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SUGGESTION AND PSYCHOTHERAPY



SUGGESTION
AND PSYCHOTHERAPY

BY
GEORGE W. JACOBY, M.D.

FELLOW OF THE NEW YORK ACADEMY OF MEDICINE, MEMBER OF THE AMERICAN-
MEDICAL ASSOCIATION, AMERICAN NEUROLOGICAL ASSOCIATION, AND
NEW YORK NEUROLOGICAL SOCIETY, CONSULTING NEUROLOGIST
TO THE HOSPITAL FOR NERVOUS DISEASES. THE GERMAN
HOSPITAL, THE BETH ISRAEL HOSPITAL, THE
RED CROSS HOSPITAL, AND THE INFIRMARY
FOR WOMEN AND CHILDREN IN THE
CITY OF NEW YORK, ETC.



\\' I T H ILLUSTRATIONS



NEW YORK

CHARLES SCRIBNER'S SONS

1912



BlOLrUBl {



Copyright, 1912, by
CHARLES SCRIBNER'S SONS



Published March, 1912




PREFACE

The influence of the mind in the causation and
in the cure of disease has been exaggerated in gen-
eral literature and many so-called scientific writ-
ings, but it is real and must be recognized. Had
physicians given more thought to psychic treat-
ment there would to-day be no cause for complaint
in regard to the increasing harm which is being done
by ignorant enthusiasts and wilful impostors.

I have endeavored in the present work to present
scientific facts impartially and to submit them to a
fair analysis; only after such treatment have I given
what seems to me to be the inevitable conclusion.
Some such guide to correct reasoning in the intri-
cate subject of suggestion and psychotherapy is
needed. Every person who has not had a scientific,
I might say a laboratory, training is prone instinc-
tively — at any rate unless he uses reflection — to
confound two verv different thing's, that which he
really perceives and his deduction from what he

V



vi PREFACE

has seen, felt, or heard. I trust this book will show
the fallacy of confounding facts with opinions.

It is very possible that I have not succeeded
throughout in expressing myself in as simple terms
as might be desired; if this is so I must ask the
reader's forbearance. While I have started from
elementary facts and from them have proceeded to
more complicated ideas, I have nevertheless been
obliged to accredit my readers with a certain degree
of general scientific culture. Such readers certainly
will not hesitate to reread any chapter which at
first may to them seem obscure.

The book, being systematically written, can be
studied profitably only as a w^hole; it would be un-
fair to reader or writer to consider single chapters
separate from their sequential context, for each fol-
lows logically upon the other and every succeeding
page is dependent upon what has gone before.
This must be borne in mind also in relation to
technical expressions, for terms used later in the
work may seem obscure to those who have not read
the short definitions given when the technical desig-
nation was employed for the first time. Nor is it
essential that every reader should understand all of
the contents of the entire book. If each gathers



PREFACE vii

but a single kernel of truth and widens his point
of view by the acquisition of but a bit of knowledge
the book will have been worth while.

Not long ago while sitting in a New York sub-
way local train we were passed by an express going
in the same direction. For a moment it seemed as
though the local had come to a stop; then it ap-
peared to reverse its course and go backward.
The illusion was complete, yet I knew I was labor-
ing under a sense deception and that both trains
were going in one and the same direction. So, in
this present time of progress and enlightenment, it
may often appear as though the large masses of
people were being carried along by ignorance and
superstition, while true mental culture stands still
or even goes backward. Yet this also would be
an illusion, a sense deception, for scientific truth
creeps forward slowly, but always steadily, and its
ultimate conquest over mysticism and other occult
enemies is assured.



CONTENTS



Introduction



Popularization of science in general — Popularization
of medicine in particular — The good and the bad in
popular instruction — Dangers of lay treatment —
Benefits of popularized psychotherapy — Outline of
the work.



PART FIRST: SUGGESTION



I. PSYCHOLOGICAL GROI^NDWORK

A. Psychology as a Natural Science . . 17

Speculative psychology — Empiric psychology — Ob-
jects of mind study — Exclusion of prejudice in in-
vestigation.

