Ganaway, George K. (1989). Historical versus narrative truth: Clarifying the role of exogenous trauma in the etiology of MPD and its variants. Dissociation, 2, 205-220.

The author notes a current trend toward viewing multiple personality disorder (MPD) and its variants as a form of chronic post-traumatic stress disorder based solely on exogenous childhood trauma, and cautions against prematurely reductionistic hypotheses. He focuses on Kluft’s Third Etiological Factor, which includes the various developmental, biological, interpersonal, sociocultural, and psychodynamic shaping influences and substrates that determine the form taken by the dissociative defense. He hypothesizes a credibility continuum of childhood and contemporary memories arising primarily from exogenous trauma at one end, and endogenous trauma (stemming from intrapsychic adaptational needs) at the other. The author offers alternative multidetermined explanations for certain unverified trauma memories that currently are being accepted and validated as factual experiences by many therapists. He describes some potentially deleterious effects of validating unverified trauma memories during psychotherapy, and recommends that the MPD patients’ need for unconditional credibility be responded to in the same manner as other transference-generated productions.

Matheson, George; Shu, Karen L.; Bart, Catherine (1989). A validation study of a short-form hypnotic-experience questionnaire and its relationship to hypnotizability. American Journal of Clinical Hypnosis, 32, 17-26.

Investigated the validity of a 16-item scale inquiring about hypnotic experience, drawn from the Hypnotic Experience Questionnaire developed by Kelly (1985) to measure components of hypnotic experience. We administered the HEQ-S and the Harvard Group Scale of Hypnotic Susceptibility: Form A (HGSHS:A) to 198 students. Factor analysis of the scale produced three stable principal components accounting for 70% of the data variance: Dissociation/Altered State (DAS), Rapport (RAP), and Relaxation (REL). Subscales representing these three factors and a composite measure, “General Depth,” were constructed. Subscale correlations with HGSHS:A scores were highest for the DAS subscale (.69) and lowest for REL (.41). Applications of the HEQ-S in clinical and research use are considered.
Using the phenomenological studies and theories of J. R. Hilgard (1979) and Shor (1962), Kelly (1985) constructed the Hypnotic Experience Questionnaire (HEQ), a 47- item scale designed to demonstrate the existence of five factors of the hypnotic experience. These factors included dissociation/altered state, relaxation, rapport, visual imagery, and a negatively correlated factor of cognitive rumination measuring the amount of anxious self-reflective, and interfering thought. A composite scale, General Depth, was also derived to provide a summary measure of the subjective quality of the hypnotic experience. The HEQ was developed as a research instrument.
The HEQ-S was administered immediately after Ss completed the Harvard response record. Items were responded to on a 5-point Likert scale ranging form one (No, none or not at all) to 5 (Yes, a great deal, or almost completely).

Chu, James A. (1988). Some aspects of resistance in the treatment of multiple personality disorder. Dissociation, 1, 34-38.

Therapists who treat patients with MPD commonly experience discomfort and frustration. This paper contends that the most significant cause of therapist discomfort is the particular resistances encountered in the treatment of MPD. In MPD, etiologic childhood traumatic experiences are defensively repressed and dissociated. In addition, the normal ability to engage in trusting interpersonal relationships is disrupted. Thus, a psychotherapy which requires the retrieval of past traumas in the context of an interpersonal therapeutic relationship is tremendously threatening to the patient with MPD. In the normal course of the psychotherapy of MPD, intense resistances are encountered at every stage. This paper outlines the nature of resistance in the treatment of MPD patients, presents clinical examples, and discusses the importance of understanding and working with resistance as an intrinsic part of the treatment.

Chu, James A. (1988). Ten traps for therapists in the treatment of trauma survivors. Dissociation, 1, 24-32.

Patients who have survived trauma, particularly those who have experienced early childhood abuse, stand out in the clinical experience of many therapists as being among the most difficult patients to treat. These patients have particular patterns of relatedness, along with intense neediness and dependency which make them superb testers of the abilities of their therapists. They often push therapists to examine the rationales and limits of their therapeutic abilities, and frequently force therapists to examine their own personal issues and ethical beliefs. A conceptual framework for understanding treatment traps is presented, along with 10 traps which these patients present, consciously and unconsciously, in the course of treatment. Included are traps around trust, distance, boundaries, limits, responsibility, control, denial, projection, idealization, and motivation.

Gorassini, Donald R.; Hooper, Cynthia L.; Kitching, Kathleen J. (1988). The active participation of highly susceptible hypnotic subjects in generating their hypnotic experiences. Imagination, Cognition and Personality, 7 (3), 215-226.

Hypnotized individuals have traditionally been considered to be detached from the control of their own suggested behavior. We tested this and the alternative notion that hypnotized subjects attempt to self-generate the experiences (i.e., mainly of involuntariness) as well as produce the behaviors thought to be prototypical of high hypnotic ability. In an experimental investigation, highly susceptible hypnotic subjects were found to engage in the kind of imaginative activity that would be expected of individuals who were attempting deliberately to generate their experiences of involuntariness; they engaged as actively in imagery-generation as did subjects who were specifically instructed to imagine during suggested responding, and they experienced as much involuntariness as subjects in whom suggested movements were produced by an external physical force. The implications of these findings for the neodissociation and social psychological theories of hypnotic responding are discussed.

Greaves, G. B. (1988). Common errors in the treatment of multiple personality disorder. Dissociation, 1, 61-66.

Psychotherapists report widely different experiences in their attempts at treating multiple personality disorder (MPD) patients. Some have deepened their interests and developed full-time specialized practices with this clinical population. Others have declined to have any further contact with them at all, referring possible MPD patients to colleagues when they first suspect that this disorder may be present. Still others have decided against treating more than one or two MPD patients. These diverse decisions are examined with a focus upon the effects of therapists’ uneven attention to the formal properties of the dyadic psychotherapeutic experiences as a possible influence upon their future work with MPD. Problems concerning the framework of psychotherapy and the countertransference conflicts which often move the therapist unconsciously and irrationally to alter the canons of psychotherapy in mutually detrimental ways appear to be crucial determinants.

