The patient, a man of middle age, highly educated, for years had heard voices calling his name. A man with whom he had some personal quarrel, had, as he believed, hypnotized him from a distance and made him act queerly or do things which he really did not want to do, by telepathic influence. It is a development which is found quite frequently. Abnormal organic sensations or abnormal impulses and inhibitions which the patient cannot account for by his own motives become connected with some vague ideas which are in the air, like wireless telegraphy or telepathy or hypnotism from a distance or electrical influence, or magnetism or telephoning, these then attached to an acquaintance who stands in a certain emotional relation. Here, too, some organic sensations evidently had been the starting point and the idea of the man with whom he quarreled had been secondarily attached. From this starting point more and more detail was reached. Every action was brought into connection with the powerful enemy who controlled more and more even the normal and reasonable doings of the patient. My first impression was decidedly that of a paranoiac. Yet in some ways the case suggested another view. There had remained an insight into the unreality of the obsession. The patient did not really believe the theory of the telepathic hypnotic influence. He felt it more as an idea which he could not get rid of and he did not know clearly himself whether he requested hypnotic treatment on my part for the purpose of counteracting the hypnotic power of his enemy or for the purpose of liberating him from his exasperating fixed idea. Moreover, I found that his voices had no hallucinatory character, but were merely sound images. I decided to make the experiment without great hope of success.
I hypnotized the man deeply and suggested that no one can have power over his actions, that he is the responsible originator of everything that he does and that no one can influence him and that from that hour he would feel free from any telepathic intrigue. The effect of the very insistent and urgently repeated hypnotic suggestion during the first rather long treatment was such a surprisingly good one that I decided to continue the psychotherapeutic cure. I hypnotized him daily for two weeks. The belief in the real wrong doings of an enemy disappeared entirely from the first. It was at once apprehended as a mere obsessing idea in the own mind and this idea itself began to be resolved. It lost its unity; the absurd impulses were still felt but they became less and less connected with the idea of another man, and as soon as they were rightly understood as doings of the own mind, the opposite motives gained in strength. A stronger and stronger appeal to his own power made these motives more and more influential. Slowly the association of the influence of the other man faded away entirely. I intentionally had not given any attention to the pseudo-voices, inasmuch as they had not taken any relation to the ideational delusion. I therefore did not include them in my suggestions, as I consider it wise to confine hypnotic suggestions always to as few points as possible. Yet these voices decreased too. At a certain point in the cure I substituted—to save my own time—an autosuggestive influence, or rather a mixed one, inasmuch as I had him read ten times a day a letter of mine which contained appropriate suggestions. After about six weeks, all the disturbances for which he had sought my advice had disappeared.
Obsessing ideas of such personal influence involve of course always a certain amount of emotional excitement and they may lead us to the unlimited field of disturbances in which the persecuting idea is surrounded by emotional attitudes. Analysis shows easily that the emotion is an essential factor and that it persists in the disease while the ideas to which it clings may change. Central is the emotion of fear; nearest to it that of worry, but any emotion may give color to the particular case. Again any number of methods may be applied and a few illustrations with quite different ways of treatment may indicate more fully the character of the trouble. There is no doctor in the city and none in the remotest village who may not find such cases in his near neighborhood. Of course slight degrees are easily hidden by the patient's own inhibition of external expression. If such suppression by the own will secures a real overcoming of the unjustified emotion, this is surely better than to begin any medical treatment. But as the suppression usually means simply lack of discharge and thus offers all the conditions for an unhealthy inner growth of the trouble, the neglect of such disturbances is most regrettable, and frankness of the patient must be encouraged. Such situation demands a careful observation of the whole case and a subtle adjustment of the treatment to the individual needs. It may perhaps be helpful at first simply to indicate the varieties of the more frequent disturbances of this kind by quoting from various letters. Each case belongs to a type which can easily be removed by psychotherapeutic influence, generally even by a skillfully directed autosuggestion.
"I have always, as long as I can remember, been very nervous and sensitive. When about seven years of age, I was attacked by St. Vitus' Dance. Before that I cannot say whether I was particularly nervous or not. Afterward it was impressed upon me by the remarks of relatives that I was nervous, so that I soon took note of this condition myself. The manner in which this weakness has been especially troublesome is that it has caused me to be very shy. I shrank from new acquaintances and disliked being observed. Often in walking along on the street, I imagined myself closely noticed by the passerby and I always felt uncomfortable.
"About three years ago I suffered from typhoid fever and after recovering, a new form of the old trouble showed itself. This time I imagined that when eating I chewed my food in a manner that was ridiculous and which made people hardly keep from laughter in observing me. Often I had to leave the table when half through because I felt I could not bear having critical eyes upon me any longer. About three months ago I determined to be troubled no further by my own foolish fancies and by constantly schooling myself I have improved very much. Still, however, when I walk alone along the street, I must fortify myself mentally before passing each group of people. If once I allow myself to think that they are looking at me, I feel almost paralyzed, my feet seem too heavy to lift, my arms do not seem to swing naturally, and in attempting to look placid and unconcerned, I feel that I am failing utterly. Also when at table, I must still tell myself before each mouthful that I have no need for fear, that my manner at table is equal and perhaps superior to the others beside me. I have gone a certain length in my self-training, and have relieved myself of a great deal of the mental distress, but now I believe I can advance no further. What seems needful now is to do away with the self-consciousness which brought on my worries, though whether this is possible is hard to say."
Here the letter of a young woman, the type which fills the army of the mind healers and faith curists.
"For years I have been seeking, or perhaps to be more accurate I should say waiting, for a mind to drift toward me; a mind that would understand my particular case of fear brought on by the constant bullying and nagging from my earliest childhood by those in my home. This fear of brutality has greatly depleted my nervous system and has unfitted me for the strong, useful, forceful life I should have expressed. If I could only rid my mind of the thought that I am always displeasing, or rather, going to displease people, for I hardly do displease them; if I could get rid of the fear of caring what the attitude of other minds toward me is, I feel that I should then strike out into a strong life of helpfulness to others. In other words I have always felt behind me a great force pressing me out into public work. When I was a child, it was so strong that I was sat down upon brutally, to so great an extent that I feared to voice my convictions and that fear still clings to me like a nemesis. It seems that every individual personality in a public or private audience rises up to overwhelm me, causing my tongue to grow heavy and my mind to become a blank. This enervating fear blends into every thought I have, whether sleeping or waking. I have fought with all my might to rid myself of it but so far in vain."
Here an expression of a very frequent variety. The writer is a middle-aged man.
"I am possessed of a fear that is constantly with me that something dreadful is going to happen and I do not seem to be able to overcome it. I am told by physicians that I am bodily sound, although very nervous, and that the fear is generated entirely by autosuggestion. When at its worst, it weakens and terrorizes me and in my better moments I am tormented with a fear of a recurrence of a bad spell. It is fear of a fear. A year ago at this time I had a very bad spell but got along fairly well through the summer, but I am afraid that I will soon again be in a bad condition and lose all that I may have gained."