Psychotherapy by Hugo Münsterberg (world of reading .TXT) 📕

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.

The writer is a young man.