A RESEARCH
ABUSE
1995
Barber, Joseph (1995, November). When hypnosis causes trouble. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES: Sexual acting out occurs, even with highly trained and responsible clinicians. But other problems occur, and it is the same qualities of hypnosis that make it useful that also make for problems. I found 20 publications that exhibited problems in therapy, and they all discussed only the mental illness of the patients.
Bryant, Richard A. (1995). Fantasy proneness, reported childhood abuse, and the relevance of reported abuse onset. International Journal of Clinical and Experimental Hypnosis, 43 (2), 184-193.
This study investigated the relationship between fantasy proneness and the age at which reported childhood sexual abuse occurs. Seventeen adult females who reported having been sexually abused before the age of 7 years, 20 females who reported having been abused after the age of 7 years, and 20 females who reported having never been abused were administered two measures of imaginative involvement (Tellegen Absorption Scale [TAS] and Inventory of Childhood Memories and Imaginings [ICMI]). Participants who were reportedly abused early in childhood obtained higher scores on the TAS and ICMI than participants who were reportedly abused later in childhood, who in turn obtained higher scores than the control participants. Findings are discussed in terms of factors that mediate fantasy proneness and reports of childhood abuse
Eisen, Mitchell L.; Henn-Haase, Clare (1995, November). Memory and suggestibility for events occurring in and out of hypnosis. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES: Resistance to misinformation uses two paradigms: 1. Elizabeth Loftus – expose Subject to slides or videotape, give misinformation with leading or misleading questions 2. Martin Orne – pseudomemory, i.e. age regress people in hypnosis and suggest events occurred.
Each approach yields mixed results. Misinformation is accepted more readily in context of hypnosis; but there is no relationship to hypnotizability. Spanos found that highs were more responsive to social pressure. In general, in the absence of social pressure, when presented subtly and outside the context of hypnosis, the relationship diminishes. Other factors play a more prominent role: source of information, type of information, salience of information, etc.
They examined whether events occurring in context of hypnosis were more prone to distortion when assessed in biased fashion with use of misleading information, than outside hypnosis. Also, form of questions (dichotomous or with ‘I don’t remember’ option).
They gave the Harvard and asked afterwards 3 misleading items (e.g. did you clench your fist, when they didn’t do it). Also asked them to circle items if they had no memory of it. Tellegen Absorption Scale and Dissociation scale (DES) were administered a week later. Also a week later asked about events that occurred, including confederate items. Half of Ss had 2 choices, half had also ‘I don’t remember’ as a third option.
In a previous study, resistance to misleading information was related to the strength of the initial memory and not to hypnotizability (article published in AJCH).
RESULTS. When given 3 choices, the number of misleading items endorsed dropped from .7 to 0.4 which is the most robust finding in the study and affects the rest of the study. Many Ss who endorsed the items reported minutes later that they had no memory for the event (on the check list). While many Ss given only two choices wrote in the margin that the event had never occurred.
Offering an ‘I don’t know’ third option decreased endorsement of the Harvard items also, from 6.4 to 5.2 which is significant. The relationship between hypnotizability and endorsement of misleading items became much weaker when accounting for this.
Scoring high on DES is significantly related to accepting misinformation. Tellegen Absorption Scale also related to accepting misleading information. Harvard Hypnotizability Scale was not related to accepting misinformation.
Total memory on the Harvard (before cue plus after cue) did not correlate with resistance to misleading information. History of abuse was related to hypnotizability. Have to evaluate whether it was traumatizing, multiple abuse, etc.
Ganaway, George K. (1995). Hypnosis, childhood trauma, and dissociative identity disorder: Toward an integrative theory. International Journal of Clinical and Experimental Hypnosis, 43 (2), 127-144.
It is contended that prevailing exogenous trauma theory provides in most cases neither a sufficient nor a necessary explanation for the current large number of diagnosed cases of dissociative identity disorder (multiple personality disorder) and related dissociative syndromes purported to have arisen as a response to severe early childhood physical and sexual abuse. Relevant aspects of instinctual drive theory, ego psychology, object relations theory, self psychology, social psychological theory, sociocultural influences, and experimental hypnosis findings are drawn on to demonstrate the importance of adopting a more integrative theoretical perspective in the diagnosis and treatment of severe dissociative syndromes. Further cooperative experimental and clinical research on the etiology, prevalence, and clinical manifestations of the group of dissociative disorders is strongly encouraged.
Guyer, Charles G. II; Van Patten, Isaac T. (1995). The treatment of incest offenders — a hypnotic approach: A brief communication. International Journal of Clinical and Experimental Hypnosis, 43 (3), 266-273.
Incest has become more prominent in public awareness over the past 15 years. The major focus of this interest has been on the incest survivor. The incest offender has received less attention. A hypnotic approach to treating incest offenders is outlined that involves a seven-stage approach. A case example is presented and future research directions suggested.
Holroyd, Jean (1995). Handbook of clinical hypnosis, by Judith W. Rhue, Steven Jay Lynn, & Irving Kirsch (Eds.) [Review]. International Journal of Clinical and Experimental Hypnosis, 43 (4), 401-403.