Kluft, R. P. (1988). The phenomenology and treatment of extremely complex multiple personality disorder. Dissociation, 1, 47-58.

Contemporary reports indicate that the average number of personalities in recently reported patients with MPD is larger than that reported in the older literature. A minority of these recent patients demonstrate extreme complexity. A group of 26 patients with 26 or more personalities and under observation for a minimum of 3 years was studied. Their presentations, the reasons that appeared to underlie their complexity, and their courses of treatment are reviewed. Findings indicate that this group of patients is diverse, with some proving readily treatable, and others proving quite refractory. Observations that appear constructive for the treatment of such patients are offered. The concept of personality is discussed and an alternative description is explored. The usefulness of the paradigms and metaphors of splitting and division as heuristics for the understanding of MPD is challenged, and a paradigm/metaphor of redoubling and reconfiguration is offered for further study.

Loewenstein, R. J.; Putnam, F. W. (1988). A comparison study of dissociative symptoms in patients with complex partial seizures, MPD, and posttraumatic stress disorder. Dissociation, 1, 17-23.

Depersonalization and dissociative symptoms have been widely reported in chronic seizure disorder patients, especially those with temporal lobe involvement and complex partial seizures (CPS). It has been theorized that development of multiple personality disorder may be related to temporal lobe pathology. We administered the Dissociative Experiences Scale (DES) to 12 male patients with severe chronic epilepsy, primarily of the complex partial type. Patients had epilepsy from 1 to 30 years. Most were being evaluated for intractable seizures occurring several times per week. DES data on the epileptic patients were compared with DES data on 9 male MPD patients and 39 PTSD patients. MPD and PTSD patients were significantly different from CPS patients in median DES scores and all DES subscale scores. MPD and PTSD patients were far more similar on the DES, although MPD patients had a significantly higher score on the dissociation/psychogenic amnesia subscale of the DES. The authors conclude that there is little data to support a relationship between MPD, dissociation, and epilepsy.

Pettinati, Helen M. (1988). Hypnosis and memory. New York and London: Guilford Press.

From a review in British Journal of Experimental and Clinical Hypnosis, 7, 175- 178, by Vernon H. Gregg]:
Book has 5 sections: 1. method, theory 2. mechanisms of memory enhancement 3. hypnotic and other forms of reversible amnesia 4. clinical uses of hypnosis for increasing accessibility of memories and fantasies 5. Summary
The chapter by Martin Orne et al presents a comprehensive review. Perry, Lawrence, d’Eon and Tallant contribute a lively assessment of age regression procedures in the elicitation of inaccessible memories. They provide a description of procedures, a brief historical review, and discuss problems of confabulation and creation of pseudomemories. Their account is illustrated by clinical and forensic examples and gives an interesting account of belief in reincarnation in terms of source amnesia.
Section 3 has Hollander’s chapter on hysteria and memory, which illustrates the concept of reversibility of amnesia with two types of hysterical conditions: one of these types, the dissociative disorders, has the potential for amnesia to be reversed but the other, histrionic personality disorders, is characterized by no reversibility.
In the section on clinical studies of memory enhancement Frankel and Kolb both accept that uncovering repressed memories and fantasies is therapeutically beneficial and that the faithfulness of recovered memories is often not important for therapeutic success. Frankel illustrates the usefulness of hypnosis with several case studies. But he thinks that clinical issues are dealt with too briefly in this book. In her summary chapter Pettinati points to the dearth of systematic research into the effectiveness of hypnosis in clinical settings.

Bandura, A.; O’Leary, A.; Taylor, C. B.; Gauthier, J.; Gossard, D. (1987). Perceived self-efficacy and pain control: Opioid and non-opioid mechanisms. Journal of Personality and Social Psychology, 53, 563-571.

Subjects who were trained to use psychological coping strategies (e.g. imagery, distraction, dissociation, sensation transformation) had both better pain tolerance on a cold pressor test and higher self efficacy ratings. Those subjects who were given naloxone (which blocks pain reduction effects of beta endorphins) showed more pain tolerance than subjects not given the cognitive training experiences. They attributed much of the pain tolerance increase associated with cognitive interventions to opiate release, suggesting that cognitive interventions may have physiological mediating effects on pain perception.

Gorassini, Donald R. (1987). Use of concurrent verbalization to assess the dissociation of conscious controls. Journal of Abnormal Psychology, 96 (3), 218-222.

The degree of dissociation of conscious controls that occurred when, according to the neodissociation theory (Hilgard, 1977, 1979), conditions were optimal for such an event was assessed. A task that required subjects to locate specified sentences in a textbook was conducted under these optimal conditions, as well as under conditions that were expected to mitigate against the occurrence of dissociation. The sentence- search task necessitated rehearsal for its successful completion The correspondence between task rehearsal and task performance did not differ between optimal and mitigating conditions, thus suggesting a failure to dissociate. Nevertheless, search behavior was self- rated as substantially more involuntary under the optimal than under the mitigating conditions. The implications of these findings for the neodissociation and social role theories of hypnosis were discussed.

Hilgard, Ernest R. (1987). Research advances in hypnosis: Issues and methods. International Journal of Clinical and Experimental Hypnosis, 35, 248-264.

There are substantial areas of agreement upon the classical phenomena of hypnosis, illustrated by what we now have learned about hypnotic talent, amnesia, hallucinations, analgesia, and dissociative processes. While genuine advances in knowledge about hypnosis have been made in recent decades, differing orienting attitudes have kept some controversy alive, particularly in the interpretation of empirical findings. Differences of interpretation of the phenomenal and behavioral facts are to be expected in the present stage of developmental, cognitive, and social psychology.

