obtain all the physical improvements which we expect from the latter, and such marked psychic improvement as never occurs in the rest cure without psychotherapy.
II.
I will now add to my former observations that in attempting to use Breuer's method in greater latitude I met this difficulty—although the diagnosis was hysteria, and the probabilities spoke in favor of the prevalence of the psychic mechanism described by us, yet a number of patients could not be put into the hypnotic state. The hypnosis was necessary to broaden consciousness so as to find the pathogenic reminiscences which do not exist in the ordinary consciousness. I, therefore, was forced to either give up such patients, or to bring about this broadening by other means.
The reason why one person is hypnotizable and another not I could no more explain than others, and hence I could not start on a causal way towards the removal of the difficulties. I also observed that in some patients the obstacle was still more marked, as they even refused to submit to hypnosis. The idea then occurred to me that both cases might be identical, and that in both it might merely be an unwillingness. Those who entertain a psychic inhibition against hypnotism are not hypnotizable, it makes no difference whether they utter their unwillingness or not. It is not fully clear to me whether I can firmly adhere to this conception or not.
It was, therefore, important to avoid hypnotism and yet to obtain the pathogenic reminiscences. Thus I attained in the following manner:
On asking my patients during our first interview whether they remembered the first motive for the symptom in question, some said that they knew nothing, while others thought of something which they designated as an indistinct recollection, yet were unable to pursue it. I then followed Bernheim's example of awakening the apparently forgotten impressions obtained during somnambulism (see the case of Miss Lucy). I urged them by assuring them that they did know it, and that they will recall it, etc., and thus some thought of something, while in others the recollections went further. I became still more pressing, I
