Rebel Without a Cause

by Robert M. Lindner

  It is within the realm of possibility that the intention of the overt psychopathic symptom, as we see it on the ward, in the street, the courtroom or the consulting room is to relieve the tension produced by underlying conflicts and restore the internal balance. If such is the case, some of the specific signs of the disorder no longer need puzzle us. As an instance, it has been noted that the emotional response of the psychopath to his depredations or other acts is lacking; and this (it follows) is to be expected since a state of dynamic equilibrium, of inner physiological and psychological peace, has been obtained through the release which produced the aggression, the asociality. Furthermore, if the homeostatic interpretation of the disorder is sufficient to the case we may have hold of a reason for diagnostic distinction between psychopathy and other conditions. For example, when the drainage is incomplete and inadequate, leaving a residue of tension and distress, guilt and remorse arise to form the symptoms manifest as in neuroses.

  III

  We have so far sketched the individual precipitating mechanisms which touch off the psychopathic personality patterning; and we have touched upon the possible predisposants of the condition. Since, however, behavior does not take place in a vacuum nor is it ever independent of the peculiar setting against which it is staged, we have yet to remark concerning the social milieu which acts to awaken latent psychopathy in the same manner as any one or group of psychological factors already discussed.

  It is a thoroughly unoriginal contention of the writer that modern society provides amply for those conditions which make for traumatization of the personality along the specific lines which lead to the evolution of the psychopathic type. These conditions flourish, for the most part, in cities or densely-populated areas resembling cities where personal and familial privacy (among other factors) are absent, and where infancy and early childhood are more than normally hazardous periods. They do not have to be stressed here, since only the conveniently deaf have failed to hear the sociologist’s condemnation of the manner in which we permit a broad segment of our population to live, and the psychologist’s monotonous belaboring of the unwholesome effects of pernicious environmental factors.

  Together with the abomination of unplanned cities and mushroom industrial centers, modern American society errs in failing to provide the kind of substitute for self-expression which in other times and in other cultures drained off a considerable portion of behavior opposed to the best interests of the most people and helped combat the sociogenic psychopathic virus.

  Concentration in cities coincident with the disappearance of frontiers—both physical and psychological—is the responsible social factor in the genesis of the psychopathic pattern. Behaviorally regarded, the psychopath’s performance is of the frontier type.

  Now it is both a psychological and sociological fact amply demonstrated in literature and history that frontiers and outposts are scenes of behavior that is typically unsocial and psychopathic. Our own West has won world renown as the theatre of crime and vice, outlawry and drunkenness, and every other type of conduct opposed to the standards of the rest of the country. There seems, in fact, to be a variety of community activity which is best expressed by the word ‘centrifugal,’ in which the community functions as a giant centrifuge in throwing off behavior contrary to the best interests of the group. It is to be noted in the saga of every great city how, in the early life of a community, the habitation of vice and crime is invariably established on the outskirts and borders. The modern roadhouse is an apt illustration of this principle. After a time the expanding city encloses these places and encysts the evil within itself. Frontiers and borders are, however, admirably suited to the working off of compulsive antisocial behavior; they sparkle with the glitter of personal freedom; the checks and reins of the community are absent and there are no limits either in a physical or in a psychological sense. So when the geography of a nation or a community or even a civilization becomes fixed, behavior of an unsocial variety which has been flung there by centrifugal action, now works itself out in a harmful manner in the culture itself. Especially is this true where the psychological horizon is similarly limited by economic underprivilege, lack of educational opportunities, the immediacy of poignant social contrasts and repetitious occupational activity; in a word, by social disinheritance.

  IV

  It seems to this writer that it is of paramount importance that we know more about psychopathic personalities than the tentative conclusions we have thus far outlined. While the present status of psychopathy is that of an irritant to the clinician (who despairs of doing anything more than diagnosing a case), a local annoyance to prison and hospital officials, a source of problems to police and service officers, and a slough of shame and hopelessness to sorely-tried parents and relatives, the essence of the problem of psychopathy is that it represents a social and even political problem of the first magnitude. It is the contention of this investigator that psychopathy is more wide-spread today than ever before in the history of our civilization; that it is assuming more and more the proportions of a plague; that it is today ravishing the world with far greater ill effect than the most malignant of organic diseases; that it represents a terrible force whose destructive potentialities are criminally underestimated.

  That the incidence of psychopathy is increasing is evident not from the neat statistical studies originating in the basement laboratories of our universities or the brightly-lighted halls of government bureaus but from a glance at the current world situation. The last few years have witnessed the triumphal heavy-booted march of psychopathy not only over an entire continent but over every painfully won tenet of what we call our civilization. And as when a stone is cast on still waters, the mononuclear psychopathic center has communicated its convulsive impulses outwardly to awaken latent psychopathy many times removed from the volcanic core.

