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Tuesday, June 23, 2015

Magical Moments of Mesorah

"Towards the end of his life Rabbeinu [Rav Michoel Forshlager] told the following story: When one of his sons was born he entered the room of the Avnei Nezer to ask him to be the sandek at the bris. 'When I entered I saw my holy master sitting very close to his son, the Shem m'Shmuel. The face of the Rebbe was burning like fire. The Shem m'Shmuel's face radiated happiness and tears flowed forth from his eyes like a streaming river. I jumped back in fear...apparently at that moment his father was transmitting to him lofty matters.'"
Michoel b'Achat by Benzion Bergman, p.42 [Hebrew]


Drawing of the Shem m'Shmuel by Yona

Monday, June 8, 2015

The Discovery of the Unconscious By Henri F. Ellenberger (1970): Summary of Chapter Three

Chapter Three: The First Dynamic Psychiatry (1775-1900)

1.     The first dynamic psychiatry gained official university recognition in 1880. Following that new schools began to develop and the first dynamic psychiatry declined by 1900. However, the new schools were very much rooted and indebted to the first dynamic psychiatry. Although there was much variation in the first dynamic psychiatry, the following points remained constant:
a.     Hypnotism was the royal road to the unconscious. Other approaches, such as automatic writing, mediums and crystal gazing, were supplementary. Psychotherapy mostly consisted of hypnosis and suggestion, with particular attention given to the rapport between patient and magnetizer/hypnotist.
b.     Attention was devoted to specific clinical issues (or "magnetic diseases") such as, spontaneous somnambulism, lethargy, catalepsy, multiple personality, and hysteria.
c.     A new model of the human mind was developed. It viewed the mind as consisting of the duality of conscious and unconscious psychism. Later the mind was viewed as a cluster of sub-personalities underlying the conscious personality.
d.     New theories of the pathogenesis of nervous illness were devised. First they were based on the concept of magnetic fluid, and then on the concept of mental energy.
2.     As previously discussed, exorcism (particularly the approach of Gassner) was a primary source of the first dynamic psychiatry. However, other sources bear mentioning. The concept of "imagination" (or Imaginatio) was widely discussed during the Renaissance. Montaigne devoted a chapter in his Essays to the topic, which discussed the power of the mind to cause physical and emotional diseases/cures. Muratori wrote a treatise On the Power of Human Imagination which discuses dreams, visions, delusions, fixed ideas, phobias and somnambulism. Another source for the first dynamic psychiatry was the history of hypnotism itself. It was used  by the ancient Egyptians and Renaissance students of natural magic.
3.     During this period the following issues surrounding hypnotism were paramount:
a.     The disagreement between the "fluidist" theory of magnetism and "animist" theory which contended that the phenomenon was psychological in nature.
b.     The relationship between the magnetizer and the magnetized: Puységur noticed that his patient Victor seemed to anticipate his orders. The question arose as early as 1785 whether the subject could oppose the magnetizer's will. This, of course, had legal implications as well; could a person in hypnotic sleep be held accountable for their actions?
c.     The influence of hypnotism extended beyond the experience into normal conscious life. The phenomenon of post-hypnotic suggestion, where the subject fulfills a command during the waking state, was already described in 1787. Post-hypnotic amnesia was not absolute; under certain circumstances the experience could be recalled.
d.     Various methods were devised to induce magnetic sleep/hypnosis. The approach of "fascination" (e.g. staring at a slightly moving point or into the eyes of the hypnotist) was used by the Salpêtriére school. Other techniques included verbal orders (Faria) and speaking in a gentle voice (Nancy school) were also used.
e.     It was understood that the subject could not be hypnotized against his will. He must be made comfortable and relaxed. It had been noticed early on that witnessing someone else in the hypnotic state made it easier to be hypnotized as well. The group method had been used since Mesmer. Early magnetizers, however, did not realize the extent that hypnosis was molded by the magnetizer/hypnotist. Janet argued that the state of hypnosis depended upon the subject's previous experiences, pathologies, and the school and style of the hypnotist.
