George W 1856-1940 Jacoby.

Suggestion and psychotherapy online

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stimulus, as the chief causative factor in the pro-
duction of suggestion and hypnosis, while he en-
tirely overlooked the psychic factor, the will of the
subject, on which Faria had laid stress.

Faria*s doctrine, however, did not receive a
scientific foundation until Liebault, the physician
of Nancy, took the matter up and showed that the



200 SUGGESTION

verbal method, the influence of words alone, was
sufiicient in itself for the production of suggestion,
provided the suggestion were accepted by the per-
son to be influenced. If, however, the constitutional
character of the subject oppose the suggested idea,
then its acceptance and consummation may be
effected neither by fixation nor by verbal hypnosis.

Although a beam of light had thus been cast
into this chaotic confusion, Liebault for a long
time did not receive the recognition which was his
due; he, too, had to learn by bitter experience how
difficult it is for people to comprehend the most
simple facts. It apparently was easy to believe
that mystic supernatural influences could be trans-
mitted to human beings by means of complicated
artifices and manipulations, as was done by the
old oracles, religious cures, and animal magnetism;
but to accept comprehensible truths, and to exclude
all that was supernatural in the explanation of
recognized facts, seemed wellnigh impossible at a
time which was still under the influence of Schel-
ling*s philosophy of nature.

Not until Bernheim of Nancy succeeded in pro-
mulgating Li^bault's doctrines among the general
public did they attain any measure of acknowledg-



SUGGESTION— ITS PAST AND PRESENT 201

ment. The existence of a certain opposition be-
tween the school of Nancy and that of Paris has
already been mentioned. Charcot promulgated
and defended, but by no means succeeded in prov-
ing, the theory that hysterics alone were amenable
to the influence of suggestion and hypnosis. The
Nancy school, by means of thousands of observa-
tions, has refuted this claim, and has clearly de-
monstrated that, although hysterics are exceedingly
susceptible to all functional disorders originating
in fallacious ideas, and, consequently, furnish ex-
cellent material for the exercise of all forms of
psychotherapy, yet all this is true of other neuroses,
as well as of organic diseases, to a certain extent.

We must yet refer briefly to those investigators
of more recent times who have aided by their work
in promulgating the doctrines of suggestion and its
psychotherapeutic application. The list is a large
one, and only a few names can be mentioned here.

In America, the names of Prince, Putnam, Sidis,
and Muensterberg stand for all that is best in
actual scientific work. The Society for Psychical
Research, on the other hand, has devoted its atten-
tion chiefly to occultism, to the mystic manifesta-
tions of mental life.



202 SUGGESTION

Among the foreign workers and writers we must
mention, in Germany, Albert Moll, Preyer, the re-
nowned physiologist, Max Dessoir, the philosopher,
and Albert Eulenberg, the neurologist; in England,
Lloyd-Tuckey and Hack-Tuke; in Switzerland,
Forel; in Stockholm, Wetterstrand, and, in Russia,
Bechterew. This enumeration of names, which
should be much extended, by no means signifies
that psychotherapy is without adversaries. Later
we shall become acquainted with their facts and
arguments; here we will merely say that such op-
position is of favorable significance for the future
of psychotherapy. The history of medicine clearly
demonstrates that those procedures which have
been at once acclaimed and enthusiastically re-
ceived have been short lived, while those which have
been slow of growth and recognition have been of
permanent worth.

The opposition to psychotherapy is due in part
to the failures which have inevitably followed the mis-
taken or unwarranted employment of this method
of treatment. Not every physician is fitted for
the practice of psychotherapy. He who is not
thoroughly convinced of the efficacy of this remedy
will not be able to satisfy the public of its value.



SUGGESTION— ITS PAST AND PRESENT 203

Apart, however, from the misdirected and unac-
cepted suggestions made by physicians themselves,
the great bulk of failures undoubtedly is due to
the practice of psychotherapy by persons without
medical training, who, because of their inability to
make correct diagnoses, can have nothing but thera-
peutic unsuccess. Only the physician schooled in
psychiatry is able to recognize the cases which are
adapted for psychic treatment, and he alone can
avoid the dangers with which suggestion and hyp-
nosis are beset. To these more attention will be
given in a future chapter.

