‘Patience Worth’

In The Nature of Mind and Human Automatism, [Franklin] Prince had written that he could not understand ‘how any right-minded person, how anyone who truly seeks after knowledge, can have any sympathy with those who refuse to accept a doctrine, however strong may be the evidence on which it is based, simply from fear that when carried to its logical consequences, it may antagonize preconceived notions.’ He was now himself to be confronted with another case of multiple personality which was providing strong evidence against his belief that ‘mind’ was the last of the supernatural phenomena, destined to be disposed of by the march of science.

Mrs Pearl Curran had grown up in the American Middle West, where she had received little formal education. Outwardly she was an undistinguished housewife until, at the age of 31, she was invited to join in ouija-board sessions. The planchette worked well for her; but nothing of interest appeared until one day a ‘communicator’ announced her presence. Although Mrs Curran was not a spiritualist, she was prepared to allow ‘Patience Worth’ to take over; and ‘Patience’ was promptly to display literary talents far in excess of Mrs Curran’s meagre capabilities. All that Mrs Curran had to do was to keep her hand on the planchette, while holding a conversation with others who were present. Meanwhile ‘Patience’ would be busy; answering questions put to her, often wittily; composing verses, of no great merit but not to be sneered at; and eventually producing full-length novels which attracted praise from the critics, and sold well, in their own right - not as curiosities.

Mrs Curran did not need to go into a recognizable state of trance for her ouija sessions. It was enough if she could achieve a degree of abstraction from what her hand, on the planchette, was doing. It was as if ‘Patience’ simply needed to be free from any interference from Mrs Curran whom she despised; when Mrs Curran tried to claim some of the credit for what was appearing, ‘Patience’s’ response was scornfully dismissive.

Most trance-transmitted writings could without too much difficulty be attributed to the wanderings of the writer’s subliminal self within the bounds of his acquired knowledge - as they could be in the case of Stainton Moses. This explanation did not fit Mrs Curran’s. ‘Patience’ was not merely far cleverer; she was able to write in ways which were outside Mrs Curran’s reach.

The novel Telka, for example, about a girl living in Anglo-Saxon Britain, was written almost entirely in words with Anglo-Saxon roots, with hardly any Norman-French or other accretions. An expert would have found it difficult to match the performance. Yet doubters who probed Mrs Curran’s background were compelled to admit that she could not have acquired the knowledge through her education, or in her married life, without detection. In any case, the sheer speed with which the novel appeared, testified to by those investigators who watched her at the ouija board, ruled out any possibility of deliberation.

In the mid-1920s, Morton Prince’s namesake Waiter Franklin Prince made a careful investigation of Mrs Curran, coming rather diffidently to the conclusion that ‘Patience’ could not be accounted for simply as a co-conscious personality, in the sense that the term could have applied to ‘Felida’ or ‘Sally’. ‘I know of no proof that a secondary personality, subliminal or alternative, can show ability so tremendously in advance of the primary or normal consciousness,’ he concluded. Either the stock concept of the subliminal mind would have to be radically revised to include hitherto unrecognized powers, ‘or else some cause operating through, but not originating in, the subconsciousness of Mrs Curran must be acknowledged’.

It was arranged that Morton Prince would investigate Mrs Curran and ‘Patience’; but when ‘Patience’ answered his questions elliptically and in her Telka dialect, Prince took the opportunity to insist that he would not continue unless Mrs Curran allowed herself to be hypnotized.

Fearing that if she consented, she might lose ‘Patience’, Mrs Curran refused- sparing Prince from the embarrassment which evidence of her mind’s ability to roam in time would certainly have caused him.

Auto-suggestion

The rapid decline in the practice of hypnotherapy after 1900 left the few remaining practitioners unable to arouse interest in their findings.