The author writes of the “domain of hypnosis” as within the larger domain of social psychology (because it is usually interpersonal); cognitive psychology (because of alterations in perception, imagination, memory, and thought); developmental and personality psychology (because of individual differences); and physiological psychology (because of neurophysiological aspects).
In terms of what we know about hypnotic talent, he notes that high hypnotizability is not generally associated with psychopathology; that it may however be associated with a personality measure called absorption; and that there may be some inherited ability (Morgan, 1973). In the author’s view, hypnosis is no longer considered simply a response to suggestion, since imagination and/or fantasy are very important.
In reviewing evidence of posthypnotic amnesia the author writes, “Subtleties in language require making careful distinctions among concepts such as compliance, suggestion, compulsivity, belief, self-deception, automaticity, the voluntary, the involuntary, and a happening. If these distinctions are glossed over, the choice of words (e.g., substituting compliance for response to suggestion) may give the impression that a finding departs more widely from conventional views than it does. We, too, have found that Ss used varied strategies or skills during amnesia, but this need not deny augmentation by suggestion.
“It takes genuinely high Ss to illustrate truly high posthypnotic amnesia… Many of the truly high hypnotizable individuals cannot break amnesia, no matter how hard they try” (p. 253).
Regarding the evidence for hypnotic hallucinations and trance logic, the author suggests that trance logic is not a clear concept because the Subject is capable of good logic while tolerating some inconsistencies. “It is ordinary logic to assume that if your hallucination is your own construction, it is you who can influence it by your own wishes. In the rare cases of transparent or diaphanous hallucinations there is still an ‘out there’ quality. People who report that they see wispy ghosts also see them as ‘out there,’ so that they qualify as hallucinations. The distinction appears to be one of perception and perception-like experiences within hypnosis rather than of logic” (p. 256).
In reviewing the evidence for hypnotic analgesia, the author acknowledges that pain relief is available with other kinds of interventions, or by using other kinds of psychological processes, but that does not diminish the contribution of hypnosis (which has a long and impressive clinical history). Following laboratory studies, it is noted that “the amount of alleviation of pain through hypnosis is positively correlated with the hypnotizability of the candidate for pain reduction. This result is not universally accepted, because some clinicians are convinced that those unsuccessful in hypnotic pain reduction are resisting hypnosis” (p. 256-257). In the present paper he acknowledges but does not review physiological literature on hypnoanalgesia.
Regarding the concept of dissociation, the author indicates that he considers it a more useful concept than the concept of trance or hypnotic state “when a person is only slightly or moderately involved in hypnosis … . The advantage is that dissociations, as compared with altered states, can be described according to limited or more pervasive changes in the cognitive or motor systems that are being activated or distorted through suggestion in the context of hypnosis. Perhaps when all-inclusive enough, such changes can justify the use of the term trance or altered state, but I believe that these terms should be used, if at all, only for those for whom the immersion in the hypnotic experience is demonstrably pervasive” (pp. 258-259).
The author goes on to describe his initial discovery of the ‘hidden observer’ in an experimental context, and to relate the ‘hidden observer’ to others’ earlier observations of a secondary report of an experience previously concealed from S’s consciousness (Binet, 1889-1890/1896; Estabrooks, 1957; James, 1899; Kaplan, 1960). “The issues are still being worked on, but as in the case of trance logic the heart of the problem is not whether to speak of a hidden observer, but to recognize that there may be cognitive distortions in hypnosis even while some more realistic information is being processed in parallel, so that everything is not reportable by S” (p. 260).

Makarec, K.; Persinger, M. A. (1987). Electroencephalographic correlates of temporal lobe signs and imaginings. Perceptual and Motor Skills, 64, 1124-1126.

Significant correlations (0.50) were observed between scores for the Wilson-Barber Inventory of Childhood Memories and Imaginings and the experiences that are indicative of temporal lobe lability. In addition, positive correlations (0.42) occurred between temporal lobe EEG measures (scalp electrodes) and numbers of temporal lobe signs. The numbers of alpha seconds per minute from the occipital lobes were correlated (0.57) with the Wilson-Barber cluster that indicated interests in ‘altered states’. Scores on the childhood imaginings section of the Wilson-Barber Inventory were correlated (0.44) with the numbers of spikes per minute over the temporal lobes when the eyes were closed.

