George W 1856-1940 Jacoby.

Suggestion and psychotherapy online

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rected in the healthy person, if they obtain a firm
hold and, together with the dependent conclusions
and opinions, acquire permanent dominance of the
mind, they may become dangerous to the victim.

The possibility of mental health even in per-
sons of defective sensory perceptions is eloquently
proved by the fact that many people congenitally
blind or deaf can develop in an entirely normal
manner, although they have no idea of color or of
tones, and by the fact that Helen Keller, despite
her lack of both those senses, which bring about
the chief connection with the outer world, went
successfully through a well-planned academic
course and now occupies herself ably in literature.
Such development of defective sensory perception,


of course, can only be understood by the presump-
tion that the defects can be corrected.

How great a power sense deception and false
concepts may exert not only on the mental activi-
ties but also on the physiological processes of en-
tirely healthy persons has been demonstrated by
Bechterew in the following drastic example:

In Copenhagen, in the year 1750, a criminal con-
demned to death was turned over to the physicians
as an object of study. The unfortunate was fast-
ened to a table by means of heavy leather straps
and blindfolded. He was then informed that an
artery of his neck was to be opened and that his
blood would be allowed to drain until not a drop
remained. An insignificant prick of the needle
was inflicted, a suction-tube was placed next to
the man's head, and a stream of w^ater flowing
across his neck was allowed to splash into a ves-
sel standing on the floor. The criminal, firmly
convinced he was listening to the dripping of his
own blood, died as a direct result of the illusion.

An example of a similar kind, reported by Rochas,
is this:

A number of students seized a school employee
who had displeased them, held n mock trial and


condemned him to death. A block and an axe
were brought forth and the prisoner was informed
that within three minutes the death sentence
would be executed. His neck was bared, his eyes
were bandaged, and he was made to kneel. Then,
with a wet napkin, a blow was given him on the
neck. The students laughingly declared the death
sentence fulfilled, but to their great astonishment
the man did not move. By great effort he was re-
vived, but he had to be placed in an asylum as
incurably insane.

Those, of course, are individual and extreme
examples. In a normal brain the imagination
alone will not always be able to produce marked
disorder; fear and the expectancy of immediate
death will not always be able to paralyze vitally
important functions. That the majority of crimi-
nals condemned to death are yet fully alive at the
moment of execution and that their life is extin-
guished only by the act of execution, proves the
expectation of death is not sufficient to cause ces-
sation of the action of the heart or of the move-
ments of respiration.

The two examples given above, however, do
show how effective may be the power of imagination


in producing severe disorder in bodily processes
as well as in the mental sphere. Later we will
demonstrate that this same power of imagination
may also be of beneficial influence and that in
psychotherapy it has already been developed into
an efiicacious curative factor.

In the same connection we must mention "psy-
chic infection" and functional nervous diseases,
neuroses. By psychic infection we understand the
aggregate of all psychic influences which force
mental action into false channels. "Functional"
nervous diseases are those disorders of sensation
and motion in which no organic changes are dis-
coverable and which, therefore, like hysterical pa-
ralyses, may be dependent on imagination alone.

That the term "neuroses'* or "functional" ner-
vous disease refers to disorders which have as a
basis no structural changes and which, therefore,
are due to mental causes, must be kept constantly
in mind. Through the progressive improvement
in anatomical methods of examination, the field of
neuroses has steadily become more and more limited.
In recent years the refinements of microscopical
technique especially have given us a clearer in-
sight into the more delicate structure of the ner-


vous system and have enabled us to recognize as
deviations from the normal many tissue forma-
tions, the pathological character of which we had
not been able to perceive by the older methods.
Hence it might be assumed actual neuroses do not
exist and that, simply because we are unable to
demonstrate the existence of organic changes which
perhaps form the basis of those disorders, we neces-
sarily designate them as functional or psychically
induced. In another century, possibly, science will
have made such progress that the final enigma
concerning neuroses will have been solved. For
it must be enigmatical that such serious disorder
as may be observed in hysteria, neurasthenia, and
other troubles should be possible without corre-
sponding change in the gross or more delicate
conformation of the organs of the body and of
their nervous elements, while everywhere else in
pathology the law holds good that disease is a
manifestation of life under abnormal conditions.

