modify themselves, even if their environments cannot change; and it can be used to increase the self-esteem of clients with disabilities.
1991
Young, M. H.; Montano, R. J.; Goldberg, R. L. (1991). Self-hypnosis, sensory cuing, and response prevention: Decreasing anxiety and improving written output of a preadolescent with learning disabilities. American Journal of Clinical Hypnosis, 34 (2), 129-136.
Divided 64 10.8 – 19.3 yr old emotionally disturbed residents of a treatment school into an experimental and control group matched for age, IQ, and reading ability. Both groups were seen 5 times/week for 6 weeks for tachistoscopic exposures of a subliminal stimulus. The stimulus for the experimental group was the phrase, “Mommy and I are one,” conceived of as activating symbiotic fantasies that in a number of previous studies with varying groups of Ss had led to greater adaptive behavior. The control group was exposed to the phrase, “People are walking.” Results show that experimental Ss manifested significantly greater improvement on the California Achievement Tests– Reading than did the controls. On 5 of 6 secondary variables–arithmetic achievement, self-concept, the handing in of homework assignments, independent classroom functioning, and self-imposed limits on TV viewing–the experimental Ss showed better adaptive functioning. It is suggested that activation of unconscious symbiotic fantasies can increase the effectiveness of counseling and teaching. (42 ref)
1977
Lazar, Billie S. (1977). Hypnotic imagery as a tool in working with a cerebral palsied child. International Journal of Clinical and Experimental Hypnosis, 25 (2), 78-87.
Hypnotic imagery ws used with a moderately severe athetoid cerebral palsied 12-year-old boy who was mildly retarded and a poor hypnotic subject. Techniques included imagery, observation of the self, revivification of relaxing experiences, proprioceptive feedback about the athetoid movements, and dealing with feelings and motivation. Athetoid movements were reduced, results extended beyond the treatment situation, and improvement was made in practical skills.
1964
Falck, Frank J. (1964). Stuttering and hypnosis. International Journal of Clinical and Experimental Hypnosis, 12, 67-74.
Differences of opinion regarding the use of hypnosis in the treatment of stuttering are briefly reviewed. A viewpoint of stuttering is presented, suggesting how this behavior develops and becomes habitual. The requirements of an adequate program of stuttering therapy are listed with the hope that clinicians will be better able to evaluate where particular hypnotherapeutic techniques may be applicable. A plea is made for comprehensive, objective reporting of clinical experiences when hypnotherapy is used in a program of stuttering therapy. (15 ref.) (PsycINFO Database Record (c) 2002 APA, all rights reserved)
1954
Madison, LeRoi (1954). The use of hypnosis in the differential diagnosis of a speech disorder. Journal of Clinical and Experimental Hypnosis, 2 (2), 140-144.
Summary and Conclusions. The case of an eight-and-a-half-year-old boy has been presented to illustrate how hypnosis was used as an aid in the differential diagnosis of a speech defect which presented symptoms of both stuttering and an articulation disorder. The case was diagnosed as primarily an articulation defect. No direct attack was made on the speech blocks other than hypnotic suggestions to relieve tension and some environmental modifications. However, the tonic spasms entirely disappeared within a period of three weeks. This remission plus the rapid strides made in the speech rehabilitation would indicate that the correct diagnosis had been made and as a result an effective plan of therapy instituted.
“It is postulated that hypnosis can be a valuable technique in the diagnosis of speech cases presenting symptoms of several disorders, especially if one of them is stuttering. It is also suggested that hypnosis may be a valuable therapeutic method for treating many cases which present stuttering symptoms” (p. 143-144).
DISSOCATION
1995
Bowers, Kenneth S. (1995, November). Revisiting a Century-Old Freudian Slip — from Suggestion Disavowed to the Truth Repressed. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES: Cites J. Herman, Mason, and Miller who accused Freud of retreating from trauma theory to save his theory. Feminists view the Oedipal theory as a coverup for the denial of child sexual abuse. This moral position fuels trauma theory and practice. It is the moral dimension of this debate that gives so many problems for the investigation of traumatic memory.
The intellectual origins of repressed trauma are examined here. Freud’s early trauma theory, his later conflict theory.
Etiology of Hysteria (1896) presents Freud’s argument, based on 18 patients: child is passive victim of experience imposed on them; memory is repressed and hysterical symptoms are derivatives of these repressed memories; when memories return as pictures the task of therapy is easier than if returning as thoughts. Bartlett’s memory research showed visual image is followed by sense of confidence that surpasses what should be there.
