Psychotherapy

by Hugo Münsterberg

V
SUGGESTION AND HYPNOTISM[Contents]

Psychotherapy has now become for us the effort to repair the disturbed equilibrium of human functions by influencing the mental life. It is acknowledged on all sides that the most powerful of these influences is that of suggestion. This is an influence which is most easily misunderstood and which has most often become the starting point for misleading theories. Before we enter into the study of the practical effects of suggestion and the psychotherapeutic results, we must examine this tool in the hand of the psychotherapist from a purely psychological viewpoint. The patient may perhaps sometimes profit from suggestion the more, the less he understands about its nature, but the physician will always secure the better results, the more clearly he apprehends the working of this subtle tool. Of course, that does not mean that any psychology is able to explain the process of suggestion to a point where all difficulties are removed, but at least the mysteries can be removed and the effects can be linked with other well-known processes.

Let us be clear from the start that suggestion is certainly nothing abnormal and exceptional, nothing which leads us away from our ordinary life, nothing which brings us nearer to the great riddles of the universe. There is no human life into which suggestion does not enter in a hundred forms. Family life and education, law and business, public life and politics, art and religion are carried by suggestion. A suggestion is, we might say at first, an idea which has a power in our mind to suppress the opposite idea. A suggestion is an idea which in itself is not different from other ideas, but the way in which it takes possession of the mind reduces the chances of any opposite ideas; it inhibits them. It is indeed the best result of any successful education, that the teachings have taken hold of the mind of the young in such a way that all the opposite tendencies and impulses and wishes do not come to development. The well-educated person does not need to participate in a struggle between good and bad motives, for that which has been impressed upon his mind does not allow the other side to come up at all. Our life would be crowded with inner conflicts if education had not secured for us from the start preponderance for the suggestions of our educators.

The love of family and friends, of our country and our party are in the same way such suggestions. We may hear arguments for the other side, arguments which easily convince the man of the other party, but they do not appeal to us: they are emasculated before they enter our minds; they have no chance to overcome the resistance because suggestions stand in their way. No argument will overwhelm the suggestion which religion has settled in our inner life, and from this strongest suggestion which can stand against any temptation of life small psychological steps lead down to the little bits of suggestion with which our daily chance life is over-flooded. Every advertisement in the newspaper, every display in the shop-window, every warm intonation in the voice of our neighbor has its suggestive power, that is, it brings its content in such a way to our minds that the desire to do the opposite is weakened. We do buy the object that we do not need, and we do follow the advice which we ought to have reconsidered. And what would remain of art if it had not this power of suggestion by which it comes to us and wins the victory over every opposing idea? We believe the painter and we believe the novelist, if their technique is good. We do not remember that the inventions of their genius are contrary to our life experience; we feel sympathy with the hero and do not care in the least that he has no real life. The suggestion of art has inhibited in us every contrary idea.

Such daily experience shows us that suggestive power may belong to different men in different degree. There are lawyers whose arguments and whose presentation open our mind, it seems, to any suggestion: while others leave us indifferent; we understand their idea, we follow their thoughts, and yet we remain accessible to opposite influences. There are teachers whose authority gives to every word such an impressiveness and dignity that every opposite thought disappears, while others throw out words which are forgotten. On the other hand, the readiness to accept suggestions is evidently also quite different with different individuals. From the most credulous to the stubborn, we have every degree of suggestibility, the one impressed by the suggestive power of any idea which is brought to his mind, the other always inclined to distrust and to look over to the opposite argument. Such a stubborn mind is indeed not only without inclination for suggestions, but it may develop even a negative suggestibility; whatever it receives awakens an instinctive impulse towards the opposite. Moreover we are all in different degrees suggestible at different times and under various conditions. Emotions reënforce our readiness to accept suggestions. Hope and fear, love and jealousy give to the impression and the idea a power to overwhelm the opposite idea, which otherwise might have influenced our deliberation. Fatigue and intoxicants increase suggestibility very strongly. To look out on a wider perspective, we may add at once that an artificial increase of suggestibility is all which constitutes the state of hypnotism.

At first, however, we want to understand the ordinary process of suggestion in that normal form in which it enters into every hour of our life and into every relation of our social intercourse. But if we begin to examine the structure of the process, we can no longer be satisfied with the vague reference to ideas and their opposites. What does it mean after all if we speak of opposite ideas? Can we not entertain any ideas peacefully together in our consciousness? From a logical standpoint, ideas may contradict each other, but that refers to their meaning. As mere bits of psychological experience, I may have any ideas together in my consciousness. I can think summer and winter or day and night or right and left or black and white or love and hate in one embracing thought. As mere mental stuff, the one idea does not interfere with the other. On the other hand, this is evident: I cannot will to turn to the right and to turn to the left at the same time. There may be a wrangling between those two impulses, but as soon as my will stands for the one, the other is really excluded. Any action which I am starting to do thus crowds out the impulse to the opposed action.

