Psychotherapy has now become for us the effort to repair the disturbed equilibrium of human functions by influencing the mental life. It is acknowledged on all sides that the most powerful of these influences is that of suggestion. This is an influence which is most easily misunderstood and which has most often become the starting point for misleading theories. Before we enter into the study of the practical effects of suggestion and the psychotherapeutic results, we must examine this tool in the hand of the psychotherapist from a purely psychological viewpoint.
The patient may perhaps sometimes profit from suggestion the more, the less he understands about its nature, but the physician will always secure the better results, the more clearly he apprehends the working of this subtle tool. Of course, that does not mean that any psychology is able to explain the process of suggestion to a point where all difficulties are removed, but at least the mysteries can be removed and the effects can be linked with other well-known processes.
Let us be clear from the start that suggestion is certainly nothing abnormal and exceptional, nothing which leads us away from our ordinary life, nothing which brings us nearer to the great riddles of the universe. There is no human life into which suggestion does not enter in a hundred forms. Family life and education, law and business, public life and politics, art and religion are carried by suggestion. A suggestion is, we might say at first, an idea which has a power in our mind to suppress the opposite idea. A suggestion is an idea which in itself is not different from other ideas, but the way in which it takes possession of the mind reduces the chances of any opposite ideas; it inhibits them.
It is indeed the best result of any successful education, that the teachings have taken hold of the mind of the young in such a way that all the opposite tendencies and impulses and wishes do not come to development. The well-educated person does not need to participate in a struggle between good and bad motives, for that which has been impressed upon his mind does not allow the other side to come up at all. Our life would be crowded with inner conflicts if education had not secured for us from the start preponderance for the suggestions of our educators.
The love of family and friends, of our country and our party are in the same way such suggestions. We may hear arguments for the other side, arguments which easily convince the man of the other party, but they do not appeal to us: they are emasculated before they enter our minds; they have no chance to overcome the resistance because suggestions stand in their way. No argument will overwhelm the suggestion which religion has settled in our inner life, and from this strongest suggestion which can stand against any temptation of life small psychological steps lead down to the little bits of suggestion with which our daily chance life is over-flooded.
Every advertisement in the newspaper, every display in the shop-window, every warm intonation in the voice of our neighbor has its suggestive power, that is, it brings its content in such a way to our minds that the desire to do the opposite is weakened. We do buy the object that we do not need, and we do follow the advice which we ought to have reconsidered. And what would remain of art if it had not this power of suggestion by which it comes to us and wins the victory over every opposing idea? We believe the painter and we believe the novelist, if their technique is good. We do not remember that the inventions of their genius are contrary to our life experience; we feel sympathy with the hero and do not care in the least that he has no real life. The suggestion of art has inhibited in us every contrary idea.
Such daily experience shows us that suggestive power may belong to different men in different degree. There are lawyers whose arguments and whose presentation open our mind, it seems, to any suggestion: while others leave us indifferent; we understand their idea, we follow their thoughts, and yet we remain accessible to opposite influences. There are teachers whose authority gives to every word such an impressiveness and dignity that every opposite thought disappears, while others throw out words which are forgotten. On the other hand, the readiness to accept suggestions is evidently also quite different with different individuals. From the most credulous to the stubborn, we have every degree of suggestibility, the one impressed by the suggestive power of any idea which is brought to his mind, the other always inclined to distrust and to look over to the opposite argument.
Such a stubborn mind is indeed not only without inclination for suggestions, but it may develop even a negative suggestibility; whatever it receives awakens an instinctive impulse towards the opposite. Moreover we are all in different degrees suggestible at different times and under various conditions. Emotions reënforce our readiness to accept suggestions. Hope and fear, love and jealousy give to the impression and the idea a power to overwhelm the opposite idea, which otherwise might have influenced our deliberation. Fatigue and intoxicants increase suggestibility very strongly. To look out on a wider perspective, we may add at once that an artificial increase of suggestibility is all which constitutes the state of hypnotism.
At first, however, we want to understand the ordinary process of suggestion in that normal form in which it enters into every hour of our life and into every relation of our social intercourse. But if we begin to examine the structure of the process, we can no longer be satisfied with the vague reference to ideas and their opposites. What does it mean after all if we speak of opposite ideas? Can we not entertain any ideas peacefully together in our consciousness? From a logical standpoint, ideas may contradict each other, but that refers to their meaning. As mere bits of psychological experience, I may have any ideas together in my consciousness. I can think summer and winter or day and night or right and left or black and white or love and hate in one embracing thought. As mere mental stuff, the one idea does not interfere with the other. On the other hand, this is evident: I cannot will to turn to the right and to turn to the left at the same time. There may be a wrangling between those two impulses, but as soon as my will stands for the one, the other is really excluded. Any action which I am starting to do thus crowds out the impulse to the opposed action.
In the sphere of psychological facts, we have here indeed the only relation between two happenings which necessarily involves an opposition. We could never understand why one brain cell might not work together with any other brain cell, but we do understand that nature must provide for an apparatus by which the impulse to one action makes the impulse to the opposite action ineffective. There is no action which has not its definite opposite. The carrying out of any impulse involves the suppression of the contrary impulse, and the impulse not to do an action involves the suppression of the impulse to do it. When we spoke of the relations of mind and brain, we mentioned that such a correlation of mental centers indeed exists. Physiological experiments have demonstrated that the activity of those centers which stimulate a certain action reduce the excitability of those brain parts which awaken the antagonistic action. As far as the world of actions is concerned, the mechanism of the process of suggestion thus seems not inaccessible to a physiological understanding.