The fact that patients had to be compelled to remember was offered by Freud as evidence against the idea that the memories were suggested. The patients initially would deny the reality of their memories, which Freud used in saying that we should not think that patients would falsely accuse themselves. In letter to Fleiss, he presented the conflict theory, which he presented in 1905 in Three Essays on Sexuality and later in My Views…on Etiology of Neurosis.
In 1905 Freud indicated he was unable to distinguish fantasy from true reports (and did not deny the existence of the latter). Freud often reconstructed the “memories” from dreams, transference, signs, symptoms, fantasies, etc. They were not produced as conscious memories, and it was Freud who inferred the sexual abuse. From signs of distress he took evidence of proof.
Freud presented his theory to his patients and then sought confirmation.
Freud asks us to abandon historical for narrative truth. The problems with Freud’s first theory became worse with his second theory. In Introductory Lectures Freud states that opponents say his treatment talks patients into confirming his theories. He relies on the patient’s inner reality confirming the theoretical ideas given to him. Success depends on overcoming internal resistance, however. The danger in leading a patient astray by suggestion has been exaggerated, because the analyst would have had to not allow the patient to “have his say.” Freud denied strongly ever having done this.
Incorrect interpretations would not be accepted by the patients, and if believed would be suggestion. Brunbaum, another writer, said that this doesn’t mean acceptance of a faulty idea won’t occur. Both Milton Erickson and especially Pierre Janet reported cases in which suggestions were used to give benign memories to replace malignant ones.
Freud also viewed patient resistance to his interpretations as evidence that the interpretations were correct. Thus both resistance and acquiescence were thought to be validating. Popper’s critiques using philosophy of science note that this makes his theory untestable.
Freud could not distinguish between the patient’s reluctant acceptance of the truth and reluctant acceptance of a suggestion.
Contemporary theorists struggle less than Freud did with the problem of suggestion and suggestibility (and Freud did not have available the research on those areas!) Emotional upheaval that accompanies “insight” is readily taken to be validating. It may be true that bad memories are repressed, but that doesn’t mean that all bad memories are true.
Treatment groups focus on recalling memories and sharing memories with others in the group, not on current relationships. Hermann states that the group provides powerful stimulus for remembering. The group, of course, is reinforced by others remembering. Repeatedly considering the possibility of abuse can increase the sense of familiarity.
Current views expressed by some clinicians that certain symptoms and syndromes (eating disorders, etc.) indicate early sexual trauma are similar to Freud’s theory of hysteria. In these proposals, the inability to recall abuse becomes evidence that it occurred; and it tallies with the patient not having a sense of remembering.
Because some believe it is necessary to bring memory to light for cure to occur, there is a tendency to believe the reports of early childhood abuse.
Recognizing that some “memories” may have been a product of a therapist’s suggestion helps prevent untoward effects. Modern therapists recapitulate Freud’s “slip” when they do not acknowledge the role of suggestion.
Endorsing repression does not commit us to a belief that recovered memories must be accurate in all particulars. A memory that is repressed does not escape the usual kinds of degradation of memory.
And just because the material comes from unconscious sources, or has emotional accompaniments, it doesn’t mean it is true. (Bowers gave an example of his dream that Israel and Venezuela shared a common border, which was rectified by his waking awareness of the Atlantic Ocean and the Mediterranean. He noted that nothing like the Atlantic can be called upon if the dream is that one’s parent molested oneself at the age of six.)
Ian Hacking, in Rewriting the Soul, labels a more fundamental indeterminacy (for the historical past itself). Bathing rituals in childhood can be redescribed as abuse, which determines the historical past rather than describing it. It is thus easier to justify abuse if the event is something that can be reinterpreted. For example, the conflicts of adolescents with their parents, may be reinterpreted later if personality problems continue. If in adulthood one concludes that abuse occurred, then bathing rituals can be reinterpreted as if it were earlier abuse, as if the abuse has continued for years.
Eisen, Mitchell L.; Henn-Haase, Clare (1995, November). Memory and suggestibility for events occurring in and out of hypnosis. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES: Resistance to misinformation uses two paradigms: 1. Elizabeth Loftus – expose Subject to slides or videotape, give misinformation with leading or misleading questions 2. Martin Orne – pseudomemory, i.e. age regress people in hypnosis and suggest events occurred.
Each approach yields mixed results. Misinformation is accepted more readily in context of hypnosis; but there is no relationship to hypnotizability. Spanos found that highs were more responsive to social pressure. In general, in the absence of social pressure, when presented subtly and outside the context of hypnosis, the relationship diminishes. Other factors play a more prominent role: source of information, type of information, salience of information, etc.