NOTES
“This is a book for the thinking clinician” (p. 401). “The editors are to be congratulated for making this volume much more coherent than most edited books” (p. 402). “My impression is that the book is best suited for an intermediate or advanced course on hypnotherapy, or for people who are already using hypnosis in treatment. Although there is some material on the basics of hypnotic inductions and a few introductory sample scripts for inductions, a beginners” course should probably use a different book, or this book could be accompanied by an inductions manual. … I recommend it very highly” (p. 403).
Levitt, Eugene E.; Pinnell, Cornelia Mare (1995). Some additional light on the childhood sexual abuse-psychopathology axis. International Journal of Clinical and Experimental Hypnosis, 43 (2), 145-162.
This exposition is an attempt to unravel the complexities of the relationship between childhood sexual abuse and adult psychopathology. Four facets of the relationship are examined in some detail: (a) the extent of childhood sexual abuse; (b) the probability that sexual abuse in childhood will result in psychopathology in the adult; (c) the reliability of early life memories in later life; and (d) the role of recovered memory of trauma in the healing process. The conclusions of this logico-empirical analysis are that first, government statistics tend to underestimate the extent of childhood sexual abuse, whereas independent surveys tend to overestimate it. Estimating prevalence is further complicated by variations in the definitions of key terms. Possibly the only safe conclusion is that true prevalence cannot be reliably determined. Second, empirical investigations of childhood sexual abuse conclude that not all victims are emotionally injured. A substantial number of these investigations find that a majority of victims suffer no extensive harm. Other variables such as family dynamics are involved; there may be only a few cases in which emotional harm results from sexual abuse as a single factor. Third, memory research suggests that memory in general is a dynamic, reconstructive process and that recall of childhood events is particularly vulnerable to distortion. Memory cannot dependably produce historical truth. Last, there is some clinical evidence that abreaction of a traumatic event in adulthood may have a remediative effect. Similar evidence for childhood trauma is lacking. The belief in the healing effect of recalling and reliving a childhood trauma depends on the therapist’s orientation.
Nagy, Thomas F. (1995). Incest memories recalled in hypnosis — a case study: A brief communication. International Journal of Clinical and Experimental Hypnosis, 43 (2), 118-126.
Accuracy of repressed memories recovered in hypnosis cannot be reliably determined with any greater certainty than non-hypnotically recalled events. Therefore, the practice of therapists’ accepting hypnotically enhanced memories as veridical, absent corroborating evidence, is not advocated. A 52-year-old woman with a 27-year history of panic attacks and sleep disorder inadvertently recovered incest memories in hypnosis. Photographs and remembered events by other family members were thought by the patient to provide general support although they did not constitute actual proof of abuse. Implications are discussed.
1994
Bloom, Peter B. (1994). Clinical guidelines in using hypnosis in uncovering memories of sexual abuse: A master class commentary. International Journal of Clinical and Experimental Hypnosis, 42 (3), 173-178.
“Joan,” a clinical psychologist, requested a psychiatric consultation to determine whether hypnosis could recover accurate memories of suspected child abuse by her still living father. Are there clinical guidelines in using hypnosis in uncovering such possible memories of sexual abuse? We asked Dr. Peter B. Bloom to share his views with us.
NOTES: Gives case example and clinical guidelines for using hypnosis in uncovering memories of sexual abuse. 1. In medical practice, “Primum non nocere,” i.e. “First do no harm.” 2. “No therapist should ever, either directly or indirectly, suggest abuse outside of a specific therapeutic context–certainly not to a client who is on the phone making a first appointment!” 3. “A therapist must not jump quickly to the conclusion that abuse occurred simply because it is plausible.” 4. “A therapist should never simply assume that a client who cannot remember much from childhood is repressing traumatic memories or is in denial.” 5. “Remember ‘a client is most vulnerable to suggestion and the untoward influence of leading questions when therapy begins to delve into painful life situations from the past, particularly from childhood.'” 6. “Therapists … should be cautious about suggesting that clients cut off communication with their families.” 7. “Therapists should reconsider the ‘no pain, no gain’ philosophy of treatment.” 8. “The context of therapy is as important as the content.” 9. “Tolerate ambiguity.” (Sincerity and conviction on the part of the patient reporting abuse are not in and of themselves reason to believe the material.) 10. “Respect the current science of memory.” 11. “Maintain responsibility for making the diagnosis and choosing the treatment.” 12. “Pursue alternative diagnoses to account for the symptoms.” 13. “Historical and narrative truth: Understand the difference.”
COMMENT: The tenet that insight is necessary for change and growth is not true. Change can occur without insight, although insight may be helpful in maintaining change once it has occurred.
SUMMARY: These guidelines are presented to enhance safe practice, however, clinicians should use their own judgement to determine the best path to follow with each patient.
