“Still other now familiar concepts can be gleaned from his 1933 book. One would be the notion of trance having a kind of ‘inertia.’ Yet another stems from his hypothesis that hypnotic suggestions produce relaxation, which in turn suppresses ‘… the spontaneous activity of the symbolic or thought processes.’ (p. 310) This may well be the first conceptualization of what most recently has been referred to by Plotkin and Schwartz (1985) as the lack of a disposition or capacity to generate final-order appraisals” (p. 183).
Wall, Patrick D. (1992). The placebo effect: An unpopular topic [Editorial]. Pain, 51, 1-3.
NOTES
The author presents a useful, brief review of the placebo effect. He suggests three hypotheses about the placebo response mechanism: 1. The effect is attributable to a decrease in anxiety (Evans, 1974). This view has not been validated (White, Tursky, & Schwartz, 1985). 2. Expectation, cognitively mediated, leads to behavioral effects. Certain personalities, described as placebo responders, report a stronger analgesia with a fixed dose of morphine than do people who are placebo non-responders (Beecher, 1968). White et al. (1985) proposed that simply asking what is expected of a medicine will identify who the placebo responders will be. Also, the placebo response to morphine is stronger than the placebo response to aspirin. Physician or nurse expectancy is influential as well as patient expectancy, and that means that ‘blind’ experimental trials are not truly blind. Kanto et al. (1966) found that the placebo effect is stronger when the placebo is given second than when it is given first in a crossover design. 3. The effect is due to a classical conditioned Pavlovian response (Wickramasekera 1980). Support for this comes from experiments on normal subjects whose pain and tolerance threshold had been established (Voudouris et al. 1989, 1990). For example, in one experiment in which electric current was the stimulus, a purportedly anesthetic ointment was applied to the locus of stimulation; some of the subjects showed a placebo response of diminished pain. A second group, treated in the same manner, had the pain producing electric current secretly reduced by the Experimenter. This second group, who had experienced reduction in pain that suggested the cream was truly analgesic, subsequently became strong placebo responders to the originally painful current and cream.
The author views the expectancy hypothesis and the conditioning hypothesis as not necessarily incompatible. Unlike the cognitively mediated expectation hypothesis, conditioning does not necessarily require cognition. But there is little support for the idea that human conditioning does not involve cognition [See Brewer, W. F. (1974). There is no convincing evidence for operant or classical conditioning in adult humans. In W. B. Weimer and D. S. Palermo (Eds.) Cognition and the Symbolic Processes. N.Y.: Wiley, pp 1-42.]
“If then the expectation and conditioning hypotheses are not clearly separate, it may be relevant to add an apparently unrelated group of phenomena. Humans and animals frequently show no signs of pain in the presence of overt injury (Wall 1979). It seems that pain appears only when reaction to injury is biologically appropriate. Could it be that expectation-conditioning is one of the factors which determines which item of our behavioural repertoire with its associated sensation is appropriate?” (p. 3).
1991
Rapee, Ronald M. (1991). The conceptual overlap between cognition and conditioning in clinical psychology. Clinical Psychology Review, 11, 193-203.
Given the fact that contemporary theories of conditioning regularly utilize information processing concepts such as memory and expectancies, classifying clinical theories as either cognitive or conditioned appears to be outdated. Yet, this dichotomy is still upheld in many clinical writings. Such a false dichotomy seems to serve more of a political function than a theoretical one and thus is likely to interfere with a complete understanding of psychopathology. While the terms conditioning and cognition are often used to imply unconscious learning on the one hand versus conscious, rational learning on the other, this usage is not consistent. A more empirically useful way to describe pathological behavior may be in terms of the amount of attentional resources utilized.
Russell, Christine; Davey, Graham C. (1991). The effects of false response feedback on human ‘fear’ conditioning. Behaviour Research and Therapy, 29 (2), 191-196.
Describes a human electrodermal conditioning experiment in which 28 students (aged 19-30 yrs) were given false skin conductance feedback during conditioned stimulus/stimuli (CS) presentation. In comparison with attentional control groups, Ss who believed they were exhibiting a strong conditioned response (CR) did actually emit a greater magnitude CR, while Ss who believed they were exhibiting a weak CR emitted a lower magnitude CR. When both self-report and behavioral measures of unconditioned stimulus/stimuli (UCS) evaluation were taken after conditioning, response feedback (RFB) had not differentially affected Ss’ evaluation of the aversiveness of the UCS. The response modulating effects of RFB may not be caused by RFB influencing evaluation of the UCS, but they are consistent with the hypothesis that beliefs about the nature of RFB influence the strength of the UCS representation itself.
Badia, Pietro (1990). Memories in sleep: Old and new. In Bootzin, Richard R.; Kihlstrom, John F.; Schacter, Daniel L. (Ed.), Sleep and cognition (pp. 67-76). Washington, DC: American Psychological Association.
