NOTES
Unlike Levitt, Baker, & Fish (1990), Lynn, Rhue, & Weekes (Psychological Review, 1990 in press) concluded that nonvoluntary behaviors in hypnosis are similar to other spontaneous social behaviors (like conversational response to social stimuli). “Hypnotized subjects, like nonhypnotized subjects, act in terms of their aims, according to their point of view, and in relation to their interpretation of appropriate behavior and feelings” (p. 239).
“Research shows that hypnotizable subjects resist and even oppose suggestions as a function of their expectancies and perceptions about appropriate hypnotic behavior (Lynn, Nash, Rhue, Frauman, & Sweeney, 1984; Lynn, Snodgrass, Rhue, & Hardaway, 1987; Lynn, Weekes, Snodgrass, Abrams, Weiss, & Rhue, 1986; Spanos, Cobb, & Gorassini, 1985). In one study (Spanos et al., 1985), when subjects were informed that deeply hypnotized subjects were capable of becoming involved in suggestions and simultaneously resisting them, subjects resisted 95% of the suggestions. When subjects were told that deeply hypnotized subjects were incapable of resisting suggestions, they passed the majority of suggestions. Thus, knowledge about what constitutes appropriate hypnotic role behavior is a reliable determinant of resistance, apparently more reliable than the monetary lures used by Levitt et al.” (P. 240).
These studies by Levitt et al. only used behavioral measures of resistance and hypnotizability, and Ss’ perceptions of the resistance instructor and hypnotist. “The ratings of global perceptions are, however, no substitute for measures of subjects’ perception of the _relationship_. … The failure to measure important variables relevant to the central dimensions of concern–coercion, compliance, involuntariness, and relational factors–precludes meaningful interpretation of the nonresisters’ motivation and behavior” (p. 240).
As Orne (1959) has suggested, we should not attribute behavior in the hypnosis context to something unique to hypnosis (such as coercive influence), because other kinds of social context also constrain behavior, e.g. psychotherapy and psychology experiments, with coercive features. Therefore, it seems important in the future to compare the responses of hypnotized subjects with those of subjects in waking-imagination and hypnosis-simulating conditions. In addition to looking at their behavior, it is important to examine their own perceptions of their actions, given the complexity of the social situation entailed in hypnosis.
“Finally, there are statistical grounds to be wary of the authors’ conclusions. They assert that ‘relational factors in the hypnotic dyad influence hypnotic responsiveness,’ yet in three of the studies (I, II, and IV), subjects’ ratings of the hypnotist failed to discriminate whether they resisted or responded to the suggestion” (p. 241). Even where Study III was compared with Study II, the difference in the percentage of Ss who resisted failed to reach statistical significance. “In fact, across all studies, differences in overall resistance rates were not documented by statistical tests–despite procedural variations and differing monetary incentives. So contrary to authors’ assertion, relational factors _in the hypnotic dyad_ generally had little bearing on resistance behavior. If anything, ratings of the resistance instructor had greater weight” (p. 241).
Spanos, Nicholas P. (1990). More on compliance and the Carleton Skill Training Program. British Journal of Experimental and Clinical Hypnosis, 7, 165-170.
NOTES
In this paper the author counters Bates’ (1990) criticisms of the Carlton Skills Training Program, e.g. that the program induces Subject compliance rather than genuine increases in hypnotizability. The author states that the training program is designed to induce conformance rather than simply compliance with suggested demands.
He notes that in order to avoid the twinges of conscience associated with a self- definition of cheating, most Ss fail suggestions to which they are unable to generate the requisite subjective response. (Most Ss fail most of the suggestions on standardized hypnotizability scales despite the fact that all of these suggestions are easily fakable.)
“The findings of the Spanos et al. (1987) and Cross and Spanos (1988) studies suggest that, given appropriate attitudes and interpretations, subjects who benefit most from skill training are those who possess the cognitive abilities that enable them to vividly create and become absorbed in the imaginary scenarios called for by test suggestions. It is much less clear how these findings could be accounted for in terms of compliance. There is no evidence to indicate that imaginal propensity indexes are strongly related to a general tendency towards compliance and, at any rate, low hypnotizables who undergo skill training are, by definition, subjects who failed to comply with test demands during initial hypnotizability testing.
“In summary, when taken together the available data suggest that compliance cannot account adequately for CSTP-induced gains in hypnotizability. Obviously, this conclusion should not be interpreted as saying that compliance plays no role in training induced hypnotizability gains, or that the role of compliance in this regard should not be thoroughly investigated. As Wagstaff (1981) has repeatedly emphasized, compliance appears to be an integral component of hypnotic responding. Recent evidence from our laboratory (Spanos et al., 1989a) supports Wagstaff’s (1981) contention by indicating that untrained high hypnotizables engage in substantial levels of compliance when the ‘pass’ at least some difficult test suggestions. Given that natural high hypnotizables engage regularly in some compliant responding, it would be rather surprising to find that created highs did not do the same. However, examining this issue empirically requires the application of experimental paradigms that allow compliance to be differentiated from conformance.
Spiegel, David (1990). Theoretical and empirical resistance to hypnotic compliance. Invited discussion of Levitt, Baker, and Fish: Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 243-245.
