SUPPLEMENT B.

HYPNOTISM.

Hypnotism (hupnos, sleep). The interest awakened in recent years in the subject of Hypnotism, and its connection with other mental phenomena make it seem desirable that we should devote what space we can afford to it here.

Historical Sketch. -- Towards the end of last century an Austrian physician named Mesmer professed publicly in Paris to heal all diseases by "animal magnetism." The treatment was so called from a "magnetic" power supposed to be exerted over living beings by certain persons or objects more than normally saturated with the mysterious influence. The magnetization was effected by passes, contact, or fixation of the eyes, but was often accompanied by ceremonies of a superstitious and sometimes of an immoral character. In 1714 mesmerism was examined by a commission of the Royal Society of Medicine of France. The commissioners decided against the reality of the alleged magnetic force. They explained the effects of the magnetization to be due to the influence of imagination and imitation, and they declared the beneficial results claimed for the new curative treatment to be more than counterbalanced by the dangers, physical and moral, attendant on its employment.^{1} Later on the Holy See also condemned mesmerism, or rather the superstitious or immoral use of methods of magnetism included under that name. For three-quarters of a century the magnetic art had fallen into general disrepute; but during the past twenty years it has again come into prominence under the title of Hypnotism. The new method of treatment, however, at least as employed by medical men of standing, is stripped of the former superstitious and objectionable practices, though certain grave dangers inevitably remain attached to its use. To hypnotism thus understood as excluding spiritualism, occultism, clairvoyance, and the like we confine ourselves here. Experiences of these latter kinds, whether viewed as preternatural or merely abnormal phenomena, must be discussed individually -- especially with respect to the evidence as to matters of fact in each particular case.

Process of hypnotization. -- The subject is requested to gaze fixedly at some object, such as a button, suspended at a little distance from his eyes and above his head; or to stare into the eyes of the operator; or to listen to a monotonous sound such as the ticking of a watch; or "passes" are made in front of his face and chest. After a time he often gradually falls into a drowsy or lethargic condition, like that preceding or following on ordinary sleep. This is a milder form of the hypnosis or hypnotic trance. Dr. Bernheim and the physicians of the Nancy School ordinarily induce the hypnosis by simple suggestion of the idea. Thus the patient being seated, the doctor says, in a quiet, authoritative voice: "Gaze fixedly at me and think of nothing except of falling asleep. You feel your eyelids heavy: you are very drowsy: your eyes grow more and more fatigued: they wink: your sight is becoming dimmer and dimmer: your eyes are closing: you cannot open them! Sleep!"^{2} If the operation is successful, the subject passes into the hypnosis, from which he is awakened either by blowing on his face, by making passes in the opposite direction, or by an emphatic "Awake!"

Characteristics of the hypnotic state. -- The trance thus induced may be of any degree of intensity, from a slight feeling of drowsiness to profound somnambulistic sleep. Different writers variously classify these states. Charcot's division of stages into cataleptic, lethargic, and somnambulistic is the best known; as it is also the most generally attacked.^{3} That adopted by Wundt of drowsiness, light sleep, and deep sleep, are as convenient as any other; though the state must not be identified with normal sleep.^{4} In the lighter forms of the hypnotic influence the subject is quite aware of what goes on around him, and can remember the various incidents afterwards, but he feels perhaps slightly drowsy. The chief peculiarity of the state is that the subject is in a condition of rapport or special relation with the hypnotizer, which is shown by his susceptibility to suggestions from the latter. In the deeper stages the subject loses connexion more and more with all other objects save the hypnotizer and the particular experiences which the latter suggests. When he awakes he cannot remember, or only very imperfectly, the incidents of the hypnotic state. Amongst some of the more remarkable phenomena are the following:

Inhibition of voluntary muscles. -- The operator authoritatively tells the subject that he cannot pronounce his own name, or open his eyes, or move his legs; and immediately the subject is helplessly paralyzed in regard to these acts, somewhat as one feels when suffering from nightmare. Or in a deeper stage the subject is commanded to hold out his arm, and is next assured that it is impossible to withdraw it. The arm then assumes a rigid cataleptic condition, and remains thus extended for a longer period than the subject could voluntarily sustain it in his normal state.