In Sweden, Sydney Alrutz, a lecturer in psychology at the University of Uppsala, conducted experiments which provided further evidence for the reality of a ‘fluence’; but when he died in 1925 they had made no lasting impression. In America, Clark Hull, Professor of Psychology at Yale, conducted an investigation in the 1930s with the aim of bringing hypnotic phenomena into line with behaviourist doctrine, in what he believed were carefully controlled scientific experiments. In retrospect, all that they succeeded in demonstrating was that the performances of hypnotized subjects tend to conform to the expectations of the hypnotists, as they had to Charcot’s, the experiments being flawed and the ‘controls’- as Hull feared- inadequate.

Almost the only useful contribution to the understanding of induced trance came from William McDougall, in his Outline of Abnormal Psychology (1926). Recalling an experience related by Janet of a girl who under hypnosis appeared willing to commit murder, but who awoke in wrath when asked to take off her clothes, McDougall surmised that under hypnosis there is a temporary splitting of the personality: ‘while one part accepts absurd suggestions and acts them out in systematic fashion, another part silently watches, aware that the whole thing is as it were a game’. If the game threatens to go too far, overstepping the limits imposed by the subject’s moral conditioning, ’ this part becomes active, steps in, and puts an end to the game by terminating the hypnosis and effecting the re-integration of personality. ’ McDougall looked for an explanation in evolutionary terms. Human behaviour under hypnosis, he suggested, is linked to the instinct of submission in gregarious species of animals. ‘We see some members of a herd or flock submitting tamely and quietly to the dominance, the leadership, the self-assertion of other members’ - and not necessarily from fear. The human race, he believed, retained this instinct.

With the development of language and intellect, words became the means of evoking and directing submission; along with prestige - ‘the power of using suggestion, of compelling bodily and mental obedience or docility, without evoking fear’.

The ordinarily dominant self was ready to relinquish control of its actions under hypnotism, McDougall suggested, because it realized that the control was being handed over to subordinates who were better able to carry out the instructions which suggestion would give.

The subordinates were capable, in ways of which the dominant conscious self was incapable, not just of receiving and understanding but of remembering and executing instructions which were given when the conscious mind had not registered them or had forgotten them.

The most promising development, though, to emerge from the earlier research into hypnotism was auto-suggestion - a form of induced trance which came into use in the 1920s as a by-product of the Nancy school. It was offered as psychotherapy by Johannes Schultz in Germany, and by Emile Coué in France. Schultz’s method attracted little attention at the time, except among his circle of patients; its importance lay in the future, half a century later, when it was to form the basis of bio-feedback training, but Coué‘s method became for a while internationally celebrated.

The story goes that Coué, a chemist in Troyes, one day substituted coloured water for a drug which a patient demanded but which he was not permitted to prescribe. The patient’s symptoms duly disappeared. Could it be, Coué wondered, that the imagination within certain limits can perform the same function as a drug? He made a pilgrimage to Nancy in 1885, and came back to Troyes convinced that suggestion under hypnosis was very effective; but he had not hypnotized the patient to whom he gave the placebo - the coloured water. The patient’s own imagination must have supplied the cure.

Surely, then, psychotherapy’s objective should be the training of patients to heal themselves, through auto-suggestion? This was far from being an original idea. Even before the Nancy school had made its name, some practising hypnotists had recommended it. In the curiously named Statuvolism (1869) a Chicago hypnotist, W. B. Fahnestock, had described how he taught patients how to enter a trance ‘at pleasure, independent of anyone’. Moll and Fore had both stressed the significance of auto-suggestion as a component of hypnotic suggestion, as had Myers; hypnotism, he had insisted; ‘was simply a name ‘for a group of empirical practices by means of which we can manage to get hold of the subliminal faculty, allowing it to emerge in a more persuasive manner than it ordinarily does’. He could not bear to use ‘auto-suggestion’- a linguistic barbarism, he complained; but self-suggestion- suggestion ‘conveyed to the subject himself from one stratum of his personality to another without external intervention’- must, he felt, be the vital component. Suggestion from without could be no more than an aid.

It was left to Coué, however, to popularize auto-suggestion by offering a simple way through which anybody could learn to exploit it, derived from the earlier research into hypnosis. We have first to recognize the existence of our two selves, he explained, conscious and -unconscious; and to understand that the unconscious, though full of potentially invaluable resources which the conscious self lacks or remains unaware of, is remarkably credulous. The unconscious is in charge of our automatic functions. If something goes wrong, therefore, suggestion should be directed at the unconscious to put it right.

