Before we proceed to a description of the technique of hypnosis we must make the following fundamental observation. It should not be forgotten whether the purpose of the hypnosis is therapeutic or merely experimental. The objects and aims of therapeutic hypnosis are of course entirely different from those of experimental hypnosis. Superficial hypnosis, which is therapeutically of such great importance, offers but slight interest, comparatively speaking, from the point of view of the experimenter. While the therapeutist will in many cases make no effort at all to deepen the hypnosis, the experimenter has every reason to desire the attainment of a profound hypnosis. The latter must therefore apply every means calculated to render the hypnosis more profound. The therapeutic hypnosis may of course be a profound hypnosis, either from the very start or on the application of more emphatic means. It is impossible to stress sufficiently the fact that the therapeutic purpose of an hypnosis may be jeopardized by any effort that is not concerned purely with healing. Therapeutic profound hypnoses should therefore not be used for hypnotic experiments, as the latter are always recognized by the patient as in some way experimental and are made the subject of an internal evaluation, which place the patient in a position with regard to the hypnotizer which is not favorable to the therapeutic end. The hypnotizer should always bear in mind that he is responsible to the hypnotized for everything that occurs in hypnosis, and that the covering by means of amnesia is never complete. We shall begin the following discussion with a consideration only of the technique of therapeutic hypnosis, and shall not take up the question of experimental hypnosis until we have presented a picture of the therapeutic hypnosis.

Our normal procedure in this technique is as follows: The patient is recumbent in the most comfortable possible position, and is first enlightened by means of a short explanation of the nature and significance of hypnosis. We then usually say something like the following: "By yielding calmly to the words of the hypnotizer and trying not to offer any internal resistance, you will attain a condition of internal repose which may lead to a condition resembling that of sleep, perhaps to sleep itself. In such a state, the effect of my words on you will be stronger. You will be more receptive to my words." We make use of this formula in instructing the patient, as a rule, when we are not convinced of the absolute necessity of a profound hypnosis. If the latter appears necessary, we assure the patient most emphatically that he will certainly fall into a profound sleep. A number of patients express fear of the hypnosis. It is important to speak to the patients concerning the causes for this fear. The patients abhor the possibility of being unconditionally subjected, under certain circumstances, to the hypnotizer. On the basis of our remarks above they may easily be calmed. In a number of cases the fear (desire!) of violation may have some weight, and this attitude is not eliminated by the presence of third persons. As a rule, a few words of explanation will suffice. These preliminary discussions as a rule enable one to get the patient into a condition of mind which makes him more accessible to hypnosis. As a rule we have him fixate a key or some shining object, step behind the patient, and begin saying to him, while stroking his brow gently and uniformly, the following: " Your eyelids are becoming heavier and heavier, you are getting tired, dull, and more and more sleepy. You feel your limbs growing heavy. Your fatigue becomes greater and greater. You feel as though you were going to sleep. Everything becomes obscure before your eyes. You can no longer keep your eyes open. You are in a condition of absolute, complete repose. You are breathing calmly,(*) deeply, and uniformly. You feel you are going to sleep." For several minutes (from two to four) we repeat this formula, or one like it. If the patient's eyes do not close of themselves we then press down the lids with a gentle pressure and say, sometimes in a commanding voice: " You are closing your eyes and are keeping your eyes closed." It is a mistake to have the patient fixate the object too long. Once he has closed his eyes of his own accord or on our more or less emphatic order, we continue the stroking of his brow and the repetitions of the formula in a uniformly convincing but not too loud voice, and then add, when it is our impression that the necessary depth of hypnosis has been attained, the suggestion we have in mind. It is in any case undesirable to offer any suggestion to the patient in the earlier sessions which may lead to a negative result. As a rule it will be sufficient to suggest to the hypnotized, while gently stroking his arm, a feeling of warmth in the arm. If one has the impression that the hypnosis is a deep one, one may also pronounce a number, without previous preparation. (Sometimes the patients, after waking up, can be convinced that they have actually been in a profound hypnosis only by making reference to this number.) Then the suggestion(**) is made which is intended to have a therapeutic effect. This suggestion, as will be stated in detail later on, should be formulated very carefully and repeated several times. The awakening from the hypnosis should never be sudden, but always slow and tactful. We say to the patient: " You will gradually awaken from the hypnosis. You will feel quite fresh and cheerful after your awakening from the hypnosis. You will not have any dizziness or headaches." This suggestion should also be pronounced several times, to have effect. Finally we say to the patient: " I shall count three; when I have counted three you will wake up." We then slowly count three.

