Review of Psychopathological Researches [1902] The Philosophical Review, 1903, 12, 232-236. |
Psychopathological Researches. By BORIS SIDIS. G. E. Stechert, New York, 1902.―pp. xxii, 329.
This is a book on the 'subconscious self' by Sidis and Drs. William A. White and George M. Parker have here reported the details of several cases of mental abnormality which they have treated successfully through what they believe to be the control of the subconscious selves of the patients. Only a few typical cases are reported, and the discussion of the theories and principles underlying the method of treatment is relegated, as we are told in the introduction, "to another work soon to appear under the title 'Principles of Psychology and Psychopathology.'" A brief outline of certain of the theories is sketched in the introduction by Dr. Sidis.
This method of only partially revealing theories which are evidently well advanced toward maturity in the minds of the writers, and of publishing applications before giving out explanations, makes it very difficult to form any final judgment of the value of the work. As mere cases of abnormality, these which are now reported add relatively little to the knowledge already at hand from the study of other cases which have been successfully treated. As cases which have been successfully treated, they are of much practical interest. If they are cases which have been more intelligently been diagnosed than earlier cases, and have been cured by the application of more fully developed and more rational methods than have ever been employed before, then they may be cases of first class importance. But their first class importance is not obvious from the present discussion. It is by no means certain from the few cases reported, or from the manner of the progress of these cases, that the cure was due to the alleged control of the subconscious. The uncertainty in regard to the meaning of the cases may be due to the preliminary character of the reports, or it may be due to fundamental defects in the theories and methods of treatment which the writers are advocating. This is just the question which it is impossible to answer until more evidence comes in.
The first case is that of a girl of thirteen, who suddenly passed from her normal condition into a boisterous, profane, and dangerous abnormal state. She was hypnotized, and exhibited all the usual phenomena of hypnosis. During the hypnotic state it was suggested to her that she would return to her normal condition and again be good as she used to be. This suggestion could not be carried over directly from the hypnotic state to the usual waking condition of the patient, but it was possible to carry the suggestion over indirectly through normal sleep. During hypnosis suggestion was given as emphatically as possible, and then the patient was told to pass into normal sleep. This normal sleep seems to constitute a kind of link between the hypnotic state and the usual wakening state. As the suggestion to be good began to affect ordinary waking life, the hypnotic experiments were abandoned for fear of interfering with the natural course of recovery.
The second case is that of a man who, through the use of alcoholic beverages, temporarily lost consciousness. Hypnotic experiments brought out the fact that his apparent loss of consciousness was not a change to mere automatism, but the substitution of a subconscious self for the normal self. This appeared in the fact that the subconscious self was reestablished in the hypnotic state and gave a full account of the man's doings during the period of its supremacy.
The third case illustrates the growth of a suicidal tendency in a young girl. It was traced through hypnosis to a series of events entirely forgotten by the ordinary personal consciousness. These events, which suggested suicide and were then apparently forgotten, continued to operate in the subconscious self as sources of auto-suggestion. Periodically these auto-suggestions became strong enough to overwhelm the normal personality.
The fourth case is that of a highly organized system of melancholic ideas. The melancholic personality thus formed had to be broken up by appealing to a subconscious self which appeared in the hypnotic state and was much more cheerful. The method was the same in this as in the first case. After the cheerful personality was discovered, it was carried over through normal sleep to the waking life.
The fifth case is one in which a young woman had acquired an apparently permanent distortion of the ankles, a serious hypersensitiveness of the skin, and an abnormality of the circulation in the lower extremities through an accidental sprain. The sprain had entirely healed, so far as the tissues were concerned, and the case was not approachable through the ordinary means of clinical treatment. Because of restrictions imposed by the family, appeal to hypnosis was not possible in this case. Treatment here consisted in a series of efforts to secure voluntary movements on the part of the patient. It is significant for any evaluation of the cases reported in this book, that the suggestions in this case were addressed to the personality normally and ordinarily present. The case seems to fit only very loosely into any category of subconscious personality.
