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Dickes, R. (1965). The Defensive Function of an Altered State of Consciousness—A Hypnoid State. J. Amer. Psychoanal. Assn., 13:356-403.

(1965). Journal of the American Psychoanalytic Association, 13:356-403

The Defensive Function of an Altered State of Consciousness—A Hypnoid State

Robert Dickes, M.D.

SUMMARY

Certain phenomena, commonplace in our culture, and which are usually termed fatigue, drowsiness, or sleepiness are actually manifestations of a hypnoid state. This is a special alteration in the state of consciousness which should be distinguished from other alterations in consciousness such as hypnagogic phenomena, fugue states, and others. The hypnoid state is not uncommon during an analytic hour and may be noted in many other life situations as well. These are situations which involve the patient in struggles with unconscious unacceptable sexual and aggressive impulses related to repressed memories. Several illustrations as observed in my patients are presented. The severest cases were exposed to major trauma in childhood during which time the hypnoid state was utilized defensively.

The hypnoid state is classified as an ego defense and categorized as another in the ego's repertory of defenses. The hypnoid state, as is typical for a defense, is reported as protecting the ego

against unacceptable instinctual demands. A theoretical discussion of the hypnoid state includes the consideration of classical hypnosis and sleep. Points of similarity and difference are noted.

Clinically, the hypnoid state can be noted to range from the mildest, almost imperceptible interference with normal alertness to a deep sleeplike state. A few of my patients report that the minimal type of alteration in alertness has been present in them for considerable lengths of time.

This special alteration in the normal state of alertness can be noted in other cultures as well as in our own. The Balinese culture is one in which hypnoid phenomena are acceptable manifestations of behavior. Similar alterations in consciousness may be observed in shamans and other religious devotees such as Buddhist monks.

Shakespeare's Othello contains a typical example of a hypnoid response to aggression. The phenomenon which I have termed the Desdemona phenomenon is exemplified by Desdemona's response that she is "half-asleep" following Othello's aggressive declamation.

The hypnoid state under consideration is so ubiquitous that it is difficult to classify all such reactions as necessarily pathological. In analysis, it constitutes a serious resistance. It may also be noted as a countertransference manifestation and must be combatted.

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