NOTE: Guidelines 1, 8, 9, 10, 11, 12, and 13 are those of Peter B. Bloom. Those labeled as Guidelines 2, 3, 4, 5, 6, and 7 were taken with permission from Yapko, M. (1993 September/October). “The seductions of memory. The false memory debate.” Family Therapy Networker, 17, pp. 30-37. All discussions, however, are those of Peter B. Bloom.
Bowers, Kenneth S. (1994, October). Bringing balance to controversy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES: Skeptics argue that concept of “repression” has no scientific merit, though even if a valid concept, it wouldn’t validate all memories recovered. Skeptics regard laboratory evidence as essential, while clinicians are impressed by case reports. See Polonyi, _Personal Knowledge_.
It is not reasonable to say there is no evidence for fugue states, when seeing one, if it has not been demonstrated in the laboratory. But you can investigate some of the phenomena in the laboratory.
Most of the time it is an affectively loaded idea that is repressed; in contrast, trauma usually lead to intrusions into consciousness. So repression of a traumatic event may be a rare way to deal with the event.
Claims for repression and ESP differ in that there are probably observable mechanisms in the former (e.g. thought avoidance). If a person ejects thoughts about a topic frequently enough, the ejections become automatic. Freud’s original description of repression used the word “intentional” and it was a footnote that took out that idea. (See Erdelyi’s publications).
Recent research we conducted on intuition and on problem solving is relevant to this problem.
[The remainder of Bowers’ presentation is not summarized here.]
Frankel, Fred H. (1994, October). On patients remembering abuse when it in fact may not have occurred. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES: The concept of hidden memories has supported the profession of psychotherapy for a century. This process can only occur if there is a mechanism to support it. Bowers says, if memory is not reliably accurate, it is not reliably inaccurate either.
“Ideas passing as descriptions lead us to equate the tentative with [the factual.]” – Gould.
Three studies purporting to establish repression: 1. Briere & Comte sampled 450 adults who reported abuse. They asked, “Was there ever a time when you couldn’t remember the forced experience?” How does respondent understand the question? Clients were all in therapy. 2. Herman and Schatzow (1989) “verification of abuse” study. 53 Ss in a survivor’s group. Reports percentages who had no or little recall. Authors don’t acknowledge that the group discussion and the attitude of therapist may have shaped the response. It is also not clear how many Ss who claimed to have “verified” their accounts were among those who had severe amnesia for the event. They could be Ss who had never lost the memory in the first place. 3. Williams interviewed women who earlier were in Emergency Rooms because of abuse being suspected. 38% did not report childhood abuse when questioned, and author concluded it was due to repression. Significant numbers of adults cannot remember things even past the age of 5.
Problem with wording of questions. Some of the women interviewed might have preferred not to report the event. This was not investigated in the study.
Freyd, Jennifer J. (1994). Betrayal-trauma: Traumatic amnesia as an adaptive response to childhood abuse. Ethics and Behavior, 4.
Betrayal-trauma theory suggests that psychogenic amnesia is an adaptive response to childhood abuse. When a parent or other powerful figure violates a fundamental ethic of human relationships, victims may need to remain unaware of the trauma not to reduce suffering but rather to promote survival. Amnesia enables the child to maintain an attachment with a figure vital to survival, development, and thriving. Analysis of evolutionary pressures, mental modules, social cognitions, and developmental needs suggests that the degree to which the most fundamental human ethics are violated can influence the nature, form, processes, and responses to trauma.
NOTES: “A logical extension of this research direction, based on a strategy that has been very effective in cognitive neuroscience, would be to look for neuroanatomical underpinnings of the cognitive mechanisms implicated in dissociation. … For instance, the ability to dissociate current experience may depend partly on representational structures that support spontaneous perceptual transformations of incoming events. One possible perceptual transformation that is amenable to scientific investigation, would be the creation of spatial representations in which the mental ‘observer’ is spatially distinct from the real body of that observer. Such a representation would fit patient descriptions of ‘leaving their body’ during a traumatic episode and viewing the scene as if from afar. Additionally one could investigate the role of mental recoding and restructuring during memory ‘recovery’ and psychotherapy” (pp. 19-20).
Loftus, Elizabeth; Polonsky, Sara; Fullilove, Mindy Thompson (1994). Memories of childhood sexual abuse: Remembering and repressing. Psychology of Women Quarterly, 18, 67-84.
Women involved in out-patient treatment for substance abuse were interviewed to examine their recollections of childhood sexual abuse. Overall, 54% of the 105 women reported a history of childhood sexual abuse. Of these, the majority (81%) remembered all or part of the abuse their whole lives; 19% reported they forgot the abuse for a period of time, and later the memory returned. Women who remembered the abuse their whole lives reported a clearer memory, with a more detailed picture. They also reported greater intensity of feelings at the time the abuse happened. Women who remembered the abuse their whole lives did not differ from others in terms of the violence of the abuse or whether the violence was incestuous. These data bear on current discussions concerning the extent to which repression is a common way of coping with childhood sexual abuse trauma, and also bear on some widely held beliefs about the correlates of repression.