Illusions and hallucinations. -- In a still more profound stage illusions can be successfully suggested. The hypnotized person is easily persuaded that a glass of water is tea, wine, or vinegar, or vice versa. Or, his attention is directed towards an imaginary cat, bird, or flower which he thereupon perceives as a real being. Still more curious are the "negative" illusions. The operator asserts emphatically that some particular member of the company has left the room; and this individual thenceforth becomes invisible to the subject, although the latter distinctly perceives all the other persons and objects in the apartment. The subject may be made to adopt some other character, as that of a policeman, a nun, a little child, or an old woman; and not infrequently acts the part remarkably well. In this deeper somnambulistic stage the actions suggested by the experimenter are almost invariably executed, even though they be absurd, unpleasant, or ridiculous.

Amnesia and "deferred suggestions." -- A common feature of the deeper forms of the trance is complete forgetfulness when awakened, of the incidents which have just happened, although they may be perfectly recalled In a future hypnosis. Nevertheless post-hypnotic suggestions or orders given during the trance with regard to future actions are often faithfully performed at the appropriate time when the subject has been restored to his normal waking state, although no recollection of the suggestion be retained. The subject simply feels a vague impulse to perform the action. It is in this force of "deferred suggestions" that the value of hypnotism as a therapeutic agency lies. But here also is obviously one of its gravest dangers. The patient, when hypnotized, is assured that he will awake in good health, that his neuralgia or dyspepsia will have ceased; and the malady accordingly disappears. Or, if ordered to do something on a future occasion, he will feel, when the circumstances arrive, an inexplicable impulse to perform the act; and this craving, it is said, possesses in some instances an overmastering force which renders the subject miserable until the deed is accomplished, or the occasion for it has passed completely away.

Exalted sensibility. -- In certain cases the sensibility of the perceptive faculties seems to be heightened in a marvellous manner, so as to enable the hypnotized subject to apprehend faint stimuli that would in the normal state be indiscernible. How far certain strange, extraordinary phenomena of this class are to be ascribed to hypnotism proper, it is very difficult to decide. At all events authenticated cases of the kind do not seem to occur in legitimate clinical practice like that of Bernheim at Nancy. On the other hand, a writer as little likely to extend unduly the territory of the preternatural as Professor James, is very frank in his confession of belief in the reality of occurrences at "seances" given by certain "mediums," as altogether inexplicable by hitherto known natural causes.^{5}

Whether the human intellect can ever naturally work more efficiently in the hypnotized state seems even more open to doubt; though it is not impossible that the suspension of inferior cerebral centres may in particular circumstances set certain higher mental processes in a freer and more unimpeded condition of activity.^{6}

The percentage of persons hypnotizable is variously stated by different experimenters, partly owing to their differences of view as to the genuineness of the lighter form of Hypnotism. Thus: "Bottey gives 30 per cent. as susceptible, Morselli 70 per cent., Delboeuf over 80 per cent., whilst Bernheim refuses the right to judge of hypnotism to all hospital doctors who cannot hypnotize at least 80 per cent. of their patients, and Forel fully agrees with him."^{7}

Men, according to some writers, are as hypnotizable as women, soldiers being particularly good subjects. The susceptibility of the subject increases with the frequency of the operation, and the induction of a morbid "hypnotic habit" is one of the serious evils attending on frequent hypnotization. As to whether we can be hypnotized against our will, it is generally admitted that if a person has already often submitted to the experiment, he may sometimes be hypnotized without his consent. It is also agreed that certain neurotic or hysterical patients can be hypnotized from the first time against their desire. As regards normal healthy persons, if they decline to comply with the conditions, the hypnotizer can do nothing. It is also generally held that an abnormally susceptible subject can be safeguarded from future abuse by the suggestion that he can never be hypnotized save by some particular person.