NOTES
Reviews literature. Conclusion: First, with reinforcement for responding, control of learned behavior can be maintained reliably by stimuli presented during sleep. Second, when stimuli are presented 4 min or more apart, behavioral control results in little or no change in sleep structure, in daytime sleepiness, or in perceptions of sleep quality. Neither perceived wakefulness nor wakefulness as it is scored on the sleep record are necessary for responding, although stimulus/response events typically result in brief EEG or EMG change. Third, within-subject, within-night variance in responsiveness is complexly related to time of night, sleep stage, and REM/NREM cycle.
Evans, Frederick J. (1990). Behavioral responses during sleep. In Bootzin, Richard R.; Kihlstrom, John F.; Schacter, Daniel L. (Ed.), Sleep and Cognition (pp. 77-87). Washington, DC: American Psychological Association.
NOTES
Subjects were 19 male student nurses who met a criterion of having EEG alpha density of at least 40% during an eyes closed, waking condition. They slept in the laboratory for two nights in succession, while being monitored by an EEG, and were told only that sleep cycles were being studied. Suggestions were presented while they were sleeping, e.g. “Whenever I say the word itch, your nose will feel itchy until you scratch it” “Whenever I say the word pillow, your pillow will feel uncomfortable until you move it.” Then they were tested by Experimenter saying the cue word (“itch” or “pillow”) during subsequent REM periods later that night and again on the next night. (The suggestions were not repeated on the second night; but two new suggestions were given on the second night when possible.)
After the Subjects awakened in the morning, they were interviewed to test their memory for the events that had occurred, and also cue words were presented in the context of a word association test to assess memory indirectly by observing behavioral and physiological responses. A more detailed inquiry was made after the second night.
The results were as follows. Ss responded to a mean of 21% of cue words administered. Ss continued to demonstrate REM sleep for at least 30 seconds for 71% of all cues administered, indicating that they were not aroused by the cue. When a suggestion was successfully completed (i.e., without eliciting alpha activity) it was not repeated. However, the cue words were tested in several subsequent REM periods. Cue word testing occurred immediately (during the same REM period as the suggestion) on the same night, as well as in a later REM period, and during REM on Night 2 (after the suggestion had been given during Night 1).
Correct responses were given for 20% of immediate, 23% of delayed, and 23% of carry-over conditions. Ss did not remember the suggestion, verbal cues, or their responses when they awoke. Since Ss often responded to the cue the next night without repetition of the suggestion itself, the authors inferred amnesia rather than forgetting had occurred. Responses were not elicited by repeating the cue word in the waking state, but appeared to be specific to the sleep condition.
Six Ss returned five months later for a third night of testing. Four had shown carryover response on Night 2 to a Night 1 suggestion. When verbal cues were presented (without re-administering the suggestion) those 4 Ss responded, even though there was no intervening waking memory about the procedure or the suggestions. Some Ss responded even more frequently than during the original two nights; hypnotic depth did not seem to account for the increased responsivity. Experimenters attempted to reverse the amnesia observed during the waking condition by using hypnosis, age regression, and other hypnotic techniques, with some positive effect. The author speculates that perhaps the techniques originally used to probe morning recall were not sufficiently sensitive. He also raises the question of whether this waking state amnesia is related to the amnesia for night dreams when people awaken in the morning.
The relationship between hypnotizability and sleep suggestibility was analyzed. Hypnotizability was measured with the Harvard Group Scale, several weeks later, by Experimenters who were blind to the Ss’ rate of responding to suggestions given during sleep. More hypnotizable Ss slept through the verbal stimuli more than low hypnotizable Ss; so they slept longer and more cues could be tested. Ss who responded most frequently to sleep-induced suggestions were more responsive to hypnosis. Analysis of response rate percentage (which controls for higher number of cues administered when Ss slept longer) showed that correlations between sleep suggestibility and hypnotizability were higher for percentage of delayed responses than for percentage of immediate responses.
Analysis by type of item on the hypnotizability scales suggested that the correlation with sleep suggestibility was due to the hallucinatory-reverie and the posthypnotic- dissociative clusters of hypnotic behavior, which are more difficult kinds of items. Correlations were significant for carry-over responses but not for immediate responses. These items represent phenomena experienced by Subjects who can be deeply hypnotized. The author reports that this relationship observed between hypnotizability and response to sleep-induced suggestions was not significant in a later study by Perry et al. (1978).
This author raises a question about why high hypnotizable subjects sleep better than low hypnotizables. The 6 Ss who were least susceptible accounted for 48% of all awakenings that occurred during the 2 experimental nights; the 6 Ss who were most hypnotizable accounted for only 26% of the awakenings (p<.01).
Because sleep learning ("hypnopedia") has been extensively practiced in Russia and Eastern Europe, especially for language learning, the author investigated language learning with nine subjects. (Hoskovec, 1966, and Rubin, 1968, have reviewed the hypnopedia literature, which suggests that only "suggestible" subjects respond; it is not clear whether "suggestible" refers to hypnotizable, or whether expectation of success is cultivated by information given in the waking state.) The nine Ss had responded to the suggestions at least twice while remaining asleep, had no waking recall of the suggestions, but were given pre-sleep instructions (increasing expectancy) that they would learn during sleep.
