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THE BIGGEST MYSTERY  by  Dr Graham Wagstaff

Having discussed some of the many phenomena attributed to hypnosis, and the associated semantic jungle, it may be useful to look again at how the whole muddle of metaphors might have come into being. I am very fortunate in that my task may have already been done for me in an excellent book by Thornton (1976), Hypnotism, Hysteria and Epilepsy, which provides a compelling solution to what is probably the greatest mystery in hypnosis, that is, how did so many disparate phenomena become linked to the term ‘hypnosis’? How did Mesmer’s writhing, convulsing patients come to be classified alongside subjects responding to suggestions for body sway and arm levitation, lifting weights, experiencing hallucinations, committing anti-social acts, falling into a state of profound relaxation and so on?   In all probability the connection is the result of a bizarre set of historical circumstances.  The possibility exists that many of these phenomena are related by historical misjudgment and error, rather than by some central unique ‘hypnotic’ property.  As Thornton so aptly puts it, the history of magnetism from which hypnosis arose ‘is a comedy of errors’ (p.43).     

   In Chapter I a brief overview of the history of hypnosis was given in which it was emphasised how different investigators managed to get their subjects to display a variety of behaviours which have now become integrated into our concept of hypnosis.  However, it is not clear from most historical accounts whether the varieties of behaviours were just ‘chanced upon’ or whether they developed from some central source.

   Thornton (1976) provides a most convincing case for the proposition that the source of the behaviours we now attribute to ‘hypnosis’ resulted from the misdiagnosis of an ancient malady, epilepsy.

   Epilepsy itself is difficult to define, but, in terms of neurophysiology, it is a condition characterised by seizures stemming from excessive neuronal discharge within the nervous system which can be caused by a variety of lesions in the brain, including scar tissue, atrophy, tumour, and inflammation (Zax and Cowen, 1976).  The first type of epilepsy to be noted was the ‘grand mal’ type, characterised by firstly a ‘tonic’ phase of tenseness and rigidity, followed by convulsions (a rapid alternation of contraction and relaxation), known as the ‘clonic’ state.  During the later clonic state the opening and closing of the jaws may produce frothy foam round the mouth.  Another type of attack is the ‘petit mal’ seizure, involving a dimming of consciousness in which the patient becomes totally or largely unaware of what is happening around him.  This is accompanied by immobility.  Sometimes these seizures are so brief that the patient may not be aware they have occurred.  Sometimes the seizures may be limited to certain parts of the body, but showing the same tonic and clonic phenomena; such attacks have been termed ‘Jacksonian seizures’.  In other instances, in ‘twilight states’, the patient may be quite still in a state of drowsiness or able to move about and talk without obvious sign of impairment, but he is either totally or partially unaware of his surroundings.

   Thornton begins his analysis of hypnotism and epilepsy by carefully reviewing the reports of Mesmer’s procedures and the responses that Mesmer’s patients manifested.  He was particularly interested firstly in the techniques that Mesmer employed; these included the use of music, the tactile manipulation of the patients’ bodies and the use of lights in a dark room.  According to Mesmer these factors were an essential feature of ‘animal magnetism’, about which he made comments such as, ‘It is like light, increased and reflected by mirrors’, ‘it is communicated, propagated and increased by sound’, and ‘By its aid the physician…can provoke and direct salutary crises, so as to completely control them’ (Thornton, 1976), p.6).  Even the most sceptical of early observers were convinced that in some patients the effects of these procedures were ‘real’ and not feigned. The convulsive fits of some of Mesmer’s patients were at times violent and characterised by ‘precipitate and involuntary motions of all limbs of the body, by a contraction of the throat, by sudden affections of the hypochonders and epigastrium….’ (Thornton, 1976, p.8).  In fact, it was often the very gruesome nature of these responses, which included becoming blue in the face and foaming at the mouth, which convinced the Commission investigation Mesmer’s claims that their therapeutic value was negligible.

The report of the Commission included statements such as, ‘How can we imagine that a man, be his disorder what it will, can need in order to his recovery the intervention of crises, in which the sight appears to be lost, the members stiffen, he strikes his breast with precipitate and involuntary motions, crises in a word that are terminated by an abundant spitting of viscous humours and even blood?’ (Thornton, 1976, p.10).  These crises were also apparently preceded or followed by a comatose condition.  Mesmer’s aim was actually to produce these convulsions or crises, as he believed that having brought the disease to a head, recovery would take place, and his speciality was the treatment of diseases of the nervous system.  Having examined these accounts Thornton came to the conclusion that in many cases the disease of the nervous system that Mesmer was supposedly treating was epilepsy.  The relationship between the sound, touch and light stimuli (as used by Mesmer) and the production of convulsive fits is well known in cases of epilepsy.  The precipitation of epileptic fits by music (musicogenic epilepsy) is well documented in modern literature, similarly the use of light (photogenic epilepsy) and touch (tactile precipitation). If we accept Thornton’s conclusion that the convulsion of some of Mesmer’s patients were manifestations of epilepsy, the next step is particularly interesting.  In 1950 Lennox classified the symptoms of 414 epileptic patients into a number of groups (Thornton, 1976).  The three main groups were psychomotor, automatic and subjective.  Symptoms of the psychomotor subgroups included rigidity of the muscles with unconsciousness and amnesia, periods of excessive muscular activity, and periods of immobility with ‘staring, stupor and sleep-like states’.  Symptoms of the automatic sub-groups included full consciousness but with confusion, impaired speech, and amnesia.  Symptoms of the subjective seizures  included dream states, feelings of unreality, illusions, hallucinations of sight, hearing, smell or taste, and although the patient might be aware of what is said or done he cannot participate or speak.  These different seizure patterns might vary from time to time and from patient to patient; also one person might have more than one pattern.  Other investigators have reported that certain patients if they have very slight seizures may perform whole series of actions in a state of apparent unconsciousness or delirium.  Thornton also cites other remarkable cases of people who during attacks of temporal lobe epilepsy follow the instructions of others; this would seem somewhat akin to the notion of ‘suggestibility’.  Furthermore Thornton suggests that, ‘A discharge from the temporal lobes to the nearby sensory cortex in the Rolandic area would bring about diminished bodily sensations, a feature of both temporal seizures and hypnotism’ (p.38).