Persinger and DeSano (1986) found that people who display temporal lobe signs were also more likely to have more imaginings (as defined by Wilson and Barber’s (1983) Inventory of Childhood Memories and Imaginings) and to be more suggestible as indicated by Spiegel’s Hypnosis Induction Profile” (p. 1124).
Subjects in this investigation were 12 male and 18 female students, ages 18-39 (M = 25 years) Bipolar measures were taken from just above the ears (approximately T3-T4) and the occipital lobe (01-02). Number of alpha seconds per minute and number of spikes per minute from each lobe was taken for 10 minutes (5 successive pairs of 1 minute eyes- open, 1 minute eyes-closed).
“The total Wilson-Barber score was significantly (p <.01) correlated ... with the major (0.46) and minor (0.50) temporal lobe clusters but not with two clusters of control items: normal psychological experiences (0.21) and mundane proprioceptive experiences (0.29). These correlations are similar to those in the Persinger and DeSano study (0.60, 0.50, 0.13, and 0.14, respectively). Like the first study (0.53), the items that were most associated with dissociation (depersonalization) were best correlated with the Wilson- Barber scores (0.60). The Wilson-Barber subcluster: adults' extreme experiences (Items 44 through 52, that indicate physiological changes associated with thinking) was again most strongly correlated with the major (0.55) and minor (0.65) temporal lobe clusters; these values were 0.42 and 0.52 in the first study" (p. 1125). "The only statistically significant (p < .01) correlations between the Wilson-Barber scales and the EEG measures were between the number of alpha seconds from the occipital lobe (with the eyes closed) and the [Wilson-Barber] 'altered state' cluster (r = 0.57; Items 33, 41, 42, 43). A weaker correlation (0.36) occurred between the number of alpha seconds per min. (eyes closed condition) and childhood vestibular experiences (items 1, 2, 3, 10, 24)" (p. 1126). 1986 Bernstein, Eve; Putnam, Frank W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease, 174, 727-734. Dissociation is a lack of the normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory. Dissociation occurs to some degree in normal individuals and is thought to be more prevalent in persons with major mental illnesses. The Dissociative Experiences Scale (DES) has been developed to offer a means of reliably measuring dissociation in normal and clinical populations. Scale items were developed using clinical data and interviews, scales involving memory loss, and consultations with experts in dissociation. Pilot testing was performed to refine the wording and format of the scale. The scale is a 28-item self-report questionnaire. Subjects were asked to make slashes on 100-mm lines to indicate where they fall on a continuum for each question. In addition, demographic information (age, sex, occupation, and level of education) was collected so that the connection between these variables and scale scores could be examined. The mean of all item scores ranges from 0 to 100 and is called the DES score. The scale was administered to between 10 and 39 subjects in each of the following populations: normal adults, late adolescent college students, and persons suffering from alcoholism, agoraphobia, phobic-anxious disorders, posttraumatic stress disorder, schizophrenia, and multiple personality disorder. Reliability testing of the scale showed that the scale had good test-retest and good split-half reliability. Item-scale score correlations were all significant, indicating good internal consistency and construct validity. A Kruskal-Wallis test and post hoc comparisons of the scores of the eight populations provided evidence of the scale's criterion-referenced validity. The scale was able to distinguish between subjects with a dissociative disorder (multiple personality) and all other subjects. Davidson, Thomas McCabe (1986, January). Recall organization and volitional/non-volitional experiencing in posthypnotic and intrahypnotic amnesia: Inattention versus dissociation hypotheses (Dissertation, University of Waterloo). Dissertation Abstracts International, 47 (7), 3103-B. Two studies are reported which seek to evaluate the relative merits of two differing hypotheses concerning the cognitive processes underlying suggested hypnotic amnesia. The inattention hypothesis maintains that amnesia effects are produced when subjects volitionally divert attention from relevant retrieval cues so that recall is inefficient. The dissociation position is that amnesic subjects are prevented from utilizing normally relevant retrieval cues by a dissociative barrier that blocks access to target memories -- a forgetting over which subjects experience no volitional control. The two hypotheses were evaluated by means of a selective amnesia suggestion in the recall organization paradigm. "In the first experiment, high, medium, and low hypnotic susceptible subjects were administered either hypnotic induction or task-motivating instructions. Results indicated that there was no disorganization of amnesia trial recall or forgetting of words not targeted for amnesia, contrary to predictions from the inattention hypothesis. "In the second experiment, high hypnotizable subjects received the selective amnesia suggestion in both posthypnotic and intrahypnotic conditions. Intrahypnotic subjects were also separated into one group that received a ten second interval between the administration of the amnesia suggestion and the amnesia trial, and another group that had a delay between the suggestion and the amnesia trial equivalent to the posthypnotic group. Eight subjects who had testified that they were volitionally amnesic on a pre- screening amnesia test were also included in the posthypnotic condition. Again, the results indicated no recall disorganization or reduction in recall of words not targeted for amnesia. Subjects also uniformly provided evidence that their amnesia was experienced as non-volitional. There was, however, evidence that some amnesiacs were aware during the amnesia trial of the specific category targeted for amnesia. "The most important finding of both experiments is that subjects may attend to normally relevant retrieval cues and yet continue to evidence amnesia. The evidence is therefore consistent with the dissociation hypothesis, but disconfirms the inattention account of hypnotic amnesia. It appears that the selective amnesia context effectively prevents the successful use of volitional forgetting strategies. (Abstract shortened with permission of author)" (p. 3103). Holroyd, Jean (1986). Hypnosis applications in psychological research. Imagination, Cognition and Personality, 5, 103-115. It is proposed that hypnosis leads to altered cognition, affect, or motivation as reflected by changes in 1) reality orientation, 2) attention and awareness, 3) imagery, 4) dissociation, 5) suggestibility, and 6) mind-body interaction. Hypnosis may be used as an experimental method to effect such cognitive, affective and motivational changes in order to pursue research in learning, personality, physiological, and social psychology. Examples of possible applications of hypnosis are provided. The influence of individual differences in hypnotic responsivity on research also is discussed. NOTES The author concludes, "Contributions of hypnosis to research in psychology may have been diminished by the confusion inherent in searching for main effects while giving insufficient attention to interaction effects between personality variables and experimental manipulations. As psychology becomes more cognitive in orientation, the phenomena of hypnosis may seem less bizarre and more amenable to inclusion in psychological research. However great care must be taken not to confuse the contributions of hypnosis with the contributions of the hypnotically responsive personality" (p. 109). Laurence, Jean-Roch; Nadon, Robert; Nogrady, Heather; Perry, Campbell (1986). Duality, dissociation, and memory creation in highly