It cannot be gainsaid, on the other hand, that
the lack of critical appreciation which has con-
founded faith, prayer, and miracle cures with true
psychotherapy, is in large part responsible for the
discredit which has been cast upon the latter.
Nor can we deny that astonishing improvements
have been achieved by "Christian Science," the
waters of Lourdes, the contact of holy relics, etc.,
without the concomitant use of physical or chem-
ical remedies. Yet we must repeat emphatically
that in such cases of amelioration it has never been
a question of supernatural, but always of quite
natural, processes. •



204 SUGGESTION

As will be demonstrated in a special chapter, the
beneficial results accomplished in those cases must
be attributed to a concurrence of fortunate condi-
tions which have neutralized the disease-producing
psychic cause by means of contrary suggestions.
Never is there involved a question of any " miracle,"
of the abrogation of any natural law. There does
not exist a single authenticated case of organic
disease which medical science has failed to cure
which subsequently has been cured by suggestive
influence. Such a case, if it did occur, might
justly be termed a miracle. Since the disorders
and symptoms which are most amenable to psy-
chotherapeutic action are those that are due to
mental influences, it can be of little significance
whether the beneficial result is obtained in one
manner or another; but what we, as scientific
physicians, must desire and demand is the recog-
nition of the fact that these beneficial results are
quite as dependent on mental influence as is the
disorder against which the treatment is directed,
and that the attainment of success should not be
left to a fortuitous happening, but attained design-
edly in accordance with physio-psychological laws.

This chapter should not be closed without show-



SUGGESTION— ITS PAST AND PRESENT 205

ing, by examples taken from most recent occur-
rences, that even to-day suggestion, when subser-
vient to superstition and fanaticism, may become
a tool of obscurity and crime.

Bechterew gives a full account of the aberra-
tions of those sects, so numerous in Russia, and
exemplified by the Dukhobortsi and the Raskolniks,
which, blindly carried away by some idea, impul-
sively follow the leader who proclaims himself to
be directed by God's inspiration, but who is actually
dominated by hallucinations and delusions of his
own brain.

Toward the end of the last century, seven thou-
sand Dukhobortsi immigrated from Russia into
Canada. There they did not find what they
sought, for they did not want to obey the laws of
any State, nor be the subjects of any ruler but God.
As "pilgrims of God upon this earth," they are
unremittingly in search of a haven in which they
may live undisturbed in accordance with their
fanatical views.

Still more extreme are the Raskolniks. In them
certain mystical ideas resurrected from mediaeval
habits and thoughts became, through psychic in-
fection, the source of a series of crimes. The



206 SUGGESTION

mental influence exerted by the life in the Ras-
kolnikite cloisters, the isolation from the outer
world, the persistent fasting and praying, all these
undoubtedly furnished an appropriate atmosphere
for the development and maintenance of religious
fanaticism. Thus it came about that, only a few
years ago, by order of the nun Vitalia, twenty-five
persons allowed themselves to be immured alive
within subterranean walls. Bechterew justly re-
marks, "He who allows the details of this appalling
occurrence, beside which even the most extreme
manifestations of Buddhist Asceticism are cast into
the shade, to pass before his mental horizon, must
certainly say to himself that these martyrs, who
could give themselves up to death with such peace-
fulness, could do so only as a result of an irre-
futable conviction, implanted by means of sugges-
tion or auto-suggestion, that through such burial
alive they would become the possessors of eternal
salvation."

Of the details of this dreadful example of aber-
rant religiosity we will merely mention that Kow-
alew, the executor of this mass interment, was a
peasant of limited mentality, entirely under the
suggestive control of Vitalia, whose commands he



SUGGESTION— ITS PAST AND PRESENT 207

accepted even after she, together with his own
mother, wife, and daughter, had been entombed
and covered with earth.

After this brief historical sketch, which has
taken cognizance of only some of the facts char-
acteristic of suggestive influence, and having seen
that suggestion in the hands of individuals either
insane or dishonest may become an instrument of
the gravest danger, w^e will proceed to a considera-
tion of that use of suggestion which seeks to com-
bat psychic infection with its own weapons, psy-
chotherapy. ^Ye shall show that this remedy,
whether employed by itself or with other methods
of treatment, is destined to become a source of
great benefit to suffering humanity — always pre-
supposing that it be employed the same as any
other remedy by the adept and experienced phy-
sician.



