An experiment was designed to evaluate the protective effects of different agents – acupuncture, hypnosis, Morphine, aspirin, Diazepam and placebo – upon experimentally-induced pain in humans. Twenty normal, healthy volunteers were subjected to cold water and tourniquet- induced pain and the protective effects of 35 minutes of hypnotic suggestion, electro- stimulation of both acupuncture points and non-acupuncture points, 10 mg/kg of Morphine, 5 grains of aspirin, 10 mg of Diazepam and a mild sugar placebo were evaluated. Data was collected on subjective evaluation of pain, EKG, EEG, respiration, skin temperature, peripheral vascular activity and EMG. A special study was also done to evaluate the effects of all the above agents on the somatosensory evoked potentials and EEG. The data were further analyzed on the basis of hypnotic susceptibility of the volunteers. The results indicated: 1) Hypnosis, acupuncture at specific sites with electrical stimulation and Morphine Sulphate had about the same reduction in experimental pain. 2) Hypnosis produced different effects from those resulting from acupuncture stimulation on EEG. 3) Acupuncture stimulation in specific loci resulted in a latency increase in the early secondary response on somatosensory evoked potential. 4) Cold water pain was remarkably reduced after true acupuncture point stimulation. 5) Tourniquet (ischemic) pain was reduced by both hypnosis and true acupuncture site stimulation. 6) Skin temperature was significantly reduced on the side of acupuncture points (true) stimulation.

1977
Fisher, R. (1977). On flashback and hypnotic recall. International Journal of Clinical and Experimental Hypnosis, 217-235.

This essay deals with both the intra-individual and inter-individual varieties of arousal state-bound experiences. The former are labelled as “flashbacks” while the latter embrace the great fantasms and repetitive schemes, the ever re-written plots and images of literature, art, and religion.
Flashbacks are both arousal-state and stage (i.e., set and setting) bound experiences.
Flashback and hypnotic recall differ only in the ways by which they are induced. Induction methods should be distinguished from induced states on the hyperaroused perception-hallucination and hypoaroused eprception-meditation continuum.
Flashbackers may be characterized by their (a) variability on perceptual-behavioral tasks; (b) tendency to minimize (or reduce) sensory input; (c) high resting heart rates; (d) hypnotizability; and, hence (e) preferential right-cerebral-hemispheric cognition; and (f) a display of EEG-alpha dominance in the resting, waking state.

Friedman, Howard; Taub, Harvey A. (1977). The use of hypnosis and biofeedback procedures for essential hypertension. International Journal of Clinical and Experimental Hypnosis, 25, 335-347.

In an attempt to evaluate a procedure combining 2 techniques, hypnosis and biofeedback, which might effect significant changes in diastolic blood pressure in essential hypertensives, Ss were placed in 1 of 4 groups: hypnosis only, biofeedback only, hypnosis and biofeedback combined, or measurement only. The first phase — training sessions and brief follow-ups (1 week and 1 month) — of the long-term study with 6 monthly follow-up periods, was evaluated. Hypnosis only and biofeedback only procedures were both capable of providing significant lowering of diastolic pressure. However, in intergroup comparisons, the hypnosis only procedure showd the most impressive effect. Unexpectedly, the procedure of combining hypnosis and biofeedback into one technique was as ineffective as the measurement only procedure.

NOTES
In their discussion of the finding that hypnosis + biofeedback did not yield more positive results, the authors state, “it is possible that two opposing sets were established that negated each other: the biofeedback instructions wherein S was enjoined to direct his attention externally and to attempt to change the displayed number which reflected diastolic pressure, versus the more passive, relaxed attitude implied in hypnotic induction. It is interesting to note that Benson et al. (1974b) have similarly suggested that the set involved in biofeedback training may interfere with the elicitation of the ‘relaxation response.’ Also, Orne [personal communication] has indicated that, although anticipating a synergistic effect as a result of combining hypnotic and biofeedback procedures, some difficulty may lie in requiring Ss to be hypnotized during [emphasis on ‘during’ in original] the biofeedback training proceduer” (p. 344).

Gatchel, Robert J.; Hatch, John P.; Watson, Paur J.; Smith, Dan; Gaas, Elizabeth (1977). Comparative effectiveness of voluntary heart rate control and muscular relaxation as active coping skills for reducing speech anxiety. Journal of Consulting and Clinical Psychology, 1093-1100.

The present study investigated whether heart rate biofeedback training is as effective as muscular relaxation training in reducing speech anxiety. Also, a combined muscle relaxation/biofeedback treatment group was included in this study. All treatment groups were compared to a false-biofeedback placebo control group. This investigation also assessed whether the degree of autonomic nervous system awareness significantly influences the treatment process. Ten speech-anxious subjects, half of whom scored high on the Autonomic Perception Questionnaire (APQ) and half of whom scored low on the APQ, were assigned to each group. Results indicated that all four groups demonstrated a decrease in self-reported anxiety. Assessment of physiological measures (heart rate and skin conductance) indicated that the three treatment groups were associated with less physiological responding during the posttreatment assessment of anxiety, relative to the false-biofeedback group. Moreover, among the three treatment groups, the combined relaxation/biofeedback group demonstrated the lowest level of responding. The degree of autonomic awareness was not found to be related to therapeutic improvement.