The verbal association material ("A is for apple; P is for palace;" etc.) was given during EEG sleep stages 2, 4, and REM. (Eight letter-word stimuli pairs were given, two per sleep stage whenever possible.) When they awakened, Ss were asked to check "any familiar word" on a list of 10 words beginning with the letter A, with the letter P, etc. So the probability was .10 for each of the eight lists that they might check one correct word by guessing. They also responded to two dummy lists containing letter-word pairs not used during sleep.
None of the dummy list words were checked, whereas 28% of the administered words were correctly checked; also, Ss selected the correct letter (without identifying the word and with instructions not to "guess") in an additional 17% of all lists. Words were rarely recalled from Stages 2 and 4, but Ss often recognized letters from those stages. False positives (incorrectly recalled words or letters) was almost never observed. Furthermore, no control Subjects (people who had not received a presleep set that they would recall) recalled any words correctly.
It was observed that whenever words presented during REM were later recalled, a transient slower frequency alpha (10.25 Hz vs. 9.64 Hz, p<.01) had been evoked within 30 sec after the presentation of the stimuli during sleep.
Total recall of words correlated with the Harvard Group Scale of Hypnotic Susceptibility .69 and the Stanford individually administered scale .42, for the 7 Ss administered hypnotizability tests.
The author concludes that under optimal conditions, sleep learning of relatively easy material can occur with subsequent waking recall.
Hajek, P.; Jakoubek, B.; Radil, T. (1990). Gradual increase in cutaneous threshold induced by repeated hypnosis of healthy individuals and patients with atopic eczema. Perceptual and Motor Skills, 70, 549-550.
Gradual increase in cutaneous pain threshold was found in healthy subjects and patients with atopic eczema during repeated hypnotic sessions with specific suggestions. This increase was less in the former than in the latter group. Repeated threshold measurements did not influence the threshold. The analgesic effect outlasted the hypnotic sessions by several months. It could be, however, suddenly reduced by appropriate hypnotic suggestion.
NOTES
Cutaneous pain threshold was measured in "time in seconds from onset of heat source of defined size, distance from skin, and temperature, to subjective threshold percept of pain" (p. 549). Used two symmetrical locations on both forearms, at healthy areas of the skin. Ten hypnotic sessions were induced in each S three times weekly, each lasting one hour.
Suggestions were the following type: "The "conduction of switch to the brain is interrupted." Your "immunologic system will digest the damaged skin cells like a shark."
Subjects were 14 healthy subjects and 13 patients with atopic eczema treated for years with the usual medications, unsuccessfully or with complications.
There was gradual increase in cutaneous pain threshold across the 10 sessions, especially for the patient group. Control experiments with repeated threshold measurements in repeated sessions without hypnosis showed no changes.
"Time of increases in cutaneous pain threshold was associated with improvement of atopic eczema. Both effects correlated significantly (r = 0.8) with hypnotizability as measured by the Stanford scale" (pp. 549-550).
"In 9 patients without further hypnotic sessions a slow spontaneous decay of the cutaneous pain threshold was observed during a 17-mo. period. Special experiments performed with six repeatedly hypnotized healthy subjects showing increased thresholds did prove, however, that the cumulative analgesic effect could be reduced to control values immediately by using the hypnotic suggestion that the 'skin sensitivity returns to normal values.'
"These results suggest a close association between hypnosis and activation and/or deactivation of endogenous analgesic systems (irrespectively whether they are of opioid or nonopioid nature)" (p.550)
McNally, Richard J. (1990). Psychological approaches to panic disorder: A review. Psychological Bulletin, 108 (3), 403-419.
Panic disorder has been the subject of considerable research and controversy. Though biological conceptualizations have been predominant, psychological theorists have recently advanced conditioning, personality, and cognitive hypotheses to explain the etiology of panic disorder. The purpose of this article is to provide an empirical and conceptual analysis of these psychological hypotheses. This review covers variants of the "fear-of-fear" construal of panic disorder (i.e., Pavlovian interoceptive conditioning, catastrophic misinterpretation of bodily sensations, anxiety sensitivity), research on predictability (i.e., expectancies) and controllability, and research on information-processing biases believed to underlie the phenomenology of panic. Suggestions for future research are made
Alexieva, A.; Nicolov, N.A. (1989). Brain mechanisms in classical conditioning. Behavioral and Brain Sciences, 12, 137.
NOTES
This is a Commentary on article by J. S. Turkkan (1989), Classical Conditioning: The new hegemony. In Behavioral and Brain Sciences.
