280 PSYCHOTHERAPY : SCIENTIFIC AND RELIGIOUS chap.
the treatment. An initial part of the treatment is to lessen the secondary psychological situation due to feelings of inferiority, which is nearly always present.
Loss of voice (aphonia) is an occasional complaint, especially round about the time of puberty and adolescence in girls. It is almost invariably the aftermath pi an emotional situation. Suggestion and persuasion are very useful in this disorder. A simple method is to use a tongue-depressor to hold the tongue down while suggestions are made that it will be possible to produce sounds. As soon as the sound has been produced, this is used as evidence to show the patient that sounds can be made.
In conversion hysteria the symptoms are sometimes dealt with by suggestion under hypnosis, the patient being ordered to walk if he were previously paralysed ; to read aloud or recite if he were previously mute, and so on. While he is complying with the order he is told that he will continue to exercise the function on awakening and that he will have no further disability. He is then awakened gradually and, to his no small astonishment, he finds his disability gone. Symptoms can also be removed by strong suggestion in the waking state, especially if the doctor invokes the help of electrical massage, of some special liniment, or even of a bottle of medicine. In spite of this, however, such administrations are dangerous, for they confirm the patient in his belief that his symptoms are due to some physical cause which the particular treatment has cured, so that when a relapse occurs, as often happens, the patient requires the services of the same practitioner using the same method, and then, after a few relapses the treatment loses its efficacy and the patient seeks a new doctor. The reason for the relapse, or for the development of new symptoms, in these cases is that the under-