Part 26

I suggest to B. C. A. in hypnosis ideas of well-being, of recovery from her infirmity; I picture a future roseate with hope, stimulate her ambitions with suggestions of duties to be performed, deeds to be accomplished. With all this there goes an emotional tone of exaltation which takes the place of the depression and of the sense of failure previously present. This emotional tone gives increased energy to her organization, revitalizing, as it were, her psycho-physiological processes [and by conflict represses the previously dissociating affect and sentiment]. The whole I weave artfully and designedly into a complex. Whatever neurotic symptoms were previously present I do not allow to enter this complex. Indeed, the complex is such that they are incompatible with it. The headache, nausea, and other bodily discomforts, pure functional disturbances in this instance, are dissociated and cease to torment. After “waking” there is complete amnesia for the complex. Yet it is still organized, for it can be recovered again in hypnosis. It is simply dormant. But the emotional tone still persists after waking, and invades the personal synthesis, which takes on a correspondingly ecstatic tone. The aspect of her environment, her conception of her relation to the world and her past, present, and future mental life have become colored, so to speak, by the new feeling, as if under a new light. But, more than this, new syntheses have been formed with new tones. If we probe deep enough we find that many ideas of the dormant complex have, through association with the environment (_point de repère_), become interwoven with those of the previous personal consciousness and given all a new meaning. A moment ago [her view was that] she was an invalid, incapacitated, exiled from her social and family life, etc. What was there to look forward to? Now: What of that? She is infinitely better; what a tremendous gain; at such a rate of progress in a short time a new life will be open to her, etc.—a radically new point of view. Now, too, she feels buoyant with health and energy, ready to start afresh on her crusade for health and life. Her neurotic symptoms have vanished. Such is the change that she gratefully speaks of it as the work of a wizard. But the mechanism of the transformation is simple enough. The exaltation, artificially suggested in hypnosis, persists, altering the trend of her ideas and giving new energy. The perceptions of her environment, cognition of herself, etc., have entered into new syntheses which the introduction of new _ideas_, new points of view have developed; thus the content of her ideas has taken a definite, precise shape. Whence came these new ideas? They seem to her to have come miraculously, for she has forgotten the hypnotic complex. But forgetting an experience is not equivalent to its not having happened, or to that experience not having been a part of one’s own psychic life. The hypnotic consciousness remains a part of one’s self (as a neurographic complex), however absolutely we have lost awareness of it. Its experiences become fixed, though dormant, just as do the experiences of our personal conscious life. The mechanism is the same.

The following letter from this patient, received by chance after these paragraphs were written, well expresses the psychological conditions following hypnotic suggestion:

“Something has happened to me—I have a new point of view. I don’t know what has changed me so all at once, but it is as if scales had fallen from my eyes; I see things differently. That affair at L—— was nothing to be ashamed of, Dr. Prince. I showed none of the common sense which I really possess; I regret it bitterly; but I was not myself, and even as [it was] I did nothing to be ashamed of—quite the contrary, indeed.... Anyway, for some reason—I don’t know why, but perhaps you do—I have regained my own self-respect and find to my amazement that I need never have lost it. You know what I was a year ago—you know what I am now—not much to be proud of, perhaps; but I am the work of your hands, and a great improvement on [my poor old self]. I owe you what is worth far more than life itself ... namely, the _desire_ to live. You have given me life and you have given me something to fill it with ... I feel more like myself than for a long time. I am ‘my own man again,’ so to say, and if you keep me and help me a little longer I shall be well.”

In interpreting the phenomena it must be remembered that in such suggestive experiments the subject after waking has complete amnesia for the whole hypnotic experience, for all the ideas which were organized into the complex to form the setting. And yet this viewpoint, in spite of this amnesia, is that which was suggested, and he does not know why his view has changed. That a large fraction of the hypnotic complex (or setting) remains submerged in the unconscious can be readily shown. The only question is whether it becomes an active subconscious process out of which certain elements emerge as meaning into consciousness.

=The setting in obsessions.=—This question of the functioning of unconscious complexes as subconscious processes is of fundamental importance for psychology, whether normal or abnormal, and if well established gives an entirely new aspect to its problems. We cannot therefore be too exacting in demanding proof for the postulation of subconscious processes as part of the mechanisms we are considering, or, at least, requiring sufficient evidence to justify them as a _reasonable theory_. If assumed as an hypothesis many otherwise obscure phenomena become intelligible by one or other theory making use of them.