f.      It was noticed that the subjects often displayed hypersensitivity to physical stimuli, greater physical strength, physical changes (e.g. turning deaf,  paralyzed, or anesthetic), and an amazing ability to display emotions, enact roles and change personalities. The first surgical operation under magnetic anesthesia was performed in 1821 by Récamier.
g.     Scant attention was given to the subjective experience of being hypnotized. Bleuler was one of the first to describe the experience after being hypnotized by a colleague.
h.     One controversial aspect of hypnotism was the phenomenon of age regression. The question was "is this true regression or only an excellent imitation of what the subject believes about the past?" Colonel de Rochas conducted hypnotic age regression experiments even to the point of the fetal period,  past lives and the future.
4.     During the first dynamic psychiatry there were certain clinical cases that were given much attention. The earliest focus was on somnambulism, then multiple personality, and then hysteria.
a.     Ambulatory Automatism (now known as Fugue state): Charcot classified these according to three etiologies — traumatic, epileptic and hysterical. These states were sometimes viewed as a transient multiple personality. Janet pointed out the sometimes unconscious motivations that triggered these shifts in personality.
b.     Multiple personality: By the later 1800's this was often discussed by psychiatrists and philosophers, but published cases can be found as early as 1791. After the "disappearance" of possession these case studies began to emerge. Two of the most important case studies at the time were Mary Reynolds case published by Kearsley Mitchell and Plumer, and the case of Estelle published by Despine Sr. Based on the latter case, Janet pointed out that the second personality at times could be the healthier personality while the "normal" personality pathological. The different types of cases can be classified as such:
                                                    i.     Simultaneous multiple personalities: the coexistence of two personalities is a rare case and is unlikely to last for long periods.
                                                   ii.     Successive multiple personalities
1.     Mutually cognizant of each other: this condition is also relatively rare. The case provided by Charles E. Cory (1920) is an example.
2.     Mutually amnestic: in this type both personalities know nothing about each other. One such case of Ansel Bourne was examined by William James. 
3.     One-way amnestic: in this group personality A is aware of B but B is not aware of A. Most cases of multiple personality belongs to this group. Azam provided a case, "Felida X.," in the late 19th century and published it with an introduction by Charcot. Also of note is Morselli's patent Elena.
                                                 iii.     Personality clusters: The only cases on multiple personality were dual personality  cases. However, in time the human mind came to be later viewed as a matrix from which whole sets of sub-personalities could emerge. The use of hypnosis could actually bring forth a third, fourth etc. personality. Morton Prince published the case of Miss Beauchamp in which she displayed four different states (which she called B I, II, III, IV). Likewise, Walter Franklin Prince published the enigmatic case of Doris.
                                                 iv.     There were different explanatory theories of multiple personality. The "associationists" thought that the mental split and loss of connection between the groups of associations led to multiple personalities. The "organicists" viewed it in terms of brain modification. Flournoy emphasized the factors of motivation, role-playing, regression etc. Gardner Murphey viewed it as "the organisms effort to live, at different times, in terms of different systems of values." Following 1910 there was a wave of reaction against the concept of multiple personalities with the claim that previous researchers were duped. There was only a revival of interest following the advent of EEG brain scans and other sensational cases.
