The historical pathway leading to the present understanding of hypnosis is long and uneven, with apparent dead-ends and switchback trails along the way. It is a path people have created over an extended period of time out of quite different philosophies, beliefs, and scientific orientations, coming from diverse national backgrounds, and with varied motives.
Early accounts of phenomena that may have been what we now call hypnotic can be found in such sources as the Bible, the Talmud, and a 3000-year-old Egyptian stone stele. A technique using a lighted lamp in what seems to have been a self-hypnosis procedure is described in a document referred to as the Demotic Magical Papyrus which is now in museums in London and Leiden (British Museum Manuscript 10070 and Leiden Museum Manuscript 1.383). Descriptions of trance states and of miraculous healing among the ancient Greek oracles, Persian magi, Hindu fakirs, and Indian yogi indicate that all of these early peoples practiced forms of hypnosis. Similarly, the healing powers attributed for many centuries to the “royal touch” of kings and princes may be viewed as having a basis in hypnosis and hypnotic suggestion, as can the achievements of healers who used their hands, religious or mystical objects, or exorcism and prayer to cure the sick.
If my work is not accepted today, it will be tomorrow when there will be a new turn in fashion’s wheel which will bring back hypnotism as surely as our grandmother’s styles.
– Pierre Janet
During the sixteenth century in Europe, some attempts were made to provide scientific explanations for the existence and the cure of disease, which had until then largely been accepted as explainable only in supernatural or metaphysical ways. One of the earliest to attempt a more scientific explanation was Paracelsus (1493-1541), a Swiss-born alchemist and physician who theorized that magnets and the heavenly bodies had healing effects on human disease. During the next two centuries, similar ideas influenced the work of various astronomers, healers, physicists, and physicians. In 1679, a Scottish physician, Gui Maxwell, proposed that a universal and vital spirit affects all humans. Isaac Newton’s attempts to identify the natural laws underlying all living systems led English physician Richard Mead (1673-1754) to investigate the universality of life. And around 1771, a Viennese Jesuit, Maximilian Hehl, became famous for cures obtained by applying steel plates to the bodies of the ill.
These experiments and hypotheses inspired Franz Anton Mesmer (1734-1815), an Austrian physician, to write his medical dissertation about the influence of the planets on the human body . Mesmer developed the theory of animal magnetism, postulating a universal fluid present in all objects that produced disease when it was out of balance in the human body. Mesmer also developed techniques that he believed could restore the balance of the magnetic fluid and thus cure the diseases of his patients. His techniques included making “passes” over the bodies of his sick patients to draw the fluid with his own “magnetic influence” and cure such problems as urine retention, toothache, earache, depression, and paralysis. However, Mesmer’s claims for animal magnetism were not accepted by his Viennese colleagues, and he left for Paris in 1778.
In Paris he practiced even more theatrical techniques, in which groups of patients joined hands and applied to their bodies iron rods protruding from a large oak tub containing water, iron filings, and powdered glass. Accompanied by piano music, Mesmer himself would appear, dressed in a lilac silk robe and passing a long iron rod over the patients. These dramatic activities resulted in hysterical outbursts by those being treated-and, astonishingly, most were apparently cured after two or three such sessions. Mesmer was unable to formulate any convincing scientific explanation for these cures. He was again denounced as a quack by his colleagues, denied acknowledgment by scientific societies, and forced to leave the city.
But “mesmerism,” as it came to be called, had gained disciples and such wide interest in France that Louis XVI appointed a royal commission in 1784 to investigate and test mesmeric treatment. Benjamin Franklin, who was serving as United States Ambassador to France, joined the famous chemist Antoine Lavoisier, the physician Joseph Guillotin (now remembered for his advocacy of the machine named for him) and other scientists and physicians on the commission. After careful observation, the members agreed that some patients were indeed cured through mesmerism, but they doubted the existence of Mesmer’s universal magnetic fluid that could be transferred from him to inanimate objects and then to his patients. The commission finally concluded that “the imagination is the true cause of the effects attributed to the magnetism” (Tinterow, 1970, p. 114).