Let us examine for a moment the obsessions as one of the most important problems with which abnormal psychology has to deal, and which offer themselves as exaggerated examples of ideas with insistent meanings. The phenomena are psychological and physical. They occur in a sporadic form, as well as in a recurring obsessional form. Let us consider them simply as phenomena irrespective of recurrence. They may be arranged by gradations in types in which they appear:

A, as purely physical disturbances;

B, as physical disturbances plus conscious emotion;

C, as physical disturbances plus conscious emotion plus a specific idea of the object of the emotion, but _without_ logical meaning;

D, as physical disturbances plus emotion plus idea plus meaning.

In the first type the physical phenomena (such as commonly attend emotion) can be traced to a functioning subconscious emotional complex of which the phenomena are physical manifestations; in the second to a functioning subconscious complex ejecting its emotion into consciousness. In the third we find by analysis an associated unconscious complex (setting), which logically would account for the emotion of the obsessing idea, and infer, by analogy with A and B, that it is a dynamic factor in the psychosis. In the fourth we find a similar complex, which logically would account for all the physical and conscious phenomena.

_Type A_: The following observation may be cited as an example. At the conclusion of some experiments, made on one subject in the presence of another patient and while conversing socially at afternoon tea, I noticed that the subject manifested marked tremor of the hands to such an extent that the cup in her hand shook and rattled in its saucer. She herself commented on the fact, and laughingly remarked that she did not know what was the matter with her; at times she would “get awfully hot all over and would break out in perspiration.” She could give no explanation of this phenomenon which had not been present before the experiments were begun. The subject was now put into deep hypnosis, in a state in which communication was obtained only by writing, and thereby the subconscious tapped. Without going into all the details, the sum and substance of the information obtained in this hypnotic state was this: coconscious images (pictures), of which she was not consciously aware, kept coming and going; these were the coconscious phenomena I have previously described (p. 169). When certain images appeared coconsciously the tremor developed, and when others appeared the tremor ceased; when still others appeared there were vasomotor disturbances and perspiration as well as tremor.

The images as I interpret them were the secondary images belonging to subconscious ideas or processes.[174] To understand the conditions in this instance it will be necessary to explain certain antecedent facts. I had arranged to make certain hypnotic and other experiments on two patients in the presence of each other. The one in question, the subject of this observation, hesitated to have them made on herself in the presence of a second person, fearing lest the various subconscious phenomena which she exhibited would be regarded as stigmata and she be thought “queer.” Each, of course, wished to see the experiments on the other. The subject in question had for a long time been rather obsessed with the insistent foolish idea that if people knew she manifested these phenomena they would not care to know her socially. It was a point of view which had been more or less obstinately maintained in spite of all contradictory arguments. The idea had specifically recurred from time to time in particular situations, and had caused considerable emotional disturbance. If not a true obsession it was close to one. Nevertheless she wanted to take part both for the object of seeing the experiments and also of meeting the second patient. Still there were anxious doubts and scruples in her mind arising from her desire, on the one hand, and a fear, on the other, that it was a social mistake to do so. This had been going on during several days and had been even the subject of correspondence, discussions, etc. It was only at the last moment that she could screw up her courage to take part in the experiments.

Finally the experiments were made, with the result as above stated. Now the coconscious images which were accompanied by the tremors, etc., were pictures of herself, of the second patient, and of myself. These images coming and going seemed, as in a pantomime, to symbolize her previous thoughts. Sometimes the image of the second patient turned away from the subject, sometimes the three images were present, but the one of the subject stood apart from the others as if an outcast, and in both these latter cases particularly she would shake with tremor, and would “get awfully hot all over,” and break out in perspiration. Then apparently reassuring pictures would come and the tremor would cease.

Besides these coconscious images there was a train of coconscious thought of which she was not personally aware. There was the thought that perhaps, after all, it was a mistake to have taken part in the experiments, as X, the second patient, was not a physician, and her wish to see the subject hypnotized must have been largely curiosity. Of this train of thought the subject was not aware. _At the same time_ concurrently there was in her personal consciousness the “thought that she liked X, that it was very good of her to have come, and awfully kind of you to take your time to conduct the experiments.” There was also a conscious emotion of pleasure and something akin to hope, and nervousness at the situation. By contrast coconsciously there was a greater feeling of nervousness and the _emotion of fear_ of which she was not consciously aware. By a few appropriate suggestions all these phenomena were made to disappear.