They examined whether events occurring in context of hypnosis were more prone to distortion when assessed in biased fashion with use of misleading information, than outside hypnosis. Also, form of questions (dichotomous or with ‘I don’t remember’ option).
They gave the Harvard and asked afterwards 3 misleading items (e.g. did you clench your fist, when they didn’t do it). Also asked them to circle items if they had no memory of it. Tellegen Absorption Scale and Dissociation scale (DES) were administered a week later. Also a week later asked about events that occurred, including confederate items. Half of Ss had 2 choices, half had also ‘I don’t remember’ as a third option.
In a previous study, resistance to misleading information was related to the strength of the initial memory and not to hypnotizability (article published in AJCH).
RESULTS. When given 3 choices, the number of misleading items endorsed dropped from .7 to 0.4 which is the most robust finding in the study and affects the rest of the study. Many Ss who endorsed the items reported minutes later that they had no memory for the event (on the check list). While many Ss given only two choices wrote in the margin that the event had never occurred.
Offering an ‘I don’t know’ third option decreased endorsement of the Harvard items also, from 6.4 to 5.2 which is significant. The relationship between hypnotizability and endorsement of misleading items became much weaker when accounting for this.
Scoring high on DES is significantly related to accepting misinformation. Tellegen Absorption Scale also related to accepting misleading information. Harvard Hypnotizability Scale was not related to accepting misinformation.
Total memory on the Harvard (before cue plus after cue) did not correlate with resistance to misleading information. History of abuse was related to hypnotizability. Have to evaluate whether it was traumatizing, multiple abuse, etc.
Eisen, Mitchell L.; Goodman, Gail S.; Qin, Jianjian (1995, November). Child witnesses: Dissociation and memory and suggestibility in abused children. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES: Our study looked at suggestibility and resistance to suggestion. During 5-day hospitalization for investigation of child abuse. The first day patient gets physical exam; 2nd day a genital exam, heart arousal, stress arousal; a later day had mental status, emotional functioning, cognitive functioning–and gross screen of IQ for age 5 and up and the digit span for 6 and up, plus rating of global functioning and provisional diagnosis. On Day 5 each child was given structured interview that included questions about the anal- genital exam, with some misleading questions included.
35 minutes after the psychological examination they were given questions about the exam, for brief memory. Next exam was forensic examination of memory for abuse. Gave memory for sentences, perceptual alterations scale (PAS), adolescent version of Dissociative Experiences Scale (A-DES); gave questionnaire to parents.
Hypotheses: suggestibility would be negatively related to age (more errors when younger). Sexually and physically abused children would show more dissociation or psychopathology. Dissociation or psychopathology should be inversely related to memory ability. IQ should be related to memory and resistance to misinformation. Wanted to reconcile two models of post traumatic stress disorder (PTSD): one says they have poorer memory, and the other says they are hypervigilant.
Over 100 children in the 200 received the questionnaire on Day 5. 39% were 3-5 years old, 41% 6-10 years old. 76% were African American. 22% had no documented abuse or neglect; 13% had experienced physical abuse; 30% sex abuse; 12% both types of abuse; 15% neglect; 8% parental addiction.
Measuring dissociation in kids is problematic. The concept is used to describe a huge range of phenomena. Scores on the DES are more highly correlated with the F Scale on the MMPI than with any other measure (Michael Nash’s research). So the DES measures psychopathology. Also, children have healthy kinds of dissociation– daydreaming, etc. Josephine Hilgard noted that young kids are naturally involved in imagination. Early traumas may lead to this dissociative style. How do we sort out the healthy imaginal involvements of children from the psychopathology? There is not sufficient data at this time.
Available measures are not validated well. The CDC indicates behavior problems in children. The C-PAS conceptualizes dissociation as relating to eating disorders; the A- DES is a self report measure that related to psychopathology.
CDC scores increase, in 3-5 year olds, as the amount of abuse increases. This looks like general psychopathology, and it is a parental rating. The A-DES and C-PAS were not related to abuse or neglect. In the older groups the CDC related to poor performance on memory tests; but only for the 6-10 year olds. (Poorer memories in younger children could have masked the effect in them.)
The main finding for the study was clinician’s estimate of Global Adaptive Functioning was significantly related to Resistance to Misleading Information. The effect did not show for the 3-5 yr old group, perhaps because their memory functioning is poor anyway. Also age was related to memory and suggestibility.
