8 female Ss scoring at least 10 on the Standford Hypnotic Susceptibility Scale were required to hold a weight in the outstretched hand in 3 states: (a) under hypnosis, (b) under hypnosis with the upper arm and shoulder anesthetized hypnotically, and (c) in the waking state with motivation provided by a verbal exhortation and monetary payment. Order of performance in the 3 states was varied. No significant differences among states were found. The interaction between states and orders was significant, but it appears more likely to be the result of intersubject variability rather than of position or fatigue effects. Ss” expectancies and estimates of performance time, obtained postexperimentally, did not appear to be related to performance itself. (PsycINFO Database Record (c) 2002 APA, all rights reserved)

EGO/EGO-STRENGTHENING

2002
Ginandes, Carol (2002). Extended, strategic therapy for recalcitrant mind/body healing: An integrative model.. American Journal of Clinical Hypnosis, 45 (2), 91-102.

The development of the power therapies, behavioral medicine, and short term interventions have reported such success even with trauma cases that it is relevant to question the justification for lengthy psychotherapy. Yet some patients with complex mind/body conditions impervious to medical treatment/hypnosis may require extended, multi-modal, integrative therapy. This paper details a single complex case of paruresis as a prototype for illustrating a holographic treatment model for recalcitrant conditions: Component features of the proposed model presented include: 1) the sequential utilization of hypnobehavioral and analytic approaches; 2) uncovering work providing access to the somatic ego state associated with the illness condition; 3) the extended treatment time frame required for deep psycho-physiological change; and 4) the stages of counter-transference expectably evoked by such patients (e.g. urgency, exuberant optimism, frustration, discouragement), and the transformation of such reactions to achieve maximum therapeutic efficacy.

NOTES
Paruresis is a social phobia involving urinary retention and “thought to affect some 17 million or 7% of the American population” (p. 92). Also known as “bashful bladder.”

McNeal, Shirley A. (2002). A character in search of character: Narcissistic personality disorder and ego state therapy. American Journal of Clinical Hypnosis, 45 (3), 233-243.

The individual diagnosed with narcissistic personality disorder presents with grandiosity, extreme self-involvement, and lack of interest in and empathy for others. This paper reviews current theories concerning the development and treatment of this disorder, and presents a case study in which ego state therapy was successfully utilized and integrated into hypnotically facilitated psychotherapy with a 48-year-old man diagnosed with narcissistic personality disorder. The ego state model of treatment is described and demonstrated with case material. Initially ego states that reveal the grandiosity are accessed. As therapy progresses, ego states that hold the underlying feelings of emptiness, rage, and depression are able to emerge. With further treatment, transformation and maturation of the ego states occur, reflecting the changes in internal structure and dynamics as well as improvement in external interpersonal relationships. Issues concerning ego state therapy as utilized with personality disorders are discussed and contrasted with more traditional methods of treatment. (PsycINFO Database Record (c) 2003 APA, all rights reserved)

1999
Daniel, Sheryll (1999). The healthy patient: Empowering women in their encounters with the health care system. American Journal of Clinical Hypnosis, 42 (2), 108-114.

Many women’s expectancies when they assume the role of patient include the experiences of regression, helplessness, passivity and fear. This paper describes techniques for interrupting this negative set and for facilitating the development of a self-efficacious state in which the woman experiences herself as an active and informed participant in her encounters with medical personnel.

1995
Ganaway, George K. (1995). Hypnosis, childhood trauma, and dissociative identity disorder: Toward an integrative theory. International Journal of Clinical and Experimental Hypnosis, 43 (2), 127-144.

It is contended that prevailing exogenous trauma theory provides in most cases neither a sufficient nor a necessary explanation for the current large number of diagnosed cases of dissociative identity disorder (multiple personality disorder) and related dissociative syndromes purported to have arisen as a response to severe early childhood physical and sexual abuse. Relevant aspects of instinctual drive theory, ego psychology, object relations theory, self psychology, social psychological theory, sociocultural influences, and experimental hypnosis findings are drawn on to demonstrate the importance of adopting a more integrative theoretical perspective in the diagnosis and treatment of severe dissociative syndromes. Further cooperative experimental and clinical research on the etiology, prevalence, and clinical manifestations of the group of dissociative disorders is strongly encouraged.

Guyer, Charles G. II; Van Patten, Isaac T. (1995). The treatment of incest offenders — a hypnotic approach: A brief communication. International Journal of Clinical and Experimental Hypnosis, 43 (3), 266-273.

