Recommends hypnotically facilitated psychotherapy as the treatment of choice for MPD and to accelerate case-finding. Twenty-one categories of hypnotic interventions with MPD patients are summarized.
Lynn, Steven Jay; Rhue, Judith W. (1992, October). Memory. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES
[Author presented a dramatic case report of patient who recalled specific events that subsequently he and the patient investigated and disproved. What the patient thought they saw could not possibly have been seen.]
The experimental literature on memory gives us some things to think about. Therapy relies highly on memory, and the therapist shapes the contours of the memory by validating the memories, which are rarely doubted. Tacit acceptance of memories as historical facts is part of the contract of therapy.
Memory studies challenge the idea of accurate storage. Some people are unduly confident of their memory. Bartlett’s research demonstrated distortion according to schema, interpretations, embellishments, etc. Jacobi et al indicate people’s theories about what happened shape memory.
One theory is that trauma leads to amnesia, repression, dissociation. But research does not show inability to recall early life events indicates presence of a traumatic history. Repression is not prima facia evidence of abuse. The Courage to Heal book states that merely thinking you were abused is evidence that you probably were.
How do vague ideas crystallize? Loftus finds if inability to remember isn’t attributed to ordinary forgetting, the person may look for memories, thereby creating them.
Studies of persons who confess to crimes, unsure whether they did or didn’t do them, indicate that these people are easily coerced. Doubt in a memory’s accuracy can be reframed by a therapist.
Hypothesis: Therapists who confidently state a view risk implanting pseudomemories. Therapists must be cautious.
Clients can confuse sources of information that they receive. Different sources of information can be integrated into a single memory (e.g. what occurred to them and what occurred to siblings can be integrated into a pseudomemory). Some limited evidence that early life experience memories could be implanted has been presented by Loftus.
Certain client characteristics contribute to false memories: 1. Present mood state (mood congruent memory). This effect is reliable when people are clinically depressed. Though clinicians may say it indicates early childhood abuse, the memory might be selective or biased. 2. History of fantasy-proneness. In childhood this type of person might have had problems distinguishing fantasy from reality. LaBelle et al found absorption made it difficult to distinguish sounds in hypnosis from what really occurred, creating pseudo- memories. With this population it is essential to avoid suggesting abuse.
Lynn was successful in implanting an idea of abuse in an alter called Person. He used the Orne technique (from the BBC film “Hypnosis on Trial”) to ask a patient what she had told him about her dog during the hypnosis; he did this to convince her of the importance of exploring her amnestic episodes.
Does hypnosis foster a literal re-experiencing of childhood events? NO. Nash, in an exhaustive review, failed to find correspondence between information from hypnotic age regression and childhood events. He notes that literal reliving is not possible. It is possibly an expression of primary process thinking. Hypnosis doesn’t ameliorate memory problems; and it may exacerbate memory problems.
Lynn views primary process thinking observed in hypnosis as due to the demand of hypnosis to fantasize and relinquish critical thinking or objectivity. This plus Therapist and Patient expectancies may foster tenacious beliefs that events occurred.
Many hypnotic suggestions may interfere with memory. The AMA 1985 report suggests that hypnosis can influence confidence in a ‘memory’ with no actual improvement in accuracy.
The effects aren’t limited to hypnosis however. Simulators and controls also generate pseudomemories. Repeated questioning of Ss who are led to believe that questioning helps distinguish memories from fantasies, actually diminishes the accuracy of memories.
Hypnotizability is correlated with pseudomemory occurrence. We should evaluate a client’s hypnotizability when evaluating for pseudomemories.
Perceived verifiability rate is important, as pseudomemories are higher where you can’t verify the reported memory, it is thought. Therefore, approach with caution. Make every effort to corroborate memories.
Subjective reports may tell narrative truths even though inconsistent with the historical record, and could be useful independent of historical accuracy. I agree that those ‘memories’ could be important, just as age progression or past life regression material could be useful in therapy. But should we base our interpretations or conclusions on events that are not confirmed? A patient’s belief in abuse by their parent has enormous implications for a family.
Therapists should understand the dynamics of a request for using hypnosis to recall forgotten memories before using uncovering techniques. Ask yourself, “Why is this being requested?” Also ask other questions: 1. Is the person fantasy prone, dissociative, suggestible, a high hypnotizable? 2. Is the person stabilized enough to focus on an abreaction? 3. Is there conscious or unconscious motivation to avoid responsibility for one’s own behavior? 4. Is there a wish to arrive at a facile solution, a magic cure, the royal road to the unconscious; or is there an attempt to control the treatment hour, to avoid issues, to test the therapist? 5. Is therapy stalled, not moving forward? 6. Am I angry with the client because they expect to uncover more?