The sixth and last case is one which would ordinarily pass for epilepsy, but was shown by hypnotization to consist in a succession of irruptions of a subconscious self which was controlled by certain memories and motives not known to the normal personality. The subconscious self was brought under control in a series of hypnotic experiments, and was eliminated after a long struggle, by absorbing it into the normal self.
The theory which is somewhat incompletely suggested and applied to all these cases is that the abnormalities described are purely functional. The patients suffered on the physiological side from a functional separation or dissociation of certain formerly well-established neuron-aggregates. This functional dissociation is not an actual organic degeneration of neuron tissue, but is a preliminary stage, which, if not checked, will always be followed by true organic degeneration. The whole neuron system of the normal individual comes to be broken up by such functional dissociations into a series of systems which are functionally, but not organically, separate. Each sub-group of neurons is the physiological seat of a subconscious personality. Subconscious personalities produced by functional dissociation appear clearly in every case of hypnosis, which is itself nothing but a stage of functional division of the neuron system. The mode of treating a patient, based upon this theory, is to hypnotize him, get control of the various subconscious personalities, and then by suggestion knit together a normal and well-organized personality, thus absorbing the other personalities and making them subordinate to the one true personality.
Functional dissociation is the only type which can be successfully treated by the method advocated. If actual degeneration of the neuron tissues sets in, the case passes out of the sphere of psychopathology into the sphere of physiological pathology. The method of determining whether a case is in the functional stage or is due to actual degeneration is to search for recollections of the normal state or the pathological state by means of hypnosis. So long as the patient can recover the lost state through hypnosis, or can perform reactions appropriate to the normal personality, the case is one of functional insanity, and can be approached by the methods described for reorganizing the self.
The presentation of cases and of theory by these authors is not satisfactory to the unprejudiced reader. That there are cases of abnormal mental life which can be cured by a systematic effort to reconstruct personality around some rational nucleus, no one is disposed to doubt. That there are periods of conscious life which do not seem to integrate with the ordinary systems of association that constitute the recognized self, every one will admit who studies carefully even the most common-place facts of normal life. That hypnosis is a form of dissociation comparable to these ordinary lapses from normal associative consciousness, though more marked and definite in type, seems to be the generally accepted view. If the term subconscious is needed to express certain of these facts and to guide in the efforts toward the reorganization of disorganized personality, then it is certainly important that the term should be clearly defined and intelligently used. If reorganization requires the use of means which are in themselves directly related to the dissociations which are to be overcome, then it is well that serious and extended experiments along these lines should be undertaken and fully reported. A few cases somewhat incompletely discussed will not establish the thesis of these writers.
There is at present a good deal of mythology about the 'subconscious,' and a good deal of apparent mystery about the motives of those who use 'suggestion' in its various forms. The only way to dispel this vagueness and uncertainty in our science of mental life is to be clear in theory and principle, and well supported in the materials on which to formulate these theories. The book before us is not satisfactory either in its theory or in its materials. The optimistic confidence of the writers on the basis of the cases reported is certainly not warranted. It is not impossible that in several of the cases the whole machinery of hypnotization was unnecessary by-play. Indeed, one case was successfully treated without the direct control of anything that could be called a subconscious self. Another one of the cases seems to have dragged along as it did just because the hypnotic experiment interfered seriously with the integration of the normal personality. The writers show themselves unable to consider the cases without prejudice and in the truly empirical spirit; for they continually reiterate, in regard to the case which was treated without hypnosis, the wholly unfounded belief that cure was slower than it could have been if they had been able to apply hypnosis. Furthermore, in a number of instances, especially in the one which dragged along so discouragingly, they found it necessary to modify their methods, so that it was after all not the subconscious self which was most important for the recovery. There is certainly need of more light on all these matters, and there is need of a more critical and definite use of terms. The theory will be put on a valid basis only when its fundamental conceptions are such that they can be accepted by the psychology of normal life as well as by psychopathology. We shall look with interest for the forthcoming, more elaborate treatise, in which the writers may succeed in clearing up the difficulties which we find in this book, and may succeed in establishing a method of treatment which will be of first class importance in dealing with functional insanity.
CHARLES H. JUDD