A Doctor's Report on DIANETICS
Theory and Therapy
by J.A. Winter, M.D.
Introduction by Frederick Perls, M.D., Ph.D.
Julian Press, Inc., New York
copyright 1951
TO MY WIFE
Introduction...
The First Phase -I-
In the Spring of 1950 a new book appeared in the bookstores of the U.S.A. With little advance publicity and virtually no advertising, it was seized upon by thousands of readers and within a comparatively short time was high on the Best Seller list. Its title was Dianetics: The Modern Science of the Mind (Hermitage House, Inc., New York); its author a man well-known in science-fiction circles, L. Ron Hubbard.
It is not surprising that a book dealing with the problems of the functioning of the mind should have a wide popular appeal. For thousands of years man has sought knowledge of the nature of his own mind; countless words have been written on the subject, and research goes on constantly in the centers of learning.
The very fact that so much has been written and that research into mental functioning occupies so much of the attention of groups of investigators indicates a condition of which most of us are well aware: we are still not completely satisfied with the state of our knowledge.
I happen to be one of those people who is not satisfied with what he knows, but who seeks for a better understanding of the nature of Man and his mind. My chosen profession of medicine has made me keenly aware of the limitations of our present knowledge and has stimulated a desire to find out as much as I can of the causes of human behavior in all of its manifestations. In the years of my medical training and practice I have tried constantly to maintain an awareness of the possibilities for increasing my knowledge.
An apparent opportunity for learning more about human behavior was presented to me in 1949 while I was practicing medicine in Michigan. It was perhaps a set of fortuitous coincidences which led to my being presented with the opportunity; it was no coincidence that I was in a receptive mood for a new idea. For several years after my graduation from medical school I had been engaged in the general practice of medicine; as part of my basic personal orientation towards medicine I felt it was important for me to know my patients as people, rather than as cases of illness. I found it necessary to help my patients with their troubles as well as their physical ailments, and I should have been pathologically unobservant not to have noted how a person's manner of going about the business of living affected his resistance to disease and his abilities to recover.
My avocations, too, had played a part in my introduction to what is now known as dianetics. For several years I had written articles on medical subjects for the laity, and some of my work had been published in Astounding Science Fiction, a magazine edited by John W. Campbell, Jr. Despite its fanciful title, this publication is one which has a wide appeal to the scientifically-trained persons; 80% of its readers are college graduates, and among its contributors are well-known doctors, chemists, engineers, physicists and astronomers.
In July, 1949 I received a long letter from Mr. Campbell, in which he told me of some investigations in which he thought I might be interested. He told me that "L. Ron Hubbard, who happens to be an author, has been doing some psychological research. . . . He's gotten important results. His approach is, actually, based on some very early work of Freud's, some work of other men, and a lot of original research. He's not a professional psychoanalyst or psychiatrist . . . . . he's basically an engineer. He approached the problem of psychiatry from the heuristic viewpoint -- to get results. . . . . The following are conclusions he's derived.
"Basically, Hubbard finds, all psychological troubles stem from a situation somewhere containing the following simple elements:
1. Strong physical pain.
2. A powerful threat (real or so believed by the organism) to the survival of the organism.
3. A non-analytic state of the brain. This - and only this - type of situation will implant a psychological jam which he calls an 'Impediment.'
"The important thing, he finds, is that most serious psychological jams stem from some basic painful, dangerous experience when the subject was unconscious or incapable of conscious, analytical thought.
"The important part of the unconscious experience is this: the analytical, evaluational functions of the mind are not in gear. A statement made under those circumstances is accepted timelessly, and without evaluation for truth, reasonableness, or anything else. Here's the sort of thing that happens:
"An amputee veteran, with loss of one foot and slight impairment of one hand is in a hopeless despondency condition -- just can't adjust. The psychiatrist takes him back to the war experience with sodium pentothal, back to the time the mortar shell got him. Pain, and plenty of it -- badly smashed left arm and leg, a number of painful, but relatively minor wounds of body and face on that side. Makes him look like a bloody mess, though. They take him through, to the period when he passed out, and pick up again when he recovered consciousness in the aid station. Doesn't seem to clear him up. He still insists he'd be better off dead.
"Hubbard took him through, through the shell burst, and through the period of unconsciousness. That's when it happened. A medic had come along, seen him and another injured man, said, 'This guy's hopeless -- he's better off dead anyway. We'll take that man there.' A second medic team had brought the patient in; he was badly injured, but nowhere near as bad as he looked.
"With the conscious mind out of the circuit, a man loses the power of evaluation, but not the power of memory. But he reacts on a lower-animal basis. The stimulus is intense pain, acute danger -- and the calculating machine in the skull, half a billion years ago, was designed to permit mammals to learn to avoid danger. It classifies and remembers all associated circumstances -- not all relevant circumstances -- as part of the danger incident, and reacts powerfully to it. It's a timeless thing, too; the statement 'He's better off dead anyhow' would, in a conscious mind, be interpreted as 'He appears from here, and right now, as though he might be better off dead.' and a conscious mind would evaluate and reject it. The unconscious mind can't evaluate. But it records with the accuracy and permanence of a phonograph."
This was an interesting concept, to say the least. I had never before heard anyone advance the idea that a person could be affected psychically during periods of unconsciousness. During all my years as a doctor I had never considered -- nor had anyone else ever suggested to my knowledge -- that a patient who was unconscious by reason of injury or anesthesia might be partially aware of what was going on. Medical knowledge, for the most part, assumed that a person who was unconscious or anesthetized was incapable of all except the vegetative functions -- certainly not the function of memory.