hypnotizability subjects. International Journal of Clinical and Experimental Hypnosis, 34, 295-310. The present paper reports an initial attempt to create a pseudomemory in a group of highly hypnotizable individuals. It was found that for approximately 50% of Ss tested, recall of a specific event was modified when Ss integrated hypnotically suggested material which then posthypnotically was believed to be veridical. This modification in a previously reported memory was linked to a particular cognitive style found in high hypnotizable Ss, namely dual cognitive functioning. Ss reporting duality in hypnotic age regression, and, to a lesser extent, the hidden observer effect, were found to be the most prone to accept a suggested memory as real. These findings suggest the need to emphasize the importance of a cognitive-phenomenological approach to hypnosis and hypnotizability. Markus, Hazel; Nurius, Paula (1986). Possible selves. American Psychologist, 41 (9), 954-969. The concept of possible selves is introduced to complement current conceptions of self-knowledge. Possible selves represent individuals' ideas of what they might become, what they would like to become, and what they are afraid of becoming, and thus provide a conceptual link between cognition and motivation. Possible selves are the cognitive components of hopes, fears, goals, and threats, and they give the specific self- relevant form, meaning, organization, and direction to these dynamics. Possible selves are important, first, because they function as incentives for future behavior (i.e., they are selves to be approached or avoided) and second, because they provide an evaluative and interpretive context for the current view of self. A discussion of the nature and function of possible selves is followed by an exploration of their role in addressing several persistent problems, including the stability and malleability of the self, the unity of the self, self- distortion, and the relationship between the self-concept and behavior Miller, Mary E.; Bowers, Kennneth S. (1986). Hypnotic analgesia and stress inoculation in the reduction of pain. Journal of Abnormal Psychology, 95, 6-14. Investigated the influence of hypnotic ability on 3 methods of reducing cold-pressor pain. Following a baseline immersion, 30 high- and 30 low-hypnotizable undergraduates were randomly assigned to 1 of 3 treatment groups: stress inoculation training, stress inoculation training defined as hypnosis, or hypnotic analgesia. Analysis of pain reports indicated a significant hypnotic ability x treatment interaction. Among Ss receiving hypnotic analgesia, high-hypnotizables reported significantly less intense pain than lows. There was no differential response for high- and low-hypnotizable Ss receiving stress inoculation training, whether or not it was defined as hypnotic. Moreover, Ss in the stress inoculation condition (whether or not defined as hypnosis) reported using cognitive strategies to reduce pain, whereas this was not the case for Ss in the hypnotic analgesia condition. The present findings seem inconsistent with the social psychological account of hypnosis and are discussed from a dissociation perspective, which views hypnosis as involving changes in the way information is processed. 1985 Bliss, Eugene L.; Larson, Esther M. (1985). Sexual criminality and hypnotizability. Journal of Nervous and Mental Disease, 173, 522-526. Investigated 33 17-35 yr old sexual offenders, 18 of whom had been convicted of rape, 9 of pedophilia, and 6 of incest. Ss completed a questionnaire containing a list of 15 factors that might have contributed to their crime, a self-report containing 305 items that are symptoms characteristic of 11 major psychiatric syndromes, and the Stanford Hypnotic Susceptibility Scale. Controls for the self-report were 48 individuals taken from a church group, nurses, technicians, and graduate students. Controls for the hypnotizability scale were cigarette smokers who smoked 1 1/2 pack/day and S data taken from the literature. Results show that two-thirds of the Ss had histories of spontaneous self-hypnotic experiences (dissociations); 7 of these were DSM-III multiples and 6 were probable multiples. This group had very high hypnotizability scores. The other one-third without histories of spontaneous self-hypnosis had normal scores. It is concluded that spontaneous self-hypnosis contributed to the perpetration of the crimes in many of tehse cases, although other factors also directed the antisocial behaviors. (22 ref). Gibson (1985). Dreaming and hypnotic susceptibility: A pilot study. Perceptual and Motor Skills, 60, 387-394. Previous experimental work has indicated that certain stable personality characteristics are reliably associated with differential susceptibility to hypnosis. It is suggested that people who are more susceptible will be characterized by an awareness of dreaming more frequently, vividly and creatively. This study describes the construction of a Dream Questionnaire and the relations of the scores obtained on it to scores previously obtained on the Harvard Group Scale of Hypnotic Susceptibility. Sex differences were noted in response to the questionnaire. For women, a global score was derived from the questionnaire, and this was positively and significantly associated with hypnotic susceptibility. Men responded rather differently to the questionnaire and as hypnotic susceptibility scores were available for only a more limited number, further analysis was postponed until more data from men may become available. Some suggestions for research are discussed, and the relations between sleep research and hypnosis research are briefly considered. NOTES: This article provides an example of dissociation-hypnosis contribution to sleep research: "There has hitherto been little link between research on sleep and on hypnosis. Cartwright's (1978) review of dream research makes no mention of hypnosis, but a little common ground is referred to in Ernest Hilgard's (1975) review of hypnosis research. More recently, Belicki and Belicki (1984) and Perreault and Montplaisir (1984) have renewed the effort to link the two areas. Such research may not begin to pay off in terms of delineating more fully the traits of personality which refer to dissociative ability both in sleep and in wakefulness. It is hoped that the pilot questionnaire provided by the present study will serve to further such research." [Note that in Nadon, Hoyt, & Kihlstrom, 1987, some questions from Evans' sleep questionnaire were predictive of hypnotizability.] Kelly, Paul James (1985, November). The relationship between hypnotic ability and hypnotic experience (Dissertation). Dissertation Abstracts International, 46 (5), 1690-B. "This study investigated the relationship between four types of hypnotic experience and hypnotic ability. The types of experiences were: dissociation, the experience of involuntariness, altered state effects, such as perceptual alterations and diminished reality sense rapport, transference-like involvement with the hypnotist, and relaxation. A 47-item scale, the Hypnotic Experience Questionnaire was developed to measure types of hypnotic experience. It was given to 484 subjects and then to a subsample of 272 students. When the scale was factored, four stable factors emerged: Nonconscious/Trance, Rapport, Relaxation, and Cognitive Rumination. A Group Profile Scale was also developed to measure students and when it was factor analyzed four factors were extracted: Hallucinations and Fantasies, Amnesias and Post-Hypnotic Compulsions, Motor Inhibition, and Direct Motor Suggestion. "Two statistical approaches were used to investigate the connections between hypnotic ability and hypnotic experience . Canonical analysis was used to identify the main relationships between hypnotic ability and hypnotic experience and factor analysis was used to explore the relationship among measures of hypnotizability and hypnotic experience. Two canonical variates from the canonical analysis were significant. The