Instead of using hypnosis to retrieve memories, I may focus on the issues to which I answer ‘Yes’ in the forgoing list.
I do not believe current research is sufficiently persuasive to throw out hypnosis for retrieving memories. The dangers of pseudomemory are endemic to therapy. Incorporating hypnosis into a broader frame of therapy depends on the skill of the clinician. However, we must use hypnosis with great caution
COMMENTS FROM AUDIENCE
oseph Dane: In 75% of cases that could be verified, they found corroborating evidence: what should you look for as an index that the memory recalled in hypnosis is more likely to be accurate?
Lynn: Many instances of abuse are corroborated. No one questions the veracity of all memories. To my knowledge there are no ways of corroborating genuine from false memories. We know subjective conviction is not sufficient, and clients’ affective experience can be very misleading. Since my experience [in the case study reported at the beginning of this presentation] I have talked with many therapists who have had similar experiences.
David Spiegel – the problem is not the hypnosis: patients go in and out of hypnosis all the time, momentarily. The problem is, how do I explore the material in psychotherapy? There is no substitute for corroboration if you can get it. But you have to be sensitive to the vulnerability of those people.
Howard Hall: What is a genuine memory? No memory is undistorted. More importantly, can we verify significant events that might have had long term consequences, like abuse? We should try to verify memories when we base treatment programs on them. The only memories in the literature that have a reputation of being accurate are highly traumatic events that stand out, and these reports are anecdotal in nature.
Strauss, Billie S. (1992, October). What’s in a name: Use and presentation of hypnotherapy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES
Psychologists have standards of ethical and professional conduct for clinical and research endeavors. Several guidelines which have particular relevance for the use of hypnosis are (1) issue of informed consent, (2) issues of training, and (3) consultation with another professional.
New Guidelines have been published by APA. 1. Informed consent is required. This raises the issue of whether we [invariably] should use the term hypnosis. What if we use hypnotic techniques in a non-hypnotic context? Or conversely, if a patient doesn’t go into a hypnotic state, are we bound to tell them so? Bauman (1988) thought, with respect to psychotherapy, that we don’t need to explain about “interpretation” or “behavior modification.” (I tend to tell patients about these, however, as much as the patient can understand.) Euphemisms for hypnosis (guided imagery, relaxation) are also used. If a patients say they don’t want to use hypnosis, it should not be used, even under the guise of guided imagery.
Does informing patients of potential hazards result in a self-fulfilling prophesy?
One needs to pay attention to the implications when the hypnotist also may be interacting with students and colleagues in a non hypnotic setting, e.g. setting up double binds when asking them to do something. Think carefully about role implications, especially if you have perceived status. 2. A second issue has to do with training. APA adopted a resolution that hypnosis should not be taught to lay people. New guidelines require that hypnosis and projective techniques only be taught to people with adequate training. 3. A third issue is consultation (e.g. when hypnosis is used by one professional, and the patient is being treated by someone else in psychotherapy). The patient should give permission for the two to communicate. This raises issues of countertransference, especially of omnipotence and control and of splitting.
Patterson, David R. (1991, August). Why hypnosis is not taken more seriously as a form of pain control. [Paper] Presented at the annual meeting of the American Psychological Association, San Francisco.
Despite the backing of laboratory studies and numerous clinical case reports, hypnotically based pain control is infrequently used in pain programs and lacks respect in the scientific community. It is argued that this is a situation that could be remedied by 1) delineating more often whether hypnosis is to be used as facilitator for other techniques or as an analgesic in itself, 2) improving the quality of clinical research, 3) resolving the issue of the significance of hypnotizability in pain control, and, 4) integrating hypnotic interventions with a better understanding of the nature of pain.
1990
Page, Roger A.; Handley, George W. (1990). Psychogenic and physiological sequelae to hypnosis: Two case reports. American Journal of Clinical Hypnosis, 32 (4), 250-256.
Two cases of hypnotic sequelae occurring in a research context (with a non-clinical college population) are reported. Case 1 was a male who experienced retroactive amnesia following hypnosis: He was unable to recall familiar telephone numbers later that day. This was not a continuation of an earlier confusion or drowsiness (as is often found) since he indicated he was wide awake following hypnosis. Two parallels exist with previous reports: unpleasant childhood experiences with chemical anesthesia and a conflict involving a wish to experience hypnosis but a reluctance to relinquish control. Case 2 was a female who, while in hypnosis, experienced an apparent epileptic seizure that had characteristics of both petit mal and grand mal seizures. Although having a history of epilepsy, she had not had a seizure in 7 years. We suspect that the seizure was psychogenic and may have been triggered by wording used in the hypnotic scale or other similarities. Possible mechanisms are discussed and preventative recommendations are made.