NOTES
Does hypnosis bypass the will, facilitate coercion? The hardest thing for trauma victims to do is to admit helplessness. Furthermore, it is interesting that these same dissociative phenomena seem to be elicited by traumatic experience, the stark imposition of involuntariness (Stutman & Bliss, 1985; Spiegel, Hunt, & Dondershine, 1988). What, then, are we to make of experiments that purport to show that hypnotizable and hypnotized individuals comply with hypnotic instructions irrationally? At some level this challenges our comfortable belief that we always act in our enlightened self-interest, unaffected by unwanted influence. If that can happen even once, our pride of self- ownership is reduced.
Taken as a whole, the studies show that high hypnotizables comply with hypnotic instructions, even in the face of resistance instructions, whereas low hypnotizables are less likely to, especially when conditions foster a relatively less negative view of the resistance instructor. As the authors note, subjects always viewed the hypnotist more positively than the resistance instructor, which in itself suggests the nonrational influence intrinsic to hypnosis. Free will is not abrogated, it is simply not exercised. The Ss are fundamentally choosing whether or not to comply. Half of the highs in Study IV resisted the hypnotic instruction. However, hypnotized individuals tend to narrow the focus of attention, thereby reducing their ability to consider alternatives such as the resistance instruction.
William James (1890) believed that all ideas were invitations to action. Why, then, do we not act on every idea we have, he pondered on a snowy morning while lying in bed. He observed that he would try to get himself to arise by picturing himself doing so. “Why, then, am I still in bed?” He realized that he was editing the primary idea, reflecting on how cold it was, how long it would take to light a fire, and how much time he had until his classes. In a state characterized by a narrowing of the focus of attention, we are less likely to edit the primary idea, and therefore more likely to act. In the experiments presented, the resistance instructor attempts to act as an external editor on the primary hypnotic instruction. Those capable of focusing attention sufficiently disattend to the editing and comply. These studies show that, thankfully, hypnosis is less than automatic submission to instruction but, interestingly, more than simple conscious response to new information.
Weitzenhoffer, Andre M. (1990). Are induced automatisms necessarily coercive? Invited discussion of Levitt, Baker, and Fish: Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 245-246.
NOTES
For the sake of maintaining historical accuracy, I would like first to remark that the ability of hypnotized Ss to resist suggestions was probably never a central issue in the Nancy-Salpetriere controversy. The main quarrel was about other fundamental matters (Crocq, 1900; Barrucand, 1967). It also needs to be said that Pierre Janet should not be seen as representing the Salpetriere in the above controversy. Very little of his extensive writings reflect the ideas of Charcot with whom he was associated for only 4 years (1889- 1893) (Barrucand, 1967; Ellenberger, 1970). Lastly, let it be noted that the association of automatism with hypnotic behavior antedates Bernheim. Despine wrote about it at length as early as 1868, and Charcot (1882) clearly stated before Bernheim that automatic responses to suggestions were characteristic of induced somnambulism. This was at least one view they shared.
Referring to the material quoted from my 1978 paper, the authors assert Bernheim’s definition of automatism implies a subject responding to a suggestion qua suggestion is “unable to resist” it. But all the definition says is that the will does not directly enter into the production of automatisms. It does not say the will cannot effectively intrude at some point or other. This definition, quoted out of context, was part of a more extensive discussion of _what the nature_ of an automatism was for Bernheim. The discussion also went into details regarding _the conditions_ under which Bernheim understood automatisms can occur and hold sway. In this greater context, Bernheim (1888a, 1888b) viewed the occurrence of automatisms as normally subject to control by the ego processes responsible for volitional activities. He saw the degree to which a person’s behavior can be controlled by automatisms initiated by suggestions to be a function of the extent to which certain ego processes become inactive, ineffective, or cooperatively permit the automatisms to occur. Bernheim recognized that both cognitive and relational factors played an important part in the latter case. Bernheim (1888a, 1888b) also stated that data he had collected showed subjects _could_ resist suggestions to varying degrees, with only 17%, who made up the class of somnambules, being _totally incapable_ of resisting” (pp. 245-246).
“Stating the matter more concretely, I doubt many people would speak of an individual having been ‘coerced’ into producing a knee-jerk reflex under appropriate stimulation. Should the situation be any different in the case of other reflexes and, more particularly, the reflex ideodynamic action presumed to underlay suggested acts (Weitzenhoffer 1978, 1989)? I do not think so. It seems to me that what the authors have really and directly examined in their article is the extent to which the classical suggestion effect can be countered by conscious, voluntary control” (p. 246).
Baker, Elgan L.; Levitt, Eugene E. (1989). The hypnotic relationship: An investigation of compliance and resistance. International Journal of Clinical and Experimental Hypnosis, 37, 145-153.
The purpose of this investigation was to assess the ability of hypnotic Ss to voluntarily resist a neutral suggestion when a monetary reward was offered for resistance. 19 of 40 Ss (47.5%) successfully resisted after money was offered by the “resistance instructor.” The correlation between resistance/compliance and hypnotizability was -.44 (high hypnotizables were more likely to comply). Ss’ impressions of the hypnotist tended to be positive; impressions of the resistance instructor tended to be neutral. There was a tendency for nonresistors to have a more positive view of the hypnotist but it is not as marked as was found in an earlier study (Levitt & Baker, 1983).
NOTES
Twelve (75%) of the high hypnotizables did not resist; two (16.7%) of the low hypnotizable Ss did not resist.
