Hypnotism - Theory and Practice


by John Milne Bramwell

This essay was originally written long ago. We have reproduced it here to provide a historical perspective on the subject and the pioneering work done iby early practitioners of hypnosis. It is true that while we have extended the application of hypnosis to various fields in the last few decades, our knowledge and understanding of the mechanism of hypnotism is still limited and vague.

I.—Pioneers of Hypnotism

Just as chemistry arose from alchemy, astronomy from astrology, so hypnotism had its origin in mesmerism. Phenomena such as Mesmer described had undoubtedly been observed from early times, but to his work, which extended from 1756 to his death, in 1815, we owe the scientific interest which, after much error and self-deception, finally led to what we now term hypnotism.

John Elliotson (1791–1868), the foremost physician of his day, was the leader of the mesmeric movement in England. In 1837, after seeing Dupotet's work, he commenced to experiment at University College Hospital, and continued, with remarkable success, until ordered to desist by the council of the college. Elliotson felt the[Pg 2] insult keenly, indignantly resigned his appointments, and never afterwards entered the hospital he had done so much to establish. Despite the persistent and virulent attacks of the medical press, he continued his mesmeric researches up to the time of his death, sacrificing friends, income and reputation to his beliefs.

The fame of mesmerism spread to India, where, in 1845, James Esdaile (1808–1859), a surgeon in the East India Company, determined to investigate the subject. He was in charge of the Native Hospital at Hooghly, and successfully mesmerised a convict before a painful operation. Encouraged by this, he persevered, and, at the end of a year, reported 120 painless operations to the government. Investigations were instituted, and Esdaile was placed in charge of a hospital at Calcutta, for the express purpose of mesmeric practice; he continued to occupy similar posts until he left India in 1851. He recorded 261 painless capital operations and many thousand minor ones, and reduced the mortality for the removal of the enormous tumours of elephantiasis from 50 to 5 per cent.

According to Elliotson and Esdaile, the phenomena of mesmerism were entirely physical in origin. They were supposed to be due to the action of a vital curative fluid, or peculiar physical force, which, under certain circumstances, could be transmitted from one human being to another. This was usually termed the "od," or "odylic," force; various inanimate objects, such as metals, crystals and magnets, were supposed to possess it, and to be capable of inducing and terminating the mesmeric state, or of exciting or arresting its phenomena.

The name of James Braid (1795–1860) is familiar to all students of hypnotism. Braid was a Scottish surgeon, practising in Manchester, where he had already gained a high reputation as a skilful surgeon, when, in 1841, he first began to investigate mesmerism. He[Pg 3] successfully demonstrated that the phenomena were entirely subjective. He published "Neurypnology, or the Rationale of Nervous Sleep," in 1843, and invented the terminology we now use. This was followed by other more or less important works, of which I have been able to trace forty-one, but all have been long out of print.

During the eighteen years Braid devoted to the study of hypnotism, his views underwent many changes and modifications. In his first theory, he explained hypnosis from a physical standpoint; in the second, he considered it to be a condition of involuntary monoideism and concentration, while his third theory differed from both. He recognised that reason and volition were unimpaired, and that the attention could be simultaneously directed to more points than one. The condition, therefore, was not one of monoideism. He realised more and more that the state was a conscious one, and that the losses of memory which followed on waking could always be restored in subsequent hypnoses. Finally, he described as "double consciousness" the condition he had first termed "hypnotic," then "monoideistic."

Braid maintained an active interest in hypnotism up to his death, and, indeed, three days before it, sent his last MS. to Dr. Azam, of Bordeaux, "as a mark of esteem and regard." Sympathetic notices appeared in the press after his death, all of which bore warm testimony to his professional character. Although hypnotic work practically ceased in England at Braid's death, the torch he had lighted passed into France.