This question might be answered by the con-
tention that the psychic cure of such disorders in
itself furnishes the proof of their psychic origin.
Obersteiner, who has given us an excellent disser-
tation on the most important differences between


functional and organic nervous diseases, very justly
states it must be impossible to assume that a severe
hysterical paralysis cured by assertion alone could
be dependent on anatomical disorder. How could
such an anatomical change be set aside by simply
arousing a belief in a cure, even if the belief is
supported by the " water of Lourdes " or any other
similar curative factor? Hence there can now be
no question of anatomical change in such cases.
Neuroses are and must remain psychic in their
origin. Functional nervous disorders are caused
essentially by the erroneous idea that specific func-
tions cannot be carried out. It is just this false
idea which produces the abnormal condition that
limits or entirely prevents the exercise of the func-
tion. Therein, therefore, lies the explanation for
the apparent contradiction between functional dis-
orders with and without organic changes, for in
both cases the expressions of disease are manifesta-
tions of life under abnormal conditions.

With Obersteiner, we may summarize as follows
the results of previous investigation regarding func-
tional disorders:

According to our present knowledge, many dis-
eases which formerly, in the absence of any ana-


tomical basis of explanation, were classed among
the functional disorders, are, as a matter of fact,
organically caused; furthermore, the field of neu-
roses becomes still more restricted through the
elimination of those abnormal manifestations of life
which have their causes in toxic conditions, dis-
orders of nutrition, hyperaemia, and anaemia. Even
if we fail to prove clearly the existence of structural
changes in these conditions, the presence of a ma-
terial basis for their occurrence is sufficient reason
in itself for separating them from the category of
functional disorders. But even with the exclusion
of those cases, there still remain numerous neu-
roses which present many evidences of disease
which frequently are very severe and which have
purely psychic causes. If, for instance, a person
w^ith a weak nervous svstem has a fit because he
has seen another person in a convulsion, no special
proof is required to show that his convulsions were
not dependent on organic disorder and that an
organic nervous disease never can be incited by
pure imitation. The same test will apply to hys-
terical paralysis, to the sensation of a ball sticking
in the throat, and to other manifestations of hys-
teria. In the same category must also be classed


all neurasthenic and allied states, obsessions, the
neuroses without any anatomical lesion of the
central nervous system which are caused by acci-
dental injury, and also the functional psychoses,
those expressions of diseased mental life which
have no foundation in organic changes of the brain.
Not only do we know that psychic symptoms are
the dominating ones in the conditions we have
mentioned, but we also know they are psychically
caused and, on the other hand, can be psychically
influenced. Obersteiner, therefore, arrives at the
conclusion that, while the mere lack of demon-
strable changes in the nervous system does not
justify classing a form of nervous disease among
the functional ones, differentiating between func-
tional disease and functional symptoms would ma-
terially conduce to the better understanding of
this diflficult subject. A picture of disease may be
made up of organic and functional symptoms. It
may even be asserted that the majority of appar-
ently pure organic nervous diseases also possess a
functional factor, the latter then being capable of
correction while the organic symptoms are not.

The important and difficult distinction between
functional disorder and functional symptoms should


now be clear. The first expression denotes a total
or partial inability to carry out a function, without
it being possible to detect the existence, in the par-
ticular organ, of any changes which might be the
cause of this disability.