In their discussion, they state that “these data support the conclusion that hypnotizability or talent accounts for a significant portion of the variance in determining compliance with suggestions during trance. … [Further], this research may be conceptualized as examining the contributions of a trait variable (hypnotizability) as compared with a variety of situational or state variables (motivation, social perception, environmental contingencies) in determining compliance and suggestibility. Inherent in this model of research is the assumption that many observed hypnotic phenomena (such as suggestibility) are interactive in nature, representing the outcome of the interplay between trait and state variables and between historically determined and contemporary forces. Such a perspective is consistent with the emerging view of trance behavior and experience and validly parallels the phenomenology of experimental and clinical hypnosis which describe both consistency and variability in hypnotic responsiveness for a specific subject or patient across varying conditions and time” (p. 151).
“This study also serves to clarify the important role of positive social perception and a positive sense of alliance with the hypnotist as a correlate of compliance with suggestion. It is clear that Ss who complied despite inducements to resist reported a more positive perception of the hypnotist and a more gratifying sense of relatedness with him than did their counterparts who resisted in response to financial inducement. These data do not indicate whether the positive perceptions contributed to compliance, as transference theories of trance involvement would predict, or whether they were consolidated after the fact due to other variables such as management of potential cognitive dissonance. It does seem reasonable to conclude, however, that the relationship is influential in the process of suggestibility and compliance” (p. 151).
1989
Holroyd, Jean; Maguen, Ezra (1989). And so to sleep: Hypnotherapy for lagophthalmos. American Journal of Clinical Hypnosis.
We used hypnosis to facilitate eye closure during sleep for a 44-year-old woman whose nocturnal lagophthalmos prevented use of a contact lens following cataract surgery and could have resulted in severe corneal damage. On three separate occasions the symptoms remitted following a very brief course of treatment. We discuss the results in terms of alternate theories of hypnotic performance.
NOTES
The Discussion section notes, “There was an excellent correlation
between the onset of hypnotherapy and the cessation of the recurrent
corneal erosion secondary to nocturnal lagophthalmos. Healing of
corneal erosion, disappearance of the superficial punctate keratopathy,
and alleviation of ocular foreign body sensation occurred promptly
following hypnotherapy (with two separate therapists)” (pp. 267-268).
The authors present the view that “heightened suggestibility, more
vivid imagery, and more specific influence of thoughts upon organ
systems probably came into play (Brown & Fromm, 1986; Holroyd, 1987).
Social influence explanations (role taking, expectancy, compliance)
seem less relevant as explanations. This highly motivated patient had
not been able to keep her eyes closed during sleep despite her
conscious efforts, her ”good-patient” role, her positive expectations
about the benefits of standard treatments, and respectful incorporation
of the assistance provided by her ophthalmologist” (p. 268).
Jupp, J. J.; Collins, J. K.; Walker, W. L. (1989). Relationships between behavioural responsiveness to hypnotic suggestions and estimates of hypnotic depth following 11 sequential instances of hypnosis. Australian Journal of Clinical and Experimental Hypnosis, 17, 93-98.
Behavioral responsiveness to suggestions was assessed in an initial hypnosis session, and hypnotic depth was assessed in this session, followed by 10 weekly standardized hypnotic experiences. Correlations were calculated between behavioral responsiveness, initial and subsequent depth estimates, and between successive trance depth estimates. Levels of trance depth estimates were found to increase through weeks 1 to 11. Significant positive correlations were found between behavioral responsiveness scores and trance depth estimates to the fourth week but not beyond. Significant positive relations were found between successive estimates of trance depth except for the correlation between estimates for the fourth and fifth weeks. These results are discussed in terms of the estimates of trance depth being attributions from self-observations of behavioral responsiveness to hypnotic suggestions.
Nash, Michael R.; Spinler, Dwayne (1989). Hypnosis and transference: A measure of archaic involvement. International Journal of Clinical and Experimental Hypnosis, 37, 129-144.
20 Likert-type items were derived directly from Shor’s theoretical propositions concerning the occurrence of transference-like experiences among hypnotic Ss. In 3 separate experiments, this 20-item Archaic Involvement Measure (AIM) was administered to 452 Ss following termination of both group and individually administered hypnosis procedures. Results suggest that: (a) AIM is internally consistent, and is significantly correlated with hypnotizability; (b) among high hypnotizable Ss, AIM scores assess an important aspect of hypnotic experience which is relatively unrelated to behavioral response to hypnotic suggestions; (c) there is no change in AIM scores associated with the sex of the hypnotist or S; and (d) there are 3 clusters of AIM items; perceived power of the hypnotist, positive emotional bond to the hypnotist, and fear of negative appraisal. Possible validational and clinical research applications of AIM are presented, along with a plea for further empirical examination of the relational dimensions of hypnosis.
NOTES:
Relates these findings to ‘countering’ (Sheehan, P., Countering preconceptions about hypnosis: An objective index of involvement with the hypnotist. Journal of Abnormal Psychology, 1971, 78, 299-322). “Countering is the tendency of some highly hypnotizable Subjects to comply with the intent of the hypnotist, even when there are strong nonhypnotic influences (e.g., social influences, expectations derived from previous lectures, perceptual constraints) to perform otherwise. … Sheehan and Dolby (1979) found that hypnotic Subjects’ dreams about the hypnotist were different than nonhypnotic Subjects’ dreams, by being more positive and more often containing themes of protection, care, and authority. Interestingly, these themes were especially evident in the dreams of hypnotic Subjects who countered” (p. 130).