NOTES: In previous research, it was reported that violent or incestuous abuse is particularly susceptible to repression. This study differs from previous investigations in the definition of violence. In the present study, ‘violence’ is defined as any act involving vaginal, oral, or anal sex. Earlier research defined ‘violence’ as involving sexual assault with physical injury or fear of death.
Depending on the definition of repression, a sizeable minority (31% or almost 1/5) of this sample forgot their earlier abuse for a period of time. The authors state that this suggests there is little ‘robust repression’ in this sample. They cannot rule out the possibility that some women who were abused still, to this day, do not recall the experience; or that some who continue to have memory loss based on organic causes, including blackouts.
The authors suggest that future research in this area use more specific questions, including assessing whether Subjects respond to statements like: “There was a time when I would not have been able to remember the abuse, even if I had been directly asked about it,” or “There was a time when I would not have been able to report the abuse because I had no idea that it had even happened to me.” Also, when Subjects report that a memory had emerged after a period in which they had no recall, the Experimenter should enquire about how and when the recovered memory occurred.
The authors conclude that remembering abuse is more common than forgetting it.
Lynn, Steven Jay; Myers, B.; Sivec, H. (1994). Psychotherapists’ beliefs, repressed memories of abuse, and hypnosis: What have we really learned?. [Comment/Discussion] .
The authors are responding to an article by Michael D. Yapko in the same issue of AJCH, “Suggestibility and repressed memories of abuse: A survey of psychotherapists’ beliefs.” They are of the opinion that “Yapko’s research and data analysis do not justify the conclusion that many, if not virtually all, therapists are naive, credulous, and out of touch with the scientific literature, although it is evident that certain therapists can be so described” (p. 184). They state that “Yapko’s research is important insofar as it suggests that unfounded stereotypes of hypnosis persist even among Ph.D.- and M.D.-level clinicians” (p. 184).
Malinoski, Peter; Aronoff, Jodi; Lynn, Steven J.; Moretsky, Michael (1994, August). Hypnosis and early memories. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
NOTES
We studied autobiographical memory in the college population, as manifested in the therapy situation, as a way of investigating an individual difference variable. Most people do not have recall before age 3 or 4 (and probably infantile amnesia begins before age 2).
Administered Autobiographical Memory Scale (AMS), and later in context of a hypnosis scale. 247 students were in phase 1, conducted as two separate experiments so that Ss wouldn’t link the AMS to measures used in the second study.
First study was presented as a study of personal memories. Asked Ss to distinguish first five birthdays, circumstances around loss of first tooth, first day of high school. Also, they were asked about their earliest memory events, rated according to 3 scales (detail, vividness, accuracy of recall). Authors summed Ss’ responses on these 3 ratings for the 8 item scale.
Part II. Administered various scales: Life Experiences, Fantasy Proneness, Wilson & Barber’s scale, Imagery Control Scale, Global Psychopathology, 25 item scale of physical and sexual abuse, Brier’s list of symptoms of abuse, and DES (Dissociative Experiences Scale). Imbedded were 12 items to test carelessness in responding (e.g. “I have never said Hello to anyone who wore eyeglasses.”)
RESULTS. Phase 1. Two people indicated they had memories dating to before their first birthday; an additional 5% of Ss gave memories between 12-24 months. This would probably be impossible. Another 14.4% described events between 24-36 months; 37.4% said their earliest memory was at age 3. Mean age for earliest memory was 3.4 years (which agrees with other surveys.) Only l subject stated his earliest memory was as late as the tenth year of life.
High intercorrelation was obtained, ranging .79 to .89, between ratings on any of the memory event ratings (as detailed, vivid, or accurate). There was a negative correlation of these ratings with age of recall. Ss who report more detail, vividness, and competence, were also likely to report earlier first memories.
Authors divided Ss into three groups based on age of first memory: 12 with first memory earlier than first year; those whose first memory was between 1-7 years; and those with a later first memory. The earlier memory group were more fantasy prone; and rated their memories as more reliable, vivid. This suggests there are persons who report memories that are covered by infantile amnesia, report them with greater detail, and are more fantasy prone than those who report memory events beginning later in life. This is consistent with Wilson & Barber’s finding that fantasy prone people have vivid recall of early childhood events.
None of the memory reports correlated with psychopathology or dissociation. Dissociation (DES) was correlated with abuse indicators, however. Compared top and lowest 10% and middle range on DES on their memory scores and found no relationship. There was no support for the idea that report of early life events in dissociative people is compromised. Failure to recall early memories shouldn’t suggest that people are dissociative (which some therapists tend to do).
All three memory measures were associated with Harvard Scale scores. The AMS was administered at the same time as the Harvard. Objective responding on the Harvard correlated with detail, vividness, and accuracy of recall. Also, involuntariness of response correlated with all 3 measures of the AMS. Finally, subjective involvement correlated with all three measures of AMS. At least when hypnosis is measured first, and explicit connection is suggested, there is a connection. Further research is needed to see if the relationship holds when measured in independent contexts. This may explain why High Hypnotizables are more prone to pseudo memories and leading questions. They may come to confuse them with historical reality.