It would take us too long and be too much of a digression to go more deeply into these subconscious phenomena. From what has been given, which is corroborated by a large number of observations of the same sort, it seems to me we are justified in concluding that the physical manifestations of emotion (tremor, etc.) in the instance were determined by subconscious processes which were the _functioning residua of antecedent thoughts with their emotions_.

But more than this these antecedent thoughts were obsessing ideas of self-abasement, i.e., of herself as a person who socially was stamped with a stigma and, therefore, as a sort of outcast. These thoughts had formed one setting to the actual situation in which she found herself. The subconscious complex, therefore, contained a perception plus the meaning of the situation plus emotion; in other words, the whole of the psychosis including the affect was subconscious in that none of its elements emerged into consciousness. Another and rival perception of the situation was that which was actually in consciousness and which has been described. The physical phenomena were the manifestation of the subconscious affect and would have been equally manifested if the affect had become conscious. In such a case, then, we may say the whole of one setting actually functions subconsciously.

The case of H. O. is the same in principle as I interpret it, but is distinguished by the fact that the dissociation of processes was not so extreme. The obsessing idea was in the ultramarginal zone of consciousness and, to this extent, subconscious. Briefly stated, H. O. for many years was the victim of an intense obsession, in consequence of which she had practically foregone social life, and found herself unable to travel for fear she would be afflicted with her psychosis in trains, etc. The physical symptom was intense nausea suddenly arising as an attack. When attacked with this there developed also depression and a mental state which is perhaps best described as a mood. She could give no explanation of the attacks. On examination it developed that always in the “background of her mind,” just preceding the attack, there came the idea of disgust of self. At once the nausea as the physical expression of disgust was experienced. The disgust-idea was always excited by some associated stimulus. The meaning of this “sentiment” was set in a large complex of past experiences. Into all this I will not go. The point is that the only conscious elements of her obsession were in the extreme fringe of consciousness, sufficiently dissociated to be practically coconscious,[175] but the _physical symptoms_ were distressingly prominent. _Relief was easily effected simply by organizing a new complex giving a new point of view of self._

Complexes consisting entirely of the physiological manifestations of emotion without conscious emotion undoubtedly occur. A long time ago I described such a neurosis under the name of Fear Neurosis[176] in distinction from psychosis. The symptom complex was interpreted as a persisting automatism derived from antecedent fear states that had been outgrown. From our present standpoint and fuller knowledge we must believe that underlying this automatism is probably an unconscious complex of these antecedent experiences including the fear which takes part in the functioning mechanism. It may be called, then, a subconscious psychosis.

True _hysterical laughter and crying_ are undoubtedly phenomena of this type and due to the same mechanism. These phenomena are well known to be purely automatic; that is to say, they are emotional manifestations unaccompanied in consciousness by thoughts or even by emotions corresponding to them. The subject laughs or cries without knowing why and without even feeling merry or sad. I forbear to digress sufficiently to present the evidence for the interpretation that the phenomena are due to subconscious processes of the kind just described. Let me merely say that in one instance, N. O., intensely studied, the automatic crying was traced by experimental and clinical methods to a persisting and often insistent subconscious childhood’s perception and meaning of self—as a lonely, unhappy child. This perception, etc., could be differentiated from the conscious perception belonging to adult age.

Numerous observations of emotional phenomena similar in principle have been recorded in the case of Miss B.[177] These observations included automatic facial expressions of pleasure, anger, and fear. These expressions could always be traced to subconscious processes and in this case to actual ideas of a coconscious personality. But the principle is the same. _Sometimes the affect linked to the process welled up into consciousness and sometimes it did not._ When, in the case of Miss B., the automatic phenomena were determined by coconscious ideas it was because the perceptions of the secondary subconscious personality had a humorous, angry, or fear setting, as the case might be. These particular observations are of especial interest because they allow us to clearly distinguish _at almost one and the same moment the different manifestations corresponding to the different settings with which the same idea may be clustered_. While, for instance, the personal consciousness of Miss B. perceived a person or situation with apprehension and manifested this apprehension in her facial expression as well as verbally, the subconscious perception of the same person or situation was one of joy which broke through Miss B.’s apprehensive feature in automatic smiles. In other words, two different perceptions (with opposite meanings) of one and the same object functioned at the same time.

These observations, as interpreted, are of wider significance in that they allow us to understand the mechanism of many phenomena of everyday life. For instance, the _hysteria of crowds_ may be explained on the same principle; likewise the outbreak of emotional physical manifestations in a person whose attention is absorbed (abstraction and distraction) in reading or hearing something (e. g., at a play), which, it may be inferred, touches some inner emotional experience of his life. In the kind of instance I have in mind introspection fails to reveal the presence of conscious thoughts or sometimes even emotions which adequately explain the physical disturbance. When not abstracted by the reading or play, the same ideas he was attending to a moment before fail to excite these disturbances.

