Nugent, William R.; Carden, Nick A.; Montgomery, Daniel J. (1984). Utilizing the creative unconscious in the treatment of hypodermic phobias and sleep disturbance. American Journal of Clinical Hypnosis, 26 (3), 201-205.

An Ericksonian hypnotherapeutic procedure is designed to access and direct creative unconscious processes toward the creation and implementation of satisfactory solutions to recurrent problem behaviors. The use of the procedure is described in 3 cases. Two of the cases involve treatment of severe hypodermic needle phobias. The third case involves use of the procedure in treatment of a somnambulistic sleep disturbance. Possible curative forces tapped by the procedure, suggestions for its continued use, and suggestions for further investigation of the procedure are also discussed.

The procedure involved: 1. Pretrance discussion of unconscious mental processes 2. Hypnosis, followed by “Now your unconscious mind can do what is necessary, in a manner fully meeting all your needs as a person, to insure that [desired therapeutic outcome], and as soon as your unconscious knows that you will [desired therapeutic outcome] it can signal by [appropriate ideomotor signal]” 3. Post-ratification.
Example: “‘Now your unconscious mind can do what is necessary, in a manner fully meeting all your needs as a person, to insure that you remain comfortably awake and alert anytime you receive an injection in the future, and as soon as your unconscious knows you will remain comfortably awake and alert when receiving an injection it can signal by lifting your right hand into the air off the chair.’ This suggestion was [their] communicative effort to access and direct unconscious processes to the creation and implementation of altered behavioral responses to injections. Three minutes after the suggestion, B’s right hand lifted jerkily into the air. She was then awakened and experienced a complete amnesia for the trance period” (p. 203).
“[They] then carried out a procedure to ratify the therapeutic change. This process presumably further develops expectancy of change, confirms change at the unconscious level, and puts doubt into any conscious beliefs contrary to positive change. This step is standardly carried out as was done with B. [They] had B sit with her hands resting on the arms of the chair. [They] told her they would ask her unconscious mind a question that only it would know the answer to. It could answer ‘yes’ to the question by lifting her left hand, ‘no’ by lifting her right hand, and ‘I don’t know’ or ‘I don’t want to answer’ by lifting both hands. Then the question was asked, ‘In the future, will B remain comfortably awake and alert anytime she receives an injection or a blood test?’ After a few minutes her left hand jerked momentarily into the air. After some discussion about the ideomotor response and her trance experience they dismissed her with the prescription to ‘await the surprising results'” (p. 203).
The authors cite as a source for their work two books: Erickson, Rossi, and Rossi, Hypnotic Realities, 1976, pp. 226-230; also Erickson & Rossi, Hypnotherapy, 1979.

Bassman, S. (1983). The effects of indirect hypnosis, relaxation and homework on the primary and secondary psychological symptoms of women with muscle contraction headache (Dissertation). Dissertation Abstracts International, 44, 1950-B.

Compared the effects of indirect hypnosis (e.g., metaphors, stories, vague suggestions, and implied directives) on muscle contraction headaches with a relaxation and a no-treatment control condition. Both hypnosis and relaxation conditions reduced symptoms more than did the no-treatment condition. Unlike relaxation, indirect hypnosis did not reduce the intensity and duration of headaches, although it did reduce the amount of medication and also benefitted sleep.
Snow, Lorraine L. (1979). The relationship between ‘rapid induction’ and placebo analgesia, hypnotic susceptibility, and chronic pain intensity (Dissertation, University of Rhode Island). Dissertation Abstracts International, 40 (n2-B), 937.

Found that the RIA [Rapid Induction Analgesia] was no more effective than oral placebo analgesia in relieving the pain of 30 paraplegics suffering from chronic pain syndrome. Although Snow found that the RIA was unrelated to hypnotizability when the effect of chronic pain experience was controlled, Crowley (1980) did find that hypnotizability was related to multiple chronic pain indices.