Gatchel, Robert J.; Proctor, Janet D. (1976). Effectiveness of voluntary heart rate control in reducing speech anxiety. Journal of Consulting and Clinical Psychology, 381-389.

The effects of learned control of heart rate deceleration and therapeutic expectancy set in reducing speech anxiety were investigated in a factorial design employing 36 speech-anxious subjects. Heart rate control training and no heart rate control training were each paired with high-therapeutic-expectancy and neutral- expectancy instructions, in order to assess the individual and combined effects of the two factors. Results demonstrated that learning to control heart rate deceleration led to a significant reduction in self-report, physiological (heart rate and skin conductance level), and overt signs of anxiety, relative to the no-heart-rate control condition. High- therapeutic-expectancy instructions also contributed to a reduction in self-reported anxiety. These results demonstrate that learned heart rate control is an effective therapeutic technique for reducing anxiety.

1975
Cowings, Patricia S. (1975, September). Observed differences in learning ability of heart rate self-regulation as a function of hypnotic susceptibility. [Paper] Presented at the 3rd Congress of the International College of Psychosomatic Medicine, Rome.

Three groups of eight men and women were given personality tests and were taught to control their own heart rates. Experimental group I and the control group had low hypnotic susceptibility (Stanford Hypnotic Susceptibility Scale), and subjects in experimental group II had high hypnotic susceptibility. The experimental groups received autogenic therapy and biofeedback, while the control group was given biofeedback only. Subjects who received autogenic therapy and biofeedback performed better than the control group. Significant differences, however, were found in all psychological test scores between high and low hypnotic susceptibles.

1974
Redmond, Daniel P.; Gaylor, Michael S.; McDonald, Robert H.; Shapiro, Alvin P. (1974). Blood pressure and heart-rate response to verbal instruction and relaxation in hypertension. Psychosomatic Medicine, 36 (4), 285-297.

Recent data have suggested that instructional set and task awareness may play a substantial role in the achievement of directional changes in blood pressure associated with “operant conditioning” techniques. Six hypertensive patients were instructed alternately to raise (UP) and lower (DOWN) their blood pressure by concentrating on changing “heart rate, force of contraction, and blood vessel resistance to flow.” Paired 10 min periods were separated by the experimenter’s entry and exit. Five of the subjects were taught progressive muscular relaxation (PMR), and the protocol repeated, with PMR induced throughout this session. The immediate cardiovascular response to PMR, induced in both the presence and absence of the experimenter, was studied. Systolic (SBP) and diastolic (DBP) blood pressure and heart rate (HR) were measured every 30 sec in all sessions. Direction of changes in BP and HR for UP and DOWN periods was appropriate and significant in both instruction sessions, and these differences for BP frequently reached significant levels of magnitude. In general, interactions for HR did not reach significant levels. Comparison of the two sessions yielded little difference between them. PMR uniformly lowered BP and HR, but was of significant magnitude only when induction of PMR involved the active participation of the experimenter. Interview data revealed considerable dramatic mental imagery associated with directional shifts in BP. The results indicate that directional instruction may result in appropriate changes in BP and HR of a magnitude comparable to those reported in studies using “external biofeedback.” PMR did not alter the response. This study adds to other data which point to the potential for nonspecific or “placebo” effects to be operative in conditioning studies.

NOTES:
The authors reviewed literature suggesting that blood pressure changes have been brought about by hypnotic suggestions of attitudes, progressive muscular relaxation, autogenic training (a form of self hypnosis), yogi, transcendental meditation, and hypnotically suggested relaxation.
The instructions to raise and lower blood pressure by concentrating on changing heart rate, force of contraction, and blood vessel resistance to flow were a repetitive monologue with a monotonous emphasis on “rate and force of heart beat and resistance of vessels to flow.” Most subjects spontaneously introduced imagery appropriate to the desired change. The authors expressed the opinion that task awareness (to change the blood pressure) influenced the results, and the changes were accomplished more by associative imagery than by responding to the literal meaning of instructions.

Surman, Owen S.; Hackett, Thomas P.; Silverberg, Elizabeth L.; Behrendt, Douglas M. (1974). Usefulness of psychiatric intervention in patients undergoing cardiac surgery. Archives of General Psychiatry, 30, 830-835.

Twenty patients undergoing cardiac surgery were seen one or more times by a psychiatrist who performed two functions. In a supportive fashion he cleared up any misconceptions the patient had about the forthcoming surgery and he taught him a simple autohypnotic technique. Twenty controls, matched for relevant variables, received routine preoperative care. Contrary to the report of others, a single visit by the psychiatrist did not influence the incidence of postoperative delirium, anxiety, depression, pain, or medication requirements. However, there was a trend for patients receiving a greater number of preoperative visits to have a lower incidence of detected delirium. Age was the only factor in this study that differed significantly between delirious and nondelirious patients.

