THEORIES ABOUT THE HYPNOTIC STATE.

The intimate nature of the hypnotic condition, when once induced, can hardly be said to be understood. Without entering into details of controversy, one may say that three main opinions have been held concerning it, which we may call respectively the theories of

1. Animal magnetism;

2. of Neurosis; and finally of

3. Suggestion.

According to the animal-magnetism theory there is a direct passage of force from the operator to the subject, whereby the latter becomes the former's puppet. This theory is nowadays given up as regards all the ordinary hypnotic phenomena, and is only held to by some persons as an explanation of a few effects exceptionally met with.

According to the neurosis-theory, the hypnotic state is a peculiar pathological condition into which certain pre-disposed patients fall, and in which special physical agents have the power of provoking special symptoms, quite apart from the subjects mentally expecting the effect. Professor Charcot and his colleagues at the Salpétrière hospital admit that this condition is rarely found in typical form. They call it then le grand hypnotisme, and say that it accompanies the disease hystero-epilepsy. If a patient subject to this sort of hypnotism hear a sudden loud noise, or look at a bright light unexpectedly, she falls into the cataleptic trance. Her limbs and body offer no resistance to movements communicated to them, but retain permanently the attitudes impressed. The eyes are staring, there is insensibility to pain, etc., etc. If the eyelids be forcibly closed, the cataleptic gives place to the lethargic condition, characterized by apparent abolition of consciousness, and absolute muscular relaxation except where the muscles are kneaded or the tendons struck by the operator's hand, or certain nerve- [p. 597] trunks are pressed upon. Then the muscles in question, or those supplied by the same nerve-trunk enter into a more or less steadfast tonic contraction. Charcot calls this symptom by the name of neuro-muscular hyperexcitability. The lethargic state may be primarily brought on by fixedly looking at anything, or by pressure on the closed eyeballs. Friction on the top of the head will make the patient pass from either of the two preceding conditions into the somnambulic state, in which she is alert, talkative, and susceptible to all the suggestions of the operator. The somnambulic state may also be induced primarily, by fixedly looking at a small object. In this state the accurately limited muscular contractions characteristic of lethargy do not follow upon the above-described manipulations, but instead of them there is a tendency to rigidity of entire regions of the body, which may upon occasion develop into general tetanus, and which is brought about by gently touching the skin or blowing upon it. M. Charcot calls this by the name of cutaneo-muscular hyperexcitability.

Many other symptoms, supposed by their observers to be independent of mental expectation, are described, of which I only will mention the more interesting. Opening the eyes of a patient in lethargy causes her to pass into catalepsy. If one eye only be opened, the corresponding half of the body becomes cataleptic, whilst the other half remains in lethargy. Similarly, rubbing one side of the head may result in a patient becoming hemilethargic or hemicataleptic and hemisomnambulic. The approach of a magnet (or certain metals) to the skin causes these half-states (and many others) to be transferred to the opposite sides. Automatic repetition of every sound heard ('echolalia') is said to be produced by pressure on the lower cervical vertebræ or on the epigastrium. Aphasia is brought about by rubbing the head over the region of the speech-centre. Pressure behind the occiput determines movements of imitation. Heidenhain describes a number of curious automatic tendencies to movement, which are brought about by stroking various portions of the vertebral column. Certain other symptoms have been frequently noticed, such as a flushed face and cold hands, brilliant and congested eyes, dilated pupils. Dilated reti- [p. 598] nal vessels and spasm of the accommodation are also reported.

The theory of Suggestion denies that there is any special hypnotic state worthy of the name of trance or neurosis. All the symptoms above described, as well as those to be described hereafter, are results of that mental susceptibility which we all to some degree possess, of yielding assent to outward suggestion, of affirming what we strongly conceive, and of acting in accordance with what we are made to expect. The bodily symptoms of the Salépêtrière patients are all of them results of expectation and training. The first patients accidentally did certain things which their doctors thought typical and caused to be repeated. The subsequent subjects 'caught on' and followed the established tradition. In proof of this the fact is urged that the classical three stages and their grouped symptoms have only been reported as spontaneously occurring, so far, at the Salpétrière, though they may be superinduced by deliberate suggestion, in patients anywhere found. The ocular symptoms, the flushed face, accelerated breathing, etc., are said not to be symptoms of the passage into the hypnotic state as such, but merely consequences of the strain on the eyes when the method of looking at a bright object is used. They are absent in the subjects at Nancy, where simple verbal suggestion is employed. The various reflex effects (aphasia, echolalia, imitation, etc.) are but habits induced by the influence of the operator, who unconsciously urges the subject into the direction in which he would prefer to have him go. The influence of the magnet, the opposite effects of upward and downward passes, etc., are similarly explained. Even that sleepy and inert condition, the advent of which seems to be the prime condition of farther symptoms being developed, is said to be merely due to the fact that the mind expects it to come; whilst its influence on the other symptoms is not physiological, so to speak, but psychical, its own easy realization by suggestion simply encouraging the subject to expect that ulterior suggestions will be realized with equal ease. The radical defenders of the suggestion-theory are thus led to deny the very exist- [p. 599] ence of the hypnotic state, in the sense of a peculiar trance-like condition which deprives the patient of spontaneity and makes him passive to suggestion from without. The trance itself is only one of the suggestions, and many subjects in fact can be made to exhibit the other hypnotic phenomena without the preliminary induction of this one.

