Psychological Automatism

the patients momentarily returned to health. We concluded from this that certain so-called nervous diseases "deserved just as much to be called psychological diseases," and that the phenomena of successive or simultaneous division of the personality constituted precisely an essential symptom of these mental illnesses. These opinions have been the subject of much controversy, for several authors are still inclined to believe that suggestion, somnambulism A state of altered consciousness similar to a trance or sleepwalking, often associated with hypnosis in 19th-century psychology., subconscious acts, and automatic writing Writing produced without conscious intent, often attributed at the time to the subconscious mind. are phenomena of normal life, compatible with the most perfect physical and moral health. This discussion is difficult to conclude, as it bears upon questions that are always insoluble—questions of boundaries. Automatic phenomena and facts of personality division are linked, like all pathological symptoms, by innumerable transitions to the phenomena of normal psychology, and one can argue indefinitely about the limit between illness and health. In order to reach an agreement, one must only consider the clearest cases and form an opinion based upon them. If one proceeds in this manner, we still believe that one will find in all complete cases of somnambulism and automatic writing a clinically indisputable hysteria In this historical context, hysteria refers to a wide range of psychoneurotic disorders characterized by emotional excess and physical symptoms without an organic cause.. On the other hand, it will be easy to see that all hysterical phenomena are characterized precisely by this doubling of the personality which exists to the highest degree in somnambulism. "Somnambulism," we said, "is not only hysterical because it coincides with symptoms of hysteria; in itself, it presents in the most complete fashion the character of all the phenomena of this disease." In our work on the definitions of hysteria to which we refer the reader, we summarized the various opinions of authors who have discussed this view and we have tried to strengthen it further ¹.

As for the medical details relating to hysteria, we will note only a few points which seem to us today to require modification. We previously identified a patient, R..., as epileptic, while expressing, it is true, some doubt; we would no longer have this hesitation now. In rereading the observation, we are convinced that he is a hysterical man and not an epileptic. Regarding the narrowing of the visual field, we wrote, following other authors, that "anesthesia extends irregularly over the retina, sometimes concentrically narrowing the visual field, sometimes cutting it in half, sometimes forming irregular scotomas Blind spots or areas of diminished vision within the visual field., that is to say, spots of insensitivity in the middle of a retina that has remained normal." Out of more than one hundred and fifty patients whom we have examined frequently from this point of view, we have only observed the more or less concentric narrowing of the visual field and never the other modifications. We do not deny a priori original: "a priori"; meaning "in principle" or "before investigation." that hemiopia Blindness in one half of the visual field. cannot be found in hysteria (uncomplicated, of course, by brain lesions); but until precise observations have been studied on this point, we consider this symptom to be highly doubtful. We would also add that it would be necessary to insist more than we have done in this work on subconscious visual sensations and especially on sensations provoked at the periphery of the visual field. Other modifications of sensation, unilateral amaurosis Blindness in one eye without an apparent physical change in the eye itself., monocular diplopia Double vision in only one eye., and allochiria A neurological disorder where a touch to one side of the body is felt on the opposite side. have likewise been studied with more care in our book on the mental state of hysterical patients.

¹ Some recent definitions of hysteria. Archives of Neurology, June and July 1893.