In 1860, Dr. A.A. Liébeault (1823–1900) began to study hypnotism seriously, and four years later gave up general practice, settled in Nancy, and practised hypnotism gratuitously among the poor. For twenty years his labours were unrecognised, then Bernheim (one of whose patients Liébeault had cured) came to see him, and soon became a zealous pupil. The fame of the[Pg 4] Nancy school spread, Liébeault's name became known throughout the world, and doctors flocked to study the new therapeutic method.

While Liébeault's work may justly be regarded as a continuation of Braid's, there exists little difference between the theories of Charcot and the Salpêtrière school and those of the later mesmerists.

II.—Theory of Hypnotism

The following is a summary of Braid's latest theories: (1) Hypnosis could not be induced by physical means alone. (2) Hypnotic and so-called mesmeric phenomena were subjective in origin, and both were excited by direct or by indirect suggestion. (3) Hypnosis was characterised by physical as well as by psychical changes. (4) The simultaneous appearance of several phenomena was recognised, and much importance was attached to the intelligent action of a secondary consciousness. (5) Volition was unimpaired, moral sense increased, and suggested crime impossible. (6) Rapport was a purely artificial condition created by suggestion. (7) The importance of direct verbal suggestion was fully recognised, as also the mental influence of physical methods. Suggestion was regarded as the device used for exciting the phenomena, and not considered as sufficient to explain them. (8) Important differences existed between hypnosis and normal sleep. (9) Hypnotic phenomena might be induced without the subject having passed through any condition resembling sleep. (10) The mentally healthy were the easiest, the hysterical the most difficult, to influence.

In England, during Braid's lifetime, his earlier views were largely adopted by certain well-known men of science, particularly by Professors W.B. Carpenter and J. Hughes Bennett, but they appear to have known little or nothing of his latest theories. Bennett's[Pg 5] description of the probable mental and physical conditions involved in the state Braid described as "monoideism" is specially worthy of note. Not only is it interesting in itself, but it serves also as a standard of comparison with which to measure the theories of later observers, who have attempted to explain hypnosis by cerebral inhibition, psychical automatism, or both these conditions combined.

(a) Physiological.—According to Bennett, hypnosis was characterised by alterations in the functional activity of the nerve tubes of the white matter of the cerebral lobes. He suggested that a certain proportion of these became paralysed through continued monotonous stimulation; while the action of others was consequently exalted. As these tubes connected the cerebral ganglion-cells, suspension of their functions was assumed to bring with it interruption of the connection between the ganglion-cells.

(b) Psychical.—From the psychical side, he explained the phenomena of hypnosis by the action of predominant and unchecked ideas. These were able to obtain prominence from the fact that other ideas, which, under ordinary circumstances, would have controlled their development, did not arise, because the portion of the brain with which the latter were associated had its action temporarily suspended—i.e., the connection between the ganglion-cells was broken, owing to the interrupted connection between the "fibres of association." Thus, he said, the remembrance of a sensation could always be called up by the brain; but, under ordinary circumstances, from the exercise of judgment, comparison, and other mental faculties, we knew it was only a remembrance. When these faculties were exhausted, the suggested idea predominated, and the individual believed in its reality. Thus, he attributed to the faculties of the mind a certain power of correcting the fallacies which each of them was likely to fall into; just as the[Pg 6] illusions of one sense were capable of being detected by the healthy use of the other senses. There were mental and sensorial illusions, the former caused by predominant ideas and corrected by proper reasoning, the latter caused by perversion of one sense and corrected by the right application of the others.

In hypnosis, according to this theory, a suggested idea obtained prominence and caused mental and sensorial illusions, because the check action—the inhibitory power—of certain higher centres had been temporarily suspended. These theories were first published by Professor Bennett in 1851.

III.—Hypnotic Induction

The methods by which hypnosis is induced have been classed as follows: (1) physical; (2) psychical; (3) those of the magnetisers. The modern operator, whatever his theories may be, borrows his technique from Mesmer and Liébeault with equal impartiality, and thus renders classification impossible. The members of the Nancy school, while asserting that everything is due to suggestion, do not hesitate to use physical means, and, if these fail, Bernheim has recourse to narcotics.

