Classical Psychoanalytic Theories of Hypnosis

Copyright © Donald Robertson, 1998.  All rights reserved.

[This is one of the first articles I published online.  Retrieved from an archive as the original website no longer exists.  I had to explain to some people at the time that this was primarily a historical article, exploring Freudian theory.  I don’t actually endorse Freud’s theory or practice, particularly in relation to hypnosis.]

We psychoanalysts may claim to be its [hypnotism’s] legitimate heirs and we do not forget how much encouragement and theoretical clarification we owe to it.  (Freud, Introductory Lectures, 1917: 516)

Freud’s Psychoanalysis & Bernheim’s Hypnotherapy

Everyone who knows psychoanalysis knows that Freud’s initiation into psychotherapy was via the only genuinely psychical treatment available in his day, hypnotherapy. I will, however, leave aside the fascinating historical and theoretical issues relating to hypnosis and the prehistory of psychoanalysis, in order to concentrate on the somewhat belated theoretical explanations offered by Freud, Ernest Jones, and Sandor Ferenczi. However, some preliminary remarks are in order.

Freud began the serious use hypnosis in his practice in 1887, only a year later he translated the principal textbook of 19th century hypnotherapy into German: Bernheim’s On Suggestion and its Therapeutic Application, to which Freud added his preface. However, he was frustrated by his own difficulty in inducing hypnotic trance, and puzzled by the variability in effectiveness and duration of his suggestions. Freud had always been uncomfortable with the tendency prevailing in his day to ground psychology on the irreducible concept of ‘suggestion’. Consequently he could never accept Bernheim’s influential attempt to reduce hypnosis to the patient’s susceptibility to suggestion, protesting, in his own words, ‘against the view that suggestion, which explained everything, was itself to be exempt from explanation.’ (1921:89). Freud was always to maintain that he was more in sympathy with the views of Bernheim’s great rival Charcot, that hypnotic suggestibility was not an irreducible psychical phenomenon but a symptom of the complex psychopathology of hysteria.

In his clinical research Freud became convinced first of the sexual and then of the infantile origins of the neuroses. Charcot’s innovation was to medicalise hysteria, which had previously been viewed as simple malingering. Freud’s innovation was to see not only hysteria but neuroses in general, as originating in infantile psychosexual attachments – in terms, that is, of erotic desire, relationally. A historical turning point occurred, however, when he began to interpret the one-sided relationship between the patient and doctor as itself a fundamentally neurotic one, a transference on the part of the patient of repressed infantile reactions onto the doctor; referred to as transference-neurosis. Like Charcot, then, Freud saw suggestibility as a symptom of neurosis, or rather as a feature of the underlying mechanisms of neurosis, mechanisms which functioned quasi-neurotically in the irrational activities of everyday life: in dreams, in slips of the tongue, in memory lapses, in love, in humour. Freud, thereby, medicalised normality – remember he wrote the title The Psychopathology of Everyday Life. Likewise, in relation to Charcot’s identification of hypnosis and hysteria Ernest Jones said that the dictum ‘Everyone is a little hysterical’ is a literal fact. Whereas Bernheim objected against Charcot that hypnosis could not be a symptom of hysteria since even non-hysterics could be hypnotised, Freud objected against Bernheim that non-hysterics were nevertheless only suggestible insofar as they were subject to the everyday manifestations of fundamentally neurotic processes.

Hypnosis, therefore, was viewed as the precipitate of an unconscious sexual relationship, a transference-neurosis on the part of the patient, directed toward the doctor or hypnotist. Ferenczi notes with irony the implied reversal, when he writes: ‘The unconscious mental forces of the [patient] appear as the real active agent, whereas the hypnotist, previously pictured as all-powerful, has to content himself with the part of an object used by the unconscious of the apparently unresisting [patient] according to the latter’s individual and temporary disposition’ (1916). What cause variability in the effects of suggestion, therefore, are fluctuations in libido, transferred by the patient onto the hypnotist. Hence, Freud provides the following definition in an article written for the Encyclopaedia Brittanica,

Transference is a proof of the fact that adults have not overcome their former childish dependence; it coincides with the force which has been named “suggestion”; and it is only by learning to make use of it that the physician is enabled to induce the patient to overcome his internal resistances and do away with his repressions.