Theories concerning Hypnotism. -- According to Charcot and the Paris school at least the deeper hypnosis is a nervous disorder, found only in hysterical patients, and exhibiting itself in the three stages of cataleptic, lethargic, and somnambulistic trance.^{8} On the other hand, the Nancy school, whose view now generally prevails, advocate not a physical but a psychical explanation of the phenomena. They teach that the hypnosis is not a nervous disorder but a state possessing close affinity to natural sleep. For them the essence of hypnotism is suggestion. They explain the contrary conclusions of their rivals, as due to the fact that the experience of the latter is confined chiefly to the neurotic patients of the Salpêtrière hospital; and they urge that the phenomena of the three stages and other features insisted on by Charcot's disciples can all be accounted for by suggestion and imitation.^{9} Still, as has been justly observed, "what needs explanation here is the fact that in a certain condition of the subject suggestions operate as they do at no other time."^{10} The matter is confessedly exceedingly obscure, and no satisfactory answer is yet forthcoming; nevertheless, some considerations connecting hypnosis with more familiar mental phenomena may be usefully indicated.

Hypnosis. -- First, then, the hypnotic trance, though not identical in any stage with natural sleep, clearly bears affinity to the latter state, especially to that type of it exhibited in spontaneous somnambulism. It is induced by similar means, and the lighter forms resemble the drowsiness which precedes or succeeds sleep. We have pointed out how the apparent reality of the dream results from the cessation of the corrective action of the external senses and the suspension of the power of reflective comparison whilst the exaggeration of the impressions which succeed in penetrating into the sleeper's mind is due to the circumstance that they secure a monopoly of his consciousness. (p. 176.) These facts help towards the explanation of some of the phenomena of hypnotism.

Fixation of attention: "Rapport." -- The primary effect of the concentration of attention involved in all the methods of hypnotizing is to starve out all rival impressions and thoughts. This seems to bring on a condition of somnolence in regard to all surrounding objects, except the operator who has induced the state by directing the fixation of the subject's attention. This peculiar "rapport" with the hypnotizer preserved throughout the trance is the chief feature by which this artificially induced sleep is distinguished from normal sleep. Even in ordinary sleep, the senses are not altogether closed. There is exerted a certain "selective" reception of impressions, and those which fit in with the current of a dream may have an abnormally intense effect. It is, indeed, sometimes possible, if we hit upon the current of a dreamer's thoughts, to direct them by suggestions. But in the hypnosis instead of this imperfect casual relation with any body, there is a fixed stable rapport with one person who possesses an absolute monopoly of the subject's consciousness. The subject by the voluntary strained fixation of his attention on the hypnotizer has fallen into a trance in which his attention is henceforth riveted, or involuntarily fascinated by the latter. Why the subject's attention should become thus "clamped" we cannot tell.

Abnormal suggestibility. -- The power of suggestion is a familiar fact already sufficiently illustrated. If the thought of a rat being in the room, or of a worm crawling up my back, is suggested to me, I am uncomfortable until I convince myself that it is not true. As St. Thomas teaches, the representations of the imagination win assent unless contradicted by sense-perception or reason. (p. 178.) In proportion to the vividness of the idea and the completeness of the suspension of the other faculties will be the intensity of the illusion. Again, vivid ideas of action tend to realize themselves. A lively conception of a word or gesture expresses itself in a faint movement of the appropriate muscles. But attention, whether voluntary or extorted, enormously increases the force of an idea or sensation. It augments the excitability of the nerve tracts and cerebral centres engaged, it suppresses the enfeebling effect of competing stimuli; and it concentrates mental energy on the object of interest. But in proportion as the trance is more profound all rival experiences seem to be excluded, and the faculties of the subject are receptive only of the suggestions of the hypnotizer, which consequently acquire very exceptional force.

