Eimer, Bruce. N. (2000). Clinical applications of hypnosis for brief and efficient pain management psychotherapy. American Journal of Clinical Hypnosis, 43 (1), 17-40. (July)

This paper describes four specific clinical applications of hypnosis that can make psychotherapy for pain management briefer, more goal-oriented, and more efficient: (1) the assessment of hypnotizability; (2) the induction of hypnotic analgesia and development of individualized pain coping strategies;
(3) direct suggestion, cognitive reframing, hypnotic metaphors, and pain relief imagery; and (4) brief psychodynamic reprocessing during the trance state of emtoional factors in the patient”s experience of chonic pain. Important theoretical and clinical issues regarding the relationship between hypnotizability to the induction of hypnotic analgesia are presented, and attempts to individualize pain treatment strategies on the basis of assessed differences in hypnotizability and patients” preferred coping strategies are described. Some ways are also presented of integrating direct hypnotic suggestion, COGNITIVE-EVALUATIVE reframing, hypnotic metaphors, and imagery for alleviating the SENSORY and AFFECTIVE-MOTIVATIONAL components of pain, with an exploratory, insight-oriented, and brief psychodynamic reprocessing approach during trance for resolving unconscious sources of resistance to treatment, and reducing the emotional overlay associated with chronic pain. Some basic assumptions underlying the use of this approach are discussed, and a brief step-by-step protocol is outlined.

Wickramasekera, Ian (1999). How does biofeedback reduce clinical symptoms and do memories and beliefs have biological consequences? Toward a model of mind-body healing. Applied Psychophysiology and Biofeedback, 24 (2), 91-105.

Changes in the magnitude and direction of physiological measures (EMG, EEG, temperature, etc.) are not strongly related to the reduction of clinical symptoms in biofeedback therapy. Previously, nonspecified perceptual, cognitive, and emotional factors related to threat perception (Wickramasekera, 1979, 1988, 1998) may account for the bulk of the variance in the reduction of clinical symptoms. The mean magnitude of these previously nonspecified or placebo factors is closer to 70% when both the therapist and patient believe in the efficacy of the therapy. This powerful placebo effect is hypothesized to be an elicited conditioned response (Wickramasekera, 1977a, 1977c, 1980, 1985) based on the memory of prior healing. These memories of healing are more resistant to extinction if originally acquired on a partial rather than continuous reinforcement schedule. High and low hypnotic ability in interaction with threat perception (negative affect) is hypothesized to contribute to both the production and reduction of clinical symptoms. High and low hypnotic ability respectively are hypothesized to be related to dysregulation of the sympathetic and parasympathetic arms of the autonomic nervous system. Biofeedback is hypothesized to the most effective for reducing clinical symptoms in people of low to moderate hypnotic ability. For people high in trait hypnotic ability, training in self-hypnosis or other instructional procedures (e.g., autogenic training, progressive muscle relaxation, meditation, CBT, etc.) will produce the most rapid reduction in clinical symptoms.

Lynn, Steven Jay (1997). Automaticity and hypnosis: A sociocognitive account. International Journal of Clinical and Experimental Hypnosis, 45 (3), 239-250.

This article provides an overview of a new theory of suggested involuntariness in hypnosis, developed in conjunction with Irving Kirsch. The theory is based on the following ideas. First, high hypnotizable participants enter hypnosis with a conscious intention to feel and behave in line with suggested experiences and movements. Second, people who are easily hypnotized hold firm expectations that they will succeed in following the suggestions of the hypnotist. Third, the intention and expectation in turn function as response sets in the sense that they trigger the hypnotic response automatically. Fourth, given the intention to feel and behave in line with the hypnotist’s suggestions, hypnotized individuals show no hesitation to experience the suggested movements as involuntary because (a) these movements are actually triggered automatically, and (b) the intention to cooperate with the hypnotist as well as the expectation to be able to do so create a heightened readiness to experience these actions as involuntary. – Journal Abstract

Walling, David P.; Baker, Jeffrey M.; Dott, Sharon G. (1996). A national survey of hypnosis training — its status in psychiatric residency programs: A brief communication. International Journal of Clinical and Experimental Hypnosis, 44 (3), 184-188.

Hypnosis training in psychiatric residency programs has not previously been well documented in the literature. This article examines the extent of such training in residency programs and the attitudes of residency directors to training and the use of hypnosis. A brief survey requesting information on hypnosis training was sent to all psychiatric residency directors in the United States. Sixty-three percent of responding program directors (n = 154) report offering either required or elective coursework in hypnosis. Of programs offering hypnosis training, the mean number of hours was 8, suggesting that many psychiatrists have only limited exposure to hypnosis during residency. The authors conclude that hypnosis training is widely variable within psychiatric residency programs and is dependent on the faculty and training director interests within individual programs.

Zachariae, Robert; Sommerlund, Bo; Molay, Francine (1996). Danish norms for the Harvard Group Scale of Hypnotic Susceptibility, Form A. International Journal of Clinical and Experimental Hypnosis, 44 (2), 140-152.

