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In order to bring about hypnosis and influence a subject therapeutically, the most important thing, as I have mentioned in Chapter III, is to create the right emotional atmosphere. The more feeling we can throw into our words, actions, and manner, the greater will be their influence. Only words that come from the heart can reach the heart.

We want to carry conviction, and conviction depends far more upon the trend of the emotions than it does on intellectual endowment. If a person is in an emotional state, and some suggestion is made, or some story told that harmonizes with his emotion, he will generally believe it. It is the same when an orator conveys his emotions to his audience. It matters little what his arguments are; if he cannot inspire, or if he inspires with the wrong emotions, the most perfect chain of reasoning will leave his audience unmoved or hostile. "In all social reactions, it is the emotional factor that counts, not the ideas that are expressed. It is not possible to make a man do what he does not wish to do; but it is quite possible to create an atmosphere in which he does wish to do it, and therefore does it." (Hugh Elliot, Human Character?)

In order to make a successful suggestion, we must have the right judgment of the psychic condition of the person to be influenced. In no other branch of therapeutics is it so necessary to individualize and to adapt one's methods to the idiosyncrasies of the patient, his individual qualities, constitution, temper, disposition, and the mood in which he happens to be at the time. We must take note of the patient's intelligence and character, prejudices and beliefs, preferences and dislikes, family life and social surroundings, ambition and prospects, sincerity and energy, memories and fancies, experiences and habits. Therefore, to practise this method of treatment, one must be an expert in human character and possess a knowledge of human nature and practical psychology, besides being gifted with unusual tact and sympathy.

To acquaint ourselves with the mind and character of the subject is our preliminary duty. The best method is undoubtedly to encourage the patient to tell his own story in his own way, with just so much of direction from the physician as will prevent the introduction of too many irrelevancies and trivialities in detail. In this way one gets hold of the material upon which psychotherapy has to operate, and at the same time receives some valuable sidelights upon the relative emphasis that things have assumed in the patient's mind. Furthermore, the sympathetic attention which the physician lends to the initial confession is sure to be rewarded in the future with confidences more intimate and important.

The patient will benefit from the opportunity to unburden his mind to a sympathetic listener; and his confidence in the ability of the physician to help him out of his misery has curative power. Having been enlightened by the physician as to the real nature of his case, understanding his own symptoms, and having further been led to a full belief in the possibility of their removal, the patient advances more easily along the path to recovery.

After these preliminaries we can proceed in the attempt to induce hypnosis. As already indicated, we are not aiming at getting the subject to sleep, but to produce such intense concentration and abstraction that the subject becomes unaware of his surroundings; that is to say, pays no voluntary attention to his environment, and even forgets that he has a body and limbs. His senses are quiescent, except for the direction one or other is given by the operator to concentrate the attention. The state produced is identical with that of complete absent-mindedness, as when an ordinary person is meditating deeply and does not notice his sensations. We are indeed aiming at a similar condition for the treatment of disease or disorder, and, as will be shown presently, for the production of supernormal mental capacities.

The room in which the patient is treated should be quiet, in semi-darkness, and contain nothing which captivates the attention too much. The patient being on a couch or in a lounge chair, with a comfortable rest for his head, the first step is to induce in him a mental

Still another method is to stroke gently the subject's forehead or one of his hands. This, besides calming his excitability, makes him forget any pain that he may previously have felt, and concentrates his attention.

By all these methods we secure a limitation of the field of consciousness, a state of absent-mindedness. The subject becomes unconscious of his surroundings, and his subconscious mind is liberated.

Most modern hypnotists practise the Nancy method, i.e. suggesting to the patient the effects they wish to produce: that he is getting drowsy, his eyelids begin to feel heavy, he has a difficulty in raising them and will soon not be able to lift them at all, and so forth. But, in my experience, if the hypnotist speaks too much, the patient expects, waits for, and relies on the suggestions made, a result which is not desirable, for it makes the subject too dependent on the operator.