first variate was characterized by a dissociative-imaginative involvement process, and the second variate tapped a rapport-social compliance process. "When 25 variables, representing components of hypnotic ability and hypnotic experience, were factored, five factors were extracted. Imaginative Involvement, Ideomotor Response, Rapport, Cognitive Inhibition, and Relaxation. The results of the factor analysis suggested that dissociative experience and altered state experience are related to hypnotic ability but rapport and relaxation are not. "The results of study, taken as a whole, suggest that relaxation and rapport may happen in the hypnotic situation, but neither experience is related to the condition of being hypnotized in any essential way. The results suggest that the hypnotic condition is characterized by dissociative experience, altered state experience, and by successful performance on hypnotic ability tasks. From a theoretical point of view, the results strongly supported Hilgard's theory, partially supported Shor's theory, and failed to support Edmonston's theory" (p. 1690). Morris, Don M.; Nathan, Ronald G.; Goebel, Ronald A.; Blass, Norman H. (1985). Hypnoanesthesia in the morbidly obese. Journal of the American Medical Association, 253 (22), 3292-3294. The advent of chemical anesthesia relegated hypnosis to an adjunctive role in patients requiring major operations. Anesthesia can be utilized with acceptable risk in the great majority of patients encountered in modern practice. But an occasional patient will present--such as one with morbid obesity--who needs a surgical procedure and who cannot be safely managed by conventional anesthetic techniques. This report describes our experience with such a patient and illustrates some of the advantages and disadvantages of hypnoanesthesia. The greatest disadvantage is that it is unpredictable. Close cooperation between the patient, hypnotist, anesthesiologist, and surgeon is critical. However, the technique may be utilized to remove very large lesions in selected patients. Hypnoanesthesia is an important alternative for some patients who cannot and should not be managed with conventional anesthetic techniques. 1984 Bowers, Kenneth S. (1984). On being unconsciously influenced and informed. In Bowers, Kenneth S.; Meichenbaum, D. (Ed.), The unconscious reconsidered (pp. 227-273). New York: John Wiley & Sons. NOTES Research on confirmatory bias has uncovered additional cognitive processes that are frequently automatic in function and significant in modifying behavior, affect, and cognition. Snyder and Swann (1976, 1978) provided subjects with set inducing hypotheses about the personalities of certain target individuals. Subjects were then asked to test these hypotheses by interviewing the target individuals. It was found that subjects regularly looked for and found evidence that was consistent with their initial hypotheses rather than for evidence which could show these hypotheses to be incorrect. This biased search strategy of the subjects had more profound effects as well, for it also influenced the behaviors of the target individuals in a manner leading them to produce behaviors that seemed to confirm the original mental set of the subjects. Subjects were unaware that their manner of interviewing was producing a biased sample of behavior from the targets. Here too an automatic cognitive process was affecting perception and thinking without conscious awareness" (p. 280). Carlson, Eric T. (1984, October/1986). The history of dissociation until 1880. In Quen, Jacques M. (Ed.), Split minds/split brains (pp. 7-30). 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: Provides summary of the history of associationism. Refers to Beddoes' essays (1802-03) which state that (1) emotions play a significant role in strengthening associations, and a study of emotions would be the 'chief secret for unriddling the inconsistencies of dreams,' and (2) variations could occur in associations (from very strong to very weak). In the 19th century there was an ongoing debate about the role of the reflex in the nervous system, about how high up it could function, and whether it could still take place if it reached areas that subserved consciousness. Dr. William Carpenter postulated three levels: (1) excitomotor reflex (spinal, and maybe lower brain), (2) sensorimotor or consensual (midbrain) which was unconscious, (3) ideomotor (cerebral) - based on evidence from hypnosis in which volition appeared suspended and the subject became 'a mere thinking automaton' whose flow of ideas resulted from external suggestions only. The ideomotor response could be unconscious. In the 1830's and 40's Thomas Laycock brought Associationism together with the concept of reflex. "By bringing the reflex into 'cerebral processes,' he proposed a model that made fast and automatic responses possible in the realm of ideas. Automatic thinking, speaking, writing, and more complex actions became topics of increasing interest to psychologists later in the century. As early as 1868, Prosper Despine had been speaking of 'psychological automatisms.' Laycock proclaimed most of these responses as being unconscious, that ideas could be charged with varying amounts of energy, and that ideas could act as causes of human disturbances, both psychological and physiological" (pp. 25- 26). 1860's - 90's saw the rise of hypnotism, with Eugene Azam using it in surgery and psychiatry; Durand de Gros's book on Braid; Liebeault publishing a book; Bernheim launching his career; Charcot shifting interest from organic neurological conditions to functional conditions; and Charcot teaching both Janet and Freud. The author notes that "in July 1880, a bright and educated young woman of 20 started to nurse her dying father. Like the shamans before her, she had to grapple with the spectre of death and in her own fashion, she developed a creative illness. Her symptoms were myriad, but many had to do with changes in her consciousness (including 'absences,' clear-cut trances) and splits in her memory, including the loss of an entire language. At one point her current personality disappeared and another took its place: in this case it was herself but existing a year before in a state in which she lived without any apparent awareness of what had happened to her in the interim. It is this case of Anna O. and her doctor, Josef Breuer, which became important to the next epoch in our review and who had so much to do in inspiring the studies that followed" pp. 27-28. Cocores, James A.; Bender, Andrew L.; McBride, Eugene (1984). Multiple personality, seizure disorder, and the electroencephalogram. Journal of Nervous and Mental Disease, 172, 436-438. Used the EEG to study multiple personality in a 48-yr-old ambidextrous male admitted for alcohol detoxification and individual psychotherapy. Despite conflicting reports in the literature, no changes in the EEG were found that could not be ascribed to the normal changes seen in transitions from various states of alertness. The problems of differentiating multiple personality as a psychiatric entity in itself from those cases arising as a result of chronic partial or partial-complex epilepsy are discussed. Crabtree, Adam (1984, October/1986). Explanations of dissociation in the first half of the twentieth century. In Quen, Jacques M. (Ed.), Split minds/split brains (pp. 85-108). 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 In 1907 Morton Prince, Editor of Journal of Abnormal Psychology, introduced a symposium by listing 6 meanings of subconscious: 1. that portion of our field of consciousness which is outside the focus of attention 2. (Janet's idea) - split off ideas which may be isolated sensations like the lost tactile sensation of anesthesia, or maybe aggregated into groups or systems. The author quotes Janet as stating that "they form a consciousness coexisting with the primary consciousness and thereby a doubling of consciousness results" (p. 87). The primary consciousness is usually dominant, but sometimes is reduced under exceptional conditions (e.g. automatic writing). 