Norms for a Danish adaptation of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) are presented. Four samples tested from 1988 to 1991 (n = 166, n = 54, n = 95, and n = 61) were pooled, resulting in an aggregate sample of 376 participants. The normative data were generally congruent with earlier normative studies with regard to score distribution, item difficulty levels, and reliability. Studies using the Danish adaptation of the HGSHS:A as a screening instrument have shown the predictive value of the instrument in a Danish context. Data for a comparable American sample of volunteers (n = 170) tested by the same hypnotist were included in the analysis. A comparison revealed a marked difference for the posthypnotic suggestion item, hinting that cultural differences between the Danish and American samples with regard to expectancies and attitudes toward hypnosis may play a role. Further studies comparing attitudes toward hypnosis across different cultural contexts are needed to clarify this issue. – Journal Abstract

Repka, Renee J.; Nash, Michael R. (1995). Hypnotic responsivity of the deaf: The development of the University of Tennessee Hypnotic Susceptibility Scale for the Deaf. International Journal of Clinical and Experimental Hypnosis, 43 (3), 316-331.

The purpose of these two studies was to develop and test a measure that assesses the hypnotic responsivity of deaf individuals. The University of Tennessee Hypnotic Susceptibility Scale for the Deaf (UTHSS:D) is a signed, videotaped version of a standard hypnotic induction with 12 standard suggestions. Experiment 1 compared the behavioral and subjective hypnotic responsivity of deaf and hearing individuals using the UTHSS:D and the Field Depth Inventory (FDI), respectively. As compared to hearing subjects, deaf participants were found to be less responsive to hypnosis when assessed behaviorally (UTHSS:D) and equally responsive to hypnosis when assessed subjectively (FDI). Experiment 2 undertook a more comprehensive examination of the hypnotic responsivity of deaf individuals, using hearing individuals as controls. Three dimensions of hypnosis responsivity were assessed: behavioral (UTHSS:D), subjective (FDI), and interpersonal (Archaic Involvement Measure). Additionally, correlates of hypnotic responsivity (absorption, attitudes, expectations) were examined for the two groups. In Experiment 2, no significant differences were found between the deaf and hearing participant groups on any measures of hypnotic responsivity or on any measure of the correlates of hypnotic responsivity.

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).

Singh, Asha (1994, August). Positive and negative effects in hypnosis: Some contributing variables. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.

Subjects (N = 155) were randomly assigned to hypnosis with the Harvard hypnotizability scale, hypnosis with neutral imagery instead of the test items in the Harvard scale, and a control condition of a taped chapter read from an Introductory Psychology text. All procedures were taped. Subjects’ attitudes toward hypnosis and psychiatric symptoms were first measured. Using self-report measures, positive and negative effects were assessed at three time periods: (a) retrospective assessment of the experience during the intervention; (b) pre-post testing for assessing state immediately after the intervention; and (c) assessment 2 to 4 days later. Results showed a consistent trend at all three time periods. Hypnosis with imagery was more positive and less negative than the control condition. It was also more positive than the Harvard scale. Hypnosis with the Harvard scale was slightly less negative and slightly more positive than the control condition. Hypnotizability was not correlated with hypnosis effects; however, the intensity of hypnosis, or ‘hypnoidal state’, predicted positive effects (but not negative effects) at every time period in all three groups. Initial attitude was only slightly associated with effect; a positive attitude predicted an overall positive reaction to the experience for all groups, and negative attitude predicted reduced state anxiety 2 to 4 days later. Psychiatric symptomatology predicted a more negative experience during all conditions, but was associated with less negative feelings, more positive feelings, and reduced state anxiety afterward. In conclusion, hypnosis with a self-selected student population in an experimental setting is no more harmful than a control condition; in fact it is more enjoyable and more positive in its effects than the latter. Hypnosis has more positive and less negative effects when the Harvard test items are replaced by neutral imagery. Subject attributes play a more complex role than hypothesized in determining hypnosis effects. The implications of these findings are discussed. (ABSTRACT from Bulletin of Division 30, Psychological Hypnosis, Fall 1994, Vol. 3, No. 3.)

Wagstaff, Graham F.; Royce, C. (1994). Hypnosis and the treatment of nail biting: A preliminary trial. Contemporary Hypnosis, 11, 9-13.

A clinical trial was conducted examining the relative efficacy of therapeutic suggestions preceded by and without a hypnotic induction in the treatment of nail biting in 17 students. Outcomes showed a hypnotic induction added significantly to therapeutic benefits and was the only condition that resulted in symptom improvement. Results from only one session showed that 7 of 11 hypnosis subjects stopped nail biting compared to only 1 of 6 control subjects. Reports of “believed in efficacy” predicted treatment success better than ratings of motivation, hypnotic induction per se, or scores on the Creative Imagination Scale. However, within the group receiving hypnotic induction, hypnotic- depth scores significantly correlated with treatment success, suggesting that state factors such as dissociation might be involved.