B. The Organs of Mental Activity ... 20

T^e nerve formations — Stimulus and reaction — Dif-
ferentiation of conduction tracts — Reflex phenom-
ena — Sensory apparatus — Specific sensory energy
— Nerve cells — The neuron — Sensory and motor
nerves — The brain — Significance of weight and
fissures — The brain cortex as the seat of the higher
psychic functions — Localization of psychic func-
tions — Results of embrj'ological studies — Associ-
ation centres — Transmission of sensory impressions
— Gray and white matter — The spinal cord,
ix



X CONTENTS

C. Contents and Course of Mental Ac-

tivity 39

Sensory perceptions the basis of ideational life — In-
voluntary expressional movements — Stimulation
confines — Sound and light perception — "After im-
ages ' ' — Secondary sensory impressions — Memory
images — Pictures of the imagination — "Passable"
connecting tracts — Sleep-walking — Other elements
of association of ideas — Psycho-physical parallelism
— Graphic methods — Concepts — Law of similarity
and simultaneity — Emotional tones — The will — Ap-
perception and attention — The feeling of self —
Speech — Freedom of the will.

D. Peculiarities of Mental Activity . . 75

Telepathy — Other "occult" phenomena — One-sided-
ness of genius — Sleep and dreams — Freud's dream
analysis — Mind of the child — Development of as-
sociation tracts — Muscular exercise — Development
of the faculty of speech — Individual peculiarities of
the male and the female mind — Difference of brain
organization — Opinions of experts.

E. Disordered Mental Activity .... 105

Psychoses — Boundary between health and disease —
False ideas and mental disease — Delusions which
cannot be corrected — Sensory deceptions — Power of
the imagination — Organic and functional nervous
disorder.



II. SUGGESTION AS A PSYCHIC FORCE

A. Possibility and Nature of Suggestion . 131

Definition — Psychic infection — Adoption of a sug-
gestion — Limits of suggestion — Reconstructed per-
sonality — Double personality — Ideational diseases —
Dissociation of personality — Potency of a suggestion
— Receptivity of weak characters.



CONTENTS xi

I

B. Scope of Suggestion 147

Possibilities of suggestion — Organic changes cannot
be produced by it — Alterations of function through
suggestion — Views of the Nancy school — Suggestion
not irresistible — Responsibility of hypnotized per-
sons — Apparent death of Yogis.



'tfT



!>:■



Forms of Suggestion 163

Hypnosis and waking suggestion — Hypnosis not sleep
— Verbal suggestion ample — Subconscious mani-
festations — Theory of dual personality — Subcon-
sciousness is co-consciousness — Natural explanation
of trance phenomena — Auto-suggestion, involuntary
and purposeful — Foreign suggestion.



Suggestion — Its Past and Present . . 182

Wolf and dog madness in olden times — Flagellantism
— Children's crusades and dance madness in the
Middle Ages — The devil as the producer of functional
nervous disorder — Temple sleep as a remedial agency
— Mesmer and magnetism — Faria — Braid — Liebault
— More recent investigators — Miracles and nature's
laws — Modern superstition — Dukhobortsi and Ras-
kolniks.



PART SECOND: PSYCHOTHERAPY



I. GENERAL CONSIDERATIONS



A. Definitions 209

Cure of the mind — Cure through the mind — Differ-
ence between psychotherapy and psychiatry — Sec-
ondary aim of psychotherapy.



xli CONTEXTS

B. The Justifiability of Psychotherapy . 211

Darwin's theory of the survival of the fittest — Alter-
ation of natural conditions of life — Adaptation to
conditions of civilization — The sick and the feeble
as factors in civilization — Detriments to civilization
and aim of combating them — Critical remarks on
disease and human fault — The folly of belief in mira-
cles — Medical science in the service of adaptation —
Arguments against psychotherapy — Their fallacy —
Psychotherapy in harmony with laws of nature.



C. Dangers of Psychotherapy 229

Special knowledge requisite — Importance of diagnosis
— Charlatans grope in the dark — Injury to health
through error of treatment — Dangers of experimen-
tation — How to avoid them.



D. Christian Science, Faith and Prayer

Cures 235

Superstition in medicine — The excuse for it in ancient
times — Miracle reports of the priests — Adoration of
relics and saints — Natural causes of "supernatural"
cures — The comedy of mysticism — Mrs. Eddy, John
Alexander Dowie, and Emmanuel movement — Dis-
turbance of the unison with God as a cause of dis-
ease — Restoration of this unison as a means of
treatment — The self-deception of faith and prayer
healers.



