[871] All those professional colleagues who are interested in the great problem of hysteria will surely welcome with joy and eager expectation a work that, judging by its bulk, promises a thorough-going treatment of the psychology of hysteria on the broadest possible basis. Anyone acquainted with the present position of the hysteria theory, and especially the psychology of hysteria, is aware that our knowledge of this obscure field is unfortunately a minimal one. Freud’s researches, which have received but scant recognition though they have not yet been superseded, have prepared the ground for thinking that future research into hysteria will be psychological. Hellpach’s book appears to meet this expectation. Casting the most cursory glance at the index of names appended to the end of the book, we find the following cited: Archimedes, Behring, Billroth, Büchner, Buddha, Cuvier, Darwin, Euler, Fichte, Galileo, Gall, Goethe, Herbart, Hume, Kepler, Laplace, de la Mettrie, Newton, Rousseau, Schelling, and many others, all illustrious names among which we now and then light on that of a psychiatrist or neurologist. There can be no doubt at all that a future theory of hysteria will go far beyond the narrow confines of psychiatry and neurology. The deeper we penetrate into the riddle of hysteria, the more its boundaries expand. Hellpach thus starts from a basis of great scope, assuredly not without reason. But when we recall the limitless range of knowledge indicated by the names in the index, Hellpach’s basis for a psychology of hysteria would seem to have undergone a dangerous expansion.
[872] From various hints thrown out by the author we gather that he is inclined to suspect adverse critics of being ill-intentioned. I would therefore like to say at once that I have no prejudices against Hellpach. On the contrary, I have read his book sine ira and with attention, in the honest endeavour to understand it and be fair to it. The text up to p. 146 can be considered an introduction. There are disquisitions on the concepts, theories, and history of science, ranging over every conceivable field of knowledge, which at first blush have nothing to do with hysteria. A mere handful of aphorisms culled from the history of the hysteria theory, chiefly appreciations of the achievements of Charcot and other investigators, have a tenuous connection with the theme. I do not feel competent to criticize the highly generalized discussions on the theories of scientific research. The sidelights from the history of hysteria research are neither exhaustive as a presentation of the subject nor do they offer the researcher anything new. They make practically no contribution to psychology.
[873] The actual treatment of the theme begins on p. 147. First we have a discussion on suggestibility. Here Hellpach’s thinking and his sure touch must be applauded: he is tackling one of the most difficult points in the hysteria theory. It is immediately obvious that the current concept of suggestibility is rather vague and hence unsatisfactory. Hellpach tries to probe the problem of volition and motivation by analysing “command” and “suggestion.” The analysis leads on to a discussion of mechanization and demotivation: emancipation of the act of will from the motive. By various convoluted trains of thought we then get to the problem of apperception (as understood by Wundt), which is intimately connected with the problem of volition. Hellpach attaches particular importance to one quality of apperception, and that is the extinction of sensation. Stimuli which are only just perceptible on the periphery of the visible field may under certain circumstances be extinguished, but the source of the stimulus (small stars, etc.) disappears as the result of focussing. This observation is extended by analogy to apperception, so-called active apperception taking over the role of focussing. A sensation-extinguishing effect is thus attributed to apperception. Hellpach expatiates at length on this notion, unfortunately in a hardly intelligible manner and without adducing sufficient reasons in support. Extinction of sensation seems to him to be something common and regular. But actually it is an exception, for apperception does not extinguish sensation—on the contrary. The discussion on apperception culminates in the passage: “The control that in the more passive state of apperception extends over the whole field of consciousness disappears with the increasing tension of active apperception. This gives rise to distracted actions.”
[874] A further “state of apperception” Hellpach finds in “emptiness of consciousness.” Here he undertakes, among other things, a little excursion into the uncultivated deserts of dementia praecox and carries off, as a trophy, negativism as a manifestation of suggestibility in the empty consciousness of the catatonic—as though anyone had the slightest idea of what the consciousness of a catatonic looks like!
[875] The following sentence may be taken as the final result of his analyisis of suggestibility: “I regard complete senselessness or complete lack of moderation as the criteria for all psychic effects that can be called suggestions.” Unfortunately I can make neither head nor tail of this. In the course of a fifty-page analysis the concept of suggestibility has, to be sure, rambled off into nebulosity, one doesn’t quite know how, nor does one know what has become of it. Instead we are offered two peculiar criteria for suggestion, whose beginning and end both lie in the realm of unintelligibles.
