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Boris Sidis, M. A., Ph.D., M.D.
William A. White, M.D., George M. Parker, M.D.

© 1908
Boston: Richard G. Badger




       THE whole make-up of the mental systems constituting the delusion was so firmly organized that the process of disintegration had to be started from various points and worked in different ways. Since the waking state was of a distinctly melancholic type, in which the central delusion was nigh inaccessible, the only way to attack it was through the subconscious, which presented the line of least resistance. Hypnosis, and the deepest stage of it, was the only practicable way of making any attempt at all to break up these stably organized systems constituting the central delusion. Direct emphatic suggestion during hypnosis is the most usual form of disintegrating stable systems, especially if the latter belong to the upper waking consciousness. The defect, however, of this form is the fact that it is not always permanent in its results, and that the disintegrated elements tend to reunite into groups and systems and re-emerge.

        The usual way is to have the systems disintegrated, submerged into subconsciousness, and then have them frittered away by various means largely dependent on the nature and individuality of the case in hand. In such cases possibly the method that suggests itself is that of substitution. Of special importance is the method of emotional substitution, and we shall see farther on what use was made of this method in this special case under investigation, a method that can be utilized in other cases of similar character, of which this particular case may be regarded as one of a type. What is specially important to point out in this case, and which at the same time is true of any other cases of like character, is the fact that the work of changing the delusional system had to be a slow one, the central delusion persisting- in spite of all insistent suggestions.

        Without directly touching the nucleus of the delusional system, some unimportant sensory changes were first attempted,―changes which could not possibly meet with any resistance. The lumps felt to the patient alternately hot and cold. This was to him a source of much annoyance. An attempt was made to have these delusional sensory experiences modified and if possible got rid of. This was but partially effected, and with great difficulty. The thermic changes of the lumps were no longer so troublesome; this evidently brought some relief in the general condition of the patient; the affective tone seemed to have become somewhat raised though to a very slight degree. On the whole, the method of substitution of sensory elements in the structure of the delusion, thus aiming to bring about a transformation of the delusional system and finally its disorganization, signally failed.

        Realizing that any attempt at modification in the delusional system, even by such an indirect method as that of sensory substitution, would be unsuccessful, the course of disorganizing the apparently unassailable systems had then to be taken up on altogether different lines. The delusion had for the present to be left alone. The direct modification of the delusion was impossible, whether by substitution or by any other direct method; in fact, it was only conducive to the strengthening of the central delusion. Whatever suggestion was given, whatever combination of stimuli was brought to act on the delusion, resulted in the increase of material and in further growth and development of this highly systematized and systematizing delusion. The very nature of the case did not allow of any direct action.

        The course taken, however, to bring about a disintegration was suggested by the character of the mental trouble and by the traits of the case under investigation. The vigor and growth of the delusion were to a great extent aided by the predominant melancholic affective conditions characteristic of the waking state. The delusion was in fact cemented and fortified by the melancholic emotional states. A change of these states, it was thought might in some way or other without changing the content of the delusion, affect this central organized system, this mental cancer, so to say.

        The changes of the affective states were not expected to modify directly the delusion, but being steeped, so to say, in a different affective mood the rigidity of the system might give way, it might lose its coherence, and thus make the process of dissolution practicable and possibly easy. All efforts then were naturally directed towards one purpose, toward the changing of the affective states forming the medium of the delusion. It was attempted to carry over the pleasant affective states and feeling of well­being present in the subconscious trance personality into the melancholic waking state, and thus displace the affective states of mental depression and substitute states of pleasure and well-being. In other words, the main purpose was to mingle and synthetize the dissociated emotional personalities, the melancholic, the gay, and the grave. Since the first and the second subconscious personalities, the gay and the grave, became mingled and synthetized in the course of their own growth and development, the gay emotional personality lapsing into the grave and forming a stable synthesis, the dissociated states were reduced to two. What had to be accomplished was the union or synthesis of these two contrasting emotional personalities.

        This fusion of the two emotional personalities was effected gradually and not without difficulty. At the later stages of this process of fusion, the work of disintegration of the central delusion also began. To go at it in a cautious methodical way, the work was started from the subconscious regions. For this purpose, dream states were employed. During hypnosis dreams were suggested to the patient with the object of effecting changes in the body of the central delusion. Although at first the results were rather meagre and by no means fully satisfactory, still the central system was on the way to dissolution. Thus in one of the dreams the patient's father was to come to him and tell him that he will soon get rid of the lumps and spots and become fully well. These dreams worked on the patient slowly and left their effects deep down in his subconsciousness. Thus in one of his hypnotic states the patient volunteered the remark that his father had told him the truth, and that his toes were really getting drier but that they were not yet completely dry.

        This method of working at the dissolution of the delusion by dream states was all the more important, because they really formed an indispensable substitute for the depressive, frightful dreams which aggravated the patient's melancholic condition and increased the stability of the delusion. Occasionally the bad dreams took the tipper hand in his sleep, but soon they ceased to work and gave way to the good dreams.

        When the two emotional personalities began to intermingle and the good dreams became well established, then some effect could be expected to result from assaults on the delusional vein, soul, and spleen. Finally the delusional soul and spleen were dissolved,―they dropped out of the delusion. The patient began to feel very happy. An electric current was substituted for the active soul, and the patient felt the change as highly beneficial. After emerging from one of the hypnotic states, he began to laugh and smile and told us he had had a good dream. "This is the first time I slept well; my spots are removed; since my last year's trouble this is my best sleep."


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