Beahrs, J. O. (1977). Integrating Erickson’s approach. American Journal of Clinical Hypnosis, 20, 55-68.
More than any other psychotherapist, Milton Erickson epitomizes the flexibility needed to do most skillfully what he feels is necessary for any psychotherapy: first, meet the patient at the patient’s level and gain rapport; second, modify the patient’s productions and gain control; third, use this control to help the patient change in a desirable direction. Several adjectives often used and misused to describe Erickson are discussed; how they sometimes apply, sometimes do not. His concepts of hypnosis and the unconscious are briefly set forth. Four major and seemingly divergent frameworks for formulating and treating human behavior are presented. My thesis is that, semantics considered, they may often be saying the same thing. The semantics is yet of vital importance, as each framework carries its own different all-important pragmatic implications for how one should work. Erickson is again notable in his uncanny ability to function within all of these modes, and possibly others, with great skill, and the flexibility which allows him to adapt totally to each patient’s own individualized system. Finally, a personal experience of my own is recounted, with a speculative hint on how it might shed some light on the mechanism of how this amazing psychotherapist might do his magic.

Erickson, Milton H.; Rossi, Ernest L. (1976). Two level communication and microdynamics of trance and suggestion. American Journal of Clinical Hypnosis, 18, 153-171.

The authors provide the transcript and commentaries of an hypnotic induction and an effort to achieve automatic writing. An unusual blend of Erickson’s approaches to two level communication, dissociation, voice dynamics and indirect suggestion are made explicit in the commentaries. The junior author offers a ‘context theory of two level communication’ that conceptualizes Erickson’s clinical approaches in terms consonant with Jenkins’ (1974) recent contextual approach to verbal associations and memory. A summary of the microdynamics of Erickson’s approach to trance induction and suggestion is outlined togetehr with a utilization theory of hypnotic suggestion.
Jenkins, J. J. (1974). Remember that old theory of memory? Well, forget it! American Psychologist, 29, 785-795.

Beahrs, J. O. (1971). The hypnotic psychotherapy of Milton H. Erickson. American Journal of Clinical Hypnosis, 14, 73-90.
The principles of hypnosis and suggestion permeate most of Milton Erickson’s psychotherapy, although formal trance induction is used in less than ten percent. Characteristic of Erickson’s style is his indirect manner of phrasing suggestions or interpretations. They come not as outside impositions, but as subtle manipulations leading the patient to institute constructive behavior from within, often without full conscious awareness. Usually Erickson first attempts to meet the patient at the patient’s level, thereby gaining rapport. As trust is developed, he modifies the patient’s productions by covert suggestions, thereby gaining control. In this manner, he is able to convert a chaotic psychotic hallucination into an orderly hypnotic one, or the desperate cries of a terminal cancer patient into hypnotic anesthesia. As interpreted here, Erickson’s therapeutic approaches can be divided into three categories. First are techniques resembling modern behavior therapy, with frequent use of desensitization. Second, uncovering or abreactive techniques are only rarely used for rigidly resistant and severe symptom patterns. With these, extreme care is taken to protect against too rapid a disclosure to conscious awareness. Third and most important, are techniques enabling the patient to shift or displace large amounts of emotional cathexis from his original problem to some new constructive outlets, usually involving the development of trusting interpersonal relationships. These techniques are the cornerstone of Erickson’s therapeutic technique.

Erickson, Milton H. (1964). The confusion technique in hypnosis. American Journal of Clinical Hypnosis, 6, 183-207.

The confusion technique is “a play on words or communications of some sort that introduces progressively an element of confusion into the question of what is meant, thereby leading to an inhibition of responses called for but not allowed to be manifested and hence to an accumulating need to respond. … [Added to the play on words] are the modification of seemingly contradictory, or irrelevant unrelated concepts, non sequiturs and ideas, variously communicated, and each of which out of context is a simple reasonable assertaion, meaningful and complete in itself. In context, such communications given in a meaningfully emphatic manner become a medley of seemingly valid and somehow related ideas that leads the subject to try to combine them into a single totality of significance conducive to a response, literally compelling a response. But the rapidity of the communications inhibits any true understanding, thereby precluding responses and resulting in a state of confusion and frustration. This compels a need for some clear and understandable idea. As this state develops, one offers a clearly definite easily comprehensible idea which is seized upon immediately and serves to arouse certain associations in the subject’s mind. The medley is then continued and another comprehensible idea is offered, enhancing the associations of the previous clear understanding. And in the process, one throws in irrelevancies and non sequiturs as if of pertinent value, thereby enhancing the confusion” (p. 256 in the article as reprinted in Jay Haley).