PART SECOND
PSYCHOTHERAPY

I. GENERAL CONSIDERATIONS
A. Definitions

What is to be understood by "psychotherapy"
can easily be deduced from the preceding explana-
tions. Etymologically the word admits of a double
interpretation, cure of the mind (J) i^v^v, v Oepa-
Treio), as well as cure through the mind.

Psychotherapy differs from psychiatry in that it
concerns itself above all with functional disorders,
or, more correctly expressed, with functional symp-
toms and their removal. That these disorders or
symptoms, psychically caused and dependent not
on organic changes but essentially on erroneous
ideas, may be influenced psychically — that is, by the
awakening of correct ideas — has already been de-
monstrated and will be made clearer in the fol-
lowing chapters. Inasmuch, therefore, as psycho-
therapy removes false ideas and the dependent

209



210 PSYCHOTHERAPY

functional disorders or symptoms, it is actually a
"cure of the mind."

It can hardly be necessary again to recall that by
"mind," in the medico-scientific sense, we under-
stand those manifestations of the central nervous
system which find their expression in apperception,
association of ideas, and conscious activity of the
will. Just as diseases are nothing else than mani-
festations of life under abnormal conditions, so, in
so far as functional disorders and symptoms are
concerned, abnormal conditions are represented by
certain false ideas, the removal of which is the task
of psychotherapy.

If, furthermore, we remember how intimate are
the relations which exist between body and mind,
especially between the higher psychic functions and
their bodily organs, the brain and the nervous
system, then we need but recall the law of psycho-
physical parallelism to appreciate at once that
a beneficial reaction of psychotherapy upon the
physical condition cannot be wanting. This does
not alone mean that, with the passing of erroneous
ideas, the dependent functional disorders must dis-
appear, but it also signifies that purely physical
diseases, associated with organic changes as well,



JUSTIFIABILITY OF PSYCHOTHERAPY 211

may be beneficially influenced by psychotherapy —
of course, not directly, but by the devious channel
of enhancing the confidence of the patient in the
therapeutic power of medicinal remedies or any
other curative factor which may be employed.
Psychotherapy, therefore, is "cure of the mind'' in
so far as false ideas are removed, and, on the other
hand, is "cure through the mind" in so far as
purely physical states may indirecdy be amelio-
rated by means of suggestive influence.

B. The JuMifiabilifij of Psijchoiherapy

After all that has been said, it may seem super-
fluous even to discuss the question of psycho-
therapy's inherent right to intervene in relieving
human suffering. Nevertheless, we must not forget
that there exists a constantly increasing number of
learned, half-learned, and unlearned individuals who
are of the opinion that the efforts of medicine and
hygiene, hence also those of psychotherapy, cannot
be made to harmonize with the aims of nature.
Applying the law of evolution unrestrictedly to hu-
man society, these people say that nature, by means
of the struggle for existence, strives to cause a sur-
vival of the fittest, but that it cannot attain this



212 PSYCHOTHERAPY

aim in human beings as it can in plants and animals,
because the science of medicine is steadily opposing
its purpose.

By means of the intense competition for the pos-
session of the restricted existing materials of sus-
tenance, nature of itself weeds out the unfit. The
final word of Darwinism, although Darwin himself
disclaimed this application of the developmental
law, may be taken to mean that the sick and the
feeble, who are not equal to the struggle for exist-
ence and who fall a prey to every infection and
other injury, should be left helpless to their des-
tiny, that they should be allowed to succumb in
the way animals and certain aboriginal peoples
are left to their fate. Certain votaries of this
prejudiced and fanatic point of view go still further
and, following the philosophy of Nietzsche, who
died insane, declare compassion to be a reprehensi-
ble frailty on the ground that it is opposed to the
intent of nature. In the opinion of these persons,
a strong and healthy race needs neither medicine
nor hygiene, both of which serve merely for the
artificial preservation of the sick and the infirm
and, in addition, enable them to propagate their
kind. Pestilence, disease, and the exertions inci-



JUSTIFIABILITY OF PSYCHOTHERAPY 213

dent to the struggle for existence, they say, are
nature's means of selection; he who is not able to
withstand such ordeals is destined for extinction, and
medical science should not intervene protectively.