Inhibition. -- Even in waking life, our Power of action is much dependent on our belief in our ability to act. The partial conviction that we cannot or can perform a certain movement goes far to make it impossible or possible for us. But in hypnosis the conviction of inability can be made absolute by simple suggestion, and the voluntary control of the subject's muscles is suspended as completely as in a nightmare. The hypnotizer cannot, as is sometimes erroneously said, directly rule the Will of the hypnotized: but he can determine, at least in extreme cases, the movements and perceptions of the latter by suggesting the images which excite his motor and sensory nerves and cerebral centres.

Suggested illusions -- The same principles help to explain both the negative and positive illusions of hypnosis. Even in waking life, when the attention is engrossed by some other subject, a man may gaze at an object without perceiving it; he may walk through a crowded street with as little notice of the sights which assail his eyes, as if it were empty; even an acute pain may remain unobserved by him. This is the ordinary character of the somnambulism of normal sleep and of the hallucination of the monomaniac. The attention is absorbed by some dominant thought or fixed idea, and the chief difference in the case of hypnosis is that the thought which is to dominate is determined by the operator. If he chooses to concentrate the mental energy of the subject on a phantasm of the imagination, since all initiative or voluntary use of reason is inhibited, hallucination is inevitable. That suggestions made under such favourable circumstances not only possess exceptional force at the time, but also produce an enduring impression which will work itself out later on appears natural enough. There is probably also something in the cerebral conditions of hypnosis which renders the brain peculiarly susceptible to suggestions of the time.

Amnesia. -- The forgetfulness of the events of the hypnotic state during the following waking period, and their recollection in a subsequent hypnosis, have their parallel in the obliviscence of dreams and somnambulistic performances in the daytime. The memory of our waking experiences presents us with analogous facts. The recollection of a past cognition seems commonly to involve, or at least to be facilitated by, the reproduction of part of the frame of mind in which the incident occurred. Each mental act forms an integral part of an environing conscious state connected with a network of nervous conditions, and when these are completely changed as from the sleeping to the waking state, remembrance of experiences of the former condition are naturally difficult. We have alluded to this before in dealing with "alternating personalities" (pp. 490, 491.) The retention in a latent subconscious form of an impulse to carry out a deferred suggestion when the appointed circumstances arise may perhaps be explained in the same way. The man who, engrossed in conversation, automatically posts a letter, owing to a friend's request, as he passes a pillar-box, executes, it has been justly said, a "deferred suggestion," of which he may have been oblivious from the moment he received the letter until he finds his pocket empty on arriving home; and he may be then utterly unable to recall the incident. In many, if not all cases, the performance of complex post-hypnotic suggestions seems to involve a relapse into the trance state.^{11}

Ethics of Hypnotism. -- The morality of hypnotism is a question rather for Ethics or Moral Theology than for the Psychologist, so a very few words must suffice here: (1) It is admitted on all hands that hypnotism is attended by serious peril to health of both body and mind when practised by unskilled persons and irresponsible charlatans. Epileptic fits, hysterical paroxysms, and permanent mental and nervous disorders have been induced by ignorant experimenters. Accordingly several continental governments have wisely made public exhibitions and the practice of hypnotism by other than duly qualified persons a penal offence. (a) Further it is generally agreed that frequent hypnotization, especially when the profounder stages are induced, brings on a morbid hypnotic habit, besides rendering the subject unduly subservient to the influence of the operator. Obviously this latter consequence may be attended with serious dangers.^{12} How far a subject can by hypnotism be led to commit a crime is much disputed, but it is clearly unlawful to suspend or diminish in this way the use of our free-will and intelligence without adequate reason and due precautions. (3) Where hypnotism is employed for illicit purposes, or in connexion with superstitious practices as in spiritualism, occultism, clairvoyance and the like, it is evidently immoral. (4) If, however, the question be put: Is hypnotism ever allowable? the true answer seems to us to be that of the moral Theologians who teach^{13} that in certain circumstances the use of hypnotism is permissible. The conditions usually prescribed are: (a) There must be a grave reason to justify the suspension of reason; and we would add that the gravity increases in proportion to the completeness of the abdication of free control involved. (b) Sufficient guarantee should be had as to the character and competence of the operator. (c) Some adequately trustworthy witness, such as a parent, husband, or guardian should be present when a person submits to being hypnotized.