The old mesmerists compelled their subjects to look steadily at their eyes while they gazed at them firmly. They then made slow passes with one or both hands downwards from the crown of the patient's head over the face to the pit of the stomach, or even down to the feet, always avoiding contact. After each pass the hands were well shaken, just as if something were shaken off them. The passes would be continued patiently for some time, until they excited the sensation of warmth, pricking or tingling, numbness or rigidity, according to the individual operated upon. By another method, the magnetizer would sit down close to the patient, taking hold of his thumbs, and gently pressing them gaze fixedly in his eyes, concentrating his mind upon him, while the subject would gaze at the operator. The gaze of the subject had the effect of concentrating the subject's attention, and the look of the operator, as it were, commanded him not to "wander" in his thoughts. The old magnetizers laid the greatest stress on the intense concentration on the part of the operator, and would often achieve success solely by intent gazing, without passes or verbal suggestion. In my experience, however, the gazing process cannot be employed by everyone- It requires a sharp, penetrating look, capable of long-continued fixedness; it will likewise seldom succeed with individuals who are magnetized for the first time.

The magnetizers, finding the patients not yielding to the influence of their passes, would close their eyes and press the fingers gently on the eyelids and retain them there for a few minutes, at the same time concentrating all their efforts.

Another method was to hold two fingers before the subject's eyes and ask him to gaze at their tips, and to concentrate his attention on the idea of sleep. The fingers were moved from a distance close to the eyes and away again, when the tiring effect of constant accommodation of vision often produced the desired effect.

At public performances magnetizers used soft strains of music, issuing from an adjoining room, which lulled the subjects and appeared to assist greatly the induction of sleep in new subjects.

These mesmeric methods are more suitable for the deeper states of hypnosis, the trance-like conditions, in which the limbs remain in the position in which they are put. If the hands are clasped together, the subject cannot get them apart; or, if he is made to rotate his arms, he cannot stop the movement until the hypnotist tells him he can do so. These deep states are not really required except as tests, or when dealing with very severe symptoms, or when we study certain phenomena of hypnosis in subjects who volunteer for scientific purposes. For such deep hypnosis not all persons are suitable, because they lack the required susceptibility or because, though they are consciously willing, they subconsciously resist.

Still, any of these methods may be tried, and sometimes must be, for some persons are more impressionable to one method than to another. Some are distracted when touched, while others go off more easily when they feel the contact of the operator. As a matter of fact, all processes succeed when they inspire confidence in the subject.

As a rule, each hypnotizer has his own pet method, but the expert is able to judge the mental susceptibility of the subject at first sight, and can tell at once what process would be most successful.

A good preliminary test whether a person can be hypnotized is to judge his sensibility by drawing the palm of the hand downwards, without contact, but very near, over his face and hands. This is best done while the eyes are closed, when it will be found that some subjects have a peculiar sensation, varying from mere warmth to pricking, and, in the most susceptible, as if a mild electric current passed over their skin. This used to be described by mesmerists as the magnetic influence, and although no such influence is admitted now, 1 have always found that these passes were felt more readily and by more persons when I had been doing much hypnotic work than when I had rested for some time.

For medical purposes we need only aim at the early stage preceding sleep that is consistent with consciousness. This is the transitional stage which anyone who has analysed his sensations has recognized as a brief period immediately preceding the unconsciousness of slumber, when by an effort he can become wide awake, or by lying still and guarding his mind against exciting thoughts can insure speedy and perfect sleep.

The induction of this semi-wakeful state is, as a rule, all that is needed, and is a fairly simple process. And in all cases hypnosis is more readily induced for medical treatment than for any other purpose, because in the sick the voluntary and conscious activity is diminished by exhaustion, and the subjects are really earnest about it in order to be cured. But it is not only sick people, or people suffering from nervous or other disorders, that can be hypnotized; perfectly healthy people make equally excellent subjects. Nor has the weakness of "will" anything to do with the susceptibility of a subject. What sometimes hinders hypnotization is "mental pre-occupation," which, however, may suddenly at some moment be removed. Nor are "credulous" persons necessarily good subjects. There are plenty of people who believe all they are told, yet often offer a lively resistance when an effort is made to hypnotize them.

Insane people are notoriously hard to hypnotize, because of the difficulty of engaging their attention and getting them to concentrate. But with persons in the primary stages of mental disorder—that is to say, not altogether mad—there is no such difficulty.