Functional symptoms, on the other hand, are
morbid alterations of function resulting from path-
ologic anatomic processes. In the one case as
well as the other the outward picture of disease
may be one and the same. If, for instance, a cer-
tain movement of a limb cannot be carried out,
this inability may be due to an interruption in the
nerve conduction or dependent upon a structural
disease of the muscle, and may have been caused
by mechanical injury, by infection, toxic processes,
etc. On the other hand, none of these causes may
obtain, in which case the disorder of function can
have been produced only by psychic means. If
this is so, then a cure by psychic means, by the
arousal of the relative opposing idea, must be pos-
sible. At the same time, of course, it is not im-
possible that the functional symptoms, due to
anatomical disorder, which are simultaneously pres-
ent, but which take their origin in some other
organ or part of the body, may be, possibly only


indirectly, ameliorated through this psychic treat-

It must be looked upon as an assured result of
anatomico-physiological brain investigation that the
normal course of mental processes is associated,
up to a certain degree, with the integrity of the
brain cortex. It is entirely impossible, however,
to localize the individual activities of mental life in
certain regions of the brain cortex. Here we are
dealing with conditions which lie beyond the scope
of the anatomist and the microscopist and which,
therefore, must be conceived as functional. While
recognizing all the truth there may be in the basic
idea of Gall's teaching concerning the different
functions of individual regions of the brain cortex,
w^e must nevertheless, as Obersteiner emphasizes,
not lose sight of the fact, so eminently important
for the understanding of functional symptoms,
that it is essentially the activities of motion and
sensation w^hich have been definitely localized in
single parts of the cortex; but we have not yet
succeeded in grouping the various phases of dis-
tinctly mental life in a similar manner upon the
surface of the brain, or even in placing them posi-
tively in any circumscribed portion of the cortex.


The endeavor to find an ample anatomical basis
for functional disorders becomes futile just as soon
as we no longer seek functional diseases but look
for functional symptoms. All pure functional ner-
vous symptoms or groups of symptoms have com-
mon characteristics which justify placing them in
the field of psychic symptoms, even when their
outward manifestations become material, as they
often do. It is only on that basis that we can ex-
plain their cure by psychic influence. Moreover,
even where the picture of disease is composed of
organic and functional (psychically caused) symp-
toms, the amelioration obtained by suggestive in-
fluence can be explained only by the assumption
of the existence of a functional factor in most
apparently pure organic nervous diseases.

As a matter of fact, there is no single nervous
symptom which could not occur in either func-
tional or organic disorder. Paralysis and spasms,
anaesthesia and hyperesthesia, are found as symp-
toms of the one as well as the other. It may be
maintained in a general way that symptoms of dis-
ease in fields not under the influence of the mind
or of the will are evidences of anatomical lesion
of the nervous system, while disorders of the psychic


sphere are raore rarely organically caused, or fre-
quently are to be looked upon as functional concom-
itants of an existing nervous disease. As a classical
example in proof of this distinction, we may take
the difference which exists between a hysterical
hemiplegia and one dependent on hemorrhage into
the brain. To the layman the clinical picture of
disease is apparently the same. Not so to the phy-
sician, for in the one ease he is able to efface the
symptom by means of psychic treatment, and in the
other case he cannot. A similar condition of affairs
obtains in those disorders of sensation and of other
kinds, already mentioned, which, when viewed cur-
sorily, may represent symptoms either of anatomical
lesion or mere functional disorder. In all those
cases careful examination and precise knowledge
alone can guard against mistakes in diagnosis and


A. Possibility and Nature of Suggestion

The outer world exists for each of us as each of
us conceives it. Each thing in our environment
always exerts the same excitation on our brains.
But our consciousness does not always react to
any single excitation in the same manner. The
world about us, broadly speaking, does not change,
while the concepts which we form in regard to it
may easily change. In that susceptibility of the
concepts to change lies the possibility of sugges-
tion, of psychic influence.

Bechterew defines suggestion as a special kind
of influence exerted by one individual upon an-
other, with or without the intent of the former,
and without the previous knowledge or positive
concurrence of the latter. The force of suggestion
is based on the arousal of a conviction, unopposed
by any contrary idea, that a certain proceeding
will take place. In so far it involves not so much

a logical conviction founded upon reason as that



credulity which springs from the emotions, which
frequently is obtuse to all processes of reasoning,
and which sways a person without his being able
to account to himself for his notions.