Frischholz, Edward J. (1995, November). A critical evaluation of the 1985 AMA Report on hypnosis and memory. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES
JAMA 1985 concluded that hypnotically refreshed memories are less reliable than nonhypnotic recall. There are two problems with their conclusion: 1. No consensually validated definition of ‘hypnosis’ is identified. They talk about administration of induction, and differences in hypnotic susceptibility. 2. Empirical criteria for discriminating the unique and/or moderating effects attributable to hypnosis are not specified.
For example Loftus showed that memory errors can be created without hypnosis. You should not just add hypnosis to that model.
The criticisms have not led to remedial practices. No research has been done to show how to minimize errors or how to facilitate accuracy.
‘What is Hypnosis?’ Something that is done vs. something that happens? A procedure or responsivity? Questions like this are relevant to research on whether hypnotically refreshed memories are less reliable than ordinary recall.
Hypnosis is not a ‘valid therapeutic modality’ (i.e., ‘hypnotherapy’ is a misnomer). Hypnosis can be used adjunctively with many different types of therapeutic modalities: –psychodynamic therapies –behavior modification treatments –cognitive restructuring strategies –systematic desensitization –flooding –direct suggestion
There is a specious communality: hypnosis is used in a different kind of way with each approach.
If hypnosis is defined in terms of whether an hypnotic induction procedure was administered to the subject, then hypnosis is a universal phenomenon (i.e., everyone can be administered an hypnotic induction procedure). This, in the AMA report, permitted the courts to define it this way, which leads to a number of ridiculous results.
We need to highlight ‘What are the variables that are the source of the errors?’ The sources are not hypnosis. We can minimize the sources by the way we ask questions, instruct the subjects, etc.
If hypnosis is defined in terms of the nature of the subjects’ response to the procedures, then hypnosis is not a universal phenomenon (i.e., there are wide individual differences in hypnotic responsivity). I have shown that it is possible to alter memories, using the Loftus model, in people who are both low and high hypnotizable.
We need to take into account induction procedure, hypnotizability, type of memory, and the retrieval/influence procedure. The demand characteristics re forced responding, expectancies about memory (e.g. video recorder model), expectancies about hypnosis (e.g., everyone remembers) must be accounted for.
Dependent variables in this type of research include memory accuracy, memory errors, and subjective confidence.
Malinoski, Peter; Martin, Daniel F.; Aronoff, Jodi; Lynn, Steven Jay; Gedeon, Scott (1995, November). Hypnotizability, individual differences, and interpersonal pressure to report early childhood memories. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES
Infantile amnesia is attributed to developmental issues before 24 months. This study indicates non-hypnotic influences can shape early memories that cross the amnesia barrier.
227 Ss completed Harvard Scale and personality measures in Session 1. In Session 2 182 completed a suggestibility scale. In Session 3 they were selected, as if independent of earlier sessions – 143 [may have misheard number] Ss.
Interviewers told the selected Ss that they were experiencing something like psychotherapy, and they were asked to recall their earliest memory (independent of photos, what people had told them, etc.) Then Experimenters probed for earlier memories; that continued until Ss denied any more memories after 2 consecutive probes. Then Ss were asked to close their eyes and get in touch with more memories. Then they were told most Ss can remember more, including sometimes their second birthday party. After 1 minute, Ss were asked about memories of their second birthday. Then they were asked to focus on even earlier memories, implying it was expected and receiving complements for reporting earlier memories. Finally, Ss completed a post-study questionnaire.
Memory report was a verbal description of an event, person, or object. Initial memory mean age was 3.7; it correlated with Openness to Experience Scale and with Fantasy Proneness. Mean age of the last earliest memory report before the close eyes instruction was 3.2 years. After receiving visualization instructions, 59% reported a memory of their second birthday. Compliance correlated .33 with this. Subjective response, nonvoluntariness, and [missed words] also correlated.
Compliance scores correlated .28 with at least one memory at or before age 24 months. Yielding to leading questions correlated also with memory for an event at or before 24 months.
Clarity of memories decreased between conditions of initial memory, earliest query, birthday, and earliest memory. Mean confidence rating on 5 point scale for second birthday memory was 3.3; mean confidence rating for earliest memory was 3.6. Mean accuracy rating was 4.0, and 94% said their memory reports were accurate to at least a moderate degree.
The post study questionnaire, totally anonymous, indicated Ss did not feel much pressure to recall (2.9 on scale of 1-5). Only 9.8% indicated they felt a lot of pressure. Subjects also usually denied that they made up memories to satisfy the experimenter. On average, the reports of memory under visualization conditions occurred two years earlier than their first reported memories.
1994
Cardena, Etzel (1994, August). Domain of dissociation. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
NOTES
Dissociation (a French term) exists when two or more mental contents are not integrated. Dissociation includes a wide variety of behaviors and experiences.