1989
Gibson, H. B. (1989). The Home Office attitude to forensic hypnosis: A victory for scientific evidence or for medical conservatism?. [Comment/Discussion] .
NOTES
The author is in agreement with the Home Office Circular (August 1988) that advises against the use of hypnosis in police investigations. However he disagrees with the Circular statement that “‘There may be danger that, in some cases, the experience of hypnosis may cause longer term harm to the mental health of the subject…’ This is certainly not true if the proceedings are carried out by a competent health professional” (p. 26).
Pinizzotto, Anthony J. (1989). Memory and hypnosis: Implications for the use of forensic hypnosis. Professional Psychology: Research and Practice, 20 (5), 322-328.
NOTES
The author reviews arguments regarding hypnosis in forensic investigations, offers procedures of a nonhypnotic nature to enhance memory recall, and suggests guidelines for hypnosis in criminal cases. The effects of hypnosis on memory, as well as the concomitant dangers regarding those effects, are discussed.
Torem, Moshe S. (1989). Iatrogenic factors in the perpetuation of splitting and multiplicity. Dissociation, 2, 92-98.
Many dissociative patients tend to have rapidly dissociative switching from one ego-state to another. These trance-like states make the patients highly suggestible to outside influences which include the therapists’ verbal and nonverbal communication. Some therapists may have an over-investment in more personalities, and thus ignore the needs of the whole person. Treating an adult patient who is in an age regressed ego-state, or alter personality, presents a particular challenge as to the patient’s boundaries since violating these boundaries may perpetuate splitting and multiplicity. Therapeutic limit setting, the issue of trust, and countertransference issues are discussed.
1988
Coons, P. M. (1988). Misuse of forensic hypnosis: A hynotically elicited false confession with the apparent creation of a multiple personality. International Journal of Clinical and Experimental Hypnosis, 36 (1), 1-11.
A case is presented in which there was flagrant misuse of forensic hypnosis. The patient, a woman in her early 30s, was accused of shooting her 2 children. During a hypnotic interview, the police hypnotist used an extremely suggestive interrogative technique, and the suspect produced an apparent secondary personality who confessed to the shootings. Subsequently the prosecutor tried to enter the “hypnotic confession” as evidence against the defendant. The evidence was dis-allowed because of the manner in which it was obtained and because of the lack of verification from other sources. The literature regarding the use of forensic hypnosis is reviewed as is the literature regarding multiple personality and the experimental production of multiple personality-like phenomena.
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.
NOTES
Discusses countertransference conflicts that often move the therapist unconsciously and irrationally to alter the canons of psychotherapy in mutually detrimental ways.
MacHovec, Frank J. (1988). Hypnosis complications, risk factors, and prevention. American Journal of Clinical Hypnosis, 31, 40-49.
There is a substantial body of clinical and experimental research data documenting the incidence of mild to severe after effects coincident with the use of hypnosis in persons with no prior history of similar medical or mental problems. This article provides an overview of relevant clinical and experimental research and a review of pertinent literature since 1887. Subject, hypnotist, and environmental risk factors are listed, a definition and classification system for hypnosis complications is suggested, and recommended preventive practices are described.
Venn, J. (1988). Misuse of hypnosis in sexual contexts: Two case reports. International Journal of Clinical and Experimental Hypnosis, 36 (1), 12-18.
A military officer was accused by 2 young men of having used hypnosis to attempt homosexual relations. The officer denied the charges and claimed that the young men had imagined these events while they were in altered states of consciousness. The officer did admit to questionable practices such as consuming alcoholic beverages with the 2 young men and then using relaxation techniques with them in bedrooms. Subject motivation and nonhypnotic coercive tactics such as abuse of authority and alcohol seem important in understanding alleged cases of hypnotic coercion.
1987
Olness, Karen N.; Libbey, Patricia (1987). Unrecognized biologic bases of behavioral symptoms in patients referred for hypnotherapy. American Journal of Clinical Hypnosis, 30, 1-8.
Twenty patients referred for hypnotherapy had organic conditions which explained their symptoms. Each had been evaluated previously by physicians. Eleven had also been in psychotherapy; two of these had been hospitalized on child psychiatry inpatient units. Presenting symptoms included five with nocturnal enuresis, four each with headaches and recurrent abdominal pain, three with recurrent headaches, two with anxiety, and one each with sleep problems and tics. Diagnoses included hyperthyroidism, diabetes, diastometamyelia, partial oxalotranscarbamylase deficiency, sinusitis, carbon monoxide poisoning, vitamin overdose, food allergy, amebiasis, constipation, urinary tract infection, paroxysmal atrial tachycardia, and seizures. Each child had complete remission of symptoms with treatment of his/her underlying disease. Morbidity related to delayed diagnoses included parental anxiety and guilt, child anxiety, growth delays, family financial difficulties, loss of parental work time, loss of school days, and loss of confidence in child health professionals by families.