The extremely characteristic expression " psychic
infection" has been selected to designate this

A physical infection, as is well known, takes
place through the interaction of three factors.
First, there must be present germs which carry
the infection; second, these germs must find an
entry into the organism; third, conditions favor-
able for the development of the germ must exist
in the organism.

It is in a similar manner that the processes of
psychic infection take their course. We may look
upon the carriers of physical infection as being
represented, in psychic infection, by all those ideas
which are able, whether by force of example, of
speech, or of printed word, to incite the imitative
impulse in the brains of persons who are receptive
— that is, weak-willed.

True, the word ''infection" connotes something
morbid, an impression which should not neces-
sarily be attached to suggestion.


According to Forel, suggestion represents an in-
road upon the association of ideas — "it dissociates
that which has been associated and associates that
which has not been associated/' Those chains of
thought which have fixed themselves in our brains
as a result of the education or the experience of
years, and on which our entire intellectual activity
is based, may therefore be disrupted, or new chains
may be constructed, by an outside invasion. That
is to say, ideas which hitherto have been foreign
to one's conceptional life may be aroused by means
of suggestion.

But not every suggestive influence attains its
purpose; many suggestions founder on the oppo-
sition of persons of strong will. In order that a
suggested idea may exert its action, not only is it
necessary that it be introduced into the brain, but
also that it be adopted by the brain. In contra-
distinction to persuasion, the methods of which
usually consist in logical expojsition and argumen-
tative proofs, suggestion acts by means of a direct
transplantation of mental states, ideas, emotions,
and sensations; it is heedless of proof and effec-
tive without the aid of logic, swaying solely by
means of the force and vehemence of words, by


means of gestures and other mimic movements.
While persuasion attains its ends chiefly in strong
and healthy minds, the successes of suggestion are
most marked where a lower degree of mental de-
velopment is encountered — in children and people
of the lower classes, for instance.

Not all persons, therefore, are equally adapted
for the acceptance of suggestions. Suggestibility is
dependent on the strength of will, the character,
the impressionability; it varies accordmg to age,
temperament, sex, education, habit, and culture.
The suggested idea, says Engelen, causes other
buds to blossom in the brain of an impulsive
young woman with lively imaginative powers than
in the brain of an old, sober, coolly calculating
and keenly critical scientist; other flowers in the
brains of people with dominating emotions than in
the brains of sceptics.

Over a person of strength of will, one to whom
the suggested idea is discordant or even repugnant,
the suggestion will prove powerless, while persons
of yielding tendencies generally will accept it easily
and carry it out.

Furthermore, the immediate mental state of the
individual to be influenced must be considered.


Whatever benumbs the powers of judgment and
resistance, whether it be fatigue, torpor due to al-
coholic or other narcotic depression, fear, or pas-
sionate excitement, will enhance the suggestibility.
Suggestion produced by taking a person unawares
and leaving him no time for reflection acts in the
same manner. Suggestibility is also increased un-
der certain pathological conditions — for instance,
in hysteria. In fact, suggestion finds all individ-
uals of irresolute character and feeble will-power

As the result of many experiments, it has been
shown that deliberate psychic inoculation is most
easily effected during a special state of conscious-
ness, that known as hypnosis. As a matter of fact,
the acceptance of the suggested idea during hyp-
nosis may take place with such force that the sen-
•sory perceptions and the entire contents of con-
sciousness — even the personality itself — become
changed. Through illusory confounding of ob-
jects by the hypnotized person, a walking-stick
may be transformed suggestively into a dangerous
snake; a handkerchief into a violet; a small child
into a rabbit. Salt water may be swallowed by
him as a rare wine; asafoetida may have for him


the odor of a rose. By the production of halluci-
nations we can conjure up in such a dissociated
personality the picture of a wondrous garden
which does not exist and have him gather flowers
from it for a bouquet; or we may lead him in a
row-boat over a tearing stream and have him live
through all the terrors of a shipwreck.