The several experiments in this study investigate reliability, concurrent validity, and factor structure of the AIM. In their discussion, Nash and Spinler make the following points. As is the case with hypnotizability, AIM scores may have a bi-modal distribution, at least when administered in the same context as a hypnosis measure. It is possible that these two modes define qualitatively different kinds of involvement with the hypnotist. “For high hypnotizable Ss, behavioral response to hypnotic suggestions appeared unrelated to the extent of archaic involvement with the hypnotist across both Experiments 2 and 3. Considering only the overall correlation between AIM and hypnotic responsiveness, one might argue that both scales measure general behavioral compliance and conformity, and that this explains their degree of association. It may indeed be correct to associate AIM scores with an overall conformity to respond, but only among low hypnotizable Subjects. For high hypnotizable Subjects, behavioral compliance (task performance) was not associated with AIM scores. Just as Sheehan’s (1971, 1980) ‘countering’ studies suggest, among high hypnotizable Ss there appears to be no clear-cut relationship between the ability to perform hypnotic tasks and the special, motivated commitment to the hypnotist evidenced in some Ss. The theory of Shor (1979) and the empirical work of Sheehan and Dolby (1979) strongly suggest that an intense involvement with the hypnotist (archaic involvement) is a distinctive feature of the hypnotizable S’s experience. The present work corroborates Sheehan and Dolby’s (1979) finding that, among high hypnotizable Ss, this involvement is not equivalent to overt response to the demands of standard test suggestions.
“Three findings further suggest that AIM scores assess an important aspect of the hypnotic S’s experience which is relatively unrelated to behavioral task performance. First, AIM scores correlated significantly with a measure of subjective depth during hypnosis (Hypnotic Depth Inventory, Field, 1966). Second, the correlation between hypnotic depth and AIM scores was substantial for both low and high hypnotizable Ss. Thus, for high hypnotizable Ss, AIM scores were significantly correlated with hypnotic depth, even though they were unrelated to behavioral task performance. Finally, regression analysis suggested that AIM scores accounted for variance in hypnotic depth which was not explained by task performance scores. These findings, then, conform to Shor’s proposition and Sheehan’s (1971, 1980) later observations that archaic involvement with the hypnotist is a fundamental dimension of hypnotic experience which may not be directly related to the extent of behavioral response to hypnotic suggestions (see Shor, 1979, p. 119).|
“It is of some interest that the mean AIM score for low hypnotizable Ss was roughly equivalent to that of control Ss who had listened to a lecture prior to AIM administration. Only Ss who were exposed to hypnosis and who were behaviorally responsive to hypnotic suggestions evidenced elevated AIM scores” (pp. 140).
Spanos, Nicholas P.; Flynn, Deborah M. (1989). Compliance, imaginal correlates and skill training. [Comment/Discussion] .
NOTES
The authors defend the Carlton skill training program against accusation that the trained Ss are simply complying in the context of social pressure. They also discuss characteristics of high hypnotizables (absorption and imagery), noting that the majority of lows do not have low absorption/imagery scores (citing de Groh, 1988, and noting the research on context dependency for absorption).
“Despite all of this, it is worth noting that the results of our modification studies are not inconsistent with the hypothesis that high hypnotizability requires imaginative skills that some subjects do not possess in sufficient degrees. For example, two recent studies (Spanos et al., 1987; Cross and Spanos, 1988) found that the extent to which low hypnotizables showed gains following administration of the CSTP was predicted by their pre-tested levels of imagery vividness. Lows with good imagery benefitted substantially more from the CSTP than did lows with poor imagery ability. When it is kept in mind that most low hypnotizables do not score low on measures of imagery/absorption (de Groh, 1988), then the findings that substantial numbers of low hypnotizables can be taught to attain high hypnotizability is not at all inconsistent with the notion that high hypnotizability requires at least moderate levels of imagery/absorption ability” (p. 14).
Spanos, Nicholas P.; Flynn, Deborah M. (1989). Simulation, compliance and skill training in the enhancement of hypnotizability. British Journal of Experimental and Clinical Hypnosis, 6, 1-8.
Subjects who underwent cognitive skill training were compared to no treatment controls and to subjects in two simulation treatments on the behavioural and subjective dimensions of two hypnotizability post-tests. Ss in a trained simulation treatment received skill training but were instructed to fake the responses of someone who had been transformed by training into an excellent hypnotic subject. Standard simulators did not receive skill training, but were instructed to fake their responses to the two post- tests. A final group of untrained Ss (i.e. naturals) who attained the same behavioural scores on a hypnotizability index as did post-tested skill-trained Ss, was also compared to the treated groups. Ss in the two simulation treatments performed similarly on all hypnotizability indexes. Simulators out-performed both skill-trained and natural subjects (who failed to differ from one another) on all indexes, and skill-trained and natural subjects, in turn, out-performed the no treatment controls. These findings suggest that sustained faking cannot account adequately for the enhancements in hypnotizability produced by skill training.
1988
Coons, P. M. (1988). Misuse of forensic hypnosis: A hynotically elicited false confession with the apparent creation of a multiple personality. International Journal of Clinical and Experimental Hypnosis, 36 (1), 1-11.