  This is the menace of psychopathy: The psychopath is not only a criminal; he is the embryonic Storm-Trooper; he is the disinherited, betrayed antagonist whose aggressions can be mobilized on the instant at which the properly-aimed and frustration-evoking formula is communicated by that Leader under whose tinseled aegis license becomes law, secret and primitive desires become virtuous ambitions readily attained, and compulsive behavior formerly deemed punishable becomes the order of the day.

  History has assigned to this country and her allies the task of cleansing civilization of the predatory creature whose typical history is presented in this volume. Psychological science has provided us with an instrument to study him closely and at first hand; to examine him thoroughly as we would a virulent bacillus; to dissect him and obtain his measure; perhaps even—assisted by those great social forces which are beginning to clear the slime and muck of underprivilege and economic expediency—to make of him a good citizen in a new world …

  THE METHOD: HYPNOANALYSIS

  I

  Since the cavalier abandonment of cathartic hypnosis by the founding fathers of psychoanalysis instituted a tradition of disrepute for hypnosis in particular and suggestive therapy in general, psychiatrists and psychologists have been wary of identifying themselves with treatment procedures reminiscent of these methods. However, informal use has undoubtedly been made of the investigative and therapeutic technique herein to be described and illustrated as hypnoanalysis. In no place and at no time, though, has it been subjected to careful scrutiny as a respectable procedure warranting the serious and unprejudiced consideration of clinicians engaged in the study and treatment of mental or behavior disorders.

  The variety of hypnoanalysis to be dealt with in the following discussion literally grew under the hand of the writer from the first tentative experiments in 1939 through to what at this writing is a respectable list of differing diagnostic categories. At no time did it spring forth full-blown and armored: its growth was independent, painful; its application cautious and, in truth, hesitant. It is as yet in a formative stage, and not all of its principles and precepts can be expounded. But, so far as it has matu
red in practice, it would seem to be at least a technique that merits, if nothing more, the critical appraisal of co-practitioners.

  Hypnoanalysis is primarily an instrument, a method, a way of approach to the riddles of behavior posed by maladjustment, crime and psychopathology. As its name proclaims, it is a technique compounded of psychoanalysis and hypnosis. From psychoanalysis it has extracted certain procedural modes and the interpretative core. In return it acts to validate beyond question the data of analysis and to provide a fixative means for the therapy without which analysis is no more than an exercise in diagnosis. From hypnosis it has drawn a probe for penetration into the darkest recesses of human performing. In return it increases the scope and function of an ancient and honorable art, removes from it the stigmata of mystery, charlatanry and ill-fame, and recalls it from the limbo where it was so hastily consigned at the turn of the present century. But while it acknowledges a sizable debt to both techniques, the very fact that it should have been necessary to call hypnoanalysis into existence is a proof of the inadequacy of each.

  Suggestive or hypnotic therapy has been concerned almost solely with the alleviation of symptoms. Very likely this has been because its practice was confined almost exclusively to physicians, who notoriously subscribe to a faith that immediate ‘relief’ is everything. A course of hypnosis aimed specifically at amelioration may for a time obviate pain or discomfort. Symptoms disappear; the organism resumes its accustomed pattern of functioning. But the tragedy is that symptoms return, often under a different guise. In the enthusiasm for ‘cure’ the obligation to discover and deal with causes has been studiously and conveniently ignored by all except such flinty pioneers as Janet and the French school, and in this country Erickson and Kubie as well as various assorted daring souls at Bellevue and in Topeka.

  Beyond this, hypnosis has been the victim of a series of malicious fictions that do not bear the light of investigation, yet have been propagated in the manner of tribal taboos on the basis of pontifical injunctions from the higher councils of Vienna, New York, Chicago and Boston. We shall weigh some of the evidence later.

  As for psychoanalysis, it stands indicted for what Devereux has rightly called its “ritualistic” character; its insistence upon punctilious cant and unrelaxed ceremony. From it has arisen a virtual man-darinism that appears to be not only inflexible but also opposed to the public interest. The activities of psychoanalysts have by and large remained hidden from the public eye, since the bulk of humanity is excluded from the quiet of the analytic chamber; and consequently there has been developed about it and its devotees a lush, effete, decadent, even (in the public mind) an obscene repute. Thus its virility, the essential wholesomeness idealized for it by its founders, has been denied it by its own champions. And beyond its economic inexpediency and cultism of orthodoxy, its endlessness in point of time constitutes a barrier to practicability, especially when it is compared by the laity with the relative swiftness of modern medical practice.

