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Suggestion





Under the head of Adjuvants and Disturbing Factors in the psychic
treatment of patients come the various phases of life which make for
and against such a favorable state of mind as predisposes to the
continuance of good health, minimizes inhibition, and adds to
favorable suggestion. By modifying the modes of life, an ever renewed
set of suggestions is initiated. By definite instruction and advice
with regard to exercise, position, training, habit, pain, occupation
of mind and diversion of mind, patients may be profoundly influenced,
and gradually made to take on an entirely new attitude of mind towards
themselves. These chapters, then, while apparently much more concerned
with physiotherapy than psychotherapy, are really directions for the
use of such physical methods as by frequent repetition make the most
valuable suggestions. There is probably nothing more valuable in the
ordinary application of psychotherapy than these various auxiliaries,
with their power to remove disturbing factors, while, on the other
hand, nothing aids more in bringing relief for many conditions than
the removal of certain disturbing factors.

There is now a general recognition of the fact that suggestion in the
waking state can in most cases be as therapeutically efficient as
hypnotism, and is probably even more enduring in its effects when
successful, without the dangers and sequelae connected with hypnosis.
Every idea tends to act itself out. When we crave something, when
there are active ideas of desire, there usually are movements of our
flexor muscles. These affect the hands especially. At moments of
hatred, detestation or abhorrence our extensor muscles are affected,
as if we would wave these things away from us. There may even be an
involuntary turning of the trunk muscles, as if we would no longer
face what is abhorrent, though the repulsive thing may be present only
to the mind. It is not far-fetched to argue that, since the voluntary
function of muscles is thus influenced, other functions are also
touched by emotions, ideas, trains of thought, especially when the
mind is much concentrated on them.

Bishop, the so-called mind-reader, whose exhibitions attracted much
attention in London and New York some years ago, confessed that his
feats were accomplished mainly through muscle reading. He would permit
a committee to select a book in a library in a certain house, and even
a particular page of that book, and then, blindfolded, sitting
with the committee in a carriage with his hand on the forehead and the
arm of one of the committee, he would direct just where the carriage
should be driven and would, while always continuing his contact with
the member of the committee, go to the particular house and room,
select the special book, and eventually find the page. There was no
opportunity for collusion in some of these feats. The most startling
things were often accomplished by the system of forcing a choice which
prestidigitateurs use in order to compel the taking of the particular
card by suggestion (though all the time they seemed to be leaving
absolute liberty of selection to the person), but there was much,
besides this, required to accomplish what he did. He said that there
were always involuntary muscle movements, little starts and tremors
that guided him in his work. Other exhibitors have been able to use
this to a considerable extent, though not with Bishop's success. That
our thoughts can be read in our muscle system is interesting and
valuable confirmation of the unconscious tendency of ideas to affect
the body.

When a single idea occupies the consciousness it will, some
psychologists insist, necessarily act itself out unless some
distracting thought prevents it. We know how difficult it is to stand
at the edge of a height, say at the brink of a waterfall or on the
cornice of a high building, or to look down a mine or elevator shaft,
because the thought comes to us, how dreadful it would be to plunge
over. As a consequence of this insistent idea taking possession of our
consciousness, we have the sense of falling, we become tremulous and
have to withdraw, or we would actually fall, or find in ourselves a
tendency to throw ourselves over. There are persons who cannot even
sit in the front row of a balcony because of the constant effort
required to neutralize the suggestion that they may fall or throw
themselves over its railing. Curious sensations become associated with
this idea--a feeling of numbness and tingling in the back, sometimes a
girdle feeling, sometimes a sense of suffocation. All of these are due
to the concentration of attention on a single idea and its
suggestions.

Very few men, shaving themselves with an old-fashioned razor, have
not, at moments of worry and nervousness, sometimes had the thought of
how easy it would be to end existence by drawing the edge of the razor
through the important structures in the neck. Some are so affected by
this thought that they have to give up shaving themselves. It is a
surprise usually to find how otherwise sensible, according to all our
ordinary standards, are the individuals who confess to having had
annoyance from such thoughts. This illustrates how strongly suggestive
the concentration of attention may make an idea, and how much a single
idea, when it alone occupies the center of consciousness, tends to
work itself out in act, though there is no reason at all for willing
in that direction. It is not improbable that in some inexplicable
cases of suicide the tendency has actually worked itself out.