A case is presented in which there was flagrant misuse of forensic hypnosis. The patient, a woman in her early 30s, was accused of shooting her 2 children. During a hypnotic interview, the police hypnotist used an extremely suggestive interrogative technique, and the suspect produced an apparent secondary personality who confessed to the shootings. Subsequently the prosecutor tried to enter the “hypnotic confession” as evidence against the defendant. The evidence was dis-allowed because of the manner in which it was obtained and because of the lack of verification from other sources. The literature regarding the use of forensic hypnosis is reviewed as is the literature regarding multiple personality and the experimental production of multiple personality-like phenomena.
Gudjonsson, Gisli H. (1988). The relationship of intelligence and memory to interrogative suggestibility: The importance of range effects. British Journal of Clinical Psychology, 27 (2), 185-187.
60 normal adults and 100 adult psychiatric patients completed a suggestibility scale and the Wechsler Adult Intelligence Scale (WAIS). Clear range effects of IQ and memory were evident in their relationship with suggestibility
Spanos, Nicholas P.; Cross, Wendi P.; Menary, Evelyn; Smith, Janet (1988). Long term effects of cognitive-skill training for the enhancement of hypnotic susceptibility. British Journal of Experimental and Clinical Hypnosis, 5 (2), 73-78.
Twelve initially low susceptible subjects, who scored in the medium or high susceptibility range on the Carleton University Responsiveness to Suggestion Scale (CURSS) following skill training, were posttested 9 to 30 months later with a group version of the Stanford Hypnotic Susceptibility Scale, Form C. Skill trained subjects scored significantly higher on behavioral and subjective dimensions of the Stanford Hypnotic Susceptibility Scale, Form C than low susceptible untrained control subjects who were posttested after an equivalent interval. Furthermore, the posttraining CURSS scores of the skill trained subjects were matched to those of subjects who received the same CURSS scores without training. Matched subjects were posttested on the Stanford Hypnotic Susceptibility Scale, Form C after only a brief delay. Skill trained and matched subjects failed to differ significantly on Stanford Hypnotic Susceptibility Scale, Form C susceptibility dimensions, but skill trained subjects showed higher levels of suggested amnesia than matched subjects. These findings support the idea that hypnotic susceptibility is modifiable and that training induced gains in susceptibility can be enduring.
1987
Evans, Frederick J.; McGlashan, Thomas H. (1987). Specific and non-specific factors in hypnotic analgesia: A reply to Wagstaff. British Journal of Experimental and Clinical Hypnosis, 4, 141-147. (Comment in response to Wagstaff, G. (1987). Is hypnotherapy a placebo? Hypnosis, 4, 135-140.)
NOTES
This article is a reply to Wagstaff’s (1984) critique of the McGlashan, Evans & Orne (1969) article which was entitled “The nature of hypnotic analgesia and the placebo response to experimental pain,” published in Psychosomatic Medicine, 31, 227-246. The paper to which the authors are replying is Wagstaff, G. F. (1984). Is hypnotherapy a placebo? Paper given at the First Annual Conference of the British Society of Experimental and Clinical Hypnosis, University College, London. An abridged version appeared in the British Journal of Experimental and Clinical Hypnosis, 1987, 4, 135-140.
The closing comments of this Evans & McGlashan 1987 paper read as follows: “The strategy in this study [i.e. McGlashan, Evans & Orne, 1969] was quite different from the usual experimental design. Our goal was to _maximize_ all of those non-specific factors that we could build into the experimental procedure. Only by attempting to maximize non-specific effects is it possible to see whether hypnosis in appropriately responsive subjects can exceed that degree of pain control which occurs due to the maximal operation of these non-specific effects. These non-specific components of the hypnotic situation may account for a great deal of clinical change. … The critical finding was that hypnosis did add a level of pain control that occurred after maximizing clinically related non-specific factors contributing to change in pain tolerance, and that this increased tolerance occurred only in subjects markedly responsive to hypnosis, in contrast to the significant non-specific effects which were uncorrelated with measured hypnotizability” (pp. 143-144).
The principal findings of the McGlashan, Evans & Orne (1969) study were: “(a) The improved ability to tolerate pain following the ingestion of placebo was roughly the same for high hypnotizable and low hypnotizable subjects. (b) The response to the non-specific aspects of taking a ‘drug’ among low hypnotizable subjects was identical to, and highly correlated (.76) with, their response to the legitimized expectation that change would occur under hypnosis for low hypnotizable subjects. The placebo component of a believe-in ‘drug’ ingestion was the same as the placebo component of a believed-in hypnotic experience for these low hypnotizable subjects. (c) The performance of the highly hypnotizable subjects was significantly greater under hypnotic analgesia conditions than it was under placebo conditions.
“This last finding is important conceptually, though of less clinical relevance. It should be noted that not all high hypnotizable subjects showed this result. Even among highly hypnotizable subjects, not all of them had the experience that profound analgesia had occurred! Thus, based on their subjective experience of the relatively small degree of analgesia, 6 of the 12 highly hypnotizable subjects behaved exactly as the low hypnotizable subjects had — their placebo and hypnotic responses were small, significant, but equal. Only 6 out of 12 carefully screened hypnotizable subjects who subjectively experienced marked analgesia showed dramatic objective changes in pain endurance. Dr. Wagstaff might consider the physiological implications of the observation that we became somewhat frightened about the possibility of tissue damage with two of these six subjects. We had to stop their performance at a point where physiologists had assured us that tissue damage could be expected. They had also assured us, wrongly for these subjects, that we did not have to worry about such a critical point because nobody could endure such a degree of occlusion with this procedure. In fact, for these two subjects, anoxia and muscle cramping were not even apparent!” ( p. 144).