It was at this point that Coué diverged from an earlier assumption about auto-suggestion. In their report on the Second International Congress on Experimental Psychology, held in London in 1892 - it had proved to be the last gathering at which induced trance and its related phenomena took a major part - Sidgwick and Myers noted that the debates on hypnosis had shown there was general acceptance of three propositions: that suggestion under hypnosis could be therapeutically effective; that the existence of susceptibility to suggestion while in the trance was not an indication of morbidity; and that independent investigators were agreed on the ‘great importance of self-suggestion in all forms of psycho-therapy’. But Delboeuf had emphasized, when auto-suggestion worked ‘in perhaps every case the patient’s cure was effected merely by a firmer reliance on his own powers of will.’ This, Coué argued, was where hypnotherapy had gone astray. It is not the will but the imagination that is crucial. Often they are in conflict, and when they are, ‘the imagination invariably gains the day.’ Coué cited as an example a plank thirty feet long and one foot wide. Place it on the ground, and anybody can walk along it. Lift it to the height of a cathedral, ‘who then will be capable of advancing even a few feet along this narrow path?’ Why the alarm? ‘Simply because in the first case you imagine that it is easy to go to the end of the plank, while in the second you imagine that you cannot do so.’ Coué cited other examples, as did his followers: the will cannot produce salivation or sexual arousal - they depend on the imagination. And recognition of the imagination’s supremacy, Coué pointed out, was of vital importance not just for individuals, but for society.

Alcoholics often claim in all sincerity that they want to give up drink, but that they lack sufficient will-power. What they in fact lack is control over the imagination. Some criminals claim they commit their crimes in spite of themselves; ‘something impelled me’. The drunkard and the criminal are telling the truth: ‘They are forced to do what they do, for the simple reason they imagine they cannot prevent themselves from doing so.’ They are puppets until they learn to control their imaginations.

But how can the imagination be tamed, and trained? It was for this purpose that Coué devised his formula: ‘every day, in every way, I get better and better.’ He had originally used it with patients in a light trance, telling them they were getting better; then he had told them to use it themselves, after first ensuring they were in a relaxed mood. They were to repeat it twenty times in a monotonous voice, emphasizing ‘in every way’ in order to remind the imagination that the aim was not just to remove some unwanted symptom, but to stir the life force into action to promote better health in general.

The formula, therefore, was not designed as an exhortation, but as a childlike litany, or a mantra. Its purpose was to dissolve consciousness of self, in much the same way as Tennyson had learned to do, to liberate inspiration. In a letter to a friend, Tennyson had described how he used to put himself into a trance with the help of an unusual type of mantra: his own name. He would repeat it to himself, silently, ‘till all at once, as it were out of the intensity of the consciousness of individuality, the individuality itself seemed to dissolve and fade away’ -not into a confused state, ‘but the clearest of the clearest, the surest of the surest, the weirdest of the weirdest, utterly beyond words’.

Coué remained chiefly concerned to demonstrate the power of the imagination in preventing and curing disease. Patients flocked to him, as they had to Liebeault; his mantra could be heard in different languages all over Europe; his name, if not his face, was as well-known internationally as AI Capone or the Prince of Wales. The medical profession, however, felt justified in dismissing him as a quack, without medical qualifications, and with so poor an understanding of   physiology that he could believe in the exploded myth of the power of the imagination to cure organic disease.

Yet ironically, the validity of Coué‘s thesis was being busily exploited by the medical profession, with lucrative results. Cronin’s ‘asthenia’ patients were demonstrating the power of auto-suggestion - the belief that their illness, now that it had been diagnosed, would be cured - coupled, perhaps, with a touch of his hypnotic effect. Not that he would have felt any need to make them aware of his influence; that would have weakened their faith in the organic nature of asthenia. But by his own account he was exploiting his personality, as well as his clinical method, to impress them.