Aiken, Linda H.; Henrichs, Theodore F. (1971). Systematic relaxation as a nursing intervention technique with open heart surgery patients. Nursing Research, 20, 212-217.

NOTES
Psychiatric problems frequently occur after open heart surgery, usually from day 2 to day 7 postoperatively. Symptoms include impairment of consciousness, disorientation, sensory disturbances like visual and auditory hallucination, and sometimes delusions and paranoid behavior. Authors defined a postoperative adverse reaction as “when the patient experienced impairment of consciousness with motor restlessness, disordered thinking, sensory disturbances, visual and/or auditory illusions or hallucinations, and paranoid ideation. All of these symptoms do not usually occur together and an additional definition was given for a minor reaction which occurred if only one of the above symptoms was present for 12 hours or less” (p. 214).
The population from which samples were drawn consisted of adult male patients admitted to a university medical center for open heart surgery. The experimental group (N = 15) consisted of all patients admitted from September 1969 through June 1970 (omitting two who were not willing to participate). Controls were 15 adult males admitted for open heart surgery in the prior year.
A relaxation and systematic desensitization technique was used for the experimental group, each patient being given a tape recorder with a 15-minute tape of the exercise “to use whenever he wanted to relax” (p. 214) but at the least four times a day.
On basis of previous research one would expect postoperative adverse reactions of 40% but the Relaxation group had only 8%. (The control group had 27%, but the difference between groups was not significant with Fisher’s exact probability test–p<.10.) Mortality rate was same in both groups. The results must be interpreted in the context of differences between groups during surgery, which may or may not relate to the intervention. The Relaxation Group was significant lower than Control Group on 4 of 5 surgical risk factors: anesthesia time, cardiopulmonary bypass time, total units of blood, and degree of hypothermia. They were (nonsignificantly) better on duration of hypothermia; and there was no difference on multivalve replacement. This suggests the Relaxation Group were less exposed to these factors to a significant degree. Discussion: The groups were matched on age, sex, preoperative diagnosis, type of surgical procedure, incidence of severe economic problems, family adjustment problems, and history of psychiatric problems (i.e. the groups did not differ). "The major difference between the two groups was in relation to the surgical stress factors studied: degree of hypothermia, amount of time on cardiopulmonary bypass, anesthesia time, and total units of blood received. The experimental group was significantly lower on mean values for all of these stress factors. Without further research it is impossible to conclude that these factors did or did not influence the lower incidence of postoperative reactions found in the experimental group. It should be noted, however, that the decreased surgical stress factors had no apparent effect on reducing mortality in this sample. Also as previously stated, prior research has not been able to demonstrate a direct relationship between these surgical stress factors and the incidence of postoperative reactions" (p. 215). "The population used in this research ranged from patients with mild symptoms of heart disease to those with severe decompensation and congestive heart failure. It was anticipated prior to beginning the research that some patients would be physically incapable of cooperating due to fatigue and dyspnea; this prove not to be the case" (p. 216). This intervention is usable by nurses, and "provides an alternative which the professional nurse may prescribe after systematically assessing a patient's needs" (p. 216). "It is a new skill to be learned that is comparable to the skill of giving an injection or learning to recognize arrhythmias. The amount of time required to teach a patient the technique of systematic relaxation is realistically within the scope of any staff nurse's role" (p. 216). 1970 Gray, Arne L.; Bowers, Kenneth S.; Fenz, Walter D. (1970). Heart rate in anticipation of and during a negative visual hallucination. International Journal of Clinical and Experimental Hypnosis, 18 (1), 41-51. Gave 10 stimulating control and 10 hypnotic undergraduates a suggestion to negatively hallucinate. Heart rate responses recorded prior to and including the hallucination period indicated consistent differences between groups. Hypnotic Ss responded with heart rate acceleration in anticipation of the hallucination, while controls responded with heart rate deceleration during the same period. It is suggested that these differences reflect differences in the subjective experiences of hypnotic and simulating Ss. (Spanish & German summaries) (PsycINFO Database Record (c) 2003 APA, all rights reserved) 1968 McCord, Hallack (1968). Hypnotic control of nosebleed. American Journal of Clinical Hypnosis, 10, 219. NOTES Nosebleeds that occurred every two or three days and could not be terminated with the usual clinical interventions were stopped, without symptom substitution, when fairly direct suggestions were added almost "as a sort of after-thought, since the primary purpose of the therapy was to aid in treating the marriage difficulty" (p. 219). Nuland, William (1968). The use of hypnotherapy in the treatment of the postmyocardial infarction invalid. International Journal of Clinical and Experimental Hypnosis, 16 (3), 139-150. DEALS WITH THE PSYCHOLOGICAL ASPECTS OF CONVALESCENCE AND