Erickson, Milton H. (1954). Special techniques of brief hypnotherapy. Journal of Clinical and Experimental Hypnosis, 2, 109-129. (Abstracted in Psychological Abstracts 55: 2508)

Author describes techniques used with patients who aren’t able, for internal or environmental reasons, to undertake comprehensive therapy, “Intentionally utilizing neurotic symptomatology to meet the unique needs of the patient” (p. 109). He provides 8 case reports.
Patient 1 was reassured, in hypnosis, that his arm paralysis was due to “inertia syndrome” which he would continue to have, but it wouldn’t interfere with his work.
Patient 2, also with arm paralysis had another comparable, non-incapacitating, symptom substituted.
Patients 3 and 4, for whome restrictions on therapy were the limits of time and situational realities, had their symptoms transformed (e.g. by introducing in hypnosis the obsessional thought or worry that he would NOT have the symptom for which he sought help).
Patients 5 and 6 were helped, through hypnosis, to symptom amelioration. (Patient 5 had an IQ of 65.)
Patient 7 “Therapy was achieved … by a deliberate correction of immediate emotional responses without rejecting them and the utilization of time to palliate and to force a correction of the problem by the intensity of the emotional reaction to its definition” (p. 121)
Patient 8 “the procedure was the deliberate development, at a near conscious level, of an immediately stronger emotion in a situation compelling an emotional response corrective, in turn, upon the actual problem” (p. 121).


Karlin, Robert (1997). Illusory safeguards: Legitimizing distortion in recall with guidelines for forensic hypnosis – two case reports. International Journal of Clinical and Experimental Hypnosis, 45, 18-40.

Two amnesic automobile accident victims remembered the information needed for their ongoing lawsuits during hypnosis. Meeting the recording requirements of the Hurd safeguards led to the admission of hypnotically influenced testimony in court in one case, whereas failure to record led to exclusion in the other. In both cases, closed-head trauma almost certainly prevented long-term memory consolidation. Thus adherence to guidelines for forensic hypnosis legitimized distortions in recall instead of preventing them. Hypnosis used to facilitate hypermnesia alters expectations about what can be remembered, makes memory more vulnerable to postevent information, and increases confidence without a corresponding increase in accuracy. Distortion of recall is an inherent problem with the use of hypnosis and hypnotic-like procedures and cannot be adequately prevented by any set of guidelines.

Barber, Joseph (1995, November). When hypnosis causes trouble. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES: Sexual acting out occurs, even with highly trained and responsible clinicians. But other problems occur, and it is the same qualities of hypnosis that make it useful that also make for problems. I found 20 publications that exhibited problems in therapy, and they all discussed only the mental illness of the patients.

Frischholz, Edward J. (1995, November). A critical evaluation of the 1985 AMA Report on hypnosis and memory. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.

JAMA 1985 concluded that hypnotically refreshed memories are less reliable than nonhypnotic recall. There are two problems with their conclusion: 1. No consensually validated definition of ‘hypnosis’ is identified. They talk about administration of induction, and differences in hypnotic susceptibility. 2. Empirical criteria for discriminating the unique and/or moderating effects attributable to hypnosis are not specified.
For example Loftus showed that memory errors can be created without hypnosis. You should not just add hypnosis to that model.
The criticisms have not led to remedial practices. No research has been done to show how to minimize errors or how to facilitate accuracy.
‘What is Hypnosis?’ Something that is done vs. something that happens? A procedure or responsivity? Questions like this are relevant to research on whether hypnotically refreshed memories are less reliable than ordinary recall.
Hypnosis is not a ‘valid therapeutic modality’ (i.e., ‘hypnotherapy’ is a misnomer). Hypnosis can be used adjunctively with many different types of therapeutic modalities: –psychodynamic therapies –behavior modification treatments –cognitive restructuring strategies –systematic desensitization –flooding –direct suggestion
There is a specious communality: hypnosis is used in a different kind of way with each approach.
If hypnosis is defined in terms of whether an hypnotic induction procedure was administered to the subject, then hypnosis is a universal phenomenon (i.e., everyone can be administered an hypnotic induction procedure). This, in the AMA report, permitted the courts to define it this way, which leads to a number of ridiculous results.
We need to highlight ‘What are the variables that are the source of the errors?’ The sources are not hypnosis. We can minimize the sources by the way we ask questions, instruct the subjects, etc.
If hypnosis is defined in terms of the nature of the subjects’ response to the procedures, then hypnosis is not a universal phenomenon (i.e., there are wide individual differences in hypnotic responsivity). I have shown that it is possible to alter memories, using the Loftus model, in people who are both low and high hypnotizable.
We need to take into account induction procedure, hypnotizability, type of memory, and the retrieval/influence procedure. The demand characteristics re forced responding, expectancies about memory (e.g. video recorder model), expectancies about hypnosis (e.g., everyone remembers) must be accounted for.
Dependent variables in this type of research include memory accuracy, memory errors, and subjective confidence.