1986
Milne, Gordon (1986). Hypnotic compliance and other hazards. Australian Journal of Clinical and Experimental Hypnosis, 14, 15-29.
Hypnosis is not an external ‘force’ or ‘power but a special kind of interaction between two persons. The outcome depends on the skill and intentions of the hypnotist and the responsiveness and compliance of the subject. Skill may be marred by procedural errors, ‘sins of omission’; intentions by a self-centred rather than a patient- centred approach, ‘sins of commission’. A hazard peculiar to the use of hypnosis is a fallacious belief in the power it enables the operator to wield over the subject.
1985
Stone, Jennifer A.; Lundy, Richard M. (1985). Behavioral compliance with direct and indirect body movement suggestions. Journal of Abnormal Psychology, 94 (3), 256-263.
Investigated the effectiveness of 2 types of suggestions in eliciting body movement by presenting 96 high-, medium-, and low-susceptible undergraduates, in hypnotic or nonhypnotic conditions, with either of 2 series of body movement suggestions. The indirect suggestions were designed to represent the approach of M. H. Erickson (see PA, vol 60:11116 and 12262) and resulted in greater compliance in the hypnotic condition. Direct suggestions resulted in greater compliance in the nonhypnotic condition. Susceptibility to hypnosis was related to compliance in the hypnosis condition, but no interactions were found between susceptibility and type of suggestion. Sense of volition in responding was unrelated to the major findings. Discussion of the results includes a call for the accurate reporting of the wording of hypnotic suggestions in future research.
1983
Levitt, Eugene E.; Baker, Elgan L. (1983). The hypnotic relationship–another look at coercion, compliance and resistance: A brief communication. International Journal of Clinical and Experimental Hypnosis, 31, 125-131.
The purpose of the present investigation was to assess the ability of hypnotic Ss to voluntarily resist neutral suggestions on a monetary reward incentive. The results were ambiguous; Ss resisted with a mean of 1.2 of 2 suggestions each. Postexperimental interviews disclosed that all Ss felt that the instructions to resist were asking them to be disloyal to the hypnotist or to betray him. Ability to resist was positively correlated with Ss’ impressions of the “resistance instructor” and tended to be negatively correlated with the impression of the hypnotist. These findings are interpreted to suggest support for an interactional conception of the hypnotic state.
Spanos, Nicholas P.; Dubreuil, Debora L., Saad, Carol L., Gorassini, Donald (1983). Hypnotic elimination of prism-induced aftereffects: Perceptual effect or responses to experimental demands?. Journal of Abnormal Psychology, 92 (2), 216-222.
Two experiments assessed adaptation to displacing prisms in hypnotically limb-anesthetized Ss. Experiment I with 18 college students disconfirmed the hypothesis that the displacement aftereffect is eliminated in limb-anesthetized hypnotic Ss who adapt to prisms in the absence of a visual target. Such Ss showed as large a displacement aftereffect as control Ss who received neither a hypnotic induction procedure nor an anesthesia suggestion. Experiment II with 30 undergraduates demonstrated that under some testing conditions hypnotic Ss complied with experimental demands and eliminated the behavioral but not the perceptual component of the aftereffect.
Wagstaff, Graham F. (1983). Comment on McConkey’s “Challenging hypnotic effects: The impact of conflicting influences on response to hypnotic suggestion”. [Comment/Discussion] .
NOTES
“Probably the most consistent finding to emerge from McConkey’s review is that hypnotic subjects tend to respond in accordance with what they feel the hypnotist really wants, regardless of conflicting experimental demands” (p. 13).
Conn, J. H. (1981). The myth of coercion through hypnosis: A brief communication. International Journal of Clinical and Experimental Hypnosis, 29 (2), 95-99.
A brief history of coercion through hypnosis is presented. Hypnosis is not an external “force,” which can be used to overcome a subject’s “will power.” It can be used as an alibi, a folie a deux, a neurotic compromise, a legitimatization, or rationalization of behavior, as well as being genuine, involuntary, automatic hypnosis. Unwitting simulation occurs frequently. Laboratory crimes and stage hypnosis are “make believe” performances occurring in a completely protected situation. Neither a long-term relationship, nor an attempt to distort perception is a necessary or sufficient cause of coercion. The possibility of “motivated helplessness,” a “self-fulfilling prophecy” or a “believed in efficacy” must be considered. Coercion through hypnosis is a myth which will not disappear so long as it is fostered by uninformed hypnotists, who believe that all initiative and self-determination is surrendered by the subject to an “all powerful” hypnotist.
1981
Graham, K. R.; Greene, L. D. (1981). Hypnotic susceptibility related to an independent measure of compliance – Alumni annual giving: A brief communication. International Journal of Clinical and Experimental Hypnosis, 29 (4), 351-354.