The results suggest caution for early memory reports. They may be vulnerable to confusing fantasy and reality, as well as to biasing effects.
Mulhern, Sherrill (1994). Satanism, ritual abuse, and multiple personality disorder: A sociohistorical perspective. International Journal of Clinical and Experimental Hypnosis, 42 (4), 265-288.
During the past decade in North America, a growing number of mental health professionals have reported that between 25% and 50% of their patients in treatment for multiple personality disorder (MPD) have recovered early childhood traumatic memories of ritual torture, incestuous rape, sexual debauchery, sacrificial murder, infanticide, and cannibalism perpetrated by members of clandestine satanic cults. Although hundreds of local and federal police investigations have failed to corroborate patients’ therapeutically constructed accounts, because the satanic etiology of MPD is logically coherent with the neodissociative, traumatic theory of psychopathology, conspiracy theory has emerged as the nucleus of a consistent pattern of contemporary clinical interpretation. Resolutely logical and thoroughly operational, ultrascientific psychodemonology remains paradoxically oblivious to its own irrational premises. When the hermetic logic of conspiracy theory is stripped away by historical and socio/psychological analysis, however, the hypothetical perpetrators of satanic ritual abuse simply disappear, leaving in their wake the very real human suffering of all those who have been caught up in the social delusion.
Nash, Michael R. (1994). Memory distortion and sexual trauma: The problem of false negatives and false positives. International Journal of Clinical and Experimental Hypnosis, 42 (4), 346-362.
Logically, two broad types of mnemonic errors are possible when adult psychotherapy or hypnosis patients reflect on whether they were sexually abused or not as a child. They may believe that they were not abused when in fact they were (false negative error), or they may believe they were abused when in fact they were not (false positive error). The author briefly reviews the empirical evidence for the occurrence of each of these types of errors, and illustrates each with a clinical case. Further, in considering the incidence, importance, and clinical implications of these errors, the author contends that clinical efficacy in no way assures that a false negative or a false positive has been avoided. A plea is made for theorists and researchers to acknowledge that both categories of errors can occur and to conduct future clinical and laboratory research accordingly.
Nash, Michael R. (1994, October). Reports of early sexual trauma: The problem of false negatives and false positives. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES The problem of false positives and problem of false negatives are distinct and should be treated differently. The question involves pseudomemories vs repression.
Evidence for false positives: 1. Memory research 2. Developmental psychopathology 3. Contemporary psychoanalytic theory 4. Clinical field studies
No laboratory researcher has produced false memories that are as gravid, or as emotionally loaded as early abuse.
Evidence for repression: 1. “Repressor Personality” research (Weinberger & Schwartz, who view it as a trait rather than a state). 2. Implicit memory research 3. Hypnosis research on memory (see Nash chapter in Fromm & Nash book on research in hypnosis) 4. Clinical field studies
Spanos, Nicholas P.; Burgess, Cheryl A.; Burgess, Melissa Faith (1994). Past-life identities, UFO abductions, and satanic ritual abuse: The social construction of memories. International Journal of Clinical and Experimental Hypnosis, 42 (4), 433-446.
People sometimes fantasize entire complex scenarios and later define these experiences as memories of actual events rather than as imaginings. This article examines research associated with three such phenomena: past-life experiences, UFO alien contact and abduction, and memory reports of childhood ritual satanic abuse. In each case, elicitation of the fantasy events is frequently associated with hypnotic procedures and structured interviews which provide strong and repeated demands for the requisite experiences, and which then legitimate the experiences as “real memories.” Research associated with these phenomena supports the hypothesis that recall is reconstructive and organized in terms of current expectations and beliefs.
Spence, Donald P. (1994). Narrative truth and putative child abuse. International Journal of Clinical and Experimental Hypnosis, 42 (4), 289-303.
Memories of early child abuse can be read in at least two distinct ways — as true accounts of an unspeakable event or as metaphors for a wide range of boundary violations which belong to both past and present. An actual memory of an early experience tends to fade unless repeatedly rehearsed; because abuse memories are inherently shameful, it seems reasonable to be skeptical of this kind of repetition and to be suspicious of their sudden emergence. An actual memory of an early experience would be told from the child’s point of view and would probably contain many false starts, internal contradictions, and all the other earmarks of a confused memory that refer to an early happening; by contrast, a seamless account with a tight narrative structure and an almost total absence of doubt or irrelevant detail is almost certainly false. An actual memory would tend to have its own flavor and style; by contrast, a memory of child abuse that sounds too much like other memories is more likely a metaphor for something else. Therapists, lawyers, and other professionals need to be trained to listen metaphorically to these accounts, to be on guard against hearing them as concrete references to a particular time and place, and to beware of reinforcing them prematurely.
Spiegel, David (1994, October). On patients not remembering abuse when it in fact may have occurred. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES:
False memories and false non-memories may be two sides of the same coin. What is the evidence for repression?
