied by a more or less serious headache, which is obviously
the reaction to an oversudden psychic adjustment and must be taken seriously,
since it is due to real changes either in the blood vessels or in other
innervation areas.
There is no doubt, therefore, that there is a suggested sleep, namely,
the sleep of hypnosis, and many of the phenomena of hypnosis can only be
explained with the aid of the psychology of sleep.
It is frequently asked whether persons may be hypnotized against their
own will. We may dispose of these questions by referring to the sleep wish. It
is the instinctive, not the conscious sleep wish, that is the determining
factor. To be sure, the conscious wish may intervene to retard or accelerate
the work of hypnotization, but in the long run the latter depends on the
instinctive readiness for hypnosis. Similarly, it is impossible, by the use of
the will alone, either to force sleep to come or prevent it from coming.(*)
Precisely in hypnosis, it is frequently observed that an urgent instinctive
desire for hypnosis is concealed under a superficial resistance, and that an
eloquently delivered wish to be hypnotized is based upon a stubborn objection
to entrust oneself to the hypnotizer and to hypnosis.
(*) This psychoanalytic
observation must be borne in mind when treating patients for insomnia, with
hypnosis.—Trans.
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