Various ideas of movements to be carried out are struggling for control in the cortex of the brain. That is the normal status which precedes any decision. The channels of motor discharge are open for both possibilities; we may turn to the right or to the left. Then the play of associations begins. A larger and larger circle of ideas surrounds the idea of the one and of the other goal. Those ideas awaken emotions. On the one side may call our duty and on the other side our pleasure.
Larger and larger parts of the central content of our consciousness, of our own personality, become involved; our principles and maxims, our memories, our hopes and fears, enter into the battle until deeper strata of the idea of ourselves enter into a firm association with the one side, reinforcing, perhaps, the idea of the goal at the right. This opens wide the channels of discharge for the movement to the right and inhibits thereby the excitability of the center which leads to the opposite action. The channel of discharge to the movement towards the left becomes closed, the idea of that movement fades away and becomes inhibited: we are moving towards the right. The outcome was the product of our total personality.
But this result would have been different, if from the start the channels of discharge had not been equally open for both possible movements, and if thus the relative resistance to the impulse had not been equal on both sides. If, for instance, we had gone from the given point frequently to the left, as a result of the habit and training, the impulse to the left would have found less nervous resistance. The channels would have become widened by the repetition and the opposite channels would have been somewhat closed by the lack of use. Or if instead of such previous habit, we should see at the decisive moment others turning to the left, the impression would have become the starting point for a reaction of mere instinctive imitation.
While we might not have followed that imitative impulse at once, yet the channels would have been widened, the discharge in the direction would have been prepared by it, the resistance would have been lowered and the chances for the opposite movement would have been decreased. Those people who moved to the left gave us by their action the same kind of an impulse which they would have furnished if they had begged us with words, or if they had ordered us to follow them with authoritative firmness. In each of these cases, the influence would have amounted to a suggestion.
Whether we watched the movements of other people or whether their words made an impression on us, in either case the way became prepared for a certain line of action and therefore the way for the opposite action became blocked. The final outcome was thus no longer an entirely free play of motor ideas, but there was a little inequality in play. The one had from the start a better chance, the other was from the start laboring under difficulties. The suggestion of actions is thus nothing but making use of the antagonistic character in the nervous paths which start from the motor centers. That all such phrases as the opening and the closing, the widening and blocking, of channels of discharge are only metaphors hardly needs special emphasis. Instead of such comparisons, we ought rather to think of chemical processes which offer various degrees of resistance to the propagation of the nervous excitement.
We see from here the direction in which many psychotherapeutic efforts must lie, efforts which are entirely within the limits of the daily normal experience, and belong to the medical practice of every physician, yes, to the helpful influence of every man in practical life. The intemperate man may suffer from his inability to resist his desire for whiskey. The idea of his visit to the saloon finds the channels of discharge open. We argue with him, we tempt him by attractions which lead to other ways, we suggest to him that he spend those evening hours perhaps with friends or with books for which we awaken his interest; we do it as impressively as we can, we appeal to his friendly feeling for us; and if again the hour comes in which the desire for the artificial stimulation sets in with a motor impulse towards the bottle, the channels for discharge have now been blocked.
The idea of the opposite action arises, it associates itself with the emotions which we stirred up in his mind, it associates itself with the respect for the adviser, and thus new clusters of thought reinforce that idea of action which we suggested, and this opposite line of action now finds a minimum resistance because our appeal has opened beforehand the gate. The desire for the book works itself out into action while the desire for the cup finds increased resistance.
Just this is the kind of suggestion with which we correct faulty action everywhere in our social circle; and yet small steps lead on from here to the case where perhaps the desire for alcohol has reached that pathological intensity in which the equilibrium is entirely disturbed and cannot be repaired without suggestions of a much more powerful character, given in a state of artificially increased suggestibility—in hypnotism. The principle of opening certain channels of discharge for the purpose of closing the opposite channels remains in the extreme case the same as in the more ordinary cases. The impulse to drink is a positive one, but the principle is not different where the impulse is negative.
A friend who comes from the quiet country may feel unable to pass the busy square of the city. The fear of an accident holds back his steps, he cannot give the impulse to walk through the crowded rush of vehicles. Now either by words of advice, by persuasion or by showing the way, we may apply our suggestion, we open the channels of discharge for the necessary movements and thus decrease the excitability of those centers in which nervous fear was playing. And again small steps lead from here to the case of the psychasthenic sufferer whose phobia does not allow him to cross any square and where reinforced suggestion has to break open the ways for the walking movement when the square is reached.
Thus we are not far from a causal understanding of suggestive influences wherever actions are concerned, where movements are to be reinforced or to be suppressed and where antagonism of the motor paths is involved. But that does not seem to lead us nearer to the much larger group of states in which the whole suggestive process concerns apparently the interplay of ideas alone, where not actions but impressions are controlled by suggestion, where not impulses but thoughts are strengthened or inhibited. Here lies the real psychophysical problem which has been by far too much neglected in scientific psychology and has almost been hidden and made to disappear in the wonderful accounts of the hypnotists.
But all those mysterious stories as to the achievements of suggestion cannot help so long as we do not understand the working of the process, and we shall have the better chance to understand it the more we keep away from the uncanny and mysterious results which refer to the most complex conditions, and rather seek to analyze the state in its simplest forms and compare it with other simple mental processes. The psychology of suggestion has suffered too much by the fascination which its most complex forms exert on a trivial curiosity.
Yet the problem of suggestion in the field of ideas stands after all not isolated. Instead of connecting it with the weird reports of mystic influence from man to man, let us rather link it with the simple experience of attention. There is no pulse-beat of our life in which attention does not play its little rôle. But does not attention share with suggestion the characteristic feature that some contents of consciousness are reinforced and others are suppressed? This negative, this suppressing character of attention is not a chance by-product, it is most essential. There is no attention without it.