The hypnotized Ss were given the T. X. Barber (1969) induction, a request for their depth estimate on a scale of 0-10, and then a set of suggestions to discourage nail biting. The suggestions were of four types: (1) to have a positive attitude, that nail biting is a habit that can be broken and that stopping will enhance attractiveness and self esteem; e.g., ‘With just a little self control you will stop biting your nails and feel better about yourself.’ (2) to stop the habit; e.g. to say to themselves, ‘I will not bite my nails today/tomorrow,’ five times each morning and at night, and whenever the temptation arose. (3) to improve feelings of self-efficacy; e.g., ‘If you ever feel the urge to bite your nails tell yourself that you want to break the habit and that you are perfectly capable of doing so. You are not weak.’ (4) that the results would be outstanding; e.g. ‘After only ten days or so … you will have no desire to bite your nails, indeed the very thought of doing so will repulse you.’
Control subjects received the same instructions, without a hypnotic induction; the procedure was labeled a ‘positive attitude for self discipline’ technique.
Judges rated improvement without being aware of the Ss’ self-report on whether they had stopped biting their nails. Judges’ ratings correlated r = .94 with Ss’ statements about whether they had stopped the habit. Improvement scores also correlated significantly with belief the treatment would be effective (r = .60) and Creative Imagination Scale scores (r = .53), but not with motivation. The hypnosis group had significantly higher belief scores than the control group. Within the hypnosis group itself, hypnotic depth was the only variable to correlate significantly with improvement.
The Discussion stated, “However, taken together, the findings indicate that hypnotic induction added significantly to the therapeutic benefits of suggestions for the cessation of nail biting, and that Johnson and Barber’s (1978) concept of ‘believed-in efficacy’ was more important in accounting for therapeutic success than motivation (at least as measured here), hypnotic induction per se, or the subject’s proclivity for imaginative involvement. Nevertheless, belief still accounted for less than 40% of the variance in improvement. This may have been due to measurement error or insensitivity in the measures. Alternatively, or additionally, other factors may have been influential. For example, if CIS scores are considered to be indirect measures of hypnotic susceptibility, then belief was more influential than hypnotic susceptibility; however, from a hypnotic state theory perspective, the significant correlation between hypnotic depth (LSS scores) and improvement within the hypnosis group might suggest that some further feature of the ‘hypnotic state’ could still have been at work, such as a dissociative process (Hilgard, 1986). On the other hand, from a non-state perspective, perhaps subjects receiving hypnotic induction and reporting high depth scores might have felt more obliged to respond to the demand characteristics of the study, and tried harder to please the experimenter (Wagstaff, 1981); the general motivation questions used here could have been insensitive to such an effect” (p. 12).

Pekala, R. J.; Kumar, V. K.; Cummings, J. (1992). Types of high hypnotically susceptible individuals and reported attitudes and experiences of the paranormal and the anomalous. Journal of the American Society for Psychical Research, 86, 135-150.

A total of 575 subjects were given the Harvard Group Scale of Hypnotic Susceptibility and completed two self-report questionnaires that assessed the frequency of paranormal and unusual experiences and attitudes and beliefs towards such experiences. Subjects highly susceptible to hypnosis endorsed a significantly greater number of the psi- related items and anomalous and unusual beliefs and experiences than did subjects who were not highly susceptible to hypnosis. Subsequent cluster analyses of the responses of the highly-susceptible subjects suggested that about 10% of the high susceptibles (about 1% of the total subject population) were especially likely to report psi-related and unusual experiences. The implications of using such individuals in parapsychological research to increase the effect size associated with paranormal events are discussed.

Spanos, Nicholas P.; Burgess, C. A.; Cross, P. A.; MacLeod, G. (1992). Hypnosis, reporting bias, and suggested negative hallucinations. Journal of Abnormal Psychology, 101, 192-199.

Examined the role of reporting bias in hypnotic negative hallucinations by using a paradigm in which reporting bias was assessed independently of perceptual change. In Experiment 1, highly hypnotizable subjects reported significant loudness reductions when tested for hypnotic deafness. Later, however, these subjects biased their reported loudness reductions in the absence of perceptual change, and their reporting bias scores were almost as large as their hypnotic deafness reports. Subjects also biased their ratings of strategy use. In Experiment 2, ratings of blindness given in response to a hypnotic negative visual hallucination suggestion were significantly correlated with reporting bias scores obtained in this paradigm. Although hypnotic blindness and hypnotic deafness correlated significantly, the partial correlation between these variables was nonsignificant when reporting bias scores were statistically controlled. Results are used to support a skeptical view of hypnotic response as being based on compliance.

Court, John (1991). Lord of the trance. Journal of Psychology and Christianity, 10 (3), 261-265.

A verbatim account of hypnotically-based therapy utilizing Christian imagery serves as the basis for illustrating some of the benefits of this appraoch where therapist and client share the same value system. The interactions challenge some of the familiar objections to Christian involvement with hypnosis.

Daglish, Mark R. C.; Wright, Peter (1991). Opinions about hypnosis among medical and psychology students. Contemporary Hypnosis, 8, 51-55.

A survey was undertaken of opinions about hypnosis among first year medical and psychology students at the University of Edinburgh. Data are presented on the effects of self-estimated hypnotizability and sex, on opinions about hypnosis. The results are compared with those from similar studies conducted in Australia and the USA. Overall, the surveyed population showed a similar level of knowledge about hypnosis to that found among the general public.

Spanos, Nicholas P.; DuBreuil, Susan C.; Gabora, Natalie J. (1991). Four-month follow-up of skill-training-induced enhancements in hypnotizability. Contemporary Hypnosis, 8, 25-32.