REHABILITATION OF PATIENTS FOLLOWING CORONARY INFARCTION. THE FOCUS IS ON THE SITUATIONAL FACTORS WHICH THE PATIENT ENCOUNTERS DURING CONVALESCENCE THAT SERVE TO PROLONG AND REINFORCE THE INVALIDISM. IT IS CONCERNED ESPECIALLY WITH THE VALUE OF HYPNOTHERAPY AS COMPARED WITH OTHER PSYCHOTHERAPEUTIC METHODS IN TREATING THESE CASES. THE ANXIETY AND EMOTIONAL STRESS WHICH CAN BE RELIEVED THROUGH THE USE OF HYPNOSIS IS DIRECTED PRIMARILY TOWARD REDUCING EMOTIONAL TURMOIL WHICH RESULTS FROM THE CORONARY ATTACK WITH THE CONSEQUENT FEAR OF PHYSICAL ACTIVITY AND OF SUDDEN DEATH. SPECIFICALLY, HYPNOSIS IS USED EFFECTIVELY IN REASSURANCE, REEDUCATION, DESENSITIZATION, GUIDANCE, AND OTHER DIRECT SUPPORT TECHNIQUES IN ACCORDANCE WITH THE PATIENT''S SYMPTOMS AND NEEDS. (SPANISH + GERMAN SUMMARIES) (PsycINFO Database Record (c) 2002 APA, all rights reserved) 1965 Barber, Theodore Xenophon (1965). Physiological effects of 'hypnotic suggestions': A critical review of recent research (1960-64). Psychological Bulletin, 201-222. Recent studies are reviewed which were concerned with the effectiveness of suggestions given under "hypnosis" and "waking" experimental treatments in alleviating allergies, ichthyosis, myopia, and other conditions and in eliciting deafness, blindness, hallucinations, analgesia, cardiac acceleration and deceleration, emotional responses, urine secretion to sham water ingestion, narcotic-like drug effects, and other phenomena. The review indicates that a wide variety of physiological functions can be influenced by suggestions administered under either hypnosis or waking experimental treatments, and direct and indirect suggestions to show the particular physiological manifestations are crucial variables in producing the effects. Black, Stephen (1964). Mind and body. London: Kimber. NOTES Defines psychosomatic disease as one that responds to psychotherapy. Believes only 5% are highly hypnotizable, that hypnosis is learnable in 1/2 hour, that hypnosis is not a useful treatment for psychosomatic disorders because you can't use interpretation [of unconscious]. The 'unconscious' is "... a complex of informational systems derived from such primaeval mechanisms" (p. 133). "Primaeval mind is involved in these mechanisms of genetics and immunology" (p. 133). "There is thus a 'somatic mind' which is unconscious and presumably without any means of verbalization of experience--and a 'cerebral mind' which is conscious" (p. 133). The dividing line is not clear. Rapport is discussed on pp. 160, 169 as one of the spontaneous characteristics of hypnosis, in the absence of suggestion. The same for posthypnotic suggestion (rapport and amnesia). Spontaneous _physiological_ changes in hypnosis relate to mind-body relationships (p. 169) Conditioned reflex is discussed on p. 161 "...the subjective evidence indicates that a perceptual change involving any sensory modality can be produced by DSUH" [direct suggestion under hypnosis] p. 178. Suggestion can selectively affect different parts of the body p. 197. Research: "Hypnosis is not only the most important and practical way of _proving_ the existence of the unconscious--which is still in doubt in some circles--but is in fact the only way in which unconscious mechanisms can be manipulated under repeatable experimental conditions for purposes of investigation" (p. 152). Mind-body is "amenability to control" Catatonia, which characterizes both animal and human hypnosis, seen in hypnosis, is induced by constriction (i.e. disorientation). The Cartesian concept of mind and body tends to confuse the issue p. 157. Rapport is discussed (p. 157). Suggestion (p. 159) "It was this concept of 'suggestion'--which so obviously parallels 'amenability to control' in animals--that eventually established hypnosis in the French schools of psychiatry as a state of increased suggestibility. ... still the standard definition of hypnosis in most medical psychiatric textbooks and in lay dictionaries" (p. 159). Black (1969) did some biochemical sleuthing to learn how information transmitted by words becomes information encoded somatically, as when psychosomatic allergies flare and recede or disappear. What accounts for suggestion "curing" an allergic skin reaction in one part of the body while another part not included in the suggestion remains reactive? What accounts for the instantaneous skin allergy cure which sometimes occurs with suggestion (in 24 hours)? Skin sensitivity tests in highly hypnotizable Ss who were also very allergic were inhibited by direct suggestion under hypnosis under highly controlled experimental conditions--and in one subject the effect (inhibition) was relatively permanent--ruling out (he suggests) a neurological mechanism. He did further experiments to examine whether the result was due to an instant neurological mechanism and a long-term endocrinal mechanism. p. 212 He ruled out peripheral blood flow as the cause of diminished skin sensitivity (there was no change in blood flow with suggestions of heat or cold). Therefore decrease in blood flow couldn't explain in neurovascular terms the 'instant' inhibition of skin sensitivity (allergy) tests. Was it due to systemic--especially adrenal-- changes? He demonstrated increases in plasma cortisol under hypnosis with suggestions of fear. On p. 230 he summarizes the facts he established by skin sensitivity tests, plasma- cortisol studies, and histology - endocrinological. 1963 Black, Stephen; Edholm, O. G.; Fox, R. H.; Kidd, D. J. (1963). The effect of suggestion under hypnosis on the peripheral circulation in man. Clinical Science, 26, 223-230. Summary The effects on the circulation in the forearm and hand of both direct and indirect suggestion under hypnosis of thermal stimuli have been studied. 