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


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


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.

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