Three Concepts: 1. nonconscious or nonintegrated mental models or processes 2. alteration in consciousness when disconnection from self or environment is experienced 3. defense mechanism
Explanation of these three concepts:
1. Within nonconscious or nonintegrated mental models/processes there are three types: (a) absence of conscious awareness of impinging stimuli or ongoing behaviors (broad, vague, not useful, because we are unaware of physiological processes most of the time) (b) co-existence of separate mental systems or identities that should be integrated (Meyers, 1903, said the memorability of an act is better proof of consciousness than its complexity). Examples: dissociative amnesia (Walter Reed Hospital patient); or in hypnosis telling a person that their hand is going to begin raising on its own (c) ongoing behavior that is inconsistent with person’s verbal report. May be part of #2. Example: commisurotomized patients – woman who wanted to smoke couldn’t get her hand to lift cigarette to her mouth. Example of student, being criticized, breaking out into a rash while saying that she felt calm.
Often repression and dissociation are confused. When dissociation is used as in (c) above, they are indistinct; they are the same. Freud used the terms for the same thing. When we talk about a dissociated memory, it is same as repression.
2. Alteration in consciousness (disconnection from the self or environment is experienced). In this case we talk about an experiential event. Caveats: Some use it to refer to *any* kind of alteration of consciousness. Braun, 1993, reported that mystical experiences are dissociative; I maintain that many people feel most in contact with the self during mystical experience. Same with drugs: it may not involve primarily separation, disengagement, from self or environment. As you listen to me, you may disengage at times. I think the only legitimate use of “dissociation” is a radical alteration of consciousness; like Tart’s altered states of consciousness, like out-of-body experiences. In clinical situation, distraction or dreaminess is usual; but if a patient disengages and starts reliving a situation, it is legitimately regarded as dissociation.
3. Defense mechanism – a theoretical construct, referring to intentional disavowing things that would cause anxiety or pain. Clinical observations of people in traumatic events, rape, people may have out of body experiences; explained as the person sending the ego somewhere else because they can’t bear the pain. But, you get this separation in non-traumatic circumstances (in meditation, revery, etc.)
Alternative Paradigm:
Janet’s theory which explains cognitively how dissociation occurs, without necessarily proposing an intentional process.
For further elaboration of these comments, see Cardena, E. (1994). The domain of dissociation. In S. J. Lynn & J. W. Rhue (Eds.) Dissociation: Clinical and Theoretical Perspectives. New York: Guilford Press
Csoli, Karen; Ramsay, Jason T.; Spanos, Nicholas P. (1994, August). Psychological correlates of the out-of-body experiences–a reexamination. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
NOTES
12% of population reports an out-of-body experience (OBE) sometime in their lives. They leave their body and can see self from the outside. Awareness is confined to the new point of view, not fragmented; there is unimpaired intellectual ability; feelings of detachment, completeness, well being, and profound relaxation. Can occur under stress or deep relaxation; not while driving a car.
Psychological correlates aren’t known. Studies are inconclusive with respect to belief systems (religious, death anxiety, etc.); measures of absorption, hypnosis, imaginative ability, imagery controls. Recent Carlton study with 87 Ss (33 had OBE) got results we didn’t expect. They completed questionnaires, were tested for hypnotizability, had an interview re OBE experience.
This study found the OBE-experiencing people had higher levels of anxiety, psychosomatic symptoms, and panic attacks. They were also higher on magical thinking, perceptual aberration, and Schizophrenia scores. They didn’t differ on mysticism, levels of drug or alcohol use, or level of self esteem.
Frankel, Fred H. (1994, October). On patients remembering abuse when it in fact may not have occurred. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES:
The concept of hidden memories has supported the profession of psychotherapy for a century. This process can only occur if there is a mechanism to support it. Bowers says, if memory is not reliably accurate, it is not reliably inaccurate either.
“Ideas passing as descriptions lead us to equate the tentative with [the factual.]” – Gould.
Three studies purporting to establish repression: 1. Briere & Comte sampled 450 adults who reported abuse. They asked, “Was there ever a time when you couldn’t remember the forced experience?” How does respondent understand the question? Clients were all in therapy. 2. Herman and Schatzow (1989) “verification of abuse” study. 53 Ss in a survivor’s group. Reports percentages who had no or little recall. Authors don’t acknowledge that the group discussion and the attitude of therapist may have shaped the response. It is also not clear how many Ss who claimed to have “verified” their accounts were among those who had severe amnesia for the event. They could be Ss who had never lost the memory in the first place. 3. Williams interviewed women who earlier were in Emergency Rooms because of abuse being suspected. 38% did not report childhood abuse when questioned, and author concluded it was due to repression. Significant numbers of adults cannot remember things even past the age of 5.
