"War Neurosis" in the 1920s (Part VI of VI)

The fallout and consequences

(The last of these six stories. Will skip next weekend and post again two weekends from now.)

[Monday the seventh of May, 1928, as told by the character Riis Evans.]

When we arrived home from Chicago a few days ago we read a letter Carmen had received:

       Dr. Evans:

It has come to the attention of the Board of Health of Colorado that you have not only applied hypnosis in your psychotherapy work, in contravention of your medical training, but that you have applied hypnosis work to a family member, in contravention of widely accepted ethical practices in the field of medicine. 

Therefore, we ask you to appear before the Certification Committee of the Colorado Board of Health, which will make a decision about your continued licensing as a medical professional in the State of Colorado.

Sincerely yours,

Dr. Wilbur Stone, Chairman

I’m sitting a couple rows behind Carmen.  The three committee members and a stenographer walk in and take their seats.  The hearing begins.

“Doctor Evans, as you know, I am Doctor Wilbur Stone, the Chairman of the Colorado Board of Health.  Under the Board’s charter, the three of us on this Certification Committee are charged with the task of determining whether or not you are fit to continue to practice medicine.  If we determine that you are not, your medical license will be revoked and you will no longer be a doctor under Colorado law.  You understand why we are here?”

“Yes, Mister Chairman,” Carmen replies.

Doctor Stone continues.  “You are under investigation by this Board for practicing hypnotherapy and for practicing it on your own brother.  Let me begin by asking you, are the facts in dispute?”

“Mister Chairman,” Carmen responds, “the facts are not in dispute.  I practice hypnosis as part of my psychotherapy work.  And I treated my brother Francis’s psychiatric condition using hypnosis.”  She looks back calmly and confidently at Dr. Stone’s glare of disapproval. 

“It certainly makes things easier for all of us for there to be no dispute over the central facts of this case,” Dr. Stone says.  “All three of us have questions for you before we vote.  I’d like to turn first to my colleague and fellow committee member, Doctor Elliot Winston.”

Dr. Winston strikes immediately.  “I think the consensus of opinion in the professional medical community is that hypnosis never treats causes.  It only treats symptoms.”

Carmen looks at him and declares, “I believe that hypnosis treats causes.”

“You are wrong,” Dr. Winston tells Carmen, then moves to his second argument.  “Isn’t it obvious that with hypnosis the patient is not active in treatment?  The patient is passive.”

“I believe that the patient is active,” says Carmen.  “And the patient is asked to repeat each memory when brought back to a normal state of consciousness.  That is quite active.”

“You are wrong again,” Dr. Winston says, his voice rising.  “There is a third problem.  Can’t we all agree that it’s harmful that hypnosis increases suggestibility?”

“We can agree that it does increase suggestibility,” Carmen answers, “but what is wrong with suggestion?  Suggestion is a major technique in psychotherapy, including hypnotherapy.”

“Wrong!” yells Dr. Winston.  “Suggestibility and passivity cannot be compatible with any cure!  If there is no real effort by the patient, the patient’s character is not strengthened; it is weakened.  No rational, autonomous man – er, no rational, autonomous patient – can surrender control over himself to a hypnotizing woman, er, to any hypnotist.  Hypnosis suppresses a person’s capacity for willed action!”

“Doctor Winston, Sir,” says Carmen, “the patient has, first and foremost, the will to heal by bringing into conscious awareness what has been hidden in the patient’s unconscious.  And second, the will to get the conscious mind out of the way, temporarily.  And third, the will to face disturbing, terrifying, horrifying experiences in the patient’s memory.  All of this, indeed, Sir, takes a very strong will.  And, in my view, healing always improves character.”

“You are defiant!” Dr. Winston shouts at Carmen.  “You are impudent!  This is why this board and this committee have been put in place, so that our wise counsel may prevail over heretical notions like yours.  To keep the medical profession professional.  Now, there is a fourth problem with hypnosis.  The evidence is quite clear that repeated hypnosis causes dissociation.”

Carmen remains steadfast.  “The evidence does not support that conclusion.”