If I am studying, I do not hear the conversation around me, and if I listen to the conversation, my studies in hand become inhibited. If I enjoy the play on the stage and give to it my full attention, my memories of the day's work are suppressed; if I think of the happenings of the day, I am not attentive to the play and hardly notice what is going on. The inhibited impression may often disappear entirely. While I am reading I am not at all aware of the tactual and muscular sensations in my legs, and if I am completely absorbed by my book, I may not even notice that the bell rings. In short, we have here as the most characteristic relation, just as in suggestion, the fact that one mental state becomes vivid, and that others are losing ground, become less vivid, are inhibited and perhaps disappear entirely.
Of course, to point to the similarity between suggestion and attention is not a real explanation. It may be answered that attention simply offers the same difficulties once more. How can we explain in the attention process the fact that one idea, the one attended to, becomes vivid and that others evaporate? The difficulty evidently cannot be removed by simply saying that only one sensorial process can be developed in the brain at one time. The popular descriptions of attention easily make it appear as if such were the solution of the problem. If one sensorial brain part is intensely engaged, the remainder of the brain is condemned to a kind of inactivity. Yet such a dogma is hardly better than the old-fashioned one that the soul can have only one idea at a time. We know too well now that the psychophysical system is an extremely complex equilibrium of millions of elements.
Thus every change must be explained with reference to this complex manifold. Above all, the facts simply contradict such an over-simple explanation, inasmuch as it is not at all true that only one content of consciousness can become vivid. Our attention does not focus upon one point at all but may illuminate a large field and thus give vividness to various complex groups. If I am thinking about a scientific problem, an abundance of reminiscences of previous reading and imaginative ideas of possible solutions, associative thoughts and conclusions are with equal vividness before my mind and the forthcoming thought may be influenced by this total combination.
I have no right whatever to say that the idea of a certain solution excludes there in my mind the consideration of the books which I have read and of the discussions which I have heard. Emotions may be superadded. In short, a world of mental states may be held together by one act of attention. And new and ever new thoughts are shooting in, and all still find place there in the field attended to, while on the other hand my slight headache is inhibited and an appointment is forgotten. At a gay banquet, my attention may be given to the whole hall with all its color effects and its flowers, and to all that the table offers and to the music from the orchestra and to the jokes of my neighbors. It is not true that any one of those parts suppresses the vividness of the others, they seem rather to maintain and to help one another; and yet in the next moment, my neighbor may bring me news which absorbs my mind entirely and leaves no room for the flowers and the music and the meal. How far can psychology do justice to these characteristics of attention?
There seems to be but one way. The attended-to idea does not exclude every other idea, but it does exclude the opposite idea, and opposite to each other is here again that pair of ideas which lead to opposite actions, to opposite psychophysical attitudes. We must remember here the psychomotor character of our brain processes which we so fully discussed. We recognized the fundamental truth that there is no sensorial state which is not at the same time the starting-point for motor reaction. We recognized that the brain is by its whole psychological development a great switchboard which transfers incoming currents into outgoing ones and that its biological meaning lies in the fact that it is the center piece of an arc which leads from the sense organs to the muscles.
We cannot conceive of those relations as complex enough; we know, of course, that millions of nerve fibers lead from the periphery to the highest psychophysical apparatus in the cortex of the brain and that millions of fibers bring about the interrelation between these central stations, but we must never forget that millions of fibers also represent the outgoing paths and that they too lead down to lower central motor instruments which are again in numberless correlations. Any impression is thus a starting point for attitudes and reactions and it is an empty abstraction to consider it otherwise. An idea is never, psychophysically considered, the end of the process, it is always also a beginning. No external action may follow, but the mental impulse to such is nevertheless starting in the highest center.
If we look at the landscape, every single spot of color, reaching a nerve fiber in our eye and finally a sensory cell in our brain, is there the starting point for an impulse to make an eye movement in the direction of the seen point. The eye may remain entirely quiet as the impulse to move to the right and to the left, to move up and to move down, may be equally strong, but those thousands of impulses work in the motor paths and only their equilibrium results in the suppression of the outer movement. With such motor scheme, we begin to understand the selective process in attention. An impression may be accompanied by other stimuli and associations, by thoughts and ideas, and thousands of sensory excitements may thus arise in the cortex, but only those have a chance for full vividness of development which cooperate in the motor action already started.
Those impressions which would lead to the opposite actions have no chance because their motor paths are blocked and their own full development is dependent upon their possibility of expression. To close the path means to inhibit the idea which demands such action. We can attend to a hundred thoughts together, if they all lead to the same attitude and deed. We can look at the opera, can see every singer and every singer's gown, can listen to every word, can have the whole plot in mind, can hear the thousands of tones which come from the orchestra; and yet combine all that in one act of attention, because it all belongs to the same setting of our reactive apparatus. Whatever the one wants is wanted by the others. But if at the same time our neighbor speaks to us, we do not notice it; his words work as a stimulus which demands an entirely different motor setting as answer. Therefore the words remain un-vivid and unnoticed.
To attend means therefore to bring about a motor setting by which the object of attention finds open channels for discharge in action. Which particular action is needed in the state of attention cannot be doubtful. Attention demands those motor responses and those inner steps by which the object of attention shows itself more fully and more clearly. When we give attention to the picture we want to see more details, when we give attention to the problem we want to recognize more of the factors involved, when we give attention to the banquet we want to grasp more of the pleasurable features.
This aim of attention involves that, as part of such reactions, the sense organs become adjusted; we fixate the eyeball, we listen, and in consequence the object itself becomes clearer, and through the easy passage into the motor channels the whole impression becomes vivid. At the same time, all those associations must be reinforced and become vivid too which lead to the same action. On the other hand, the opening of the one passageway closes the path to the opposite action and inhibits the impressions which would interfere with our interest. Every act of attention becomes, therefore, a complex distribution in the reinforcement and inhibition of mental states.