2. The induction of hypnosis did not significantly alter the forearm blood flow, but a small reduction in hand blood flow was usually observed. Pulse rate in general slowed slightly as did respiration rate. 3. The effect of body heating on forearm and hand blood flow was not modified by hypnosis. 4. Direct suggestion under hypnosis of body heating or body cooling, with and without body heating, produced only small changes. 5. The changes associated with suggestion were not related to the thermal suggestion. Whatever the suggestion, the usual response was a reduction in hand blood flow and an increase in forearm blood flow. 6. The rise of body temperature with heating was not modified by direct suggestion, under hypnosis, of body cooling. 7. No change in body temperature could be elicited by suggestion. 8. In a few experiments marked changes in forearm blood flow occurred. These appeared to resemble the changes in the circulation produced by emotional stimuli. 9. The smaller changes more frequently observed were also similar to those produced by mild emotional stimuli" (p. 229). [N.B. The Subjects were normal, healthy adults, N = 9, between 21-45 years old; highly hypnotizable, amnesic for trance.] 1960 Crasilneck, Harold B.; Hall, J. A. (1960). Blood pressure and pulse rates in neutral hypnosis. International Journal of Clinical and Experimental Hypnosis, 8 (3), 137-140. Author''s Summary: "Twenty-five Ss were tested for pulse rate and blood pressure in a wakeful resting state and immediately after the induction of neutral hypnosis. No change was found in the measurements by application of the t-test for differences between correlated means. These results strongly suggest that changes in pulse rate and blood pressure do not occur simply from the induction of hypnosis. The effect of various direct, indirect (emotive), and hallucinatory suggestions remains to be established" (p. 138). Crasilneck, Harold B.; Hall, James A. (1959). Physiological changes associated with hypnosis: A review of the literature since 1948. International Journal of Clinical and Experimental Hypnosis, 7 (1), 9-50. ( Abstracted in Psychological Abstracts, 61: 6626) Topic headings include: Experimental Techniques (Depth, Type of suggestion, Other variables) Cardiovascular Effects (Clinical reports, Blister formation, Bleeding, Peripheral vasomotion, Heart rate, EKG changes, Blood pressure, Hematological changes) Respiration Urogenital System Gastrointestinal System Metabolism and Temperature Endocrine System Central Nervous System (Electroencephalography, Epilepsy, Age regression, Galvanic skin response, Muscle control, Electromotive changes, Multiple sclerosis, Cold adaptation, Exocrine glands, Reflexes, Russian reports) Special Senses (Hearing, Taste) Raginsky, Bernard B. (1959). Temporary cardiac arrest induced under hypnosis. International Journal of Clinical and Experimental Hypnosis, 7 (2), 53-68. NOTES "An experiment is described in which the symptoms of syncope and temporary complete cardiac arrest were induced under hypnosis in a patient who had been operated on for a so-called Adams-Stokes syndrome and who had, until the time of the experiment, remained free of such symptoms. An attempt is made to correlate contemporary knowledge in explaining this phenomenon. "It is pointed out that maturity in the biological sciences takes about twice as long to achieve as does maturity in the physical sciences. This holds especially true in the use of hypnosis" (p. 66). The authors report that in attempting to reinduce a fainting episode, "We were not at all prepared for the complete cardiac arrest which followed the hallucinated episodes" (p. 59). 1958 Duncan, Irma W.; Dressler, Robert L.; Lyon-James, Sara; Sears, Alden B. (1958). The search for an index of hypnosis. Journal of Clinical and Experimental Hypnosis, 6 (2), 95-108. NOTES "Blood and urine samples were obtained from 18 university students at the beginning and end of two experimental sessions, one with and one without hypnosis. Some of the subjects relaxed during the sessions; others imagined or hallucinated a traumatic experience. "Of a variety of measurements made, urinary volumes and 17-ketosteroids, the eosinophil count and psychogalvanometer recordings appear to give useful information about any changes due to the hypnosis. The biochemical changes caused by the experimentally produced emotions seem to depend on the individual and his past experience rather than the hypnosis. The data suggest that if the experience hallucinated is known to the subject, the biochemical changes indicate a relaxed state during the hypnosis. The psycho-galvanometer recordings may indicate an agitated state while the biochemical indices suggest a relaxed state" (pp. 106-107). Schneck, Jerome M. (1957). Hypnoanalytic observations on the psychopathology of fainting. Journal of Clinical and Experimental Hypnosis, 5 (4), 167-171. (Abstracted in Psychological Abstracts 62: 3 II 67S) Varieties of fainting have been described as hysterical syncope, vasodepressor syncope, and carotid sinus reactions, among others. Fainting has been linked in general with personality problems, emotional instability, and immaturity. It has been called a mechanism for blocking of ego functions in its role of primitive defense against overwhelming stimuli. The present paper gives in greater detail the specific dynamics in a patient with fainting episodes. A crucial event incorporating major dynamic ingredients was an operative procedure in childhood. The psychological impact of this trauma was revivified during a spontaneous hypnotic regression. The personality matrix significant for this patient in relation to the fainting episodes consisted of passive, masochistic submission to a dominant, highly influential mother whose pressure was felt by the patient as pervasive and stifling. Circumstances associated psychologically with this feeling apparently triggered the fainting reactions. As he matured through the years and cast off increasingly this type of maternal influence, the tendency toward fainting reactions diminished" (p. 170). 