c.     Hysteria (now known as Conversion Disorder): This condition was considered a mysterious disease that afflicted women and originated in the uterus. In the 16th century some physicians claimed that it originated in the brain and could also afflict men. Briquet published the first systematic exploration of hysteria in 1859. He defined it as "a neurosis of the brain, the manifestations of it consisting chiefly in a perturbation of those vital acts which are concerned with the expression of emotions and passions." He claimed that 1 in 20 patients were men. He denied the commonly held view that erotic frustration led to this disease. He viewed it related to negative psychosocial experiences and a hypersensitivity and genetic predisposition. Charcot conception of hysteria was mostly influenced by Briquet. Nevertheless, the theory of sexual frustration maintained its power in the scientific and general perception.
d.     By the end of the 19th century hysteria came to be viewed as the synthesis between somnambulism, multiple personality, catalepsy, lethargy, hallucinations and ecstasis; the hysteric could demonstrate all of these symptoms. Moreover, hypnosis could produce all of these states and, under favorable conditions, cure these symptoms. At times, Charcot described hysteria as a permanent state of semi-somnambulism, while Janet viewed it as a permanent state of multiple personality. Thus, the understanding of hysteria effected a synthesis between the hypnotists and the official psychiatry.
5.     Models of the Mind
a.     Dipsychism suggests that the mind is fundamentally double. Early magnetizers believed this and it culminated in Dessoir's famous book "The Double Ego" in 1890. Within this theory there were two schools. One considered the hidden mind to be closed, that is, it contained only things that went through the conscious mind. The other school contended that the unconscious mind was open in that it could communicate with a mysterious realm. It was hypothesized that this enabled paranormal/extra-sensory perception and communication with the World Soul. This appears to be a precursor to Jung's collective unconscious. 
b.     Polypsychism, the belief that the mind consists of a complex cluster of sub-personalities, also has its roots in the early magnetizers. Duran de Gros and Reil were proponents of this approach. Both Freud and Jung began with dipsychism and ended with polypsychism (e.g. id, ego, superego)
6.     Concepts of Psychogenesis of illness
a.     The Fluidic Theory: Mesmer believed in the existence of a universal physical fluid, and disturbance thereof caused disease. Although this theory was eventually abandoned other concepts such as psychological forces or nervous energy replaced this theory. 
b.     Ideodynamism: The power of hypnotic suggestion was recognized and it was thought that implanted "fixed ideas" or a group of associates ideas ("complexes") were the cause of pathology. This was recognized by Liébeault, Charcot, Janet, and later, Jung.  
7.     Psychotherapeutic Procedures
a.     In 1803 Reil presented a holistic approach to psychotherapy, including  reform of mental health institutions, bodily and sensory stimulation, pharmacology and surgical cures, psychodrama, and occupational therapy. He has been called the founder of rational psychotherapy.
b.     The Mesmerists, as mentioned, provoked crises as the first step towards their resolution. This may be branded a type of cathartic theory. At times hypnosis was later used in this sense as well. However, hypnotic sleep in-and-of-itself could be also therapeutic, with some patients describing it as the "most absolute rest one can imagine." Hypnotism also acted through suggestion — the direct implantation of an idea into the passive mind of the patient. Sometimes, though, there would be a kind of bargaining between the hypnotist and patient with the patient foretelling the end of the symptoms and prescribing the treatment.
8.     Rapport: The Therapeutic Channel
a.     Psychotherapeutic procedures notwithstanding, they all utilized rapport. The term rapport has developed since its use by Mesmer. He borrowed it from contemporary physics experiments where people formed human chains and transmitted to each other an electrical current originating in a machine. Thus, magnetizer and patient formed a connection where the magnetizer can transmit magnetic fluid. The magnetized became hypersensitive to the magnetizer. The French magnetizes emphasized that the influence of the magnetizer continued in between sessions. At times the magnetized patient would become fascinated with the magnetizer to the extent that they would have visions of him or might adopt their personal behaviors or medical theories.