Incest has become more prominent in public awareness over the past 15 years. The major focus of this interest has been on the incest survivor. The incest offender has received less attention. A hypnotic approach to treating incest offenders is outlined that involves a seven-stage approach. A case example is presented and future research directions suggested.

1993
Watkins, Helen H. (1993). Ego-State therapy: An overview. American Journal of Clinical Hypnosis, 35, 232-240.

Ego-state therapy is a psychodynamic approach in which techniques of group and family therapy are employed to resolve conflicts between the various “ego states” that constitute a “family of self” within a single individual. Although covert ego states do not normally become overt except in true multiple personality, they are hypnotically activated and made accessible for contact and communication with the therapist. Any of the behavioral, cognitive, analytic, or humanistic techniques may then be employed in a kind of internal diplomacy. Some 20 years experience with this approach has demonstrated that complex psychodynamic problems can often be resolved in a relatively short time compared to more traditional analytic therapies.

1992
Frederick, Claire C.; Phillips, Maggie (1992). The use of hypnotic age progressions as interventions with acute psychosomatic conditions. American Journal of Clinical Hypnosis, 35 (2), 89-98.

Age progression as a hypnotherapeutic technique is mentioned infrequently in the literature when compared with its counterpart, age regression. In this paper we explore the use of progressions, or ‘views of the future,’ as prognostic indicators of therapeutic progress and as valuable tools for ego strengthening and for the integration of clinical material. Age progressions vary in the types of suggestions given and can be used to promote growth on multiple levels, facilitating treatment goals and deepening the working-through process. We present six cases in which we used different types of age progressions, and we discuss the significance of the progressions used in each case, within the context of relevant clinical material. We conclude from our observations that the use of hypnotic progressions can be a sustaining, valuable aspect of hypnotherapy, particularly in providing an index of the current direction and progression of the therapy process itself. – Journal abstract.

Goodman, Linda; Holroyd, Jean (1992). Ego receptivity and hypnotizability. International Journal of Clinical and Experimental Hypnosis, 40 (2), 63-67.