Problem with wording of questions. Some of the women interviewed might have preferred not to report the event. This was not investigated in the study.
Frankel, Fred H. (1994, October). Working with the concept in a clinical setting. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES:
I have concerns about the construction of the Diagnostic and Statistical Manual (DSM) as a whole. It was initially a research document, but it has come to dominate clinical diagnostic practice, and worse, it governs what treatment third party payers will compensate.
Dissociative Identity Disorder (DID) to replace Multiple Personality Disorder (MPD) may well change the way the condition is viewed, and we may see fewer alters in each person.
I have difficulty understanding the precise nature of dissociation–especially with its powers to produce amnesia. The dissociative disorders are part of the legacy of hysteria; though some parts of hysteria are represented in other DSM categories. The influence of environmental factors and imagination were suspected when the diagnosis was hysteria; everyone knew the picture was complicated, and subject to contagion, etc. The DSM makes little attempt to take that into account in the section on Dissociative Disorder.
Questions we must address: 1. How voluntary is clinical dissociation? To what extent can we expect the patient to claim agency for it, e.g. if it is claimed that a crime was committed by an alter? 2. To what extent does the clinical manifestation of dissociation overlap with absorption and attention? 3. How does morbid preoccupation with images differ from regression? How much is the patient the willing agent of that kind of behavior? 4. To what extent are flashbacks remembering or imaginings? 5. How do we control for contagion or imitation on the dissociative disorder inpatient units? 6. Could we be creating things to fit our theories? 7. Are other diagnoses being displaced here? The dissociative disorders being put on center stage may lead us to do disservice to the patient in dealing with their other life crisis. 8. If the shock of the trauma is associated with impaired perception, altered attention, and memory problems, how dependable are the reports that are ultimately retrieved–perhaps decades later? 9. What do we in truth understand by the word dissociation? Is it a psychological event with underlying physiology, or just a metaphor?
Psychiatry is subject to diseases rising and falling, e.g. the disappearance of hysteria itself.
Freeman, R.; Barabasz, A.; Barabasz, M. (1994, October). EEG topographic differences between dissociation and distraction during cold pressor pain in high and low hypnotizables. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES:
Hilgard once said we should study what is going on inside the skull when we study hypnotic behavior. Theta EEG was studied, in 3.5 and 5.5-7.5 band widths, based on Crawford’s research (no differences between high and low hypnotizables in low range but significant differences in waking state, eyes closed condition).
Also employed new type of distraction procedure. Previously used as comparison conditions things like imagine a pleasant scene, do whatever you can do to reduce pain, or imagine an instructor giving a lecture. Barabasz theorized that highs, given the opportunity, may spontaneously get involved in imagery; so distraction used in some experiments may actually become hypnosis. Here, distraction involved using a storage box, with plexiglass covering front, and 3 lights–subjects were to recall sequence of light changes that occurred during 60 sec when arm was in the cold water.
Cold pressor pain. 3 immersions with simultaneous pain reporting and EEG monitoring. –Waking State –Light array distraction –Hypnotic induction and suggested analgesia (Distraction and hypnosis with analgesia were presented in a balanced design)
Pain Ratings ranged from 0 = no pain, 10 = level would very much like to remove arm from water (rating could exceed 10 however). After removing arm, subjects were to report the maximum amount of pain that they had felt. Pain Scores were obtained at 30 seconds and 60 seconds after immersion in the cold water.
Also got qualitative data. During recovery period after each arm immersion, Subjects were asked what if anything they had done to reduce the pain felt.
30 second pain scores: Waking 7.60 vs 7.50 Distraction 8.60 vs 6.80 Hypnotic analgesia 7.80 vs 4.10 (Significantly different).
60 second pain scores: Showed same trend
There was no difference whatsoever for the lows.
Results for the 2 EEG sites: P3 left hemisphere parietal in waking and hypnotic analgesia, high theta, had significantly different activity O1 left hemisphere in waking and hypnotic analgesia, was significantly different between highs and lows (same as above).
Results for two theta ranges: Low theta range, T4 temporal right hemisphere, for lows in waking and [missed words] condition–hard to interpret this finding.
RESULTS. Highs demonstrated pain reduction in hypnotic analgesia compared to waking and distraction conditions and compared to lows. Lows had no differences in any condition.
Enhanced EEG theta in left parietal area differentiated highs and lows. This suggests that highs generate enhanced disattention that may be controlled by these areas.