b.     By 1784 the term "magnetic reciprocity" was introduced, indicating that the magnetizer also become extremely sensitive to the magnetized.
c.     From the beginning of magnetism the suspicion of eroticism implicit in rapport was discussed and even investigated. Other magnetizers compared magnetic rapport to the relationship between mother and child or brother and sister.
d.     Charcot and Bernheim did not pay much attention to rapport  and it was reintroduced by Janet. At the International Congress of Psychology in 1896 Janet elaborated a theory of rapport. He distinguished between two phases of rapport: hypnotic influence and passion. In the first phase the patient generally improved and was freed of most symptoms. In the second phase there is an increased need to see the hypnotist; this could develop into jealousy, fear, profound respect, love. It could manifest in dreams and hallucinations. Of therapeutic interest, he found that posthypnotic suggestions were obeyed in the first, not the second, phase. In a paper in 1897, Janet suggested that the second phase was influenced by a certain type of love towards to the hypnotist (erotic, maternal, filial etc.) and by their need to be directed. He therefore suggested that the therapist must first gain command of the patients mind and then, in the second phase of treatment, teach the patient to do without him. He would accomplish this by lengthening the intervals between sessions and by exploring the feelings the patient has towards the therapist.
9.     The Psychotherapist
a.     The magnetizer and hypnotist constituted a new type of healer. They quickly developed their own journals, textbooks, societies and professional ethics. We can gain insight into what they were like by a number of autobiographies (mosty of stage magnetizers) and textbooks, especially that of Aubin Gauthier:
                                                    i.     The magnetizer must be a good health lest he transmit his own diseases to his patients. If should become ill he needs to purify himself before returning to work. He must lead a "wise and well regulated life." His personality should be calm, reserved, kind, and with measured speech.
                                                   ii.      Gauthier rejected  Puységur position that magnetizers should practice without pay. Other professional ethics include keeping a journal of sessions, completing the course of treatment, prohibiting a male magnetizing a woman without her husband or another witness present, and abstaining from clinical experimentation. 
10. The Cultural Impact of the First Dynamic Psychiatry
a.     As early as 1787 a novel was written on magnetism. Some well-known novelists incorporated magnetism and dual personality into their works, such as  Balzac, Stevenson (The Strange Case of Dr. Jekyll and Mr. Hyde) and Marcel Proust. 
b.     Poets, such as E.T.A. Hoffmann and Edgar Allan Poe, were influenced by magnetism and dual personality. 
c.     As will be discussed in next chapter, magnetism also greatly influenced philosophy, especially the Romantic philosophers (Schelling, Fichte, Schopenhauer). Bergson himself experimented with hypnosis.
d.     It also influenced Protestant and Catholic theologians and Christian medicine. In France was met with fierce resistance by many religious circles, but in 1846 Father Lacordaire gave a sermon in Notre Dame Cathedral supporting magnetism as an antidote to materialism.
11. The Decline of the First Dynamic Psychiatry
a.     It is paradoxical that relatively soon after the new discoveries of the first dynamic psychiatry became accepted as official medicine they began to decline and were eventually abandoned. After 1882 the subject of hypnotism flooded publications and interest declined. However, there were other factors to the decline. Simply put, the reliability of hypnotism was questioned due to subjects feigning the hypnotic state or unconsciously simulating the state. Again it was realized that results were based on the expectations of the hypnotist, and vice versa, the hypnotist was influenced by the subject.
b.     Both Janet and Fredrick Myers were well aware of the pitfalls of hypnotism. However, they believed that our knowledge could be expanded. The new dynamic psychiatry, in fact, incorporated much from the first. To better understand the new dynamic psychiatry a survey of the sociological and cultural background of the 19th century is necessary. 

