SIMULATION.

I NOW come to the question of fraud, or simulation. As is well known, hypnosis has only lately been generally recognized. The scepticism which once reigned, and which is an advantage so long as it does not pass into a priori prejudice, has been overpowered by facts. But it took some time to attain this result. At present, when it is generally acknowledged that " there is something in it," it is not necessary, when discussing simulation, to consider whether there is such a thing as hypnotism at all. We have only to consider the question of " simulation or hypnosis " for each separate case.

Those who believed in hypnosis were for a long time regarded as deceivers or deceived. It was occasionally less harshly supposed that any man who busied himself with hypnotism must be suffering from some loss of mental health or balance ; which was said of some of our best-known investigators. Such personal attacks are sure to be made on men like Forel, Krafft-Ebing, Hirt, Mendel, &c. Less celebrated per-sons, may console themselves that they are in good company. Accusations of deceit, credulity, or madness, are luckily not likely to be made in the future.Inthe first place, fraud is much rarer than is gene-rally believed. It has been too much the habit to look for one physical symptom or another, and settle the question of fraud from its presence or absence. And yet this is exactly the opposite of what is generally done in judging of mental states; e.g., when we want to diagnose a case and decide whether it is insanity or not, no authority on mental disorders would suppose fraud simply because some bodily symptom was absent. He will consider and weigh the case as a whole. Even when each symptom taken separately might be fraudulent they would be weighed against one another and a diagnosis formed from them. If the doctor finds also some symptom which cannot be simulated, he will weigh this too, but he will not conclude fraud from its absence. It is true that in this way the conviction may be only subjective, or rather it will be clear only to those who have studied mental disease. The outsider may often be able to raise the objection that this or that symptom may be feigned. But no doctor of mental diseases would allow himself to be influenced by this.

If we apply this to hypnosis, which is also a mental state, it follows that only he who has studied hypnosis practically is in a position to diagnose it. The idea has gradually grown up that every one is able to judge of hypnotism, and may express his opinion and demand consideration for it, however ignorant he may be about hypnotic experiment. Kron and Sperling have very rightly contested this supposition. It is not correct to diagnose fraud in hypnotism from a certain bodily symptom. Even when each separate symptom may be feigned, the experienced experimenter will diagnose by summing up the different symptoms and comparing their relation to each other. It is satisfactory if he finds an unfeignable symptom besides ; this is an objective proof, convincing even to those who have no practical knowledge of hypnosis. But it is to be said that objective physical symptoms are more seldom found in hypnosis than in mental diseases. The first is a transitory mental state, in which objective physical change is less likely to happen than in mental disorders, which last for months and years. However, we must of course try to find bodily symptoms in hypnosis. Many authors have done so, among them Charcot in particular, who threw the weight of his name into the scale for hypnotism. The school of Nancy also sought for objective symptoms and found them, though different from Charcot's ; I mean the blisters, &c, produced by suggestion. As a mistaken notion is beginning to take root, that the question of fraud forms the point of difference between the two schools, because that of Nancy had found no objective symptoms, I will here point out the real difference between them.

To exclude fraud we look for symptoms which cannot be voluntarily simulated ; it is indifferent whether these are produced by suggestion or not.

Now, there are phenomena which are produced by suggestion and which are independent of the subject's will. And in these the chief difference between the schools lies.

The Nancy school believes that all the symptoms are caused by suggestion, even those independent of the will, while the school of Charcot finds bodily symptoms which are independent of the will and of suggestion. Consequently, suggestion is the main pointon which they differ. I shall show that the questions of suggestion and fraud are very different. The case of Siemerling teaches us this. His subject was hemianaesthetic, both with regard to sight and feeling, i.e., the power of sight was limited on the side on which the skin was without feeling. The field of vision was concentrically narrowed, so that anything beyond a certain distance from the point on which the eyes were fixed could not be seen. Now in hypnosis the sense of feeling on the hemianaesthetic side was restored by suggestion, and directly feeling was restored the eye on the corresponding side became normal, without direct suggestion. Westphal and Siemerling thought this an objective proof of hypnosis, and I also believe that such a proof might satisfy even somewhat strained demands, since the power of sight is independent of the will. And yet this effect was produced only by suggestion, though by indirect suggestion. Krafft-Ebing had a case like this ; mental paralyses with objective symptoms were produced by suggestion, and the symptoms were those mentioned by the school of Charcot as happening in mental paralyses.

