Hidden Minds (9 page)

By the age of twenty-three Janet seemed destined to distinguish himself as a philosopher; however, the intellectual climate of the time encouraged the consideration of many other possibilities. Advances in science and technology promised to change the world beyond recognition (indeed, Paris was less than five years away from having its skyline transformed by Eiffel’s engineering marvel that would become one of its defining features). The most controversial advances, however, were occurring in the field of psychology.

In 1882, while Janet was at the École Normale, the eminent neurologist Charcot delivered a highly influential lecture at the Académie des Sciences. He dismissed reservations concerning the credibility of hypnosis and insisted that it could be used to understand mental illnesses, most notably,
hysteria.
In the 1880s hysteria was a relatively common diagnosis. Patients would experience pains or numbness (anaesthesiae) in different parts of the body, adopt unusual postures, and become emotionally disturbed for no apparent reason. These symptoms tended to occur during acute episodes (also called attacks or crises) although minor symptoms such as muscular contractions or numbness could be a permanent feature. Between episodes, patients could make a full recovery; however, their recollection of events that occurred during attacks was usually very poor. Physical investigations failed to reveal any biological problems or diseases of the nervous system. Hysteria was a mystery. When Charcot claimed to have found some answers he became the talk of Paris. The young Janet, like many of his contemporaries at the École Normale, began to formulate a long-term plan to study medicine.

Charcot became what the French described as a
prince de la science.
He was a distinguished investigator, whose wealth and reputation gave him influence that extended well beyond the parameters of academic medicine. He once arranged an informal meeting that resulted in the formation of the Franco-Russian alliance; however, he was most famous for his dramatic lectures which (like Elliotson’s antics with the Okey sisters) became major cultural events, attracting visiting foreign dignitaries, writers, celebrated actresses, and, needless to say, members of the medical and scientific community.

Charcot would often use patients to illustrate key points, beguiling his audience by showing how hysterical symptoms could be created and removed by the power of suggestion. In spite of his enormous historical importance, it is difficult to assess the value of Charcot’s work. Indeed, it has been suggested that, at least to some degree, Charcot, his students, and his patients, all colluded with each other to keep the ‘circus’ going. The show that they devised was very successful, and ensured celebrity for all who took part. One patient, for example, became known as the ‘Queen of the Hysterics’. Charcot believed that much could be learned from the study of faith healing and perhaps, in the final reckoning, Charcot’s greatest clinical tool was not hypnotism but showmanship. Like Mesmer before him, Charcot’s charismatic carriage and performances worked by raising expectations of improvement – the placebo effect.

Irrespective of the ultimate value of his work, Charcot inspired a generation of European intellectuals, a good example of which was the young philosophy teacher in Le Havre, indeed, when a small ward was placed at Janet’s disposal in Le Havre hospital, he called it — in jest, but nevertheless revealing a deep respect – Salle Saint-Charcot. Not only had Charcot’s work suggested to the young Janet that hypnotism might be used to good effect in clinical settings, but it also suggested that ‘physical’ problems might have a psychological origin. Moreover, this psychological origin might take the form of ‘ideas’ that the patient was ordinarily unaware of. These fixed ideas –
idées fixes
– were perhaps lodged in some inaccessible part of the mind that could be exposed by hypnosis. This concept, one that Charcot never fully developed himself, made a deep impression on the young Janet. Indeed, its influence would affect the direction of his work for many years.

After the extraordinary (although ultimately unsatisfactory) case of Madame B, Janet was given permission by Dr Gibert to examine another young woman. Although her case would never lure the likes of Frederick Myers across the English Channel, it would inspire Janet to consider more carefully the clinical implications of his ‘experiments’,

Lucie was only nineteen. She suffered from an anaesthetic (insensate) hand and hysterical paralysis of the arm. Moreover, she was tormented by fits of absolute terror and extreme anxiety. When asked to account for her behaviour she could give no explanation. Her perplexed and repeated response was merely, ‘1 don’t know why’. In order to understand the origins of her fear, Janet employed a technique usually associated with the practice not of medicine but of spiritualism: automatic writing.

