Table of Contents
HYPNOIDAL STATES AND SYNTHESIS
AFTER these hypnoidal states were discontinued for the day, the patient proceeded to enlarge on certain attacks which came later in the series and had not been revived in these states. Then, passing entirely over the attacks which had been previously re-associated, he arrived at the last attacks in the series, namely, those which had occurred at the hospital on the 7th of December and a few days following.
He recalled the hospital attack perfectly―described with great accuracy where he had been, whom and what he had seen, what had been said to him, and what had been his replies. These memories bad not been revived with any degree of success under hypnosis. At this time, however, they were perfectly recalled. No new causative factor other than the hypnoidal states had been introduced. It was the hypnoidal states alone which had initiated the greater degree of synthesis.
In the hypnoidal states which now followed, much of the content had been re-associated in the interval. The revival continued as follows:
He said: "I was on the St. Paul, when we were coming home from England. and I was on watch, and I had the bad feeling and fall down. The trimmer puts me on the side and runs to the engine room and gets the engineer. He say to the engineer, 'What is the matter with the man?' The engineer say, 'Get hold of his feet and carry him to the passageway, where there is more breeze.' Then two fellows come and look at me, and the engineer ask, if you ever see that before. One of the fellows say: 'Yes, I was on the Paris with him. It won't take long.' And then one gets water and lifts my head up, and I wake up."
The next: "I sit in the bar-room, and some one say, 'Come out, some one wants to see you.' I go out, and Lizzie was there, and we were standing. She say: 'You look pale in the face. You feel bad.' I say: 'No, I feel all right. If you go home, I will walk with you.' She say; 'No, you stay here. You look so bad.' Then I fall down against the steps. I lay there a moment, and Lizzie, she say, 'William, what is the matter?' She get hold of me and try to get me on the steps. Then I get up on my feet, and they tell me to go home. Then I say: 'I am all right. I am not sick.' Then they brought me before the house, and they call some one out to bring William upstairs. When I came in my own room, I wake up."
He continued: "The next time, I was walking up and down in the saloon, when I feel bad in the throat; and I sit down in the chair. The lunchman, he say, ‘What is the matter?' Then the longshoreman, he come, and the lunchman, he tell him, 'Keep away.' Then one of the longshoremen say, 'I never see a man get it so often as William get it.' One man say to another, 'Is it cramps, or what is it?' The lunchman say: 'Just keep away. That is no cramps. He only gets it when he gets excited. You never get cramps when you get excited.' They stand in front of me still. Then I wake up and go to the front door, and come back, and the lunchman ask, if I knew I had it, and I say: 'No. Was it hard?'"
It is to be noted that the aura is present throughout all the attacks.
He continued: "The next time, I feel the bad taste and pain. I sit down in the chair in the bar-room. I was only a little bit dizzy. I see everything that go on. After a few minutes, I get up on my feet."
"The next time, I was coming down-stairs, and I go to the lunchman and I sit down quick in the chair and he say, 'William, you want any coffee?' and I say: 'No, I just want to sit here. I think I get my trouble.' I sit there a moment, and then all is right. I do not lose my senses."
These light attacks were never before recalled in such detail. Not only have the attacks become re-associated, but much of the intervening psychic material which, while not dissociated, was at least feebly associated, has become synthetized. It will be remembered that his condition previous to coming to the hospital had been very confused. It will further be recalled that the inception of a continuous amnesia seemed apparent during this period. This lapsed content has now been accurately re-associated. He has given the date of his visit to the clinic, to the Marine Hospital, and to the Hudson Street Hospital. A slight mistake made at this time, purposely uncorrected by myself, involving the date of his first visit to me, was corrected two days later. He said that now it was possible for him to think of the whole series as they had occurred. He fully appreciated that only for the past ten days has he been able to grasp them so clearly. This is the exact period of the use of the hypnoidal method.