[876] There now follows a chapter on one of the thousand hysterical symptoms: ataxia-abasia. The essence of this chapter is its emphasis on the meaning of hysterical paralysis. Another chapter deals with the meaning of hysterical disturbance of sensation. Hellpach treats hysterical pain-apraxia as an illness on its own, but offers no proof of this. Equally, he treats hysterical hyperaesthesias as a physiological and not a psychological problem. Here again conclusive reasons are lacking. Particularly in hysteria, however, “explanatory principles should not be multiplied beyond the necessary.”2 To explain anaesthesia, Hellpach uses the apperceptive extinction of sensation, that aforementioned paradoxical phenomenon which is anything but a simple, certain, clear-cut fact. The proposition that hysterics cease to feel when they ought to feel must be applauded. But this singular fact should not be explained by an even more obscure and ill-founded observation.
[877] Hellpach finds the hysterical intellect characterized by fantastic apperception and tractability. Fantastic apperception is a psychological state in which “fantasy activity is linked with a tendency towards passivization of apperception.” One can dimly guess what Hellpach is getting at with this turgid pronouncement, but I must own I am incapable of forming any clear conception of it. And I do not think that Hellpach had any clear conception of it either, or he would have been able to communicate it to an attentive reader.
[878] Hellpach defines tractability as follows: “The tractable person is one who meets the demands made upon him willingly or with psychic indifference, or at least without actively fighting down inner resistances.” Suggestibility, which in an earlier chapter vanished beneath a flood of psychological and conceptual verbiage, unexpectedly surfaces here in the innocuous guise of “tractability.”
[879] In the chapter entitled “The Psychological Bar to a Psychology of Hysteria,” we get to the “root phenomenon of hysteria.” The “disproportion between the insignificance of the affective cause and the intensity of the expressive phenomenon” is supposed to be the core of hysterical mental abnormity.
[880] The last section of the book deals with the further elaboration and application of the principles previously laid down, and partly with a discussion of Freud’s teachings in regard to the genesis of hysteria. It is to Hellpach’s credit that he understands Freud and is able to keep in check and counterbalance certain biases and exaggerations of the Freudian school. But as regards the genesis of hysteria he nowhere advances beyond Freud, and in point of clarity he lags far behind.
[881] Now and then Hellpach makes sorties against the “unconscious.” He set out to explain various expressive movements in hysteria without reference to this hypothesis. This attempt deserves to be read in the original (pp. 401ff.). To me it seems neither clear nor convincing. Moreover, expressive movements are, par excellence, not unconscious phenomena. It is known that the hypothesis of the psychological unconscious is based on quite other facts, which Hellpach does not touch on. Even so, he makes use of the concept of the unconscious several times, probably because he knows of no better one to put in its place.
[882] His attempts in the concluding chapters to elucidate the sociological and historical aspects of the hysteria problem deserve to be greeted as a general tendency; they show that the author has an unusual, indeed splendid over-all view of his material. Unfortunately he remains stuck at all points in the most general and uncertain of concepts. The net result of all this effort is disproportionately small. The psychological gain reduces itself to the announcement of a grand design and to a few astute observations and interpretations. For this failure the blame lies not least with the extreme infelicities of Hellpach’s style. If the reader has at last managed to grasp a sentence or a question, and then hopes to find its continuation or answer in the next sentence, he is again and again pulled up by explanations of how the author arrived at the first sentence and all that can or could be said about this first sentence. In this way the argument proceeds by fits and starts, and the effect of this in the long run is insufferably fatiguing. The number of wrong turns Hellpach takes is astonishing, but he enumerates still more circumstantially how many others he could have taken. The result is that he often has to explain why he is coming back to his theme again. Because of this, the book suffers from a peculiar opacity which makes orientation extraordinarily difficult.
[883] The author has, furthermore, committed a grave sin of omission in that he cites next to no examples. This omission is especially painful when pathological phenomena are being discussed. Anyone who wants to teach something new must first teach his public how to see, but without examples this is impossible. Maybe Hellpach could still come out with a few good and new things if he deigned to descend into the nether regions of case material and experimental research. If he wishes to address himself to the empiricist at all, he will find this advice assuredly justified.