Now let us come back to suggestion. It shares, we said, with attention, the power to reinforce and to inhibit. But if we examine what is involved in the suggestion of an idea, we find surely more than a mere turning of the attention towards one idea and turning the attention away from another idea. That which characterizes and constitutes suggestion is a belief in the idea, an acceptance of the idea as real and the dismissal of the opposite idea as unreal. Yes, we may say directly that it is meaningless to speak of suggesting an idea; we suggest either an action or, if no action is concerned, we suggest belief in an idea. If I suggest to the fearful man at twilight that the willow-tree trunk by the wayside is a man with a gun, I do not turn his attention to an abstract idea of a robber nor do I simply awaken the visual impression of one, but I make him believe that such an idea is there realized, that he really sees the person.
If I suggest to him that he hears distant bells ringing or that he feels a slight headache, he may not be suggestible enough to accept it, but if he accepts it he is not simply attending to the idea which I propose but he is convinced of its real existence. The same holds true with the negative; if I suggest to him that the slight headache of which he complained has disappeared or that the smell which he noticed has stopped, I do not simply invite him to think of the absence of such sensations. It becomes for him a suggestion only if he becomes convinced that these disturbances have now become unreal.
The same holds true for all those suggestions of ideas which belong to our practical life, the suggestions which art imprints on our minds, or which politics and religion impart. As long as we are under the suggestion of the novelist, we really believe in the existence of the heroine; we really believe in the validity of the political party principle; it is not an argument to which we simply give our attention, it becomes a suggestion only when the belief in its objective existence controls our minds. We may say in general that suggestions which are not suggestions of actions are without exception suggestions of belief. Actions and beliefs are the only possible material of any suggestion.
Yet what else is a belief than a preparation for action? I may think of an object without preparing myself for any particular line of behavior. Here in the room I may think of rain or sunshine on the street as a mere idea, but to know that it now really rains or shines means something entirely different. It means a completely new setting in my present attitude, a setting by which I am prepared to act along the one or the other line, to take an umbrella or to take a straw hat, when I am to leave the house. I may think of the door of this room as locked or unlocked without transcending the mere sphere of imagination, but to believe that it is the one or the other means a new setting in my motor adjustments. If it is locked I know that I cannot leave the room without a key. Every belief means the preparation for a definite line of action and a new motor adjustment in the whole system of motor paths, an adjustment by which my actions in future will be switched off at once into particular paths. And there is theoretically no difference whether my belief refers to the proposition that the door is locked or that a God exists in Heaven.
But if every belief is such a new motor setting, then we are evidently brought back to the mechanism which was essential for every suggestion of action on the one side and for every process of attention on the other side, namely, the mechanism of antagonistic movements. To prepare ourselves for one line of action means to close beforehand the channels of discharge for the opposite. The suggestible mind sees the man with a gun on the wayside because he is preparing himself in his expectation for the appropriate action; he is ready for the fight or ready to run away, and every line of the tree trunk is apperceived with reference to this motor setting. The smell, on the other hand, has disappeared under the influence of the suggestion because a new motor adjustment has set in, in which he is prepared to act as if there were no smell.
The difference between suggestion and attention lies thus only in this: the motor response in attention aims towards a fuller clearness of the idea, for instance, by fixating, listening, observing, searching; while the motor response in suggestion aims towards the practical action in which the object of the idea is accepted as real. In attention, we change the object in making it clearer; in suggestion, we change ourselves in adapting ourselves to the new situation in which we believe. If you consider attention as a psychophysical process open to physiological explanation, you have surely no reason to seek anything mysterious in the process of suggestion; and no new principle is involved, if we come from the effect of the smallest suggestive hint to the complex and powerful suggestions which overwhelm the whole personality.
The two great types of suggestion, the suggestion of actions and the suggestion of ideas, have now come nearer together since we have seen that the suggestion of ideas is really a suggestion of the practical acceptance of ideas, and that means, of a preparation towards a certain line of action. In the one case I suggest the idea of a certain action and this motor idea leads to the action itself, and in the other case I suggest a certain preparatory setting for action and that will lead to the appropriate action whenever the time for action comes. Every suggestion is thus ultimately a suggestion of activity. The most effective suggestion for an action results, of course, if both methods are combined, that is, if we suggest not only the will to perform the action, but at the same time the belief that the end of the action will be real. Suggestion reaches us usually from without.
Yet there is again no new principle involved, when the new motor setting results from one's own associations and emotions. Then we speak of auto-suggestion. It is the same difference which exists between the attention called forth through an outer impression and the attention directed by our own will. Loud noise demands our attention, and even a whispered word may awaken associations which stir up the attention. In both cases the channels for adjustment become opened without our intention. But if we are expecting something of importance, if we start to watch a certain development and to find something which we seek, we open the channels by our own effort beforehand and produce our own settings thus through a voluntary attention. In this way suggestion too may start from without,—by a spoken word, by a movement, by a hint; or may start within us and may give us our caprices and our prejudices.
We must not neglect one other feature of the suggestion. Not every proposition to action or to belief can be called a suggestion. Essential too remains the other side of it, the overcoming of the resistance. A mere request, "Please hand me the book on the table," or a mere communication, "It rains," may produce and will produce the fit motor response, the movement towards handing over the book or opening of the umbrella, and yet there may be no suggestive element involved. We have a right to speak of suggestion only if a resistance is to be broken down, that is, if the antagonistic impulse, or the motor setting for the antagonistic action is relatively strong.