It will be noticed that, though all the methods we have described for inducing hypnosis vary, the conditions are practically the same:

1. First and foremost is that of fixation of the attention.

2. Monotonous environment, to produce monotonous impressions and intellectual drowsiness, the prelude of sleep.

3. Limitation of voluntary movements by relaxation of the muscles.

4. Limitation of the field of consciousness by allowing no new incoming impression and

5. Inhibition of ideas by making the mind as nearly

as possible a blank.

These conditions suffice for all practical purposes. Sleep need not be induced, but only the somnolent state we have described. This method has the advantage that nearly everybody can be subjected to it.

Most important is the fixation of attention. In the physical procedure it is the sensorial attention that is fixed; when the procedure is purely suggestive, the attention is held captive by an idea. It would seem, then, that a special modification of attention is a persistent psychological characteristic of hypnosis.

We can now address the subject, speak plainly and emphatically to him about his ailment or injurious habit, and he will remain perfectly passive, so long as we say nothing with which he is likely to disagree. If the idea runs counter to the sentiments and firmly held beliefs of the individual, other things being equal, he is much less likely to accept it than if it accords with his own feelings and convictions.

In the case of minor mental disorders and overactive dispositions, we can impress upon him the desire to break himself of the morbid idea or impulse, and, by calling his own powers of thought and volition into play, we can show him the way to self-control.

The manner in which an idea is conveyed is often the determining factor in the patient's suggestibility regarding it. It may be presented directly or indirectly, persuasively or commandingly, once or repeatedly. The idea may be put forward as an abstract proposition, or crystallized in the form of a picture or a practical demonstration.

It is advisable to condense the idea which is to be the object of the suggestion, to sum it up in a brief phrase which can readily be graven on the memory.

Whatever idea is presented to the mind in hypnotic treatment is intended as a post-hypnotic suggestion, to take effect after waking. When subjects are subsequently questioned as to their motive for acting, they generally believe that they have so acted of their own accord; for no suggestion is made in medical treatment which the patient would not himself desire.

The suggestion made for post-hypnotic action may be direct or indirect. A direct suggestion would be, for example, if we told an alcoholic subject that he will no longer have a desire for drink. This, in many instances, will not work at all, because it does not give the patient a motive for abstaining. I much-prefer giving indirect suggestions, such as will provide him (in the case of the alcoholic) with pictures of utter ruin and degradation if he persists in the habit, and of his success in life, the realization of his aims and ideals, his gaining respect and esteem if he will abstain. This supplies the patient not only with the necessary motives, but also with the emotional background so essential for the successful exercise of his will.

If we tell a person in the conscious state that a certain habit is detrimental to his health, he will say that he knows as much, but cannot break himself of it. If we draw attention to his habit, while he is in the concentrated state of hypnosis, and supply him with reasons why he should stop it, he receives the message passively, i.e. subconsciously, and automatically acts upon it. When later he is tempted again, there comes into play a restraining impulse, an inhibition, and sometimes even a repulsion of the former desire.

We shall succeed best by projecting upon the mind of the subject a new and stimulating idea, which will have a wholesome, regenerating, aspiring, uplifting effect. We do not employ, therefore, so much a method of suggestion as is commonly assumed, but we train the patient to act by his own will. Especially where there is a conflict of emotions it is better not to make any suggestions, but to let the patient pass into a state of reverie. This enables the subconscious to break through to the surface, and, by allowing the patient to talk about whatever comes into his mind, we may bring to consciousness an event, long forgotten, which is at the root of all the patient's troubles.

The free talk in the passive, uncritical, subconscious state will reveal not only those "complexes" arising from past events which are still smouldering and exerting an undesirable influence on conscious life and behaviour, and giving rise to physical symptoms, but may also reveal to the operator's critical faculty a failure of adaptation, which he must rectify. So long as the complexes are unconscious they are beyond our control; merely bringing them into consciousness helps to remove the trouble from which the patient is suffering. In any case, having discovered where the mischief lies, we are able to advise the patient and re-educate him to take a proper view of life and to adapt himself to the conditions of his surroundings.

All psychic treatment strives to free the innate forces that have been bound and to adjust the individual to that external reality in which he must live. (P. Bjerre.)