3. the subconscious _self_ or hidden self -- a part of every human, not just seen in psychopathology; this is a personalized entity; every mind has a double, with the unconscious self having powerful effects on feelings, thoughts, and reactions of the conscious self 4. extends #3 to include not only ideas that remain active below surface but also those which are inactive -- forgotten or out of mind 5. Frederic Myers' concept of the 'subliminal self' which had 3 functions: a) inferior - seen in processes of dissociation b) superior - seen in works of genius, arising from 'subliminal rush' of information, feelings, and thoughts which lie below consciousness c) mythopoeic - the unconscious tendency to create fantasies 6. physiological meaning, e.g. William Carpenter's 'unconscious cerebration' in which unconscious phenomena are interpreted in terms of pure neural processes unaccompanied by mental activity. Prince suggested some redefinitions to clarify unconscious and subconscious. He would replace Janet's subconscious with co-conscious and reserve unconscious for physiological processes that lack the attributes of consciousness. Prince noted that co- conscious ideas have been called unconscious (e.g. by Freud) but said that is confusing and to be avoided. "Coconscious ideas include states we are not aware of because they are not the focus of our attention, and also pathologically split-off and independently active ideas or systems of ideas, such as occur in hysteria and reach their most striking form in co- conscious personalities and automatic writing. "Prince prefers the term coconscious to Janet's subconscious for two reasons. First, because it expresses the simultaneous coactivity of a second consciousness. And second, because the coactive ideas or idea systems may not be outside the awareness of the personal consciousness at all. They may be recognized by the personal consciousness as a distinct consciousness existing alongside it. "Thus, through his redefinition of terms, Prince makes simultaneous activity of two or more systems of consciousness in one individual the key element in dissociation. He thereby moves the issue of amnesia or lack of awareness by one system of another into the background, making it a secondary, nonessential element. Prince was one of the few to provide a theoretical framework for dissociation in which any combination of interawareness among the coconscious systems was possible" (p. 91). Two researchers at the turn of the century came to opposite conclusions about the nature of the Subconscious Self that every human has. Morris Sidis saw it as "a brutelike consciousness with a tendency toward personalization. Frederic Myers held that it included those functions and much more, being the source of all that is human, including the highest intuitive powers" p. 96. Bernard Hart, in 1910, did an analysis of Janet and Freud. Janet's work is essentially descriptive: "he is always talking about a consciousness which manifests itself in a way we can _perceive_, whether by listening to it talk, reading its written communications, or watching its movements" (p. 97). However Janet's spatial model of dissociation cannot explain the presence of the same material (e.g. memories) in two or more dissociated systems. According to Hart, Freud offered the conceptualization that Janet lacked, in his idea of the Unconscious . Freud's Unconscious is not in competition with Janet's subconscious. "Janet's subconscious is the arena of dissociated phenomena which manifest in observable form as elements coactive with the personal self. Freud's unconscious is a conceptual, nonobservable construction put forward to explain certain facts of human experience. In this way Hart equates the unconscious with the atomic theory in physics or the theory of heredity in biology" p. 99. But Hart also thought Freud's theory did not do justice to dissociative phenomena. Not only do psychoanalysts show little interest in double personality or multiple personality, they also neglected dissociation on the phenomenal level. In 1915 Freud denied the existence of a second consciousness and wrote, "there is no choice for us but to assert that mental processes are in themselves unconscious, and to liken the perception of them by means of consciousness to the perception of the external world by means of the sense organs" (p. 101). Janet claimed that Freud had simply taken over his own system and given it a new terminology, and in 1924 Freud wrote an angry rebuttal. For him, "dissociated systems are simply separate groups of mental but unconscious elements. As our consciousness turns now to one group, now to another, as a searchlight shines now on one object and now on another, the dissociated groups manifest in conscious life. ... There exists no doubling of consciousness" p. 102. Jung's ideas were closer to those of Janet, and like Janet he made dissociation a key concept in his theory. The _complex_ is unconscious, has an archetypal core clothed in personal experience, is like a self-contained psyche within the big psyche, sometimes called a fragmentary personality dwelling inside us. Dissociation for him meant being cut off from the Ego, which is the center of an individual's field of consciousness. "Dissociated or autonomous complexes are those which have no direct association with the ego" (p. 103). If complexes are charged with enough energy they will become manifest--as a neurotic symptom, as projected into idea of a god or demon, or perhaps as an alternate personality. Therefore Jungian treatment aims at assimilating dissociated complexes into the ego. Decker, Hannah S. (1984, October/1986). The lure of nonmaterialism in materialist Europe: Investigations of dissociative phenomena, 1880-1915. In Quen, Jacques M. (Ed.), Split minds/split brains (pp. 31-62). 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 Emphasizes spiritism, hypnotism, and the career of Pierre Janet. Janet's career paralleled an increased interest in dissociation, because he had contact with scientists studying spiritism, used hypnosis, and insisted on a scientific approach. He coined the words "subconscious" and "dissociation." As his sphere of influence declined, so did scientific interest in dissociation--especially multiple personality disorder. Scientific study of dissociation began with investigations into religious exorcism and spirit possession. For example, at the behest of Prince Max Joseph of Bavaria, Mesmer duplicated the exorcisms of Father Gassner (causing convulsions) using hypnosis. Following Mesmer, there were reports of multiple personalities (e.g. an "exchanged personality" in Germany, reported in 1791 by Eberhardt Gmelin). "Partly because of this growth of knowledge of multiple personality, a new model of the mind developed during the early 19th century: the mind was dual; there were conscious and unconscious mental states. Later, it was said that there was a dominant conscious personality with a group of underlying subpersonalities. Eventually it was declared that split fragments of personality could act autonomously" p. 37. The scientific study of these phenomena continued under the leadership of Frederic Myers of The Cambridge Society for Psychical Research. According to William James, Myers was the first to consider the phenomena of hallucination, hypnotism, automatism, double personality, and mediumship as connected parts of one whole subject. The Cambridge Society was involved in the transition from the use of automatic writing by mediums to its use for clinical purposes and experimental research in the 1880's and 1890's. Increasing numbers of multiple personalities reported in the literature in late 19th century led to increased interest in hypnosis and to the concept of dissociation. The author details the contributions of Janet, and then explains how interest declined in dissociation and in hypnosis due to the following: 1. Experimental psychologists in Germany (e.g. Wundt) refused to deal with anything that resembled the "unconscious," and neglected the point of view of the experiencing person. 