Low hypnotizability subjects were exposed to skill training aimed at enhancing hypnotizability, and post-tested 2 weeks later. Those in a short delay condition were administered a second hypnotizability post-test within 2 weeks of the first, whilst those in a long delay condition were administered the second post-test 16-18 weeks after the first post-test. Skill-trained subjects in the two delay conditions did not differ on the first post-test. Skill-trained subjects in the two delay conditions did not differ significantly on behavioural or subjective indices of hypnotizability at either post-test. However, skill- trained subjects attained significantly higher hypnosis scores on both post-tests than did no-treatment control subjects. Attitudes towards hypnosis were also significantly enhanced by skill training, and these enhancements were maintained across the post-test intervals. Among the skill-trained subjects, post-tested hypnotizability was predicted by subjects’ attitudes and by the trainer’s ratings of subjects’ receptivity and resistance towards the training.

“Immediately before each hypnotizability test, subjects’ attitudes towards hypnosis were assessed with a 14-item questionnaire taken from Spanos, Cross et al. (1987). On this instrument higher scores indicate more positive attitudes” (p. 27).
“Immediately following each skill-training session, the trainer evaluated the subject’s receptivity to the training using a nine-item checklist. The items described aspects of the training which experienced trainers in our laboratory have judged to be indicators of successful modification. The items (e.g. ‘Does the subject volunteer that they found the ideas presented interesting/fun?’) were scored dichotomously (yes/no), and summed to yield a receptivity to training score for each subject. The trainer also rated the degree to which each subject displayed resistance to the training on a global three-point scale” (p. 27)
The correlation between receptivity towards the skill training procedure and baseline attitudes toward hypnosis was .50.
“Some evidence indicates that untrained subjects (high hypnotizables included) exhibit substantial decrements in responsiveness to suggestions when they are exposed between testings to negative information about hypnosis (Barber & Calverley, 1964; Spanos & McPeake, 1975) or to information that alters their expectations about their responsiveness (Spanos, Gabora, Jarrett & Gwynn, 1989)” (p. 30)
“These findings suggest that the subjects who initially hold the most negative attitudes towards hypnosis are the least receptive to skill-training procedures. After training, these subjects continue to hold relatively negative attitudes towards hypnosis which limit the extent of their hypnotizability gain” (p. 30).

Spanos, Nicholas P.; DuBreuil, Susan C.; Gwynn, Maxwell I. (1991). The effects of expert testimony concerning rape on the verdicts and beliefs of mock jurors. Imagination, Cognition and Personality, 11, 37-51.

Mock jurors heard one of 4 versions of a ‘date rape’ case and deliberated in small groups, to a verdict. Exposure to the direct examination of an expert who testified about rape myths undermined belief in the defendant’s testimony that sex with the complainant had been consensual, and increased the frequency of guilty votes. However, exposure to the expert’s cross-examination reversed the effects of the direct examination on the frequency of guilty votes. Women jurors disbelieved the defendant and voted him guilty to a greater extent than male jurors, while in both sexes profeminist attitudes correlated with disbelief in the defendant’s testimony but failed to correlate significantly with final verdicts. Implications are discussed.

Spanos, Nicholas P.; Gabora, Natalie J.; Hyndford, Christine (1991). Expectations and interpretations in hypnotic responding. Australian Journal of Clinical and Experimental Hypnosis, 19, 87-96.

A total of 304 subjects rated the extent to which they expected to respond to hypnotic suggestions immediately before being administered an hypnotic induction procedure. After the induction procedure, but before administration of the test suggestions, subjects again rated their expectations, and also rated the extent to which they planned to adopt each of three interpretations of suggestions: (a) resisting suggestions, (b) actively generating suggested effects, and (c) passive waiting. Subjects were then assessed on behavioural and subjective indexes of hypnotizability. Post- induction expectancies correlated with hypnotizability more highly than did pre-induction expectancies. The extent to which subjects adopted an active set towards suggestions also correlated with hypnotizability and, contrary to the response expectancy hypothesis, active interpretation scores predicted hypnotizability above and beyond the effects of post- induction expectancies. Theoretical implications are discussed.

“The most important findings of the study indicate that the extent to which subjects held active pre-suggestion interpretations predicted hypnotizability above and beyond the effects of post-induction expectancies. Relatedly, subjects with uniformly high expectancies continued to exhibit variability on both behavioural and subjective indexes of hypnotizability, and this residual variability correlated significantly with the degree to which subjects planned to adopt an active interpretation of suggestions. …..
“The present findings, along with those of Spanos, Gwynn, Gabora, and Jarrett, (1990), are inconsistent with the hypothesis that response expectancies are the direct determinant of responsiveness to suggestion. A number of other recent studies have also obtained results than [sic] run counter to the predictions of the response expectancy hypothesis. For example, two recent studies found that suggestion-induced wart regression was unrelated to subjects’ post-suggestion expectations of treatment success (Spanos, Stenstrom, & Johnston, 1988; Spanos, Williams, & Gwynn, 1990). Relatedly, Spanos, Perlini, and Robertson (1989) found that suggestions produced significantly greater reductions in reported pain than did a placebo, even though subjects in the suggestion and placebo treatments reported equivalent post-treatment expectations. Finally, Johnston, Chajkowski, DuBreuil, and Spanos (1989) found that false feedback substantially raised subjects’ hypnotic response expectancies but failed to influence their level of subjective responding on tests of hypnotizability” (p. 93).
[Although ] “the extent to which subjects endorsed passive interpretations correlated in a negative direction to a slight but significant degree with hypnotizability … at least some of the subjects who reported passive interpretations attained relatively high hypnotizability scores” (pp. 93-94). [The authors go on to give possible reasons why, on p. 94.]
Terr, Lenore C. (1991). Childhood traumas: An outline and overview. American Journal of Psychiatry, 148, 10-20.