If I say to the boy, "Hand me the book," when he was anxious to hide the book from my eyes and thus had the wish not to hand it to me and the tone of my request overwhelmed his own intention, then to be sure suggestion is at work. The stronger the resistance, the greater the degree of suggestive power which is needed to overcome the motor setting. If I say to the normal man, "It rains," while he sees the blue sky and the dry street, his impression will be stronger than my suggestion; but if he is suggestible and I tell him that it will rain, he may accept it and take an umbrella on his walk, even if no indication makes a change of weather probable. The present impression of the dry street was strong enough to resist the suggestion, the imaginative idea of that which is to be expected in the next hour was too weak, and was overwhelmed by the suggestion of the weather prophecy.
It is clear that the whole suggestive effect, being one of a new motor setting, depends thus entirely on the equilibrium of the personality which receives the suggestion. Every element which reaches the mind through sense organs or through associations must have influence in helping the one or the other side, that is, in opening the channels of action in the suggested direction or in the antagonistic one. The results appear surprising only if we forget how endlessly complex this psychomotor apparatus really is. If we disregard this complexity we may easily have the feeling that one person has an unexplainable influence over another, as if the will of the one could control in a mysterious way the will of the other.
But as soon as we see that every action is the result of the coöperation of hundreds of thousands of psychomotor impulses which are in definite relation to antagonistic energies, and that the result depends upon the struggling and balancing of this most complex apparatus, then we understand more easily how outer influences may help the one or the other side to preponderance: as soon as the balance turns to the one side, a completely new adjustment must set in. And we understand especially that there is nowhere a sharp demarcation line between receiving communications and receiving suggestions. By small steps suggestion shades over into the ordinary exchange of ideas, propositions, and impressions, just as attention shades over into a neutral perception.
To be suggestible means thus to be provided with a psychophysical apparatus in which new propositions for actions close easily the channels for antagonistic activity. Such an apparatus carries with it the disadvantage that the personality may too easily be guided contrary to his own knowledge and experience. He will be carried away by every new proposition and will accept beliefs which his own thoughts ought to reject. On the other hand, it has the advantage that he will be open to new ideas, be ready to follow good examples, never stubbornly close his mind to the unaccustomed and the uncomfortable. It is easy to determine the degree of suggestibility.
Take this case. I draw on the blackboard of a classroom two circles of an equal size, and write in the one the number fourteen and in the other the number eighty-nine, and ask the children which is the larger circle. The suggestible ones will believe that the circle with the higher number in it is really larger than the other, the un-suggestible children will follow the advice of their senses and call both equal, and there may be a few children with negative suggestibility who would call the circle with the higher number the smaller circle. What happened to the suggestible ones was that the higher number brought about a motor attitude which faced that whole complex as being more imposing and this new motor setting was with them strong enough to overcome the motor adjustment which the circles alone produced.
Such experiments of the psychological laboratory can be varied a thousandfold, and it might not be unwise to introduce them into many practical fields. Everybody knows for instance how much may depend upon the suggestibility of the witness in court. The suggestible witness believes himself to have seen and heard what the lawyer suggests. The memory picture which such a witness has in mind offers, of course, much less resistance to the opposite action and attitude and belief than the immediate impression.
If I show the witness a colored picture of a room and close the book and ask him whether there were three or four chairs in the picture and whether the curtain was green or red, the suggestible man will decide for one or the other proposition, even if there were only two chairs and a blue curtain. The perception would have resisted the suggestion, the fading memory image cannot resist it. Thus suggestibility is really a practical factor in every walk of life. And it is in the highest interests of psychotherapy that this intimate connection between suggestion and ordinary talk and intercourse, between suggestion and ordinary choice of motives, between suggestion and attention be steadily kept in view and that suggestion is not transformed into a kind of mysterious agency.
To be sure, the importance of suggestion for psychotherapy is not confined to these suggestive processes of daily life. They play a rôle there, as we shall see, and we shall claim that even the mere presence of the physician may have its suggestive power and so may every remedy which he applies. But no doubt many of his suggestive effects depend on a power which far transcends the suggestions of our daily life. Yet the psychologist must insist again that no new principle is involved, that even in the strongest forms of suggestion, in hypnotism, nothing depends upon any special influence emanating from the mind of the hypnotizer or upon any special power flowing over from brain to brain; but that everything results from the change of equilibrium in the psychomotor processes of the hypnotized, and thus upon the interplay of his own mental functions.
All that is needed is a higher degree of suggestibility than is found in the normal life. In a more suggestible mind even the direct sense impressions may be overwhelmed by the proposition for an untrue belief and the strongest desires may yield to the new propositions of action. This library may then become a garden where the hypnotized person picks flowers from the floor, and the wise man stands on one leg and repeats the alphabet, if the hypnotizer asks him to do so. Let us consider at first this extreme case. By a few manipulations I have brought a man into a deep hypnotic state. He is now unable to resist any suggestion, either suggestion of impulse or suggestion of belief, and as every one of the hypnotic phenomena can be explained in this way, we may claim that the hypnotic state is in its very nature a state of reënforced suggestibility.
Whether I say, "You will not move your arm," or whether I say, "You cannot move your arm," awakening in the one case the impulse to the suppression of the movement, in the other case the belief in the impossibility of the movement, in either case the result is the same; the arm remains stiff and any effort of his to move it is inhibited. I may go to the extreme and tell him that our friend by my side has left the room; he will not see him, he will not even hear a word which the friend speaks. If I take a hat in my hand and put it on the friend's head, the hat appears to hang in the air. Every impression of sound or sight or touch which comes from the friend is entirely inhibited. The direct sense impression of eye and ear is thus completely overwhelmed by the suggestion.
What has happened? Are the manipulations which I applied sufficient to produce the changes by their physical influence? Certainly not; they are of the most different kinds and yet all may have the same effect. Perhaps I may have used the easy method of making the subject stare at a shining button held in front of his forehead. Or I may have used slight tactual impressions, while he was lying with closed eyes, or I may have produced the abnormal state by monotonous noises of falling water drops, or I may have simply spoken to him and asked him to think of sleep and to relax and to feel tired, while I held my hand on his forehead or while I held his hand in mine.