Despite the findings of the commission, mesmerism continued to capture the interest of many, leading to experimentation and related discoveries: Petetin observed and discovered catalepsy; the Marquis de Puysegur described “artificial somnambulism,” in which the ideas and actions of the “magnetized” patient could be directed by the “magnetizer”; and Barbarin discovered that he could “magnetize” without the use of paraphernalia.
Thus, new variations, theories, and uses were formulated out of the practice of mesmerism. Jose Custodi di Faria, an abbot who had lived in Portuguese Goa, a colony in India, gave public exhibitions of animal magnetism in Paris in 1814 and 1815, using neither the manipulations nor the elaborate equipment of Mesmer. Faria, who could induce somnambulism in his subjects with a simple command, felt that the resulting cures were not due to magnetism but rather to the expectations and the cooperation of the patients-elements now considered to be crucial to hypnotic induction.
French and American surgeons who were interestd in mesmerism began performing major operations using hypnoanesthesia and claiming good results. In England, John Elliotson (1791-1868), a professor of theology and medicine at London University, became an enthusiastic experimenter with mesmerism. Despite his distinguished status in the medical community (he was responsible for the introduction of the stethoscope in England) his lecture on magnetism before the Royal College of Physicians caused him to be denounced, criticized, and finally asked to resign his post. He continued his strong interest in the subject, however, and between 1842 and 1856 he published 13 volumes of a journal, The Zoist, concerning mesmerism and cerebral physiology. Elliotson also published a book in 1843, Numerous Cases of Surgical Operations Without Pain in the Mesmeric State, in which he concluded that the positive results he and his colleagues had observed were due to mesmeric passes, and that imagination had no role in the cures of his patient.
HYPNOSIS IN MEDICAL PRACTICE
Braid (1795-1860), a Scottish surgeon and a contemporary of Elliotson, was one of many distinguished contributors to our present knowledge who began as skeptics and later became ardent proponents of hypnosis. He was so skeptical about the claims of mesmerism that in 1841 he tried to expose it as a fake during a public demonstration by La Fontaine, a Swiss mesmerist on tour in Manchester. Instead, Braid became convinced that the girl on stage was in a genuine trance. His subsequent investigations of mesmerism left us with a new term-”hypnosis” – which he later tried to change to “monoideism,” and provided the basis for much of our present understanding.
Experimenting with friends and relatives, Braid found that he was able to produce a trance by having his subjects fix their eyes on a bright object, such as his lancet case. He also recognized that some people could enter a trance without a formal induction. In his investigations, he searched at first for a physiological basis for mesmerism but finally concluded that the French commission had been correct in rejecting the idea of a universal magnetic fluid or forces flowing from the operator’s body. Instead, Braid formulated a theory of hypnosis that included the contributing factors of expectation, imagination, and fixed attention bythe subject. His observation led him to recognize the power of the mind over the body and conclude that hypnotic phenomena are the result of suggestion and that the power of hypnosis resides within each person.
As others before him, Braid met with opposition and ostracism. He was criticized for his conclusions, not only by the mesmerists, but by the British Medical Association, which refused to allow him to present a paper and give a demonstration in 1842. However, he continued to use hypnosis for anesthesia during surgery, as well as self-hypnosis to ease his own arthritic pain. In Neurypnology; or the Rationale of Neroous Sleep (1843), Braid elucidated his theories and techniques. He also had early insight with an idea that he called “double consciousness,” which foreshadowed the investigations of Pierre Janet and Morton Prince into the phenomena of multiple personalities SO years later.
PSYCHOLOGICAL CHARACTER OF HYPNOSIS
While Braid is sometimes called the father of modern hypnosis for bringing hypnosis within the sphere of science, two Frenchmen who were working at about the same time have been considered the founders of modem psychotherapy. Ambroise-Auguste Liebeault (1823-1904) was a country doctor in Nancy who offered to treat his poor patients without fee if they would accept hypnotic treatment instead of more conventional approaches. His use of hypnosis in the treatment of illnesses was the subject of a book he published in 1889, Le sommeil provoque. It received little notice.