Janet had found that patients left holding a pen would begin writing automatically, particularly if their attention was focused elsewhere. He subsequently began to refine his technique. Janet enlisted the help of a colleague who conducted a conversation with Lucie. Meanwhile, Janet placed a pen in Lucie’s anaesthetic hand and whispered questions to her from behind. Lucie seemed completely unaware of Janet’s questions; however, without interrupting her primary conversation, she began to write. Although Lucie was ordinarily unable to tell her story, a part of her mind – dissociated from the rest – was able to write it.

When Lucie had been seven years old two men, concealed behind a curtain, had frightened her as a practical joke. When Lucie experienced her fits of terror, a part of her mind was reliving that same moment; however, the truly remarkable discovery, was that this ‘part’ of her mind had acquired a separate identity. Lucie was not only a nineteen-year-old woman, she was also Adrienne – a secondary personality fated to exist in the overwhelming and terror-filled world of a child. The early trauma had fragmented a single consciousness into two, one concealed within the other like a Russian doll. Janet hypnotised Lucie and, exploiting her state of heightened suggestibility, began to remove her symptoms. Adrienne disappeared. Janet observed: ‘It is because the unconscious has its dream; it sees men behind the curtains, and puts the body in the attitude of terror.’

Although Janet’s treatment method was not very different from his contemporaries (removing symptoms by suggestion in hypnotised subjects was not new), his investigative technique (automatic writing) was novel and inventive. Moreover, Janet was clearly already formulating a sophisticated theory Traumatic memories could be replaying, over and over again, in the unconscious, literally paralysing the body with fear. He was definitely on to something,

Janet’s next case provided him with a yet more powerful demonstration of the effects of unconscious thoughts and memories, A young woman, known as Marie, had been brought from the country to Le Havre hospital. At the age of only nineteen she was considered both insane and incurable. Marie suffered from convulsive ‘hysterical’ attacks with delirium, which subsequently lasted for days. After several months of observation it became clear that Marie’s symptoms were associated with the onset of menstruation. She still suffered from psychiatric symptoms between menses; however, these were far less severe than the dramatic ‘attacks’. Various parts of her body would go numb (for no reason) and she would experience episodes of ‘terror’. In addition, Marie claimed to be completely blind in her left eye (although medical investigations suggested that her eye was in perfect condition).

Just before the onset of menstruation, Marie’s character would suddenly change. She became gloomy, more violent, and exhibited nervous muscular spasms. However, the most curious symptom that developed was ‘shivering’; as though the temperature had suddenly dropped. Twenty hours after her menstruation had begun, her menses would suddenly stop and a great ‘tremor’ would pass through her body. Marie would then experience a sharp pain, rising slowly from her abdomen to her throat. At this point, she would begin to convulse for a short period of time before experiencing a long and severe delirium.

While delirious, Marie would sometimes engage in the most disturbing behaviour. She would cry out, with an expression of terror on her face, and ceaselessly speak of blood and fire. Sometimes she would run, seeking desperately to escape imaginary flames. The hospital ward would be thrown into chaos as she mounted furniture or climbed on the stove. Marie’s delirium and violent bodily contortions alternated with brief periods of rest for forty-eight hours. Then the ‘attack’ would finally end with a macabre finale, during which Marie would repeatedly vomit blood. With this extraordinary climax, the feverish episode of activity and delirium was brought to a close. After two days’ rest, Marie would become quiet, and could remember nothing of her attack.

The doctors at Le Havre undertook traditional treatments. Marie was given medication and ‘hydrotherapy’ (a procedure involving immersion in water). Predictably, these were ineffective. After seven months of hospital residence (and seven dramatic attacks), the doctors were ata loss. Janet had been aware of Marie, but he was not eager to be involved. Any attempts at psychological intervention appeared to make Marie worse. For example, talking to her about her menstruation only made her delirium more extreme. Between attacks Janet had conducted a few hypnotic experiments on Marie, examining her anaesthesiae, but he remained a peripheral figure in her life.