Although Freud says here that suggestion and transference ‘coincide’ it is doubtful if this can be taken literally, if only because transference is ambivalent, i.e., containing both loving and hostile possibilities. Insofar as hostility predominates the patient will exhibit a general recalcitrance to suggestion. Hence, Ferenczi and Jones both insist that suggestion is just one species of transference relationship. Moreover, even a predominantly positive transference seems unlikely to exhibit the degree or kind of suggestibility occurring in profound hypnotic trance, and Freud admits that suggestibility cannot be straightforwardly reduced to a form of transference. Suggestibility and transference, then, are not simply the same thing. Nevertheless, for psychoanalysis, the phenomenon of suggestion is implicated in the clinical conception of transference, and vice versa.

Consequently, it was possible for psychoanalysts to explain the variable duration of post-hypnotic suggestions by appeal to the inevitable impoverishment of the subject’s transference onto the hypnotist. Months or years after being hypnotised, when the subjects affective attachment to the hypnotist has faded into the past and been replaced by new libidinal ties, hitherto effective suggestions will be rendered impotent. Likewise fluctuations in the effectiveness of suggestion during the course of therapy can be attributed to the vicissitudes of the transference relationship. And of course, the notorious variability in effectiveness of hypnosis between different individual practitioners -who may be employing identical techniques- can be explained in terms of their potential for eliciting a positive transference from particular subjects. Psychoanalysis differed from Bernheim’s hypnotherapy, however, in aiming, among other things, at the resolution of the transference. This resolution is achieved primarily through the judicious use of interpretations, which are offered to the analysand in an attempt to bring his infantile erotic relation to the analyst into consciousness in their specificity. As Ernest Jones puts it, in analysis ‘the suggestive influence of the physician is expressly resolved into its constituent elements’ (Jones, 1911). Consequently, as he states elsewhere, it is generally accepted by analysts that ‘when a patient really recovers from his neurosis his abnormal suggestibility […] greatly diminishes or ceases’ (1910), along with his general propensity for transference.

In other words, clinical psychoanalysis proceeds, in part, by the interpretation and analysis of the very mechanisms which determine suggestibility. For this reason we would expect Freud to provide us with a generalised theoretical interpretation of the phenomenon of suggestibility in terms of the same libidinal mechanisms which determine transference. To provide a psychoanalytic theory of hypnotic suggestion. This does not happen explicitly until 1921, about 20 years after Freud’s discovery of transference, and is tucked obscurely away in his Group Psychology & the Analysis of the Ego. There, ironically, he complains that in the thirty years since Bernheim’s book was published ‘there has been no explanation of the nature of suggestion, that is, of the conditions under which influence without adequate logical foundation takes place,’ (1921:90) and that the concept of suggestion acts as a screen obscuring the fundamentally sexual basis of interpersonal influence.

Love & Hypnosis

Freud’s discussion of hypnosis is embedded within a longer investigation of group processes. The kind of groups which concern Freud are ones which depend for their survival on the influence of a powerful leader, generally this is because they lack the degree of organisation required to function as a genuine democracy. The principle concept which Freud uses to theorise group relations is that of identification. Precisely, what Freud means by identification, however, is not always clear, and his exploration of its various forms is protracted and somewhat tortured. ‘We do not ourselves,’ concedes Freud, ‘regard our analysis of identification as exhaustive […]’ (1921).

In groups, Freud, notes, suggestion and identification generally function along two discrete axes. Firstly, there is a degree of mutual identification between the members of the group -colleagues, comrades, classmates- this form of identification resembles that between siblings; a horizontal axis. Secondly, a qualitatively different identification, one between the individual group members and their leader, teacher, God, or abstract ideal, the father figure; a vertical axis. Identification between group members, however, is strictly subordinate to their identification with the leader, which in a more sublimated form may be replaced by an abstract ideology. (Incidentally, this aspect of Freud’s theory is virtually identical to Sartre’s account of group cohesion in Being & Nothingness, 1943.)