An attempt was made to relate hypnotic susceptibility to an objective measure of compliance in a real-life setting. Hypnotic susceptibility scores for 235 college graduates, who graduated between the years 1971-1979, were compared to their records for alumni annual giving. Those who had made at least 1 contribution to the college since graduation were significantly higher in hypnotic susceptibility than those who had made no contribution. The rsults suggest that willingness to respond to a persuasive appeal may be related to a person’s susceptibility to hypnosis.
1980
Sheehan, Peter W. (1980). Factors influencing rapport in hypnosis. Journal of Abnormal Psychology, 89 (2), 263-281.
The phenomenon of countering expresses the tendency of some highly susceptible subjects to favor the intent of the hypnotist when placed in a conflict situation where social influences of another kind dictate an alternative response. The present research explored the parameters of this objective index of involvement with the hypnotist to investigate the special relevance of rapport processes to the hypnotic setting. Rapport was manipulated in five different experiments, varying either the warmth or genuineness of the hypnotist. It was predicted from transference theorizing that countering would decrease in the negative context and increase in the positive one. Results confirmed predictions for highly susceptible subjects tested in the former context but not the latter. In the negative setting, subjects were inhibited in their rate of countering, but maintained their previous level of response to the hypnotist when rapport was facilitated. Results highlighted the relevance of interpersonal processes to theorizing about hypnosis.
1979
Perry, Campbell (1979). Hypnotic coercion and compliance to it: A review of evidence presented in a legal case. International Journal of Clinical and Experimental Hypnosis, 27 (3), 187-218.
There are 2 main positions concerning the potential of hypnosis to coerce unconsenting behavior. One position asserts that coercion is possible through the induction of distorted perceptions which delude the hypnotized person into believing that the behavior suggested is not transgressive. The other position asserts that where hypnosis appears to be a causal factor in coercing behavior, other elements in the situation — especially a close hypnotist-client relationship — were the main determinants of behavior. The present paper analyzes the court transcript of a recent case in Australia in which a lay hypnotist was found guilty of 3 sexual offenses against 2 female clients. The uniqueness of the case is that it pits the 2 main positions on hypnotic coercion against each other. The hypnotist admitted the acts attributed to him; his defense was that hypnotic coercion is impossible since a hypnotized person would resist immediately any transgressive suggestion. The women involved stated that they were aware of what was happening but that, because they were hypnotized, they were unable to resist. Analysis of the court transcript indicates that neither a hypothesis of hypnotically induced perceptual distortion, nor one of a close hypnotist-client relationship can account for the events that occurred. Other alternative explanations are discussed within the context of the inherent difficulteis of analyzing a court transcript.
1977
Wickramasekera, Ian (1977). The placebo effect and medical instruments in biofeedback. Journal of Clinical Engineering, 2 (3), 227-230.
This article defines a “placebo effect” and identifies some of its parameters in pain control and in other areas of medicine. It proposes a new model of the placebo effect and advances the hypothesis that biomedical instruments used in biofeedback studies, like drugs, can acquire and generate placebo effects. Such placebo effects can complicate the interpretation of specific experimental treatments in human clinical research in which biomedical instruments are used.
1963
Sarbin, Theodore R.; Lim, Donald T. (1963). Some evidence in support of the role-taking hypothesis in hypnosis. International Journal of Clinical and Experimental Hypnosis, 11, 98-103.
A study was conducted to test the hypothesis that hypnosis is a form of role-taking behavior. Independent measures of hypnotizability as measured on the Freidlander-Sarbin Scale and role-taking ability (improvisations) as judged by the Dramatics Department faculty were found to be significantly related. Those rated high in role-taking were above the mean in hypnotizability, but some high on hypnotizability were low in dramatics ability. (PsycINFO Database Record (c) 2002 APA, all rights reserved)
1958
Rosenberg, M. J.; Gardner, C. W. (1958). Some dynamic aspects of posthypnotic compliance. Journal of Abnormal and Social Psychology, 57, 351-366.
Within the context of a general, psychoanalytically-oriented theory of hypnosis there were presented two hypotheses on the nature of compliance with posthypnotic suggestions. According to the first, such compliance is viewed as facilitated by the subjects being able to interpret the posthypnotic suggestion in a manner consistent with the mechanisms and affective reactions that, for him, characterize and maintain the hypnotic relationship. In the second, compliance with a posthypnotic suggestion is viewed as facilitated if that suggestion permits the subject safely to express and indulge a previously warded-off and conflicted drive. Case record data drawn from a recent experimental study were presented which tend to confirm these two hypotheses.
CONDITIONING
1996
Montgomery, Guy H.; Kirsch, Irving (1996, August). Conditioned placebo effects: Stimulus substitution or expectancy change. [Paper] Presented at the annual meeting of the American Psychological Association, Toronto, Canada.
Stimulus substitution models posit that placebo responses are due to pairings of conditional and unconditional stimuli. Expectancy theory maintains that conditioning trials produce placebo response expectancies, rather than placebo responses, and that the expectancies elicit the responses. I tested these opposing models by providing some participants with information intended to impede the formation of placebo expectancies during conditioning trials and by assessing placebo expectancies. Although conditioning trials significantly enhanced placebo responding, this effect was eliminated by adding expectancies to the regression equation, indicating that the effect of pairing trials on placebo response was mediated completely by expectancy. Verbal information reversed the effect of conditioning trials on both placebo expectancies and placebo responses, and the magnitude of the placebo effect increased significantly over 10 extinction trials. These data disconfirm stimulus substitution models and provide strong support for an expectancy interpretation of conditioned placebo effects. (ABSTRACT from Bulletin of Division 30, Psychological Hypnosis, Fall, 1996, Vol. 5, No. 3.)