1956 Bigelow, Newton; Cameron, G. H.; Koroljow, S. A. (1956). Two cases of deep hypnotic sleep investigated by the strain gauge plethysmograph. Journal of Clinical and Experimental Hypnosis, 4 (4), 160-164. Two subjects, studied by means of a strain gauge plethysmograph, have shown greater changes in the peripheral pulse and the finger volume during deep hypnosis than they did immediately before or after. In the absence of external stimuli, the presence and the degree of such changes reflect the activity of the autonomic nervous system. This result suggests that in hypnosis the inhibiting tendency of the cortex on the autonomic nervous system is reduced or nullified" (p. 164). Kupfer, David (1954). Hypnotherapy in a case of functional heart disorder. Journal of Clinical and Experimental Hypnosis, 2 (3), 186-190. NOTES "Summary. A young soldier with functional cardiac complaints was treated with hypnosis in a total of 4 interviews. The dynamics were bypassed and the therapeutic suggestions attached to 2 significant events in the patient's childhood, dealing intimately with the oedipal conflict and castration fears. Follow-up studies of 3 weeks duration revealed that significant changes had been produced in the patient's attitudes towards himself and towards his role in the military service" (p. 190). 1953 Schneck, Jerome M. (1953). Hypnoanalytic study of a patient with extrasystoles. Journal of Clinical and Experimental Hypnosis, 1 (4), 11-17. (Abstracted in Psychological Abstracts 6413?) Author's Summary - Psychosomatic studies of heart abnormalities are available in the literature. A few deal with extrasystoles. Fewer still involve hypnosis. Extrasystoles are reported to have been induced hypnotically. Hypnosis has also been used to study other aspects of cardiac functioning. This report deals with some psychological aspects of extrasystoles in a patient treated hypnoanalytically. In the hypnotic state there appeared to be enhanced recall, less obsessiveness, greater spontaneity, more emotional involvement with material elicited, and improved integration of data made available. A direct relationship was shown to exist between states of tension and the extrasystoles. Variation in the frequency of their occurrence set in and this was followed by progressive lessening in the symptom as tension decreased. The symptom was related to the identification by the patient with his father in relation to pulmonary infections. The heart as a vital organ and the early death of the patient's father both assumed considerable psychological significance for the patient and were obsessively elaborated by him. His mother's death following a heart attack resulted in an exacerbation of the symptom and reenforced his concern. Use of the symptom corresponded to his passive inclinations and his conflict over passivity-aggressivity and dependence-independence problems. His failures could be rationalized on the basis of physical malfunctioning and sympathy enlisted thereby. The symptom appeared to be related also to marked guilt about his relationship with his mother and furthered a dependent masochistic relationship with his mother-in-law who dominated his household and (as revealed in other data) was identified in part with the patient's mother. (At this time, incidentally, his mother-in-law, like his mother, was said to be quite ill with hypertension.) Therapeutic contact with this patient was time-limited. He travelled a considerable distance from another state for each of his appointments. The psychodynamics available are undoubtedly a fraction of many additional elements involved. Removal to another part of the country interrupted treatment but further opportunity for hypnoanalytic work may become available in the future. CARELTON SKILL TRINING PROGRAMME 1999 Comey, Gail; Kirsch, Irving (1999). Intentional and spontaneous imagery in hypnosis: The phenomenology of hypnotic responding. International Journal of Clinical and Experimental Hypnosis, 47 (1), 65-85. Students were given 1 of 2 versions of the Carleton University Responsiveness to Suggestion Scale (CURSS): (a) the original version, which contains instructions to intentionally imagine goal-directed fantasies, and (b) a modified version, in which instructions for suggestion-related imagery were deleted. Participants were asked to report their goal-directed fantasies and to indicate whether these occurred spontaneously or were generated intentionally. They were also asked whether they had tried intentionally to generate the suggested experience and to indicate whether they had believed that the suggested states of affairs were real (e.g., whether they thought a hallucinated cat really existed). The deletion of instructions for goal-related imagery significantly increased responsiveness to CURSS suggestions. Spontaneous goal-directed imagery was significantly correlated with behavioral response, but intentional imagery was not. Most successful responders tried to generate suggested experiences intentionally, indicated that they could have resisted challenge suggestions if they really waned to, and reported believing in the reality of suggested ideomotor and challenge experiences but not of cognitive suggestions. Voluntary attempts to generate suggested experiences were correlated with subjective