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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




       SEEING that the delusion was giving way, that the soul and the spleen were out of the way, the nucleus of the delusion was then attacked. Instead of lumps, small spots were substituted, as the total annihilation of the former could not possibly be effected,―it would have met with too much opposition. The line of least resistance was to follow the delusion and now and then to effect modifications and substitutions. Immediately after emerging from his hypnotic state, the patient felt so well that he asked to be rehypnotized. The spots persisted, but they were now associated with pleasant affective states and happy moods. Upon awaking, the patient was happy and laughing, and declared that the "spots" (no longer "lumps") ran off very quickly, which gave him the highest satisfaction possible. "I do not feel mixed up," he said; "I like such treatment, for I sleep well; my toes are going to be dry; the spots do not stay thick, but thin; I am soon going to be well and happy. I wish the spots would move at night as they do now; I feel light in my feet; I feel bright and strong."

        In order to be more sure of the working of these subconscious dream agencies and also to get rid more effectually of the old memories, amnesia was specially enforced. To weaken the intensity of the melancholic delusional states they were projected into the far past of the patient's life. The patient was to feel them as past, as faint, as long gone by, as difficult to recall. In other words, the disintegrated elements as well as the disintegrating forces were merged into the subconscious, there to work out their effects without the patient's knowledge.

        This enforcement of amnesia is all the more important, because of the very effectiveness of the disintegrating forces: When a system present in the upper personal consciousness is to be disintegrated, the suggestions given should be kept out of the patient's personal memory. One can observe this fact clearly in post­hypnotic suggestions. If a post-hypnotic suggestion is fully remembered, it usually miscarries,―the suggestion loses its efficacy, and most often comes up as a word-memory without the stringency of realization, motor or sensory. When, however, amnesia is enforced, the post-hypnotic suggestion is fully realized. A dissociated system present in the subconscious when coming to the surface of the upper strata of consciousness becomes manifested with intense sensori­motor energy. Dissociation gives rise to greater dynamogenesis. This principle of dynamogenesis is very important, and cases of so-called impulsive insanities and psychic epilepsy are really due to this cause and are worked on this principle with great success.

        A system entering into the association with other systems is set into activity not only directly by its own appropriate stimuli, but also indirectly through the activities of the various systems associated with it. These associative interrelations bring about an equable and normal functioning activity, controlled and regulated by the whole mass of associated systems. The mass of associated systems forms the "reductives" of each individual system. In dissociated systems the controlling influence of the "reductive mass" is lost and the result is an over-activity unchecked by any counteracting tendencies.

        This relation of dissociation and dynamogenesis is closely related to periodicity of function with its concomitant manifestation of psychomotor activity characteristic of all passions and periodically appearing instincts; Dissociated systems present impulsiveness, because of lack of associated counteracting systems. The only way to diminish the overpowering impulsiveness with which the dissociated subconscious systems make an onset in their rush into the upper region of personal consciousness is to bring about an association, to work the dissociated system into the tissue of the patient's consciousness. As we shall discuss this principle of dynamogenesis in its proper place, we make here only a reference to the subject.

        Physiologically, it may be said that a neuron­aggregate, entering into association with other aggregates and being called into activity from as many different directions as there are aggregates in the associated cluster, has its neuron energy kept within the limits of the physiological level.1 A dissociated neuron-aggregate, on the contrary, is not affected by the activity of other aggregates; it is rarely called upon to function and stores up a great amount of neuron energy. When now an appropriate stimulus liberates the accumulated energy, the activity is overwhelming and is very much like the eruption of an underground volcano, giving rise to temporary attacks, to "seizures" by subconscious states of the whole field of the upper consciousness,―"seizures" which being really of the nature of post-hypnotic automatisms are generally mistaken for epilepsy, the attacks being regarded as epileptic manifestations, as "larval epilepsy," as "epileptic equivalents," as "psychic epilepsy."2 With the restoration of equilibrium of the neuron-aggregates, with the synthesis of the dissociated systems, a synthesis which can be brought about by different methods, the subconscious eruptions, attacks, or "seizures" vanish never to return. This principle of synthesis of dissociated systems is clearly demonstrated in our researches, some of which appear in the present series and will be fully developed in subsequent series.

        In cases where a stably organized system is to be disintegrated by the artificial formation of counteracting systems, the principle of dynamogenesis by dissociation is of the highest consequence.