He sleeps easily and quietly. There are no further dreams. The remarkable change in his behavior has been noted by all his acquaintances,―by men who are not over-ready to notice fine distinctions. There have been no further attacks of any nature. He feels that there will be none. The last of the memories are now recovered:
He said: "I was on the Philadelphia, on my watch, and I was changing my clothes, and I dropped down. My friend come and look at me and put me on the bench. He come and stand and look at me, and I was lying on the bunk. Then I look at my clothes, and then get up and go through them. I was looking for some tobacco. The other fireman put me back in the bunk, and I start and sleep there, and I sleep only a few minutes, and when I wake up all the fellows have gone."
The next time: "Lizzie was coming down, and I was walking with her, when I had the bad taste in my throat and I fall down, and the people stop and look at me. She say to them, ‘It will be all right.' Then some man gave her a hand to help me up, and they start to clean my clothes, and I begin to walk up and down. Then she said, ‘Do you feel better?' I give no answer, because I have some pain, and I would not let her know that there was any. Then she say, 'Come on, we go home.' Then, on the corner of Cortlandt Street, I come to myself. I did not know I had it."
"The next time, I was in the fire-room and leaning against the ladder, and I have the bad taste and fall down. The fireman he come and lift me up and wet my face. The water-tender he come and say, 'Well, he get it again.' Then I get up, and sit down and hold my head in my hands. The water-tender, he say, ‘He will be all right soon. We don't need the other man.' Then I wake up."
"The next time, I was on the St. Paul. I feel bad in my stomach and fall down quick. The fireman, who was working, come and look at me. He say, 'What is the matter?' Then he call the engineer, and the engineer ask if he had it before. And the fellow say: 'Yes, he had it twice before. I saw him.' The coal-passer, he take my fire. I was sleepy for ten minutes. Then the engineer come and ask me, 'How you feel now?' and I wake up."
"The next time, I was sitting in the saloon on a chair, when I dropped down. Two longshoremen picked me up. I started to take my coat and shoes off. They keep hold of my hands and stop it. The boss, he was standing in front of me, and he say, ‘When he wake up I will tell him to go and get some medicine.' Then I put my shoes and coat on and sit up for a minute. I take my shoes and coat off, because I think I am in my own room. When I put them on again, I do it because I see I am in the saloon."
The hypnoidal states were continued. He said: "I was in the saloon when I feel bad. I go to the closet, that no one should see me. I drop clown and lay there a minute, and the lunchman come and pick me up. He say, 'What do you do here, William?' I say, 'Let me alone.' Then I drink a glass of water. Then he say, ‘Sit on a chair at the first table.' Soon I wake up and feel tired."
"The next time, I was walking up and down in the saloon. I fall down by the lunch bar. The lunchman come from behind and pick me up and put me on the chair. Some people come and look at me. The lunchman stand in front and keep both hands on my shoulders. When he take his hands from my shoulders, then I take off my coat. When I get my shoes off, the lunchman he say, 'William, you not upstairs, but down here.' Then I put on my coat again. Then they both say, 'I wonder what he thinks when he starts to put his coat off.' Then they put some water on my face and I wake up."
A few lighter attacks occurring after this were re-associated by the patient himself without, the use of the hypnoidal method.
The patient has had no attacks. His condition, mental and physical, is widely different from that displayed at the time, when first seen. He is well and has resumed his former occupation.
A review of the case shows a genesis of the aura and recovery of experiences of the psychomotor attacks, experiences belonging to dissociated mental states. It shows that these experiences, although dissociated, were recoverable. It clearly shows that what is often regarded as epilepsy does not really belong there,―that many a "typical” epilepsy may on a closer study turn out to be a functional psychosis. This is especially true of the so-called "psychic epilepsies," which, as the psychopathological researches of our laboratory on many other different cases incontestably demonstrate, are all pure functional psychoses, subconscious dissociated states, having the tendency to recur, periodically or not, with all the energy characteristic of a fully dissociated system, reproducing the original psychomotor conditions during the accident, and often closely mimicking the psychomotor manifestations of epilepsy.1
It further demonstrates the possibility in this case of recovering all the dissociated memories of the attacks. But, more than this, it definitely points out the great importance of bringing all these dissociated memories out of the depths of the subconscious and re-associating them in the synthesis of the upper personality, restoring all the lost psychic material to the contracted active personal consciousness, and thus bringing about a state of former mental activity which will maintain the formed synthesis.2