Along with the development of the theory of combination reflexes, which I studied in collaboration with a number of individuals, initially on animals, and then from the beginning of this century on people, the special role of the artificial education of combination reflexes began to emerge in the sense of restoring disturbed functions of the nervous system in neuroses. As is known, the associative motor reflex in the formulation of our methodology is obtained by repeated combination of a motor reflex caused by electrical stimulation with an indifferent (in the sense of this reflex) sound, light and other stimulus, after which the same motor effect is obtained on some sound, light and other irritation. And it turned out that the same technique acquires therapeutic significance in anesthesia and paralysis of neurotic origin. In this regard, back in 1918, in the Review of Psychiatry, Neurology, and Experimental Psychology, which I edited, I wrote the following: weaken, initially at the site of irritation with injections, and then in other parts of the affected area. The same is observed in the development of combination motor reflexes, if the anesthetized area is subjected to methodical stimulation with the help of an electric current in order to obtain from it an association motor reflex according to the method developed by us. Little by little the anesthesia weakens and finally disappears completely.
It has also repeatedly happened to observe that if patients have hysterical paralysis, then the development of associative reflexes on the paralyzed limb leads to the fact that, together with the appearance of the associative reflex, movements in the paralyzed areas begin to gradually recover and, finally, hysterical paralysis is cured more or less completely. Thus, after the development of the associative motor reflex on the paralyzed limb comes the restoration of those movements that we call personal or, as they are usually called, voluntary. Since then, observations in this respect have been carried out in the same direction, and it has been possible to verify that in the method of educating associative motor reflexes we have a real remedy for anesthesia and paralysis in neuroses.
No less favorable results were obtained with us in the development of associative reflexes to sound stimuli in persons with functional deafness in traumatic neuroses, as well as in hysteria. Along with a repeated trial to develop the combination reflex according to the method developed by us in those deaf from concussion, gradually, but in general quickly, most often within several sessions, completely lost hearing was restored. According to the testimony of the same kind of patients, along with the education of associative reflexes, their ears, as it were, “open”.
It is obvious that hysterical blindness can be corrected by exactly the same method. In any case, in the method of educating associative reflexes, we obtain an important therapeutic tool that makes it possible to quickly correct hysterical paralysis and anesthesia of the skin surface and specially perceiving organs. Obviously, functionally inhibited cortical connections in these cases, under the influence of appropriate stimuli and the establishment of combinational connections between them and the motor apparatus, are subject to disinhibition, which is what is achieved in this case, the restoration of functional activity.
Later, the method of educating associative reflexes expanded significantly. Thus, during work at the State Reflexological Institute for the Study of the Brain, which I manage, it became possible, on the one hand, to obtain an associative reflex by combining an active movement of the hand with the verbal stimulus “act” with simultaneously produced indifferent stimulation, for example, sounds, after which this movement is carried out and with one indifferent stimulation through sound. Thus, here we have a real associative reflex in the form of a movement of the hand to one sound. At the same time, it turned out that the same combinations of passive hand movement with sound do not make it possible to develop an associative reflex of the above nature (Dernova, Yarmolenko). In exactly the same way, if the sound stimulus is combined with the verbal stimulus “pick up” and at the same time the subject actively raises his fingers from the key on which they lie, then when these combinations are repeated, an associative reflex of withdrawing the fingers of the hand to one sound stimulus is easily formed.
Subsequently, it turned out to be possible to use the combination of the exciting verbal stimulus “lift up”, as well as the inhibiting given action in the sense of the counteracting order “do not raise” (i.e., do not raise your fingers) with sound in another respect. Let us assume that an associative reflex has been brought up by combining an electrocutaneous and sound stimulus to the sound “to”. As you know, at first such a reflex is undifferentiated, since the withdrawal of the fingers occurs both to the sound «do» and to the sound «fa» and to any other sound. But instead of continuing differentiation by constantly reinforcing the received reflex by combining “do” with an electrocutaneous stimulus and leaving such combinations of other sounds unreinforced, we spoke simultaneously with the sounds “fa” and “without taking away.” In this case, the subject’s reflex to «fa» is inhibited. But at the same time, inhibition also extends to other sounds: “re”, “mi”, etc., and sometimes even to “do”, and in this case, to restore the associative reflex to “do”, a new combination of it with electrocutaneous stimulation is required. , which, with the restoration of the associative reflex, can again extend its exciting influence to other sounds, until the corresponding reflex to one sound “do” is finally established. On the other hand, if we have inhibition of an educated associative reflex to a given sound and we combine this sound with the word “take away”, we will thereby disinhibit the associative reflex to this sound and, at the same time, the associative reflexes to other sounds will also be disinhibited. The experiments that Dr. V. N. Osinova conducted with us showed that a verbal stimulus of an inhibitory nature in most cases evokes a response faster than a verbal stimulus of an exciting nature and, on the other hand, the impact of the first stimulus also leads to inhibition of an educated person. earlier associative reflex. The above method shows the value of combining a verbal stimulus of one character or another, i.e. inhibitory or exciting, with a reflex stimulus.