Ego receptivity has been described as important for the psychotherapy process and as a characteristic of hypnosis (Deikman, 1974; Dosamantes-Alperson, 1979; Fromm, 1979). Receptivity also has been associated with a measure of absorption (Tellegen, 1981). In the first pilot study with 6 dance/movement therapy students, higher observer ratings of receptivity were associated with greater hypnotizability (r = .79, df = 4, p<.05, 2-tailed test). In the second pilot study, the correlation was replicated (r = .51, df = 12, p = .06, 2-tailed test) with 14 dance/movement therapy students. In the second pilot study, receptivity did not correlate with absorption. Receptivity and absorption, however, accounted for 54% of hypnotizability population variance in a step-wise multiple regression. Receptivity accounted for a unique part of the variance after the effects of absorption were removed. It was concluded that receptivity should be explored as a potential predictor of hypnotizability, and that a reliable scaled measure of receptivity should be developed. NOTES Receptivity was rated by dance instructor on the following scale. "TABLE 1 Criteria for Ranking Ss on Receptivity A. Individuals were rated high if they could consistently do the following most of the time: 1. If they moved with emotional involvement. 2. If they could readily verbally describe their movement experience in terms of sensations or feelings. 3. If they were able to image while moving. That is, their movement experience could be transformed into representational visual images. 4. In their describing their movement experience verbally, if they readily alluded to the images which were generated from their body movement. 5. If they could relate their movement experiences to other contexts outside of the therapeutic one. 6. If they could develop a working alliance with the therapist (based on students' capacity to risk experiencing self with increased emotional depth). B. Individuals were rated low, if they were not able to do the above most of the time. C. Individuals were rated in the mid-range if they were able to do the above some of the time" (p. 65). 1991 Stanton, Harry E. (1991). The reduction in secretarial stress. Contemporary Hypnosis, 8, 45-50. 30 secretaries from a large business firm were matched on their stress thermometer scores and one member of each pair was allocated at random to either an experimental group or a control group which discussed stress management procedures. The experimental group had two treatment sessions in which they learnt a technique of induction, deepening and ego-enhancement which included (1) physical relaxation; (2) mental calmness; (3) disposal of unwanted mental and physical 'rubbish'; (4) removal of a negative barrier; and (5) enjoyment of a special place. The stress thermometer was administered on two further occasions, one immediately after completion of the second training session and one as a follow-up 2 months later. In addition, on these two occasions, subjects completed anecdotal reports, recording their impressions of the experiment. After completion of this first stage of the study, control group secretaries experienced the same two treatment sessions as had the experimental group. Results indicated that stress level was significantly lower both immediately after treatment and at the two-month follow-up. 1989 Peebles, M. J. (1989). Through a glass darkly: The psychoanalytic use of hypnosis with post-traumatic stress disorder. International Journal of Clinical and Experimental Hypnosis, 37, 192-206. A severe case of post-traumatic stess disorder stemming from consciousness (with auditory and pain perception) during surgery was treated with 8 sessions of hypnosis. Abreaction and revivification used alone initially retraumatized the patient, and her symptoms worsened. Ego-mastery techniques were then added; emphasis was placed on the role of the therapist as a new object presence to be internalized in restructuring the traumatic memory; memory consolidation and working-through techniques were instituted. The patient's symptoms abated and her condition remitted. The similarities between hypnotic and analytic work are highlighted. In addition, the case material provides a clinical example of the existence and potential traumatic effects of conscious awareness during surgery. 1988 Hines, Larry; Handler, Leonard (1988, November). Hypnotizability and ego functions. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Asheville, NC. NOTES Researchers employed Bellak's Ego Functions Test (based on the clinical interview). Ss were 47 students and 1 non-student, some of whom had previously experienced hypnosis. They were all volunteers. Studied 12 ego functions. Used plateau hypnotizability which was defined as no improvement in Stanford Hypnotic Susceptibility Scale Form C after two hypnotic inductions; if they did not reach a plateau by Session 4, the highest score was used. Stanford Hypnotic Susceptibility Scale scores ranged 4-12. High 10-12, Medium 6-9, Low 4-5. x=9.04, SD=2.21. On the Bellak Test, High 12-13, Medium 10-11 (average functioning.), Low 1-9. Range 5-13; widest range was in Adaptive Regression in Service of Ego Highest Mean = reality testing Lowest Mean = ARISE Majority fell into the medium range on all 12 ego functions measured. A significant difference was found between High and Low hypnotizables on the following ego functions. [N.B. There may be transcription errors in the figures that follow.] 1. ARISE p<.02 r = .31 Highs have greater ability to experience pleasure in regression. 2. Stimulus Barrier p<.003 Highs are more flexible in their ability to separate from stimuli in their environment, Lows experienced stimulus overload. 3. Autonomous Functioning p<.01 Primary acct./ in attention, learning, memory, motor function. 4. Objective Relativity p<.07 5. Regulating control of drive p<.06 Multiple regression accounted for 33% of variance in 12 ego functions. Stimulus Barrier alone accounted for 14% (p<.005); ARISE accounted for 5% (p<.01). 47% of Ss were High hypnotizables, 42% were in the Medium range. Koe, G. Gerald; Oldridge, O. A. (1988). The effect of hypnotically induced suggestions on reading performance. International Journal of Clinical and Experimental Hypnosis, 36, 275-283. 52 volunteer Ss, 19 years or older, at U. of British Columbia, were hypnotized and given post hypnotic achievement and esteem suggestions to investigate the influence of these suggestions on reading performance as measured by the total score on the Nelson-Denny Reading Test (Nelson & Denny, 1960). Differences among groups were compared using a hierarchical regression approximation of analysis of covariance. Hypnotizable Ss scored higher than unhypnotizable Ss. Other-esteem suggestions were found to improve reading performance. Young, W. C. (1988). Psychodynamics and dissociation: All that switches is not split. Dissociation, 1, 33-38. Contrasts the roles of splitting and dissociation in multiple personality disorder. It is proposed that dissociation is a unique defensive process that serves to protect the patient from the overwhelming effects of severe trauma and that multiple personality disorder need not call upon splitting as its central defensive process. Fantasies of restitution may be incorporated into the dissociative defense. Psychological, physiological, and behavioral models all are of use, making it likely that ultimately dissociation will be understood along multiple lines of study. 