“Mister Chairman,” Dr. Winston states firmly, “I’ve pointed out her errors, her heretical beliefs, to this woman, this so-called doctor, whom we are here to judge.  She is not a professional medical doctor.  She is a charlatan.  I’ll be voting to remove Carmen Evans from the medical profession!”

Carmen stays calm as Dr. Stone looks toward his fellow board member.  “Thank you for your work and assessment in this matter, Doctor Winston.  I ask now for questions from our colleague and fellow investigator and board and committee member, Doctor David Norton Hughes.”

“Thank you, Mister Chairman,” Dr. Hughes begins.  “Doctor Evans, I am founding my own basis for judging this case not in my own views of hypnosis, but in your medical judgment.  I’ve not yet decided how I will vote, and so hearing your answers today is important to me.  Tell me first, how did you arrive at your view of hypnosis?”

“Thank you, Doctor Hughes,” Carmen replies.  “My view of hypnosis has been shaped by many medical professionals.  I’d say that the British doctor William Brown stands out most.  I was affected, especially strongly, by his 1919 article in The Lancet entitled ‘War Neurosis and Hypnosis’.  There are others, including the leading British doctor Charles F. Myers.”

“In your view, then, Doctor Evans,” Dr. Hughes asks, “what is the goal of hypnosis in psychotherapy and in the treatment of psychological disorders and disturbances?”

“Doctor Hughes,” Carmen responds, “my view is that the goal of hypnosis is to restore experiences of the shocked personality so that they can be faced, integrated with, and thus restored to the normal personality.”

“The shocked personality?” Dr. Hughes asks.

“My term,” Carmen says. “My term for the part of the self that is holding on to these repressed or dissociated memories.”

“What then, in your view, is curing the patient?”

“Re-integration,” Carmen answers.  “The normal personality has been divorced from certain experiences by shock.  Revival of those forgotten memories is facilitated in the hypnotic state.  Successful hypnosis leads to re-synthesizing the repressed or dissociated memories into conscious awareness.  Successful hypnosis helps re-integrate the shocked personality, now free of its uncontrolled and pathological quality, into the normal personality.”

“Thank you, Doctor Evans.”  Dr. Hughes thinks for a moment.  “Mr. Chairman, I believe that Doctor Evans has based her medical thinking and her medical practice on science and reasoning that she finds sound.  While I remain skeptical of hypnosis and hypnotherapy, I will vote to allow Doctor Evans to keep her medical license.”

“Thank you, Doctor Hughes,” says Dr. Stone, “thank you for your work and assessment in this matter.  Doctor Evans, I have a few questions now.”

“Yes, Mister Chairman.”

“What was the outcome of your hypnotherapy treatment for your brother?” Dr. Stone asks.

“His arm and hand tremors are less frequent and much less severe,” Carmen observes.  “His nightmares have been reduced by at least two-thirds.  He almost never gets overly excited, restless, anxious, angry, or depressed.  His self-confidence is much higher.” 

“That’s all for the good,” Dr. Stone tells her.  “But how can you justify providing medical treatment, especially psychological treatment, to your own brother?”

Carmen pauses for a moment.  “Mister Chairman, I understand why you object to this.”

“I object strenuously.”

“Yes, Doctor Stone, and rightfully so,” Carmen says.  “The truth is that my brother refused to be treated for his war neurosis by any therapist or doctor other than me.  And I eventually gave in to family love.”

Dr. Stone raises his eyebrows in surprise.  “Family love?  All right.  I’m going to conclude this hearing now.  Doctor Hughes votes to allow you to keep your medical license.  Doctor Winston votes that your medical license be forfeited.  For me, while I have concerns about hypnosis and would rather see it disappear from the fields of medicine and psychology, I would not vote to take your license away on that basis alone.  But I cannot excuse you choosing to provide psychological treatment, especially hypnotherapy, to your own brother.  I consider this a violation of sound medical reasoning as well as a violation of proper medical practice and care.  Therefore, I vote to remove from you, Carmen Evans, your medical license – and thus to forbid you under the law from ever practicing medicine again in the State of Colorado.  You are dismissed and this hearing is adjourned.”