(*) A method of enhancing the rapidity with which the hypnotic patient falls asleep is to have him breathe deeply, raising the hand of the operator placed on the patient's abdomen. The abdominal breathing thus causes fatigue and desire to relax and fall asleep quickly.—Trans, method.

(**) The duration of time for superficial hypnosis before " suggestion " is given should not be protracted too long—fifteen to twenty minutes will suffice in most cases. Allowing the patient to sleep after the suggestion is given increases the effect of the suggestion.—Trans.

Having thus concluded the hypnosis, we now at once ask the patient as to his experiences and feelings during the hypnosis. If the hypnosis was a superficial one, the patient will in most cases state that he has heard everything, has not been asleep, and only felt a little tired, perhaps also with a feeling of heaviness in his limbs. In most cases, also, even in otherwise very superficial hypnoses, he will state that he had the sensation of warmth. He will remember the number if the hypnosis was superficial.

Very frequently the patient is disappointed by a superficial hypnosis of this kind and will state expressly that he has heard everything, that he was particularly disturbed by this sound or that, that it was impossible for him to suppress his thoughts, etc., etc. It is particularly important, in cases that do not require a profound hypnosis, to assure the patient with calm firmness that the depth of the hypnosis attained has been sufficient for the desired purpose, but that it may be possible in the later hypnoses to attain a profounder stage of hypnosis.

Many patients do not even attain the depth of hypnosis above described. But after rising from the sofa they show dizziness, headaches, stagger a little, and then experience a feeling of fatigue and heaviness. On the basis of such undesired concomitants it is possible frequently to explain to the patient that his state nevertheless gives evidence of a certain susceptibility to hypnosis.

In general, we do not as a rule attach overmuch importance to the external circumstances. As a rule it is not at all necessary to exclude all auditory sensations or darken the room. To be sure, cruder stimuli are kept out. Yet it is important that the persons to be hypnotized should understand that the most essential element is their own attitude.

And as a rule the hypnotic condition becomes more profound at each session up to the third or fourth hypnosis, without any particular auxiliary methods.

The more simple devices for making the hypnosis more profound may be mentioned: The patient may be ordered to stop blinking as far as possible. It seems that this effort enhances the ocular lassitude (Federn), and we know also that sleep begins with the eyes, and that Mauthner arrived at correct notions concerning the localization of the sleep center by reason of his observation of this circumstance.

Distributing the hypnotic procedures over a long period is frequently accompanied by success. Particularly to be recommended is the fraction method of O. Vogt. After the first process of hypnosis is passed, and the patient has had certain sensations in hypnosis, the experienced sensations are made use of as an auxiliary for further suggestions, and a more or less extended series of individual hypnoses may be carried out in the same session. It is then possible to attain quite profound depths of hypnosis within the same session, which would not have been so easy to attain by other methods.

At times it is possible to strengthen the hypnosis by proceeding from catalepsy. One of the few interferences not directly required by the therapeutic purpose and justifiable during the hypnosis is to raise the patient's arm. In profound hypnosis, the arm will either remain cataleptic or drop back absolutely lax. A direct order may be given to the patient, resulting in his retaining the arm in an uncomfortable position, which quite frequently has an enhancing effect on the hypnosis.

In view of the ease with which muscular suggestions are followed as a rule, the experiment may sometimes be made of moving the patient's hand to his head and now assuring him explicitly that he cannot take his hand away from his head. Such a procedure, however, like the suggestion, " You will not be able to open your eyes now," is expedient only when it is absolutely necessary to deepen the hypnosis for therapeutic reasons, for there is always the danger that the patient may insist on carrying out the motion which has been represented to him as impossible. Thus, many patients, on being told they cannot open their eyes any more, will stare wide-eyed at the hypnotizer, which of course does not help the situation at all.