1987 Baker, Elgan L. (1987). The state of the art of clinical hypnosis. International Journal of Clinical and Experimental Hypnosis, 35 (4), 203-214. This paper reviews the contemporary status of clinical hypnosis in light of the current emphasis on briefer, pragmatic forms of therapy and consumer demands to demonstrate effectiveness. Conceptual shifts and an expansion of clinical applications are related to changes in hypnotic strategies and technique. Suggestions for future avenues of clinical research are outlined and the importance of the continued integration of scientific rigor, empirical clarity, and clinical acumen and sensitivity is emphasized. 1986 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 1983 Baker, Elgan L. (1983). Resistance in hypnotherapy of primitive states: Its meaning and management. International Journal of Clinical and Experimental Hypnosis, 31 (2), 82-89. This paper examines varous aspects of resistance that become manifest in hypnotherapy with borderline, narcissistic, and psychotic patients. Specific clinical presentations are described and contrasted with forms of resistance encountered in work with neurotic patients. An ego psychology theoretical perspective is presented to conceptualize these more primitive resistance phenomena in terms of transference issues and dynamics relating to separation/attachment conflicts, and specific suggestions for management are outlined. 2 case examples are presented to demonstrate both conceptual and technical aspects of this approach. 1980 Hurley, John D. (1980). Differential effects of hypnosis, biofeedback training, and trophotropic responses on anxiety, ego strength, and locus of control. Journal of Clinical Psychology, 36 (2), 503-507. Pretested 60 college students on three scales: the IPAT Anxiety Scale, the Barron Ego-strength scale, and the Rotter I-E scale. The Ss then were assigned randomly to one of four treatment groups designated: hypnotic treatment, biofeedback treatment, trophotropic treatment, and control. Three of these groups met separately for 60 minutes once a week for 8 weeks. The control group did not meet during this time. During the sessions, each group was trained in a different technique for self-regulation. At the end of the 8-week period the scales were readministered to all groups. A series of covariance analyses indicated that hypnosis was a more effective self-regulatory technique for lowering anxiety levels when compared to biofeedback or trophotropic response procedures. With regard to increasing ego strength, both the hypnotic training group and the biofeedback training group proved to be significant. No significant difference was found between the experimental and control groups on the I-E scores. 1979 Watkins, John G.; Watkins, Helen H. (1979-80). Ego states and hidden observers. Journal of Altered States of Consciousness, 5 (1), 3-17. Hilgard and Hilgard discovered that subjects who had been rendered hypnotically deaf, or whose hand had been anesthetized under hypnosis, were hearing and sensing the pain at levels below the threshold of normal awareness. They described this phenomena as a cognitive structural state and termed it "the hidden observer." Federn theorized that the ego is subdivided into segments (organized patterns of behavior and experience) which are semi-autonomous in normal individuals, and which are manifested as completely separate entities (multiple personalities) when the internal boundaries between such parts are rigid and impermeable. He termed these entities "ego states." When activated under hypnosis each ego state experiences its self as subject (I) and the other states as objects (he, she, or it). We have discovered in hypnoanalytic therapy that these ego states act like "covert" multiple personalities, and that clashes between them often create anxiety and psychosomatic symptoms. Ego-state therapy thus becomes a kind of family or group therapy aimed at resolving conflicts between the various ego states which constitute "a family of self" within a single individual. Two studies are reported here to investigate the possibility that Hilgard's "hidden observers" are the same phenomena as these " ego states." The data derived appear to support such a hypothesis. Consideration is given to the possible influence of suggestion and operator variables. 1978 Kir-Stimon, W. (1978). Hypnosis as a tool for termination of therapy. International Journal of Clinical and Experimental Hypnosis, 26 (3), 134-142. Cases are presented with varied induction methods to illustrate the use of hypnosis as a final step in psychotherapy. In each situation, therapy had been clinically active without hypnosis. Problems in termination revolved around patients' fear of taking the ultimate step in controlling their own lives. Hypnosis helped to provide a bridge between previous and current self-concept and an acceptance of individual creativity. Discussion focuses on the use of hypnosis as an adjunct in overcoming anxiety in the ego's relation to the _umwelt_ rather than for initiating rapport or working through transference. Hypnosis then becomes a positive factor in enhancing self-mastery and autonomy as well as in handling resistance to the full utilization of ego strength. 1977 Fromm, Erika (1977). An ego-psychological theory of altered states of consciousness. International Journal of Clinical and Experimental Hypnosis, 25, 372-387. In this paper a new ego-psychological theory is proposed for the understanding of altered states of consciousness. The dichotomies of primary and secondary process, ego activity and ego receptivity, and automatization and de-automatization of ego functions in daydreaming, in the inspirational phase of creativity, in hypnosis, in psychedelic states, and in meditation are discussed; so are the roles of fantasy, imagery, and varous forms of attention. NOTES The author provides a table titled "Typology of Waking State and Several Altered States of Consciuosness by Attention Mode." The states listed in the table are: Waking, normally alert, and concentrated; Waking, fascinated, entranced; Free association; Daydreaming; Dreaming; Psychedelic drugs; Hypnosis; Self-hypnosis; Biofeedback; Transcendental meditation; Concentrative meditation; Satipatthana [mindfulness of body, feelings, mind, and mental events]; Classical vipasyana [Clear intuitive insight into physical and mental phenomena as they arise and disappear, seeing them for what they actually are]. She summarizes, "In general, the present author strongly feels that the advantage of hypnotherapy over therapy in the waking state is that hypnosis allows the therapist to help patients work with more primary process thinking, more fantasy, more imagery, more ego receptivity than they would employ in the waking state" (p. 385). "What helps the therapy is not the depth itself; it is that in the hypnotic state there is greater mobility, a greater ability to dip into the unconscious and to bring the unconscious material back into the waking state of consciousness" (p. 385). Stanton, Harry E. (1977). The utilization of suggestions derived from rational-emotive therapy. International Journal of Clinical and Experimental Hypnosis, 25 (1), 18-26. A series of positive suggestions derived from Ellis' rational-emotive therapy were compared with Hartland's "ego-strengthening" technique in terms of patients' belief in their efficacy. Both pre- and post-treatment ratings were collected. Patients tended to approach treatment with a positive feeling that the treatment would help them with their problem and this belief was strengthened after the 10 therapy sessions had been completed. Further ratings taken 6 months later indicated that patients' belief in the value of the suggestive therapy had not decreased over time. 3 groups of hospitalized chronic schizophrenic patients