Commentators note that the objective of the target article is to show how current thinking about Pavlovian conditioning differs substantially from the historical view; also that this has been recently emphasized by Rescorla (1988). Commentators note that the neural pathways and neural mechanisms involved in Pavlovian conditioning are of great interest and are investigated by many neuroscientists all over the world (Grigoryan & Tchilingaryan 1988; Kositsyn N.S. & Dorochov 1986; Onifer & Durkovic 1988; Storzhuk 1986: Vartanyan & Pirrgov 1986). Commentators also note the work of Ramachandran & Pearce (1987) and Uryvaev Yu.V. et al. (1988).
They express the opinion that Turkkan's review affords a thorough description and interpretation not only of basic data and new conceptual views, but also of certain key notions in the modern theories of Pavlovian associative learning.
1989
Gardner, Beatrix T.; Gardner, Allen R. (1989). Beyond Pavlovian classical conditioning. Behavioral and Brain Sciences, 12, 143-144.
NOTES
This is a commentary on the article by Turkkan (1989) entitled "Classical conditioning: The new hegemony" in Behavioral and Brain Sciences, 12, 121-179. (Pavlov's theory of hypnosis was based on a conditioning model, which is why this material may be relevant.)
"Traditionally, the mechanism of stimulus association proposed by Pavlov early in this century is invoked to account for conditioning that is independent of the positive and negative consequences of responding. ... Pavlov attributed this result to stimulus substitution (i.e., the subject responds to the Sa as if it were the S*) and this has been the dominant view throughout this century" (p. 143).
'In Pavlov's classical procedure, only increases and decreases in the original consummatory or defensive response are counted as conditioned responses. ... Pavlov's classical procedure is only a special case of a much broader case of a phenomena" (p. 143).
"Key-pecking by pigeons and lever-pressing by rats are responses that were long held up as prototypes of arbitrary behaviors that could only be shaped by response- contingent reinforcement. In the autoshaping procedure, however, these same responses have been easily conditioned to an arbitrarily selected stimulus (Sa) when the delivery of food was entirely independent of the response of the subjects. Not only that, but robust rates of responding have been maintained when food was withheld if the pigeons pecked the key or the rats pressed the lever, that is, when the contingency was negative (Williams & Williams 1969)" (p. 143).
"Turkkan follows a grand tradition when she discusses the similarities between associative conditioning and fundamental aspects of human verbal behavior. Yet an essential characteristic of verbal behavior is the difference between the response to an object and the response to a word for the object. The response to the spoken or written word 'apple' must be distinctly different from the response to an actual apple. Whatever we learn when we acquire vocabulary, it cannot be the simple stimulus-stimulus connection advocated in Pavlov's classical theory. Even the popular Rescorla (1967) design for separating stimulus-stimulus contiguity from stimulus-stimulus contingency only succeeds in comparing two sources of stimulus-stimulus association. Meanwhile, the recently discovered autoshaping experiment does offer us a laboratory model in which associative conditioning can result in a response to the Sa that is different from the consummatory response to the S*" (p. 144).
"The theory of stimulus-stimulus association that Pavlov built upon the results of his special procedure is inadequate to deal with the wide range of phenomena of associative conditioning that have been discovered since his time.
"We wholeheartedly agree with Turkkan regarding the enormous theoretical and practical significance of the new discoveries but we are convinced that the terms 'Pavlovian conditioning' and 'classical conditioning' serve us best in their historical usage. ... The new discoveries seem to us to show that a wide range of significant phenomena fall outside the boundary conditions of traditional Pavlovian and Skinnerian theories" (p. 144).
Griffiths, M. D.; Gillett, C. A.; Davies, P. (1989). Hypnotic suppression of conditioned electrodermal responses. Perceptual and Motor Skills, 69, 186.
NOTES
With 5 subjects who had previously been aversively conditioned to a stimulus, during hypnosis previously acquired electrodermal responses were found to be significantly lower than in 12 control Ss. Thus previously conditioned electrodermal responses were suppressed. This contradicts findings of Edmonston (1968) who found that neutral hypnosis does not influence conditioned electrodermal responses and the validity of Pavlov's (1927) conditioning (inhibition) theory of hypnosis.
Holroyd, Jean; Maguen, Ezra (1989). And so to sleep: Hypnotherapy for lagophthalmos. American Journal of Clinical Hypnosis.
ABSTRACT: 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).
1988
Borgeat, Francois; Rezanowicz, Thaddeus; Chaloult, Louis (1988). La stimulation preconsciente et consciente de l'imaginaire erotique. Revue Canadienne de Psychiatrie, 33, 394-398.
The stimulation of erotic fantasies through the association of relaxation and erotic conscious or preconscious suggestions has been evaluated. This study was attempted following positive results in the stimulation of fantasmatic activity in alexithymic subjects with a similar procedure. Thirty female subjects, allocated into three groups practiced relaxation daily for two weeks including three sessions with psychological measures. During the second week, erotic suggestions, preconscious for one group and conscious for another one were added. The third group (control) received only relaxation throughout. Results have shown an increase of sexual arousal and erotic imagery during the sessions with erotic suggestions. Sexual activities and desire increased in the two experimental groups. There was no difference between the effects of the preconscious and conscious suggestions. Possible clinical applications of such a procedure are discussed.