I answered Mr. Campbell's letter and requested more information on Hubbard's work. Within a short time another long letter arrived, elaborating on the reactions to this sort of therapy and discussing some of the implications of the aberrative effects of information received during unconsciousness. He concluded by saying that "these things are unexplored byways just indicated vaguely by the solid work Hubbard has actually done. There is only one important statistical fact that I think should be dealt with. This has been research; Hubbard has been working on it as a research program, trying to find out what causes what, and how to fix it. Therefore, with cooperation from some institutions, some psychiatrists, he has worked on all types of cases. Institutionalized schizophrenics, apathies, manics, depressives, perverts, stuttering, neuroses -- in all, nearly 1000 cases. But just a brief sampling of each type; he doesn't have proper statistics in the usual sense. But he has one statistic. He has cured every patient he worked. He has cured ulcers, arthritis, asthma."
My response to this information was one of polite incredulity. How could it be that a man without any medical training could get results which doctors had rarely, if ever, been able to obtain? Notwithstanding, I thought of the times when medical knowledge had been increased by contributions from non-medical practitioners -- how Withering learned of the medicinal properties of the purple fox-glove from an old woman in the country, how the science of microscopy was advanced by a Dutch janitor, how the technique of retinoscopy was developed by a postmaster. Could this idea of Hubbard's be another non-medical contribution to medical advancement?
I became aware again of the perplexity which plagues all doctors -- the "why" of human behavior. I thought of all the questions which had gone unanswered or which had been answered in a tentative or equivocal manner -- of questions which were frequently unasked because of their presumed unanswerability. Why did Mr. M. attempt to commit suicide? Why was it that Mrs. E. began to hear voices telling her to kill her new-born baby? Why did an intelligent man like Mr. P. find it necessary to drink a quart of whiskey every day? Why did Mrs. T. have coronary occlusion?
The list of questions beginning with "why" could be extended indefinitely. They all had one element in common: I knew of no satisfactory answer for any of them. The "answers" and explanations which I had learned in medical school and which I passed on to my patients were superficial, taking into account only the preceding link in the chain of causality. A patient would ask me. "Why does a person get coronary occlusion?" and I would answer glibly, "Because there is a narrowing of the lumen of the coronary arteries." And with that answer he would appear to be satisfied.
I was not satisfied with that sort of answer, however, nor did I find the explanations of "familial predilections" and "lowered resistance" to be operational. An explanation for the causation of a disease would, if it were satisfactory, include the means of treating that disease. If one explained typhoid fever as a punishment inflicted by a malign Fate or a whim of the gods, there was no rational treatment; when it was found to be a water-borne infection, the medical profession could do something to prevent it.
I was of the opinion, moreover, that questions of causation of illness could be answered only if one had a holistic view of the patient. To consider diabetes as a disease of the pancreas led one into a therapeutic cul-de-sac -- one could treat this condition only by substitutional means, giving the patient the hormone which he apparently lacked. But what about the woman, previously healthy, who developed a sever case of diabetes shortly after her husband committed suicide? The bullet which ended her husband's life certainly did not injure her pancreas -- but she behaved as if it did.
In my past efforts to regard a person as a whole organism I had become interested in endocrinology, taking the viewpoint that the endocrine system was a means of integrating a person's total response to environmental stresses. I found that a man who could not think clearly, who was nervous and irritable, could be helped to a more effectual way of living by giving him androgenic substances, that a woman who nagged her husband might cease doing so if she was given a sufficient amount of estrogen. Some of my results were good, but I was well aware that they were limited. I could not predict with any degree of accuracy how effectual my methods would be, nor could I forecast how long any benefits would persist. I found, moreover, that I could get endocrine-like effects merely by giving counsel and advice; helping a person to resolve a dilemma by open and friendly discussion was often as effectual as a hypodermic injection of a hormone.
I had spent a year in part-time research at the University of Illinois in an effort to increase my knowledge of the human-as-a-whole, but found instead a tendency in academic circles toward further compartmentalization of the patient, with the holistic viewpoint conspicuous for its absence. I had become interested in General Semantics, too -- and while I agreed with Korzybski that "the word is not the object," I found no satisfactory explanation for how such a confusion between levels of abstraction had arisen in the first place.
Because of my eclecticism it was not difficult for me to decide that Hubbard's ideas deserved more than a casual dismissal; to ignore them might be depriving my chosen profession of a possibly valuable methodology. I therefore communicated with Hubbard and suggested that he present his ideas to the medical profession for their consideration. I told him that I had some friends in Chicago, well-known in the psychiatric field, who might be interested in examining his results and testing his methods.
I received a courteous reply, in which he said that he was "preparing, instead of a rambling letter, an operator's manual for your use. . . . Certainly appreciate your interest. My vanity hopes that you will secure credit to me for eleven years of unpaid research, but my humanity hopes above that this science will be used as intelligently and extensively as possible, for it is a science and it does produce exact results uniformly and can, I think, be of benefit."
I had also suggested that he attempt to publish some of his findings in some lay magazine as a means of stimulating interest in his work; to this he replied, "The articles you suggest would be more acceptable coming from another pen than mine."
The manual eventually arrived; in the letter which accompanied it Hubbard said, "That I spent eleven years on this should not be very surprising. I am, after all, a trained mathematician and studies my theory of equations very well. . . . The work in Abnormal Dianetics is up now to the state where it can be effectively applied broadly with exactly predictable results and uniform success. . . . If a good operator works on any patient 'sane' or 'insane' not physically neurasthenic he will get 100 out of 100 'clears.' [*"Clear": the state postulated by Hubbard as resulting from dianetic therapy; in a sense, the goal of the therapy. This concept is discussed at greater length in this book.] There aren't any 'special cases' save in the diagnosis and initial entrance where an operator has to use his wits against one of these "Self-preserving' impediments. A very exhaustive research has located no exception to any axiom and broad application to types has discovered no exception to treatment technique -- anything surrenders.
"No existing case histories are of use to the dianetic researcher as they lack the essential data and no existing neurotic or psychotic classification has been found to have any meaning in dianetic practice or diagnosis. So it's a clean slate. . . . Every field (psycho-analysis, hypnotism, Christian Science, etc.) I investigated had 10,000 wrong [answers] for every right one."