Objective symptoms can be produced by suggestion. It is doubtful whether they happen without suggestion. We see that the suggestion need not be direct; the symptom may be produced by an indirect and partly unknown mental influence. Siemerling said to his patient, " Now you can feel again " ; when the patient recovered sight as well as feeling, this was the effect of an indirect suggestion, induced by a certain mental interdependence between the anasthesia of the eye and that of the skin. Both organs were functionally disordered, and this common disorder disappeared, when the function of one organ was restored by suggestion. Krafft-Ebing's case is like those mental paralyses studied by the school of Charcot. In these, when the subject is told, " Your arm is paralyzed," vasomotor disturbances follow on some mental process, with which we are at present Unacquainted. As the vasomotor disturbance is the direct consequence of the paralysis we are obliged to think that some mental communication causes both phenomena.

To return to the objective symptoms of Charcot. We see that there are certain bodily phenomena in the three stages. Thus the point of difference between the two schools is this: Are these bodily symptoms a result of suggestion or not ? I believe (as I said, pp. 82-83) that suggestion plays an important part in most of the symptoms, but I by no means maintain that they have no objective value, though I am not quite sure. For phenomena might he produced by practice, even without hypnosis, which at first sight would seem impossible to simulate (p. 189). This is the point of difference between the two schools. I have discussed it here in order to show that objective symptoms may be caused by suggestion, and that, consequently, the objective symptoms in themselves do not separate the two schools, although the symptoms mentioned by each are rather different.

Let us now ask what symptoms should help us to decide the question of fraud. In the first place we must notice how the eyes close, and how the subject tries to open them. This closing of the eyes is difficult to describe. The gradual falling of the lids is important, and the action of the muscles of the forehead when opening the eyes, in a way like that after sleep, as well as the convulsive rolling upwards of the eyeballs, which is often seen. The fibrillary twitching of the eyelids is, on the contrary, of no importance, as it often happens without hypnosis.

In cases where the eyes are open their expression is most important. The look is often blank and meaningless, the mask-like expression and the attitude of the subject are often characteristic also. He moves his limbs slowly and heavily when commanded. But I should mention that in certain cases, particularly of light hypnosis, these symptoms are wanting, and the movements in especial are quick and lively. The expression during sense delusions is also very important. Every one knows how difficult it is to place oneself in an imaginary situation so that the expression, the attitude, and the actions should correspond to the idea. This is the great art of actors, and everybody knows how seldom an actor is able to represent a scene by the mere exertion of his own will ; but it is still more difficult to change the mood in a moment, and pass from one situation to another in a few seconds. It is extremely difficult for a person awake, but the hypnotic subject does it easily. It is astonishing that outsiders should regard this very ability as a sign of fraud, as a competent judge once did at Vienna (cf. p. 165). It is surely one of the most difficult things to do, and it would be wonderful that all the suspected persons should devote themselves to the thankless part of fraud, when with such talents for acting a very different career would be open to them. The expression of pain, the smiles, the chattering of teeth and shivering at different suggestions of pain, pleasure, cold, &c, would be no easy task to the supposed impostor.

The waking in many cases is just as characteristic ; the astonished face with which the subject looks round, as if to find out where he is. His behaviour in post-hypnotic suggestion is likewise important.

The impostor generally exaggerates, like a person pretending madness. In spite of the variability of the symptoms of hypnotism there is a certain conformity to rule in its development. The impostor usually accepts all suggestions very quickly, while the experienced experimenter knows that susceptibility to suggestion increases with a certain uniformity. It is very easy to simulate analgesia to slight feelings of pain, as this analgesia is mistakenly thought to be a common symptom. An unexpected pain causes the usual reflexes in the face and eyes, and yet the impostor will declare that he felt no pain. It is the same with sense delusions, where the suggestion generally requires to be emphasized before it takes effect. The impostor usually exaggerates here also.

Let us consider certain objective symptoms which have been said to be particularly characteristic. Charcot and his pupils lay great stress on the Curves of the muscular contraction and respiration in the cataleptic stage. Charcot says there is no essential difference in the duration ; a cataleptic person cannot hold up his arm longer than an impostor. But when the curve-tracings from the raised arm and the respiration are noted, there is an important difference; the impostor soon shows that he is tired by irregularity in the arm and respiration curves; the hypnotic subject, on the contrary breathes calmly and evenly from beginning to end, and there is no perceptible trembling in his arm.