Davies, Peter (1988). Some considerations of the physiological effects of hypnosis. In Heap, Michael (Ed.), Hypnosis: Current clinical, experimental and forensic practices (pp. 61-67). London: Croom Helm Ltd.
NOTES
This chapter reviews literature on physiological correlates of hypnosis, but these notes are limited to only one fact reported in the review. The author writes, 'A recently completed, and as yet unpublished study by C. Gillett and H. D. Griffiths at Bradford University investigated the relation between hypnosis and classical conditioning of psychophysiological responses. In a complex design involving both normal conditioning and normal test trials and a repetition of both acquisition and test trials under hypnosis, they found not only suppression of the conditioned response but also suppression of skin conductance responses to the half-second bursts of a 115-dB tone used as the unconditioned stimulus. Not to produce a significant autonomic response to such an intrinsically aversive stimulus is a remarkable feat which is probably outside the repertoire of simulators. However, even such results are not conclusive as the design did not included simulator control groups nor even neutrally instructed non-hypnotized group' (pp. 64-65 ).
Malone, M.; Strube, M. (1988). Meta-analysis of non-medical treatment for chronic pain. Pain, 34, 231-234.
Conducted a meta-analysis of 109 published studies which assessed the outcome of various nonmedical treatments for chronic pain, 48 of which had sufficient information to calculate effect sizes. The remainder were examined according to proportion of patients rated as improved. Mood and number of subjective symptoms consistently showed greater responses to treatment than did pain intensity, pain duration, or frequency of pain, indicating the importance of using a multidimensional framework for pain assessment. Effect sizes for treatments were 2.74 for autogenic training, 2.67 for hypnosis, 2.23 for pill placebo, 1.33 for package treatments that allowed patients to choose from diverse pain management strategies, .95 for biofeedback, .76 for cognitive therapy, .67 for relaxation, .55 for operant conditioning, and .46 for TENS units. However, the largest numbers of studies were in the area of biofeedback, a treatment package, and relaxation, and we must be cautious in interpreting the effect sizes due to the small number of studies in the sample.
Tsushima, W. T. (1988). Current psychological treatments for stress-related skin disorders. Cutis, 42, 402-404.
Surveys current methods used by psychologists in the management of stress-related skin disorders, including hypnosis, relaxation training, biofeedback, operant conditioning, and cognitive behavioral therapy. These techniques offer promise in the treatment of certain dermatologic conditions, but the limited amount of well-controlled and replicated studies of their use suggests that caution be taken in their application.
Minichiello, William E. (1987). Treatment of hyperhidrosis of amputation site with hypnosis and suggestions involving classical conditioning. International Journal of Psychosomatics, 7-8.
Hyperhidrosis of an amputation site utilizing hypnosis and/or behavioral strategies has not been reported in the literature. This case report is on the successful use of hypnosis utilizing principles of classical conditioning in the treatment of a patient with hyperhidrosis of an amputated limb with two previous unsuccessful sympathectomies. The patient possessing moderate hypnotic ability as measured by the Stanford Hypnotic Clinical Scale (SHCS), reported a pre-treatment score of 10 on a 0-10 severity and intensity of sweating scale, and a post-treatment score of 0. All gains were maintained at the two-year follow-up.
NOTES
The patient was hypnotized while an electric fan was blowing on his stump and prosthesis. Direct suggestions were given according to procedures of thermal biofeedback. The suggestions were: 1. You will notice in days ahead that your stump feels increasingly cooler and drier. 2. You will feel throughout the day as if a cool breeze from a fan is blowing on your stump. 3. Whenever you pay attention to your leg during the day, particularly after the first few hours of the morning, you will associate that leg with a cool dry breeze from a fan blowing on it. 4. You will increasingly develop the power to cool and dry your stump.
The results were that 2 1/2 weeks later patient reported reduced frequency and intensity of sweating and significant healing of the stump ulcers; rating = 2. One month later, patient reported continued progress with almost normal skin color and stump condition; the patient discontinued disability, and returned to work. Patient returned one month later reporting, "It's cured and my physician can't believe it." Rating = 0.
Author concludes that hypnosis should be tried prior to more invasive traditional procedures. In this case two previous sympathectomies failed to correct the condition and a third sympathectomy was being contemplated.
1984
Fogel, Barry S. (1984). The 'sympathetic ear': Case reports of a self-hypnotic approach to chronic pain. American Journal of Clinical Hypnosis, 27 (2), 103-106.
Secondary gain issues may limit the success of hypnotherapeutic approaches to chronic pain. A self-hypnotic suggestion that promotes patients' awareness of the interpersonal aspects of their pain complaints was used in the treatment of two patients with chronic headache. Hypnotic suggestions that help make secondary gains conscious may be a useful addition to hypnotic techniques of pain management.