Suggests 4 characteristics common to most cases of childhood trauma: visualized or otherwise repeatedly perceived memories of the traumatic event; repetitive behaviors; trauma-specific fears; and changed attitudes about people, life, and the future. Childhood trauma is divided into 2 basic types. Type I trauma includes full, detailed memories, “omens,” and misperceptions while Type II trauma includes denial and numbing, self-hypnosis and dissociation, and rage. Characteristics of both types of childhood trauma can exist side by side. Such crossover Type I – Type II traumatic conditions of childhood are characterized by perceptual mourning and depression and childhood disfigurement, disability, and pain. Case examples are provided.

Appel, Philip R. (1990). Clinical applications of hypnosis in the physical medicine and rehabilitation setting: Three case reports. American Journal of Clinical Hypnosis, 33 (2), 85-93.

Hypnosis is useful in the rehabilitation setting to help patients master skills, to increase their sense of self-efficacy and self-esteem and, in general, to facilitate and accelerate their rehabilitation program. I used hypnosis with three patients where patient behaviors and beliefs were interfering with the rehabilitation treatment goals set by the patient and the health care team. Collectively, these cases demonstrate the use of hypnotic techniques in diagnosing and treating problems with patient compliance and assisting patients to gain greater benefit from their rehabilitation regimen. – Journal Abstract

Baker, Elgan L.; Hulsey, Timothy L.; Glenn, Michael B. (1990). Attitudes and practices regarding clinical hypnosis with psychotic patients–a survey: A brief communication. International Journal of Clinical and Experimental Hypnosis, 38 (3), 162-167.

Attitudes toward and actual use of hypnotherapeutic techniques with psychotic patients were assessed. Results are discussed in light of historical and current attitudes toward the use of hypnosis with psychotics. Respondents were selected from the 1980 membership directory of the Society for Clinical and Experimental Hypnosis (SCEH). 80 respondents completed and returned the survey. Results indicate that the perceived usefulness of hypnosis with psychotics is currently quite high and negative attitudes toward its use quite low. The growth of the use of hypnotherapeutic techniques and the need for further research are discussed.

Labelle, L.; Lamarche, M. C.; Laurence, Jean-Roch (1990). Potential jurors’ opinions on the effects of hypnosis on eyewitness identification: A brief communication. International Journal of Clinical and Experimental Hypnosis, 38 (4), 315-319.

The present study examined a selected group of potential jurors’ opinions on the effects of hypnosis on eyewitness identification and testimony. A group of 78 undergraduate psychology and optometry students completed a 2-part multiple choice questionnaire. The first part assessed Ss’ knowledge of several issues concerning eyewitness testimony. The second part of the questionnaire contained 11 items which assessed Ss’ beliefs and expectations concerning the effects of hypnosis on eyewitness identification and testimony. It was found that Ss’ opinions on the effects of hypnosis on eyewitness testimony and identification were at odds with current empirical findings. These results, in accord with the previous literature, suggest that it is imperative that the courts be informed of the use of hypnosis during police work and that adequate precautions be taken to avoid a potential source of miscarriage of justice.

Ross, Colin A. (1990). Twelve cognitive errors about multiple personality disorder. American Journal of Psychotherapy, 44 (3), 348-356

Presents 12 cognitive errors made by mental health professionals regarding multiple personality disorder. The errors include the mistaken idea that (1) multiple personality patients actually harbor more than one personality, (2) these patients can evade responsibility for their behavior because of their diagnosis, and (3) the disorder will disappear if treated with benign neglect. The errors are corrected by argument and by reference to research findings.

Van Denberg, Eric J.; Kurtz, Richard M. (1989). Changes in body attitude as a function of posthypnotic suggestions. International Journal of Clinical and Experimental Hypnosis, 37, 15-30.

Hypothesized that highly hypnotizable subjects who remained amnesic for posthypnotic suggestions to improve body attitude would show greater changes than subjects who were not amnesic. Subjects given simulating instructions were used as a comparison group to assess experimental demands. 48 females were screened with the Harvard and assigned to one of 4 conditions: (a) high hypnotizable with amnesia suggestions, (b) high hypnotizable without suggested amnesia, (c) low hypnotizable simulator with amnesia, and (d) low hypnotizable simulator without suggested amnesia. A fifth group was formed of those high hypnotizable subjects who remembered the suggestion despite instructions to the contrary. The Body Attitude Scale (Kurtz, 1966) was administered prior to and 3 days after the experimental suggestions. Results generally demonstrated that high hypnotizable amnesic subjects manifested the greatest attitudinal and phenomenological changes as a result of the posthypnotic suggestion, although conclusions were tempered by performance of simulating subjects. The implications for hypnosis research and clinical practice are discussed.