Or I may have relied upon mild talking without touching him at all; and yet every time the result was reached in the same degree. There is thus certainly no special physical energy which like a magnetic force flows over. It cannot even be said that my will is engaged. I have often hypnotized without even thinking of the subject before me, going through adjusted manipulations while my thoughts were engaged in something else. I have even hypnotized over the telephone; and a written note may be substituted with the same result. I write to the patient that two minutes after receiving this letter by mail, he will fall into hypnotic sleep. The effect sets in; and yet at that time, I may not remember sending the note at all.
It is thus entirely evident that the hypnotic effect results only from the mental conditions of the subject.
Whatever may stimulate his mind to the right kind of reaction will produce the desired result. The increased suggestibility thus sets in by his own imagination which may be stirred up by slight visual or tactual or acoustic stimuli or by monotonous words or by feelings of relaxation and especially by words which encourage sleep. But just because it is the play of his own imagination, the most essential factor certainly is the will and expectation of the subject. No one can really be hypnotized against his own will. And to expect strong hypnotic effect from a certain hypnotist is often in itself sufficient to produce hypnotic sleep. Thus there is no special personal power necessary to produce hypnotism. Everybody can hypnotize. And almost with the same sweeping statement it may be said everybody can be hypnotized, provided that he is willing to enter into this play of imagination. The young child or the insane person is therefore unfit.
Of course, not everybody can be hypnotized to the same degree. Just as the normal suggestibility showed itself very different with different persons, the degree of artificial reinforcement varies still more. Practically everybody can be brought to that breakdown of the resistance in which he can no longer open the eyes against the order of the hypnotist, but rather few can be brought to the point of seeing extended hallucinations, or accepting the disappearance of persons who are speaking, or of yielding to the impulse to a dangerous action.
The highest reported degree, in which even criminal actions are performed by honest men, exists in my opinion only in the imagination of amateurs; it is certainly not difficult to produce sham crimes for performance sake, with paper daggers and toy pistols, but that is no proof at all that the hypnotized person would commit a crime under conditions under which he has the conviction that he faces a real criminal situation. But if we abstract from real crime, we certainly have to acknowledge that actions can be performed which appear in striking contrast with the habits and character of the normal personality, upset his knowledge, and are based on beliefs which would be immediately rejected under ordinary conditions. These higher degrees of hypnotic state are easily followed by complete loss of memory for all that happened during the abnormal state.
How have we to interpret such a surprising alteration of mind? It lies near to compare it with sleep. The brain seems powerless to produce its normal ideas, the associations do not arise, the normal impulses have disappeared and a general ineffectiveness has set in; in short, the brain cells seem unable to function. Of course, the explanation of sleep itself may offer difficulties. Is it a chemical substance which poisons the brain during the sleep, or are the brain cells contracted so that the excitement cannot run over from the branches of one nerve cell into those of another?
Or are the blood-vessels contracted so that an anaemic state makes their normal function impossible? But whatever the physical condition of sleep may be, have we really a right to emphasize the similarity between sleep and hypnosis? After all that we have discussed, we ought rather to recognize that the hypnotic state too comes much nearer to the process of attention than to the process of sleep. We saw that in every act of attention the process of inhibition is essential. All that is not in harmony with the attended idea is suppressed. Yet we should hesitate to say that in attention parts of our brain are asleep.
We should feel reluctance to group such inhibition together with sleep because it would be a sleep which at any moment can pass from one part of the brain to others and which certainly leaves at every moment most of the cell groups unaffected. We saw that attention does not at all focus on one narrow point, but that an abundance of impressions, of ideas and associations, of thoughts and emotions can enter the field of attention, if they all lead to one and the same motor attitude, and that only the one part is inhibited which involves the opposite action. Such a jumping sleep which at every moment selects a special part would be, of course, just the contrary of that which characterizes the sleep state of the fatigued brain. But exactly these characteristics of attention belong to hypnotism too.
It is not true that the mind of the hypnotized is asleep and that perhaps only one or the other idea can be pushed into his mind. On the contrary, his mind is open to an abundance of ideas, just as in the normal state. If I tell him that this is a landscape in Switzerland, he sees at once the mountains and the lakes, and his mind provides all the details of his reminiscences, and his imagination furnishes plenty of additions. His whole mind is awake; the feelings and emotions and volitions, the memories and judgments and thoughts are rushing on, and only that is excluded which demands a contrary attitude. This selective process stands decidedly in the center of the hypnotic experience and makes it very doubtful whether we are psychophysically on the right track, if we make much of the slight similarity between hypnosis and sleep.
This has nothing to do with the fact that hypnosis is best brought about by suggesting the idea of sleep, that is, the belief that sleep will set in. This belief is indeed effective in removing all the ideas which are awake in the mind which would interfere with the willingness to submit to the suggestions of the hypnotizer. But the fact that belief in sleep and expectation of sleep bring with them the hypnotic state is not a proof that the hypnotic state itself is sleep. Even the mental experiences which can remain in sleep, the dreams, are characteristically different from the hypnotic experience. Thus the dreams show that un-selective awakening of ideas which is to be expected from a general decrease of functioning. The hypnotic variation is characterized just by its selective narrowing of consciousness. For the same reason, hypnotism is strikingly different from such diseases of the mind as dementia. Certainly in dementia too, many associations are cut off, but it is not a selective inhibition, it is a haphazard destruction resulting from the degeneration in the brain.