No psychotherapy is any good, certainly not lasting, if it does not include the re-education of the patient; for his illness is often nothing more than an unsuccessful effort to solve the conflicts of his life and a failure of adaptation. We have to bring about a readjustment, some sought-for and desirable reorganization of the individual in respect of his inner and outer experiences, to assist him, as well as may be, in his efforts, hitherto frustrated, toward the consummation of a more harmonious adaptation to his social and physical environment. In other words, we seek the reconciliation of the patient with reality. We evoke new ideals and the impulse to pursue them, and make them so attractive to the patient that they become embodied in the processes of his conduct. Of course, the ideals must be practical, not Utopian. By the implanting of new ideals we tap the potential subconscious reserve energy of the patient, bring about a reassociation and synthesis of the dissociated mental systems underlying the symptoms of the disease, and guide the mind of the patient to self-realization and self-perfection. The subject must be brought to realize his previous misconceptions, his undesirable mental habits have to be uprooted, he must be taught to minimize his difficulties, to stop the magnification of trifles, and to gain self-control. We have to teach him orderly thought and controlled emotion, and supply him with new motives for right conduct. Undesirable elements of mental life have to be supplanted by the concentration of attention on new interests, the furnishing of new outlets of activities. A new attitude and outlook on life has to be acquired and disturbing inner or outer conditions have to be adjusted. Mere exploration of his mental contents without such reeducation is bound to prove a failure.

By the methods I have described, the subject retains his consciousness unimpaired, and can, if requested, discuss and reason with the operator or any person present with more intelligence than before. It will be found that the concentration he practised while on the couch or in the chair has increased the energy and power of his ideas, so that he will have more determination for the realization of his aims. Again I lay stress, there must be an emotional contact between the subject and operator. Men of sympathetic personality will always have more influence than those of a colder nature. The cold, commanding personality succeeds, if at all, chiefly by the fear he inspires.

We have seen that the factors necessary for successful mental healing are, first of all, sympathy for the sufferer, which must be expressed in gentle words and action, to bring peace to his mind and bodily activity. Then hope with which to reanimate the reserves of energy. Stimulating words revive the faith and induce the patient to make an effort. They encourage him to gain control, to keep alive. Furthermore, we have to take stock of the patient's mind and assess its various contents at their proper value.

In all diseases, whether functional or organic, there is a psychical factor, for man does not suffer like an animal, feeling only crude sensations, but his feelings are influenced by his fears and pessimistic reflections, and often his mental suffering is greater than the actual bodily pain. We have to deal not merely with the symptoms as they present themselves to the patient's consciousness, but with the interpretation he invariably places upon these symptoms.

On the other hand, actual pain, though we can remove it in hypnosis, must be traced to its causes; for all pain that is not imaginary is a signal of some disorder or disease, which, if unattended, is bound to increase. To remove pain without discovering its cause is a dangerous proceeding.

Last, but not least, the physical needs of the patient must not be neglected. We must not lose sight of the fact that disease has a physical basis, and that even in functional affections there is some nutritional or other disturbance, some change in the bio-chemistry of the tissues, which cannot be corrected by merely making suggestions to the patient. We must restore not merely the mental condition, but the health of the organization with which mind is connected, and upon the normal state of which its soundness depends. Much good can be accomplished by psychical measures, but those who are not carried away by enthusiasm will recognize that psychotherapy is not a panacea, and, although valuable in many cases, should not be employed to the exclusion of other measures. It is the duty of the practitioner when called upon to treat a patient to carry out not one, but all of the measures which have been shown by years of experience to be advantageous. He therefore requires an intimate knowledge of the normal working and the disorders of the brain and nervous system, and a proper knowledge of general medicine. These qualifications only a properly trained physician can possess.

The first thing to do is to put the patient on the best physical basis. Then we have solved part of the problem of his mental condition. We examine his constitution to discover any defect there may be in the working of an organ, and treat such defect according to the recognized methods of medical science. We do not, as Christian Scientists and practitioners of other cults do, relegate tried methods to the dust-heap, but recognize that, even if there be no actual disease anywhere about the body, the patient, owing to his habitual indulgence in morbid thoughts or habits, has weakened his constitution, and may suffer from a state of nervous exhaustion or irritability, which requires our treatment on established lines.

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