E. The Personality of the Physician . . 262

Not the remedy but the physician cures — Essential
attributes of the psychotherapist — Psychotherapeu-
tic training — Knowledge of humanity and human
conduct — Emotional (jualities.



CONTENTS xiii

F. The Personality of the Patient . . . 270

Those most easily influenced — Insanities cannot be
benefited — Psychotherapy addressed to personaH-
ties — Indirect influence on organic changes — Impor-
tance of individualization — Suggestibility of men,
women, and children — The opposition of sceptics —
Adaptation to the individuality an essential to
psychotherapeutic success.



II. SPECIAL APPLICATION OF PSYCHOTHERAPY



A. The Most Important Methods . . . 282

1. Mental Therapeutics

Suggestion method — Catharsis — Freud's psycho-analy-
sis — Determination of the cause of functional ner-
vous disorders — Subsequent discharge of repressed
emotions — Persistence of suppressed emotions in
subconsciousness — Their reawakening in hypnosis
— Memory exploration by means of association of
ideas — Significance of the sexual sphere in hyster-
ical symptoms — Criticism of the psycho-analytic
method — Relation of dreams to nervous diseases —
Mental rest and exercise — Reduction of activity —
Relief of sleeplessness — Exhaustion as a cause of
functional nervous disorder — Perimetry as a metre
of treatment — Varying ways in which patients react
— Advantages of sanatorium treatment.



2. Psycho-Prophylactic Treatment

Prevention of nervous disorder — Educational tasks
of the psychotherapist — Question of over-strain in
school — Mental defectives — Noxious influences in
childhood — Education of the adult — Excessive ten-



xiv CONTENTS

derness and sensitiveness — Lack of occupation and
luxurious living as causes of degeneration — The
struggle for existence as a means of exercise — The
aim of psycho-prophylactic treatment.

B. Practical Examples 315

Direct and indirect, simple and combined suggestion
treatment — Relief from morbid symptoms — Severe
disorders of function as a result of mere imagination
— Their prompt relief through annulling the false
ideas — Symptomatic suggestion treatment of vari-
ous organs — Cure of hypochondriacal depression —
Psychic sea-sickness — Removal of anorexia — Psychic
diarrhoea and costiveness — Psychic dyspnoea —
Traumatic neuroses — Other examples of disorders
of function psychically caused and psychically cured.

Conclusion 338

Literature 347

Index 351



SUGGESTION AND PSYCHOTHERAPY



INTRODUCTION

" Le plus grand dereglement de I'esprit est de croire les
choses parce qu'on veut qu'elles soient." — Pasteur.

The most conspicuous trend of the intellectual
life of our times is toward the popularization of
science. The feverish activity so characteristic of
modern life manifests itself, and not by any means
least, in the zeal with which the results of scientific
research are being presented to constantly growing
audiences. The standard of general education is
raised simultaneously by public lectures, by scien-
tific essays in the daily press and magazines, and
by books covering their subjects exhaustively.

It is doubtful whether enlightenment actually re-
sults from such methods, or whether they produce
a certain questionable semi-education, which fre-
quently is worse than gross ignorance. The bene-
fit to be derived by those in the lecture audience
or by the readers of the periodicals must depend
on their critical acumen and independence of judg-
ment, their ability to separate the essential from

the unessential, to re-examine the facts adduced,

3



4 INTRODUCTION

and, above all, to recognize what is based on con-
jecture and what is proved by evidence.

But from the mass of scientific material most of
them absorb only what appeals to their own traits
or desires. Therefore, while the object of the pop-
ularization of science is to annul a 'priori belief
in authorities, and to correct blind confidence in
transmitted dogmas, what really is attained is often
the revival of similar belief in other forms. Such
semi-education, though it produces confusion in
untrained minds and excites the ridicule of those of
more intelligence, generally causes most harm in
the field of medical dilettanteism, that most harm-
ful form of amateurishness. Where we are dealing
with the most valuable possession of mankind,
mental and bodily health, half-knowledge indis-
putably is much worse than crass ignorance.

Neither a knowledge of the construction and the
functions of the body, nor of the more important
rules of health, is to be classed as medical dilettan-
teism. The laws on which our weal and woe pri-
marily depend are quite as fit objects of general
education as, for instance, simple mathematics or n
the primary facts in history. But the popular
medical literature, in its description of diseases and



INTRODUCTION , 5

their treatment, ignores those laws, produces mis-
conceptions of all sorts, and, therefore, is detri-
mental and dangerous.