As has been said, “everyone is a little hysterical,” meaning that under certain conditions—particularly those of stress and strain and strong emotion—the mind becomes a bit disintegrated, and unconscious complexes manifest themselves through what are called hysterical symptoms.

_Type B_: In this class the subject is afflicted with attacks of _conscious emotion_, most conspicuously and commonly fear, _plus the same physical disturbances as in type A_, but without any specific idea in consciousness to which the emotion is related. When we examine certain favorable subjects like Miss B., B. C. A., H. O. and O. N., in whom memories of subconscious processes can be obtained by technical procedures, specific coconscious ideas can be demonstrated during the attacks of fear. These ideas are those of fear of some specific object. The emotion pertaining to these ideas _alone_ emerges into consciousness, the subject remaining unaware of the ideas themselves. In the case of Miss B. numerous observations of this kind were recorded.[178] When the obsessing fear constantly recurs it is a so-called “_anxiety neurosis_,”[179] as I interpret the phenomena.

A typically perfect example of anxiety neurosis was the recurring attacks of intense anxiety accompanied by a feeling of suffocation and oppression of the chest experienced by one of my subjects. Investigation disclosed that the first attack immediately followed a dream which was forgotten, but recovered in hypnosis. It appeared that in the dream she was accused by a certain person of certain delinquencies and threatened with exposure. At this point in the dream she was overcome with fear and anguish as in the after attacks. It also appeared that previously she had been and still was apprehensive of this person’s loyalty. By inference and analogy with the well-established after-phenomena of dreams (p. 101), we must assume that the dream process still functioned subconsciously and produced the anxiety attacks.[180]

In this connection it is well to notice that it is a common observation that not only the affect of emotion but that of _feeling_ also may emerge from the subconscious into consciousness and color the attitude of the personal consciousness. This may be demonstrated by hypnotic procedures. When in hypnosis complexes of ideas with strong feeling tones, whether of pleasure or displeasure, of exaltation or depression, are suggested, the subject after awakening experiences these same feeling tones which dominate the personality. The subject then feels pleasantly exalted or unpleasantly depressed, as the case may be, without knowing the reason why. In alternating personalities the same phenomena may sometimes be observed. In the case of Miss B. the feeling tones which dominated the one personality invaded the consciousness of the other personality, often causing considerable distress after the alternation had occurred and although there was amnesia for all that had gone before.[181] Thus BIV complained of the feelings of depression from which BI shortly before had suffered, although her own ideas were far from being of a depressing nature. This depression welled up from the unconscious. It was in consequence of this phenomenon that BIV wrote: “BI’s constant grieving wears on my nerves. It is harder to endure than one would believe possible. I would rather give and take with Sally—a thousand times rather.” Likewise when a subject has feelings of unpleasantness and depression which he cannot explain it is easy in certain subjects to demonstrate the concurrence of coconscious ideas with these feeling tones. The affect in such cases emerges into consciousness, though the subject is unaware of the coconscious ideas. Correspondingly the feelings may be those of pleasantness and exaltation. The demonstration of coconscious processes as the sources of the conscious feelings of course can only be made in subjects in whom memories of coconscious processes can be evoked. In such subjects I have observed the phenomena on almost numberless occasions. But it can be provoked in almost any good hypnotic subject. To awake pleasurable and exalting feelings, to substitute them for their opposite when such are present, belongs to therapeutic art. The skillful therapeutist endeavors to provoke the former by the various procedures at his command. The important principle underlying such procedures is that the feeling tones pertaining to ideas may still invade the personal consciousness after the ideas have become dormant in the unconscious.

This principle, it seems to me, is of far-reaching application. The persistence of the feeling tone in a pleasant or unpleasant mental attitude after the experience giving rise to it has become dormant is _observed in everyday life_ and can be explained on this principle. We have an exalting experience, engage in a spirited game of tennis, watch an exciting football match, or take part in an exhilarating dance. For the remainder of the day or the next day we still experience all the stimulating pleasurable feeling, even though in the cares of our vocation the memories of the previous experiences have remained dormant, not having once been called to mind. The only difference between such experiences of everyday life and those of hypnosis is that in one case we can, if we will, recall the origin of the feeling and in the other we cannot. In both we do not.[182]