Kolb, Lawrence C. (1984, October/1986). Comments on post-traumatic stress disorder and dissociation. In Quen, Jacques M. (Ed.), Split minds/split brains (pp. 171-178). New York: New York University Press. (Based on symposium in Bear Mt., N.Y., by Section on the History of Psychiatry of Cornell University Medical Center)
NOTES:
Kolb indicates that people may not be able to overcome the neurological changes consequent upon trauma. In this event, post traumatic stress disorder would have lasting, irremediable effects.
Venturino, Michael (1984, August). Perceptual monitoring and allocation of attention (Dissertation, University of Maine). Dissertation Abstracts International, 45 (2), 707-B.
The processing ability of perceptual monitoring was investigated using a dichotic listening and shadowing task. Individual differences in the effectiveness of perceptual monitoring were also investigated by using susceptibility to hypnosis as a grouping factor. Subjects' skin conductance response (SCR) was conditioned to specific words by an electric shock. These conditioned words, and words semantically and acoustically related to them were presented in the relevant and irrelevant messages of the dichotic listening and shadowing task. Probability and magnitude measures of SCRs and subjects' verbal shadowing accuracy were used to assess performance. SCRs to critical words were significantly greater than to control words in both the relevant and irrelevant messages. However, the SCRs to words in the irrelevant messages were not as great as those responses elicited to words in the relevant message. The pattern of responding to the semantically and acoustically related words was similar for both the relevant and irrelevant messages. Subjects low in hypnotic susceptibility responded to critical words with significantly greater probability and magnitude of response than did subjects high in hypnotic susceptibility. Analysis of the shadowing performance data showed that the perceptual monitoring process was quite effective. The occurrence of the conditioned word in the irrelevant message caused a shift in attention to the irrelevant message, manifested by a shadowing error. Subjects shadowing the message in their left ear committed significantly more shadowing errors than subjects shadowing the message in their right ear. No differences in shadowing performance were obtained for the hypnosis factor. The results were interpreted in terms of the deployment of attention to the environment, and the relationship of this deployment to the perceptual monitoring process" (p. 707).
1983
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.
Hoffman, Mark L. (1982/83). Hypnotic desensitization for the management of anticipatory emesis in chemotherapy. American Journal of Clinical Hypnosis, 25 (2-3), 173-176.
A hypnotic treatment employing systematic desensitization was used to alleviate anticipatory nausea and vomiting in a middle-aged man undergoing chemotherapy for Hodgkin's Disease. After four treatment sessions, all nausea associated with chemotherapy was eliminated. Results of this treatment are compared with those of another hypnotic treatment recently reported by Redd et al (1982), and reasons for differences are discussed. [Redd, W. H., Andersen, G. V. & Minagawa, R. Y. (1982). Hypnotic control of anticipatory emesis in patients receiving cancer chemotherapy. Journal of Consulting and Clinical Psychology, 50, 14-19.]
1982
Redd, William H.; Andrykowski, Michael A. (1982). Behavioral intervention in cancer treatment: Controlling aversion reactions to chemotherapy. Journal of Consulting and Clinical Psychology, 50 (6), 1018-1029.
ABSTRACT: During the protracted course of cancer chemotherapy, approximately 25% of patients develop aversion reactions to treatment by becoming nauseated and/or vomiting before their chemotherapy treatments. This phenomenon has been conceptualized as a result of respondent conditioning. Since commonly used antiemetic drugs do not reliably control anticipatory nausea/emesis, behavioral techniques of control have been studied. They include hypnosis used in conjunction with guided-relaxation imagery, progressive muscle relaxation with guided imagery, and systematic desensitization. (67 ref)
Redd, William H.; Andresen, Graciela V.; Minagawa, Rahn Y. (1982). Hypnotic control of anticipatory emesis in patients receiving cancer chemotherapy. Journal of Consulting and Clinical Psychology, 50 (1), 14-19.
NOTES
Deep muscle relaxation hypnosis controlled nausea, gagging, retching in all cases. Anticipatory emesis recurred when hypnosis was not used. During subsequent sessions in which hypnosis was reinstated, anticipatory emesis was again controlled.
Redd, William H.; Rosenberger, Patricia H.; Hendler, Cobie S. (1982-83). Controlling chemotherapy side effects. American Journal of Clinical Hypnosis, 25 (2-3), 161-172.
Severe nausea and vomiting are commonly experienced by cancer patients after receiving chemotherapy treatments. Moreover, approximately 25% of these patients develop conditioned aversions to treatment and become nauseated before they receive their chemotherapy injections. The use of deep muscle relaxation hypnosis in conjunction with guided imagery to control pre- and post-chemotherapy nausea and emesis is discussed. Theoretical and clinical issues raised by this application of hypnosis in cancer treatment arc also addressed.