I must confess to a slight feeling of perturbation at the apparently absolutistic viewpoint which Mr. Hubbard's letter implied. I had become accustomed to a more guarded expression of one's views, to an orientation based on statistical probability rather than invariability. Yet I realized that enthusiasm for one's work was a prerequisite for continuing effort, and I did not wish to permit my own conservatism to prejudice my efforts to learn more of Hubbard's ideas.
Several copies were made of the manual which Hubbard had sent: two of them were sent to colleagues of mine in Chicago. Both of them expressed interest in the ingenuity of the ideas, but they were strongly skeptical of the efficacy of the method. I concluded from their comments that neither of them planned to make any further investigation.
In spite of their negative reactions I decided to continue with my study of the manual and I attempted to apply the technique to one of my patients who had a rather bizarre illness, apparently psychosomatic, which had been diagnosed as an atypical form of epilepsy. My attempts to produce Hubbard's results were unsuccessful with her; when I queried him about it, he stated that I was working with a late-life incident instead of looking for the basic causation in very early -- possibly prenatal -- life.
There were numerous times when I was tempted to dismiss the entire concept as an ingenious but ineffectual ideal and to concentrate my efforts on the practice of conventional medicine, but one of the phases of my practice intervened. I was doing some work for the Probate Court which, in Michigan, has jurisdiction over the insane and the juvenile delinquents. In this capacity I was called on to examine a variety of people who presented problems of maladjustment to society and to recommend whether or not they should be committed to a state institution for care and treatment. During the process of examining these maladjusted people I had numerous opportunities for discussing the social problem of the misfit with those who specialized in this field. The judges, the psychiatrists and the social workers with whom I talked were unanimous both in expressing a dissatisfaction with present social methodologies and in feeling rather hopeless about improving their methods. When I discussed Hubbard's ideas with them I observed a limited sort of enthusiasm, which might be expressed as, "That would be nice if it worked; you try it out and then tell me about it." In other words, my attempts to interest them in an investigation of dianetics met with verbal encouragement but a dearth of actual cooperation.
There was, as I saw it, only one conclusion to be drawn at that time: if anyone in medicine were to investigate dianetics, it would have to be myself. I also concluded that exposition by correspondence alone would not teach me to use dianetic techniques, but that I would have to observe it in action. I thereupon made arrangements to spend a week or so in New Jersey, where Hubbard was living at the time. He had very hospitably invited me to stay at his home, and he told me that I would have the chance to observe his technique, apply it to patients whom Hubbard had under treatment at this time, and spent hours each day in watching him send these men "down the time-track." After some observation of the reactions of others, I concluded that my learning of this technique would be enhanced by submitting myself to therapy. I took my place on the couch, spending an average of three hours a day trying to follow the directions for recalling "impediments." The experience was intriguing; I found that I could remember much more than I had thought I could, and I frequently experienced the discomfort which is now known as "restimulation." While listening to Hubbard "running" one of his patients, or while being "run" myself, I would find myself developing unaccountable pains in various portions of my anatomy, or becoming extremely fatigued and somnolent. I had nightmares of being choked, of having my genitalia cut off, and I was convinced that dianetics as a method could produce effects.
I observed that these periods of discomfort were apt to precede a session wherein my depth of insight was increased, and I therefore developed a tolerance of my own discomfort -- an attribute which had previously been absent. The idea that discomfort heralded relief and insight seemed encouraging to me.
I felt, in general, that I was obtaining some benefits from Hubbard's methods of therapy; I was also aware of the possible inaccuracies of a subjective evaluation of my own progress; I therefore endeavored to make up for this by observing the other patients closely. It was possible during this short period of observation to note only the differences in their behavior before and after each therapy session. The changes were obvious: before a session I would see agitation, depression and irritability; after a session the patient would be cheerful and relaxed.
One day I was amazed to observe one of the patients go into a period of uncontrollable laughter; he had gone into his therapy that day looking quite depressed and withdrawn, and the material he brought up that session seemed to be quite unremarkable. Suddenly, on recalling a phrase, he began to laugh heartily and kept it up for well over an hour. The laughter was so prolonged and could be re-excited by such trivia that I suspected either an acute mania or a hebephrenia. I mentioned this to Hubbard, who told me that he had observed this phenomenon frequently in the past, and that it was characteristic of every case in which there had been much fear or terror. It was as if the phrase which the person had recalled carried a terrifying threat and the realization of the essential silliness of equating fear with words brought forth the laughter. Other than this he offered no theoretical explanation for the phenomenon. The patient's laughter subsided after a while and he seemed none the worse for it.
After three weeks my wife came from Michigan to visit me. In this relationship I had an opportunity to compare my reactions and attitudes of that time with my pre-dianetic state. I felt that my capacity for communicating with her had improved, and I now seemed capable of feeling and expressing a depth of affection which I had never experienced before.
During her stay she observed several sessions of my therapy and of the therapy of the other patients and familiarized herself with the major points of technique. I tried my abilities with this new therapy on her, and observed the signs of the state which is now known as "reverie" -- the fluttering eyelids, the deepening of respiration, the lessened awareness of the present environment. I was, of course, aware of certain similarities between this and the hypnotic state; however, certain features also appeared to distinguish it. My wife reported that the repetition of certain phrases would elicit discomfort in various parts of her body, and that continued repetition of the phrase would be associated with a decrease in the intensity of the discomfort.
After a week's visit she returned home, while I stayed on in Bay Head, determined to continue with my investigation of dianetics. My evaluation of it continued to be ambivalent. I felt certain that the technique was effectual, at least; by application of dianetic principles certain effects could be produced. These effects, so far as I could determine, had never before been observed, although certain aspects were known. Investigators from Freud up to Flanders Dunbar had long since demonstrated one or another type of association of words with illness. For example, it had been known that a patient might feel pain in his neck region because his wife was "a pain in the neck" to him, and that adjustment of the marital conflict would sometimes relieve the patient of his pain. I knew of no work, however, where an effect was produced in which a person would develop a pain in the neck following the repetition of a phrase, and would have the pain disappear on further repetition. This specific cause and effect relationship between words and dysfunction was new -- and it appeared to offer a means of manipulating the function of the mind which had never been known before.