P3 area regulates the integration and association of somatic perceptions. The O1 area controls processing of visual imagery. Perhaps high hypnotizables have more ability to alter afferent sensory information through focused attentional processes. Also, the ability to alter the suffering portion of pain experience may involve visual imagery activity.
State and trait differences are apparent.
The low theta range may be more closely related to slower delta range 0-3.5 that is associated with sleep and drowsiness. High theta = low arousal and attention capacity. That’s why theta seems associated with wide range of behaviors that appear contradictory
The qualitative data shows highs reported they spontaneously preferred strategies that were more than distraction (associating colors with warmth, thinking of warm water) and the most frequent responses of lows were “nothing” or “told myself it would be over soon.”
Highs in analgesia condition used no specific strategy: 8/10 reported the arm simply felt more numb.
Freyd, Jennifer J. (1994). Betrayal-trauma: Traumatic amnesia as an adaptive response to childhood abuse. Ethics and Behavior, 4.
Betrayal-trauma theory suggests that psychogenic amnesia is an adaptive response to childhood abuse. When a parent or other powerful figure violates a fundamental ethic of human relationships, victims may need to remain unaware of the trauma not to reduce suffering but rather to promote survival. Amnesia enables the child to maintain an attachment with a figure vital to survival, development, and thriving. Analysis of evolutionary pressures, mental modules, social cognitions, and developmental needs suggests that the degree to which the most fundamental human ethics are violated can influence the nature, form, processes, and responses to trauma.
NOTES
A logical extension of this research direction, based on a strategy that has been very effective in cognitive neuroscience, would be to look for neuroanatomical underpinnings of the cognitive mechanisms implicated in dissociation. … For instance, the ability to dissociate current experience may depend partly on representational structures that support spontaneous perceptual transformations of incoming events. One possible perceptual transformation that is amenable to scientific investigation, would be the creation of spatial representations in which the mental ‘observer’ is spatially distinct from the real body of that observer. Such a representation would fit patient descriptions of ‘leaving their body’ during a traumatic episode and viewing the scene as if from afar. Additionally one could investigate the role of mental recoding and restructuring during memory ‘recovery’ and psychotherapy” (pp. 19-20).
Ganaway, George K. (1994, October). The thin line: Reality and fantasy in hypnotically facilitated memory retrieval during psychotherapy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES
Historical review: Every hundred years there has been a peak in interest in altered states–a fin de ciecle zeitgeist. It is the Brigadoon effect, i.e. something materializing for one day every 100 years. The theories developed then suffer from “paradigm grandiosity.” In hypnosis, we can refer back to:
1694 Salem witch trials
1790s Gaussner’s exorcism (see Ellenberger); in a 1775 showdown between him and Mesmer, there occurred the turning point between exorcism and psychotherapy.
1880s Charcot at Salpetrier ‘demonstrated’ that hypnosis was an organic, pathological condition. Ultimately this contributed information about the plasticity of hypnotized people. (In the 1880s Bernheim thought it wasn’t pathological and thought that suggestion was the important element in hypnosis.)
Recent historical contributions have influenced our views of MPD. Spiegel and Kardiner published book about hypnosis and war neuroses. Cheek & LeCron developed ideomotor questioning, which ignores the contribution of unconscious fantasy. Jacob Arlow’s metaphor for MPD is two movie projectors aiming at a screen from two different sides. The subjectively known experiential world thereby combines external reality and the person’s internal, motivated perceptions. The author presented a case study of female therapist, who had been previously diagnosed as MPD, who presented with dissociative symptoms that she thought were due to abuse by her grandmother. She fabricated the memories in order to get the holding and physical nurturing from her therapist for being courageous and remembering the abuse.
Maintenance of professional boundaries is very important in treatment.
Kihlstrom, John F.; Glisky, M. L.; Angiulo, M. J. (1994). Dissociative tendencies and dissociative disorders. Journal of Abnormal Psychology, 103, 117-124.
Although dissociative disorders are relatively rare, dissociative experiences are rather common in everyday life. Dissociative tendencies appear to be modestly related to other dimensions of personality, such as hypnotizability, absorption, some facets of openness to experience, and quite modestly to fantasy proneness. These dispositional variables may constitute diatheses, or risk factors, for dissociative psychopathology, but more complex models relating personality to psychopathology may be more appropriate. The dissociative disorders raise fundamental questions about the nature of self and identity and the role of consciousness and autobiographical memory in the continuity of personality.