Werner, William E. F.; Schauble, Paul G.; Knudson, Marshall S. (1982). An argument for the revival of hypnosis in obstetrics. American Journal of Clinical Hypnosis, 24, 149-171.
Available research, clinical reports, and extensive personal experience demonstrate that hypnosis, and especially the hypnoreflexogenous technique, facilitates the mother's comfort in pregnancy, labor, and delivery; is superior to the use of chemicals or other psychophysical methods as the primary aid in childbirth; and results in lasting benefit for the mother, the child, and the family as a whole. Prior to delivery, with the patient in hypnotic trance, a verbal conditioning technique is used that (1) neutralizes the fear of delivery with a positive emotion that exalts maternity as a sublime experience, (2) substitutes the uterine contraction concept for the pain concept, and (3) presumably lowers the excitability of the cortex by psychological sedation. While hypnosis experienced a temporary decrease in popularity due to a number of misconceptions, there has been renewed and promising application of hypnosis to obstetrics and other areas of medicine.
1979
Clarke, Christopher (1979). Hypnotherapy in the treatment of alcoholism. Australian Journal of Clinical and Experimental Hypnosis, 7 (1), 1-5.
If an aversive technique is used as a part of a hypnotic or behavior therapy treatment programme for problem drinking, the therapist is faced with the question of which aversive stimulus (or image) to use. This question has been given little in the way of systematic attention because of the widespread belief that there are no grounds for choosing between aversive stimuli which are equally safe, convenient and, of course, noxious. However, recent research in behavioural biology as well as certain clinical results call this assumption into question. Instead this work supports the contrary view: that the quality of the aversive stimulus is a crucial determinant of the effectiveness of aversion therapy. Specifically, this research strongly suggests that an illness or "malaise" experience must occur in conjunction with the alcohol for the conditioning (of an aversion) to be successful. Specific suggestions for the conduct of hypnotic aversion therapy are made in light of this work.
1978
Slutsky, Jeffrey; Allen, George J. (1978). Influence of contextual cues on the efficacy of desensitization and a credible placebo in alleviating public speaking anxiety. Journal of Consulting and Clinical Psychology, 46 (1), 119-125.
This investigation was designed to determine the extent to which contextual cues mediated the effectiveness of systematic desensitization and a plausible placebo in alleviating public speaking anxiety. After participating in a public speaking situation that allowed the collection of self-report, physiological, and behavioral manifestations of anxiety, 67 subjects were randomly assigned to receive five sessions of either desensitization, "T scope" therapy, or no treatment. Each of these conditions was conducted in a context that either stressed the clinical relevance of the procedure or presented the procedure as a laboratory investigation of fear without therapeutic implications. Analysis of changes both between groups and within individuals indicated that desensitization reduced public speaking anxiety in both contexts, whereas the placebo was effective only in the therapeutic setting. The superiority of desensitization was most pronounced on the physiological variables. The results are interpreted as indicating support for a counterconditioning, rather than an expectancy, interpretation of desensitization.
1977
Avila, Donald; Nummela, Renate (1977). Transcendental meditation: A psychological interpretation. Journal of Clinical Psychology, 33 (3), 842-844.
The authors suggest that Transcendental Meditation offers a great deal of promise for use in helping relationships. They also suggest that the technique might receive wider acceptance if it could be explained in other than a purely philosophical or mystical way. For that reason, in their article they offer a psychological interpretation of he TM process.
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.
1976
King, Dennis R.; McDonald, Roy D. (1976). Hypnotic susceptibility and verbal conditioning. International Journal of Clinical and Experimental Hypnosis, 24, 29-37.
18 Subjects highly susceptible to hypnosis and 18 Subjects refractory to hypnosis were studied in a verbal conditioning task modeled after the one used by Taffel (1955). Results indicated that the highly susceptible group showed significantly greater conditioning than the low group. Awareness of the reinforcement contingency by S was not related to the learning task nor to hypnotic susceptibility. A measure of S's attitude toward the reinforcement cue during learning showed that the highly susceptible group had a more positive set toward the cue, whereas the low group tended to respond to it in a neutral or negative manner. Results were interpreted in terms of the theoretical nature of hypnotic susceptibility.
NOTES
They review literature on attempts to correlate hypnotizability with verbal conditioning ability.
Volunteer students participated; screened by HGSHS:A: highs 10-12, lows 0-4.
Verbal conditioning procedure: S viewed 100 3x5 cards on which were a two- syllable, past tense verb, below which typed in upper case letters on one line were the pronouns I, WE, HE, SHE, THEY, and YOU (randomly assigned to different orders). E was blind to hypnotizability. E instructed S to make up a sentence using the verb and a pronoun; gave no response for first 20 trials; said "good" to usage of I or WE during conditioning.
Afterwards, S filled in an Awareness Questionnaire (What was purpose? If E gave cues, what were they? If you noticed cues, what do you think they indicated?) and attitude toward the reinforcement cue (Did you notice that I did anything special? What? Did I say "good" for a special reason? What was the reason for my saying "good"? How did hearing the word "good" affect you during the experiment? IN a positive, negative, or neutral way?