However, Liebeault’s work came to the attention of Hippolyte Bernheim (1840-1919), a professor of medicine at Strasbourg and a famous neurologist, when Liebeault cured a chronic case of sciatica in one of Bernheim’s patients. Hoping to expose Liebeault and his country clinic as fraudulent, Bernheim traveled to the clinic and was, instead, amazed. Within a short period of time, Bernheim went on to become an authority on the subject of hypnosis, and because he was known and respected in the medical profession throughout Europe, his theories could not be easily dismissed. Together, Bernheim and Liebeault clarified Braid’ s theories by recognizing the importance of imagination and the key role played by suggestion. They also viewed hypnosis as a function of normal behavior and recognized individual differences in response to suggestions. Bernheim published his now-famous book, De la suggestion et de ses applications a la therapeutique, in 1884. A milestone in the history of hypnosis, it called attention to the importance of Liebeault’s earlier work and cited many examples of cures to support the idea that hypnotic treatment is psychological rather than physical in nature. In his book, Bernheim claimed cures for such problems as hysterical hemiphlegia and aphonia, gastric difficulties, “depression of the spirit,” pains, tremors, and sleepwalking.
Liebeault and Bernheim were not unopposed in France. The great French neurologist, Jean-Martin Charcot (1825- 1893) also studied hypnosis but reached quite different conclusions. Working with a limited :mmer of patients at the Salpêtrière Hospital in Paris, he concluded that hypnosis was a pathological state and a form of hysteria. Nevertheless, the serious attention and experimentation given hypnosis by one of France’s greatest medical teachers fueled new interest in the scientific and medical communities. Sigmund Freud’s interest in the psychological source of neurosis was stimulated by his study of hysteria with Charcot in 1885. After Charcot’s investigations,entire journals devoted to hypnosis appeared in France and Germany; articles on hypnosis were printed in both medical journals and popular publications.
Although hypnosis had moved away from the dramatics of Mesmer and into modern scientific scrutiny by the 1800s, misconceptions and misinterpretations of this ancient phenomenon were still to occur during the next hundred years. Once Bernheim’s work had established the therapeutic possibilities of hypnosis, many experimenters began to apply hypnotic treatment to an assortment of ills. The list of such practitioners and the diseases they claimed to cure through hypnosis is a long one (Wolberg, 1948, p. 5-6). Success was claimed for such problems as hysteria, agoraphobia, satyriasis, nymphomania, homosexuality, drug addition, epilepsy, depression, skin diseases, and alcoholism. Children were treated for such disorders as incontinence, untruthfulness, and nail-biting.
In recent times, Ronald Shor (1972) pointed out an inherent ambivalencein hypnosis research: A researcher must maintain a disciplined, scientific skepticism, and yet maintain a confident persuasiveness to be a “positive catalyst” as a hypnotist (p. 15). In considering the list of ills and cures claimed by nineteenth-century practitioners, it becomes evident that they must have felt this difficulty and that their enthusiasm for “cures” overshadowed the necessary scientific skepticism. Followup studies were seldom done on presumably cured patients, and there was little understanding of the problems, often psychological, that lay behind the complaints.
Eventually, a few of those who were observing and studying the therapeutic methods of hypnosis began to look into the etiology of symptoms. French psychologist Janet, Prince in the United States, and others began to formulate hypotheses that proposed multiple systems of consciousness and underlying causes for manifest symptoms. But the research and observations of Josef Breuer (1842-1925) and Sigmund Freud (1856-1939) had the greatest impact on the subsequent study of causes hidden under symptoms. Although Freud finally took a position that rejected hypnosis as a therapeutic method, many of his contributions in charting the human psyche and in developing the process of psychoanalysis grew from his 1889 observations of Liebeault’s clinic in Nancy (Chertok, 1968). Watching Liebeault and Bernheim perform their “astonishing experiments,” Freud wrote later that he received “the profoundest impression of the possibility that there could be powerful mental processes which nevertheless remained hidden from the consciousness of men” (Freud, 1925/1953-1966, p.17).
Freud collaborated with Breuer, his colleague, in studying hypnosis and using it to encourage patients with hysterical symptoms to talk freely, often evoking revelations of long-repressed experiences that seemed in some way to cause the symptoms. Furthermore, the venting or catharsis provided by this spontaneous verbalization often led to the elimination of symptoms. Breuer and Freud published their studies together, Studien uber Hysterie (Studies in Hysteria, 1895/1957), but for Freud this was only a starting point for his further explorations into the unconscious mind.
