The hypnoidic state developed further, the patient living through, as in a dream, the whole experience that had taken place at that period. He was in a carriage, though he did not know who put him there. Then in a few moments he was again home, in his house, with his parents attending on him as in the onset of his first epileptiform seizures.
The attack terminated at this point, and thereupon he became perfectly passive, and when spoken to answered again in English. Now he was again twenty-one years old, was conscious of where he was, and was in absolute ignorance of what had just taken place.
It was found that an attack could regularly and artificially be induced, if the patient in hypnosis was taken back by suggestion to the period when the accident happened.
The experiment was now tried of taking him back to a period antedating the first attack. He was told that he was fifteen years old, that is, a year before the accident occurred. He could no longer speak or understand English, he was again in Rovno, engaged as a salesman in a little store, had never been in America, and did not know who we were. Testing sensation, it was found that it had spontaneously returned to the hand. There was not a trace of the anaesthesia left. The hands which did not feel deep pin pricks before now reacted to the slightest stimulation. Spontaneous synthesis of the dissociated sensory impressions had occurred. Just as formerly before the accident, sensation was in normal association with the rest of his mental processes, so now this association was re-established with the memories of that period to which the patient was artificially reduced.
The patient was now (while still believing himself to be fifteen years old) taken a year forward to the day on which the accident occurred. He says he is going to the ball tonight. He is now at the ball; he returned home; he is sent back to look for a ring. Like a magic formula, it calls forth an attack in which again he lives through the accident,—the terror and the spasms.
It was thus possible to reproduce an attack at any time with clock-like precision by taking him back to the period of the accident, and reproducing all its details in a hypnoidic state. Each time the fear and the physical manifestations of the attack (spasms, paresis, and anaesthesia) developed. These induced attacks were identical with the spontaneous attacks, one of which we had occasion to observe later.
At periodic intervals, as under the stress of fear, the dormant activity is awakened and, though still unknown to the patient, gives rise to the same sensori-motor disturbances which characterized the original experience. These subconscious dissociated states are so much more intense in their manifestations by the very fact of their dissociaton from the inhibitory influences of the normal mental life.
The psychognosis of such cases reveals on the one hand a dissociation of mental processes, and on the other hand an independent and automatic activity of subconscious psychic states, under the disaggregating, paralyzing influence of the fear instinct.
A patient under my treatment for four months during the year of 1922 presents interesting traits. I regard the case as classic as far as the fundamental factors of neurosis are concerned.
Patient, male, age 32, married, has two children. He lives in an atmosphere of fear and apprehension about himself. He comes from a large, but healthy family. The patient is of a rather cowardly disposition especially in regard to his health. He worked hard in a store during the day, and led a life of dissipation at night. One day, after a night of unusual dissipation, or orgy, when on his way to his work, he felt weak, he was dizzy, he became frightened about himself; he thought he had an attack of apoplexy, and that he was going to die. His heart was affected, it began to beat violently, and he trembled and shivered in an “ague” of intense fear. The palpitation of the heart was so great, the trembling was so violent, and the terror was so overwhelming that he collapsed in a heap. He was taken to his father’s store in a state of “fainting spell.” A physician was called in who treated the patient for an attack of acute indigestion.