Patterson, David R.; Questad, Kent A.; Boltwood, Michael D. (1987). Hypnotherapy as a treatment for pain in patients with burns: Research and clinical considerations. Journal of Burn Care and Rehabilitation, 8 (3), 263-268.
Hypnotherapy has increasingly been included in the management of burn patients, particularly in the area of acute pain. To better understand such issues as (1) overall efficacy of hypnotherapy to alleviate acute burn pain, (2) instances in which hypnotherapy is contraindicated, (3) interaction of hypnotherapy with medication, (4) standard induction techniques to use with various age groups, (5) role of nursing and other staff in facilitating hypnotic effects, and (6) future methodological directions, they examined the clinical and methodological merits of recent studies of hypnoanalgesia. A literature search found 17 studies in which hypnotherapy was applied to the management of burns. The literature generally supports the efficacy of this approach to reduce burn pain; however, little else can be concluded from these studies. Several recent studies have applied hypnotherapy to aspects of burn care other than pain using excellent experimental designs. It is suggested that future studies of acute pain management follow suit.
American Medical Association Council on Scientific Affairs (1986). Scientific status of refreshing recollection by the use of hypnosis. International Journal of Clinical and Experimental Hypnosis, 34, 1-12.
The Council finds that recollections obtained during hypnosis can involve confabulations and pseudomemories and not only fail to be more accurate, but actually appear to be less reliable than nonhypnotic recall. The use of hypnosis with witnesses and victims may have serious consequences for the legal process when testimony is based on material that is elicited from a witness who has been hypnotized for the purposes of refreshing recollection.
NOTES
The Council finds that recollections obtained during hypnosis can involve confabulations and pseudomemories and not only fail to be more accurate, but actually appear to be less reliable than nonhypnotic recall. The use of hypnosis with witnesses and victims may have serious consequences for the legal process when testimony is based on material that is elicited from a witness who has been hypnotized for the purposes of refreshing recollection.
APA Council of Representatives (1986, December). Resolution on hypnosis. Newsletter of Division 30, Psychological Hypnosis, of the American Psychological Association, 1.
NOTES
The Council of Representatives adopted a motion that opposes the teaching of hypnosis to persons who are not fully trained in a health delivery profession. The motion presented by Dr. Gene Levitt, Division 30 representative to Council of Representatives, was passed by voice vote on August 24, 1986. It read as follows:
“Be it resolved that the American Psychological Association, in the interest of the public, opposes applications of hypnosis by persons who are not fully trained members or advanced students of a health delivery profession and who lack specific, in-depth training in hypnosis. Therefore, be it also resolved that APA opposes the teaching of hypnotic induction techniques or applications of hypnosis that involve treatment or assessment with patients or clients to persons who are not fully trained members or advanced students of a health delivery profession. Be it resolved further that upon passage of this resolution, its text shall be conveyed to the APA Ethics Committee to consider its incorporation in the APA Code of Ethics. We note that the resolution is consistent with the preamble of Principle 1 of the code as well as the Standards for Providers of Psychological Services (Principles and Implications of Standards, 3)”
Dr. Levitt proposed that the motion be named the “Erik L. Wright Memorial Resolution” in honor of the Division 30 Council representative who introduced the first version of it in 1980.
Judd, Fiona K.; Burrows, Graham D.; Dennerstein, Lorraine (1986). Clinicians’ perceptions of the adverse effects of hypnosis: A preliminary study. Australian Journal of Clinical and Experimental Hypnosis, 14, 49-60.
Questionnaires were sent to all members of the Australian Society of Hypnosis and responses obtained from 202 members and associate members who used hypnosis clinically. Respondents’ experience in the use of hypnosis and the frequency of use of hypnosis as a treatment modality varied. Overall 43.5% of respondents reported adverse effects with one or more patients over the preceding year. Most adverse effects attributed to hypnosis were transient and included development of panic or extreme anxiety, development of excessive dependence and difficulty in terminating hypnosis. Exacerbation or precipitation of significant depression was an infrequent but serious adverse effect attributed to hypnosis. Other infrequent adverse effects included symptom substitution, acting out behaviour, fantasied sexual seduction, precipitation or worsening of psychotic illness or difficulties in the management of organic conditions The difficulties were acknowledged of differentiating between the effects of hypnosis itself and other components of the therapeutic transaction, but the results of this survey suggested both that hypnosis be employed clinically by properly trained professionals and that further sensitive clinical research is needed in the area.