This gave grounds to apply the above method for the purpose of reflexology. At the State Reflexological Institute for the Study of the Brain, this method has been applied against habitual theft in preschool children and part of school age. Dr. V. N. Osipova conducted reflexology of this kind on 7 orphanage children aged 9 to 12 years, including 3 girls and 4 boys, and in this number there were both real kleptomaniacs and children with habitual theft. At the same time, in order to avoid the conditions of suggestion, no conversation was conducted with the children brought to the institute for treatment in advance about their theft, but only a survey of the name, surname, age, school, class was made and no other questions were allowed. The very same treatment consisted of the following.
After establishing the degree of excitability of the fingers to an electric current, the child is brought up with an associative reflex to sound and the speed of the associative reflex is determined to determine the associative-excitable or associative-inhibitory type. Then a combination of such minimal electrocutaneous stimulation is produced, which causes the withdrawal of fingers with the word «do not take.» There are 10 such combinations, and with this the case ends for the first time. Similar treatments are repeated after about a week or more or less days. Subsequently, the technique was reduced to a combination of the same word «do not take» with one call and, moreover, with the same success. Already after 2-3 such sessions, improvement was observed, and after 6 sessions recovery occurred, followed up for 6-7 months. There was only one relapse, which could depend on the unsuitable environment. Some of the recovered children themselves declared with surprise that «the attraction to theft had ceased due to the treatment with electric current.» Further, an attempt was made on the part of V. N. Osinova to apply the same method against children’s onanism by combining the word «do not touch» with an electric current.
Dernovo-Yarmolenko and Taranova, a similar method of combining electric current was used in children with bedwetting, and here the verbal inhibitory stimulus «do not urinate» was combined with the electric current. And in this and in another case, it is only the beginning of research and the number of observations is still too small to draw the appropriate conclusions, but nevertheless, in masturbation, and in bedwetting, the results of such therapy have so far turned out to be quite favorable. These studies, of course, will continue and then the final word will be said about them.
In order to be aware of the meaning of the verbal stimulus in the above cases, it must be borne in mind that it always and everywhere has a substitute meaning in relation to the action of which it serves as a symbolic sign. Thus, in life conditions, “take”, “don’t take”, “don’t touch” are based on a strong connection of these verbal stimuli with the conditions of measures of influence — encouraging if the corresponding execution is carried out, counteracting if this order is not carried out. Obviously, in the above cases, repeated anchoring of such a verbal stimulus in connection with the main stimulus that excites the defensive reflex, and then with the stimulus combined with it, is enough to have an appropriate therapeutic effect.
Naturally, the question arises whether we are not dealing in the latter cases with suggestion, or whether we are dealing with a direct disinhibition of the oppressed function in some cases or the stimulation of an active delay in others. This question is all the more pertinent, as in kleptomania, and in masturbation, and in bedwetting, I have, on the basis of my experience, had excellent results with distraction psychotherapy.
Since the suggestion itself from a reflexological point of view should be considered as disinhibition by a verbal stimulus in one case (for example, when eliminating an obsessive attraction) and the establishment and strengthening of the connection between an external stimulus and action in another case (for example, when a suggestion is made: “at the sight of you will do such and such an object”), then, apparently, one cannot see a significant difference between the above technique using a combination reflex to a verbal stimulus and suggestion, but nevertheless, in the method used, we have a more mechanized process of combining higher reflexes with a reflexogenic, or indifferent stimulus, rather than a practiced suggestion, as a result of which there can be no opposition from the suggestible with the character of a counter-suggestion, on the other hand, there are no traces of a hypnotic state in it.
Let us take the example of Togau, a therapeutic method against alcoholism, which consists in giving emetic several times with wine and which is based on the direct combination of two stimuli — one with the character of attraction and the other, a stronger stimulus, with a protective character. Is it possible to speak in this case of suggestion? I guess not. Another example: in my practice, there was repeatedly a favorable calming effect of a saline solution injected under the skin instead of the usual injection of a morphine solution, which can most likely be explained by the beneficial effect of the injection itself on the general condition of the body established by combining it, rather than by suggestion.
In any case, the aforementioned therapeutic techniques with the nature of reflexology deserve special attention in view of the fact that they give excellent results in general and in those individual cases where the use of hypnotic suggestion and other types of psychotherapy may not give appropriate results.
Conclusions
1. Combination-reflex therapy, being close in nature to suggestion, differs from it in a more mechanized nature, making it impossible for the subject to carry out counter-suggestion.
2. Combination-reflex therapy, being a new means of therapeutic action, in appropriate cases can have an unconditionally beneficial effect.
3. This therapy may be of particular importance in hysterical paralysis and anesthesia, and in hysterical deafness.
4. With painful and habitual drives, combination-reflex therapy, as shown by experiments on theft in children, also gives useful results where suggestion may not have a corresponding effect.