In many cases a continuing of the strokes over the arms and over the entire body is of some advantage, yet we are extremely sparing in our use of this device, for we avoid, as a rule, everything that might transform the goal-inhibited sexuality in hypnosis in a goal-conscious sexuality. Not for reasons of prudishness, but because the unleashing of the sexuality in hypnosis is therapeutically by no means desirable, and involves the danger that the therapeutic rapport may become entirely dependent on manifest signs of affection on the part of the hypnotizer. One of the reasons why we cannot recommend the method of fascination, namely, hypnotizing with the eyes, is in the fact that the eye to eye hypnosis involves too pronounced an emphasis of the erotic moment in hypnosis. To this statement we should like to append a short theoretical observation. In the minds of simple persons the erotic use of the eyes is an essential component of hypnosis. As we have said, we are not accustomed to making use of the method of fascination. Yet one of our female patients stated that for some time after the hypnosis she continued to see the " black " eyes of the hypnotizer before her eyes, against her will.

One of the most essential means for bringing about profound hypnosis is that of hypnotizing other susceptible persons in the presence of the patient. It becomes perfectly apparent that hypnosis in this sense is a phenomenon which is closely related with those of imitation, identification, social communion. Particularly good results are obtained in the production of profound hypnosis if the patients are hypnotized in series, and preferably by interspersing a few good mediums among the group. The results obtained by Wetterstrand in the field of profound hypnosis may be explained by the fact that he was making use of this group method.

The attainment of profound hypnosis may be particularly facilitated by means of soporifics, concerning which we shall speak later in the proper place.

Our own attitude as physicians causes us to avoid in principle hypnosis by intimidation, by shouting at the patient, frightening him, etc., and thus forcing him into hypnosis. In the hypnosis itself we do not select the hard, severe, brutal procedure, but rather the path of calm, firm persuasion. Of course, it is not possible to set up a hard and fast rule. During the preparatory stage of the hypnosis it may perhaps be necessary to put down the patient's laughter by energetic discipline, by shouting, etc. If we obtain the impression, during the profound hypnosis, that the patient is about to free himself from the hypnotizer's influence, emphatic measures, perhaps even an immediate awakening from the hypnosis, become absolutely necessary. And now we arrive at the point where we may discuss the important therapeutic problem, the manipulation of profound hypnosis.

While in superficial hypnosis it is sufficient as a rule to formulate the question plainly and to repeat it several times, we must count, in profound hypnosis, on the possibility that the suggestion may not be perfectly understood. For cases of profound hypnosis are at least in part cases of a dream-like transformation of consciousness. The best protection against such a possibility is to have the patient himself repeat the content of the suggestion. If we are dealing with amnesic patients, it is not sufficient to content oneself, in principle, with a mere enunciation of the suggesting formula. Otherwise there is a danger that the patient may not know what has been said to him at all. The fact that patients frequently make an effort, while under profound hypnosis, to break contact with the hypnotizer and to live out their own complexes, has already been mentioned by us several times. The best way of guarding against such an eventuality is that of not continuing the first hypnotic session too long, if the case appears to be one requiring profound hypnosis. All experimenting that goes beyond the immediate medical purpose of the hypnosis increases the danger of an hysteriform liberation of the hypnotized from the hypnotizer. Many persons fall into a condition, even in the first hypnotic procedures, which urges them to release themselves from the hypnotizer. They hallucinate without having been required to make the corresponding hallucination by the hypnotizer, pay but little attention to the hypnotizer's words, etc. When the patient acts thus, the hypnotizer should regain control by shouting at him loudly, and if this does not meet with success, he should wake the patient at once. The later hypnoses, which should if possible take place on the same day, should be made very short and usually the operator is successful in his effort to have the patient yield amicably to the requirements of the hypnotizer in hypnosis. Due attention paid to this condition will prevent the occurrence of hysterical disturbances, which are not in themselves a danger to the success of a treatment, but which may cause embarrassment to the physician in his office hours. The mildest form of releasing is of course found in the patient's simply breaking off his rapport with the hypnotizer during the hypnosis and sleeping on, without paying any attention to the hypnotizer's efforts to wake him. Even such occurrences will not take place if the hypnotizer makes sure that he is in contact with the patient, and interrupts the hypnosis at once when the restoration of the contact appears impossible. Even after sleep has begun an active shaking will frequently wake up the patient. Of course, in a hospital, it is quite possible to permit the patient to sleep on without disturbance; no harmful effects for the patient and for the treatment could be expected from such sleep. But in the consultation hours, and in treatment by a visiting physician, everything must be done to prevent the occurrence of such states of sleep. As we have mentioned, it is a mistake to believe that the depth of the hypnosis alone assures the therapeutic success and a retention of the suggestion. A cautious formulation of the suggestion should not be neglected because we are dealing with profoundly hypnotized patients. Statements made by the profoundly hypnotized person are by no means always trustworthy, whether we are dealing with the illumination of an amnesia pure and simple, or with a cathartic hypnosis. The correctness of such statements is shown not by the hypnosis alone but by the entire condition of affairs. In waking from profound hyp-noses, particular caution is necessary, even when applying the most considerate rules of caution (a slow preparation for awaking, suggestions to oppose headaches and other after effects), such unpleasant consequences as dizziness, staggering, absentmindedness, are not unusual. Effort may be made to eliminate these by a suggestive stroking of the brow. Sometimes also a short after-hypnosis, which is aimed exclusively against the post-hypnotic discomforts, is of advantage. Furthermore, it may be said, in general, that after effects are customarily stronger when much experimentation was attempted in hypnosis and the hypnosis was of long duration. This is another serious reason for our admonition not to permit the first profound hypnoses to last too long. It is a mistake in practice to leave unobserved even an apparently sleeping, profoundly hypnotized person. Somnambulous acts may succeed upon the apparently calm sleep of the hypnotized person. After breaking off the profound sleep, it,is desirable not to dismiss the patient at once from observation, but to keep him in the vicinity of the physician for some time Dizziness, fainting, may in some cases result unexpectedly On the whole, we must bear in mind the fact that a profound hypnosis is not an indifferent interference, for profound hypnosis addresses itself to deep lying strata of the human soul, which, once they are unfettered, are not always easily subdued.