1985
Fellows, Brian J. (1985). Hypnosis teaching and research in British psychology departments: Current practice attitudes and concerns. British Journal of Experimental and Clinical Hypnosis, 2 (3), 151-156.
NOTES
The author mailed a questionnaire to 58 departments of psychology to determine the extent/nature of hypnosis teaching and research, and attitudes toward teaching and research on hypnosis. The author noted a general anxiety about teaching students how to do hypnosis (as contrasted with learning about hypnosis). “Some of the anxieties which departments have about the teaching of hypnosis seem to stem from some rather ancient and invalid conceptions about the nature of hypnosis and what it can do” (p. 153). The author also relates his personal experience teaching undergraduates “something about the procedures and phenomena which have been traditionally associated with hypnosis” (p. 153). They may use one of the standard hypnotizability scales, study a particular hypnotic phenomenon such as ideomotor action or age regression, or study an empirical issue such as facilitation of recall. He reports not meeting with “any particular difficulties,” but also that he has seen two problems: the student who is anxious about doing the procedure, and an occasional subject who reports the experience was unpleasant or disturbing–e.g. during age regression. He reports teaching students to handle these events in a normalizing manner. J. Holroyd
Orne, Martin T. (1985). The use and misuse of hypnosis in court. In Rosner, Richard (Ed.), Critical issues in American psychiatry and the law (2, ). New York: Plenum Press. (Reprinted from Crime and Justice: An Annual Review of Research, vol. 3, edited by Michael Tonry and Norval Morris, 1981, The University of Chicago Press.)
NOTE
An earlier version of this essay appeared in the Monograph Issue of the International Journal of Clinical and Experimental Hypnosis on the forensic uses of hypnosis, 27 (4) (1979): 311-41.
1984
Allison, R. B. (1984). Difficulties diagnosing the multiple personality syndrome in a death penalty case. International Journal of Clinical and Experimental Hypnosis, 32 (2), 102-117.
The problems involved in diagnosing the multiple personality syndrome in a rape-murder suspect are illustrated by the case of Kenneth Bianchi and the Hillside Stranglings. Hypnotic investigations of his amnesia revealed “Steve,” who admitted guilt for the rape-murders. “Billy” later emerged, claiming responsibility for thefts and forgeries. Attempts to evaluate Kenneth Bianchi with methods used in therapy yielded an original opinion that he was a multiple personality and legally insane. Later events showed the diagnosis to be in error. A new diagnosis was made of atypical dissociative disorder due to the effects of the examining methods themselves. Warning is given that it may be impossible to determine the correct diagnosis of a dissociating defendant in a death penalty case.
Braun, Bennett G. (1984). Hypnosis creates multiple personality: Myth or reality?. International Journal of Clinical and Experimental Hypnosis, 32 (2), 191-197.
Since before the turn of the century, multiple personality has been associated with hysteria and hypnosis. The myth that hypnosis can create multiple personality is examined in this paper by reviewing studies that have suggested or implied a casual link between hypnosis and multiple personailty. While it is possible that personality fragments can appear under hypnosis, there is no evidence that personalities with separate life histories and a full range of affect can be crated with hypnosis. The author concludes that hypnosis is a valuable tool in diagnosing and terating multiple personalities.
Kleinhauz, Moris; Beran, Barbara (1984). Misuse of hypnosis: A factor in psychopathology. American Journal of Clinical Hypnosis, 26, 283-290.
Six cases of posthypnotic trauma are presented to illustrate possible psychopathologic symptoms that may be exhibited in Ss following the misuse of hypnosis, particularly for a stage performance. Medical professionals must be made aware of the possibility of immediate as well as long-term deleterious effects that may follow misuse of hypnosis so that those cases which come to the attention of the physician will be properly diagnosed and treated.
Orne, Martin T.; Soskis, David A.; Dinges, David F.; Orne, Emily Carota (1984). Hypnotically induced testimony. In Wells, G. L.; Loftus, E. F. (Ed.), Eyewitness testimony: Psychological perspectives (pp. 171-213). New York: Cambridge University Press.
NOTES
This is a modified version of a policy brief prepared for the National Institute of Justice. The Conclusions read:
“The use of guidelines is designed to permit the subsequent evaluation of a hypnosis session by independent experts, in order to determine whether undue suggestiveness was present. Nonetheless, even when hypnosis has been used appropriately in a forensic situation and when the session has been monitored and conducted in a manner that is likely to minimize undetected biasing, inadvertent distortions of memory may still occur. Although the recommended guidelines for conducting the hypnosis session help determine what was done during the session, they do not prevent (nor is there any reliable way to prevent) subjects from confounding distorted hypnotic memories with prior and subsequent nonhypnotic recall or from placing undue confidence in these distorted recollections. Thus, the use of the results of hypnosis applied in forensic situations, as well as the use of the procedure itself, demands extreme caution.