After eight months, Janet happened to be undertaking one of his routine ‘experiments’ with Marie. She was ‘between’ menses, and therefore quite lucid. The young woman was very depressed, and she said to Janet, in despair, that she believed that she would never get better. She was doomed to a life in medical institutions. Perhaps Marie’s sorry disclosure touched Janet, He asked her what it was that she experienced before getting sick. She replied: everything stops. I have a big shivering, and I don’t know what happens next.’ Janet asked her more questions, particularly about her menstruation; however, Marie was unable to give any clear answers. She became more and more vague and seemed to have forgotten almost everything that Janet thought might be relevant. Nevertheless, a human bond had been forged. Janet the philosophy teacher, Janet the experimental psychologist, was somehow more inclined to help this tormented young woman.

Because of his work with Lucie, Janet suspected that Marie’s symptoms were caused by some inaccessible memory. A trauma perhaps, now lost below the threshold of consciousness. Janet hypnotised Marie and asked her questions. These were more or less the same questions he had asked while she was awake. This time, however, Marie answered. There was a story to be told. A story that she could only tell when asleep.

At the age of thirteen Marie had started to have her first period. She was filled with shame. Whether out of ignorance, or having been given misleading information, Marie was disgusted by what was happening to her. She had formed the belief that she might be able to stop the bleeding and her preferred method of doing this involved plunging herself into a bath of freezing water. Exactly twenty hours after the start of her first period Marie’s plan succeeded. She was seized with a violent shivering and her menstruation stopped; however, shortly after, she became quite sick and for several days was in a delirious state. Eventually the delirium passed and Marie returned to normal health. She did not menstruate again for another five years. When she did, her shame and distress returned.

Janet summarised his findings in the following way:

Like Lucie, Marie’s severe psychological problems stemmed from a lost traumatic memory. Janet had the idea that he would rebuild her memory; plant in her mind, a ‘false’ memory. One that had no negative associations;

Janet had treated an incurable patient and he had done so using entirely psychological means. This was a remarkable breakthrough. Yet his understanding of Marie was not complete. He had not understood all of her symptoms. So he continued foraging in her unconscious mind for clues.

He discovered that Marie’s episodes of terror were the repetition of an emotion first experienced when she was sixteen years old. Marie had witnessed the suicide of an old woman who had thrown herself down a flight of stairs. The ‘blood’ that she spoke of during her delirium was not menstrual blood but the old woman’s blood. Janet treated Marie’s terrors using his new technique. He hypnotised her and took her back to the time of the suicide. He told her that the old woman had merely stumbled; she did not intend to kill herself. Once the new memory was in place, the attacks of terror did not recur.

Janet then turned his attention to Marie’s blindness. She was reluctant to discuss her impairment, and told him that she had been blind in her left eye from birth; however, Janet found that when he regressed Marie under hypnosis to the age of five she regained her ability to see. Clearly, something had happened when Marie was six years of age that had resulted in a form of ‘hysterical’ blindness.

The origins of Marie’s blindness were eventually discovered in the form of what Janet described as a ‘trifling incident’. Against her will, Marie had been forced to sleep with another child whose face was affected by impetigo on the left side. Impetigo is a bacterial skin infection which produces small fluid-filled blisters that eventually burst, leaving a brown crust. Some time later Marie herself developed impetigo in exactly the same place. The impetigo was eventually treated; however, neither her parents nor her doctors noticed that she had developed a numbness (or deadening) affecting the left side of her face and that her left eye had lost the power of sight. Janet took his patient back through time again and began to rebuild her memories. Without drama, and in a rather matter-of-fact, almost inconsequential way, Janet recorded his therapeutic procedure and its successful consequence: