The question is taken by the patient to mean that the doctor expects that the prick will not be felt–or why should he ask? The hint is accepted and the insensibility established, though its unreal nature is shown by the fact that the patient is not especially disposed to burn or injure the limb, unlike the sufferer from a true loss of sensation, who is always liable to such an accident owing to the lack of the protective sense of pain. I believe that this is the true explanation for many cases, and put it forward as a good example of receptivity.
The insensitiveness is similarly explained by Babinski, who uses a different method of examination. He blindfolds the patient, who must not have been subjected to a previous test, and stimulating him variously in different places asks what he feels. This avoids the suggestion of loss of sensation, and the result is that Babinski finds few examples of such loss in cases where the ‘Do you feel that?’ method would produce many positive results.
[Footnote 10: _Hysteria or Pithiatism and Nervous Troubles of Reflex Order._ London University Press.]
It may also be explained by a dissociation of consciousness, in which the split-off stream deals with the paralysed limb and therefore the main stream of consciousness knows nothing about the prick. The difference between the two theories is not so great as appears, for the control of the supposed loss of sensation, once it is established, finds its home in a split-off stream, and the process I describe is only a stage in the dissociation.
I must admit, however, to seeing cases where a hysterical loss of voice of long duration is accompanied by a loss of sensation in the throat which is not explicable by receptivity, and it is possible for the dissociation to be directly responsible for the loss.
Jung expresses sound views when he writes:–
‘It should long ago have been realised that a suggestion is only accepted by one it suits…. This pseudo-scientific talk about suggestion is based upon the unconscious superstition that suggestion actually possesses some magic power. No one succumbs to suggestion unless from the very bottom of his heart he be willing to co-operate.'
[Footnote 11: _Analytical Psychology_, p. 469. Baillière, Tindall & Cox, 1917.]
Whilst stripping suggestion of its magic I by no means deny its power. Let one person at a dinner suggest that the fish is tainted and he will generally have one or two supporters who would have eaten it without a doubt of its freshness if no one had cast suspicion upon it; or let one of a class of medical students say with sufficient assurance that he hears a murmur over a patient’s heart and, even if the heart sounds are quite ordinary, others will hear it too.
There are conditions, such as fatigue or sleep, in which the effort necessary to examine the truth of a proposition seems too great, and suggestions are accepted which would be rejected in a state of fuller consciousness. For example, I was awakened one night, when a hospital resident, and told that one of my patients was very restless. I could not remember the man, but asked a few questions about him and ordered a soporific. Next morning on waking I became aware that I had no such patient, and on enquiry found that I had been mistaken for another resident whose slumbers had been undisturbed, thanks to my suggestibility, for had I been fully awake I should have repudiated any connection with the case. The confident manner of the messenger assisted the suggestion, and I like to think that had there been a trick intentionally played upon me even my sleepy consciousness might have detected some warning change of tone.
Psychologists regard hypnotic suggestibility as only a further stage of this sleepy non-resistance, but I see in the former a more active desire to accept. Though suggestion might be further classified according to the factors concerned in its acceptance, the class showing ‘receptivity’ is the important one for our consideration.
There remains auto-suggestion to be considered; it is as difficult to define as suggestion, but in the absence of any more precise term it must be accepted as indicating certain mental processes.
The sensations felt in the arms and hands by the water-diviner or table-turner are partly the result of auto-suggestion and partly of muscular contractions, themselves produced by the same cause, and some of the varied sensations of the hysteric are of similar origin. Creepy feelings at the mention of snakes, and unpleasant sensations at the thought of those ‘minor horrors of war’ that live in undergarments, are further examples.
As far as the persons concerned are able to judge, the sensations are often real enough, though it was long before I could believe that a confirmed hysteric who complained of a severe pain really suffered from that pain; the description of a water-diviner’s sensations, given by himself and quoted in another chapter, are such that one must believe in the honesty of the writer.