Psychotherapy

by Hugo Münsterberg

Just this is the kind of suggestion with which we correct faulty action everywhere in our social circle; and yet small steps lead on from here to the case where perhaps the desire for alcohol has reached that pathological intensity in which the equilibrium is entirely disturbed and cannot be repaired without suggestions of a much more powerful character, given in a state of artificially increased suggestibility—in hypnotism. The principle of opening certain channels of discharge for the purpose of closing the opposite channels remains in the extreme case the same as in the more ordinary cases. The impulse to drink is a positive one, but the principle is not different where the impulse is negative. A friend who comes from the quiet country may feel unable to pass the busy square of the city. The fear of an accident holds back his steps, he cannot give the impulse to walk through the crowded rush of vehicles. Now either by words of advice, by persuasion or by showing the way, we may apply our suggestion, we open the channels of discharge for the necessary movements and thus decrease the excitability of those centers in which nervous fear was playing. And again small steps lead from here to the case of the psychasthenic sufferer whose phobia does not allow him to cross any square and where reënforced suggestion has to break open the ways for the walking movement when the square is reached.

Thus we are not far from a causal understanding of suggestive influences wherever actions are concerned, where movements are to be reënforced or to be suppressed and where antagonism of the motor paths is involved. But that does not seem to lead us nearer to the much larger group of states in which the whole suggestive process concerns apparently the interplay of ideas alone, where not actions but impressions are controlled by suggestion, where not impulses but thoughts are strengthened or inhibited. Here lies the real psychophysical problem which has been by far too much neglected in scientific psychology and has almost been hidden and made to disappear in the wonderful accounts of the hypnotists. But all those mysterious stories as to the achievements of suggestion cannot help so long as we do not understand the working of the process, and we shall have the better chance to understand it the more we keep away from the uncanny and mysterious results which refer to the most complex conditions, and rather seek to analyze the state in its simplest forms and compare it with other simple mental processes. The psychology of suggestion has suffered too much by the fascination which its most complex forms exert on a trivial curiosity.

Yet the problem of suggestion in the field of ideas stands after all not isolated. Instead of connecting it with the weird reports of mystic influence from man to man, let us rather link it with the simple experience of attention. There is no pulse-beat of our life in which attention does not play its little rôle. But does not attention share with suggestion the characteristic feature that some contents of consciousness are reënforced and others are suppressed? This negative, this suppressing character of attention is not a chance by-product, it is most essential. There is no attention without it. If I am studying, I do not hear the conversation around me, and if I listen to the conversation, my studies in hand become inhibited. If I enjoy the play on the stage and give to it my full attention, my memories of the day's work are suppressed; if I think of the happenings of the day, I am not attentive to the play and hardly notice what is going on. The inhibited impression may often disappear entirely. While I am reading I am not at all aware of the tactual and muscular sensations in my legs, and if I am completely absorbed by my book, I may not even notice that the bell rings. In short, we have here as the most characteristic relation, just as in suggestion, the fact that one mental state becomes vivid, and that others are losing ground, become less vivid, are inhibited and perhaps disappear entirely.

Of course, to point to the similarity between suggestion and attention is not a real explanation. It may be answered that attention simply offers the same difficulties once more. How can we explain in the attention process the fact that one idea, the one attended to, becomes vivid and that others evaporate? The difficulty evidently cannot be removed by simply saying that only one sensorial process can be developed in the brain at one time. The popular descriptions of attention easily make it appear as if such were the solution of the problem. If one sensorial brain part is intensely engaged, the remainder of the brain is condemned to a kind of inactivity. Yet such a dogma is hardly better than the old-fashioned one that the soul can have only one idea at a time. We know too well now that the psychophysical system is an extremely complex equilibrium of millions of elements. Thus every change must be explained with reference to this complex manifold. Above all, the facts simply contradict such an over-simple explanation, inasmuch as it is not at all true that only one content of consciousness can become vivid. Our attention does not focus upon one point at all but may illuminate a large field and thus give vividness to various complex groups. If I am thinking about a scientific problem, an abundance of reminiscences of previous reading and imaginative ideas of possible solutions, associative thoughts and conclusions are with equal vividness before my mind and the forthcoming thought may be influenced by this total combination. I have no right whatever to say that the idea of a certain solution excludes there in my mind the consideration of the books which I have read and of the discussions which I have heard. Emotions may be superadded. In short, a world of mental states may be held together by one act of attention. And new and ever new thoughts are shooting in, and all still find place there in the field attended to, while on the other hand my slight headache is inhibited and an appointment is forgotten. At a gay banquet, my attention may be given to the whole hall with all its color effects and its flowers, and to all that the table offers and to the music from the orchestra and to the jokes of my neighbors. It is not true that any one of those parts suppresses the vividness of the others, they seem rather to maintain and to help one another; and yet in the next moment, my neighbor may bring me news which absorbs my mind entirely and leaves no room for the flowers and the music and the meal. How far can psychology do justice to these characteristics of attention?

There seems to be but one way. The attended-to idea does not exclude every other idea, but it does exclude the opposite idea, and opposite to each other is here again that pair of ideas which lead to opposite actions, to opposite psychophysical attitudes. We must remember here the psychomotor character of our brain processes which we so fully discussed. We recognized the fundamental truth that there is no sensorial state which is not at the same time the starting-point for motor reaction. We recognized that the brain is by its whole psychological development a great switchboard which transfers incoming currents into outgoing ones and that its biological meaning lies in the fact that it is the center piece of an arc which leads from the sense organs to the muscles. We cannot conceive of those relations as complex enough; we know, of course, that millions of nerve fibers lead from the periphery to the highest psychophysical apparatus in the cortex of the brain and that millions of fibers bring about the interrelation between these central stations, but we must never forget that millions of fibers also represent the outgoing paths and that they too lead down to lower central motor instruments which are again in numberless corelations. Any impression is thus a starting point for attitudes and reactions and it is an empty abstraction to consider it otherwise. An idea is never, psychophysically considered, the end of the process, it is always also a beginning. No external action may follow, but the mental impulse to such is nevertheless starting in the highest center.