If the adept and experienced physician cannot
avoid diagnostic errors, is it reasonable to expect
the layman to recognize disease and to understand
its complicated processes?

Faulty instruction on such a subject, especially
when it comes from an incompetent source, cer-
tainly cannot be very beneficial. Usually such
teaching leads the layman to ascribe to himself or
to others some disease which is not present, or else
he fails to comprehend the nature of an actual dis-
order, in which case he resorts to remedies which
should not be applied. Volumes might be filled
with an enumeration of the known victims of such
medical dilettanteism, self-treatment, charlatanism,
and " prayer cure." The number would be much
larger were all such cases made the object of official
record or juridical investigation.

Bitter experience has proved the evil of incom-
petent administration of drugs, and medical dilet-
tanteism, therefore, has turned in recent years to
suggestive therapeutics, on the erroneous assump-
tion that this method of treatment, if not successful,



6 INTRODUCTION

at least could do no harm. To the better-informed,
however, it long has been clear that treatment by
suggestion, or psychotherapy, if not directed by
the experienced physician, may cause considerable
detriment, even if only because the opportune
moment for rational intervention by the competent
physician has been missed.

True, the objection may be raised that physicians
themselves, in speech and writing, have encouraged
such pernicious instruction by taking popular meth-
ods to spread their own views. Much of the popu-
lar medical literature of recent years, in fact, is the
work not of quacks and charlatans, but of compe-
tent medical authorities eager to enlighten and edu-
cate. In fact, the literary activity of the real physi-
cian has largely been forced by the pretender. Of
two insurmountable evils, the trained medical man
has chosen the lesser.

That it is an evil to discuss indiscriminately be-
fore a lay public the complexities of etiology, pa-
thology, pathogenesis, symptomatology, differential
diagnosis, prophylaxis, and therapy cannot be dis-
puted, but as that is being done to an inordinate
extent by persons thoroughly unqualified to express
intelligent opinion on those subjects, and as the



INTRODUCTION 7

physicians themselves cannot check such deleteri-
ous methods, there remains no alternative for the
completely equipped practitioner of medicine ex-
cept to wield the superior arms which science has
placed at his disposal.

If the public receives the desired instruction from
a source competent to give it, because correctly in-
formed, the evil cannot be as great as when char-
latans, by their writings and lectures, deliberately
lead to confusion and error. Their misteaching is
unpardonable, for how should those not even con-
versant with the fundamental theories of exact in-
vestigation assume the duty of transmitting medical
knowledge? While they proclaim that their pur-
pose is to spread enlightenment, they really are
actuated only by unconscientious covetousness, friv-
olous presumption, and, to put it mildly, a fanati-
cism which is open to correction by neither reason
nor authority. They speculate on a belief in the
stupidity of the public, and for that reason alone
make no geniune effort to disseminate true knowl-
edge.

The scrupulous exponent of popular medical
knowledge must convince the layman that it is
impossible for him to diagnose diseases and to



8 INTRODUCTION

treat them scientifically. With that principle in
mind, the great Virchow, with Holtzendorf, put
forth a " Collection of Popular Scientific Lectures/*
a work which has done much to change the attitude
of the profession toward the wide promulgation of
medical instruction. Not so long ago any work of
that nature was deprecated as a breach of profes-
sional ethics. Fortunately for the advancement of
culture, that attitude has changed.

This work is addressed to cultivated persons
generally, with the purpose of helping them to
comprehend the difficulties of medical investiga-
tion, and of instilling a conviction of the evils and
dangers which result from the treatment of diseases
by the unqualified. That this authoritative mate-
rial will ultimately overcome the ill effect of the
harmful literature of the day we have no doubt, for
even in literary controversy Darwin's maxim of the
survival of the fittest must apply. These words of
Schrenck-Notzing explain the reason of much that
is written here:

" Especially in view of the enormous significance
of suggestion in the domain of mental life, and in
view of the false impression which still sways large
classes of people in their opinion of charlatanism



INTRODUCTION 9

and wonder cure, as well as in other branches of
knowledge, the proper conception of suggestion by
the public can only be productive of good and
enlightenment."