Barber, Joseph (1994, October). How to use and abuse boundaries with hypnosis. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco. Keywords: abuse, ethics/standards of care, hypnotherapy, hypnotist, psychodynamic, relationship/transference, suggestion

(for only part of the presentation) I would like to focus on how we can productively use boundaries. Hypnosis experience reactivates archaic experiences with parents; if therapist can evoke trust, the patient can feel increasingly that they can relax into the experience.

Beahrs, John O. (1994). Why dissociative disordered patients are fundamentally responsible. International Journal of Clinical and Experimental Hypnosis, 42 (2), 93-96.

The author was asked to respond to the question, “To what extent should patients with multiple personality disorder (MPD) be held fundamentally responsible for their actions?”

Bloom, Peter B. (1994). Clinical guidelines in using hypnosis in uncovering memories of sexual abuse: A master class commentary. International Journal of Clinical and Experimental Hypnosis, 42 (3), 173-178.

“Joan,” a clinical psychologist, requested a psychiatric consultation to determine whether hypnosis could recover accurate memories of suspected child abuse by her still living father. Are there clinical guidelines in using hypnosis in uncovering such possible memories of sexual abuse? We asked Dr. Peter B. Bloom to share his views with us.

Gives case example and clinical guidelines for using hypnosis in uncovering memories of sexual abuse. 1. In medical practice, “Primum non nocere,” i.e. “First do no harm.” 2. “No therapist should ever, either directly or indirectly, suggest abuse outside of a specific therapeutic context–certainly not to a client who is on the phone making a first appointment!” 3. “A therapist must not jump quickly to the conclusion that abuse occurred simply because it is plausible.” 4. “A therapist should never simply assume that a client who cannot remember much from childhood is repressing traumatic memories or is in denial.” 5. “Remember ‘a client is most vulnerable to suggestion and the untoward influence of leading questions when therapy begins to delve into painful life situations from the past, particularly from childhood.'” 6. “Therapists … should be cautious about suggesting that clients cut off communication with their families.” 7. “Therapists should reconsider the ‘no pain, no gain’ philosophy of treatment.” 8. “The context of therapy is as important as the content.” 9. “Tolerate ambiguity.” (Sincerity and conviction on the part of the patient reporting abuse are not in and of themselves reason to believe the material.) 10. “Respect the current science of memory.” 11. “Maintain responsibility for making the diagnosis and choosing the treatment.” 12. “Pursue alternative diagnoses to account for the symptoms.” 13. “Historical and narrative truth: Understand the difference.”

The tenet that insight is necessary for change and growth is not true. Change can occur without insight, although insight may be helpful in maintaining change once it has occurred.

These guidelines are presented to enhance safe practice, however, clinicians should use their own judgement to determine the best path to follow with each patient.

Guidelines 1, 8, 9, 10, 11, 12, and 13 are those of Peter B. Bloom. Those labeled as Guidelines 2, 3, 4, 5, 6, and 7 were taken with permission from Yapko, M. (1993 September/October). “The seductions of memory. The false memory debate.” Family Therapy Networker, 17, pp. 30-37. All discussions, however, are those of Peter B. Bloom.

