What, then, to begin with, is Dr. Janet's general conception of the psychological states of the advanced hysteric? "In the expression I feel," he says (L'Etat Mental, p. 39), "we have two elements: a small new psychological fact, 'feel,' and an enormous mass of thoughts already formed into a system 'I.' These two things mix and combine, and to say I feel is to say that the personality, already enormous, has seized and absorbed this small new sensation; ... as though the I were an amœba which sent out a prolongation to suck in this little sensation which has come into existence beside it." Now it is in the assimilation of these elementary sensations or affective states with the perception personnelle, as Janet terms it, that the advanced hysteric fails. His field of consciousness is so far narrowed that it can only take in the minimum of sensations necessary for the support of life. "One must needs have consciousness of what one sees and hears, and so the patient neglects to perceive the tactile and muscular sensations with which he thinks that he can manage to dispense. At first he could perhaps turn his attention to them, and recover them at least momentarily within the field of personal perception. But the occasion does not present itself, and the psychological bad habit is formed.... One day the patient—for he is now veritably a patient—is examined by the doctor. His left arm is pinched, and he is asked whether he feels the pinch. To his surprise the patient realises that he can no longer feel consciously, can no longer bring back into his personal perception sensations which he has neglected too long—he has become anæsthetic.... Hysterical anæsthesia is thus a fixed and perpetual distraction, which renders its subjects incapable of attaching certain sensations to their personality; it is a restriction of the conscious field."
The proof of these assertions depends on a number of observations, all of which point in the same direction, and show that hysterical anæsthesia does not descend so deep into the personality, so to say, as true anæsthesia caused by nervous decay, or by the section of a nerve.
Thus the hysteric is often unconscious of the anæsthesia, which is only discovered by the physician. There is none of the distress caused by true anæsthesia, as, for instance, by the "tabetic mask," or insensibility of part of the face, which sometimes occurs in tabes dorsalis.
An incident reported by Dr. Jules Janet illustrates this peculiarity. A young woman cut her right hand severely with broken glass, and complained of insensibility in the palm. The physician who examined her found that the sensibility of the right palm was, in fact, diminished by the section of certain nerves. But he discovered at the same time that the girl was hysterically anæsthetic over the whole left side of her body. She had never even found out this disability, and the doctor twitted her with complaining of the small patch of anæsthesia, while she said nothing of that which covered half her body. But, as Dr. Pierre Janet remarks, she might well have retorted that these were the facts, and that it was for the man of science to say why the small patch annoyed her while the large one gave her no trouble at all.
Of similar import is the ingenious observation that hysterical anæsthesia rarely leads to any accident to the limb;—differing in this respect, for instance, from the true and profound anæsthesia of syringomyelitis, in which burns and bruises frequently result from the patient's forgetfulness of the part affected. There is usually, in fact, a supervision—a subliminal supervision—exercised over the hysteric's limbs. Part of her personality is still alive to the danger, and modifies her movements, unknown to her supraliminal self.
This curious point, I may remark in passing, well illustrates the kind of action which I attribute to the subliminal self in many phases of life. Thus it is that the hypnotised subject is prevented (as I hold) from committing a real as opposed to a fictitious crime; thus it is that fresh ideas are suggested to the man of genius; thus it is—I will even say—that in some cases monitory hallucinations are generated, which save the supraliminal self from some sudden danger.
I pass on to another peculiarity of hysterical anæsthesiæ;—also in my eyes of deep significance. The anæsthetic belts or patches do not always, or even generally, correspond with true anatomical areas, such as would be affected by the actual lesion of any given nerve. They follow arbitrary arrangements;—sometimes corresponding to rough popular notions of divisions of the body,—sometimes seeming to reflect a merely childish caprice.
In these cases what is only a silly fancy seems to produce an effect which is not merely fanciful;—which is objective, measurable, and capable of causing long and serious disablement. This result, however, is quite accordant with my view of what I have termed the hypnotic stratum of the personality. I hold, as our coming discussion of hypnotism will more fully explain, that the region into which the hypnotic suggestion gives us access is one of strangely mingled strength and weakness;—of a faculty at once more potent and less coherent than that of waking hours. I think that in these cases we get at the subliminal self only somewhat in the same sense as we get at the supraliminal self when the "highest-level centres" are for the time inoperative (as in a dream) and only "middle-level centres" are left to follow their own devices without inhibition or co-ordination. I hold that this is the explanation of the strange contrasts which hypnosis makes familiar to us—the combination of profound power over the organism with childish readiness to obey the merest whims of the hypnotiser. The intelligence which thus responds is in my view only a fragmentary intelligence; it is a dreamlike scrap of the subliminal self, functioning apart from that self's central and profounder control.
What happens in hypnotism in obedience to the hypnotiser's caprice happens in hysteria in obedience to the caprice of the hypnotic stratum itself. Some middle-level centre of the subliminal self (to express a difficult idea by the nearest phrase I can find) gets the notion that there is an "anæsthetic bracelet," say, round the left wrist;—and lo, this straight-way is so; and the hysteric loses supraliminal sensation in this fantastic belt. That the notion does not originate in the hysteric's supraliminal self is proved by the fact that the patient is generally unaware of the existence of the bracelet until the physician discovers it. Nor is it a chance combination;—even were there such a thing as chance. It is a dream of the hypnotic stratum;—an incoherent self-suggestion starting from and affecting a region below the reach of conscious will. Such cases are most instructive; for they begin to show us divisions of the human body based not upon local innervation but upon ideation (however incoherent);—upon intellectual conceptions like "a bracelet," "a cross,"—applied though these conceptions may be with dreamlike futility.
In this view, then, we regard the fragments of perceptive power over which the hysteric has lost control as being by no means really extinguished, but rather as existing immediately beneath the threshold, in the custody, so to say, of a dreamlike or hypnotic stratum of the subliminal self, which has selected them for reasons sometimes explicable as the result of past suggestions, sometimes to us inexplicable. If this be so, we may expect that the same kind of suggestions which originally cut off these perceptions from the main body of perception may stimulate them again to action either below or above the conscious threshold.