Several inferences applicable to experimental hypnosis result directly from the above statement. Experimental hypnosis of course promises rich results only when dealing with profoundly hypnotized persons. Profound hypnosis must therefore be attempted with every conceivable technical means. Persons with whom one is not acquainted will probably not be available for such experiments It is a self-evident requirement that the person with whom one intends to attempt a profound hypnosis should be instructed as to the fact that the interference projected is not an entirely indifferent one Only a serious scientific interest, a suitable preliminary training and a particular aptitude for productive scientific investigation can justify the practice of experimental hypnosis, although it appears questionable, from a legal standpoint, whether experimental hypnosis is admissible at all, even with the consent of the person to be hypnotized A sufficient legal justification of hypnosis is found, in the last analysis, only in the therapeutic end pursued by the hypnosis

But before we consider in more detail the dangers of hypnosis let us consider the most effective means at our disposal for the production of profound hypnosis in persons otherwise refractory, namely hypnosis with the use of soporifics. This procedure has been repeatedly used as such by the hypnotizers of the old school. Of late Kauffman and Hallawer have applied it rather often.

At times hypnosis in the same individual may be more profound if carried out at the normal period for his afternoon or evening slumber Elsewhere we have again and again emphasized the relation between hypnosis and sleep, pointing out the fact that sound sleepers are as a rule more easy to hypnotize. With sound sleepers, one may also use the method of approaching their beds while they sleep and talking to them softly. Very frequently it is possible to enter into contact with the sleeper while his sleep is in progress. This rapport is completely identical with the rapport with the hypnotized, and these experiences suggest that even artificially induced sleep may be conducted over into hypnosis. Earlier hypnotizers used to make use of chloroform for this purpose, and Hallawer still uses this drug Hallawer usually does not tell his patients (they are women, he is a gynecologist) that he intends to hypnotize them. On the contrary, he promises them narcotics and thus frequently obtains hypnosis by merely putting the mask in place, or by more or less extensive use of chloroform. He considers it to be a special advantage of his procedure that his patients do not know that suggestion and hypnosis are involved, but believe that they have been drugged. We do not consider it an advantage to have the patient kept in ignorance of what is happening to him. Modern psychotherapy attempts, and rightly so, to avoid prevarication toward patients, and thus it has brought about a more dignified relation between the psychotherapeutist and his subject. There may be cases and situations in which it is not possible to apply the principle of the honesty of the psycho-therapeutist, but the principle as such should not be sacrificed. Of course, it is not the most essential component of Hallawer's procedure of hypnonarcosis to keep the patient ignorant of the fact that he is to be hypnotized, and the procedure as such is doubtless valuable, though the question must be raised whether chloroform—which is a very strong drug, frequently producing severe injuries in cases of extreme susceptibility to chloroform, injuries that may even include sudden death, though the dose be small—should not be replaced by some other drug. We should similarly hesitate to recommend the use of scopolamine, which Kausch administers, in the case of strong men, in doses of 0.0015 grm., adding 0.01 grm. of morphine. Now, the maximum dose of scopolamine is 0.005 grms., and we consider it very dangerous to exceed maximum doses for purposes of hypnosis by means of soporifics, for general reasons. We also reject the use of morphine for artificial sleep hypnoses, as the danger of making a morphine addict out of any individual, however slight this danger may be, should not be incurred without very good cause. It appears most expedient, therefore, to give veronal or one of the veronal derivatives, as does Kauffmann. In view of the slow operation of veronal, as well as of soporifics of its class, it is necessary to administer the drug about two hours before it is intended to perform the hypnosis. During these two hours the patient must be instructed to prevent himself from falling asleep. The hypnosis is then most expediently begun by means of the sleep suggestion, and the patient is then left alone. Kauffmann tells his audiences: " You cannot believe how easy an hypnosis often is after you have given a little veronal." We can confirm this statement fully. In general, we prefer medinal, of which we give 0.5-1 grm., going as high as 1r/2 grms. in exceptional cases.