2. Those few psychologists interested in the unconscious found projective tests (Rorschach, TAT) an easier avenue than hypnosis or automatic writing. 3. Many mediums were exposed as frauds, e.g. Flournoy's popular "From India to the Planet Mars". 4. Janet himself was very critical of parapsychology. 5. When Charcot died suddenly, it was discovered that some of his assistants had rehearsed the behavior of hypnotized patients. 6. Hypnotists' extravagant claims (e.g. past life age regression) led to a wave of reaction against them. 7. Questions were raised about the iatrogenic nature of multiple personality. 8. Conscientious hypnotists discovered drawbacks - not everyone could become good hypnotists (e.g. Freud) - not everyone could be hypnotized - some patients faked hypnosis - extreme sensitivity of hypnotized patients to the hypnotist's wishes led to biased results - hypnotist sometimes was conditioned to things in certain way by his first patient 9. Janet didn't have the personality of a leader, and he argued with the psychoanalysts about who should get credit for certain ideas. Fewtrell, W. E. (1984). Relaxation and depersonalization. British Journal of Psychiatry, 145, 217. NOTES In 40 anxious patients treated with Jacobson's progressive relaxation, 7 reported distress (something like Heide's Relaxation Induced Anxiety). Looking retrospectively at the clinical notes, these seven usually reported symptoms of a depersonalization syndrome prior to treatment. The author administered Dixon's (1963) Self Alienation Questionnaire, which purports to measure depersonalization. The patients who had distress scored significantly higher on Self-Alienation than ten randomly selected control subjects who had responded to the relaxation procedures without problems (adverse effects patients' mean = 32; controls' mean = 22; P = .05). This article presents evidence that the presence of relaxation may distress depersonalized patients, presumably exacerbating feelings of unreality. Kelly, Paul James (1984, December). The relationship between hypnotic ability and hypnotic experience. Newsletter of Division 30, Psychological Hypnosis, of the American Psychological Association, 5. This study investigated the relationship between four types of hypnotic experience and hypnotic ability. The types of experience were: dissociation, the experience of involuntariness; altered state effects, such as perceptual alterations and diminished reality sense; rapport, transference-like involvement with the hypnotist; and relaxation. A sample of 230 students was given the HGSHS:A, a group version of the SHSS:C, and the Hypnotic Experience Questionnaire (Kelly, 1984), a 47-item multidimensional scale of hypnotic experience. Items were taken from these tests to form 11 hypnotic ability variables (Positive Hallucinations, Dreams and Regressions, Post- Hypnotic Compulsions, Amnesia (HGSHS:A), Amnesia (SHSS:C), Arm Rigidity, Arm Immobilization, Other Motor Inhibitions, Head Falling, Moving Hands Together, and Hand Lowering). Fourteen hypnotic experience variables were also formed (Generalized Dissociative Effects, Dissociative Inhibition, Trance, Unawareness, Transference-like Involvement, Trust, Friendliness, Physical Relaxation, Mental Relaxation, Imagery Presence, Imagery Vividness, Imagery Detail, Self Consciousness, and Analytic Thoughts). The 25 variables were intercorrelated and factored with principal axis factoring. Five factors with eigenvalues greater than 1 were extracted and rotated to varimax criteria. These factors, which accounted for 54.4 percent of the variance, were called: Imaginative Involvement, Ideomotor Response, Rapport, Cognitive Inhibition, and Relaxation. Hypnotic ability variables loaded significantly on three of the factors (Imaginative Involvement, Ideomotor Response, and Cognitive Inhibition) and these three factors also tapped some aspect of altered state experience and/or dissociative experience. It was concluded therefore that dissociative experience and altered state experience are related to hypnotic ability. The remaining two factors, Rapport and Relaxation, showed significant loadings only for rapport variables and relaxation variables, respectively. Neither of these two factors were related to any of the traditional measures of hypnotic ability or to the experience of dissociative effects or altered state effects. The results of this study suggest that rapport and relaxation may happen in the hypnotic situation but neither experience is related to the condition of being hypnotized in any essential way. The hypnotic condition is characterized by dissociative experience, altered state experience, and by successful performance on hypnotic ability tasks. The results also raise questions about Edmonston's (1981) theory that relaxation is the essence of hypnotic responsiveness. The finding that the experience of relaxation is unrelated to hypnotic ability is more congruent with Hilgard's (1977) view that relaxation is a nonhypnotic process. Lynn, Steven Jay; Nash, Michael R.; Rhue, Judith W., Frauman, David C.; Sweeney, Carol A. (1984). Nonvolition, expectancies, and hypnotic rapport. Journal of Abnormal Psychology, 93 (3), 295-303. Prior to hypnosis, subjects were informed either that hypnotizable subjects can resist motoric suggestions or that such control does not characterize good hypnotic subjects. During hypnosis, susceptible and simulating subjects received countering suggestions involving inhibiting suggestion-related movements. Susceptible subjects' responses were found to be sensitive to prehypnotic normative information. There was a corresponding tendency for reports of involuntariness to be sensitive to the expectancy manipulation. Furthermore, subjects were able to feel deeply hypnotized and to rate themselves as good subjects yet concomitantly experience themselves as in control over their actions when normative information supported this attribution. Reports of suggestion-related sensations but not imaginative involvement were associated with movements in response to countersuggestion. Simulators were unable to fake susceptibles' reports of sensations and involuntariness. However, for all subjects, movements paralleled expectancies about appropriate response, supporting the hypothesis that involuntary experiences are sensitive to the broad expectational context and are mediated by active cognitive processes. Also, rapport with the hypnotist was found to be a factor. Susceptible subjects with highly positive rapport resolved hypnotic conflict, in part, by achieving a compromise between meeting normative expectations and complying with the hypnotist's counterdemand. Nash, Michael R.; Lynn, Steven Jay; Givens, Deborah L. (1984). Adult hypnotic susceptibility, childhood punishment, and child abuse: A brief communication. International Journal of Clinical and Experimental Hypnosis, 32, 6-11. Earlier empirical and theoretical work has suggested that there is a relationship between higher hypnotic susceptibility and severity of childhood punishment. Experiment 1 surveyed the parents of 14 extremely high and 11 extremely low susceptible Ss concerning punishment. Low susceptible Ss were found to be more frequently punished than highs; no significant differences were found on the severity measure. Experiment 2 assessed the hypnotizability of 16 adult Ss who reported being physically abused before the age of 10 and compared these scores to those of 300 adult Ss who had not reported being abused. The mean hypnotizability of abused Ss was greater than that of controls, and the distribution of their scores appeared bimodal. Limitations of both experiments are discussed and suggestions are made for future investigations. Nash, Michael R.; Lynn, Steven Jay; Stanley, Scott (1984). The direct hypnotic suggestion of altered mind/body perception. American Journal of Clinical Hypnosis, 27, 95-102.