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Classics in Psychology

Robert H. Wozniak - Bryn Mawr College

Hippolyte Bernheim: Suggestive Therapeutics (1886; English 1889)


In the mid-1860s, a French physician who had been working among the poor in a small village not far from
Nancy, published a book on the therapeutic use of a form of sleep variously known as artificial
somnambulism, magnetic, or hypnotic sleep.219 Unlike most of those who had preceded him, 220 AmbroiseAugustin Libeault 221 recognized the central importance of mental suggestion in the induction of hypnotic sleep
and the enhanced susceptibility to mental suggestion that characterized a patient who had been hypnotized.
Putting his patients into a light trance, he assured them that their symptoms were being relieved; and when
they awoke, many found that their condition had improved.
When rumors of Libeault's therapeutic successes reached the University of Nancy, they attracted the attention
of Hippolyte Bernheim, 222 the university's renowned professor of internal medicine. In 1882, Bernheim visited
Libeault and became convinced of the efficacy of his treatment methods. Returning to the university, he
incorporated Libeault's techniques into the regimen employed at the medical hospital, and refined and
rationalized his approach.
In 1884, Bernheim published the first major account of his work, De la suggestion dans l'tat hypnotique et
dans l'tat de veille. 223 Here he provided an historical and theoretical analysis of the nature of suggestion and
the suggestive nature not only of hypnotic phenomena but of all normal automatic behavior. In 1886,
Bernheim revised and expanded this work, adding a section on the application of suggestion to therapeutics.
Published as De la suggestion et de ses applications la thrapeutique and translated into English in 1889 as
Suggestive Therapeutics. A Treatise on the Nature and Uses of Hypnotism, 224 this work is widely considered
to be the classic treatment of mental suggestion.
In Suggestive Therapeutics, Bernheim provided the clearest and most detailed exposition of his theoretical
views. While these views were not for the most part original, 225 they were so effectively articulated and so
well supported by clinical observation and Bernheim was a figure of such high scientific reputation that they
exerted a powerful influence on late 19th and early 20th century psychology. Figures as diverse as Sigmund
Freud, James Mark Baldwin, and Walter Dill Scott made significant use of Bernheim's views. 226
Suggestive Therapeutics also served as the definitive text for what came to be called the 'Nancy School' of
'psychotherapeutics.' Following its publication, enthusiasm for the therapeutic application of suggestion began
to gather momentum; and by the turn of the century, the Nancy approach had become widespread, both
within Europe and throughout the United States. 227
For Bernheim, suggestibility was defined as the capacity to transform an idea directly and automatically into a
sensation or movement. Sensations and movements so produced were respectively called ideosensory or
ideomotor automatisms, where an automatism is any simple or complex activity proceeding without conscious
monitoring, without conscious volition.
Suggestibility, Bernheim believed, was a natural state of the normal, healthy individual. Only when
automatisms were consciously regulated by reason, attention, and judgment was suggestibility reduced. Any
condition that tended to lessen the influence of consciousness, therefore, would tend to increase suggestibility.
Natural sleep was one such condition; so too was the artificial sleep of hypnosis. Hypnosis, on this account,
was a state of enhanced suggestibility in which ideas provided to the subject by the hypnotist tended to lead
immediately and directly to sensation or movement. Paradoxically, this state of enhanced suggestibility was
itself induced by suggestion. The susceptible subject, told 'you are getting sleepy, your eyelids are getting
heavy, your vision is becoming blurry,' lapsed into a state in which the conscious monitoring characteristic of
the waking state was greatly reduced and suggestibility consequently increased.
For Bernheim, then, hypnosis was the result of suggestion rather than a separate and necessary prerequisite
to it. Anyone willing to be hypnotized could be hypnotized; and all of the various hypnotic phenomenacatalepsy, automatic movements, illusions, active and passive hallucinations-could be produced in a willing