In the sphere of psychological facts, we have here indeed the only relation between two happenings which necessarily involves an opposition. We could never understand why one brain cell might not work together with any other brain cell, but we do understand that nature must provide for an apparatus by which the impulse to one action makes the impulse to the opposite action ineffective. There is no action which has not its definite opposite. The carrying out of any impulse involves the suppression of the contrary impulse, and the impulse not to do an action involves the suppression of the impulse to do it. When we spoke of the relations of mind and brain, we mentioned that such a corelation of mental centers indeed exists. Physiological experiments have demonstrated that the activity of those centers which stimulate a certain action reduce the excitability of those brain parts which awaken the antagonistic action. As far as the world of actions is concerned, the mechanism of the process of suggestion thus seems not inaccessible to a physiological understanding.

Various ideas of movements to be carried out are struggling for control in the cortex of the brain. That is the normal status which precedes any decision. The channels of motor discharge are open for both possibilities; we may turn to the right or to the left. Then the play of associations begins. A larger and larger circle of ideas surrounds the idea of the one and of the other goal. Those ideas awaken emotions. On the one side may call our duty and on the other side our pleasure. Larger and larger parts of the central content of our consciousness, of our own personality, become involved; our principles and maxims, our memories, our hopes and fears, enter into the battle until deeper strata of the idea of ourselves enter into a firm association with the one side, reënforcing, perhaps, the idea of the goal at the right. This opens wide the channels of discharge for the movement to the right and inhibits thereby the excitability of the center which leads to the opposite action. The channel of discharge to the movement towards the left becomes closed, the idea of that movement fades away and becomes inhibited: we are moving towards the right. The outcome was the product of our total personality.

But this result would have been different, if from the start the channels of discharge had not been equally open for both possible movements, and if thus the relative resistance to the impulse had not been equal on both sides. If, for instance, we had gone from the given point frequently to the left, as a result of the habit and training, the impulse to the left would have found less nervous resistance. The channels would have become widened by the repetition and the opposite channels would have been somewhat closed by the lack of use. Or if instead of such previous habit, we should see at the decisive moment others turning to the left, the impression would have become the starting point for a reaction of mere instinctive imitation. While we might not have followed that imitative impulse at once, yet the channels would have been widened, the discharge in the direction would have been prepared by it, the resistance would have been lowered and the chances for the opposite movement would have been decreased. Those people who moved to the left gave us by their action the same kind of an impulse which they would have furnished if they had begged us with words, or if they had ordered us to follow them with authoritative firmness. In each of these cases, the influence would have amounted to a suggestion. Whether we watched the movements of other people or whether their words made an impression on us, in either case the way became prepared for a certain line of action and therefore the way for the opposite action became blocked. The final outcome was thus no longer an entirely free play of motor ideas, but there was a little inequality in play. The one had from the start a better chance, the other was from the start laboring under difficulties. The suggestion of actions is thus nothing but making use of the antagonistic character in the nervous paths which start from the motor centers. That all such phrases as the opening and the closing, the widening and blocking, of channels of discharge are only metaphors hardly needs special emphasis. Instead of such comparisons, we ought rather to think of chemical processes which offer various degrees of resistance to the propagation of the nervous excitement.

We see from here the direction in which many psychotherapeutic efforts must lie, efforts which are entirely within the limits of the daily normal experience, and belong to the medical practice of every physician, yes, to the helpful influence of every man in practical life. The intemperate man may suffer from his inability to resist his desire for whiskey. The idea of his visit to the saloon finds the channels of discharge open. We argue with him, we tempt him by attractions which lead to other ways, we suggest to him that he spend those evening hours perhaps with friends or with books for which we awaken his interest; we do it as impressively as we can, we appeal to his friendly feeling for us; and if again the hour comes in which the desire for the artificial stimulation sets in with a motor impulse towards the bottle, the channels for discharge have now been blocked. The idea of the opposite action arises, it associates itself with the emotions which we stirred up in his mind, it associates itself with the respect for the adviser, and thus new clusters of thought reënforce that idea of action which we suggested, and this opposite line of action now finds a minimum resistance because our appeal has opened beforehand the gate. The desire for the book works itself out into action while the desire for the cup finds increased resistance.