The fundamental principle of the hypnotic state lies in its selective character. Inhibited and cut off are those states which are antagonistic to the beliefs in the suggested ideas, and as their antagonism consists in their connection with opposite actions, the whole is again a question of motor setting. No doubt, such new motor setting can precede the normal sleep too; thus the sleeper may be insensitive to any surrounding noises, but perhaps awake at the slightest call from a patient who is entrusted to his care. In that case, one special feature of hypnotism is superadded to sleep but the sleep itself is not hypnotic. Again sleep may go over into a state which shares many characteristic features with hypnotism, that is, somnambulism, and it may be said with a certain truth that hypnotism is artificial somnambulism. But somnambulism, while arising in sleep, is not at all a feature of sleep.
While sleep is characterized by a decrease of sensitiveness and of selective powers, the selective process of hypnotism rather reinforces sensitiveness and memory in every field which is covered by the suggestive influence. Stimuli may become noticeable which the normal man is unable to perceive, and long-forgotten experiences which seem inaccessible to the search of the waking mind may reproduce themselves and may vividly enter consciousness. Again we have there symptoms which rather characterize the state of over-attention than the state of sleep. We might add further that we know states with all the characteristics of hypnotism in which even the subjective idea of sleep is entirely absent, for instance, all those which are usually called states of fascination.
A certain shining light or a glimpse of an uncanny eye may startle and upset the imagination of the subject and throw him into a state of abnormally increased suggestibility. It is well known that whole epidemics of such captivation have occurred and have resulted in hysterias of the masses in which the subjects become the slaves of their impulse, perhaps to imitate what they see or hear, or to realize ideas in which they believe without logical warrant. They surely are not asleep, are not even partially asleep. Every center of their brains would be ready to work, if the captivated attention were not forcing the mind in one direction and selectively suppressing every impulse to opposite actions. The developed hypnotism finally shades off into innumerable states of hypnoid character in which the sleep like symptoms are entirely in the background.
Thus the increased suggestibility of the hypnotic state will result not from a partial sleep like decrease of functioning but the decrease of function is a motor inhibition which results from over-attention. In the ordinary attention, our motor setting secures only an increase in clearness and vividness of the attended ideas, but in an abnormal over-attention the new motor setting produces a complete acceptance with all its consequences. Abnormal or heightened attention thus goes directly over into the belief and into the impulse without resistance. There is no hypnotism which does not contain from the first stage this definite relation to certain objects of attention, usually to a particular person. All the manipulations, passes, fixation, monotonous speaking, and so on narrow the contents of consciousness but hold the idea of the hypnotizing person steadily in the center of attention.
The awakened expectation of sleep, the associated feeling of tiredness all help to cut off attention from the remainder of the world, but as no real sleep sets in, this cutting off from the remainder reinforces the focusing of attention on the one central idea of the hypnotizing personality. Every word and every movement of this personality become therefore absorbed with that over-attention which leads at once from a mere perceiving and grasping to a complete sinking into the suggested idea with the suppression of all opposites, and thus to a blind acceptance and belief. We saw before that such belief is indeed nothing else but a motor setting in which certain ways of action are prepared.
We are to think in accordance with the belief in the suggested idea and the channels for discharge in the opposite direction are closed. Even the ordinary life shows us everywhere that the step from attention to belief is a short one. The effort to grasp the object clearly works as a suggestion to accept that which we are seeking as really existing, and that from which we are to abstract and which we are to rule out through our attention, we believe to be non-existent. The prestidigitator does his tricks in order to sidetrack our attention, but he succeeds in making us believe that we see or do not see whatever he wishes.
That the motor setting alone determines those changes and that a real sleep like inability of the centers does not set in, can also be demonstrated by the results of later hypnotizations. I ask my hypnotized subject not to perceive the friend in the room; he is indeed unable to see him or to hear him. Yet his visual and acoustic centers are not impaired, the defect is only selective, inasmuch as he sees me, the hypnotizer, and not the friend. But even this selection inhibits only the attitude and not the sensorial excitement. If I hypnotize him again to-morrow and suggest to him now to remember all that the friend did and said during yesterday's meeting, he is able to report correctly the sense impressions which he got, which were inhibited only as long as they contradicted the suggestion, but now rush to consciousness as soon as the suggestion is reversed. As a matter of course, he must therefore have received impressions through eye and ear in his hypnotic sleep of yesterday from all that happened, only he was not aware of it because the channels of the accepting attitude were blocked.
As soon as the over-attention has produced the acceptance of the belief, all further effects are automatic and necessary. If I tell the hypnotized person that he cannot speak and he absorbs this proposition, with that completeness in which he accepts it as a fact, not speaking itself unavoidably results. The motor ideas with which the speech movement has to start are cut off and the subject yields passively to the fate that he cannot intonate his voice. Thus a special influence on the will is in no way involved. If the idea is accepted, and that means, if the preparatory setting for the action has been completed, the ideas of opposite activity must remain ineffective; the suggested idea must discharge itself in action without resistance. As a matter of course the new line of action will then surround itself with its own associations and will thus give to the subject the impression that he is acting from his own motives.
As soon as the psychophysical principles are understood, there is indeed no difficulty in going from the simplest experience to those spectacular ones where we may suggest to the profoundly hypnotized person that he is a little child or that he is George Washington. In the one case, he will speak and cry and play and write as in his present imagination a child would behave; in the other case, he will pose in an attitude which he may have seen in a picture of Washington. There is nothing mysterious and his utterances are completely dependent upon his own ideas, which may be very different from the real wisdom of a Washington and the real unwisdom of a child. I may suggest to him to be the Czar, by that he will not become able to speak Russian. In the same way I may suggest changes of the surroundings; he may take my room for the river upon which he paddles his canoe, or for the orchard in which he picks apples from my bookshelves.