Cronin, though, did not think of what he was doing as a contribution towards restoring suggestion and auto-suggestion to a respected place in orthodox medicine. ‘I was, I assure you, a great rogue at this period,’ he recalled, ‘though perhaps not more so than many of my colleagues.’ So ingrained had the dogma of organicism become that it would have been disastrous for him and his colleagues to admit the deception, and to point out that suggestion and auto-suggestion were actually more potent than the drugs available at that era.

A handful of doctors, usually under the influence of Freudian theory, tried to warn that organicism was untenable. ‘All disease is disorder of function,’ F. G. Crookshank wrote in 1928. ’ If there is no functional disorder there is no disease, and the so-called organic changes we find in some cases are just as much the effect as the cause.’ Accurate diagnosis was all very well, but for many diseases there was in fact no effective treatment. ‘Organic disease is what we say we cure, but don’t; functional disease is what the quacks cure and we wish to goodness we could .’ Three years later Crookshank returned to the assault. The concentration of medical research on organic symptoms, he complained, had led to blind indifference .to their functional origins. He had even begun to wonder why ‘some hard-boiled and orthodox clinician’ had not thought of categorizing emotional weeping as a new disease, calling it ‘paroxysmal lachrymation’, prescribing a salt-free diet, with locally applied drying agents, and ‘proceeding in the event of failure to early removal of the tear glands’. Ludicrous though this might sound, Crookshank claimed, ‘a good deal of contemporary medicine and surgery seems to me to be on the same level.’ In 1930 two young cardiologists in the London Hospital, William Evans and Clifford Hoyle, became worried by the ineffectiveness of some of the drugs then in use in the treatment of angina. It occurred to them that one way to find out which of the drugs were worth prescribing was to test them against placebo pills, manufactured from bicarbonate of soda. In their report in the Quarterly journal of Medicine in 1933 they described how they had found that the placebos ‘gave better results than most of the actual drugs, and appeared statistically to be the better form of protection’. A few of the drugs, such as morphine, were a little more effective; but this had to be set off against the risk of addiction.

Further trials along similar lines were soon to show that placebo effect, as it came to be called, was surprisingly consistent, particularly in the treatment of pain of many different kinds. A third, sometimes as many as a half, of patients put on a course of placebos responded as well to them as to the standard pain-killers. This was a startling vindication of Coué‘s theory. Clearly the explanation must lie in auto-suggestion, patients’ expectations being responsible for the beneficial effects.

To admit this, however, would have been embarrassing. Angina was assumed to be organic. It would be difficult to send patients away from hospitals and consulting rooms on the ground that if it responded to auto-suggestion, it must be functional. Placebo-effect was taken up by the profession, but only in its role as a handy technique for testing drugs. The evidence which it provided for the therapeutic powers of the subliminal mind was tacitly ignored.

The absurdity of dogmatic organicism was to be underlined by Sir Waiter Langdon-Brown, Emeritus Professor of Physics at Cambridge, in Thus We Are Men (1938). From his long experience he had come to the conclusion that the incidence of organic disease was much lower than was assumed, largely because hospitals gave an erroneous impression - most hospital cases had been selected precisely because they were taken to be organic. In general practice it was a very different story. He had asked a number of GPs what proportion of their patients they thought were suffering from functional, rather than organic, disorders; ‘not one of them placed it at less than 40 per cent, while some put it as high as 75 per cent.’ For a GP to use hypnotism to treat these patients would have been regarded as, at best, eccentric; by the 1930s auto-suggestion was also recalled chiefly as just another weird craze of the 1920s, like mahjong. And shortly before the outbreak of the Second World War the advent of the sulfa drugs, soon to be reinforced by penicillin and the antibiotics, relieved GPs of any need to reconsider whether the rejection of hypnotherapy had really been justified. It even became possible for patients to believe that in the not too distant future, there would be ‘a pill for every ill’.

“Patience Worth and Auto-suggestion” is an extract from Trance: A Natural History of Altered States of Mind by Brian Inglis