Thursday, April 16, 2015

The Discovery of the Unconscious By Henri F. Ellenberger (1970): Summary of Chapter Two

Chapter Two: The Emergence of Dynamic Psychiatry

1.     The emergence of dynamic psychiatry can be traced to the year 1775 when the physician Mesmer clashed with the exorcist Gassner. Father Johann Joseph Gassner (1727-1779) was a very famous healer and his exorcisms were carefully recorded. In 1774 he published a pamphlet explaining his method.
a.     There are two kinds of illnesses: natural ones which require a physician and preternatural ones (e.g. imitation of illness caused by devil, effect of sorcery, or diabolical possession)  which required exorcism. 
b.     He entreated the demon to manifest the symptoms of the disease. If the symptoms were produced he concluded that it was the work of the devil. If they were not produced he sent the patient to a physician.
2.     Gassner had many supporters but many adversaries as well. His opponents included Catholic and Protestant theologians but mainly representatives of the Enlightenment. There were inquiry commissions established to investigate his authenticity. One such commission invited a Dr. Mesmer, who had claimed to discover the new principle of "animal magnetism" which enabled him to perform cures. He was reportedly able to elicit in patience the appearance and disappearance of various symptoms. This was essentially Gassner's approach without the theological backdrop of exorcism. This demonstration essentially ended Gassner's career and began a new stage in the development of dynamic psychiatry.
3.     Franz Anton Mesmer (1734-1815) was forty-years old (1774) when he discovered his new treatment approach. He was working with a twenty-seven year old patient, Fraulein Oesterlin. He studied the periodicity of her symptoms and became able to predict their reoccurrence. At the time some English physicians were treating certain diseases with magnets. He attempted to provoke an artificial crises in his patient by means attaching magnets to her body. She reported that she felt a mysterious fluid running through her body and she was cured after several hours. He viewed the magnets on her body as an auxiliary means of reinforcing and directing his own innate magnetism. Hence the term "animal magnetism". Eventually he dispensed with the use of magnets.
4.     Using this method he was able to affect many marvelous cures and gained fame and high acclaim. He was nevertheless met with resistance from the medical establishment in Vienna. He moved to Paris where he privately magnetized patients.  There, in 1779, he expounded his system of healing, which can be summarized as follows:
a.     A subtle physical fluid fills the universe and forms a connecting medium between man, earth, the heavenly bodies and between man and man.
b.     Disease originates from the unequal distribution of this fluid in the human body; recovery is achieved when the equilibrium is restored
c.     With the help of certain techniques, this fluid can be channeled, stored and conveyed to other persons
d.     In this manner, "crises" can be provoked in patients and diseases cured
5.     While Mesmer's private practice thrived and he established a society and disciples to spread  his teachings he was never accepted in the scientific and medical world. Like Gassner, commissions consisting of world-class scientists and personalities (one included Benjamin Franklin) were formed to investigate Mesmer's theory. Possible therapeutic effects were not denied, but were ascribed to "imagination," not a mysterious physical fluid. Mesmer was also disturbed by his disciples developing magnetism in ways that he did not intend. Mesmer was an extremely charismatic and authoritative personality who was convinced of the epoch importance of his discovery and sought to control his "intellectual property" [compare to Freud].
6.     Although Animal Magnetism seems world away from dynamic psychiatry, there are many similarities:
a.     The therapeutic agent of the cures is the magnetizer himself
b.     To make healing possible the magnetizer must establish "rapport," a tuning-in with his patient
c.     Healing occurs through crises — manifestation of latent diseases produced artificially by the magnetizer
d.     It is better to produce several weaker ones than one severe crises
7.     Mesmer's most important disciple was Marquis de Puységur (1751-1825). One of his first patients was a 23 year old peasant by the name of Victor Race. Victor was suffering from a mild respiratory disease and Puységur magnetized him. Unlike Mesmer's patients he did not have convulsions or disorderly movements. Rather, he fell into a deep sleep in which he appeared to be more awake and higher functioning than his normal waking state. Puységur found that while in this state Victor was able to diagnose his disease, foresee its course and prescribe treatments. Upon awaking from this state of  "perfect crises" the patient did not remember it. Demand for Puységur's treatment was so great that he organized collective treatment around magnetized trees. It was reported that within one month he cured 62 out of 300 patients using his collective treatment. Puységur organized a society in Strasbourg to train magnetizers, which was successful, and they published case histories.
8.     Based on his clinical experience Puységur conceptually diverged from Mesmer:
a.     Most important, Puységur rejected Mesmer's "physical fluid theory" and adopted a psychological theory. The primary agent of magnetism was the magnetism's commands
b.     He also simplified Mesmer's techniques
c.     The "perfect crises" seemed remarkably similar to "somnambulism" and was thus called "artificial somnambulism". Later this would be renamed "hypnotism"
d.     Patients, like Victor, would be more comfortable telling secrets when in magnetic sleep
9.     Charles Richet considered Puységur the true founder of Mesmerism and stated that the "new" discoveries in hypnosis in the mid-to-late 19th century was already contained in Puységur's writings. Following Puységur, around 1812, new concepts and methods were introduced to magnetism.