Results. Groups did not differ at baseline but did differ at Blocks 2 (highs 9.7 vs lows 6.3; p<.p<.05) and 3 (highs 10.4 vs lows 6.3; p<.05). Although the High group continued to maintain a somewhat higher level of responding than the Low group during extinction (9.8 vs 7.6), this difference did not reach statistical significance. (The graph shows an increase for Lows during extinction!)
Using a liberal definition of awareness and a learning index computed for each S by subtracting his operant level of response from the mean number of correct responses shown during the 3 blocks of acquisition trials, Subjects were ordered and a median test applied; contingency coefficient of .28 not significant (p<.10).
Attitude significantly differentiated High and Low hypnotizability groups (see Table 2) with Highs more often responding in positive manner to reinforcement cue and Lows giving a neutral rating. Awareness of reinforcement contingency was equally represented in High and Low groups. The Aware High Positive groups learning index differed significantly from Aware Low Neutral group (p<.01); the Unaware Low Positive group (p<.05); and the Unaware Low Neutral group (p<.001).
Thus, the Aware High Positive group's learning index score was significantly higher than that of the 3 Low groups. Also, the Unaware High Positive group differed significantly from the Unaware Low Neutral group (p<.05). No other High groups differed from the Low groups and none of the High groups differed among themselves.
Among the Low groups, only the Unaware Low Positive group differed significantly from the Unaware Low Neutral group (p<.05).
Discussion. Data show that hypnotizability is important in response to verbal conditioning, extending findings of Das (1958) by showing that primary suggestibility is associated with operant as well as classical conditioning but also those of Weiss et al. (1960) in illustrating that higher hypnotic susceptibility leads to enhanced verbal conditioning, using an improved measure of hypnotic susceptibility.
Awareness of reinforcement contingencies is not sufficient to account for subject differences in verbal conditioning; the characteristics tapped by HGSHS:A produce conditioning which cannot be accounted for by awareness alone.
The fact that high susceptible Subjects here rated E's cue more positively than low susceptible Subjects is further consistent with some of the personological descriptions associated with hypnotic susceptibility which have been offered by Hilgard (1968). In addition, Cairns and Lewis (1962) and Spielberger et al. (1962) found that persons who assigned more positive value to the kind of reinforcement present in verbal conditioning experiments produced greater conditioning than Subjects whose attitudes were less favorable or non-committal toward the reinforcement. This relationship is not clear-cut in the present data in that although he High groups had an overall more positive attitude regarding reinforcement, only the Aware High Positive group learned better than all the Low groups, while the only other High group learning better than a Low group was the Unaware High Positive which had a significantly better learning index score than the Unaware Low Neutral group. Moreover, positive attitude did not differentiate learning within the High groups or the Low groups. Thus, the present data are unclear regarding the role attitude plays in the acquisition of verbally conditioned responses.
The roles of awareness and attitude could probably be better defined in future research using larger experimental groups. The attitude measure employed here was a gross one and a more sophisticated assessment of the valence characteristics of reinforcement cues could reveal more complex relationships in subsequent research. In addition, a more careful assessment than was done here of the role of cooperation and demand characteristics would contribute substantially to understanding more completely the effect of awareness on these phenomena.
The general indications regarding attitude may in part account for the increased interest in production of conditioned responses in Figure 1 shown by the Low group (graph) during the extinction phase of this experiment. Although highly susceptible Subjects show a decrease in the correct response with nonreinforcement, low susceptible Subjects begin to evidence an increase in the correct response. The attitude measure indicates that Subjects in the Low group did not respond positively to the reinforcement cue, and one of these Subjects reported in the interview that he did not like being told what to do by the E. It can be speculated that these Subjects were aware of the reinforcement contingency but did not "cooperate" until the reinforcement was absent. This follows the interpretation of Farber (1963) who found that aware Subjects who conformed to the demand characteristics of the experimental situation showed greater verbal conditioning than those who were aware and nonconforming. It thus appears that a willingness to go along with E's expectations and a positive, cooperative attitude are common features in individuals who make good hypnotic Subjects and who evidence an enhanced propensity for verbal conditioning.
1975
Bender, V. L.; Navarett, F. J.; Nuttman, D. (1975). Effects of neutral hypnosis on a conditioned physiological response. Psychological Reports, 37, 1155-1160.
The objective of the present experiment was to determine whether hypnosis without explicit suggestion of analgesia would diminish physiological responses to an operationally defined painful shock stimulus. Muscle tension (EMG) was significantly lower during hypnosis than pre- or posthypnosis. Pulse rate remained stable throughout all conditions. Also, the question of whether a tone paired with shock might acquire some unique property because of that association was investigated. It was found that EMG response to the tone alone was significantly greater than to the tone-shock combination, in prehypnosis and posthypnosis, but not during hypnosis.