If people are abducted by extraterrestrials, why don’t they just keep them? [Joke!] It seems counter-intuitive that people would forget important, arousing things that happen.
The three main components of hypnosis (suggestibility, absorption, and dissociation) are also aspects of memory: 1. Absorption relates to encoding (narrowing attention); also happens during traumatic events (Loftus’ “gun memory” which is so clear, while they don’t encode what gunman’s face looks like). 2. Dissociation relates to memory storage (compartmentalization of information). Traumatized people have symptoms of dissociation, depersonalization. If you are in an unusual mental state, you may watch the event; the memory is stored without the usual network of associations. 3. Suggestibility relates to retrieval. The way questions are asked influences one’s response. But hypnosis is not an infinite influencer; the main damage to memory contributed by hypnosis is “confident errors” (McConkey).
We did research one week after the Loma Prieta earthquake, and found significant cognitive alterations, memory alterations, etc. In our sample, 1/4 of the people felt detached from their body or from the ground right after the earthquake.
Memory alterations were compared with data from other studies after other traumas. Difficulties with memory occurred in 29% of our sample.
The disorganization of memory can follow even just witnessing trauma (e.g. the recent slaying of 8 people in the law office in San Francisco) And people who witnessed the execution of Harris. They were in no danger themselves, yet the level of dissociative symptoms were as high in the former.
The Briere & Cone and Herman & Shatzow studies are based on self report of earlier trauma, and that is a problem in research. But Williams’ study does have the age of people when they were abused as children; see her article in Journal of Consulting and Clinical Psychology.
COMMENTS FROM THE AUDIENCE:
Dabney Ewin: Sex abuse trauma differs from earthquakes because the abuser says, “If you tell anybody I’ll kill you.” This is like a post hypnotic suggestion, which is carried out compulsively when given to the victim during fear.
Dale: How to we account for the vigor in the attempts of each side to convince the other. The people who have been real victims of sexual abuse need to be able to talk with the people who are victims of False Memory Syndrome. The impact on a family is just as traumatic as the sexual abuse itself.
Response by D. Spiegel: I wouldn’t recommend that combination, but the point you make about damage to the falsely accused is relevant. Their lives are shattered but remember the damage done throughout life by sexual abuse.
Stewart, James (1994). Hypnotherapy with dental patients. [Lecture] UCLA Hypnosis Seminar.
NOTES: [Dr. James Stewart is both a dentist and a clinical psychologist.] Among dental patients, 15% of patients are anxious; 75% of those patients could associate that fear to early childhood experiences, and showed signs of post traumatic stress disorder (PTSD) but only when they have to go for dental treatment. Those 75% respond well to hypnosis (respond quickly, short-term; it is even great to do the therapy in the dental chair, e.g., relieving trauma in trance).
It is important to diagnose PTSD because treatment will be different if the patient has an anxiety disorder. The disorders are not “simple phobias” because the trauma does not meet the criterion of “silly and unreasonable.”
In hypnosis I routinely use the suggestion, “find a safe place,” and may tell them they can go through a videotape or a filing cabinet to find a safe place. If the patient cannot remember a safe place, it is diagnostic of serious problems, more than dental anxiety. The exploration, verbalization of a safe place enhances rapport. A dentist should not accept a referral for hypnosis when the dental work has to be done next week; better to use sedation, and schedule hypnosis Rx later.
For anxiety or pain, do not try to relax it away; better to go where it is, define it (size, density, etc.) How does it feel? Can you put your finger on it? Like vapor? Soft, like steel?
PTSD. During World War I they called it malingering and gave shock (not ECT). During World War II the psychoanalytic view was that PTSD was pre-Oedipal. Viet Nam used phenothiazines for “delayed stress reactions.” Almost all the variance in the number and severity of symptoms can be explained by the length of time the patients were in battle. During World War II, they did a lot of age regressions under sodium pentathol (a “catharsis”) which was often very successful, but there was no theoretical understanding. After that the patient got psychoanalysis.
These days in doing desensitization for phobias I do not bother with developing a hierarchy [of feared situations] and I let the patient go through the anxiety more often. Also, one can have the patient walk away from the scene until they subjectively feel far enough away not to feel anxiety.
Yapko, Michael D. (1994). Suggestions of abuse: True and false memories of childhood sexual trauma. New York, NY: Simon & Schuster.
NOTES: From the section titled “A Note to Therapists:”
“I would encourage you _not_ to (1) preclude open communication at all times among family members; (2) act as your client’s ‘hired gun’; (3) act as if corroboration of allegations of abuse were unnecessary; (4) jump quickly to the conclusion abuse occurred simply because it is plausible; (5) suggest a history of abuse to someone who is not your client; (6) refer a client out for hypnotic confirmation or disconfirmation on the false premise that hypnosis is some kind of lie detector; (7) ask leading or suggestive questions; (8) assume repression is in force when someone does not have much memory from childhood; (9) rely on your memory of the interaction. Tape your investigative sessions and review them later for any evidence of possible unintentional contamination of your client’s recollections” (p. 217).
