Adventurings in the Psychical

by H. Addington Bruce

He then explained that the one great cause of her ills was her insistent, if subconscious, brooding over the disappointment she had experienced, and that her cure depended upon her ability to overcome this mental attitude. Realizing for the first time, as a result of the dream analysis, that she was really in love with the man she had three times declined to wed, she soon solved the problem. Only a hint was needed to transform him into a suitor once more, and within a very few months they were happily married.[41]

Sometimes direct questioning is sufficient to enable the physician to get at the underlying mental cause of trouble. Take, for example, another case successfully treated by Doctor Donley.

The patient was a woman of thirty-five who was troubled by a constant and involuntary hacking, which sounded as though she were trying to clear her throat. Drugs, local applications, and electricity had been tried at intervals during more than four years, but to no purpose. On inquiry, it was found that the trouble had set in about five years before, when the patient, who was a mill hand, had suffered from a sore throat. The physician whom she then consulted told her that she had a bad case of tonsilitis, and that her tonsils would have to be burned out.

Greatly frightened, she had hurried home, refusing to submit to the operation. In a few days the tonsilar symptoms disappeared, and she returned to work. But she was attacked a second time three weeks later, and visited another doctor, to be informed that her tonsils were so badly diseased that it would be well to have them removed by cutting.

Again she refused to submit to an operation, but the fear of cutting, added to her previous fear, now revived, of burning out her tonsils, threw her into a highly nervous state. She then began to experience an unpleasant stinging, tickling feeling in her throat, which she tried to remove by hacking. As the tickling continued, the hacking became more and more frequent, and by the time she came under Doctor Donley’s observation had taken on the character of a “tic,” or uncontrollable muscular movement.

These facts in the early history of the case, the patient herself remembered only vaguely. But she confessed that she was still tormented by a haunting fear of a possible future burning or cutting of her tonsils. Finding her exceedingly suggestible, Doctor Donley made no attempt to hypnotize her. He merely requested her to close her eyes, remain perfectly passive, and listen attentively to him.

“She was then told, with much emphasis,” he says, in describing the treatment, “that her tonsils were perfectly healthy, that no cutting or burning ever was or ever would be required; that the tickling sensation in her throat arose from the constant fixation of attention upon this part; that she would feel no more desire to hack because her supposed reason for hacking had ceased to exist, and finally, that when she should open her eyes she would feel better than she had in a good many years.

“Much emphasis was placed upon this feeling of health, because it was desired to leave her on the crest of a pleasurable emotion, which of itself has a very great suggestive value. What had been predicted in her regard actually occurred. When she sat up, her tic had disappeared, and she expressed herself as feeling quite grateful and happy. The treatment lasted an hour, and except for two slight recurrences easily removed by waking suggestion, this patient has had no further difficulty.”[42]

Unfortunately, such an easy solution of problems like this is comparatively rare, particularly when, as in this instance, a physical trouble is superadded to the mental. Often—a fact which cannot be emphasized too strongly—it happens that, in dissociational cases, physical symptoms so far predominate as to lead to totally wrong diagnosis, even by experienced physicians. This results, as was hinted above, from the power inherent in subconscious “fixed ideas” of producing an endless variety of disturbances simulating true organic diseases, it may be diseases remediable only through surgical operations.

As a consequence, innumerable operations have been performed on patients who should have been given, not surgical but psychopathological treatment. I have in mind as I write a case of this kind that was called to my attention by a friend who participated in the lamentable affair.