206. It is possible that if we could discern the minute psychology of this long series of changes, ranging from modifications too minute to be noted as abnormal to absolute revolutions of the whole character and intelligence, we might find no definite break in all the series; but rather a slow, continuous detachment of one psychical unit or element of consciousness after another from the primary synthesis. It is possible, on the other hand, that there may be a real break at a point where there appears to our external observation to be a break, namely, where the personality passes into its new phase through an interval of sleep or trance. And I believe that there is another break, at a point much further advanced, and not to be reached in this chapter, where some external intelligence begins in some way to possess the organism and to replace for a time the ordinary intellectual activity by an activity of its own. Setting, however, this last possibility for the present aside, we must adopt some arrangement on which to hang our cases.

For this purpose the appearance of sleep or trance will make a useful, although not a definite line of demarcation.

We may begin with localised psychical hypertrophies and isolations, - terms which I shall explain as we proceed; and then pass on through hysterical instabilities (where intermediate periods of trance may or may not be present) to those more advanced sleep-wakings and dimorphisms which a barrier of trance seems always to separate from the primary stream of conscious life. All such changes, of course, are generally noxious to the psychical organism; and it will be simpler to begin by dwelling on their noxious aspect, and regarding them as steps on the road - on one of the many roads - to mental overthrow.

The process begins, then, with something which is to the psychical organism no more than a boil or a corn is to the physical. In consequence of some suggestion from without, or of some inherited tendency, a small group of psychical units set up a process of exaggerated growth which shuts them off from free and healthy interchange with the rest of the personality.

The first symptom of disaggregation is thus the idée fixe, that is to say, the persistence of an uncontrolled and unmodifiable group of thoughts or emotions, which from their brooding isolation, - from the very fact of deficient interchange with the general current of thought, - become alien and intrusive, so that some special idea or image presses into consciousness with undue and painful frequency. We may perhaps suppose that the fixed idea here represents the psychological aspect of some definite, although ultra-microscopic, cerebral lesion. One may look for analogy sometimes, as I have said, to a corn, sometimes to a boil, sometimes to an encysted tumour, sometimes to a cancer. The idee fixe may be little more than an indurated prejudice, which hurts when pressed upon. Or, again, it may be like a hypertrophied centre of inflammation, which sends its smart and ache abroad through the organism. Or for certain hysterical fixed ideas we shall find our best parallel if, accepting a well-known hypothesis, we suppose that a tumour may originate in the isolated and extravagant growth of some fragment of embryonic matter, accidentally nipped off or extruded from the embryo's concordant development.

Such tumours may be encysted or encapsuled, so that they injure surrounding tissues by pressure, while yet their own contents can only be discovered by incision. Just such, one may say, are the forgotten and irrecoverable terrors which Dr. Janet has shown us as giving rise to hysterical attacks. (See 207 A, in Appendices at end of volume.) Such tumours of the mind may sometimes be psychologically cut down upon and removed by free discussion; "talked out," as Dr. Breuer has it.1 Worst of all, of course, are the cancer-like cases, where the degeneration, beginning it hardly matters where, invades with rapid incoherence the whole compass of the mind.

1 For a series of independent, but fully concordant observations, see " The Use of Hypnotism in the First Degree." by Dr. Russell Sturgis (Boston, 1894).

The fixed idea, thus originating probably from various causes, may develop in different ways. It may become a centre of explosion, or a nucleus of separation, or a beginning of death. It may induce an access of hysterical convulsions, thus acting like a material foreign body which presses on a sensitive part of the organism. Or it may draw to its new parasitic centre so many psychical elements that it forms a kind of secondary personality, co-existing secretly with the primary one, or even able at times (as in some well-known cases) to carry the whole organism by a coup-de-main. (Such changes, it may be noted in passing, are not always for the worse.) Or, again, the new quasi-independent centres may be merely anarchical; the revolt may spread to every cell; and the forces of the environment, ever making war upon the organism, may thus effect its total decay.

207. Let us dwell for a few moments on the nature of these fixed or insistent ideas. They are not generally or at the first outset extravagant fancies, - as that one is made of glass, or the like. Rather will "fixed ideas" come to seem a mere expression for something in a minor degree common to most of us. Hardly any mind, I suppose, is wholly free from tendencies to certain types of thought or emotion for which we cannot summon any adequate check - useless recurrent broodings over the past or anxieties for the future, perhaps traces of old childish experience which have become too firmly fixed ever wholly to disappear. Nay, it may well be that we must look even further back than our own childhood for the origin of many haunting troubles. Inherited tendencies to terror, especially, seem to reach back far into a prehistoric past. In a recent "Study of Fears," which Professor Stanley Hall has based on a wide statistical collection,1 it would seem that the fears of childhood, - indications of the nervous instability of the yet immature system, - often correspond to no existing cause for uneasiness, but rather to the vanished perils of primitive man.

The fear of darkness, for instance, the fear of solitude, the fear of thunderstorms, the fear of the loss of orientation, speak of primitive helplessness, - just as the fear of animals, the fear of strangers, suggest the fierce and hazardous life of early man. To all such instinctive feelings as these a morbid development is easily given.

Of what nature must we suppose this morbid development to be? Does it fall properly within our present discussion? or is it not simply a beginning of brain-disease, which concerns the physician rather than the psychologist ? The psychologist's best answer to this question will be to show cases of fixed ideas cured by psychological means. (For instances of such cures, see 207 A, in Appendices at end of volume.) And indeed there are few cases to show which have been cured by any methods except the psychological; if hypnotic suggestion does not succeed with an idee fixe, it is seldom that any other treatment will cure it. We may, of course, say that the brain troubles thus cured were functional, and that those which went on inevitably into insanity were organic, although the distinction between functional and organic is not easily demonstrable in this ultra-microscopic realm.

1 Stanley Hall's "Study of Fears," American Journal of Psychology, vol. viii., No. 2, January 1897.

At any rate, we have actually on record, - and that is what our argument needs, - a great series of idées fixes, of various degrees of intensity, cured by suggestion; - cured, that is to say, by a subliminal setting in action of minute nervous movements which our supraliminal consciousness cannot in even the blindest manner manage to set to work. Some such difference as exists on a gross scale between striped and unstriped muscle seems to exist on a minute scale among these smallest involved cells and fibres, or whatever they be. Some of them obey our conscious will, but most of them are capable of being governed only by subliminal strata of the self.

If, however, it be the subliminal self which can reduce these elements to order, it is often probably the subliminal self to which their disorder is originally due. If a fixed idea, say agoraphobia, grows up in me, this may probably be because the proper controlling co-ordinations of thought, which I ought to be able to summon up at will, have sunk below the level at which will can reach them. I am no longer able, that is to say, to convince myself by reasoning that there is no danger in crossing the open square. And this may be the fault of my subliminal self, whose business it is to keep the ideas which I need for common life easily within my reach, and which has failed to do this, owing to some enfeeblement of its grasp of my organism.