Finally there is no new principle involved, if the action which is prepared by any belief has to set in after the awaking from hypnotic sleep, the so-called post-hypnotic suggestion. As a matter of course, just these have an eminent value for psychotherapy. I may suggest to-day that the subject will overcome to-morrow his desire for the morphine injection, or that he will feel to-night the restfulness which will overcome his insomnia. But if the suggestion of an idea means belief, and if belief means a preparation for action, we have indeed no new factor before us if the action for which we prepare the subject is from the start related to a definite time. If we do not link it with the consciousness of a special time or of a special occasion which will occur later, the suggestion soon fades away.
That my library is an orchard is forgotten perhaps within ten minutes, if I have not come back to it in the conversation. But if I say that after awaking as soon as I shall knock on my desk three times, you will be in the orchard again, the psychophysical apparatus is prepared, a new setting has set in, the three knocks will bring about the complete transformation. In short the difficulties disappear as soon as we are consistent in interpreting all suggestive influences as changes in the motor setting and as the result of the antagonistic character of all of our motor paths.
We say the difficulties disappear. Of course, that is meant in a relative sense only. It means essentially that we are able to bring the complex state of hypnotism down to the similar state of attention and motor adjustment, but of course we must not forget that we are far from a satisfactory explanation of the process in attention itself. We know that the opening of motor channels in one direction somewhat closes the channels for discharge in the opposite direction, but what mechanism does that work is still very obscure. Whichever principle of hypothetical explanation we might prefer, it certainly leads to difficulties in view of the extreme complexity of attention in states of suggestion and hypnotism.
We might think of a mechanism which through the medium of the finest blood-vessels should produce a localized anæmia in those centers which lead to the antagonistic action. Or we might fancy that by extremely subtle machinery the resistance is increased in those tissues which lie between the various neurons, or we might even think of toxic and antitoxic processes in the cerebral regions; and any day may open entirely new ways of explanation. We may add that even if the mechanism of attention were completely explained, we are also still far from understanding the physiological changes which go on in the sphere of the blood-vessels or of the glands and the internal organs.
We understand easily that the idea of the subject that he cannot move his arm keeps the arm stiff; but that his idea to blush really dilates the blood-vessels of his cheek is much less open to our causal understanding; still less that in very exceptional cases perhaps a part of the skin becomes inflamed, if we make believe that we touch it with a glowing iron. And yet here too we see that we move in the same direction and that we have to explain these exceptional and bewildering results by comparing them with the simpler and simpler forms, that the process of attention contains all the germs for the whole development.
In claiming that hypnotism depends upon the over-attention to the hypnotizing person, we admit that the increased suggestibility belongs entirely to suggestions which come from without. Only that which at least takes its starting point from the words or the movements of the hypnotizer finds over-sensitive suggestibility. Ideas which arise merely from the associations of the subject himself have no especially favorable chance for acceptance. But surely we also know states in which the suggestibility for certain of one's own ideas is abnormally increased.
Great individual differences exist in that respect in normal life. There are normal hypochondriacs who believe that they feel the symptoms of widely different diseases under the influence of their own ideas, and others who are torturing themselves with fears on account of unjustified beliefs. But the abnormal increase of suggestibility parallel to that of hypnotism for suggestions from without exists for suggestions from within, mainly in nervous diseases, especially in neurasthenic, hysteric, and psychasthenic states. Within certain limits, we might almost say that this increase of suggestibility for autosuggestion is the fundamental characteristic of these diseases, just as increase of suggestibility for hetero-suggestions characterizes hypnotism.
Especially in earlier times, the theory was often proposed that hypnosis is an artificial hysteria. Such a view is untenable to-day; but that hysteria too shows abundant effects of increased suggestibility is correctly indicated by such a theory. The hysteric patient may by any chance pick up the idea that her right arm is paralyzed or is anaesthetic and the idea at once transforms itself into a belief and the belief clings to her like an obsession and produces the effect that she is unable to move the arm or that she does not feel a pinprick on the skin. These autosuggestions may take a firmer hold of the mind than any suggestions from without, but surely such openness to self implanted beliefs must be acknowledged as symptomatic of disease, while hypnosis with its impositions can be broken off at any moment and thus should no more be classed among the diseases than are sleep and dreams.
The hysteric or psychasthenic autosuggestion resists the mere will of breaking it off. Here, therefore, is the classical ground for strong mental counter influences, that is, for psychotherapeutic treatment. Experience shows that the strongest chance for the development of such auto suggestive beliefs exists wherever an emotional disposition is favorable to the arriving belief. But emotion too is after all fundamentally a motor reaction. The whole meaning of emotion in the biological sense is that it focuses the actions of man into one channel, cutting off completely all the other impulses and incipient actions. Emotion is therefore for the expressions of man what attention is for the impressions. An emotional disposition means thus in every case a certain motor setting by which transition to certain actions is facilitated.
It is thus only natural that a belief can settle the more easily, the more it is favored by an emotional disposition, as the motor setting for the one must prepare the other. Hypnosis and hysteria thus represent the highest degrees of suggestibility, the one artificial, the other pathological; the one for suggestions from without, the other for suggestions from within. But between these two and the normal state there lie numberless steps of transition. The normal variations themselves may go to a limit where they overlap the abnormal artificial product, that is, the suggestibility of many normal persons may reach a degree in which they accept beliefs hardly acceptable to other persons in mild hypnotic condition.
Thus there is no sharp demarcation between suggestions in a waking state and suggestions in a hypnoid state. And the expectation of coming under powerful influence may produce a sufficient change in the motor setting to realize any wonders. Moreover probably every physician who has a long experience in hypnotizing has found that his confidence in the effectiveness of the deep hypnotic states has been slowly diminished, while his belief in the surprising results of slight hypnotization and of hypnoid states has steadily grown and has encouraged him in his psychotherapeutic efforts.