  The relinquishment of hypnosis as an agent in analysis was encouraged by the early analysts. They urged, in the first place, that its use was limited since (they claimed) not all patients could be hypnotized. Now it seems that this criticism is not only unjustified but, in a sense, ludicrous when it originates with practitioners of a method which is confined to individuals under a certain age, possessed of a certain level of intelligence and generally obliged to fulfill other conditions. And what is more, it is not conclusive that all individuals cannot enter the hypnotic state. While this writer has encountered persons whom he could not immediately hypnotize, he has found that failure was usually due to (1) the fact that in the eyes of his subject he lacked prestige; or (2) that he too soon abandoned his efforts. It is now his belief that there is no other reason for the inability of some persons to enter a hypnotic trance than the fact that in such cases the transference—depending as it does upon the neat balance of prestige, flow of energy toward the analyst and the analyst’s own attitude—is inadequate. Where the transference is complete and adequate, hypnosis can be accomplished. Positive transference in a very real sense is actually the end-product of disintegrated resistance. Hypnoanalysis offers a means to the dissolution of the resistance normally present when treatment begins, and for the continual control of the transference as treatment proceeds. Moreover, with such a method Stekel’s objection that the patient “is never freed from the transference” is meaningless, since its dissipation becomes, through hypnosis, a relatively simple matter.

  In the past hypnosis was likewise regarded unfavorably since it was said that although a specific symptom could be ‘cured’ through the emotional catharsis during the trance, the ‘cure’ was temporary. Anna Freud has even stated that in hypnosis the ego could take no part in the therapeutic procedure, implying that the patient was robbed of the cathartic working-through of the precipitating events. But the hypnoanalytic method—as will be explained and demonstrated subsequently—guarantees the full effect of the cathartic action by providing not only that the emotion these events evoke sich auswirken in the trance state but in the waking state as well. It is a sort of ‘double-action,’ certifying the reliability and validity of what transpires, enabling the clinician to measure accurately the depth and color of feeling involved and, above all, is one in which the whole personality shares. The further objection to hypnosis on the score that it influences those ‘unconscious’ factors which have been striving for expression and does not effect the prohibiting ‘forces’ responsible for their exclusion is correspondingly obviated by the peculiar hypnoanalytic concern with resistances and their dynamic treatment.

  Through the use of hypnoanalysis the period of treatment for most if not all psychopathological conditions can be shortened effectively without loss to the patient, for the cathartic and abreactive processes are just as complete and the therapeutic yield as rich as that claimed for any other given psychotherapeutic tool. In this respect the method may be viewed as an heroic one, assaulting the organism somewhat in the manner of metrazol or electric-shock therapy, literally tearing aside the veil. Hypnoanalysis should last no more than three or four months, the final month being devoted to reorientation, exposition and re-education. With Stekel, the writer holds that the orthodox analysts betray a lack of psychological acumen in their naive dependence upon patients to disclose their secrets voluntarily. It is always to be reckoned with that there is in any psychological condition of mal- or dysfunction a gain to the patient that bids him cling to his symptoms or ways of behavior. It is in the establishment of satisfactory transference relationships, in the overcoming of resistances and natural reluctances and, finally, in the attempt to promote relinquishment of these “rewards-of-illness” that time is consumed in the passive way of analysis. With hypnoanalysis it is as if surgical removal of such barriers and hazards has been accomplished. Moreover, each disclosure is subject to test; and so the presence of screen-memories which so frequently blur and obscure true but latent memories of utmost importance—and so often lead astray—do not interfere with the progress of the analysis.

  The peculiar conditions of hypnoanalysis make insignificant the question regarding the validity of hypnotic data, since the core of the method is a perpetual checking of material obtained in both the waking and the hypnoid states. Because of this, the position that the hypnotic reaction is an hysterical one is demonstrably untenable.

  II

  Hypnoanalysis functions both as a research and a therapeutic instrument. In its investigative capacity it operates to pierce to the psychic substrata in the most direct fashion and thence to raise to the level of awareness the repressed, often emotionally surcharged material. It seeks also to validate beyond doubt the contents of that segment of ‘consciousness’ which is not immediately available to ordinary recall. As a therapeutic tool it provides for the development of self-knowledge based upon a reconstructed approach to individual history. It further aids in the implantation of healthy attitudes and approaches to life by imbedding fir
mly, as novel accretions to the personality, the analytic interpretations arrived at through the mutual efforts of analyst and patient.

  A hypnoanalytic course of investigation or therapy is initiated by training in hypnosis. The writer’s method is first to instruct patients or subjects in the technique of achieving the trance state with a minimum of effort on the part of either participant. In a series of daily sessions wherein the aim is to enable a rapid passage from the waking state to sleep, patients are familiarized with hypnosis and its functions. The usual response—no matter what the condition of the patient or his problem—is a rapid mobilization of all those factors which comprehend a workable and manipulable transference. By the end of this preliminary period (to which no more than a week is given) that unique relationship is in a state of readiness for exploitation.