The theory of suggestion may be said to be quite triumphant at the present day over the neurosis-theory as held at the Salpétrière, with its three states, and its definite symptoms supposed to be produced by physical agents apart from co-operation of the subject's mind. But it is one thing to say this, and it is quite another thing to say that there is no peculiar physiological condition whatever worthy of the name of hypnotic trance, no peculiar state of nervous equilibrium, 'hypotaxy,' 'dissociation,' or whatever you please to call it, during which the subject's susceptibility to outward suggestion is greater than at ordinary times. All the facts seem to prove that, until this trance-like state is assumed by the patient, suggestion produces very insignificant results, but that, when it is once assumed, there are no limits to suggestion's power. The state in question has many affinities with ordinary sleep. It is probable, in fact, that we all pass through it transiently whenever we fall aslHREF="page04#linkeep; and one might most naturally describe the usual relation of operator and subject by saying that the former keeps the latter suspended between making and sleeping by talking to him enough to beep his slumber from growing profound, and yet not in such a way as to wake him up. A hypnotized patient, left to himself, will either fall sound asleep or wake up entirely. The difficulty in hypnotizing refractory persons is that of catching them at the right moment of transition and making it permanent. Fixing the eyes and relaxing the muscles of the body produce the hypnotic state just as they facilitate the advent of sleep. The first stages of ordinary sleep are characterized by a peculiar dispersed attitude of the attention. Images come before consciousness which are entirely incongruous with our ordinary beliefs and habits of thought. The latter either vanish altogether or withdraw, as it were, [p. 600] inertly into the background of the mind, and let the incongruous images reign alone. These images acquire, more-over, an exceptional vivacity; they become first 'hypnagogic hallucinations,' and then, as the sleep grows deeper, dreams. Now the 'mono-ideism,' or else the impotency and failure to 'rally' on the part of the background-ideas, which thus characterize somnolescence, are unquestionably the result of a special physiological change occurring in the brain at that time. Just so that similar mono-ideism, or dissociation of the reigning fancy from those other thoughts which might possibly act as its 'reductives,' which characterize the hypnotic consciousness, must equally be due to a special cerebral change. The term 'hypnotic trance,' which I employ, tells us nothing of what the change is, but it marks the fact that it exists, and is consequently a useful expression. The great vivacity of the hypnotic images (as gauged by their motor effects), the oblivion of them when normal life is resumed, the abrupt awakening, the recollection of them again in subsequent trances, the anæsthesia and hyperæsthesia which are so frequent, all point away from our simple waking credulity and 'suggestibility' as the type by which the phenomena are to be interpreted, and make us look rather towards sleep and dreaming, or towards those deeper alterations of the personality known as automatism, double consciousness, or 'second' personality for the true analogues of the hypnotic trance. [3] Even the best hypnotic subjects pass through life without anyone suspecting them to possess such a remarkable susceptibility, until by deliberate experiment it is made manifest. The operator fixes their eyes or their attention a short time to develop the propitious phase, holds them in it by his talk, and the state being there, makes them the puppets of all his suggestions. But no ordinary suggestions of waking life ever took such control of their mind. [p. 601]

The suggestion-theory may therefore be approved as correct, provided we grant the trance-state as its prerequisite. The three states of Charcot, the strange reflexes of Heidenhain, and all the other bodily phenomena which have been called direct consequences of the trance-state itself, are not such. They are products of suggestion, the trance-state having no particular outward symptoms of its own; but without the trance-state there, those particular suggestions could never have been successfully made. [4]