{1} Cf. Binet and Féré Animal Magnetism, pp. 1-30.

{2} H. Bernheim, De la Suggestion et de ses Applications à la Thérapeutique, pp. 2, 3.

{3} See A. Moll, Hypnotism, pp. 48-52.

{4} Human and Animal Psychology, p. 329.

{5} Principles of Psychology, Vol. I. p. 396; and The Will to Believe, 319.

{6} Such would seem to be the view of St. Thomas in regard to some states. But though he lays down the general principle, he is rather considering the possibility of supernatural communications: "Anima nostra, quanto magis a corporalibus abstrahitur, tanto intelligibilium abstractorum fit capacior. Unde in somniis, et alienationibus a sensibus corporis magis divinae revelationes percipiuntur, et praevisiones futurorum." (Sum. 1. q. 32, a. ii. Cf. Coconnier, L'Hyp notisme franc, p. 363.)

{7} Moll, Hypnotism, p. 47. Only a small percentage, however, reach the deeper stages.

{8} Cf. Binet and op. cit. cc. vi. vii.

{9} Cf. Bernheim, op. cit. c. vi.

{10} James, Principles of Psychology, vol. ii. p. 601

{11} See Coconnier, L'Hypnotisme franc (Paris, 1897), cc. xii. -- xiv. This is an able and judicious work on the subject. There are good cbapters also in Meric's Le Merveilleux et la Science.

{12} The grave words of Wundt are worth recording: "Hypnotism is a therapeutic agency is a two-edged instrument. If its effects are strongest when the patient is predisposed to it in body and mind, or when suggestion has become a settled mode of treatment, it may obviously be employed to intensify or actually induce a pathological disposition. It must he looked upon, not as a remedy of universal serviceability, but as a poison whose effect may be beneficial under certain circumstances. . . . (Some assert) that the hypnotic sleep is not injurious, because it is not in itself a pathological disposition. But surely the facts of post-hypnotic hallucination and the diminution of the power of resistance to suggestive influences furnish a refutation of this statement which no counterarguments can shake. It is a phenomenon of common observation that frequently hypnotized individuals can, when fully awake, be persuaded of the wildest fables and thenceforth regard them as passages of their own experience." (Lectures on Human and Animal Psychology, pp. 334, 335.)

{13} Génicot writes: "Vitatis conatibus superstitiosis, et adhibitis cautelis supra explicatis. licet seipsum ob gravem causam hypnotizanti tradere. . . . Graves causae ob quas licite hypnotismus adhibeatur, aunt praesertim duae; curatio morborum quibus sanandis desit aliud medium prorsus innocuum; et progressus quarundam scientiarum, puta medicinae vel psychologiae, his experimentis obtinendus. Praeterea censemus hypnotismum licite adhiberi, ad tollendas, vel saltem minuendas, quasdam malas propensiones quae, ob vehementiam suam, libertatem tollunt vel extenuant, puta propensionem ad suicidium, ad liquores inebriantes, &c." (Theologia Moralis Institutiones, vol. i. § 275 (1898). Cf. Lehmkuhl, Theologia Moralis, vol. i. n. 994; Sabetti, Theologia Moralis, § 209; Coconnier, op. cit. cc. xxi.-xv.; Pucceroni, Casus Conscientia, § 89 (1895).