a.     Abbé Faria, a Portuguese priest who came from India, taught that certain individuals were more susceptible to magnetization. His technique consisted of seating his patients in a comfortable chair and fixate on his raised hand after which he commanded "sleep!" Once the patients were in a magnetic sleep he would produce visions in them as well as posthypnotic suggestions. Janet viewed Faria as the ancestor of the Nancy school (see below)
b.     Deleuze was successful in spreading magnetism in France. He published a textbook on the subject and warned against potential dangers. Alexandre Betrand sought to study magnetism in a scientific manner and convinced Noizet of the fallacy of the fluidist theory of magnetism. They both emphasized that the human mind conceives of thoughts of which we are unaware and which can only be recognized through their effects. Other French students of magnetism (Charpignon, Teste, Gauthier, Lafontaine, Despine, Dupotet, Durand) emphasized the role of rapport — the reciprocal influence between the magnetizer and the patient — as the central component in magnetism. Despite the clinical experience and scientific approach used by these magnetizers, the French scientific authorities did not accept magnetism. 
10. The situation in Germany was quite different. The German mesmerists included men of intellectual distinction. The German Romanticists were attracted to Mesmer's theory of a universal fluid since they viewed the world as a living organism. They were also excited about the "sixth sense" or extra-lucidity of magnetic somnambulism since it provided a way for the human mind to communicate with the World Soul. Thus, magnetism, for the Germans, was experimental metaphysics.
a.     Kluge, in his textbook on animal magnetism, proposed a phenomenology of magnetic somnambulism, including six degrees: 1) The Waking State, with a sensation of warmth, 2) Half-sleep, 3) Inner Darkness, referring to sleep and insensitivity, 4) Inner Clarity, which includes lucid perception and consciousness of one's body, 5) Self-contemplation, where the patient is able to perceive with greater accuracy the interior of one's own body and that of those with whom he is put into rapport, and 6) Universal Clarity, where the veils of time and space are removed. There were many extraordinary subjects in Germany during this time who displayed paranormal phenomenon. Among the most famous were Katharina Emmerich and Friedericke Hauffe. The latter was made famous by the poet-physician Justinius Kerner (incidentally, who also influenced the Rorschach tests) and aroused enormous interest among the German elite (e.g. Shelling and Schleiermacher) and masses.
11. Magnetism was met with resistance in England until 1840-1850. It reached the United States early on through the French city of New Orleans. One American adherent, Phineas Parkhurst Quimby, understood that the true agent of healing was suggestion and practiced "mind cure." One of his patients, Mary Baker Eddy, became the founder of Christian Science.
12. The history of Magnetism went through successive stages of positive and negative phases. The first phase took place during Mesmer's activity in Paris from 1777-1785). The second phase began in 1815 into the early 1820's. The third phase was from 1840-1850. Braid coined the term "hypnosis" in 1843. Following 1850 Positivism and scientific rationalism dominated and Magnetism fell into disrepute. Between 1860-1880 a physician would end his career by openly practicing magnetism and hypnosis.
13. At the same time, though, there was a huge interest in Spiritism and parapsychology, beginning in the 1850's and continuing to the end of the century (the Society for Psychical Research was founded in 1882 by Fredrick Myers and Edmund Gurney, in England). The study of mediumship led to new techniques with which to study the unconscious (e.g. automatic writing, divining rods).
14. Auguste Ambroise Liébeault (1823-1904) was among the few physicians who openly hypnotized patients during this time. He lived near the city of Nancy and his school of therapy was known as the Nancy School. He maintained that hypnotic sleep is no different than normal sleep except that the former is induced by suggestion of the hypnotizer. His method of inducing hypnotic sleep was to look into the eyes of the patient while suggesting that he was getting sleepy. While hypnotized he would suggest that the patient was cured of his symptoms. Although tales of medical miracles circulated, Liébeault was considered a quack by the medical establishment. This changed when Hippolyte Bernheim (1840-1919), a renowned professor who lived in Nancy, met Liébeault in 1882. He viewed himself as Liébeault's pupil and friend and introduced his ideas and methods to the medical world. In 1886 he published a textbook on hypnosis.
a.     Bernheim believed that hypnosis was easier to induce in people who are used to passive obedience. He had poorer results with people of the upper class.
b.     Bernheim maintained that hypnosis was the product of suggestion. He defined suggestion as "the aptitude to transform an idea into an act."
c.     Unlike Liébeault, Bernheim only utilized hypnosis when he thought it had a good chance of success. Eventually, Bernheim limited his use of hypnosis and maintained that the same effects could generally obtained by suggestion in the waking state. This was called "psychotherapeutics" by the Nancy School.
15. The Nancy School consisted of a loose group of psychiatrists and it had a vast international influence (e.g. Mortin Prince in America). By 1900 Bernheim was considered by many to be Europe's greatest psychotherapist (but by 1910 he was almost forgotten). Among those who visited Bernheim and Liébeault were Auguste Forel, who was the director of the Burghölzli mental hospital (where Jung would work for nine years) and Freud. Freud was particularly interested in Bernheim's belief that posthypnotic amnesia was not as complete as assumed and the patient could remember what occurred during hypnosis.
16. However, Bernheim's assertion that hypnosis was not a pathological condition unique to hysterics was the cause of a long struggle between himself and the greatest neurologist of the time, Jean-Martin Charcot (1835-1893). Bernheim also denied Charcot's theory of hysteria.