   The similarity of all these symptoms with hypnotic phenomena hardly requires comment, and Thornton concludes, ‘We can thus identify the condition they produced and which they called “somnambulism”, which later generations named “hypnotism” or nervous sleep, as a psychomotor or temporal lobe epileptic seizure’  (p.30).   The ‘comedy of errors’ that followed the magnetisers then stemmed from the fact that temporal lobe epilepsy was not conclusively established until this century.  It was not known to the earlier investigators who, perhaps not surprisingly, had concluded that something particularly weird and wonderful was happening to these unhappy epileptic patients.  It was thus from these beginnings that the myths of ‘somnambulism’ and ‘hypnosis’ grew.  If a magnetiser could produce such dramatic, convulsive and trance-like results, perhaps he should be able to make his subjects perform paranormal feats of levitation, elongation of body, and mental telepathy.  Nevertheless, in clinical situations the familiar comatose and convulsive states continued to be manifested in patients, and Thornton feels there is evidence to suggest that some of Charcot’s patients who manifested hypnotic catalepsy were epileptic patients who had incorrectly been diagnosed as ‘hysteric’.  In fact, Thornton doubts whether the disease of ‘hysteria’ ever really existed, as eve the earliest accounts of hysteria by the ancient Egyptians and Greeks make the symptoms appear very similar to forms of epilepsy.  For instance, the ‘wandering womb’ disorder (hysteria comes from the Greek ‘hystera’, uterus or womb) was typified by convulsions in which the fits commenced in the abdomen, and were accompanied by apparent suffocation, foaming at the mouth, and followed by unconsciousness.  According to Thornton neurosurgeons have confirmed that in temporal lobe epilepsy it is very common for a spasmodic sensation to travel from the low regions of the abdomen, up through the chest, into the throat and to be followed by unconsciousness or by psychomotor automatism.  These symptoms correspond exactly with Charcot’s ‘boule hysterique’, or ‘globus hystericus’.  According to Freud and Breur (1974) Charcot had isolated four main phases of a ‘major’ hysterical attack:  1, the ‘epileptic ‘ phase (convulsions); 2, the phase of large movements;  3, the phase of hallucinations; and 4, the phase of terminal delirium.  Freud and Breur (1974) also noted ‘hysterical’ symptoms such as ‘clonic spasms or cataleptic rigidity’ (p.65), though they did admit that such convulsions could well be epileptic in nature.  Other accounts of ‘hysterical fits’ include the following by Dr. John Fulton in the Lancet in 1953,  ‘Suddenly she announced that she felt a fit coming on and in a few seconds more she was in a convulsion.  The hands were tightly clenched; the lips firmly pressed together; the eyes open and slightly turned up;  the pupils delating;  the pulse much accelerated’. This fit was diagnosed as ‘hysterical’ because the patient had an ‘approaching knowledge’ of it (Thornton, 1976).  According to Thornton epileptic fits are sometimes followed by a temporary neurological deficit, such as paralysis or weaknesses of limbs, numbness, blindness or aphasia.  He thus suggests that physicians of the time diagnosed these deficits as ‘hysterical’ because due to their lack of knowledge of the nervous system they did not appreciate that these were genuine neurological deficits.  For example, they would label blindness  after a fit ‘hysterical’ because they did not realise that the pupillary reaction to light could be preserved because of the separate innervation of this reflex.  Thornton notes how a variety of symptoms including aphasia, facial paralaysis, and double vision may have been misdiagnosed in this fashion.  There are many rather undignified accounts of physicians shouting at, sticking pins in, pinching and slapping patients in an attempt to test ‘hysterical’ paralysis and anaesthesia that followed fits of varying degrees of severity.  It seems that in the latter part of the eighteenth century diagnoses of hysteria were occurring in epidemic proportions.  Charcot possibly had not helped, for by relating hysteria to the cerebral cortex this may have simply confirmed that the determinants were psychological.  Papers appeared at the time, including reports of ‘hysterical’ symptoms simulating heart disease, peritonitis, tetanus, meningitis, pregnancy, toothache, dysmenorrhoea, coma, and even death (Thornton, 1976, p.132). The result, according to Thornton, was that the physicians of the time had only themselves to blame when ‘by the laws of supply and demand’ they eventually obtained what they were looking for; professionals entered the scene, and many of the patients at the Salpetriere were ‘ex-filles-de joie’ from the music hall stage who were ‘agile comedians and excellent ‘imitators’ (p.134).  Thus starting from a basic misdiagnosis of epileptic symptoms, the disease of ‘hysteria’ began to become exaggerated by overenthusiastic investigators and compliant exponents of dramatics. This resulted in the bizarre range of cataleptic, hallucinatory, and anaesthetic effects that Charcot and his associates seemed to be able to turn on and off, and the use of this misinterpretation by quacks and charlatans who realised their chance to ‘earn a quick buck’ by taking advantage  of the compliance of their subjects, and the gullibility of an astounded public.  In this way, the concept of hypnosis at the time of Charcot became inextricably linked with hysteria, the primary manifestations of which were originally epileptic symptoms resulting in the emergence of a range of more specialised hypnotic phenomena which have now been integrated into a cultural understanding of the term ‘hypnosis’.

   One possible result of this historical ‘comedy of errors’ is that we now have a term ‘hypnosis’ which relates to mimicking of these clinical symptoms, and the bizarre range of extrapolations and exaggerated effects that accompanied and developed from them, by normal people (i.e. non-sufferers from pathological illnesses such as epilepsy).  In blunt terms, when  ‘normal’ subjects are given modern hypnosis scales they are being asked to perform, to the best of their ability, what really amounts to a parody of epileptic symptoms.  The contradictions of hypnotic phenomena could now become clearer.  Supposing we take two epileptic symptoms, muscular rigidity, and a trance-like stuporific appearance.  In the epileptic the two symptoms are not incompatible, they are accompanied or followed by an electrical discharge which is identifiable on EEG records.  However, in a ‘normal’ person a stuporific trance-like appearance might best be produced if the subject is told to relax and appear to be sleepy. However, deep relaxation, which some confirmation in terms of an abundance of alpha waves, is incompatible with muscle tonicity which occurs when the normal subject has to try to hold his body or his arm rigid in a distinctly unrelaxed state.  These contradictions may thus exist in hypnosis because different methods have to be employed to mimic different epileptic symptoms.