All of this may be answered by the recognized
fact that civilization has completely changed the
natural conditions of life, and that, for this reason,
the law of development as affecting human society
must be materially restricted in its application.
The number of accidents occurring as a result of
industrial conditions has been augmented propor-
tionately with the progress in the development of
technical appliances; nor, despite our vaunted
civilization, has the number of those injured on the
field of battle been diminished.

The victims of industry and of war may have
been just the ones selected by nature for survival.
Should we, then, leave them to their injuries and
stand passively by, waiting to see whether their
broken bones will unite, their torn tissues heal,
their loss of blood cease, without intervention?
So ridiculous is this thought that no person of in-
telligence can question the right of surgery to come
to the aid of nature in such cases, and, in many
instances, to forestall fatal results.



214 PSYCHOTHERAPY

Material conditions have been so altered by civil-
ization that to-day life is less a question of bodily
than of mental fitness. For people living in a
rough and uncultivated land, not yet influenced by
cultural development, and for those who pass
their lives in a primeval forest or on a lonesome
prairie, the natural requirements are entirely differ-
ent, of course, from those of dwellers in a densely
inhabited community. Where the people are iso-
lated and dependent on themselves, they require,
in their struggle for existence, well-developed mus-
cles and impregnable health, but where pioneer
work is no longer needed other qualifications are
essential.

Civilization causes a survival of the fittest in
quite another sense than does nature. Our civili-
zation could not persist and could not develop if
pestilence, disease, and accident, through which the
best cultural elements are often swept away, were
allowed full sway. Nor should we lose from sight
for a moment the fact that civilization has been
the cause of numberless evils which originally did
not exist and against which nature has supplied no
means of defence. We ourselves can and must
provide for such defence by scientific insight into



JUSTIFIABILITY OF PSYCHOTHERAPY 215

the origin of these evils and the methods of com-
bating them.

It cannot but be considered fortunate that the
very same civilization which, through interference
with natural laws of life, has been the cause of so
many new ills to man, should at the same time
place in his hands, through the achievements of
medicine and hygiene, the weapons with which
these afflictions may be combated.

Animals are furnished by nature with all sorts
of means of defence, without which they would be
helpless against every attack. Once they have be-
come domesticated these means of defence, being
no longer necessary, waste away from disuse.
Nature has not provided the domesticated animals
with the implements which their subserviency to
man makes requisite. The horse, when living in
freedom, needs no artificial protection for its hoofs,
but without such protection it soon goes lame on
the pavement of our streets. Civilization, there-
fore, has altered the conditions under which the
horse naturally lives and, making demands on this
animal for which nature has made no provision,
produces an affliction which can be forestalled or
remedied only by civilization itself. This one ex-



216 PSYCHOTHERAPY

ample suffices to show that medical science does
not work against the aims of nature, but meets the
altered conditions of life which civilization has
produced.

Considerations of still another kind make the
thought that medical science is ' superfluous, or
even detrimental, appear absurd. Human beings
are not animals among whom exists no law of
morals, but only the law of superior force. Fre-
quently the cultural elements of greatest worth are
those which, in the sense of nature, are not fit.
Not always does a strong body go together with a
strong mind; sometimes the body is weak but the
mind strong. Often the most valuable cultural ele-
ments, great scientists, inventors, writers, are indi-
viduals of infirm constitution, and yet their worth
to progress is found to be far greater than that of
the great mass of people.

The able, the robust, the healthy, therefore, are
not necessarily the most precious. Darwin him-
self was an invalid the greater part of his life.
How many valuable lives would have been lost to
the world had selection been left entirely to nature!
Then humanity would have consisted of none but
the strong, but the fact that these powerful ones



JUSTIFIABILITY OF PSYCHOTHERAPY 217

had rid themselves of the sick, the infirm, and the
helpless would mean at the same time a subjuga-
tion to atavistic instincts, in consequence of which
the human race again would sink to the level of
the brute.

