ABSTRACT
Suggestion has already been discussed at some length in connexion with hysteria, particularly in relation to the incidence of symptoms. It remains to consider it as a therapeutic agent. A great deal has been made recently of the supposed difference between hetero-suggestion and auto-suggestion, but the importance attached to this distinction seems to indicate a misconception of the nature of suggestion and the manner of its action. So far we have accepted McDougall’s definition that “Suggestion is a process of communication resulting in the acceptance with conviction of the communicated proposition in the absence of logically adequate grounds for its acceptance,” but before going further this requires some elaboration. Firstly, acceptance with conviction would be better expressed as—acceptance without opposition, which is not quite saying the same thing in different words. Acceptance with conviction seems to imply special facilitation for the pattern established, while acceptance without opposition implies an absence of inhibitions. Facilitation is more than a mere absence of inhibition, and the very nature and scope of suggestion does not imply any such positive effect as facilitation seems to be. In therapeutics the suggestive influence is generally an idea, and if we credit this idea with the positive influence of facilitation, we may easily slip into the error of the ideo-motor theory, which McDougall himself has done so much to explode, showing that it is the instincts or emotional dispositions and not ideas which are dynamic. What seems to happen is that the idea merely acts as a stimulus which starts the activation of a pattern involving affective-conative subpatterns, i.e., emotional dispositions or instincts, and, so long as this is not inhibited by other patterns “set” in a contrary direction, the original pattern will continue to dominate the personality and determine behaviour. The stimulus may be a situation, a word, an image, a sensation or even an affect, and all these must be included in McDougall’s somewhat narrow term “proposition,” though this seems also to include the result of the suggestion as well as the source. If then we regard this as the way in which suggestion works, namely by setting off some already determined pattern, it is clear that the stimulus may arise either from the environment, in which case the process is called hetero-suggestion, or from the activation of another pattern in the patient’s own ego, in which case the process is termed auto-suggestion. Hence there is no such essential difference between the two processes and they can be discussed together. Nor do we need to concern ourselves about the disputes as to whether M. Coué’s methods involved hetero-suggestion or auto-suggestion; they worked by suggestion and that is sufficient. The important point to remember is that we must avoid the error that is fostered by most popular writers on the subject, that the “implanted idea” can do anything. At the utmost all an idea can do is to act as a stimulus of activation to a pattern already existent in the patient’s mental equipment, and if this activation is to be effective so far as behaviour is concerned, this pattern must not be seriously inhibited by contrary patterns. This conception explains a good many points in connexion with suggestion, its therapeutic effects and methods of induction. It is a truism that a subject cannot be made to do anything which is really against his will by suggestion. Under certain circumstances he will be made to do something which he does not positively wish to do, as in the case of post-hypnotic suggestions, such as commands to get up and shut the door in ten minutes’ time. Such a suggestion may succeed because this pattern may have been activated and there is no definite contrary pattern inhibiting the action; but the subject cannot be made to murder his grandmother, because there are definite contrary patterns which inhibit such an action. Similarly suggestion is successful in removing neurotic symptoms when there are no definite contrary patterns to inhibit the recovery from these, but when a symptom is of real use to a patient in protecting him against some impossible, or very difficult demand in adjustment to life, or where a severe conflict exists between two patterns of almost equal consequence, then suggestion cannot achieve its object. It follows, therefore, that when the hindrance to adaptation is slight, the circumstances under which suggestion is given may make it possible for the more desirable pattern to become dominant, and a cure may be effected in such milder cases of neurosis. On the other hand, where the hindrance to adaptation is severe and deep-seated then suggestion is not effective, at least until some sort of analytic treatment has freed such severely afflicted patients from their resistances.