Other people say that a cataleptic posture is sometime's maintained a very long time, and therefore offers an objective proof.

Charcot mentions increased neuro-muscular irritability as a particular characteristic of lethargy. It isnot to be denied that this is impressive when seen for the first time. It cannot for a moment be sup-posed that a person can thus bring single muscles, and also groups of muscles supplied by single nerves, into contraction. But these contractions would only be important if they appeared instantaneously from the first.

Charcot does not think that the contractures induced by stimulation of the skin in the somnambulic state are of much value, and in fact they might easily be simulated. Apart from these symptoms of Charcot's stages we must, in judging of fraud, consider some abnormal muscular actions—e.g., the cessation of the uncertain, staggering gait in cases of locomotor ataxy, which Berger described and I also have observed—and other like phenomena.

Binet, Fere, and Parinaud have made particular investigations on the sense delusions of sight. They say that a prism doubles the hallucinatory object as it would a real one; and in hallucinations of colour, the complementary colour is said to be seen afterwards. But Charpentier and Bernheim have refuted these experiments, particularly those with the prism, which from the first seemed very improbable. They showed that the apparent doubling of the hallucination was due to some point de repere, which the subject found for himself. He first saw some real object doubled by the prism, and concluded from this that the suggested hallucination should be doubled also. In any case, the great point is that the prism only produces the doubling when a real object can be seen through it. If there is no such, point de repere ; i.e., if the experimenter is in a dark room, or if he shows the subject a perfectly blank, white screen, the doubling does not happen.

According to Charpentier and Bernheim the experiments with complementary colours were not more exact; and the same is the case with other experiments of Binet and Fere on colours, from which they drew the conclusion that in suggested perceptions of mixed colours the effect was the same as with real optical images.

The phenomenon presented by the pupil of the eye, which they mention, seems to me more valuable. In suggesting a hallucination, e.g., that of a bird, the suggested approach of the object causes a contraction of the pupil, and vice versa. At the same time there is often convergence of the axes of the eyes, as at the approach of a real object. But it must be remembered that some people are able to produce this phenomenon in themselves by an effort of will (Hack Tuke, Budge).

Bernheim lays great weight on the analgesia of hypnotic subjects. I agree with him. If a completely analgesic subject is touched with a faradic brush he shows no trace of pain. There are no impostors who could repress the expression of pain under these circumstances, particularly if the contact were unexpected. But we must consider that such a high degree of analgesia is very rare in hypnosis. Naturally, this true analgesia must be distinguished from the simulated analgesia, which I mentioned on p. 279. The anaesthesia of the mucous membrane, e.g., of the membrane of the nose, with regard to ammonia, is to be tested. There is no need to say that certain rare phenomena, e.g., secretion of tears and sweat, flushings, changes in the heart's action and organic changes produced by suggestion, are of the highest value. Finally, I shall direct attention to a phenomenon whose absence may be of some importance ; I mean the absence of movements which I should prefer to call movements caused by tedium (Langweiligkeit). As is known, a waking man is unable to retain any posture for a long time, even when all his muscles are relaxed. In the latter case the movements cannot be caused by fatigue of particular muscles ; it is rather that when one position is long maintained, a lively feeling of discomfort ensues, that is subjectively felt as tedium. This, it seems to me, induces certain movements difficult to describe, the movements from tedium. Their absence is strong evidence of the presence of hypnosis, and I think this an important and almost unmistakable symptom. They are best observed when the subject has been left for some time to himself.

From two points of view, however, all these symptoms have only a relative value. In the first place their presence is important, and is in favour of hypnosis, but their absence is unimportant. We are never justified in concluding fraud from the absence of any particular symptom. In the second place we must consider whether any symptom might not be produced by practice without hypnosis, and whether the subject could use this practice, or whether there may not be a special capacity for the voluntary production of this symptom.

On the first point I should say that in some cataleptic postures there are perceptible tremors, that analgesia is rare, and that neuro-muscular hyper-excitability is but rarely found.

The second point is often overlooked ; for it is not yet decided whether by practice some persons might not produce even all the above-mentioned symptoms without hypnosis. Perhaps there is no hypnotic symptom which has not been observed in some person or another without hypnosis. For example, neuromuscular hyper-excitability is found in hysterical patients, so that it is not enough to prove hypnosis. And the most strained cataleptic attitudes can be produced by gymnasts, by means of practice. Some persons have been known to influence the action of their hearts without a change of breathing ; though, according to Beaunis, a distinction can be found here : the hypnotic obeys suggestion at once, while out of hypnosis a short time must always elapse before the will can exercise its influence.