There was much to be said in favor of dianetics: there were also some points which could be criticized. For one thing, my training in medicine and my studies in General Semantics made me extremely hesitant to accept broad generalizations and absolutistic statements; I was oriented toward a reality based on statistical probability, rather than a two-valued logic. The philosophy of dianetics, as it was propounded to me, seemed to abound in the type of concepts which I tended always to question. The possibility of alternative explanations for these phenomena also kept coming to my mind.
A careful recapitulation of what I had learned led me to conclude the following: here were some observations which appeared to me to be original and a hypothesis which offered a tentatively acceptable explanation. The observations could not be explained in any conventional psychologic theory that I knew of; ergo, dianetics at least warranted further investigation.
My therapy continued; I went through the experience of being terror-stricken at the idea of recalling my grandmother's death and finding this terror dissolve in sobbing and weeping when I reviewed a childhood scene in which I was first told about what happens when a person dies. I saw the others experience a similar emotional discharge or release of affect during the recounting of comparable situations, and saw how terror would be followed by weeping, the tears being succeeded by an attitude of cheerful acceptance, which might be expressed as, "Well, I understand this now. What's next?"
I returned to Michigan for a few days visit at Thanksgiving and found that my six-year-old son was having difficulties. A few weeks previously he had gone to a high-school play in which one of the characters was a ghost, dressed in the usual white sheet. That night he developed a fear of the dark, and refused to go upstairs alone, demanding that all the lights be turned on. I asked him why he should be afraid of the dark; his reply was, "That's were the ghosts are."
"Why should you be afraid of ghosts?" I asked.
He looked at me with a very serious and tremulous gaze and said, "They choke you."
I remembered that when he was born he had had considerable difficulty. There was a premature separation of the placenta, and it had been necessary to perform a version and extraction to deliver him. My wife had also told me that he had shown evidences of respiratory dysfunction immediately after birth. This gave me an idea of a possible cause of his present fears, so I had him lie down and close his eyes. I began the counting procedure which was used at the time to assist a patient into the process of recall.
I suggested, "Let's go to the first time you saw a ghost. Can you see him?"
"Yup."
"What does he look like?"
"He has on a long white apron, a little white cap on his head and a piece of white cloth on his mouth."
I noticed at this time that his respirations were labored, and that he twisted and squirmed on the couch as if agitated.
"What's the ghost's name?" I asked.
"Bill S[hort]" he answered.
It was the name of the obstetrician who had delivered him. I had him look at the "ghost" a few more times, and as he did so I observed that his respiratory rate gradually decreased, that the generalized tension was replaced by a more relaxed attitude and that his agitated squirming diminished markedly. When the maximum relaxation had apparently been obtained after ten or twelve recountings, I told him to open his eyes. It has been over a year since that short session with my son, and he has not had a recurrence of his fear of the dark in all that time.
My wife and I had numerous discussion about the validity of our son's recollection and have tried to determine if he could have acquired this information by some other channel. We are certain of the following: he never saw Dr. S. dressed in a surgical cap and gown except at the moment of delivery; he has never been told that there was any respiratory difficulty associated with his birth. To the best of our knowledge he has never seen Dr. S. since leaving the hospital at the age of two weeks. It is also interesting to note that Dr. S. is a schoolmate of mine, and is therefore called by his first name rather than his title; it would seem therefore that my son was unaware that "Bill" was also a doctor, and that therapeutic benefits were obtained without the realization of the role which "Bill S." played in his life. I can offer no explanation of why my son brought up the name "Bill S." instead of Dr. S."; the fact remains that that is what he said.
I feel, however, that the validity of this data is of secondary importance; I am not trying to adduce "proof" so much as I am desirous of demonstrating the efficacy of the method.
On my return to New Jersey after Thanksgiving I continued with my therapy by Hubbard and also did some preliminary work on a presentation of dianetics to the medical profession. Nomenclature proved to be a prime obstacle to expressing the concepts of this new method of approach to mental illnesses. Hubbard had used the word "impediment" as a label for the moment of pain, unconsciousness and threat to survival which he believed resulted in aberration of the patient's behavior. We (Hubbard, Campbell and I) felt that this word should be discarded because it was too long and might be confused with other usages, such as an impediment in one's speech.
After considerable discussion we concluded that terminology should be revised with the following criteria kept in mind: older terminology or terminology from other medical fields should be avoided, because the acceptance of a term from a certain school of thought might imply acceptance of the tenets of that school of thought. Rather than create a confusion between the Freudian "unconscious" and the dianetic concept of unconsciousness, we would coin a new term. Secondly, words in common usage might be associated with pain in the minds of some patients, and should therefore be avoided. Finally, some of the concepts of dianetics could not be expressed accurately in the words we had at our disposal. For example, we deal with "memories" which are not easily recallable -- how then were we to refer to these? We might have referred to "forgotten past experiences," but that term would have been unwieldy as well as incorrect, as the patient acted as if he never forgot these traumatic events. While the Freudian term of "repressed memory" was recognized to be somewhat parallel, it was discarded because of the somewhat different approach of dianetics both in theory and methodology.
Several alternatives were suggested. The phenomenon of less-than-complete-consciousness was called anaten, a condensation of the words "analyzer attenuation." What had been called an "impediment" was now called a norn, the name for the Norse goddesses of Fate, who controlled Man's destiny and made him follow a course of conduct nolens volens. These terms were used in the article by Hubbard which appeared in the May, 1950 issue of "Astounding Science Fiction;" this was the first appearance in print of the subject of Dianetics.
I attempted another approach to the problem of terminology, using the conventional medical scheme of constructing neologisms from Greek roots. As a substitute for "impediment" I proposed the word comanome, from "coma" meaning unconsciousness and "nomos" meaning law. A "comanome," therefore, was both an unconscious law and a law of unconsciousness. Instead of calling it "unconsciousness" I used the word allocoma, another type of unconsciousness, to point up the difference between the usual and the dianetic sense of the word.