The following is now my usual method: I rarely begin treatment the first time I see a patient, but confine myself to making his acquaintance, hearing his account of his case, and ascertaining his mental attitude with regard to suggestion. I usually find, from the failure of other methods of treatment, that he is more or less sceptical as to the chance of being benefited. I endeavour to remove all erroneous ideas, and refuse to begin treatment until the patient is satisfied of the safety and desirability of the experiment. I never say I am certain of being able to influence him, but explain how much depends on his mental attitude and power of carrying out my directions. I further explain to the patient[Pg 7] that next time he comes to see me I shall ask him to close his eyes, to concentrate his attention on some drowsy mental picture, and try to turn it away from me. I then make suggestions of two kinds: the first refer to the condition I wish to induce while he is actually in the armchair, thus, "Each time you see me, you will find it easier to concentrate your attention on something restful. I do not wish you to go to sleep, but if you can get into the drowsy condition preceding natural sleep, my suggestions are more likely to be responded to." I explain that I do not expect this to happen at once, although it does occur in rare instances, but it is the repetition of the suggestions made in this particular way which brings about the result. Thus, from the very first treatment, the patient is subjected to two distinct processes, the object of one being to induce the drowsy, suggestible condition, that of the other to cure or relieve disease.

I wish particularly to mention that although I speak of hypnotism and hypnosis—and it is almost impossible to avoid doing so—I rarely attempt to induce so-called hypnosis, and find that patients respond to treatment as readily, and much more quickly, now that I start curative suggestions and treatment simultaneously, than they did in the days when I waited until hypnosis was induced before making curative suggestions.

I have obtained good results in treating all forms of hysteria, including grande hysterie, neurasthenia, certain forms of insanity, dipsomania and chronic alcoholism, morphinomania and other drug habits, vicious and degenerate children, obsessions, stammering, chorea, seasickness, and all other forms of functional nervous disturbances.

It is impossible to discuss the different theories in detail here, but I will briefly summarise the more important points, (1) Hypnotism, as a science, rests on the recognition of the subjective nature of its [Pg 8]phenomena. (2) The theories of Charcot and the Salpêtrière school are practically a reproduction of mesmeric error. (3) Liébeault and his followers combated the views of the Salpêtrière school and successfully substituted their own, of which the following are the important points: (a) Hypnosis is a physiological condition, which can be induced in the healthy. (b) In everyone there is a tendency to respond to suggestion, but in hypnosis this condition is artificially increased. (c) Suggestion explains all. Despite the fact that the members of the Nancy school regard the condition as purely physiological and simply an exaggeration of the normal, they consider it, in its profound stages at all events, a form of automatism.

These and other views of the Nancy school have been questioned by several observers. As Myers justly pointed out, although suggestion is the artifice used to excite the phenomena, it does not create the condition on which they depend. The peculiar state which enables the phenomena to be evoked is the essential thing, not the signal which precedes their appearance.

Within recent times another theory has arisen, which, instead of explaining hypnotism by the arrested action of some of the brain centres which subserve normal life, attempts to do so by the arousing of certain powers over which we normally have little or no control. This theory appears under different names, "Double Consciousness," "Das Doppel-Ich," etc., and the principle on which it depends is largely admitted by science. William James, for example, says: "In certain persons, at least, the total possible consciousness may be split into parts which co-exist, but mutually ignore each other."