received "the taped hypnotic treatment" twice a week for 4 weeks. The treatment differed for each of the 3 groups of 18 patients, but neither the patients nor the nursing staff were informed of this difference. The first group was exposed to music only, the second group was given music with superimposed hypnotic suggestions, and the third group heard music with superimposed hypnotic suggestions for improving self-confidence. The staff filled in an evaluation form about the patient's health beforehand, immediately afterward, and then 1 month after the treatment program. No difference between the groups was found if the comparison was based only upon the directions of the changes. However, twice as many positive changes as negative ones were observable in every group after the control period. If the changes noted are restricted only to those attaining the statistically significant (p < .05) level, the majority of positive ones was more evident. From this point of view, the reactions of the groups to the treatments were also different. Improvement appeared directly after the treatment of the Music and Self-confidence groups, but was not evident during the observation time 1 month later. In the Relaxing group, there was, on the contrary, only slight improvement directly after the treatment, but 1 month later during the follow-up observation time, the improvement was considerable. Thus, while encouraging hypnotic suggestions proved on the follow-up to be ineffective, hypnosis appeared to have a real influence when only relaxing suggestions were used. 1976 Lavoie, Germain; Sabourin, Michel; Ally, Gilles; Langlois, Jacques (1976). Hypnotizability as a function of adaptive regression among chronic psychotic patients. International Journal of Clinical and Experimental Hypnosis, 24, 238-257. The Rorschach and the Stanford Hypnotic Susceptibility Scale, Form A (SHSS:A) were administered to a sample of 56 chronic psychotic patients, mainly schizophrenics (N = 48). Verbatim transcriptions of tape-recorded Rorschach protocols were scored according to the Holt system (Holt et al., 1963), which provides an index of adaptive regression. Experimental procedures were conducted single blind. With one exception, all the patients high on SHSS:A were among those obtaining a higher adaptive regression index, while 50% of those obtaining higher adaptive regression index were high on SHSS:A. A systematic investigation of ego functions was proposed for a better understanding of this asymmetry, although the results already gave ostensible positive support to the Gill and Brenman (1959) theory, and to the theory of ego autonomy. Levin, L. A.; Harrison, R. H. (1976). Hypnosis and regression in the service of the ego. International Journal of Clinical and Experimental Hypnosis, 24, 400-418. 28 highly hypnotizable female Ss were selected to test the hypothesis that hypnosis is characterized by regression in the service of the ego (adaptive regression). 2 tasks, producing a hypnotic dream and telling a TAT story, were administered individually under hypnotic and normal waking conditions. Scoring for adaptive regression yielded 2 factors, one for the regressive aspects of the fantasies produced, the other for cognitive mastery of those fantasies. An increase in primary process thinking was found in hypnosis, particularly in the hypnotic dream. There was a relationship between S's capacity for adaptive regression and the amount of adaptive regression found in hypnosis. Although facilitating regression from secondary to more primary process thinking, hypnosis does not inherently provide mechanisms by which primary process manifestations can be utilized adaptively by the ego. Such mechanisms are ego functions which tend to be amplified by hypnosis only in Ss who demonstrate good capacity for adaptive regression. 1975 Spear, J. E. (1975). The utilization of non-drug induced altered states of consciousness in borderline recidivists. American Journal of Clinical Hypnosis, 18, 111-126. Utilizing non-drug induced altered states of consciousness, various modes of interior reflection, behavior modification and reprogramming of conscious attitudes and values were utilized with 49 borderline recidivists. Such offenders were so determined by the Department of Corrections, Probation and Parole Office, District II. No coercion was used to induce such individuals to enter the program and there was no reprisal for stopping therapy at any time. Over a two and one-half year period the recidivist rate among this group was less than 5%. It is suggested that non-drug induced altered states of consciousness combined with indirect as well as symbolic techniques may prove to be the most effective means of criminal rehabilitation. NOTES Berderline recidivists were "individuals, who, in the opinion of the P.O. [probation officer] were, in all probability, to be returned to prison within a few months, or less, if there wasn't a major change in attitude and actions" (p. 111). Therapy employed closed circuit TV with bi-directional audio and induction of altered state of consciousness using an ophthalmology-type rotary prism. Therapy involved (s) recall of relaxed state when under stress, (2) exploration of early conditioning events, (3) self evaluation during the ASC, (4) use of symbolic mental exercises and mental practice for similar circumstances in normal waking state, (5) suggestions for setting goals and ideals, (7) a type of logotherapy, (7) 'nudging' the person to examine their relationship with their concept of God. The author noted in the parolees: (1) low levels of self esteem, (2) depression, (3) going into deep levels of altered states once trust was established with the therapist. 1971 Kihlstrom, J. F.; Edmonston, W. E., Jr. (1971). Alterations in consciousness in neutral hypnosis: Distortions in semantic space. American Journal of Clinical Hypnosis, 13, 243-248. 30 highly hypnotizable Ss were equally divided into three groups, equated for age, sex and hypnotic susceptibility. A semantic differential scale was administered to each S in waking, individual sessions. An oral form of the same scale was administered during: (a) hypnosis (E), (b) waking -- post hypnosis (C1), and (c) waking -- no hypnosis (C2). All groups showed significant change between administrations of the scale; E showed more change than C1, and the latter more than C2. Ratings of "My Self" changed toward the negative pole in the evaluative factor. Results wre interpreted as indicating a distortion in semantic space and an alteration in ego-state occurring spontaneously with hypnosis. 1970 Fromm, Erika; Oberlander, Mark I.; Gruenewald, Doris (1970). Perceptual and cognitive processes in different states of consciousness: The waking state and hypnosis. Journal of Projective Techniques and Personality Assessment, 34, 375-387. Hypnosis was assumed to influence perceptual and cognitive functioning in the direction of increased primary process ideation and adaptive regression. The Rorschach test was administered to 32 Ss in the waking state and under hypnosis in counterbalanced order. Hypnosis was induced by a standardized procedure. Ss received identical instructions for the Rorschach in both conditions. Protocols were scored according to Holt's system for manifestations and control of primary process. Hypnotic Rorschachs showed an increase in primary process manifestations, but no changes in defensive and coping functioning, and no overall changes in the Adaptive Regression Score. However, the nature of the data was found to be influenced by Ss' sex and level of adjustment. NOTES The authors used High hypnotizables (SHSS>9) in this investigation.