“‘Hypnotically refreshed’ memories cannot be used to ‘verify’ facts for which no adequate evidence exists, especially when subsequent investigation has failed to produce any substantial independent corroboration and the individual did not recall the fact or was not confident of it prior to hypnosis. As long as the detail recalled is verified by independent physical evidence, the utility of hypnosis can be considerable and the risk attached to the procedure – if properly conducted – minimal. There is no way, however, by which anyone (including an expert with extensive experience in hypnosis) can for any particular piece of information obtained in hypnosis determine whether it is an actual memory or a confabulation. For these reasons, hypnotically induced testimony is not reliable and ought not be permitted to form the basis of testimony in court” (pp. 210-211).
Gruenewald, Doris (1982). Problems of relevance in the application of laboratory data to clinical situations. International Journal of Clinical and Experimental Hypnosis, 30 (4), 345-353.
Advantages and disadvantages of measuring hypnotic susceptibility in clinical settings are presented. The argument for standardized methods of measurement in the interest of scientific advancement is balanced against clinical considerations and counterindications. The question of identity of hypnotic processes in the laboratory and in the clinical situation is addressed.
1982
Sacerdote, Paul (1982). A non-statistical dissertation about hypnotizability scales and clinical goals: Comparison with individualized induction and deepening procedures. International Journal of Clinical and Experimental Hypnosis, 30 (4), 354-376.
Researchers and theoreticians in the field of hypnosis have insisted for some time that reports of clinical applications of hypnosis should include the patients’ classification based on their responses to standardized hypnotizability scales. Accordingly, clinical scales (Barber & Wilson, 1978/79; Cooper & London, 1979; J.R. Hilgard & E.R. Hilgard, 1979; Morgan & J.R. Hilgard, 1979; Wilson & Barber, 1978) have been developed or adapted from pre-existing standardized scales. For the same purpose, the Hypnotic Induction Profile (HIP) of Spiegel (1978), which claims reliability in classifying patients according to hypnotizability and psychopathology, has been developed and utilized.
Additionally, tailored scales which include specific qualitative items have been proposed (E.R. Hilgard, Crawford, P. Bowers, & Kihlstrom, 1979). According to a few clinical investigators (Frankel, Apfel, Kelly, Benson, Quinn, Newmark, & Malmaud, 1979) no disadvantage does ensue from routinely subjecting patients to hypnotizability scales. The positive results are: accumulation of reliable information about the validity of hypnotic intervention in various clinical conditions; differentiation between results of hypnosis and results of psychotherapy; and also a determination of whether hypnotizability is a fixed talent or whether it can be improved with training. With the individual patient the use of hypnotizability scales would rapidly indicate if his score will be high enough for certain specific applications and in general to determine whether therapy with hypnosis should even be attempted. The present author recognizes the rationale for the use of scales in the therapeutic realm, especially if the results are to be reported. The present author notes, however, that the generally accepted hypnotizability scales give disproportionate weight to some categories of hypnotic responses, but they are not comprehensive enough to tap all the possible capabilities of individual patients. Standardized scales of hypnotizability rely almost entirely upon written or spoken instructions and therefore miss the opportunities of nonverbal communication. Also, most hypnotizability scales implicitly seem only to recognize hypnosis obtained by progressive relaxation as “the typical hypnosis.” Some examples are presented to clarify how the use of standardized scales or of HIP (Spiegel, 1978) would wrongly classify a considerable minority of patients as nonhypnotizable or poorly hypnotizable, thus depriving them of potential theapeutic benefits.
1981
Gruenewald, Doris (1981). Failures in hypnotherapy. International Journal of Clinical and Experimental Hypnosis, 29 (4), 345-350.
Failures in hypnotherapy are discussed in the context of considerations applying to treatment in general. Emphasis is given to the principle that hypnotherapy must be structured according to patients’ personality and needs. When treatment fails, therapists should examine carefully what may have led to an unsatisfactory outcome.
Kleinhauz, Moris; Beran, B. (1981). Misuses of hypnosis: A medical emergency and its treatment. International Journal of Clinical and Experimental Hypnosis, 29 (2), 148-161.
Hypnosis is an intense interpersonal relationship requiring 2-way respect and involvement. Inadequate understanding of this dynamic relationship, and a consequent inability to cope with its potential dangers, may result in posthypnotic trauma. Unless treated carefully by a hypnotherapist who is experienced in both the techniques of dehypnotization and the utilization of psychotherapy, such traumas may persist for a very long time. In this paper, one striking case illustrates mishandling of the hypnotic event and immediate posthypnotic treatment and details the procedure by which successful treatment was eventually determined.