So deplorable a state could be brought about
only through the stunting of that which is best in
man, of that which raises him high above the
animal, and gives him the character of an ethical
personality, the feeling of altruism. Nothing but
cold, crass egotism can endorse the doctrine which
places compassion and weakness on one plane.

Since, therefore, it is personal interest which bids
the human race to preserve the sick and the feeble,
in so far as they constitute valuable cultural ele-
ments, considerations of an ethical and altruistic
kind demand that the same be done for those of
inferior worth.

The endeavors of medicine and hygiene are
rooted in a soil of altruistic sentiment, which looks
beyond the mere question of benefit. Yet medical
science does not desire artificially to prolong the
lives of degenerated and incurable weaklings. Its
aim is to make the weak strong, the sick well, to
restore to them the joy of living and of usefulness



218 PSYCHOTHERAPY

so they may again fulfil their missions in life. It
aims at the recognition and the avoidance of those
noxious influences which threaten human health
and well-being at every step, and which modern
cultural development has called into existence in
the shape of new dangers and diseases in nowise
ordained by nature.

It aims also, however, to protect the healthy
against any injury which might be caused through
the physically or mentally diseased. To stand pas-
sively by while the helplessly degenerate transmit
noxious germs to healthy individuals would no
longer be compassion but would be criminal weak-
ness. All that has been achieved by medical sci-
ence through prophylaxis and therapeutics is the
outcome of laborious investigations the justifiability
of which can be questioned only by visionary fa-
natics. Unfortunately even in this twentieth cen-
tury there exist people who believe disease should
be accepted with resignation as a divine dispensa-
tion. Instead it should be a matter of universal
knowledge that disease is a result of our ignorance
and disregard of natural laws. If the sins of the
fathers be visited upon the children unto the third
and fourth generations, it is a purely natural proc-



JUSTIFIABILITY OF PSYCHOTHERAPY 219

ess of development, which must take place even if
there is no co-operation of supernatural powers.
For any one who realizes thoroughly that it is as
impossible for races as for individuals to return to
a state of nature, to the days of childhood, from
maturity to immaturity, from reason to belief, and
that they must meet the age of maturation and in-
dependence with fortitude and decision, there can
exist not the least doubt that in our battle against
disease we cannot rely on nature to make any selec-
tion adapted to the requirements of civilization,
much less expect any aid from chance occurrence
or miraculous happening. Even from a religious
point of view it would be unreasonable to expect
that God would intervene between us and the or-
derly course of natural processes for the purpose of
mitigating suffering of our own making, and for
which there exists a natural relief.

It will be unnecessary to do more than refer to
the fact that a belief in the miraculous is sure to be
a hindrance to progress of all kind, in that it causes
a passivity which allows every misfortune unop-
posedly to take its course. No words are truer
than those of Horace, " Nihil sine magno vita labore
dedit mortalibus," and we must learn that progress



220 PSYCHOTHERAPY

is essentially a question of our own endeavors, and
that the impulse which is innate in the human race,
to defend itself against evils, whether dependent
on our own misdeeds or not, has been implanted
in us so we may learn to recognize the laws of
nature and adapt ourselves to them.

What can be accomplished by such persistent
endeavor is nowhere more strikingly shown than in
the remarkable achievements of medical science
and hygiene. That we are no longer impotent
against pestilence and disease which formerly de-
populated entire countries, that infant mortality
has been reduced extraordinarily, that the average
duration of human life has increased notwithstand-
ing the exhausting struggle for existence, that we
are able to trace most processes of disease from
their first causes to their final stages and to influ-
ence their course prophylactically as well as thera-
peutically, are facts which of themselves must
silence all objections to the legitimacy of the sci-
ence of medicine, whether they be raised by fanat-
ics on the subject of nature's manner and purpose
of selection or by religious enthusiasts. Many an
unsolved and apparently insoluble enigma still con-
fronts us; our discernment of the course of disease



JUSTIFIABILITY OF PSYCHOTHERAPY 221

and of its remedies is by no means perfect, and we
still must allow people to die without ascertainable
cause; but not even those facts constitute valid
arguments for the opponents of medical science.


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Online LibraryGeorge W 1856-1940 JacobySuggestion and psychotherapy → online text (page 11 of 18)