1967
Van der Walde, P. H. (1967). Trance states and ego psychology. International Journal of Clinical and Experimental Hypnosis, 15 (3), 95-105.

ANALYZES THE BASIC CHARACTERISTICS OF HYPNOSIS, WHICH COMPRISE INDIVIDUAL, INTERPERSONAL, AND CULTURAL VARIABLES. THESE ELEMENTS ARE UTILIZED IN A TRANSCULTURAL COMPARISON TO DEMONSTRATE THAT TRANCE PHENOMENA ARE GOAL-ORIENTED BEHAVIORS WHICH ARE EXPRESSED BY INDIVIDUALS WITHIN A GIVEN CULTURE BY METHODS WHICH ARE CULTURALLY SANCTIONED FOR ACHIEVING THOSE ENDS. THE DIFFERENCES BETWEEN TRANCE STATES CAN BE UNDERSTOOD TO REPRESENT CULTURAL VARIANTS OF SIMILAR PSYCHOLOGICAL MECHANISMS. (SPANISH + GERMAN SUMMARIES) (PsycINFO Database Record (c) 2002 APA, all rights reserved)

1966
Scott, E. M. (1966). Group therapy for schizophrenic alcoholics in a state-operated outpatient clinic: With hypnosis as an integrated adjunct. International Journal of Clinical and Experimental Hypnosis, 3, 232-242.