Further discussion led to dissatisfaction with all three words, and it was finally decided to use the term engram, which is defined by Dorland as "a lasting mark or trace. The term is applied to the definite and permanent trace left by a stimulus in the protoplasm of a tissue. In psychology it is the lasting trace left in the psyche by anything that has been experienced psychically; a latent memory picture."[1] It should be noted that this term was not borrowed from Semon, as some have suggested. At the time this term was chosen, Semon's work was unknown to our group.[2]
[[1] Dorland's Medical Dictionary, 17th ed., W. B. Saunders Co., Philadelphia, 1936. [2] Semon, Richard, Mnemic Psychology. George Allen & Unwin, Ltd., London, 1923.]
A paper, using the terminology of Greek derivation, and giving a brief resume of the principles and methodology of dianetic therapy, was prepared and submitted informally to one of the editors of the Journal of the American Medical Association. The editor informed me that the paper as written did not contain sufficient evidence of efficacy to be acceptable and was, moreover, better suited to one of the journals which dealt with psychotherapy. A revision of this paper, together with some case histories given me by Hubbard, was submitted to the American Journal of Psychiatry; it was refused, again on the grounds of insufficient evidence.
During this time there was considerable discussion among us as to the theory of valence. It has been observed that when a person acted in an aberrated manner, he usually used a set of stock phrases which were often not quite appropriate to the situation. He might also use little mannerisms, such as a cough or a throat-clearing or a scratching of the head, as an accompaniment to his less-than-ideal conduct. It was suggested that these mannerisms and phrases had been used by the person from whom the patient had learned the response-pattern, and that the patient was assuming the role or valence of the person he was emulating. It was further observed in therapy that a patient might not recall a situation from his own viewpoint, but could recall it more easily if he was permitted to take the viewpoint, or valence, of the most successful person in the situation.
With further observations, it was frequently discovered that some patients acted as if they were completely unable to recall their own sensations and emotion during a painful episode; instead, they identified themselves with and dramatized the behavior of this other successful person -- or "winning valence," as Hubbard called it. It became rather obvious that a good deal of aberrated behavior was characterized by such dramatizations. It also became evident that the more of these dramatizations were uncovered and the events approached in dianetic therapy, the less need the person had to adopt them in a behavioral sense; as a result, he was better able to experience his own reality, or, as Hubbard put it more mechanistically, "enter his own valence."
I returned to my home in Michigan again over the Christmas holidays. During that time I gave numerous demonstrations of dianetic technique to my friends. This was the first opportunity I had had to work with anyone who had not had previous experience with dianetics. The event I chose to investigate for demonstration purposes was birth, which I felt was sufficiently dramatic to make an impression on people who were certain that they couldn't recall anything which had happened to them before the age of three. My subjects responded as predicted; they developed the characteristic headache, certain appropriate phrases occurred to them, and the headache decreased on repetition of the phrases.
I was rather surprised to find out that two of my friends developed upper respiratory infections about three days after the demonstration in which they had taken part. One case was sufficiently severe to necessitate this person's being absent from work for several days. This succession of events led me to wonder if dianetics was quite so harmless as I had been led to believe.
While at home, I came to the decision that I would no longer be content to practice medicine as I had done before. One of the phases of medical practice which had always been baffling to me was the difficulty in predicting the reaction of a patient to a given form of therapy. With dianetics the predictability of results appeared to be extremely high. Moreover, the potentialities inherent in the philosophy of dianetics were so great that I felt challenged to do all I could to help them develop into actualities. The practice of medicine was, I thought, bound to be affected in a constructive fashion. I wanted to be able to assist in the task of making dianetics a useful tool in the hands of the medical profession, and I knew that I would not be content until I had acquired much more experience in the use of the technique. I also felt that certain aspects of the hypothesis needed revision or clarification, and I was anxious to study this aspect.
I returned to New Jersey long enough to find a home for my family, then returned to Michigan, sold my office equipment and with my wife and children left for our new home.
Soon after I had established my home in New Jersey I acquired a patient who had previously had some dianetic therapy in an attempt to be relieved of a state of chronic terror. Physical examination showed that she was otherwise in good health, her difficulties being mainly psychic. She reported that the results which had been obtained from therapy had been but slight. On further questioning I discovered that she had spoken a foreign language until the age of five, and that she had neglected to give this information to her former therapist. When therapy was resumed, the language factor was taken into account; in the recounting of early "engrams" the words were repeated in the language in which they had been originally spoken. There was soon a noticeable improvement in her status; she became much less fearful and was able to join in social gatherings with greater ease.
This was an extremely interesting observation to me: it offered suggestive evidence in proof of the theory that these extra-conscious "memories" were recorded as sounds and not as meaningful words.
By this time Hubbard had begun to write his book and was so immersed in his labors that I had little opportunity to see him. He had decided, I knew, to write a book directed toward the laity rather than at the medical profession; he felt that professional interest in dianetics would be stimulated more rapidly by first informing the public, then having the public urge their doctors to find out more about the techniques of the new therapeutic approach.
The article which was to appear in "Astounding Science Fiction" had been completed and was scheduled for publication. Mr. Campbell had informed his readers of the forthcoming article, and some inquiries were already beginning to be made by interested readers.
One inquiry came from a young man who was a student in a professional school in New York City. His wife, he said, had been in the hospital since the first of the year suffering with an intractable case of diarrhea. He had been told by her attending physician that the prognosis was a gloomy one, and that there was a strong probability that she would not survive for longer than a month.
[snipped a couple of pages describing this woman's condition - quite gloomy. Dr. Winter continued his narrative...]
I did not try to indoctrinate her in the terminology of dianetics, merely asking her to lie down and relax with closed eyes. She was instructed not to try to "remember" anything, but simply to tell me whatever thoughts occurred to her without attempting to evaluate them.
I first asked her to consider her illness and to think about her dysentery, then asked her to give me the first word which flashed into her mind. She replied, "Dirty." I asked her to repeat the word and to go back to a time when someone was saying it to her.