The local flushings of Mantegazza are a more extreme case. Mantegazza says that at one time in his life he was able to induce local reddening of the skin simply by thinking intently of the spot; he even adds that wheals sometimes appeared. It has often been asserted that people can perspire at any place they please. Delboeuf says that he can influence the secretion of saliva by his will or ideas. It is well known that this last is much under the influence of the ideas.

I have purposely made these remarks, because mistakes about the objective symptoms are made on all sides. For this reason I think that the first question to be decided is the one mentioned above : whether the subject could not produce the symptoms by practice, without hypnosis. I know well that I thus lessen the value of my earlier explanations ; but I think it is more honest to say that we do not know enough about the objective symptoms of hypnosis.

I have as yet only spoken of such symptoms as take the form of bodily functions; but according to Pierre Janet these symptoms, contractures for example, are of much less importance to the question of fraud than the mental ones ; the memory in particular.

Gurney also thought the memory of great importance here. The postulate from which these authors start is that there is loss of memory after waking from hypnosis, and that consequently the subject remembers nothing that has happened during the state. Now this loss of memory is to be used to decide the question of fraud. An example will make this clear.

I tell X., whom I have hypnotized, that when he is going to bed he is to dip a handkerchief in warm water and tie it twice round his throat. When he wakes he seems to remember nothing about it; upon which I repeat the command, but omit the doubling of the handkerchief. When I ask him what he is to do, he answers, " I am to dip a handkerchief in warm water and wrap it twice round my throat." It will be seen that I gave the order differently before and after hypnosis ; yet X. repeats the command as it was given in hypnosis.

According to the views of Pierre Janet and Gurney, this would very likely be a case of fraud ; for X., who had apparently completely forgotten everything after waking, yet mentions the one point omitted in the second command. But must we really consider this a case of fraud ? I believe not, and I appeal to a long series of experiments with perfectly trustworthy subjects, in whom I often observed objective bodily symptoms also. The subject may very well make such a statement as the above about the twice-folded handkerchief quite automatically, neither remembering nor remarking it; but he may also make it consciously, as a previously forgotten idea may be suddenly called into consciousness by the law of association mentioned on p. 125.

On account of their practical importance I shall speak of other symptoms which, according to experience, are often wrongly considered by outsiders as proofs of fraud. I begin by insisting that there are very few hypnoses which really correspond to the outsider's ideal picture of a hypnosis. At least the inexperienced often think that the apparent impostor is forgetting his part when some symptom appears which, according to them, ought not to appear.

First, the laughter of hypnotic subjects. Of course many subjects laugh, just as a waking man does. In the light stages the subject is quite aware that he is playing a somewhat absurd part, e.g., he makes all the movements of eating an apple, and feels compelled to make them, but knows quite well that he looks rather ridiculous ; therefore it is not odd that he should laugh. But there is often a trace of consciousness even in deep hypnoses ; the subject separates himself, so to speak, into two parts, one of which acts the suggested part and the other observes it and laughs.

I have already spoken of the trembling of cataleptics. I add that the subject sometimes makes movements unforeseen by the experimenter, and which sometimes interrupt the suggestion. I stretch out a subject's arm and suggest that he cannot move it. It remains as I placed it. But now a fly settles on the subject's forehead and he moves his arm at once to rub the place. This is a common occurrence. Rubbing when one is tickled has become a habitual, rapid, unconscious act. So that if the first suggestion has lost its vividness, the new impulse causes a change of posture. I have seen people put their hands to their faces when they sneezed, as we habitually do, though the hands had previously been made motionless by suggestion. Besides, many movements which have been prevented by suggestion become possible when the subject does not think of the suggestion ; if he is forbidden to say " a" he can use it unconsciously ; he only cannot say it when he thinks about it (Laverdant, Hack Tuke, Max Dessoir).

There are many phenomena of this kind. I say to the subject, A., " You are a rope-dancer, and are on the rope." He believes it, and I pretend to cut the rope, on which he falls down ; but he falls so as not to hurt himself. This is caused by a normal, mechanical, nearly unconscious process which is always going on in us. We always use our hands to shield ourselves when we fall. This habitual mechanism works on in hypnosis regardless of the suggestion. Hysterical paralytics for this reason seldom hurt themselves when they fall. Hack Tuke told a subject that he was dead ; he fell without hurting himself.