For certain purposes it may be inexpedient to make use of the veronal group, owing to the tardy results of its operation. Now paraldehyde is a soporific which is absolutely harmless, even when taken in large doses, and has a very prompt effect. Its only disadvantage is its bad taste. We use paraldehyde always when we wish to produce hypnosis quickly, for the patient is already mature for hypnosis five or ten minutes after taking the drug. Sometimes it is necessary to experiment a bit in dosage. Furthermore, in paraldehyde hypnosis there is greater danger that the patient may swiftly attain a depth of slumber in which it is impossible to produce a rapport or that the paraldehyde will produce a condition of dreamlike confusion, which would destroy the possibility of receiving suggestions. We make use of paraldehyde in doses of between 4 and 12 grms., doses over 8 grms. being being exceptional. As a rule we have found it desirable to permit the patient to continue sleeping after hypnosis. If smaller doses are given, let us say 4 grms., as Hoff has given them in our ambulatorium, the patients may be sent home with an escort, after waking them from hypnosis. They are a little unsteady on their pins, but will get home safely and will sleep off the effects of the soporific at home.

Hoff, in the quantity production of an ambulatorium, where ten or fifteen persons had to be hypnotized, found it advantageous to give inadvance to each of the patients to be hypnotized 4 grms. paraldehyde The hypnoses may then be attained more easily and with less waste of time although, as we have already stated, we avoid in principle any neglect to inform the patient that he is taking a soporific to aid us in bringing about hypnosis, there may in some cases be need of such neglect for external reasons. We should like in this connection to communicate an interesting experience, such as may often be had as a result of hypnosis by means of soporifics. A patient is hypnotized after a pathological alcoholic intoxication for the purpose of illuminating the existing amnesia. Hypnosis succeeds in digging out none of the amnesic material. The patient is thereupon given 0.75 grm. medinal, without being told that it is a soporific, and is again put under hypnosis three hours later. It is observed, before the hypnosis that the patient is very vivacious, presenting no evidence of fatigue, desire for sleep, etc., although he had never before taken soporifics.(*) In the subsequent hypnosis the patient at once falls into a profound slumber, and a perfect illumination of the amnesia is attained. Before waking up, the patient receives the customary suggestion that he will feel perfectly sound and cheerful, and will not be sleepy. After his punctual awakening from the hypnosis, this patient is extremely sleep-intoxicated, and staggers, in spite of the suggestion given him, and on being gotten to bed, enters at once into profound sleep. This experience strikingly confirms our remarks concerning the mutual relations and the interchangeability of psychological and pharmacological influences on the sleeping apparatus. The mechanism in this case is the following: On the one hand, the pharmacological effect of the soporific breaks forth almost eruptively, as it were, and only because it is conditioned by the psychological influence of the hypnosis, while on the other hand the pharmacological effect survives the effect of the psychological suggestion made before awakening, and can no longer be suppressed by the latter. The question might be asked whether hypnoses by means of soporifics are not simple cases of sleep and whether we are really dealing with hypnoses at all in such cases. Anyone who has ever undertaken hypnoses by soporifics will reject this objection at once, for the patients carry out suggestions and demean themselves in every way after the manner of the profoundly hypnotized. It may not even be said that the turgidity of the consciousness is a more profound one than in other hypnoses, but of course this depends on the quantity of the drug that is used.