subject through the influence of suggestion alone. Although others had hinted at this position, Bernheim was
the first to take it explicitly and unambiguously. 228
Since suggestibility, not hypnotic sleep, was the basic underlying phenomenon for Bernheim, he also argued
that while hypnosis, and especially the deep sleep of somnambulism, helped eliminate the interference of
conscious reason and judgment and therefore promoted suggestibility, it was not a prerequisite for suggestion
to be effective. The influence of suggestion could be observed in the waking state just as it could under
hypnosis.
This fact, together with the observation that both negative (inhibitory) phenomena such as paralysis and
systematized anesthesia and positive (excitatory) phenomena such as ideomotor actions and hallucinations
could be elicited in the subject through suggestion led Bernheim to the realization that suggestion could be
turned to good effect in relieving subjects of unhealthy symptomatology. This was the method of suggestive
therapeutics and it was to the elucidation of this method that Bernheim devoted the last section of his book.
After providing a short historical review of the various ways in which therapeutic use had been made of
suggestion in the past, even when the effective mechanism was unknown to those who employed it,
Bernheim presented almost 200 pages of detailed observations taken from his own clinical use of this
technique. These case studies documented the use of suggestion in the treatment of diseases of the nervous
system, hysteria, neuropathy, neuroses, paralyses, pain, rheumatism, gastrointestinal ailments, and menstrual
disorders. Coupled as they were with a brilliant theoretical analysis of suggestibility, Bernheim's observations
provided both a persuasive argument for the use of suggestive therapeutics and a manual for how to proceed.
219

Libeault, A-A. (1866). Du sommeil et des tats analogues, considrs surtout au point de vue de l'action
du morale sur le physique. Paris: Victor Masson et fils; Nancy: Nicolas Grosjean.
220

By 1866, the therapeutic use of artificial somnambulism already had a long history, beginning with its
discovery in 1789 by Amand-Marie-Jacques de Chastenet, Marquis de Puysgur. While most of those involved
in the therapeutic application of artificial somnambulism subscribed to one or another version of Franz Anton
Mesmer's physical fluid theory, a few, such as Abb Faria, Alexandre Bertrand and Gnral Noizet, had early on
recognized the importance of mental suggestion in the production of therapeutic effects. For a lovely
discussion of this history, see Ellenberger, H.F. (1970). Discovery of the Unconscious. The History and
Evolution of Dynamic Psychiatry. New York: Basic Books.
221

1823-1904. For biographical information on Libeault, see Renterghem, A.W. van (1898). Libeault en zijne
School. Amsterdam: F. Van Rossen.
222

1840-1919. For biographical information on Bernheim, see Huard, P. (1973). Hippolyte Bernheim. In C.C.
Gillispie (Ed.). Dictionary of Scientific Biography (Vol. 2). New York: Scribner's, pp. 35-6.
223

Bernheim, H. (1884). De la suggestion dans l'tat hypnotique et dans l'tat de veille. Paris: Octave Doin.

224

Bernheim, H. (1886). De la suggestion et de ses applications la thrapeutique. Paris: Octave Doin; the
English translation, from the second revised edition, is Bernheim, H. (1889). Suggestive Therapeutics. A
Treatise on the Nature and Uses of Hypnotism. New York: G.P. Putnam's Sons.
225

Not only did Bernheim derive much of the content of his views from Libeault, who had, in turn, profited
from the work of those mentioned in footnote 220, he was also anticipated by the British physiological
psychologist, William B. Carpenter, who published a seminal paper on suggestion in 1852: Carpenter, W.B.
(1852). On the influence of suggestion modifying and directing muscular movement, independently of volition.
Proceedings, Royal Institution of Great Britain, 1, 147-53.
226

For Freud, see Chertok, L. & De Saussure, R. (1979). The Therapeutic Revolution. From Mesmer to
Freud. New York: Brunner/Mazel; for Baldwin, see Baldwin, J. M. (1930). James Mark Baldwin. In C.
Murchison (Ed.), A History of Psychology in Autobiography (Vol. 1). Worcester, MA: Clark University Press,
pp. 1-30; for Scott, see Kuna, D.P. (1976). The concept of suggestion in the early history of advertising
psychology. Journal of the History of the Behavioral Sciences, 12, 347-53.
227
228

Renterghem, op. cit.

In doing so, Bernheim placed himself in direct opposition to the great Paris neurologist, Jean-Martin
Charcot, who argued that hypnotic susceptibility was pathological, closely linked to hysteria, and that hypnotic
phenomena emerged in a strictly defined, physiologically determined series of stages. For a discussion of this
interesting controversy, see Ellenberger, op. cit.

Extracted from Classics in Psychology, 18551914: Historical Essays


ISBN 1 85506 703 X
Robert H. Wozniak, 1999
Classics in Psychology, 18551914 Historical Essays - Contents