“The hypothesis that hypnotized subjects would report greater positive changes in affect, self-esteem, and social functioning than simulators was tested using a brief structured questionnaire. An analysis of Subjects responses to the questionnaire while with the ‘blind’ research assistant (simulators in role) revealed number significant differences between groups (N = 48) on six of the seven questions. … An analysis of Subjects’ responses to the questionnaire while being debriefed by the primary investigator (simulators out of role) revealed significant differences among groups (N = 48) on three of the seven questions. … High hypnotizable subjects with maintained amnesia demonstrated a strong tendency to be the most responsive of all groups of subjects on the first and second assessment. In contrast, the high hypnotizable Ss for whom amnesia ‘broke down’ reported the fewest phenomenological changes of any of the five groups during the first assessment, and comparatively few during the second assessment. Also of note is that once out of their role, simulators in both conditions dramatically reduced their reporting of positive change” (pp. 23-24).
“Moreover, a closer examination of the data demonstrated that phenomenological and behavioral differences in the groups did appear at several points during the experiment. For example, the 10 high hypnotizable subjects told to explicitly remember the suggestion did so, while 3 of the 10 simulators in this condition claimed to have forgotten it. On debriefing, these Subjects reported they did this because they believed ‘really hypnotized subjects wouldn’t be able to remember anything, even if they were told they could.’ Further, no simulator in the amnesia condition reported they could recall the suggestion, in contrast to the high hypnotizable subjects, 44% of whom said they did remember it. With regard to phenomenological differences, simulators stated during debriefing with the primary investigator that they intentionally faked changes on BAS, and that they experienced no true effects from the suggestion for positive body attitude change. In contrast, high hypnotizability amnesic subjects reported global, pervasive changes in their mood and self-esteem that went beyond specific alterations in attitudes toward their appearance. By comparison, high hypnotizable subjects told to remember the suggestion reported greatly increased self-absorption and acute awareness of the suggestion, ‘sort of like a broken record in my head'” (pp. 25-26).
“As shown by the present study, amnesia maintenance can be quite problematic. Of 18 high hypnotizable subjects for whom amnesia was suggested, only 10 remained fully amnesic for the suggestion after 3 days. In addition, those 8 subjects for whom amnesia ‘broke down’ showed minimal shifts on BAS, or in reports of phenomenological changes. Such frequent amnesia failure has been reported by other researchers, although the effectiveness of the suggestion is not always so compromised” (p. 26).
e Groh, Margaret (1989). Correlates of hypnotic susceptibility. In Spanos, Nicholas P.; Chaves, John F. (Ed.), Hypnosis: The cognitive-behavioral perspective (pp. 32-63). Buffalo, NY: Prometheus Books.

The author describes a non-linear relationship between imagery and hypnotizability and between absorption and hypnotizability. People good at imagery may be high or low on hypnotizability scales; the same is true for people high on absorption trait. However, people low on those traits generally are low on measured hypnotizability.

Donovan, David (1988). Factor analytic structure of attitudes towards hypnosis, guided imagery, and relaxation. [Unpublished manuscript] (Paper written for Comrey’s Factor Analysis Course, UCLA)

Factor analysis of semantic differential responses of 212 adults regarding 3 terms (hypnosis, imagery, relaxation) placed imagery in an intermediate position between the extremes of hypnosis and relaxation. Both common and unique factors extracted are discussed.

Tobacyk, Jerome; Milford, Gary; Springer, Thomas; Tobacyk, Zofia (1988). Paranormal beliefs and the Barnum effect. Journal of Personality Assessment, 52 (4), 737-739.

Examined in 128 college students the hypothesis that paranormal beliefs emphasizing divinatory procedures that produce personalized feedback are associated with greater susceptibility to the Barnum effect, which is acceptance of bogus personality feedback consisting of relatively trivial statements with a high base rate. 76% of the Ss rated the accuracy of their personality descriptions favorably, showing a robust Barnum effect

Spanos, Nicholas P.; de Groh, Margaret; de Groot Hans (1987). Skill training for enhancing hypnotic susceptibility and word list amnesia. British Journal of Experimental and Clinical Hypnosis, 4 (1), 15-23.

Subjects who pretested as low on hypnotic susceptibility received either cognitive skills training aimed at inculcating positive attitudes and interpretations concerning hypnotic responding, or no treatment. Trained subjects scored significantly and substantially higher on subjective and behavioral dimensions of susceptibility than controls. A second posttest assessed amnesia for a previously learned word list. Trained subjects showed more word list amnesia than either no treatment controls or subjects who had been matched to the trained subjects in terms of posttest susceptibility. Theoretical implications for theories of hypnotic susceptibility are discussed.

Judd, Fiona K.; Burrows, Graham D.; Dennerstein, Lorraine (1986). Clinicians’ perceptions of the adverse effects of hypnosis: A preliminary study. Australian Journal of Clinical and Experimental Hypnosis, 14, 49-60.

Questionnaires were sent to all members of the Australian Society of Hypnosis and responses obtained from 202 members and associate members who used hypnosis clinically. Respondents’ experience in the use of hypnosis and the frequency of use of hypnosis as a treatment modality varied. Overall 43.5% of respondents reported adverse effects with one or more patients over the preceding year. Most adverse effects attributed to hypnosis were transient and included development of panic or extreme anxiety, development of excessive dependence and difficulty in terminating hypnosis. Exacerbation or precipitation of significant depression was an infrequent but serious adverse effect attributed to hypnosis. Other infrequent adverse effects included symptom substitution, acting out behaviour, fantasied sexual seduction, precipitation or worsening of psychotic illness or difficulties in the management of organic conditions The difficulties were acknowledged of differentiating between the effects of hypnosis itself and other components of the therapeutic transaction, but the results of this survey suggested both that hypnosis be employed clinically by properly trained professionals and that further sensitive clinical research is needed in the area.