By observing that many memories were inaccessible even while a patient was under hypnosis, Freud was able to hypothesize other forces that were keeping certain memories from consciousness. When he was unable to induce a somnambulistic trance in “Lucie R.,” Freud tried placing his hand on her forehead and encouraging her to repeat whatever came to mind. This was the beginning of the “free association” method, which would become a significant part of the psychoanalytic process. As Freud collected more evidence from his observations of the purposeful nature of symptoms in his patients, he concluded that the observed symptoms served an economic function in the psychic life of the patient and that symptom removal through hypnosis was not an adequate treatment.
Years later, in 1919, Freud would modify his rejection of hypnosis. In light of its usefulness in the treatment of war neuroses and with large numbers of people, he would speak of the need to blend “the pure gold of analysis plentifully with the copper of direct suggestion” (Freud, 1946, p. 402). But his early rejection of hypnosis slowed the development and understanding of hypnotic treatment. Despite its unpopularity, which was largely due to increased interest in Freudian psychoanalysis, hypnosis was still the subject of study by Janet (1859-1947), a contemporary of Freud. This great French psychologist and neurologist had begun in opposition to hypnosis but became a strong advocate after his investigations on relaxation.
Interest in psychoanalytic theory and the increasing use of chemical agents to produce surgical anesthesia caused a temporary decline in the use of hypnosis in medicine, as well. By the early 1900s, except for the studies of a small number of investigators like Janet, hypnosis was visible mainly in occult practices or in demonstrations meant for entertainment. But the need to treat men suffering from battle neuroses during World War I, and later during World War II and the Korean War, greatly increased interest in hypnotherapy. The hypnotic trance was used to remove symptoms directly and to treat soldiers who had repressed the emotions of traumatic battle situations. Under hypnosis, the soldiers were able to recall those situations and thus release the tension relating to their experiences. As a result of wartime use, techniques of hypnosis became more acceptable in the field of psychiatry and created a wave of enthusiasm for hypnotherapy.
After World War I, American psychologist Clark Hull (1884-1952) carried out experiments at Yale using more precise scientific and statistical methods than had been previously applied to research in hypnosis. He used control groups, for example, in experiments designed to determine the nature of hypnosis. Both unhypnotized and hypnotized subjects were exposed to the same experimental conditions so that investigators could observe the differences caused by the hypnotic induction process. In 1933, Hull reported his findings in Hypnosis and Suggestibility, in which he observed that “the essence of hypnosis lies in the fact of change in suggestibility” (Shor and Orne, 1965, p. 179). His meticulous methods of experimentation were important as precedent for further studies and for the development of standardized, objective procedures for research in hypnosis.
Near the turn of the century, Janet had predicted that hypnosis would return to fashion just as surely as outmoded styles of dress (Janet, 1925). After World War II, this prediction was well on its way to fulfillment . Practitioners in the fields of medicine, dentistry, and psychology showed increasing interest in the techniques of hypnosis, and the number of publications, both books and articles, reflected this growing interest. In 1945, a practicing psychiatrist, Louis Wolberg, published Hypnoanalysis, which included a detailed case history of a patient treated with hypnoanalytical techniques. This book has been called a landmark in the developing history of hypnosis because the author was willing to attempt some. combination of his classical Freudian orientation with the use of hypnosis.
In 1949, SCEH was founded in the United States, becoming an international society in 1959, when a second society, ASCH, was formed. The British Medical Association added new stature to the study and use of hypnosis when it passed a formal resolution in 1955 to approve hypnosis as a valid therapeutic technique for treating psychoneuroses and for relieving pain in surgery and childbirth. In 1958, the American Medical Association and the American Dental Association made policy statements recognizing hypnosis as a legitimate form of treatment in medicine and dentistry, and they encouraged training in hypnosis for students in those fields. In 1960, the American Board of Hypnosis in Dentistry was established to certify practitioners trained in the use of hypnotic suggestion. The American Psychological Association has also created a section for psychologists who are primarily concerned with hypnosis.
This chapter began with the observation that the historical pathway to the present understanding of hypnosis has been long and uneven. It is not yet clear just where the trail may lead, but it is certain that the subject of hypnosis-especially its neurophysiological and psychological aspects-is open for serious research, and that the availability and interchange of information among various fields of research has greatly increased.
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