responding. Milling, Leonard S.; Kirsch, Irving; Burgess, Cheryl A. (1999). Brief modification of suggestibility and hypnotic analgesia: Too good to be true?. International Journal of Clinical and Experimental Hypnosis, 47 (2), 91-103. A 10-minute training procedure, based ont the Carleton Skill Training Program, has previously been reported to produce substantial increments in responsiveness to hypnotic suggeston. The authors attempted to replicate this effect and also assessed the impact of the training procedure on hypnotically suggested analgesia. Ninety-eight students who had been preselected for high, medium, and low levels of initial suggestibility were randomly assigned to experimental and control gorups. Training failed to increase overall suggestibility scores or to enhance the effects of a suggestion for pain reduction. Suggested pain reduction was more highly correlated with posttreatment suggestibility scores than with pretreatment suggestibility and, in a regression analysis, only posttreatment suggestibility predicted pain reduction uniquely 1995 Gearan, Paul; Schoenberger, Nancy E.; Kirsch, Irving (1995). Modifying hypnotizability: A new component analysis. International Journal of Clinical and Experimental Hypnosis, 43 (1), 70-89. The effects of the Carleton Skills Training Program (CSTP) on hypnotizability were compared to those of a modified training program in which instructions for physical enactment of the response were omitted. After training, subjects in the original CSTP reported an increase in the extent to which they intentionally enacted suggested behaviors. In contrast, subjects in the modified training program reported increased fantasy without voluntary physical enactment. Nevertheless, both training programs increased behavioral and subjective responsiveness to suggestion, and there were no significant differences in response enhancement between the two programs. Across conditions, increases in behavioral and subjective responses to suggestion were correlated with increased use of fantasy. In contrast, increases in enactment were correlated only with compliance. The modified training program is recommended as a means of enhancing suggestibility with less likelihood than the original CSTP of engendering compliance. 1993 Bertrand, Lorne D.; Stam, Henderikus J.; Radtke, Lorraine (1993). The Carleton Skills Training Package for modifying hypnotic susceptibility--a replication and extension: A brief communication. International Journal of Clinical and Experimental Hypnosis, 41, 6-14. This study employed the Carleton Skills Training Package (CSTP) to attempt to enhance both objective and subjective components of hypnotic susceptibility. In addition, changes in susceptibility were compared for subjects administered a standard hypnotic induction procedure and for subjects given brief "place yourself in hypnosis" instructions. Results indicated that subjects who were administered the CSTP exhibited significant gains in both objective and subjective susceptibility scores that were maintained at two separate posttests with different scales. No differences were observed between the groups administered the standard induction and those administered the self-induction instructions. NOTES: The authors do not make much of the latter finding, but I find it to be the more interesting outcome. "Two experiments (Barber & Calverley, 1969; Stam & Fraser, 1986) found that subjects who sat quietly for 5 minutes following an instruction to "place yourself in hypnosis" attained similar scores when responding to test suggestions as did subjects who were administered a 5-minute hypnotic induction procedure. The CSTP informs subjects that hypnotic induction procedures do not achieve their effects by inducing a trance state and that such procedures function to produce relaxation rather than to enhance responsiveness to suggestion. In addition, the CSTP emphasizes to subjects that responses to suggestions do not 'just happen' but must be actively generated. To the extent that subjects attend to these aspects of the CSTP procedure, they should exhibit equivalent increments on behavioral and subjective indexes of susceptibility regardless of whether they are administered a formal hypnotic induction procedure or simply told to 'place themselves into hypnosis.'" (p. 7). "That naive subjects can produce equivalent objective, subjective, and involuntariness scores following such instructions highlights the degree to which hypnotic responses are not dependent on formal induction procedures. The fact that so-called active-alert induction procedures are also equivalent in producing hypnotic responses supports this notion (Banyai & Hilgard, 1976)" (p. 13). Spanos, Nicholas P.; Flynn, Debora M.; Gabora, Natalie J. (1993). The effects of cognitive skill training on the Stanford Profile Scale: Form I. Contemporary Hypnosis, 10, 29-33. Low hypnotizable subjects who attained high hypnotizability scores following cognitive skill training (i.e. created highs) were compared with untrained low hypnotizables and with subjects who attained high hypnotizability scores without training (i.e. natural highs) on Form 1 of the Stanford Profile Scale (SPS:I). Created and natural highs did not differ significantly on the SPS:I and equivalent proportions of created and natural highs attained 'virtuoso performance' on the SPS:I. None of the initially low hypnotizables attained high SPS:I scores. Findings indicate that the performance of high- scoring, skill-trained subjects cannot be 'explained away' in terms of post-test hypnotizability scales with limited upper ranges. 1992 Bates, Brad L. (1992). The effect of demands for honesty on the efficacy of the Carleton Skills-Training Program. International Journal of Clinical and Experimental Hypnosis, 40 (2), 88-102. 