"Every rational conjecture is cut off and conse-
quently the maddest of confabulations are pos-
sible," says Engelen.

To the hypnotized person^s eyes the moon may
be made to fall on one of the spectators and set
him aflame; on command the frightened subject
will dip air, instead of water, from a hat and labori-
ously attempt to extinguish the fire. The con-
scious concepts may be interrupted to such an
extent that the subject will forget his name, age,
and home, and apparently become a new per-
sonality. Krafft-Ebing, in fact, reports a very in-
teresting case of the reconstruction of a previous

To a woman, lima Szandor, thirty-three years
of age, showing no evidence whatever of hysteria,
was suggested the seventh year of her own life,
and then she was confronted by her mother.


When asked, "Who is that?" she ejaculated,
"My mother, but she is so changed in appear-
ance!" Then she burst into childish tears. This
woman, therefore, was dominated by the false be-
lief that she was seven years of age; she had in
mind the appearance of her mother in that period
of her own life, and she was alarmed by the change
which twenty-six years had produced in her moth-
er's looks. Krafft-Ebing says it will never be pos-
sible, even in pathological fields, to produce more
convincing proof than this of the reconstructed per-

On the other hand, the existence of a complete
cleavage of consciousness in certain individuals
may be demonstrated by means of hypnosis. In
such cases the subject, when hypnotized, knows
nothing of what he has done in the waking state;
when in the latter condition, he ha? no recollection
of the hypnotic happenings. Such an instance of
cleft or double personality is cited by Bernheim.
The subject is a young man, twenty-five years of
age, whose complete metamorphosis can be accom-
plished by a mere glance. As a rule he is earnest,
mild, quiet, and timid. Suddenly he becomes hi-
larious, reckless, intrepid. A worm is shown to


him and he seizes and examines it with interest.
A touch on the forehead brings him back to the
normal state. He sees the worm, throws it from
him, and turns away in disgust. **But you had
the worm in your hand just a moment ago," he is
told. "Oh, but that is a joke," he replies. "I
have such a loathing for it that I would not touch
it for all the money in the world." He has for-
gotten everything which happened when he was
under the spell. Another glance suffices to re-
store that condition, and with no prompting what-
ever he again seizes the worm.

Besides the sudden revivals of memory impres-
sions which have already been mentioned, we en-
counter in normal life other occurrences which
remind us of states of double consciousness. In
this category belong those causeless, recurrent emo-
tional changes of certain people. Those changes
may be so marked as to represent a complete tem-
porary transformation of the moral self, so that,
according to Bernheim, the most timid person
will, at command, pick up a revolver, in order in
cold blood to shoot a harmless observer completely
strange to him, or in order to commit the most
intricate thefts. In the higher degrees of such


alteration *of consciousness, of course, a pathologi-
cal disorder of emotional life is recognizable.

Such remarkable occurrences as those instanced
above were attributed at first to mystification of
the observers, or even to direct trickery, but they
must be explained for the greater part in the same
manner as hysterical paralyses or other functional
disorders in which the great power of the imagina-
tion discloses itself. In the normal state a decep-
tion such as occurs in hypnosis will hardly be
possible; it will be prevented by the control of the
sensory organs combined with active attention and
by the proper Functioning of the mentality.

If, for instance, we say to a person in the wak-
ing state, "Do you see this dog?" the expectation
of seeing the dog will be aroused by the credulity
natural to every one. The attention becomes con-
centrated on the fixed memory picture of a dog,
and almost at the same instant is directed toward
the sensory organs which immediately develop
their controlling and corrective activity. The per-
son sees no dog, the brain impression of the dog

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Online LibraryGeorge W 1856-1940 JacobySuggestion and psychotherapy → online text (page 7 of 18)