"Dirty . . . dirty . . . dirty . . . that's funny! I can hear my mother saying it to me."
I asked her to answer my next question with the first number that occurred to her; then abruptly asked, "How old are you?"
"Six."
"Six what?"
"Six weeks. That's silly. I couldn't possibly be able to remember anything at that time."
It was again pointed out that she should make no attempt to evaluate the validity of her responses but to accept them as just that -- responses. She was then asked to continue to repeat the word "dirty."
She interrupted her repetition after a few seconds by saying, "My mother is spanking me; I can feel it and it hurts!"
She continued to repeat the word, then amplified it to the phrase, "You're always dirty." A few more repetitions and she yawned; when asked about the discomfort in the gluteal region, she remarked that it had disappeared.
In this fashion I worked with her for about two hours, touch on such incidents as her witnessing an attack in which her mother had suffered a cerebral hemorrhage. She reported that she had screamed at the doctor, "Do something!" Another incident was reported wherein her father was complaining, "Everybody else gets what they want; all I get is shit."
She was quite reluctant to verbalize this four-letter vulgarism; from the distortion of her features and the writing on the couch one could infer that the word caused her violent discomfort. After ten or fifteen repetitions of the phrase her agitation subsided; a few more recountings and the words in the phrase "lost their meaning." At the end of the session she said she felt well, although slightly fatigued.
[The woman got better, was dismissed from the hospital. The diarrhea completely stopped, and she gained weight, 20 pounds in six weeks.]
I was very pleased with the results this girl seemed to obtain from dianetic therapy. I did not regard these results as a permanent cure -- and subsequent developments suggest that dianetics as practiced at that time did not necessarily obtain "cures." What was important to me was that a psychotherapeutic technique produced immediate results in a case which was refractory to usual medical and psychiatric measures. The use of a type of treatment based on a hypothesis of mental function had been effectual in halting a process which was rapidly leading towards death.
[...] The next job was to find out about the exceptions to this hypothesis, the zones in which it did not work -- to test it, as rigorously as possible.
[The next case the patient improved, but ...]
Her improvement, I felt could have been credited as much to the difference in environment as it could to the therapy which she had been receiving ...
Hubbard had claimed (he also has expressed this claim in his book) that virtually anyone could practice dianetics [...] If dianetics could be practiced by anyone, it would be available to all -- perhaps this could be the beginning of a Golden Age of greater sanity.
My efforts to teach this patient how to "audit" did not meet with success; I soon found out that Hubbard's claim and my wishful thinking were both inaccurate. [...]
When it was suggested that I be assigned the duties of medical director [of the Hubbard Dianetic Research Foundation, inc. 1950] I accepted without qualms, as I could foresee an opportunity for continuing with my investigations of the human mind. I realized that some of my more captious brethren might criticize my acceptance of such a position, but I felt that the contributions to knowledge which would ensue would ultimately counteract any criticism.
One of the first official duties of the Foundation was to present the concepts of dianetics to a group of psychiatrists, educators and any people in Washington, D.C. [...]
I did not feel that the Washington venture was a successful one -- at least, not from the medical point of view. It was noteworthy that most of the people whose interest in dianetics had been augmented by this presentation were members of the laity, rather than the profession, and I thought that I could detect in their attitudes the fervor of the convert, rather than the cool, objective interest of the scientist. The professional people evidenced an interest in the philosophy of dianetics; their interest was repelled, however, by the manner of presentation of the subject, especially the unwarranted implication that it was necessary to repudiate one's previous beliefs before accepting dianetics. [...]
It soon became apparent that neither my medical knowledge nor my past experience in research were going to be utilized. [...]
It was a period of intense confusion and rapid expansion, with little or no opportunity for analysis of accomplishments or for consideration of future developments. In spite of this, I found my appraisal of dianetics becoming more and more clear.
There were several elements which seemed to be of importance: the cardinal point was that there was a difference between the ideals inherent within the dianetic hypothesis and the actions of the Foundation in its ostensible efforts to carry out these ideals. The ideals of dianetics, as I saw them, included non-authoritarianism and a flexibility of approach; they did not exclude the realization that this hypothesis might not be absolutely perfect. The ideals of dianetics continued to be given lip-service, but I could see a definite disparity between ideals and actualities.
Other points in my appraisal which I thought important were the evidences of potential dangers in the method, the inability to confirm Hubbard's concept of "clear" and the effects of positive suggestion.
In my early investigation of dianetics, I had seen no evidence of danger in dianetic therapy. After Hubbard's book was published, however, and people less well-grounded in the precepts of psychotherapy began "auditing," it became apparent that dianetics was not entirely innocuous. It was called to my attention that two individuals had developed acute psychoses subsequent to dianetic "processing." Both of these people had apparently been sane prior to this time; they were neurotic and unhappy, but yet adapted to society sufficiently well so that their conduct fell within the bounds of social acceptability. One, a woman, developed an acute manic psychosis, characterized by the usual increased psycho-motor activity, disorientation, delusions and deterioration. It became necessary to institutionalize her, as any further attempts at dianetic therapy were ineffectual. [...]
It is most unfortunate that these patients, in their efforts to secure a promised greater sanity, appeared to lose what sanity they had. Yet a larger benefit may accrue as a result of this observation: if we can find out how a psychosis is precipitated, we are that much closer to discovering how to cure it.
Among the promising factors which mitigate these unfortunate occurrences are the reports that there have been several cases in which patients have ceased to be psychotic following dianetic therapy. I have observed only one of these cases, and that superficially; I am, therefore, not in a position to say that this is a proof of the efficacy of dianetics. It makes me believe, however, that further investigation with proper controls may furnish us with useful information.