   In this context it is not difficult to see why ‘hypnosis’ has been used to  apply to a whole range of contradictory phenomena from relaxation with accompanying feelings of pleasure and even euphoria, to the most unpleasant manifestations of anxiety, convulsions, and the spitting of blood and saliva from the mouth.  Of course, Thornton’s arguments, at present, are historical and speculative in nature, and rather difficult to validate systematically for a number of reasons.  Cases of ‘hysteria’ as reported by Charcot, Freud and Breur are now comparatively rare, possibly as the result of more accurate diagnostic classifications of epilepsy and organic pathology, and also possibly because of advances in experimental and clinical technology some may feel they are less likely to get away with malingering.  There would certainly be a public outcry if Mesmerists continued to roam the country inducing convulsive fits, though it may be possible that a few cases of epileptic seizures of a ‘petit mal’ or Jacksonian type may still conceivably occur in a few hypnotic subjects in clinical situations.  In order to substantiate Thornton’s arguments it could be possible to embark on an exercise involving the physiological and behavioural monitoring of a large sample of subjects to determine the extent to which seizure-like episodes might occur with various types of hypnotic induction procedure.  However, there might be considerable ethical as well as methodological problems with this kind of approach.

   Nevertheless, in spite of the absence of systematic evidence for Thornton’s analysis, it does seem to be a very plausible interpretation of the evolution of hypnotic phenomena, which possibly gives some insight into and support for the notion that the modern hypnotic subject, who has no abnormal organic pathology, rather than spontaneously lapsing into a unique state of consciousness, actively takes the role of the hypnotic subject.  One way of viewing the situation would be to say that, in many respects, the modern hypnotic subject plays the ‘game’ of hypnosis and his individual attitudes and preconceptions.  If he is a very good subject he will play very hard, but he will not know that what he is really doing is employing a variety of strategies in order to mimic, in many ways, the tragic condition of epilepsy.  The epileptic  may look in a trance, so the hypnotic subject relaxes and tries to mimic this; the epileptic may suffer spontaneous hallucinations, so the hypnotic subject tries his best to imagine thing which are not present; the epileptic may suffer spontaneous amnesia, so the hypnotic subject ‘pretends’ he cannot remember, or engages in a number of strategies such as thinking about something else in order to mimic amnesia.  Fortunately, the modern hypnotic subject no longer has to mimic the more violent and more distasteful aspects of a ‘grand mal’ seizure, such as convulsions and foaming at the mouth, but he may have to mimic behaviours appropriate to the myths that grew from the early misunderstandings of the nature of epilepsy, and the ‘powers’ of those who seemed able to evoke fits in others.  Thus he may be required to transcend his ‘normal’ capacities, or commit some anti-social acts like a zombie, or regress to childhood with incredible accuracy.

   However, the set of historical accidents, or the ‘comedy of errors’ which gave rise to modern concepts of hypnosis has also produced some interesting beneficient consequences.  In playing this ‘game’ of hypnosis along the way both hypnotists and subjects have also chanced upon examples of the benefits of relaxation in the removal of anxiety and pain, covert conditioning in the treatment of maladaptive behaviours, and the importance of patient-therapist interaction.


A common conclusion to many discussions of ‘hypnosis’ is that ‘no one knows exactly what it is, or why it works, but it does’. I would suggest that it may not be a unitary entity but rather a collection of phenomena; that we know more than many are prepared to admit about how some of the associated hypnotic procedures might exert their effects; and that hypnotic procedures do not always ‘work’ as often or as effectively as is sometimes claimed.  In providing this interpretation I have not found some magic solution to solve all the mysteries of ‘hypnosis’, but what I hope I may have done is to draw attention to a variety of important phenomena, not mystic, not supernatural, but nevertheless intriguing and ripe for investigation in a systematic and controlled manner.


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