17. Charcot was the chief physician of the massive Salpêtriére hospital. The hospital houses four to five thousand women. In the years 1862-1870 he made the discoveries that made him the foremost neurologist of his time. However, beginning in 1870 Charcot began investigating hysterical patients who, like epileptic patients, displayed convulsions. He gave a description of a full-blown hysterical crises (grande hystérie) which will be described in detail later.  In 1878 he began exploring hypnosis and experimented with hysterical patients. He found that they developed the hypnotic condition through three stages of "lethargy," "catalepsy," and "somnambulism." Charcot read his findings in 1882 to the Académie des Sciences, giving hypnotism a new prominence in the established scientific world. However, Bernheim and Janet disputed the three stages of hypnosis. In 1884-5 Charcot investigated traumatic paralyses, which he replicated using hypnosis. Thus, Charcot grouped hysterical, post traumatic and hypnotic paralyses under "dynamic paralyses" as opposed to "organic paralyses." Likewise, in 1892 he distinguished "dynamic amnesia" from "organic amnesia." Charcot as nicknamed "Napoleon of Neuroses" and his public lectures attracted laymen, physicians and foreign visitors (included Sigmund Frued between 1885-6).  

Thursday, April 2, 2015

Sippur Yetziat Mitzraim, Narrative Therapy and Amalek

As humans we are constantly creating narratives about ourselves and the world. At times those narratives can be limited or limiting; we only tell half of the story, minimizing or maximizing aspects, and sometimes never aware of significant dimensions of the narrative. Narrative therapists pay special attention to the stories we tell, and invite people  “to take a new look at their own lives and to find significance in events often neglected, to find sparkling actions that are often discounted, to find fascination in experiences previously overlooked, and to find solutions to problems and predicaments in landscapes often previously considered bereft.” 1


Thus, the story-telling on Passover night is not merely an act of remembrance; it is a creative redemptive force. It is through telling the story of our exile and redemption - delving into and exploring our history year-in and year-out -  that a more full, true, and pristine Vision emerges. The Sefat Emet (Pesach 5635) explains:


"It is stated in the Haggada that 'All those that tell the story at length are praiseworthy,' for story-telling [sippur] leads to knowledge [da'at], as the verse states 'and that you may tell in the ears of your son, and of your grandson...  that you may know that I am the Lord.' Since the Exodus from Egypt is written in the Torah and the Torah was given to Israel, it has the potential to awaken the force of redemption, for the redemption moves from potential to actual through story-telling. This is similar to the relationship between the Written Torah and the Oral Torah through which Israel creates new understandings of Torah. This comes through the power of language, which reveals hidden reasons.

“The Tannaim [R. Yosi the Gallilean, R. Eliezer, and R. Akiva] mentioned in the Haggada accomplished this when they expounded that each plague consisted of four or five plagues and at the splitting of the sea two-hundred and fifty plagues. These plagues were hidden in the plagues [explicit in the narrative], and the Tannaim brought them from potential to actual. This is the meaning of  'All those that tell the story at length are praiseworthy,' that they increase and expand the miracles through recounting the Exodus.

“The final redemption will emerge when all of the hidden aspects of the narrative of the Exodus from Egypt will become clarified. The initial redemption included within it the future redemption. This is why the Sages stated that ‘All the days of my life’ comes to include the Messianic era, since through remembering and recounting the Exodus it will bring the Messianic era.”

However, there is an insidious danger in viewing our current narratives as incomplete, contingent, and malleable. It can lead to the destructive view that all narratives are relative, subjective, socially constructed, and ultimately meaningless. This outlook maintains that there is no such thing as Reality, Truth, and Objectivity; all narratives can be deconstructed and subverted. In fact, it was this perspective of Amalek that confronted Israel when they first left Egypt. The Sefat Emet continues:


“When Israel left Egypt it was intended that this would be the final rectification, with the revelation of God is One and His Name is One. However, the wicked Amalek confused Israel, as it states: '[Amalek] cooled you [the Children of Israel] on the way'. Therefore we must remember our hatred of Amalek for all time since they caused all future exile. Only through telling the story of the Exodus from Egypt every year will the ultimate rectification emerge and the name of Amalek erased little by little.”

Amalek, the primal cynics, injected doubt into the minds of Israel. The philosophy of Amalek expounds that all life just “happens” and is lacking any telos and purpose. All that is precious and sacred is targeted by Amalek’s cynicism. In a moment of weakness, Israel’s confrontation with Amalek led them to question the absoluteness of their redemption. It placed a question mark on their narrative and they were thus open to doubt if “God is in our midst or not” (Exodus 17:7).