30 low hypnotizable Ss were administered the Carleton Skills-Training (CST) program. Prior to testing, 15 Ss were administered honesty instructions (Bowers, 1967) in an effort to encourage responses that were consistent with subjective experiences and to dissuade Ss from performing in a manner intended to please E. Posttraining hypnotizability scores for Ss given honesty instructions were consistently smaller than those for 15 Ss who did not receive these instructions, implying that scores for the latter group exaggerate the extent to which hypnotic experiences are altered by the CST program. The pattern of results supports the view that demand characteristics contribute to the efficacy of the CST program, and that improvements in actual hypnotic talent are more limited than Spanos' original work implies. 1991 Bates, Brad L.; Kraft, Patricia M. (1991). The nature of hypnotic performance following administration of the Carleton Skills Training Program. International Journal of Clinical and Experimental Hypnosis, 39, 227-242. 30 low hypnotizability Ss were administered the Carleton Skills Training (CST) program, while 8 were assigned to a practice group. Prior to treatment, an attempt was made to facilitate training by altering the ecological conditions of the laboratory. All Ss were tested immediately after treatment, and trained Ss were retested after 5-7 months. Immediate training gains were large and were comparable in magnitude to those routinely found at Carleton University. In addition, (a) trained Ss responded comparably whether screened once or twice, (b) practice alone did not enhance hypnotic performance, and (c) natural high hypnotizability Ss obtained significant larger Field Inventory of Hypnotic Depth (Field, 1965) scores than created high hypnotizables. Follow-up scores fell between scores posted at screening and immediately after training. Current findings are interpreted in the context of existing evidence concerning the CST program. NOTES: (based on the Discussion) "Results from these two investigations (include Bates et al., 1988) challenge the claim that lasting changes have occurred in the ability of most trained Ss to experience hypnosis. With regard to the present findings, it is reasonable to wonder whether scores would have been even lower had follow-up data been gathered a few months later. In the only other published study to address the problem of maintenance, Spanos, W. P. Cross, Menary, and Smith (1988) found that after at least 9 months, trained Ss outscored low hypnotizability Ss who had never received training. Unfortunately, these investigators do not report comparisons between trained Ss' follow-up scores and either original screening or immediate posttest scores. The authors do report, however, that 20% of trained Ss obtained high scores at follow-up. Given that at least 50%, and as high as 80%, of Ss routinely score in the high range immediately after receiving the CST program at Carleton University, a follow-up figure of 20% implies that with time, the hypnotic performance of most trained Ss began to return to baseline levels. "With regard to the subjective experience of trained Ss.... These results confirm previous findings by Bates & Brigham (1990) which indicated that the hypnotic experiences of CST graduates - even those who are the most responsive to the modification program - may not be comparable in all respects to those of untrained, high hypnotizable individuals" (pp. 237-238). "The present study altered the context in which training occurred by increasing the salience of the laboratory; adding, repainting, carpeting, and redecorating experimental rooms; requiring Es to dress professionally; and temporarily attributing the CST program to Washington State University. When demand characteristics were arranged in this manner, training gains were of the same magnitude as those found at Carleton University and were much larger than those found in all prior replication studies. The apparent importance of contextual factors is underscored by findings reported by Bates et al. (1988), who manipulated demand characteristics in a systematic fashion and observed that Ss' responses to the CST program are moderated by the context in which training occurs. Given the important role that ecological variables have generally played in hypnosis research, it should come as no surprise that factors like these would affect attempts to modify hypnotic performance" (p. 238). Kirkeby, Judith L.; Payne, Paul A.; Hovanitz, Christine; Moser, Steven (1991). Increasing hypnotizability: A comparison of a multimedia form of the Carleton Skills Training Program with a self-administered written form. Contemporary Hypnosis, 8, 161-165. Compared a group-administered form of the multimedia Carleton Skills Training Program (CSTP) to a self-administered training program similar in content, but limited to written materials. One hundred and forty-one female subjects were administered one of four conditions: (1) the multimedia CSTP; (2) the self-administering booklet training; (3) a practice-only condition; or (4) a no-practice control condition. Subjects then responded to a shortened form of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A). [6 items: arm lowering, arm rigidity, hands together, fly hallucination, eye catalepsy, and amnesia.] Results indicated that objective and subjective hypnotizability measures were higher in both of the training conditions than in the practice-only or control conditions. In comparisons of the two training conditions, the booklet program was judged to be equal in effectiveness to the multi-media group form of the CSTP.