Madigan, R. J.; Bollenbach, A. K. (1986). The effects of induced mood on irrational thoughts and views of the world. Cognitive Therapy and Research, 10 (5), 547-562.

Sixty college students participated in an experiment concerning the influence of somatic mood induction statements on measurements of irrationality as defined by Ellis. Subjects were randomly assigned to depression, elation, and neutral mood induction groups. There were significant differences between groups on mood and irrationality. Results are discussed in terms of the Ellis and Beck cognitive models of depression, the Isen cognitive loop model, and the relationship between irrationality and depression. This study added irrational thinking as defined by Ellis to the growing list of cognitions that have been manipulated by mood, and it supports a body of findings that demonstrate the reciprocal influence of cognition and mood in depression. The study also has implications for the Beck and Ellis hypothesis that cognitions are the dominant causes of depression.

McConkey, Kevin M. (1986). Opinions about hypnosis and self-hypnosis before and after hypnotic testing. International Journal of Clinical and Experimental Hypnosis, 34, 311-319.

Before hypnotic testing, Ss completed a questionnaire on their opinions about hypnosis and self-hypnosis Approximately 1 week later, they completed a similar questionnaire that included questions about their experiences of hypnotic testing. Data are presented concerning Ss’ agreement with statements about hypnosis and self-hypnosis. Findings are discussed in terms of their generality and in terms of whether Ss’ opinions are consistent with scientific evidence.

Spanos, Nicholas P.; Robertson, Lynda A.; Menary, Evelyn P.; Brett, Pamela J. (1986). Component analysis of cognitive skill training for the enhancement of hypnotic susceptibility. Journal of Abnormal Psychology, 95, 350-357.

Four treatments to enhance the hypnotic responsiveness of subjects who pretested as low in hypnotic susceptibility were compared. Complete skill training included information aimed at encouraging (a) positive attitudes, (b) the use of imagery strategies, and (c) an interpretation of hypnotic behavior as active responding. Partial training included only components (a) and (b). Both training packages enhanced attitudes toward hypnosis to an equivalent degree. However, complete training was much more effective than either partial training or no treatment at enhancing behavioral and subjective responding on two different posttest scales of hypnotic susceptibility. More than half of the subjects who received complete training, but none of the partial training or control subjects, scored in the high-susceptibility range on both posttests. Subjects explicitly instructed to fake hypnosis and those in the complete skill-training treatment exhibited significantly different patterns of posttest responding. Findings support social psychological perspectives that emphasize the importance of contextual factors in hypnotic responding.

Spanos, Nicholas P.; Voorneveld, Peggy W.; Gwynn, Maxwell I. (1986-87). The mediating effects of expectation on hypnotic and nonhypnotic pain reduction. Imagination, Cognition and Personality, 6, 231-245.

High and low hypnotically susceptible subjects were assigned to three treatments and administered a baseline trial and two posttest trials of finger pressure pain. Subjects in one treatment received hypnotic analgesia on both posttest trials while those in a second treatment received hypnotic analgesia before their first posttest trial and waking instructions to ” do whatever you can to reduce pain” before their second posttest trial. Controls received their two posttest trials without intervening treatment instructions. During hypnotic analgesia high susceptibles reduced reported pain, increased pain tolerance and rated themselves as more deeply hypnotized than low susceptibles. Low susceptibles reduced pain to a significantly greater degree under waking instruction than under hypnotic analgesia. Importantly, lows given waking instruction reduced pain to the same degree as highs given hypnotic analgesia. These findings underscore the importance of attitudes and expectations in hypnotic pain reduction. However, they are inconsistent with the view that high susceptibles are intrinsically more able than low susceptibles to cognitively control pain.

“Social psychological accounts of suggested analgesia emphasize the role of subjects’ attitudes and expectancies in the cognitive control of pain. According to this perspective high susceptible subjects usually hold positive attitudes and expectancies toward hypnosis and are strongly invested in validating their role as ‘good’ hypnotic subjects. … [while Lows] often hold negative attitudes about hypnosis and negative expectations about their responsiveness to hypnosis even before they are tested [and their poor performance] only confirms their already negative attitudes and expectancies. Standard analgesia suggestions and the suggestions employed on scales hypnotic susceptibility are often similarly constructed. In both cases these suggestions are typically worded in the passive voice to imply that things are happening to rather initiated by subjects (e.g., ‘Your hand is becoming numb dull and insensitive,’ ‘Your arm is stiff and rigid.’). Furthermore, both types suggestions usually invite subjects to imagine specific events (e.g. ‘Imagine Novocain being injected into your hand,’ ‘Imagine your arm is held tightly by a cast.’) Thus the usual superiority of high susceptibles at suggested analgesia may occur because expectations from the hypnotic susceptibility test situation are carried over to the pain testing situation” (p. 232).
“Low susceptibles subjects may fail to exhibit hypnotic responding for at least two different reasons. Some lows may be quite willing to cooperate with the proceedings, but hold negative or inaccurate expectations that interfere with appropriate responding. Other low susceptibles , however, may be purposefully uncooperative. They may become actively invested in presenting themselves as unresponsive to hypnotic procedures because they wish to be seen as independent-minded and nongullible. …
“Alternatively we anticipated that the low susceptibles would attempt to validate their status as independent-minded and nonsuggestible. To this end they would show little pain reduction under a hypnotic condition but large pain reductions when the situation was divorced from hypnosis and pain reduction was defined in terms of independent self- control. Unlike the high susceptibles, we expected the low susceptibles to rate themselves as unhypnotized under both the hypnotic and nonhypnotic situations” (pp. 233-34).
“Our major finding, however, was that the low susceptible subjects instructed to try and reduce pain in a context that was divorced from hypnosis and defined in terms of self control exhibited just as much pain reduction as high susceptible subjects . In sum, hypnotic susceptibility correlated either positively with degree of pain reduction (under hypnosis) or negatively with degree of pain reduction (under instruction), depending upon the expectations conveyed to subjects by their experimental instructions” (p. 241).
“The present findings clearly contradict the hypothesis that low susceptibles lack the cognitive capacities required to reduce pain to the same degree as high susceptibles. … In short, low susceptibles usually exhibit less hypnotic analgesia than high susceptibles not because of intrinsic deficiencies in the pain-reducing capacities of low susceptibles, but instead, because low susceptibles hold negative attitudes and expectations about hypnosis that interfere with the use of their pain reduction abilities” (p. 242).