Because Alcoholics Anonymous has been so unsuccessful with the schizophrenic alcoholic, no therapeutic modalities structured to fit this population have reached the literature. For 3 yr. specific therapeutic techniques, among them hypnosis, have been employed, and the results appear to be rather encouraging. (Spanish & German summaries) (PsycINFO Database Record (c) 2002 APA, all rights reserved)

1965
Klemperer, Edith (1965). Past ego states emerging in hypnoanalysis. International Journal of Clinical and Experimental Hypnosis, 13 (3), 132-144.

Patients with anxiety, conversion, or phobic reactions differ from those with obessive-compulsive reactions in the type of visualization shown in hypnoanalytic regression or revivification. The former produce visualizations showing a well-rounded picture with logical progression of activity and few symbolic distortions. The latter, however, produce visualizations lacking a logical progression of activity and showing a somewhat disorganized and poorly-rounded picture. Symbolic distortions are frequent, often recurring intermittently. Case studies are presented. (PsycINFO Database Record (c) 2002 APA, all rights reserved)

NOTES
Author”s Summary: “Insight occurs on different levels of psychological awareness and with varying degrees of curative effect. The complex interplay between psychodynamic factors and therapeutic situations does not permit any accurate predictability of either the patient”s level of insight at any one moment or of his readiniess to assimilate deep disclosures. Psychoanalytic theory sheds the greatest light upon these phenomena as well as upon the analogous aspects in hypnotherapy. The hypnotic state is peculiarly suited to overcome resistance and to utilize consequent insight with great effectiveness. Progress in hypnotherapeutic technique has evolved an approach that assures the assimilation of crucial revelations at a pace in accordance with the strength of the ego to tolerate the resultant anxiety” (p. 145).

ELECTRICAL STIMULATION

1988
Danziger, N.; Fournier, E.; Bouhassira, D.; Michaud, D.; De Broucker, T.; Santarcangelo, E.; Carli, G.; Chertock, L.; Willer, J. C. (1998). Different strategies of modulation can be operative during hypnotic analgesia: A neurophysiological study. Pain, 75 (1), 85-92.

Nociceptive electrical stimuli were applied to the sural nerve during hypnotically-suggested analgesia in the left lower limb of 18 highly susceptible subjects. During this procedure, the verbally reported pain threshold, the nociceptive flexion (RIII) reflex and late somatosensory evoked potentials were investigated in parallel with autonomic responses and the spontaneous electroencephalogram (EEG). The hypnotic suggestion of analgesia induced a significant increase in pain threshold in all the selected subjects. All the subjects showed large changes (i.e., by 20% or more) in the amplitudes of their RIII reflexes during hypnotic analgesia by comparison with control conditions. Although the extent of the increase in pain threshold was similar in all the subjects, two distinct patterns of modulation of the RIII reflex were observed during the hypnotic analgesia: in 11 subjects (subgroup 1), a strong inhibition of the reflex was observed whereas in the other seven subjects (subgroup 2) there was a strong facilitation of the reflex. All the subjects in both subgroups displayed similar decreases in the amplitude of late somatosensory evoked cerebral potentials during the hypnotic analgesia. No modification in the autonomic parameters or the EEG was observed. These data suggest that different strategies of modulation can be operative during effective hypnotic analgesia and that these are subject-dependent. Although all subjects may shift their attention away from the painful stimulus (which could explain the decrease of the late somatosensory evoked potentials), some of them inhibit their motor reaction to the stimulus at the spinal level, while in others, in contrast, this reaction is facilitated.
Abstract from National Library of Medicine, PubMed

Borgens, Richard B. (1988). Stimulation of neuronal regeneration and development by steady electrical fields. In Waxman, S. G. (Ed.), Functional recovery in neurological disease (47, pp. 547-564). New York: Raven Press.