Bloom Peter (1994, October). Training boundaries that enhance responsible therapy: Using hypnosis creatively in one’s own discipline. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.

Presented three cases that he elected not to treat, to illustrate the principle that we should only treat cases we would be professionally trained to treat without hypnosis. (1) a hemmorhoidectomy patient, where he elected not to do hypnosis because he is not trained specifically in anesthesiology and didn’t know how to do anesthesia procedures; (2) conversion hysteria in 12 year old girl, because he isn’t trained in child psychiatry and doesn’t know child development; (3) to confirm the supposed existence of unidentified flying objects, or UFOs (when a woman tried to get him to hypnotize her so the “truth” would emerge). We must free ourselves from treatment of patients who retreat from reality, when we can’t find commonality in goals.

Ganaway, George K. (1994, October). The thin line: Reality and fantasy in hypnotically facilitated memory retrieval during psychotherapy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.

Historical review: Every hundred years there has been a peak in interest in altered states–a fin de ciecle zeitgeist. It is the Brigadoon effect, i.e. something materializing for one day every 100 years. The theories developed then suffer from “paradigm grandiosity.” In hypnosis, we can refer back to:
1694 Salem witch trials
1790s Gaussner’s exorcism (see Ellenberger); in a 1775 showdown between him and Mesmer, there occurred the turning point between exorcism and psychotherapy.
1880s Charcot at Salpetrier ‘demonstrated’ that hypnosis was an organic, pathological condition. Ultimately this contributed information about the plasticity of hypnotized people. (In the 1880s Bernheim thought it wasn’t pathological and thought that suggestion was the important element in hypnosis.)
Recent historical contributions have influenced our views of MPD. Spiegel and Kardiner published book about hypnosis and war neuroses. Cheek & LeCron developed ideomotor questioning, which ignores the contribution of unconscious fantasy. Jacob Arlow’s metaphor for MPD is two movie projectors aiming at a screen from two different sides. The subjectively known experiential world thereby combines external reality and the person’s internal, motivated perceptions. The author presented a case study of female therapist, who had been previously diagnosed as MPD, who presented with dissociative symptoms that she thought were due to abuse by her grandmother. She fabricated the memories in order to get the holding and physical nurturing from her therapist for being courageous and remembering the abuse.
Maintenance of professional boundaries is very important in treatment.

Lynn, Steven Jay; Nash, Michael R. (1994). Truth in memory: Ramifications for psychotherapy and hypnotherapy. American Journal of Clinical Hypnosis, 36, 194-208.

In this article we address a number of issues relevant to the practice of psychotherapy and hypnotherapy: How reliable is memory? How are therapists’ and clients’ beliefs and expectancies related to pseudomemory formation? Are certain clients particularly vulnerable to pseudomemory creation? Does hypnosis pose special hazards for pseudomemory reports? What are the variables or factors that mediate hypnotic pseudomemories? In addition to reviewing the literature on these topics, we intend to sensitize the clinician to the potential pitfalls of critical reliance on the patient’s memories, as well as uncritically accepted clinical beliefs and practices.

London, Ray William (1993, October). Refreshed adult memories: Abuse survivor or therapeutic victim?. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.

The author addresses four areas: 1. public policy 2. psychological issues 3. legal issues (evidence) 4. how to properly deal with it
A definition of sexual abuse is being applied to behaviors that for years were not considered out of bounds (e.g. entering a bathroom where someone else is). Furthermore, using the word “survivor” for abused people equates patients with survivors of concentration camps, who do not present with repressed memories typically. National incidence of child abuse remains unclear estimates are 6 to 60% of females. In Florida, only 13% of cases reported are confirmed.
Some therapists who specialize in this area in surveys indicate that they have false beliefs regarding memory and effects of trauma.
[These represent only partial notes on a lengthy and substantial paper.]

Perry, Campbell (1993, October). A case of multiple allegations of masturbation by a psychiatrist during hypnotic and/or sodium amytal therapy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.

This is a case study of a Canadian psychiatrist accused by 5 women of masturbating during therapy.