Another point in which dianetics did not seem to follow out the claims of its originator was in the concept of "clear." Hubbard defines a "clear" as an individual who, through dianetic therapy, has had all his engrams removed, who "has neither active nor potential psychosomatic illness or aberration" (p. 170). He further states that an engram, once removed, is gone permanently, and can never return to influence a person's behavior. In our early correspondence he mentioned that a "clear" had been obtained in as few as twenty hours of therapy; this sort of result has not, to my knowledge, been obtained by other practitioners of dianetics. I know of persons who have had 1500 to 2000 hours of therapy and do not approximate the state of "clear," as defined. True, they are in better health and are more effectual and happy citizens -- but they have not reached this absolute goal.
I have yet to see a "clear" before and after dianetic therapy. I have not reached that state myself, nor have I been able to produce that state in any of my patients. I have seen some individuals who are supposed to be "clear," but their behavior does not conform to the definition of the state. Moreover, an individual supposed to have been "clear" has undergone a relapse into conduct which suggests an incipient psychosis.
This does not mean that I am denying the existence of the state of being "clear." It remains a theoretical possibility, granting the validity of certain postulates. I must, however, regard this claim as one which has not been confirmed. [...]
Another observation which I made during my association with the Foundation had to do with the phenomenon called "positive suggestion." It has been known since the days of the Egyptians that most people can be put into a state in which they act as if whatever they are told is true; they are said to be hypnotized, and the statements made by the operator in manipulating the subject's actions are called "positive suggestions." Hubbard in his book had inveighed against hypnosis and pointed out that being hypnotized was tantamount to being given an engram.
It has been known for some time that hypnosis can alter a person's behavior pattern for better or worse, not only during the hypnotic state but also for an indefinite period thereafter. [Werner Wolff, "The Threshold of the Abnormal," Hermitage House, Inc., New York, 1950, p. 328.] It was generally believed, however, that the person had to be in the hypnotic state in order to have a positive suggestion installed and his conduct thereby altered.
During my first acquaintance with dianetics I had supposed that it was a form of hypnosis; patients in "reverie" manifested all the signs of the hypnoidal state as defined by Davis and Husband [Davis, L. W. and Husband, R. W., "A Study of Hypnotic Susceptibility in Relation to Personality Traits," J. Abnorm. and Soc. Psychol., 26:175; 1931] When I discussed this with Hubbard, he pointed out numerous reasons why, in his opinion, dianetics was different than hypnosis. I remained unconvinced of their complete dissimilarity and frequently found myself in agreement with critics who pointed out their parallel manifestations.
One observation in particular enabled me, I feel, to relate dianetics and hypnosis in an operational manner. According to the Hubbardian hypothesis, all aberrated conduct stems from the engram, an event characterized by unconsciousness and pain, which might result from physical trauma, anesthesia, electric shock, "painful emotion" or hypnosis. Further, the existence of an engram could be verified by the behavior of a patient during his recollection of the event; if the patient yawned, stretched, underwent a mood-change ("a rise in tone-level") and acted as if he had re-evaluated the event, the event was an engram by definition.
I began to notice that some experiences produced engram-like effects when reviewed, although the events did not contain trauma, anesthesia, etc. Statements which Hubbard had made to me in ordinary conversation, statements which I had made to the students, statements made to patients when they were fully conscious and comfortable were, when subjected to dianetic recall, observed to produce a similar response to that seen in a "valid" engram. Not all statements produced this effect, however; the engram-like response was seen when the statements tended to restrict a person's choice of action or his ability to differentiate.
In other words, it seemed as if a person could be hypnotized by ordinary conversation; ordinary informational statements could, under some circumstances, have the same effects as a hypnotic positive suggestion, even when the recipient of the information was wide awake.
I found, moreover, that each person acted as if he had an orderly list of those from whom he would accept positive suggestion with varying degrees of willingness. In general, those who headed such lists were parents and loved ones; a simple statement coming from one of these had the force of a command. Next in the hierarchy came teachers, doctors and those in positions of authority, which at the bottom of the list were those who had made demonstrably false statements and those who had caused pain; statements made by the latter persons were ignored or negated against. It is, of course, possible for a person to occupy two positions on this list: the doctor or parent might cause pain, or the loved one might be detected in a lie. I suggest that this may be a factor in the developing of ambivalence or mixed feelings toward certain people.
In general, however, I found that I, as a doctor, could make positive suggestions which would alter a person's conduct much more easily than could a person whose position in society was less respected. The implications of this have done much to make me aware of my responsibilities to the people with whom I speak.
As a corollary of these observations I found that the simplest restrictive statements, even when the listener was fully conscious, tended to alter responses. For example, I have tried to recall a conversation with a colleague and found myself unable to remember what he said; when I recollected that during the course of the conversation he had said, "I don't remember," then I was able to recall the remainder of his words. It apparently makes no difference what pronoun is used; "I don't remember" and "You don't remember" seem to have an equally restrictive effect on the listener. The restrictive effect occurred; when I became aware that there was a restriction of my action of remembering, I was no longer restricted.
I have also found that therapeutic benefits could be obtained by utilizing the converse of this mechanism. During therapy I use a great number of permissive positive suggestions; "You can remember; you may obey this command or not, as you wish; you can understand this; you do know; you can differentiate." Compare, if you will, these phrases and their potential effects with the restrictive positive suggestions, such as "You can't; you mustn't; you're stupid." [...]
By October, 1950, I had come to the conclusion that I could not agree with all the tenets of dianetics as set forth by the Foundation. I could not, as previously mentioned, support Hubbard's claims regarding the state of "clear." I no longer felt, as I once had, that any intelligent person could (and presumably should) practice dianetics. I noted several points on which the actions of the Foundation were at variance with the expressed ideals of dianetics: one of these points was a tendency toward the development of an authoritarian attitude. Moreover, there was a poorly concealed attitude of disparagement of the medical profession and of the efforts of previous workers in the field of mental illness. Finally, the avowed purpose of the Foundation -- the accomplishment of precise scientific research into the functioning of the mind -- was conspicuously absent.
I expressed my opinion on these matters to the Board of Trustees on several occasions, with no discernible effect. Nor was I alone in my disagreement with the Foundation policies; those of us who advocated a more conservative attitude were in the minority, however, and our efforts were unavailing. I therefore, felt it incumbent upon me to submit my resignation. [...]