Since then we have been struggling to piece together the complete story year after year, knowing that we cannot capture the full picture in our current state but that through asking the questions and being open to new answers we can slowly awaken to the full Vision of Redemption.


“Every time we ask a question, we're generating a possible version of a life” 2


“Why is this night different than all other nights?...Next year in Jerusalem!”


1 Retelling the Stories of Our Lives: Everyday Narrative Therapy to Draw Inspiration and Transform Experience, by David Denborough, p. x, quoting Michael White

 2 David Epston in,Narrative Therapy: The Social Construction of Preferred Realities, Jill Freedman and Gene Combs, p. 113

Sunday, March 22, 2015

The Discovery of the Unconscious By Henri F. Ellenberger (1970): Summary of Chapter One


Chapter One: The Ancestry of Dynamic Psychotherapy

1.     Primitive healing theory and techniques display many similarities to modern psychodynamic theory and techniques. This has been recognized by Charcot, Levi-Strauss, Aldous Huxley, and Oskar Pfister, among many others. As will been shown in chapter two there is also a historical continuity between primitive healing and modern psychotherapy.
2.     Forest E. Clements distinguished five main aspects of primitive disease theory and healing:
3.     Disease-object intrusion -> Extraction of disease object
a.     Loss of the soul -> To find and restore lost soul
b.     Spirit intrusion -> Exorcism, mechanical extraction of foreign spirit or transference of foreign spirit into another being
c.     Breach of taboo -> Confession or propitiation
d.     Sorcery -> Counter magic 
4.     Loss of soul is related to the dynamic concept of patients being "alienated and estranged" from self, or an "impoverished ego" which needs to be reconstructed.
5.     There are three general types of possession (see Oesterreich):
a.     "Somnambulic possession" where the individual loses consciousness of self and speaks with the "I" of the supposed intruder vs. "Lucid possession" where the individual feels a "spirit within his own spirit"
b.     Spontaneous vs. artificial possession. The latter is not a disease but a voluntary mental technique
c.     Overt vs. Latent possession. It is latent when the patient is unaware of the spirit. The exorcist's task is to make the possession manifest.
6.     The modern possession/exorcism case of Gottliebin Dittus and the Reverend Blumhardt (1842/3) has been the subject of much discussion from a psychiatric standpoint (e.g. Michaelis, Benedetti).
7.     Other primitive healing techniques included:
a.     Healing through (public) confession: In modern terminology this is known as a pathogenetic secret and it being made conscious. This played a role in hypnosis and was emphasized by Moritz Benedikt in 1864. This greatly impacted Breuer/Freud,  Pfister, Janet, and Jung. 
b.     Healing through gratification of frustrations
c.     Ceremonial healing: There are many different types but sometimes they take on the character of psychic shock therapy or psychodrama. They might re-enact a trauma or a myth. They often included song, art and rituals.
d.     Healing through incubation: This was usually part of a larger ceremony but this segment consisted of spending a night in a cave or sanctuary. Therapeutic dreams or visions were the healing agents.
e.     Healing through hypnosis: It is not clear if this was a therapeutic agent or a side effect of other procedures.
f.      Magical healing: There are many different practices and types of magic but it is understood that suggestion plays a large role in its efficacy.
g.     Rational therapies: This includes diet, massage, oils, bathing, light work, sleep schedule, abstinence from alcohol etc.
h.     Philosophical psychotherapy: The Greek schools of philosophy were not merely proponents of philosophical systems but were organized sects. This included mental training, mode of living, education, discipline, and written and verbal exercises to develop control over emotions. It has been suggested by R. de Saussure that Stoicism is found in the Adlerian and existential schools of psychotherapy, Platonism in the Jungian school and Epicureanism in Freud's school.
i.       Religious healing and "Cure of souls":  This consisted of confession and moral theology taught by priests, and use of the charismatic personality of a pastor.

8.     Modern dynamic psychotherapy derives from primitive medicine with an uninterrupted continuity. As will be shown in next chapter, exorcism developed into magnetism, magnetism into hypnotism, and hypnotism into the modern dynamic schools.