Stolar, Donald Sigmund (1993). History of hypnosis in court. [Lecture] UCLA Hypnosis Seminar.

Disclaimer–The following information is not intended to substitute for professional legal advice and should not be used as such.
The following events led up to our current situation in California, regarding the use of hypnotically elicited information in court:
1968 – Harding vs. the State of Maryland. First case in which the state prosecution requested use of hypnosis. (Prior to this hypnotically refreshed memory was not used in court testimony because the memory was regarded as unreliable.) Police hypnotized a state’s witness, and a man was convicted of rape. Hypnosis in this case was considered no different from other memory jogging techniques (Like showing a witness pictures.)
1978 – Reiser published “Hypnosis and it’s use in law enforcement.” In it he stated that 60% of witnesses hypnotized by police gave important information that helped the case. Reiser is a psychologist working in the Los Angeles Police Department.
1976 – Chowchilla kidnaping case, the driver of the bus was hypnotized, and remembered enough of a license plate to catch the kidnappers.
1980 – Reiser, _Handbook of Investigative Hypnosis_ N=384 cases were investigated using hypnosis. In 67% of these cases, hypnosis was thought to have led to valuable information. Where external corroboration was possible, 90% of the new pieces of information were accurate. The Society for Investigative and Forensic Hypnosis was established by Reiser.
During this same period, courts were pulling back from permitting hypnotically refreshed memories to be given in court testimony.
1979 Martin Orne (in the International Journal of Clinical and Experimental Hypnosis) proposed safeguards for the use of hypnosis for forensic purposes. 1. Licensed psychologist or psychiatrist does the hypnosis. 2. Hypnotist is independent of prosecution, defense, and investigator. 3. Any information regarding a crime given to the hypnotist before hypnosis must be written down. 4. The hypnotist writes everything the witness says. 5. All interviews, including the pre-hypnosis interview, are recorded. 6. Only the hypnotist and witness are in the room, and 7. independent verification is very important.
Inasmuch as Reiser had been training detectives to do investigative hypnosis, he countered the Orne requirements by noting that: 1. Therapists are not trained investigators; detectives typically work with trauma victims. 2. Reports of adverse side effects following investigative hypnosis are exaggerated 3. Confabulation and fantasy are no more prevalent in hypnosis than in waking state.
Herbert Spiegel, in addressing the reliability of hypnotically refreshed memories, said hypnosis can make an “honest liar” out of a person. That is, they can be personally convinced that they have remembered something that in fact did not happen.
1980 – Bernard Diamond, M.D. (psychiatrist and law professor) wrote an article in the California Law Review, noting that: 1. Hypnotically refreshed testimony is full of fantasy and confabulation. 2. A hypnotist cannot tell if the subject is simulating. 3. A hypnotized subject cannot discriminate between fact and fantasy. 4. A hypnotized subject could become hardened against cross examination because with hypnosis he becomes more confident.
Courts began using the Frye Rule: in order for expert testimony to be admissible, it must be what is generally accepted to be true, in the scientific research literature.
1982 – The Shirley Decision (California Supreme Court) A woman who was raped was hypnotized before the trial. The accused, a man named Shirley, admitted having sex but said it was not forced. The Supreme Court used the Frye Rule to exclude any testimony from either side from anyone who had been hypnotized. (This rule applied to any hypnosis, including hypnotherapy.) Later the Court revised it to say that the defendant could be hypnotized (but not the plaintiff) because nothing should impede their defense.
1982 – Proposition 8 passed (Victim’s Rights bill) and allowed hypnotically refreshed testimony to be used.
1986 – Three Justices, including Justice Rose Bird, were removed from the California Supreme Court (by election) and the legislature wrote Section 795 (which represented a middle ground). Hypnotically refreshed memory is allowed if the court testimony is limited to pre-hypnotic recall.

Weissberg, Michael (1993). Multiple personality disorder and iatrogenesis: The cautionary tale of Anna O.. International Journal of Clinical and Experimental Hypnosis, 41, 15-34.