I feel also that medical practice might be improved by utilization of some of the observations which have been noted in dianetics. However, in order to make any new idea acceptable to the medical profession, it should be presented in a scientific manner. That, I fear, is not going to happen so long as the Foundation pursues its present policies. [...]
Even a wrong answer is closer to the truth than an apathetic "I don't know"; a wrong answer can be proved to be wrong, and the correct answer sought, while unquestioning ignorance or hopelessness leads only to stagnation.
[Other observations from Dr. Winter's book...]
[p. 47.] It is interesting to observe that therapeutic results can be obtained even if the patient does not believe in the possibility of prenatal "memory." The actual existence of prenatal memory is, in my opinion, of secondary importance; of primary importance is the observation that the patient seems to benefit from reviewing such "memories" and from having the concomitant pain reduced.
[p. 48-9] In such a fashion, have the person review the painful incident at least eight or ten times. In the majority of instances, the patient will report that the pain becomes more intense at the second or third recounting, then diminishes rapidly until it disappears entirely. Moreover, it is a clinical impression that injuries so treated heal much more rapidly than is usual. It also seems that it is necessary to review all the content of this segment of time; if the patient overlooks or omits a portion of the experience, the relief from the pain is not so complete. [...]
This technique is the essence of dianetics. It includes looking for a specific event of injury, of directing one's awareness to all concepts which were acquired during that segment of time, and of repeating the re-examination of the event until the pain content is exhausted.
It is in this technique that the major differences between dianetics and the older psychotherapies lie; specificity of event, totality of content and repetition to exhaustion are not, to my knowledge, included in any other method of treating psychic or psychosomatic illness.
[p. 52] It has been observed, moreover, that one should be cautious in using anthropomorphisms in scientific words. The statement that the mind works like a calculating machine contains a modicum of truth -- but it is one of those statements which is often misinterpreted to mean that the mind works only like a calculating machine, which is an obvious absurdity. The human mind is a complex affair -- not too complex, perhaps, for us to understand it, but not so simple that we can accurately say that it works "just like" anything else. The human mind works just like the human mind, and I am not willing to detract from its uniqueness by over-simplified mechanistic devices. Moreover, it may be pointed out that a calculating machine works like the human mind because it was invented by the human mind.
[p. 54] It seems as if living organisms can choose between reacting and not-reacting, the choice being made on the basis of past experience. [...]
Consider the "thinking" process of a one-celled organism which is floating in an aqueous substrate. It can react to changes in its environment -- or, to express it another way, some changes in its environment will cause observable changes in the functioning of the cell.
[p. 55] "Cellular memory" -- or, better, protoplasmic memory might be defined as the state which exists in a cell after it has been exposed to a force sufficient to alter the spatial configuration of the protein molecules. A force is exerted on the cell which, in essence, crystallizes the protein in such a manner that it will no longer react to another presentation of a similar force. It is obvious that the function of "memory" implies a difference in reaction to successive applications of similar stimuli; I suggest that the difference occurs as a result of the change made by the first experience.
[p. 65] If a person predicts pleasure (in this sense, the possibility of continuing action), he acts in a manner which we call happy. If a person predicts "Death," he acts in a manner called sad.
[This chapter attempts to make scientific calculations out of human emotion - anger, happiness, fear, etc.]
[p. 184] It was common practice in the Foundation to direct the patient in therapy by saying, "The file-clerk will hand up the incident we need next and the somatic strip will go to the earliest moment of discomfort." A patient who had been well-indoctrinated in Hubbardian terminology (or jargon, if you prefer) would usually respond by developing a sensation of discomfort in some portion of his anatomy.
I used this device but little, feeling that it was unnecessary and perhaps dangerous. It was my belief that any psychotherapy should act to integrate the various functions of the mind, and that splitting off one function in order to control other function could be considered tantamount to training the patient in schizophrenia. It seemed, moreover, as I mentioned previously, that the device of designating a function by a personification could lead to semantic confusion, making to indoctrination of a patient needlessly complicated. It is a commentary on the marvelous functioning of the human mind that such a device works at all.
[p. 185-6] For about a month I carried on a short and cursory investigation of the effects of oxygen and carbon dioxide as an adjunct to dianetic therapy. I had had the opportunity of watching Dr. Paul Wilcox of the Michigan State Hospital at Traverse City give a demonstration of his "psycho-penetration" technique. His method is to give the patient five or ten breaths of a mixture of 20% CO2 and 80% O2 -- a modification of Meduna's original technique. [...]
Most of the patients observed had previously been well-indoctrinated in the tenets of Hubbardian dianetics, and I therefore hesitate to place value on the associations brought up by this technique as distinguished from reactions obtained in ordinary dianetic therapy. Most of them said, however, that the sense of discomfort was reached more quickly and with a greater sense of reality when the gas was used.
[p. 187 narration of a gas patient] I asked him to notice the dizziness and to give me the first phrase he thought of, to which he replied, "I really can't think of anything." A few moments silence, then he said, "My head feels like it's detached from my body; I feel like I'm hanging from my feet. My God, can this be my birth?"
[p. 188] I felt that simply using this medication as an adjunct to Hubbardian dianetics was not giving me the information for which I was searching. There were still too many gaps in the hypothesis, too many unexplained observations. Some of the explanations for relative failures in therapy were more ingenious than explanatory. The uncritical use of such "gimmicks" as the file-clerk seemed to be stultifying to further advancement of knowledge.
[p. 189] I had no objection to seeing patients consider a "past death" as an exercise in fantasy synthesis (a technique which Jung has long claimed to have therapeutic benefit) or as an approach to a real situation via the imagination route -- but to give to these highly improbable events the evaluation of complete reality was to me an indication of a lack of scientific skepticism.
Hell it won't be post 10,000 at all. 
I'm not 'IT'. I just looked and expected to see me hogging the big honor. Nope. 
Only post 9900#. Ya really had me goin. 