(*) In one patient on whom hypnosis was attempted after giving 10 grs of veronal, a peculiar effect was noticed in that she became very wakeful

Of course, soporific hypnoses may also be produced by means of other sleep drugs. We have not made any experiments with them. Of course, the first demand must be that the drug used be absolutely harmless, for it must never be forgotten that hypnosis itself is only a technical device for the treatment of neuroses, and has absolutely no therapeutic value as such. Even a glass of wine or cordial or a little bromide will be just as useful in some cases. Once a soporific hypnosis has been obtained, it is often found, as we may state in support of Kauffmann, that it is no longer necessary to administer soporifics again for each new hypnosis. The attainment of a single profound hypnosis in these cases also facilitates all the later hypnoses. It may also be asked whether that which was attained by means of soporific hypnoses could not also have been attained without and excited over her condition and hypnosis seemed impossible. Inquiry disclosed a similar excitability when the patient had taken soporifics on previous occasions.—Trans. soporifics. It is not possible to give a short answer to this question. We have taken as our point of departure the presupposition that the condition of hypnosis is a condition which may follow with the necessity of natural law from sleep itself. As a matter of principle any human being may be placed in profound hypnosis. But the conditions of bringing about profound hypnosis may not always be realizable in every individual without further ado. We very frequently find that persons who have been quite hypnotizable for some time suddenly become refractory to hypnotic attempts. When, therefore, a person turns out to be not hypnotizable, it is to be conjectured that under special circumstances, provided the hypnotizer put forth special effort, or under favorable conditions, he might yet be hypnotizable without the use of soporifics. For we also find that persons that have repeatedly shown themselves refractory suddenly turn out to be excellently hypnotizable without our being able to assign a precise reason for this change. We have also pointed out that the time of day may be of some effect in this connection. But fatigue, weakening due to diseases of the body, also play an important part in the conditions for susceptibility to hypnosis. Accidental intoxications may also be of importance. Thus, the morphine addict during his phase of abstinence is usually exceptionally susceptible to hypnosis. In the case of a dipsomaniac, whom we first tried to hypnotize during a lucid interval, the hypnosis at first was not effective, but a particularly profound hypnosis was attained when he was hypnotized out of a dipsomaniac attack on the next occasion, immediately after being brought to the clinic. But this is again coming back to the question of hypnosis by soporifics. The soporific creates favorable circumstances for bringing about a condition which may in principle be produced in other ways also, but which cannot always be technically realized without further device. To recapitulate, a hypnosis by means of soporifics enables the susceptibility to profound hypnosis, which is present in all mankind, to be more easily brought out.

Nor should we be unclear as to the fact that there are cases which are refractory even when treated with hypnosis by means of soporifics. Even in the matter of testing what constitutes an effective dose, we are limited by the fact that we cannot make too many experiments on the same patient. It is quite conceivable that by making use of an improved technique, perhaps by adding the use of ether, the number of refractory cases might be very practically reduced.

Injuries due to hypnosis are particularly to be feared in profound hypnoses. We have discussed most of the phases of this matter in the paragraph on the technique of profound hypnosis. The after effects of hypnosis are either in the domain of the physical, dizziness, headaches, etc., or there may also be psychic symptoms of every type, from the general domain of psychogenetic pathology. Exacerbations, or aggravations of hysterical symptoms, are quite possible. Hysterical peculiarities may arise out of hypnosis, etc. J. H. Schultz has collected all that is known concerning injuries due to hypnosis. All these phenomena of course appear most easily in the case of hypnoses serving the purposes of curiosity, or the popular amusement, and in which the suggestibility of the hypnotized is abused in order to carry on a more or less stupid horseplay at his expense. In the case of hypnosis serving therapeutic purposes, such incidents may be present only as a reaction favoring the ultimate therapeutic end. The physician should not permit himself to be nonplused by subsidiary phenomena of any kind in the course of such a treatment. Furthermore, injuries due to hypnosis, such as may result from popular exhibitions of hypnosis, etc., may usually be cured by appropriate treatment. A danger of hypnosis is in the fact that it may be used as a technical device for producing a state of subordination. This danger should not of course be exaggerated, since the hypnotized always retains a will of his own. A transfer from hypnosis to subordination presupposes of course, in general, bad faith on the part of the hypnotizer. To be sure, the attachment of the hypnotized to the hypnotizer may become too pronounced even without bad faith on the part of the latter. This is a danger which the psychotherapeutist must recognize and combat in advance. We shall have more to say on this subject in general in our therapeutic section. But of course hypnosis shares this danger with all the other forms of psychic treatment, whether we are dealing with an unconscious or with a clearly conscious psychic influence, for the results of psychoanalysis have shown us beyond doubt that the healing effects are brought about by the path of transference, i.e., the reappearance of former psychic-love adjustments and their attachment to the physician. In any psychic treatment, in fact, in any medical treatment, we are in danger of attaching the patient to us too strongly, of making him lose his independence. It is difficult to say whether this danger is more pronounced in the case of hypnotic treatment. At any rate, the danger is quite avoidable, and where too strong an attachment to the physician remains after a hypnotic treatment deficient technique is to blame. Where hypnotic treatment is carried out in a technically correct manner there is hardly any possibility of thinking of deleterious effects from the hypnosis.

