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The author describes sleep-like states that commonly occur in many cultures and that constitute an altered state of consciousness or a hypnoid state. In the analytic situation this invariably represents a defensive function against aggressive or sexual impulses and may lead to a formidable resistance unless analyzed. He emphasizes that 'there is no real gratification for the patient in the hypnoid state … that the intent is to conceal and prevent the development of affect and insight'. This state may also represent a defense against the threat of aggression from without. Such states strongly impede progress in analysis until worked through. In actuality the hypnoid state must be distinguished from normal sleep.
It is suggested that those who experience this syndrome to a marked degree have suffered unusual seductions and beatings in childhood which forced them to such refuge in stupor. Examples of hypnoid states are culled from the literature. A distinction is made between the dynamics of hypnoid and hypnotic states on one hand and true sleep on the other. The adult hypnoid state is a repetition of a childhood hypnoid state which represented a means of warding off intolerable feelings due to excessive stimulation or abuse. The analyst may experience the same state as a countertransference phenomenon.