1995
Montgomery, Guy H. (1995). Mechanisms of placebo analgesia: Expectancy theory and classical conditioning (Dissertation, University of Connecticut). Bulletin of Division 30, Psychological Hypnosis, APA, 5 (3), 2.
Stimulus substitution models posit that placebo responses are due to pairings of conditional and unconditional stimuli. Expectancy theory maintains that conditioning trials produce placebo response expectancies, rather than placebo responses, and that the expectancies elicit the responses. I tested these opposing models by providing some participants with information intended to impede the formation of placebo expectancies during conditioning trials and by assessing placebo expectancies. Although conditioning trials significantly enhanced placebo responding, this effect was eliminated by adding expectancies to the regression equation, indicating that the effect of pairing trials on placebo response was mediated completely by expectancy. Verbal information reversed the effect of conditioning trials on both placebo expectancies and placebo responses, and the magnitude of the placebo effect increased significantly over 10 extinction trials. These data disconfirm stimulus substitution models and provide strong support for an expectancy interpretation of conditioned placebo effects. (ABSTRACT from Bulletin of Division 30, Psychological Hypnosis, Fall, 1996, Vol. 5, No. 3.)
1993
Kraft, Tom (1993). Using hypnosis with cancer patients: Six case studies. Contemporary Hypnosis, 10, 43-48.
Hypnosis can be used in a number of different ways for helping patients suffering from cancer. As well as pain relief, hypnosis may be used to correct insomnia that does not respond to sleeping tablets; for the reduction in skin irritation and dyspnoea when these are due to organic causes, and for treatment-related over-eating. Some patients will use hypnosis in a symbolic way. When this occurs, just as in dream interpretation, it is important to ask the patient for associations, so that these symbols can be understood. Hypnosis can be an extremely useful addition to the medical armamentarium, and should be employed as an adjunct to standard forms of cancer treatment. This paper reports six case studies in which hypnosis was used to help cancer patients.
Wickramasekera, Ian (1993). Observations, speculations and an experimentally testable hypothesis on the mechanism of the presumed efficacy of the Peniston and Kulkosky procedure. Biofeedback, 21, 17-20.
Raises the speculation that alpha/theta EEG brainwave training procedures that have shown preliminary effectiveness with alcoholics and PTSD war veterans may be effective, at least in part, because of an enhancement of hypnotizability resulting from such training. Research to evaluate this is suggested.
1992
Kay, L. M. (1992, October). The effects of hypnosis, relaxation, and suggestion on visual acuity (Dissertation, California School of Professional Psychology, San Diego). Dissertation Abstracts International, 53 (4), 2065-B. (Order No. DA 9221587)
Evaluated the relative efficacy of several aspects of the hypnotic process on facilitating change in hypnotic state-dependent visual acuity in myopic student subjects. Five conditions included hypnosis with suggestions, neutral hypnosis, nonhypnotic suggestion, progressive relaxation, and a control (comedy). Visual acuity was assessed as baseline (a task-motivational situation where they were to try to see as well as possible) and after the experimental condition. Results found that hypnosis facilitated a significant improvement in visual acuity (p = .002), although no differences were found in the other conditions” (p. 2065).
Page, Roger A. (1992). Clark Hull and his role in the study of hypnosis. American Journal of Clinical Hypnosis, 34, 178-184.
NOTES
The contributions of Hull include his attempts to dispel misconceptions about hypnosis, comparisons of capacities in the hypnotic state with those in the awake state, a sampling of early findings that are still valid today, and examples of his contributions to methodology. Additionally, the roots of many modern-day models and concepts are to be found in his early works.
“Bernheim (1902) had believed hypnosis was identical to natural sleep, while Braid (1899) had believed the resemblance between hypnosis and natural sleep was just superficial. Pavlov (1923) held an intermediate position; he hypothesized that hypnosis was a transition to true sleep involving selective inhibition of certain brain centers” (p. 179).
“His proposition that hypnosis conforms to the basic principles of habit formation was supported by his own work (1933) and, with few exceptions, holds true today. For example, many studies have found that hypnotic responding improves with practice and eventually reaches a plateau (e.g., As, Hilgard, & Weitzenhoffer, 1963; Evans & Schmeidler, 1966). Parenthetically, one can see a resemblance here to the later notion of ‘plateau hypnotizability’ (Shor, Orne, & O’Connell, 1966). Although Barber and Calverley (1966) did demonstrate that an exception to this proposition will occur if subjects become bored and disinterested, it is still true that hypnosis is generally facilitated by practice” (p. 181).
“Yet another example from the same work can be found in the following description of the results of a conditioning experiment: ‘… it is possible that the hypnotic group were conditioned more readily because they were the kind of individuals who are susceptible to hypnosis rather than because they were actually in the trance when subjected to the conditioning procedure.’ (p. 219) In this statement, one can see the now taken-for-granted distinction between hypnotic susceptibility and being hypnotized, as discussed, for example, by Graham and Leibowitz (1972)” (p. 182).