If we look at the landscape, every single spot of color, reaching a nerve fiber in our eye and finally a sensory cell in our brain, is there the starting point for an impulse to make an eye movement in the direction of the seen point. The eye may remain entirely quiet as the impulse to move to the right and to the left, to move up and to move down, may be equally strong, but those thousands of impulses work in the motor paths and only their equilibrium results in the suppression of the outer movement. With such motor scheme, we begin to understand the selective process in attention. An impression may be accompanied by other stimuli and associations, by thoughts and ideas, and thousands of sensory excitements may thus arise in the cortex, but only those have a chance for full vividness of development which coöperate in the motor action already started. Those impressions which would lead to the opposite actions have no chance because their motor paths are blocked and their own full development is dependent upon their possibility of expression. To close the path means to inhibit the idea which demands such action. We can attend to a hundred thoughts together, if they all lead to the same attitude and deed. We can look at the opera, can see every singer and every singer's gown, can listen to every word, can have the whole plot in mind, can hear the thousands of tones which come from the orchestra; and yet combine all that in one act of attention, because it all belongs to the same setting of our reactive apparatus. Whatever the one wants is wanted by the others. But if at the same time our neighbor speaks to us, we do not notice it; his words work as a stimulus which demands an entirely different motor setting as answer. Therefore the words remain unvivid and unnoticed.

To attend means therefore to bring about a motor setting by which the object of attention finds open channels for discharge in action. Which particular action is needed in the state of attention cannot be doubtful. Attention demands those motor responses and those inner steps by which the object of attention shows itself more fully and more clearly. When we give attention to the picture we want to see more details, when we give attention to the problem we want to recognize more of the factors involved, when we give attention to the banquet we want to grasp more of the pleasurable features. This aim of attention involves that, as part of such reactions, the sense organs become adjusted; we fixate the eyeball, we listen, and in consequence the object itself becomes clearer, and through the easy passage into the motor channels the whole impression becomes vivid. At the same time, all those associations must be reënforced and become vivid too which lead to the same action. On the other hand, the opening of the one passageway closes the path to the opposite action and inhibits the impressions which would interfere with our interest. Every act of attention becomes, therefore, a complex distribution in the reënforcement and inhibition of mental states.

Now let us come back to suggestion. It shares, we said, with attention, the power to reënforce and to inhibit. But if we examine what is involved in the suggestion of an idea, we find surely more than a mere turning of the attention towards one idea and turning the attention away from another idea. That which characterizes and constitutes suggestion is a belief in the idea, an acceptance of the idea as real and the dismissal of the opposite idea as unreal. Yes, we may say directly that it is meaningless to speak of suggesting an idea; we suggest either an action or, if no action is concerned, we suggest belief in an idea. If I suggest to the fearful man at twilight that the willow-tree trunk by the wayside is a man with a gun, I do not turn his attention to an abstract idea of a robber nor do I simply awaken the visual impression of one, but I make him believe that such an idea is there realized, that he really sees the person. If I suggest to him that he hears distant bells ringing or that he feels a slight headache, he may not be suggestible enough to accept it, but if he accepts it he is not simply attending to the idea which I propose but he is convinced of its real existence. The same holds true with the negative; if I suggest to him that the slight headache of which he complained has disappeared or that the smell which he noticed has stopped, I do not simply invite him to think of the absence of such sensations. It becomes for him a suggestion only if he becomes convinced that these disturbances have now become unreal. The same holds true for all those suggestions of ideas which belong to our practical life, the suggestions which art imprints on our minds, or which politics and religion impart. As long as we are under the suggestion of the novelist, we really believe in the existence of the heroine; we really believe in the validity of the political party principle; it is not an argument to which we simply give our attention, it becomes a suggestion only when the belief in its objective existence controls our minds. We may say in general that suggestions which are not suggestions of actions are without exception suggestions of belief. Actions and beliefs are the only possible material of any suggestion.

Yet what else is a belief than a preparation for action? I may think of an object without preparing myself for any particular line of behavior. Here in the room I may think of rain or sunshine on the street as a mere idea, but to know that it now really rains or shines means something entirely different. It means a completely new setting in my present attitude, a setting by which I am prepared to act along the one or the other line, to take an umbrella or to take a straw hat, when I am to leave the house. I may think of the door of this room as locked or unlocked without transcending the mere sphere of imagination, but to believe that it is the one or the other means a new setting in my motor adjustments. If it is locked I know that I cannot leave the room without a key. Every belief means the preparation for a definite line of action and a new motor adjustment in the whole system of motor paths, an adjustment by which my actions in future will be switched off at once into particular paths. And there is theoretically no difference whether my belief refers to the proposition that the door is locked or that a God exists in Heaven.

But if every belief is such a new motor setting, then we are evidently brought back to the mechanism which was essential for every suggestion of action on the one side and for every process of attention on the other side, namely, the mechanism of antagonistic movements. To prepare ourselves for one line of action means to close beforehand the channels of discharge for the opposite. The suggestible mind sees the man with a gun on the wayside because he is preparing himself in his expectation for the appropriate action; he is ready for the fight or ready to run away, and every line of the tree trunk is apperceived with reference to this motor setting. The smell, on the other hand, has disappeared under the influence of the suggestion because a new motor adjustment has set in, in which he is prepared to act as if there were no smell.