Zelig, Mark; Beidleman, William B. (1981). The investigative use of hypnosis: A word of caution. International Journal of Clinical and Experimental Hypnosis, 29 (4), 401-412.
The purpose of the present experiment was to determine the efficacy of hypnosis for enhancing the recall of Ss exposed to a stress provoking motion picture. This stimulus, which vividly displayed several workshop accidents, was selected to provide an analog to witnessing an actual crime. After viewing the film, Ss were questioned in either hypnosis or in a waking state and responded to a questionnaire which contained leading and nonleading questions. Dependent measures included the number correct, number of errors, and the average confidence rating given to their responses. Analyses of these data revealed that waking Ss were significantly more accurate on leading questions. No significant differences were observed when Ss’ responses to nonleading questions were examined. Post hoc correlational analyses across both hypnotic and waking conditions revealed that hypnotic susceptibility and confidence ratings were positively correlated while susceptibility and the number of correct responses were not significantly correlated. These findings are compared with previous research and the resulting implications for hypnoticalloy conducted interrogations are discussed.
1980
Fromm, Erika (1980). Values in hypnotherapy. Psychotherapy: Theory, Research and Practice, 17 (4), 425-430.
Hypnosis is an altered state of consciousness characterized by a regression in the service of the ego along with increased access to the unconscious. This makes it possible to achieve lasting therapeutic results faster in hypnosis than in the waking state. Hypnosis is also a state of decreased vigilance, a vulnerability that involves dangers if a patient is in the hands of a poorly trained, incompetent, or unscrupulous therapist. In general, the same human and moral values that guide responsible therapists with patients in the ordinary waking state must guide them with patients in hypnosis, only more so. Contemporary permissive hypnotherapists do not superimpose their own wills or personalities onto patients but provide support, help patients face the frightening parts of the unconscious, and thus aid them in coping with conflicts and gaining full autonomy and freedom from fear. (11 ref).
Reiser, Martin; Nielson, Michael (1980). Investigative hypnosis: A developing specialty. American Journal of Clinical Hypnosis, 23, 75-84.
NOTES
Author describes his involvement with the Los Angeles Police Department, using hypnosis for “enhancing the recall of key witnesses whose memories of the crime were poor” (p. 75). In 1975, the author and other experts in hypnosis trained 11 lieutenants and 2 captains to use hypnosis. The author describes the training program and a one-year demonstration project, during which volunteer witnesses and victims were interviewed by the hypnotist investigators. “In 77% of cases, important information was elicited that had not been available by routine interrogation. Approximately 16% of cases were solved with the aid of hypnosis” (p. 76). “Follow-up with the involved witnesses and victims has not revealed any instance of ill effects stemming from the hypnosis program, while 39.8% of the hypnosis subjects reported some relief or benefit resulting from the hypnosis session” (p. 77). Jean Holroyd
1979
Ault, R. L. Jr. (1979). FBI guidelines for use of hypnosis. International Journal of Clinical and Experimental Hypnosis, 27 (4), 449-451.
The Federal Bureau of Investigation uses hypnosis as a tool for investigative purposes in selected cases where further leads are needed and witnesses or victims are willing to participate in a hypnotic interview. All sessions are tape recorded, preferably by video. A hypnotic interview cannot necessarily provide accurate leads, and therefore careful investigative work is done to verify the accuracy of any information obtained in hypnosis. Psychiatrists, psychologists, or physicians specially trained in hypnotic techniques have been employed to add protection for the witnesses or victims being questioned under hypnosis.
Frankel, Fred H.; Apfel, R. J.; Kelly, S. F.; Benson, H.; Quinn, T.; Newmark, J.; Malmaud, R. (1979). The use of hypnotizability scales in the clinic:
A review after six years. International Journal of Clinical and Experimental Hypnosis, 27 (2), 63-73.
This is a review of the use, after 6 years, of the Stanford Hypnotic Susceptibility Scale, Forms A and B (Weitzenhoffer & E. R. Hilgard, 1959); the Harvard Group Scale of Hypnotic Susceptibility, Form A (Shor & E. Orne, 1962); the Hypnotic Induction Profile (Spiegel & Bridger, 1970); and the Stanford Hypnotic Clinical Scale (Morgan & J. R. Hilgard, 1975) in the clinical situation. The great majority of over 300 patients found their experience with the scale to be a positive one, despite the authors’ initial hesitancy about exposing them to the probability of failure on at least some of the items. The standardized scales were administered as specific tests, not as part of therapy.
The data on responsivity has not only contributed to clinical strategy in individual cases, but has also added to our understanding of hypnosis, of psychopathology, and of therapeutic outcome.