Wagner, Mark T.; Khanna, Prabha (1986). A neuropsychological model of hypnosis. International Journal of Psychosomatics, 33 (3), 26-28.
Authors refer to an unpublished article by Budzynski (Twilight-state learning: A biofeedback approach to creativity and attitude change, 1973) in which he “tested the effect of attitude change when information is prsented via a tape recording, during waking, drowsy, and sleep conditions. He found that attitude change only occurred during drowsy conditions. … He maintained that while Ss were in the ‘twilight state’ their logical/analytical faculties were temporarily suspended. Furthermore, he stated that the information processing in this state was quite different from that in the waking state. Susceptibility was increased and critical thinking was decreased” (p. 28).

Authors refer to an unpublished article by Budzynski (Twilight-state learning: A biofeedback approach to creativity and attitude change, 1973) in which he “tested the effect of attitude change when information is prsented via a tape recording, during waking, drowsy, and sleep conditions. He found that attitude change only occurred during drowsy conditions. … He maintained that while Ss were in the ‘twilight state’ their logical/analytical faculties were temporarily suspended. Furthermore, he stated that the information processing in this state was quite different from that in the waking state. Susceptibility was increased and critical thinking was decreased” (p. 28).

Wilson, L.; Greene, E.; Loftus, Elizabeth F. (1986). Beliefs about forensic hypnosis. International Journal of Clinical and Experimental Hypnosis, 34 (2), 110-121.

The beliefs people hold about hypnosis have an impact on the behavior of a witness who is hypnotized and on juries who hear these witnesses and weigh hypnotically influenced testimony. Students in Experiment 1 and registered voters from the community in Experiment 2 responded to questions about forensic hypnosis. Over 70% of the students as compared to about 50% of the community members were favorable toward the use of hypnosis by police for memory enhancement. In both groups, however, twice as many people reported that they would put less faith rather than more faith in the testimony of someone who had been hypnotized. A substantial portion of the students affirmed common myths about the effects of hypnosis on memory and behavior.

Gottschalk, Louis A. (1985). Hope and other deterrents to illness. American Journal of Psychotherapy, 39, 515-524.

Reviews animal and human research demonstrating that events during early development influence vulnerability to physical and mental illness. In addition, effectiveness of coping methods used to deal with problems of living can affect susceptibility to illness. The intervening mechanisms between stressful life experiences and illness appear to involve physiological homeostasis and immune competence.

372 preclinical medical students from the University of Sydney, Australia were surveyed concerning their beliefs about hypnosis and its medical use. Several “myths” concerning hypnosis emerged (e.g., hypnosis is a passive state, there are sex differences in hypnotizability, posthypnotic amnesia is inevitable, and there is automatic obedience to the hypnotist). Sex differences in expectations of hypnotizability were found. Relatively few physical problems wre perceived as being amenable to treatment by hypnosis and the proportion of medical practitioners in the national professional hypnosis society was grossly underestimated.

Spanos, Nicholas P.; Kennedy, Sharon; Gwynn, Maxwell I. (1984). The moderating effects of contextual variables on the relationship between hypnotic susceptibility and suggested analgesia. Journal of Abnormal Psychology, 93 (3), 285-294.

Assessed 75 undergraduates high, medium, or low on hypnotic susceptibility (the Carleton University Responsiveness to Suggestion Scale) on the cold pressor task before and after 1 of 3 instructional treatments. The treatments were (a) brief instructions to try to reduce pain, (b) the same analgesia instructions preceded by a hypnotic induction procedure, and (c) no hypnotic induction or instructions. In the hypnotic treatment, susceptibility correlated significantly with reductions in reported pain, and high-susceptible Ss reported significantly larger pain reductions than did control ss. In the instruction-alone treatment, there was no significant relationship between susceptibility and pain reduction, and Ss at all 3 susceptibility levels reduced reported pain significantly more than did controls and as much as did high-susceptible hypnotic Ss. Findings suggest that the correlation between hypnotic susceptibility and hypnotic analgesia is moderated by Ss attitudes and expectancies concerning their own performance in situations defined as related to hypnosis