1993
Eisen, Mitchell (1993). Assessing the hypnotizability of college students from addictive families. Contemporary Hypnosis, 10, 11-17.
ABSTRACT: The present study examined the relation between hypnotizability and the report of growing up in an addictive family where one or both parents were addicted to drugs and/or alcohol. A sample of 113 college students (47 male, 66 female) were studied for measure of childhood abuse, addiction history, dissociation and hypnotizability. As predicted, subjects from an addictive family were more hypnotizable than subject from a nonaddictive family. However, no relation between family addiction and dissociation was secured. Whereas abuse was found to be related to dissociation, it was not related to hypnotizability. The findings are discussed in terms of the effects of child abuse and neglect on dissociation and hypnotizability as it relates to the addictive family.
NOTES
Author reviews the literature in area of abuse and hypnotizability as well as dissociation. Subjects were unaware of purposes of the experiment when they volunteered. Of 113 Ss, 18% were reared in an addictive family; 13 Ss reported being abused, of whom 6 reported sexual abuse and seven physical abuse. Five of the 21 Ss who reported being reared in addictive families also reported being abused (3 physical, two sexual). Only one S reported both physical and sexual abuse.
Used HGSHS:A, Children of Alcoholics Screening Test, and Dissociative Experiences Scale of Carlson and Putnam (1986). Those with addiction in the family had Harvard scale mean score of 8.05, compared to those who didn’t have it with mean of 6.95. No significant effect was found for ABUSE or the interaction of ABUSE and family addiction. The abuse question was, “Before the age of 12 parent punishment of you resulted in your physical injury (bruises, scarring, broken bones, etc.). Second question was, “Before the age of 12, did you participate in sexual behaviors (either with or without coercion) with a much older person?”
The Discussion thoroughly explores the possible reasons why their results differ from those of others.
Hawkins, Russell (1993). An analysis of hypnotherapist-client sexual intimacy. International Journal of Clinical and Experimental Hypnosis, 41, 272-286
While sexual interaction between psychologists, physicians, and other health therapists of all kinds and their clients is typically condemned by professional bodies as unethical, the controversy regarding the potential for hypnosis to produce compliant behavior in unwilling or nonconsenting subjects suggests that hypnotherapist-client sex may warrant special attention. Because the experiments required to clarify the potential for hypnosis to potentiate nontrivial compliance are themselves unethical and/or inconclusive, experimental methods cannot be adequately used to clarify this issue. Instead, the matter can be addressed by reference to other forms of evidence, such as the responses of therapists and clients to anonymous surveys and the analysis of cases, that have reached the courts. Consideration of this qualitatively deficient evidence suggests that even if the use of hypnotic suggestion can lead to compliance to sexual demands, overt coercion is seldom used in practice. Social psychological and situational factors are particularly salient in understanding therapist-client sex. The question of whether there are special properties of the dynamics of the hypnotic experience, other than specific coercive suggestion and beyond those typically found in other forms of therapy, is considered. Comparisons are drawn with other examples of socially condemned sex, such as teacher-student sex, sexual harassment in the workplace, incest, and extramarital sex.
Litwin, R. G.; Cardena, E. (1993, August). Dissociation and reported trauma in organic and psychogenic seizure patients. [Paper] Presented at the annual meeting of the American Psychological Association, Toronto, Canada.
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Early detection and differential diagnosis of non-epileptic seizures (NES) versus epileptic seizures (ES) is a major clinical issue in comprehensive epilepsy centers. Recent research suggests that differences in dissociative experiences between NES and ES patients may prove useful for diagnostic purposes. Non-epileptic seizures are frequently conceptualized as a dissociative response to past emotional trauma or abuse; dissociation in ES occurs as a result of electrophysiological abnormalities, most often associated with the temporal lobes. The purpose of this study was to evaluate the effectiveness for the differential diagnosis of NES from ES of several measures of dissociation and of a self- report measure for physical and sexual abuse. Four quantitative measures of dissociation were utilized in this study: the dissociative disorders interview schedule (DDIS), dissociative experience scale (DES), Tellegen absorption scale (TAS) and the Stanford Hypnotic Clinical Scale (SHCS). The incidence of sexual and physical abuse was obtained from structured questions in the DDIS. Forty-one patients being evaluated for intractable seizures participated in this study; 13 ES patients with non-temporal lobe involvement (ES/NTL), 18 ES patients with temporal lobe focus (ES/TLE) and 10 patients with NES spells of psychiatric origin. The main researcher was blind to these diagnoses until the study was completed. Results show a trend toward greater incidence of dissociative experiences in the NES versus ES group on the DDIS, TAS and DES, although these differences tended to be modest and not statistically significant, perhaps given the small N of the study. There were no significant trends or differences in dissociative experiences reported by ES/NTL patients versus ES/TLE patients. Contrary to the study’s hypothesis, ES patients were slightly more susceptible to being hypnotized than NES patients. As hypothesized, a significant difference was that NES patients reported physical and sexual abuse of higher incidence and longer duration than did ES patients. Logistic regression analysis for prediction of NES using the DES, TAS and SHCS instruments correctly predicted only 10% of NES patients. However, exploratory logistic regression analysis using the demographic variables of gender, months of sexual abuse and years of recurrent seizures suggest that these characteristics may be specific and sensitive in the prediction of NES. Being a female, having a higher incidence and longer duration of abuse and fewer years of recurrent seizures all predicted significantly the existence of non-epileptic seizure events, allowing for a 95% accuracy in diagnostic prediction. Our findings reinforce prior research indicating that dissociation is an important symptom component of both ES and NES events. The trend toward more prevalent dissociative experiences in the NES group suggests that in depth examination of these differences and of key demographic variables may help differentiate between these two groups.