The clearest statement of this view was given by the late Frederic Myers; he suggested that the stream of consciousness in which we habitually lived was not our only one. Possibly our habitual consciousness might[Pg 9] be a mere selection from a multitude of thoughts and sensations—some, at least, equally conscious with those we empirically knew. No primacy was granted by this theory to the ordinary waking self, except that among potential selves it appeared the fittest to meet the needs of common life. As a rule, the waking life was remembered in hypnosis, and the hypnotic life forgotten in the waking state; this destroyed any claim of the primary memory to be the sole memory. The self below the threshold of ordinary consciousness Myers termed the "subliminal consciousness," and the empirical self of common experience the "supraliminal." He held that to the subliminal consciousness and memory a far wider range, both of physiological and psychical activity, was open than to the supraliminal. The latter was inevitably limited by the need of concentration upon recollections useful in the struggle for existence; while the former included much that was too rudimentary to be retained in the supraliminal memory of an organism so advanced as that of man. The recollection of processes now performed automatically and needing no supervision, passed out of the supraliminal memory, but might be retained by the subliminal. The subliminal, or hypnotic, self could exercise over the vaso-motor and circulatory systems a degree of control unparalleled in waking life.

Thus, according to the Nancy school, the deeply hypnotised subject responds automatically to suggestion before his intellectual centres have had time to bring their inhibitory action into play; but, on the other hand, in the subliminal consciousness theory, volition and consciousness are recognised to be unimpaired in hypnosis.

IV.—Curative Value of Hypnotism

The intelligent action of the secondary self may be illustrated by the execution of certain post-hypnotic acts.[Pg 10] Thus, one of my patients who, at a later period, consented to become the subject of experiment, developed an enormously increased power of time appreciation. If told, during hypnosis, for example, that she was to perform some specific act in the waking state at the expiration of a complicated number of minutes, as, for example, 40,825, she generally carried out the suggestion with absolute accuracy. In this and similar experiments, three points were noted. (1) The arithmetical problems were far beyond her normal powers; (2) she normally possessed no special faculty for appreciating time; (3) her waking consciousness retained no recollection of the experimental suggestions or of anything else that had occurred during hypnosis.

It is difficult to estimate the exact value of suggestion in connection with other forms of treatment. There are one or two broad facts which ought to be kept in mind.

1. Suggestion is a branch of medicine, which is sometimes combined by those who practise it with other forms of treatment. Thus it is often difficult to say what proportion of the curative results is due to hypnotism and what to other remedies.

2. On the other hand, many cases of functional nervous disorder have recovered under suggestive treatment after the continued failure of other methods. Further, the diseases which are frequently cured are often those in which drugs are of little or no avail. For example, what medicine would one prescribe for a man in good physical health who had suddenly become the prey of an obsession? Such patients are rarely insane; they recognise that the idea which torments them is morbid; but yet they are powerless to get rid of it.

3. In estimating the results of suggestive treatment, it must not be forgotten that the majority of cases are extremely unfavourable ones. As the value of suggestion and its freedom from danger become more fully[Pg 11] recognised, it will doubtless be employed in earlier stages of disease.

4. It should be clearly understood that the object of all suggestive treatment ought to be the development of the patient's will power and control of his own organism. Much disease would be prevented if we could develop and control moral states.

Suggestions for Further Reading

Author: John Milne Bramwell was born in Perth, Scotland, May 11, 1852. The son of a physician, he studied medicine in Edinburgh, and after obtaining his degree of M.B., in 1873, he settled at Goole, Yorkshire. Fired by the unfinished work of Braid, Bernheim and Liébeault, he began, in 1889, a series of hypnotic researches, which, together with a number of successful experiments he had privately conducted, created considerable stir in the medical world. Abandoning his general practice and settling in London in 1892, Dr. Bramwell became one of the foremost authorities in the country on hypnotism as a curative agent. His Works include many valuable treatises, the most important being "Hypnotism: its History, Practice and Theory," published in 1903, and here summarised for the World's Greatest Books by Dr. Bramwell himself.

Source: THE WORLD'S GREATEST BOOKS JOINT EDITORS ARTHUR MEE Editor and Founder of the Book of Knowledge J.A. HAMMERTON Editor of Harmsworth's Universal Encyclopaedia VOL. XV SCIENCE WM. H. WISE & Co.

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