The expression, "he is a man of one idea," enshrines in popular
language the conclusion of psychologists that if a single idea is
present in the mind it will surely work itself out. We all know how
much men of one idea accomplish. All their powers, physical and
mental, are brought to bear on its development. Obstacles that deter
other men, conditions that prevent others from daring even to think of
doing the thing, seem as nothing to the man of one idea, and in
spite of discouragement, and even apparent failure, he often succeeds,
notwithstanding obstacles that seemed insurmountable. What is thus
true in the practical world is paralleled, for both good and ill, in
the microcosm of the human body. A man who has one idea to urge him on
is capable of accomplishing things in spite of pains and aches and all
sorts of disturbances of function. On the other hand, if the one idea
is unfavorable, then, in spite of a heritage of good physical and
mental powers, his efficiency is inhibited. If a man gets an idea that
there is something the matter with any organ, and concentrates
attention on it, he will surely disturb the function of that organ.
Just the opposite, however, will happen in case, even with physical
defect, he believes that there is nothing the matter, or only
something that can be overcome. This is the power of faith as
illustrated in the various forms of faith healing, from mental science
to Eddyism and the rest.

This is the power that the physician must learn to use. In The
Lancet for November, 1905, Dr. J. W. Springthorpe, writing on the
"Position, Use and Abuse of Mental Therapeutics," said:

Few indeed are the medical practitioners who daily prescribe
suggestion as well as diet, hygiene and drugs. Yet the physician who
makes even a minimum effort in this direction often does more for
his patient than his more highly qualified confrere, who makes none.
To some, and they naturally the most successful, this endeavor comes
without conscious search, and improves with experience, but in some
measure it may be acquired by all and no one who has become familiar
with its powers will henceforward be content to remain without its
constant aid.

This power is thoroughly exploited by the irregular practitioner, and
the regular practitioner is bound in duty to learn to use it just as
thoroughly.

What is true for the lesser faculties is eminently true for our most
important faculty, the intellect. We all know how intellectual
training enables us to accomplish without difficulty what at first
seemed almost impossible. Not only that, but we acquire the power to
devote ourselves to a subject that was at first irksome, if not
actually forbidding. There are educators who insist that this
discipline of mind, by which the power to devote ourselves to what we
do not care for is gained, is the principal fruit of genuine
education. It has been lost, or at least impaired to a great degree,
by educational experiments, especially those related to the elective
system which pushed interest, instead of discipline, into the
foreground of education. In the same way the power of self-control,
and the faculty of self-denial, so precious to the human race, have
been lessened by the methods of training which omitted the
consideration of these and emphasized the idea of personal comfort.
Much can be done to make the unpleasant things that are inevitable in
life not only tolerable, but actually to give a satisfaction
surpassing selfish pleasure. It is this discipline that is needed in
psychotherapy at the present time and the physician must endeavor to
encourage it by every means in his power.

The one purpose of the use of suggestion in therapeutics, then, is to
secure as far as possible concentration of mind on a single idea. This
is what is done in hypnosis, but frequently in such a way as to leave
the idea to work out unfavorably associated suggestions. If
there could, in the conscious state, be the same absolute
concentration of mind on an idea, a great force for good, without
accompaniment of ill, would be secured. Experience has shown that with
patient effort and definite methods such concentration of attention on
a single idea can be secured, at least to such an extent as to make it
efficiently therapeutic.

Ordinarily, suggestion accompanies the material remedies that the
doctor prescribes. He must emphasize just when and how the medicine is
to be taken, and it is well to emphasize the effects that are expected
and just about how they will come. If he is prescribing a tonic, he
does not merely say before meals. He specifies from ten to twenty
minutes before meals, according as he wishes it taken, with a definite
amount of water, stating that the taste of it will excite appetite and
that only food in reasonably liberal quantities will satisfy the
craving produced by it. If he is prescribing a laxative, he states
just when it should be taken and when its effects may be expected. The
arousing of expectancy does much to relax inhibition and to permit the
flow of nervous impulses that may be helpful. If a sleeping potion is
given, the patient is directed to compose himself for sleep
immediately after it is taken, or to take it just a definite time
before he gets into bed, and then to expect its action in the course
of twenty minutes or a half hour, designating rather definitely just
when it shall have its climax of effect. Two or three things done
together, as, for instance, a gentle rubbing with cool water over the
body to produce a glow, a warm foot-bath, and then a sleeping potion,
will combine to produce a climax of physical and psychical effect.