From Bulletin of Division 30, Psychological Hypnosis, Fall 1993, Vol. 2, No. 3.)
London, Ray William (1993, October). Refreshed adult memories: Abuse survivor or therapeutic victim?. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
NOTES: The author addresses four areas: 1. public policy 2. psychological issues 3. legal issues (evidence) 4. how to properly deal with it
A definition of sexual abuse is being applied to behaviors that for years were not considered out of bounds (e.g. entering a bathroom where someone else is). Furthermore, using the word “survivor” for abused people equates patients with survivors of concentration camps, who do not present with repressed memories typically. National incidence of child abuse remains unclear estimates are 6 to 60% of females. In Florida, only 13% of cases reported are confirmed.
Some therapists who specialize in this area in surveys indicate that they have false beliefs regarding memory and effects of trauma.
[These represent only partial notes on a lengthy and substantial paper.]
Rhue, Judith W.; Lynn, Steven Jay (1993, October). Dissociation, childhood sexual abuse, and fantasy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
NOTES: We are reporting on part of an ongoing study, with results still being analyzed. We are looking at imagination, fantasy, and dissociation in abused and non-abused children. This focuses on the relationship between dissociation and fantasy and imagination.
For Janet, dissociation was the primary defense against trauma. [Quotes D. Spiegel also.] There is a body of research on trauma associated with the development of dissociation. 1. NIH found 97% of multiple personality patients reported trauma in childhood; 83% were sexually abused; 75% were repeatedly physically abused; 68% had both types of abuse. 2. Bliss – studied 70 MPDs and found same results. 3. Ross, Norton, and Noosney [?name] – found same results 4. Coombs & Milstein – same
The incidence of retrospective reports of abuse is much lower in other types of patients.
So, what is going on during child abuse? We wanted to look at children experiencing or who recently experienced abuse. Also looked at a children’s scale of dissociation symptoms and validated other studies.
We studied 39 children referred to Ohio University College of Osteopathic Medicine; 12 had primary problem as sexual abuse (8 of whom were female). Non-abused Ss were either behavioral or adjustment disorders. 8 reported severe physical abuse. Parents concurred in presence of abuse. Physical abuse consisted of broken bones, burns, etc. Average age 9-10.
Ss were given the Beck Depression Scale, Children’s Fantasy Inventory, Meyers’ Children’s Creative Imagination Scale, Children’s Perception Alteration Scale, Figure Drawings, WISC-R, and 2-3 other measures. Research assistants administering the scales didn’t know the children’s diagnoses.
We found no support for the hypothesis that sexual abuse in childhood is associated with imagination, fantasy, or dissociative tendencies–not surprising considering that only 4 Ss were abused by their father or stepfather, 2/3 of Ss had fondling as the most severe abuse they had experienced; only 2 had intercourse; 2/3 were abused only 1-3 times. Sexual abuse that is not violent, severe, prolonged, or perpetrated by a parent may not lead to the same problems.
In a sample of women whose assaults were rape, only 25% reported it as rape.
On other hand, physical punishment was more reliably associated with dissociation (.47), imagination and fantasy in absorption scale (.41-.51 with question about using imagination to block awareness of punishment). Physical punishment was associated with increased dissociation.
Sample size is small and the trend is in the predicted direction, so later results may be significant.
Conclusion: measures of fantasy, dissociation, and imagination were correlated. Children’s Perception Alteration Scale and the measures of fantasy and imagination were validated. Diverse measures of fantasy were highly correlated with one another.
We need a non-abused sample to add to this research.
The clinical sample had a higher dissociation score than Evers, Sanders, and Shostick’s cutting score. We use 60 as a cutting score (for an abused sample) while they used 55.
COMMENTS FROM THE AUDIENCE:
Jack Watkins: the sexual abuse for the most part was not painful. Answer by Rhue: The group of sexual abuse cases includes very wide varieties of experiences; we need to examine that in our research. Also, trauma and the perception of trauma is an individual matter.
Etzel Cardena: We presented a paper at APA in which sexual abuse was a predictor of psychogenic seizures, and most important, the duration of the abuse.
Phyllis Alden: In a recent study in Germany, it was length of time for the abuse that predicted [dissociative symptoms?].
Sivec, Harry; Lynn, Steven Jay (1993, October). Hypnosis and early memories. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
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