The so-called herd instinct of the group is derived by Freud from the mutually aggressive desire of its members to replace one another in the desire of its leader. The ontogenetic model is this: siblings are jealous of each other for the love they receive from their parents, they want to kill each other but their father won’t let them. Their response to this is to repress their aggression and defend themselves against its subsequent irruption by developing the opposite affect, love (reaction-formation). Moreover, this love is not allowed to be erotic either (sibling incest is cross-culturally the strongest taboo) so it becomes inhibited in its aim, sexual hunger becomes Platonic affection. This Platonic love then regresses to the level of a narcissistic identification, something facilitated by the similarity between siblings-comrades, and their shared attachment to the father-leader. Moreover, this defensive reaction provides a secondary gain, in that identification with the other permits the vicarious enjoyment of the love and approval received by them from the leader or parent. In Freud’s words, ‘social feeling is based upon the reversal of what was first a hostile feeling into a positively-toned tie in the nature of an identification […] under the influence of a common affectionate tie with a person outside the group’ (1921). The development of this narcissistic identification, then, accounts for such phenomena as group hysteria, and mass hallucination; referred to as ‘group contagion’. However, it does so only by appeal to the relation of each group member to the leader, group contagion is subordinate to the vertical axis of suggestion, that between father and child.

Freud several times describes hypnosis as ‘group psychology without a group’. It is unlike group formation in that it consist in a relationship between two people (Freud was presumably not in a position to consider the technique of group-hypnosis). In this respect hypnosis is more like love, indeed, Freud assures us that ‘From being in love to hypnosis is only a short step’ (1921). For Freud, love develops out of primitive sexual attachment by a process of aim-inhibition and sublimation. Love differs from libido, but only by being a refined species of the former. Pure sexual arousal is inherently short-lived, once satisfied it is, at least temporarily, quiescent. Once the aim of sexual satisfaction is inhibited, however, libidinal attachments can never be fully discharged. Making of love a more enduring relationship than libidinal lust, a development that ultimately contributes to group formation and to socialisation. Most love involves some element of primitive erotic gratification, even if it is only through touch or sight. Love, then differs from pure libido by degree of aim-inhibition. Freud places hypnosis at the opposite end of this scale from primitive sexual lust, as the single most aim-inhibited species of love; ‘the unlimited devotion of someone in love, but with sexual satisfaction excluded’ (1921). This, then, is the completely desexualised love of the child for his parents which develops out of the massive psychical reorganisation of the Oedipus situation.

To this schema Ferenczi added an innovative distinction between two forms of hypnotic suggestibility, between a maternal and paternal hypnotic relationship. Ferenczi rightly observed that hypnosis generally takes either of two forms, a warm, permissive, and supportive approach and an aggressive, authoritarian, and directive form. The permissive approach encourages the subject to transfer his identification to the mother onto the hypnotist, the directive approach invokes a paternal transference. Both may entail qualitatively different forms of identification, derived from the identifications of the Oedipal triangle. Little is said about the mechanisms of maternal hypnosis by Freud, Jones or Ferenczi, however I would suggest that it resembles in some respects the narcissistic identification involved in group contagion. (However, identification with the mother ontogenetically precedes the relationship with the father in a way that sibling identification does not).

Regarding the phenomenon of paternal hypnosis, Freud provides a formula which crucially distinguishes it from group contagion. The hypnotic subject’s paternal transference-identification puts the hypnotist ‘in the place of his superego’. The superego, is that part of the mind which critically observes the ego, and which represents the ego-ideal, the image of perfection which it aspires to. Moreover, the superego is for Freud a monument to the psychical trauma of the Oedipus situation. It is both a developmental and a defensive reaction to the threat of castration anxiety. On Freud’s model the prohibitions which the father represents against the infants erotic desire for his mother are introjected, internalised in such a vigorous manner as to constitute an autonomous psychical agency, split off in its functioning from the child’s ego. In paternal hypnosis, then, the subject acts out his infantile relationship to his father, and regresses back to a level of psychical organisation where his superego is not differentiated from his father.

This, then, is my (tentative, and incomplete) overview of the Freudian model of hypnotic suggestion. To it, in conclusion, I would add one more observation. Freud tells us that, depending on how the Oedipus situation is resolved, the degree of dissociation between superego and ego may vary. Moreover, he suggests that it may fluctuate periodically (something he relates to mood swings in manic depression). If Freud is right that authoritarian hypnosis depends on eliciting a paternal transference-identification, then is it possible to employ this approach with an individual whose superego is relatively undifferentiated from his ego, or at stages in a therapy where this dissociation seems to have temporarily waned (as in periods of mania)? Likewise is the permissive maternalistic approach to hypnosis contra-indicated for use with individuals exhibiting a high degree of superego differentiation (such as obsessives)?