Competent instruction is nowhere more neces-
sary or more difficult to obtain than in relation to
the influence of the mind upon the body, and, at
the same time, in no subject is the interest greater.
As we have indicated before, one great office of
such a work as this is to make the public realize the
penalty it is paying for its ready attention to the
teachings of the charlatans.

With the increasing specialization and division
of labor in medicine, the science of suggestion and
psychotherapy has acquired extraordinary import.
Many an enigma of the mind has been solved since
psychology has ceased to be a speculative science,
since we know that the mental functions cannot be
recognized introspectively, but can be understood
only in connection with bodily processes — above all,
in their indissoluble relationship to the central nerv-
ous system; since, in a word, psychology has be-
come an exact science in which, as in other branches
of natural science, observation and experiment are
recognized as the only valid methods of investiga-



10 INTRODUCTION

tion, and since the mystic darkness which has en-
shrouded "the soul" has been lifted. In all this
progress the literature on suggestion and psycho-
therapy has assumed almost unv/ieldy dimensions,
and its volume ps being swelled constantly by pop-
ular writings. Excluding those which are value-
less because they are the fabrications of charlatans
and prayer healers, there remain many admirable
productions by qualified experts which excel quite
as much by the strict objectivity of their con-
tents as by the popular manner in which they are
written.

Under these circumstances, it might be considered
supererogation to increase this literature by still
another book. Nevertheless, there are two points
which must not be overlooked.

First, science is progressive. That which some
time ago may have been looked upon as a true
record of existing knowledge may to-day have been
enlarged or restricted. Without disregarding older
views, on which modern progress to a great extent
is founded, our object will be to acquaint the edu-
cated reader, of any pursuit or calling, with the
newest products of investigation in the field of sug-
gestion and psychotherapy. In so doing, of course.



INTRODUCTION 11

it will often be necessar}^ to refer extensively to the
literature of former years.

The second point to bear in mind is that science
cannot be better served than if many writers occupy
themselves with the same subject. Each adduces
points of view which had escaped his predecessors,
starts from different premises, has different experi-
ences, and arrives at entirely dissimilar conclusions.
Thus scientific progress is constantly being cor-
rected, so that errors can never be maintained long.
My hope is that this book, in which I shall endeavor
as much to give due weight to the opinions of quali-
fied writers of various countries as to overthrow the
unsupportable assertions of others, will be accepted
as a guide and as a critical supplement to the earlier
works.

The book being divided into the two main parts
named in the title, "Suggestion" and "Psycho-
therapy,'' I show in the first part what suggestion
is, how it is produced, and how it acts. From the
historical retrospect it may be seen that the power
of the suggestive influence of the will was well
understood in ancient times, and was adroitly used
by forceful persons for the attainment of many ends.
In discussing suggestion as a psychic force, I take



12 INTRODUCTION

up the startling effects which, during the period of
superstition and behef in miracles, must have been
ascribed to supernatural causes, and I show their
dependence upon natural laws, and especially upon
the close mutual relationship between bodily and
mental processes. To do that, of course, I shall
have to define the stand-point of science as opposed
to the stand-point of faith.

It is the province of science to perceive and ex-
plain the facts of nature, but even to-day, as the
attentive reader will appreciate, science often must
be satisfied with simply discerning those facts w^ith-
out being able to understand or elucidate them.
In the field of suggestion, especially does the ob-
server note many a phenomenon which apparently
cannot be reconciled with the recognized laws of
nature, although the actuality of it cannot be re-
futed. In such cases faith repels any attempt at
explanation, and assumes that the action of natural
laws has been arrested by supernatural powers — in
other words, clings to a belief in miracles — while
science, though conceding there is a limit to the
powers of human cognition, and admitting that we
probably never shall achieve a clear insight into the
ultimate causes of all things, insists that the con-



INTRODUCTION 13

tradiction between "miracles" and the orderly laws
of nature is merely an apparent one, inasmuch as
not all those laws are yet known to us. That stand-
point of science alone has made possible the re-
markable progress in human discernment, and
through it alone could light be created to dispel
the darkness which has enshrouded the phenomena
of suggestion. Thanks to unceasing investigation,
much which a century ago was looked upon as
"wonderful" has been traced to its natural causes,
and perhaps in a century more the mystery will be


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Online LibraryGeorge W 1856-1940 JacobySuggestion and psychotherapy → online text (page 1 of 18)