Lynn, Steven Jay (1994, October). Toward an integrative theory of hypnosis. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
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This is a re-evaluation of neodissociation and cognitive models of hypnosis, and an attempt to be integrative. This paper focuses more on ideomotor behaviors but we will extend the model to other hypnotic behaviors in the future.
Automaticity of behavior in hypnosis can be accounted for without using a concept of divided consciousness or weakened consciousness. Parapraxes (doing one behavior while intending another) are not instances of decreased control of behavior, but relate to where attention is drawn. This requires a different use of the hierarchy concept from Hilgard’s model (which in turn comes from Hull’s concept of habit hierarchy).
Here hierarchy is a concept drawn from Miller, Galanter, & Pribram: acts are comprised of molecular units, that are comprised of even more molecular units. Behavior only needs to be processed at an executive level when unusual events occur. But one or more hierarchies may be set into motion at the same time. Dissociation is not an infrequent event. Behavior is controlled by subroutines rather than by an executive control structure; subroutines operate in parallel rather than in a hierarchy. Parapraxes are due to an overlap between two subfunctions.
Parapraxes are different from ideomotor responses, where we pay close attention and involuntariness is reported not just post facto but as part of the experience.
Malinoski, Peter; Aronoff, Jodi; Lynn, Steven J.; Moretsky, Michael (1994, August). Hypnosis and early memories. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
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We studied autobiographical memory in the college population, as manifested in the therapy situation, as a way of investigating an individual difference variable. Most people do not have recall before age 3 or 4 (and probably infantile amnesia begins before age 2).
Administered Autobiographical Memory Scale (AMS), and later in context of a hypnosis scale. 247 students were in phase 1, conducted as two separate experiments so that Ss wouldn’t link the AMS to measures used in the second study.
First study was presented as a study of personal memories. Asked Ss to distinguish first five birthdays, circumstances around loss of first tooth, first day of high school. Also, they were asked about their earliest memory events, rated according to 3 scales (detail, vividness, accuracy of recall). Authors summed Ss’ responses on these 3 ratings for the 8 item scale.
Part II. Administered various scales: Life Experiences, Fantasy Proneness, Wilson & Barber’s scale, Imagery Control Scale, Global Psychopathology, 25 item scale of physical and sexual abuse, Brier’s list of symptoms of abuse, and DES (Dissociative Experiences Scale). Imbedded were 12 items to test carelessness in responding (e.g. “I have never said Hello to anyone who wore eyeglasses.”)
RESULTS. Phase 1. Two people indicated they had memories dating to before their first birthday; an additional 5% of Ss gave memories between 12-24 months. This would probably be impossible. Another 14.4% described events between 24-36 months; 37.4% said their earliest memory was at age 3. Mean age for earliest memory was 3.4 years (which agrees with other surveys.) Only l subject stated his earliest memory was as late as the tenth year of life.
High intercorrelation was obtained, ranging .79 to .89, between ratings on any of the memory event ratings (as detailed, vivid, or accurate). There was a negative correlation of these ratings with age of recall. Ss who report more detail, vividness, and competence, were also likely to report earlier first memories.
Authors divided Ss into three groups based on age of first memory: 12 with first memory earlier than first year; those whose first memory was between 1-7 years; and those with a later first memory. The earlier memory group were more fantasy prone; and rated their memories as more reliable, vivid. This suggests there are persons who report memories that are covered by infantile amnesia, report them with greater detail, and are more fantasy prone than those who report memory events beginning later in life. This is consistent with Wilson & Barber’s finding that fantasy prone people have vivid recall of early childhood events.
None of the memory reports correlated with psychopathology or dissociation. Dissociation (DES) was correlated with abuse indicators, however. Compared top and lowest 10% and middle range on DES on their memory scores and found no relationship. There was no support for the idea that report of early life events in dissociative people is compromised. Failure to recall early memories shouldn’t suggest that people are dissociative (which some therapists tend to do).
All three memory measures were associated with Harvard Scale scores. The AMS was administered at the same time as the Harvard. Objective responding on the Harvard correlated with detail, vividness, and accuracy of recall. Also, involuntariness of response correlated with all 3 measures of the AMS. Finally, subjective involvement correlated with all three measures of AMS. At least when hypnosis is measured first, and explicit connection is suggested, there is a connection. Further research is needed to see if the relationship holds when measured in independent contexts. This may explain why High Hypnotizables are more prone to pseudo memories and leading questions. They may come to confuse them with historical reality.
The results suggest caution for early memory reports. They may be vulnerable to confusing fantasy and reality, as well as to biasing effects.
Marmar, Charles (1994, October). Peritraumatic dissociation and PTSD. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
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