Hypnotism. Despite the interpretation of the phenomena of hypnotism in accordance with the principles upon which the science of psychology is founded there is still a widely held belief that hypnotism is induced by the action of a mysterious force or fluid which emanates from the operator. This would make of the hypnotiser a superman to be feared or revered, trusted or avoided, in proportion as confidence was felt in his morality or integrity. All this is nonsensical. No other force or fluid flows from the operator while hypnotising a subject than flows from a child modelling a snow man.
The simple procedure in inducing hypnotism is first, to obtain obedience from and engender faith in the person to be hypnotised. The subject being in a submissive attitude, without antagonism of will, is then asked to look steadily at an object. The operator will then say to him over and over, “Go to sleep,” assuring him the while that he will inevitably do so, No mysterious, occult or superhuman power save that to inspire confidence is needed. Hypnotism is ordinarily induced by monotonous stimulation of one of the senses, such as fixed gazing, and passes with contact or through central stimulation by means of suggested ideas or by both together.
There is no doubt whatever as to the effectiveness of hypnotism in inducing sleep. The fact, however, that it involves on the part of the person hypnotised a complete surrender of the will power and that each successive abdication of effort will render the subject less able to exert his will, argues seriously against the use of hypnotism save as a last resort. The insomniac who relies upon the hypnotist for his sleep may find himself so dependent upon this unnatural and artificial subterfuge, as to be utterly unable to acquire sleep in any other manner. Hypnotism is all the more to be deprecated for the reason that direct or indirect suggestion during the waking state will prove fully as efficacious as suggestion made during the hypnotic state. If the insomniac prove himself not amenable to simple suggestion, then and then only should he avail himself of the aid of hypnotism. The advantage of hypnotism lies in the great susceptibility to suggestion of the individual hypnotised. The subject responds at once, even when the suggestion is made in the very lightest and shallowest stages of hypnosis. Indeed, in the treatment of insomnia by hypnosis the most successful practitioners only induce the lightest stages. Properly used, hypnotism may be of real service to the insomniac in aiding him to a restoration of a normal function, disturbed through apprehension or other emotional causes. But its use to overcome insomnia or any other disorder should be restricted narrowly to the physician and psychologist. The individual who seeks to avail himself of it for the relief of his suffering ought to feel absolute assurance that the person who utilises it knows what he is doing and what he aims to accomplish.
Suggestion. Much mystery surrounding the response of the body, to mental stimuli has been dispelled. Although we are far from being able to give a satisfactory explanation of the way in which the brain exerts its influence upon the remainder of the nervous system and upon the entire body, yet these effects having been definitely ascertained, the physician can avail himself of the cause with the confident expectation that the result which he desires will be attained.
The readiness of bodily action to follow upon mental conditions varies greatly in different subjects. Some measure of response to mental incitement is manifest in all and in many the reaction may be heightened by the appropriate conjunction of circumstances. The mental incitement may be accidental without personal volition and initiation of it may emanate from things within or without the individual. Or it may be deliberate and carefully planned and emanate from the volition of another.
The physician who employs mental suggestion in his treatment of insomnia must take into consideration the patient’s temperament, his manner of life, culture, social scale, personal and family history, specific beliefs, likes and dislikes, prejudices, aversions and many other features of his makeup. If the patient is religious, helpful suggestions may find ready lodgment in his mind while in meditation or in the midst of his devotions. If he is superstitious, suggestion arising from the possession of a charm will prove effective. If he is credulous, some plausible explanation, weighted with a large measure of the obvious will induce a sane condition. It is the belief of the patient that does the work.
Suggestion may be direct or indirect. Direct suggestion, verbal or personal, may be effectual of itself, but most generally the suggestion that is most potent is indirect and extra personal and proceeds from the environment. Thus music or devotion to any art, physical exercise, mental work, preoccupation in a favourable love affair or contemplation of some sublime ideal may bring about a remedial state of consciousness, whether the disorder be insomnia, introspection, or organic disease. An apparently unstudied remark to the nurse or a member of the family that the patient will soon be fast asleep often works better than the direct suggestion that he will not hear the clock strike ten because he will be asleep. This does not mean that direct suggestion, particularly when made after the patient’s mind has been prepared by explanation, expostulation or exhortation is not of value. It is, on the contrary, of great use and efficacy and in few conditions or states of mind is it more effective than in overcoming insomnia. The poor sleeper is so convinced that he will continue to “thread a dim and perilous way through words and things” that he falls into a state of fear and apprehension in which he dreads the advent of the night. He asks himself the purpose of his going to bed as he knows he will not sleep. He envies those who are sleeping and is convinced, even though he does not admit it aloud, that he will not sleep. I have had such patients tell me, “I was tired enough to sleep and I felt sleepy, but I could not get it out of my mind that I would not be able to go to sleep.” It is in such instances that direct suggestion works most beneficently. It calms the fear, counteracts the apprehension, uproots the conviction of inadequacy and fosters the will to sleep. It restores confidence and impregnates the individual with self-reliance. Often a sleeping draught on the night table will act quite as efficiently as if the insomniac took it. This is a most potent form of suggestion. The patient feels that there is something at hand that can rob the night of its terrors. His fears are calmed and he goes to sleep.
Drugs or substances that are inert and that have no soporific virtue act in a similar way. The insomniac believes that he is taking something that will make him sleep and so the miracle is accomplished with a few grains of bicarbonate of soda or a capsule of methylene blue. This is an extremely successful expedient with patients. The drawback to it is that the patient on finding that he has been deceived may shut himself off from all further efforts to reach him by suggestive methods.
An efficacious method used by the Emmanuelites is to invite the insomniac to sit in a certain chair, assuring him at the same time that every one of the sufferers from sleeplessness who has sat in that particular chair has gone to sleep almost immediately.
Many of the non-medicinal measures found useful in the treatment of insomnia, such as massage, electricity, diet and regimen act partly by virtue of the suggestion that accompanies their employment. Of course, they do good of themselves but much of their potency is derived from suggestion.