        What was necessary to do in the case under investigation was to follow the lines of this dynamogenetic principle and enforce amnesia for the disintegrating agencies, in order to give them the energy of bearing down with full force on the central delusional system and shattering it into fragments, which in their turn were to be further dissolved in the subconscious and absorbed and assimilated by various systems to which they could offer but little resistance. At the same time pleasant dreams were inserted with full memory of them on awaking. The object of these dreams was to raise the pleasantness of the affective moods in waking states, Thus dreams were inserted in which the patient was to see one of the experimenters who was to assure him that the spots would soon disappear and that he would get well. In this way the forces that were at work day and night in undermining the delusional system could not possibly be counteracted by the patient's consciousness and were fully effective in their results.

        More often the dream states were absent from the patient's upper consciousness only in so far as content was concerned; what was remembered was their affective tone,―nearly all of them were pleasant. The patient used to tell that he had pleasant dreams, but that he had forgotten them. No effort was made to bring them out as it was rather preferred to have them remain in the subconscious. Sometimes what remained reverberating in the patient's mind after he had emerged from his normal sleep in the morning was just a phrase, "You are well and dry," evidently the remnant of some forgotten dream. The mode of breaking up the established system by means of dreams lapsing from conscious memory proved very successful; the patient used to wake in a happy mood feeling that his melancholic state was almost totally gone.

        One of the important modes employed in breaking up and dissolving the delusion was that of limitation of the delusional nucleus, The spots, instead of being left in the dispersed condition as conceived by the patient, were by a persistent effort more and more confined and limited to definite areas. By different modes, sensory and motor, the spots were finally confined to the legs and arms, while at the same time the Jumps were reduced to small spots, which the patient insisted on feeling as "wet"; hence they went under the name of "small wet spots," of which the patient made a diagram. The hole through which the lumps used to make their escape was of course preserved in order to have a well established place of exit for the small wet spots. Further limitation brought the spots down to the legs, and there they finally became confined to a single foot, and then most of them became localized in the toes. This limitation and localization of the spots on a small circumscribed area, so as to diminish the importance of the spots by the reduction of their massiveness and extension, met at first with much resistance. Only after persistent repetition did the attempt at limitation finally succeed.

        The sensation of wetness, which the patient attributed to the toes, was found to be very persistent. An attempt was therefore made to have this sensation assimilated to, or rather substituted by, a normal sensation,―that of sweat. It was expected that once this was effected the illusory or rather delusive perception of wetness could be removed in some very simple way, such as by thermic or electric stimulations. It turned out, however, that this wetness could not be removed, and although it could be assimilated to, or substituted by, the sensation of sweat, still that suggested delusional sweat of the spots could not be fused with the ordinary normal sensation of sweat of the toes. The patient persistently distinguished two kinds of sweat sensations: that of the' spots, which he termed "inside" sweat; and the normal, which he termed "outside" sweat. Suggestions given to the effect that the spots should be felt on the toes were not taken by the patient,―he felt the wet spots in the toes. It is very probable that the sensation of the spots was given rise to by some form of paræsthesia. The whole course of the process of dissolution was towards further disintegration of the now degenerated nucleus of the delusion, namely, the wet spots. The spots became limited to a small area, and the sensation of wetness was counteracted by a suggested sensation of dryness.

        One thing that specially deserves our attention is the fact that the delusion formed such a stably organized system that the only way of getting at it was to follow in its wake and attack it in the rear, so to say, but never face it. The patient was led by apparently closely following him. The complete destruction of the delusion and the full restoration of the healthy normal state had to be put in such a way as to make the patient feel that they came all of his own initiative, of his own free will, so to say. The diseased mental state is to disappear, and the healthy condition is to come spontaneously. Hence, it is highly characteristic to find that the patient often makes his own diagnosis as well as prognosis, and foretells changes in his own mental condition. This method of having the changes wrought in the patient's mind appear to emanate from his active sense of personality was demanded by the very nature of the case. This method was found highly satisfactory in other cases unlike this in character. The modifications effected by this method in the mental condition of the patient are permanent; they become part and parcel of his living personality. Meanwhile, the process of disintegration of the organized delusion went on slowly but surely.



1. "Neuron Energy," Archives of Neurology and Psychopathology, vol. i., p. 1. Link
2. "Epilepsy and Expert Testimony," State Hospitals' Bulletin, vol. ii., p. 189.


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