Piano Lesson Essay, Research Paper

In the mid-1860s, a French physician who had been working among the poor in a small village not far from Nancy, published a book on the therapeutic use of a form of sleep variously known as artificial somnambulism, magnetic, or hypnotic sleep.219 Unlike most of those who had preceded him,220 Ambroise-Augustin Libeault221 recognized the central importance of mental suggestion in the induction of hypnotic sleep and the enhanced susceptibility to mental suggestion that characterized a patient who had been hypnotized. Putting his patients into a light trance, he assured them that their symptoms were being relieved; and when they awoke, many found that their condition had improved.

When rumors of Libeault’s therapeutic successes reached the University of Nancy, they attracted the attention of Hippolyte Bernheim,222 the university’s renowned professor of internal medicine. In 1882, Bernheim visited Libeault and became convinced of the efficacy of his treatment methods. Returning to the university, he incorporated Libeault’s techniques into the regimen employed at the medical hospital, and refined and rationalized his approach.

In 1884, Bernheim published the first major account of his work, De la suggestion dans l’tat hypnotique et dans l’tat de veille.223 Here he provided an historical and theoretical analysis of the nature of suggestion and the suggestive nature not only of hypnotic phenomena but of all normal automatic behavior. In 1886, Bernheim revised and expanded this work, adding a section on the application of suggestion to therapeutics. Published as De la suggestion et de ses applications ? la th?rapeutique and translated into English in 1889 as Suggestive Therapeutics. A Treatise on the Nature and Uses of Hypnotism,224 this work is widely considered to be the classic treatment of mental suggestion.

In Suggestive Therapeutics, Bernheim provided the clearest and most detailed exposition of his theoretical views. While these views were not for the most part original,225 they were so effectively articulated and so well supported by clinical observation and Bernheim was a figure of such high scientific reputation that they exerted a powerful influence on late 19th and early 20th century psychology. Figures as diverse as Sigmund Freud, James Mark Baldwin, and Walter Dill Scott made significant use of Bernheim’s views.226

Suggestive Therapeutics also served as the definitive text for what came to be called the ‘Nancy School’ of ‘psychotherapeutics.’ Following its publication, enthusiasm for the therapeutic application of suggestion began to gather momentum; and by the turn of the century, the Nancy approach had become widespread, both within Europe and throughout the United States.227

For Bernheim, suggestibility was defined as the capacity to transform an idea directly and automatically into a sensation or movement. Sensations and movements so produced were respectively called ideosensory or ideomotor automatisms, where an automatism is any simple or complex activity proceeding without conscious monitoring, without conscious volition.

Suggestibility, Bernheim believed, was a natural state of the normal, healthy individual. Only when automatisms were consciously regulated by reason, attention, and judgment was suggestibility reduced. Any condition that tended to lessen the influence of consciousness, therefore, would tend to increase suggestibility.

Natural sleep was one such condition; so too was the artificial sleep of hypnosis. Hypnosis, on this account, was a state of enhanced suggestibility in which ideas provided to the subject by the hypnotist tended to lead immediately and directly to sensation or movement. Paradoxically, this state of enhanced suggestibility was itself induced by suggestion. The susceptible subject, told ‘you are getting sleepy, your eyelids are getting heavy, your vision is becoming blurry,’ lapsed into a state in which the conscious monitoring characteristic of the waking state was greatly reduced and suggestibility consequently increased.

For Bernheim, then, hypnosis was the result of suggestion rather than a separate and necessary prerequisite to it. Anyone willing to be hypnotized could be hypnotized; and all of the various hypnotic phenomena-catalepsy, automatic movements, illusions, active and passive hallucinations-could be produced in a willing subject through the influence of suggestion alone. Although others had hinted at this position, Bernheim was the first to take it explicitly and unambiguously.228

Since suggestibility, not hypnotic sleep, was the basic underlying phenomenon for Bernheim, he also argued that while hypnosis, and especially the deep sleep of somnambulism, helped eliminate the interference of conscious reason and judgment and therefore promoted suggestibility, it was not a prerequisite for suggestion to be effective. The influence of suggestion could be observed in the waking state just as it could under hypnosis.

This fact, together with the observation that both negative (inhibitory) phenomena such as paralysis and systematized anesthesia and positive (excitatory) phenomena such as ideomotor actions and hallucinations could be elicited in the subject through suggestion led Bernheim to the realization that suggestion could be turned to good effect in relieving subjects of unhealthy symptomatology. This was the method of suggestive therapeutics and it was to the elucidation of this method that Bernheim devoted the last section of his book.

After providing a short historical review of the various ways in which therapeutic use had been made of suggestion in the past, even when the effective mechanism was unknown to those who employed it, Bernheim presented almost 200 pages of detailed observations taken from his own clinical use of this technique. These case studies documented the use of suggestion in the treatment of diseases of the nervous system, hysteria, neuropathy, neuroses, paralyses, pain, rheumatism, gastrointestinal ailments, and menstrual disorders. Coupled as they were with a brilliant theoretical analysis of suggestibility, Bernheim’s observations provided both a persuasive argument for the use of suggestive therapeutics and a manual for how to proceed.