In many conditions that come for treatment to the modern physician,
the physical remedies are much less important than the psychical. This
is particularly true for the affections known as psychoneuroses, in
which some slight nervous disturbance is exaggerated into an extremely
painful condition or a disturbing paralytic state; in the so-called
hysteria of the older times; in the drug habits; in the sex habits; in
the over-eating and under-eating habits, and then with regard to
dreads and other psychic disturbances connected with dreams,
premonitions and the like. In all these cases it is important to
secure concentration of the patient's mind on a neutralizing
suggestion. This must be done deliberately and in such a way as to
secure thorough concentration of attention. It is often a time-taking
process, but nearly everything worth while requires time, and the
results justify the expenditure. Methods mean much in the attainment
of this. They must be impressive, the patient must be convinced of the
power of the physician to help him, and he must have trust in the
efficacy of the mode of treatment.

The patient should be put into a comfortable position, preferably in a
large, easy arm-chair, should be asked to compose himself in such a
way as to bring about thorough relaxation of muscles, and then to give
his whole attention to the subjects in hand. Occasionally the arms
should be lifted and allowed to fall, to see whether relaxation is
complete, and the knee jerks may be tested, to show the patient that
he is not yet allowing himself fully to relax. There should be no
lines in the face: the muscles around the mouth, and especially those
in the forehead, should relax. It is surprising how much can be
done, sometimes by slight touches on the forehead, to secure this. The
patient should then be made to feel that the tension in which he has
been holding himself, and which makes it so difficult for him to
relax, has really been consuming energy that he can use to overcome
the tendencies to sensory or motor disturbance, or to supply the lack
of will which makes him a victim of a drug or other habit, or takes
away from him that mental control that would enable him to at once
throw off dreads and doubts and questionings and bothersome
premonitions which now, because of the short circuiting on himself
through worry and nervousness, he cannot do.

Two or three seances usually show a patient how much better control
over himself even a short period of relaxation will give. He comes out
of a ten-minute session of relaxation, during which he has been talked
to quietly, soothingly, encouragingly, with a new sense of power.
Often he feels that there will be no difficulty in overcoming his
habit. This may pass, of course, but he has received a new idea of his
own resources of energy and self-control.

In most cases it is well, after securing relaxation, to ask the
patient to close his eyes gently and to keep them closed till all his
muscles are relaxed. Then suggestions may be made to him with regard
to his power to control cravings, and to put away doubts and
questionings, because, after all, as he sees them himself, they are
quite irrational and entirely due to habitual tendencies that he has
allowed to grow on him. A concentration of attention on the idea, not
only of conquering but of being able to conquer, will be secured.
Unless this complete attention can be had, suggestion in the waking
state may not prove efficient. There are nervous, excitable people for
whom, at the beginning, it will be quite impossible to secure such
relaxation and peaceful quiet as will be helpful to them. For these a
number of seances may be necessary, but on each occasion a little more
of quieting influence is secured.

In recent years, this quiet, peaceful condition, with eyes closed,
thorough relaxation and absolute attention, has sometimes been spoken
of as the hypnoidal state. If it be recalled that hypnos in Greek
means sleep, and that this is a state resembling sleep with the
restfulness that sleep gives, the term is valuable in its suggestions.
If, however, the word is connected with hypnotism, then there may be
an unfortunate connotation. This state is entirely free from the
dangers of hypnotism, and instead of making a patient dependent on his
physician, teaches him to depend on his own will. It is not a new
invention as this term hypnoidal might seem to indicate, but is as old
as our history at least.





Next: Exercise

Previous: General Principles Of Psychotherapy



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