Hilgard, Ernest R.; Loftus, Elizabeth F. (1979). Effective interrogation of the eyewitness. International Journal of Clinical and Experimental Hypnosis, 27 (4), 342-357.
Eyewitness reports have been investigated in the psychological laboratoy from time to time ever since 1900. Specimen studies from the early period and from the last decade indicate that free reports are consistently more accurate but less complete than reports obtained through specifically directed inquiry. The optimal combination is free report followed by the asking of specific questions. The wording of those questions, however, can have a substantial effect on the answers given. Furthermore, the wording of questions put to a witness can distort the witness’s memory for the previously experienced event. These techniques and findings have implications for the study of other “retrieval” techniques such as hypnosis. Although laboratory-type control cannot be expected in practical settings, scientific validation of interrogation methods as practiced can be obtained if recording is complete and accurate, if proccesses of memory restoration or amplification are studied as they occur in the course of interrogation, and if outcome studies are fully reported, including both successes and failures to gain new information or to substantiate existing information.
Kleinhauz, Moris; Dreyfuss, Daniel A.; Beran, Barbara; Goldberg, Tova; Azikri, David (1979). Some after-effects of stage hypnosis: A case study of psychopathological manifestations. International Journal of Clinical and Experimental Hypnosis, 27, 219-226.
Some deleterious effects of stage hypnosis are described through a case report. A middle-aged respected member of a kibbutz who became the subject of an evening’s entertainment by a stage hypnotist suffered a posttraumatic neurosis. The stage hypnotist, unaware of her traumatic childhood during World War II when she and her sister were hidden by Gentiles, requested her to regress to that age. This reactivated a former successfully repressed trauma and acted as a precipitating factor to the development of a traumatic neurosis which was left untreated. She was self-referred for adequate psychiatric treatment 11 years ater. This treatment successfully restored her to an adequate level of functioning.
Orne, Martin T. (1979). The use and misuse of hypnosis in court. International Journal of Clinical and Experimental Hypnosis, 27, 311-341.
The various forensic contexts in which hypnosis has been used are reviewed, emphasizing its advantages and pitfalls. The technique may be helpful in the context of criminal investigation and under circumstances involving functional memory loss. Hypnosis has no utility to assure the truthfulness of statements since, particularly in a forensic context, subjects may simulate hypnosis and are able to willfully lie even in deep hypnosis; most troublesome, actual memories cannot be distinguished from confabulations either by the subject or by the hypnotist without full and independent corroboration. While potentially useful to refresh witnesses’ and victims’ memories to facilitate eyewitness identification, the procedure is relatively safe and appropriate only when neither the subject, nor the authorities, nor the hypnotist have any preconceptions about who the criminal might be. If such preconceptions do exist — either based on information acquired before the hypntotic procedure or on information subtly communicated during the hypnotic procedure — hypnosis may readily cause the subject to confabulate the person who is suspected into his “hypnotically enhanced memories.” These pseudomemoreis, originally developed in hypnosis, may come to be accepted by the subject as his actual recall of the original events; they are then remembered with great subjective certainty and reported with conviction. Such circumstances can create convincing, apparently objective “eyewitnesses” rather than facilitating actual recall. A number of minimal safeguards are proposed to reduce the likelihood of such an eventuality and other serious potential abuses of hypnosis.
Perry, Campbell (1979). Hypnotic coercion and compliance to it: A review of evidence presented in a legal case. International Journal of Clinical and Experimental Hypnosis, 27 (3), 187-218.
There are 2 main positions concerning the potential of hypnosis to coerce unconsenting behavior. One position asserts that coercion is possible through the induction of distorted perceptions which delude the hypnotized person into believing that the behavior suggested is not transgressive. The other position asserts that where hypnosis appears to be a causal factor in coercing behavior, other elements in the situation — especially a close hypnotist-client relationship — were the main determinants of behavior. The present paper analyzes the court transcript of a recent case in Australia in which a lay hypnotist was found guilty of 3 sexual offenses against 2 female clients. The uniqueness of the case is that it pits the 2 main positions on hypnotic coercion against each other. The hypnotist admitted the acts attributed to him; his defense was that hypnotic coercion is impossible since a hypnotized person would resist immediately any transgressive suggestion. The women involved stated that they were aware of what was happening but that, because they were hypnotized, they were unable to resist. Analysis of the court transcript indicates that neither a hypothesis of hypnotically induced perceptual distortion, nor one of a close hypnotist-client relationship can account for the events that occurred. Other alternative explanations are discussed within the context of the inherent difficulteis of analyzing a court transcript.
Warner, K. E. (1979). The use of hypnosis in the defense of criminal cases. International Journal of Clinical and Experimental Hypnosis, 27 (4), 417-436.