In the preceding treatment we have discussed essentially the technique of hypnosis, in the form in which we usually apply it. Of course, we may substitute for the hypnotic method proper the waking suggestion, in which the patient is given in advance only the precisely formulated suggestion, and may be left lying with his eyes open or shut. As a preliminary to the suggestion the technique elaborated by Coue and Baudouin may also be of value. This technique was intended by these two authors to make clear to the patient the power of thoughts and ideas over the body.

First experiment: The person experimented on, who is standing, is instructed to hold himself perfectly rigid, so that when taken out of equilibrium by a push or thrust he will fall down, swinging on his heel as a fulcrum. After this preliminary experiment, the subject is instructed to concentrate intensively on the idea that he will fall backward. Most of the persons experimented on actually do fall backward after a short time. This method may be further supported by having the hypnotizer step behind the patient and exert a slight pressure against his forehead. This experiment yields positive results with the great majority of persons. It is somewhat more difficult to secure a falling forward by means of this technique, obviously owing to the fact that the statics of the human body permit a falling backward more easily than a falling forward.

Second experiment: The person experimented on, who is standing, is instructed to clasp his hands firmly. He is then instructed to concentrate on the thought, while keeping his eyes either shut or open, that it is impossible for him to unlace his fingers. Most persons actually cannot separate their hands. Of course, other psychological factors enter into this experiment besides the factor of suggestion. When our hands are clasped we have only an imperfect notion of the situation of the individual fingers and are consequently not capable, at a moment's notice, to hit upon the proper innervation.

Third experiment: A heavy object, such as a ring, is attached to a thread, causing the latter to depend tautly (Chevroeuil's pendulum). The subject is now instructed to concentrate intensively on a circle. Very soon the pendulum will begin a corresponding oscillatory motion, of which the subject becomes aware with astonishment on opening his eyes. If the subject has been instructed to think of oval or straight lines, etc., the motion will be changed accordingly.

The advantage of these tests is in their succeeding almost universally with all persons. By means of these tests even otherwise refractory persons will be brought to admit the effect of the mind on the body. The experiments may be used both as preparation for waking suggestions and as an introduction to hypnoses in the sense described above.

It seems desirable to make a few general remarks concerning the attitude of the hypnotizer during hypnosis. The popular view is to the effect that the hypnotizer must carry out the hypnosis by putting forth unusual effort and energy. This view is of course wrong. His inner interest or indifference has nothing to do with the success of the hypnosis. What the hypnotizer needs is a calm firmness; he must not permit himself to be dismayed by deviations from the expected course of the hypnosis. Specific personal qualities are not required on the part of the hypnotizer.¹ Hypnotizing is a technique that can be learned by anyone. We prefer to have the hypnotizer assume the part of the physician and do not emphasize the magic formulas. It may be that under certain circumstances the latter will be of value in producing profound hypnosis. To what extent the hypnotizer will emphasize the magic character of his acts is more or less a matter of personal taste. But the magical gesture is no doubt unnecessary for the attainment of therapeutic successes.

(*) In this country hypnosis has been largely discarded in recent years and the laity has come to look upon its use for therapeutic purposes with disdain and skepticism. The profession, too, has neglected to continue its normal interest in this subject as compared with that of the European profession, though the magic character of occasional cures affected by hypnosis leads to amazement in place of understanding of the true value of the method.—Trans.