NOTES
At the end of the review, author notes that a combination of electromyography and computer modeling of agonist-antagonist, flexor-extensor muscle contraction patterns in the functional body parts of hemiparetic patients, artificially imposed on the paralyzed portions of the body using repetitive electrical stimulation to effect more normal movement, sometimes leads to functional recovery. Such recovery has been observed in some chronic cases of paralysis associated with head injury, stroke, and cerebral palsy. These clinical observations challenge the way we should view paralysis in general. Perhaps there are many redundant pathways in the CNS that will support certain kinds of functional return in the absence of the original pathways destroyed by trauma. Perhaps CNS-associated paralysis is a problem, at least in part, of too much competing signal in spared pathways, not one of impoverished signal. Can use of these neuronal pathways be entrained or retrained? Is the return of function in patients who experience repetitive functional electrical stimulation due to a reorganization within the CNS? These are exciting questions whose answers will possibly lead to our ability to further modify the plasticity of the brain and spinal cord.
[This would fit with the inhibition model of hypnosis, and with the high theta power findings during hypnosis, the implication being that hypnosis facilitates filtering out non-essential competing stimuli.]

DeBenedittis, Giuseppe; Sironi, Vittorio A. (1988). Arousal effects of electrical deep brain stimulation in hypnosis. International Journal of Clinical and Experimental Hypnosis, 36, 96-106.

In an earlier study, DeBenedittis and Sironi (1986) demonstrated that during depth EEG studies, electrophysiological correlates of hypnotic behavior emphasize the role of the limbic system in mediating the trance experience. In the case of a young man who was affected by medically resistant temporal lobe epilepsy and who was a potential candidate for surgical treatment, diagnostic depth EEG in hypnotic and non- hypnotic conditions offered a unique opportunity to stimulate limbic structures. This permitted an evaluation of the subjective and behavioral responses, as well as of the electrophysiological correlates. During hypnosis, repeated stimulations of the left and the right amygdala produced arousal from the hypnotic state each time, whereas the stimulation of other cerebral structures (e.g., temporal neocortex, Ammon’s horn) or pseudostimulations were ineffective on the hypnotic state. These data represent the first experimental, controlled evidence of the amygdala’s effects on the arousal from the hypnotic state in man, thus suggesting that hypnotic behavior is mediated, at least in part, by a dynamic balance of antagonizing effects of discrete limbic structures–the amygdala and the hippocampus.

NOTES
The patient was a 30-year-old man who had suffered from medically resistant psychomotor temporal lobe epilepsy since age 7; a diagnostic EEG showed right temporal seizure focus, concomitant with independent, contralateral, temporal spiking abnormalities. Hypnotizability was measured at 6 on the SHSS:C; the patient was given two training sessions in hypnosis, with suggestions for “dissociation, rehearsal and reframing of spontaneous seizure events, desensitization of their negative emotional impact, and amnesia” (p. 99).
Electrodes were implanted in deep cerebral structures (amygdala, Ammon’s horn) and corresponding superficial areas of temporal cortex, with confirmation of placement by X-ray. Two weeks later the patient’s brain was stimulated on two consecutive days, first in the waking state (Session 1) and then in hypnosis (Session 2). (Antiepileptic medication was discontinued three days before the stimulation sessions.) False (placebo) stimulations were randomly provided along with the true stimulations.
The false (placebo) stimulations did not result in subjective or behavioral changes in either the waking or the hypnosis condition.
In the waking condition, a psychomotor seizure was produced by stimulation of Right amygdala and Left Ammon’s horn; stimulation of Left amygdala evoked only the aura patient usually had before a seizure, or a brief lapse of consciousness. Stimulating the temporal neocortex did not evoke seizure activity.
In the hypnosis condition, arousal from hypnosis into the waking condition occurred with stimulation of amygdala (either Right or Left). Stimulation of the temporal neocortex or of the Right Ammon’s horn did not arouse the patient. Stimulation of Left Ammon’s horn led to abortive seizures, such that it could not be determined whether the hypnotic state had been interrupted. Stimulating the Right amygdala “triggered a psychomotor attack similar to that recorded during the waking stimulation, but with reduced emotional involvement” (p. 100). For the Left Ammon’s horn, “waking stimulation always induced clinical seizures with prolonged after-discharge, whereas hypnotic stimulation evoked only abortive seizures, without after-discharge” (p. 100).