An examination of Breuer’s treatment of Anna O. Illustrates some of the controversies surrounding the recent rise of case reports of multiple personality disorder. Anna O., the first patient of the cathartic method, psychoanalysis, and dynamic psychiatry, fits current criteria for multiple personality disorder. Breuer’s treatment, however, may have contributed to her states of absence; the timing, type, and intensity of Breuer’s interventions make it possible that he unwittingly encouraged and amplified Anna’s dissociations, reified her ego fragments, and then explained Anna’s symptoms with the pseudomemories and confabulations recovered from Anna while she was hypnotized. A review of Breuer’s treatment highlights some of the controversial aspects of multiple personality disorder, specifically its possible vulnerability to iatrogenesis via suggestion and unconscious collusion and other factors. The current stance of some multiple personality disorder enthusiasts, opaque to their participation in interactions that may lead to certain patient productions, resembles the older psychoanalytic stance exemplified by the early Breuer and Freud. The dialectic of the therapist as a neutral observer versus as an influential participant continues to be a focus of controversy, both within psychoanalysis and psychotherapy and in the understandings of the etiology and treatment of multiple personality disorder.

Crawford, Helen J.; Kitner-Triolo, Melissa; Clarke, Steven W.; Olesko, Brian (1992). Transient positive and negative experiences accompanying stage hypnosis. Journal of Abnormal Psychology, 101 (4), 663-667.

Frequency of positive and negative experiences accompanying stage hypnosis was assessed in follow-up interviews with 22 participants of university-sponsored performances. Most subjects described their experience positively (relaxing, interesting, exciting, satisfying, illuminating, and pleasurable), but some described it negatively (confusing, silly, annoying, and frightening). Five subjects (22.7%) reported partial or complete amnesia; all were highly responsive to the stage hypnosis suggestions. One subject was completely unable to breach amnesia and felt annoyed and frightened. Five subjects (22.7%) believed the hypnotist had control over their behavior. Participants (n=15) tested subsequently on the Stanford Hypnotic Susceptibility Scale, Form C (Weitzenhoffer & Hilgard, 1962) were mostly moderately to highly hypnotizable (M = 7.07), and the scores correlated significantly (r = .68) with the percentage of passed stage hypnosis suggestions.