I will further point out that the eyes sometimes open very quickly. I have seldom seen this, but can safely assert that it happens in genuine hypnoses. An impostor will also often open his eyes when he thinks he is not observed ; the hypnotic subject does it whether he thinks he is observed or not. I must also direct attention to those sense delusions in which a dim dream-consciousness persists, which prevents the full effect of the delusion. In such cases fraud is often suspected; e.g., the case mentioned on p. 183, where the subject fought with an enemy, taking pains not to hit him.

Further, a complicated suggestion may be misunderstood or half-forgotten, in which case it will be carried out imperfectly. A post-hypnotic suggestion can naturally only be fulfilled when it is remembered. As memory is the first condition for the success of a suggestion, a person with a good memory {ceteris paribus) will execute a suggestion better than another. If the post-hypnotic suggestion is badly remembered it will be badly carried out, as the memory only acts in a natural way. I mention this though it seems a matter of course, because I have heard the existence of hypnosis doubted, purely in consequence of such mistakes. To a man whom I have hypnotized in the presence of A., B., C, and D., I make the posthypnotic suggestion that when A. speaks he is to say " Ha ! " when B. speaks," He ! " when C. speaks, " Hi!" and when D. speaks, " Ho ! " It is not surprising that he is confused in carrying out the suggestion, and makes the wrong exclamation to each person. For all depends upon the strength of the memory, and its power to retain and reproduce the suggestion.

Finally, a subject will sometimes confess to imposition, or to having acted to please others. Such a confession must be judged with caution. Many who have made hypnotic experiments have observed that subjects will often say after the hypnosis that they have been pretending, though their actions were really compulsory. I need not say that there are people who think they show weakness of will by allowing themselves to be hypnotized ; then they cosciously tell untruths. Another group is more interesting psychologically. Their self-deception is the same as we have found in some cases of posthypnotic suggestion. They think they could have acted otherwise if they had pleased (F. Myers). Heidenhain mentions such a case; a doctor said, after the hypnosis, that he could have opened his eyes if he had pleased ; but when the hypnosis was renewed he could no more help himself than the first time. I could add a number of personal observations.

One case was that of a doctor, who often asserted after the first hypnosis that he could have behaved otherwise ; but in each fresh hypnosis his will was inhibited. Finally he himself became aware of his loss of will-power. In another case I hypnotized X. at least ten times before he would agree that the suggested paralysis of his arm had really made him unable to move it; he previously believed that he had so behaved to oblige me.

All this makes it evident how difficult it is to decide the question with regard to fraud. It seems to me to occur more often with children, but the transition from simulation to true hypnosis is so gradual that even an experienced experimenter is sometimes uncertain. For example, when a subject shuts his eyes to be obliging, it is not the same thing as if he shut them to deceive ; or he shuts them because he is tired of fixing them on something, but could open them by a strong effort, though he keeps them shut because it is more comfortable. It would be a great mistake to identify this with simulation. Others do what the experimenter wishes, to please him, but not to deceive him. This is not pure fraud either, for the wish to deceive is absent. And there is another complication; for people in hypnosis sometimes pretend, just as it is known insane persons do. Thus a hypnotic will say he sees something when he does not. It is naturally very difficult to say where deceit begins and ends in such a case ; but, generally speaking, practice will enable us to judge the mental state of the subject with some certainty. There is no doubt that even the most experienced deceive themselves or are deceived ; the most experienced doctor of mental diseases is in the same case. But as he learns to diagnose by experience so will the experimenter in hypnotism. The fear of being deceived has prevented many from interesting themselves in the subject. But no advance can be made unless the fear is put on one side and the question examined. It is possible to maintain a complete scientific reserve. The question of fraud must be treated in a scientific manner, as mental diseases are treated. We must not make impossible demands in order to exclude imposition ; to do so would prove neither scepticism nor a scientific spirit; it would, on the contrary, be unscientific. And yet I have heard a " cultivated " man, who thought himself scientifically sceptical, say, when watching a hypnotic subject, that he would believe in the reality of the hypnosis only if the subject could see through a non-transparent substance ; e.g., if he could see through a man as if he were glass!