Echterling and Emmerling (1987, American Journal of Clinical Hypnosis) conducted a follow-up of 18 people who participated in stage hypnosis at a university, within a month after the experience. Referring back to the hypnosis itself, 39% reported positive experiences, 39% reported both positive and negative experiences, and 22% (four people) reported ‘strongly negative’ experiences. The present study contacted subjects immediately after the stage hypnosis experience, either in person or by telephone. They completed both objective questions and open-ended questions referring to three time periods: after the hypnotic induction, during the hypnotic suggestions, and after the stage hypnosis had been terminated. Subjects were invited to come to the laboratory to be tested for hypnotizability, and 15 of the 22 did return for testing.
Of the 22 Ss, 4 had previously participated in stage hypnosis, one in laboratory hypnosis, and one had been hypnotized by her father. Of the 15 tested with the Stanford Hypnotic Susceptibility Scale, Form C: 7 were high hypnotizables (scoring 9-12), 7 were medium hypnotizables (scoring 4-8), and one was a low hypnotizable (scoring 0-3). Several people reported that they ‘went along with’ the hypnotist’s suggestions, role playing rather than actually experiencing the suggestions.
“Most of the subjects found the experience positive: 86.4%, relaxing; 86.4%, interesting; 77.3%, exciting; 59.0%, satisfying; 54.6% illuminating; and 54.6%, pleasurable. Negative experiences were also reported: 36.4%, confusing; 36.4%, silly; 9.1%, annoying; and 9.1%, frightening. Only 1 subject reported the stage hypnosis experience as entirely negative.
“The stage hypnotists told the participants about the suggestions at the end of the stage hypnosis performance and supposedly lifted amnesia. Despite this, some participants continued to experience partial or full amnesia for the suggestions. …
“One participant reported complete amnesia even after the interview and was distraught, permitting only a telephone interview and not accepting an offer to be hypnotized at a later time to help recall what had been forgotten. …
“… The interviewer told her what had been observed and attempted to breach the amnesia. The subject continued to report complete amnesia.
“Two other participants continued not to remember many of the suggestions but showed no major concern. Waking suggestions to breach amnesia were given, but no further information was obtained.
“Five participants reported feeling that the hypnotist had complete control over their behavior and that they could not resist the hypnotist’s suggestions” (p. 664).
In their Discussion, the authors note that in general, when negative experiences occur, they tend to be mild and transient. None of the subjects in this investigation reported some of the negative sequelae reported in earlier literature (headaches, nausea, drowsiness). The few subjects who had strong cognitive distortions following hypnosis were highly hypnotizable, which also was observed in an earlier study published by the first author and her colleagues (Crawford, Hilgard, & Macdonald, 1982, International Journal of Clinical and Experimental Hypnosis).
Spontaneous post hypnotic amnesia is one example of cognitive distortion. The authors remarked on the rather high incidence of spontaneous amnesia for some specific suggestions (22.7%) , which was discovered when friends of the subjects described to them what they had done on stage. In an experimental study by Hilgard and Cooper (1965), only 7% of student subjects had spontaneous amnesia (though 35% had amnesia following suggestions for posthypnotic amnesia). Furthermore, in the Hilgard and Cooper study, hypnotizability correlated with suggested amnesia but not with spontaneous amnesia. Cooper (1972) reviewed the literature on posthypnotic amnesia and observed that spontaneous occurrence is less frequent than suggested amnesia.
Explanations of spontaneous amnesia include ideas that high hypnotizables who experience it are significantly different from those who do not (Chertok, 1981; Weitzenhoffer, 1989); or that it is due to expectancy (Kirsch, 1985); or that it is found in people with a tendency for dissociation in and out of hypnosis, or people who may be prone to repression or dissociative and post-traumatic stress disorders. For reviews of these issues, see Kihlstrom, 1987; Kihlstrom & Hoyt, 1990; Frankel, 1990; Nemiah, 1985; Spiegel, 1990; Spiegel & Cardena, 1991).
The authors note that stage hypnotists, while they may otherwise be ethical, do not provide information to subjects to correct misperceptions about hypnosis. For example, in this study 22.7% of the subjects believed, after the stage hypnosis experience, that the hypnotist had control over their behavior and they couldn’t resist the suggestions. “Appropriate guidelines for stage hypnosis (see also Crawford et al., 1982) include screening out participants who are in therapy or counseling, correcting misperceptions about hypnosis among the participants before the hypnosis begins, screening subjects prior to hypnosis, avoiding embarrassing or upsetting suggestions, providing dehypnosis instructions to those who do not remain in hypnosis (or are asked to leave the performance), terminating fully the hypnotic experience, removing all amnesia suggestions and reviewing the events at the end of hypnotic experience, and remaining available afterward for further questions” (p. 666).

Deutch, James A. (1992, October). Ethics in clinical social work. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.

[Introductory comments by the Moderator Dr. Sam Migdall from Beverly, Mass.: Insurance may not cover you if you are practicing outside the scope of your practice. How do internists bill for treating a phobia with hypnosis?
In training sessions we hear about single session cures, but usually we need to work much longer (and using the same methods we would use not using hypnosis).
How do we initiate and decide on hypnotic treatment? Is there a solid diagnosis, treatment plan? Or do we accept the patient’s opinion of what is going on?]
Deutch’s paper presented the following information:
Article 7 of socialwork ethics says people who use hypnosis must abide by our ethics plus those of SCEH (and ASCH if they belong). In my opinion, though different, the ethics all have the goal of providing to the consumer the best service they can render.
All are focusing on practicing within one’s level of competency. [Details of talk not recorded.]

Hoencamp, E. (1992). Comment on the Nelson case. [Comment/Discussion] .

Comments on paper by H. B. Gibson, ‘A recent British case of a man charged with using hypnosis for rape and other sexual offences.’ Comentator refers to his earlier article, Hoencamp, E. (1990). Sexual abuse and the abuse of hypnosis in the therapeutic relationship. International Journal of Clinical and Experimental Hypnosis, 28, 283-297.

Kluft, R. P. (1992). Hypnosis with multiple personality disorder. American Journal of Preventative Psychiatry & Neurology, 3, 19-27.