Neodissociation theory proposes that hypnotic suggestions are performed relatively automatically, whereas sociocognitive theories suggest that effortful cognitive strategies are necessary. To distinguish between the predictions derived from the two theories, we gave hypnotized subjects the suggestion to forget the number eight, and asked them to solve a series of addition problems using that number. It is a well- established finding in cognitive psychology research that subjective estimations of time depend on the amount of cognitive effort expended during that time. Increases in cognitive effort are associated with decreases in subjective time. Accordingly, if hypnotic subjects carry out a suggestion relatively automatically, they should perceive the time taken as longer than if they carry it out using effortful cognitive strategies. Highly hypnotizable subjects under hypnosis and low hypnotizable subjects instructed to simulate hypnosis were given the suggestion to forget the number eight and to replace it with nine. They were then given a page of addition problems, many of which included eights in the solutions, and were instructed to do the problems as quickly and accurately as possible. They were also informed that they would be asked to estimate the time spent completing the problems.
Subjects completed the addition problems and then gave their time estimates. As a control for changes in time estimation brought about simply by being hypnotized, all subjects also completed a series of addition problems without the amnesia suggestion, and again estimated the time. The order of the two conditions (i.e., with and without the amnesia suggestion) was counterbalanced across subjects.
Results showed that the simulators, who intentionally avoided the number eight in their solutions to the problems, perceived the time spent doing these problems as shorter than the time spent doing problems normally, without the suggestion to forget the number eight. The increase in cognitive effort therefore resulted in decreased subjective time, as expected. The hypnotized subjects, on the other hand, showed no difference in their time estimations under the two conditions. The two groups did not differ in their time estimates without the amnesia suggestion, but with the suggestion, the hypnotized group perceived the time as longer than did the simulators. The results, then, are consistent with neodissociation theory, since the hypnotized subjects appeared to expend relatively less cognitive effort in carrying out the amnesia suggestion.. (ABSTRACT from Bulletin of Division 30, Psychological Hypnosis, Fall, 1995, Vol. 4, No. 3.)
Orne, Emily Carota; Whitehouse, Wayne G.; Dinges, David F.; Orne, Martin T. (1996). Memory liabilities associated with hypnosis: Does low hypnotizability confer immunity?. International Journal of Clinical and Experimental Hypnosis, 44 (4), 354-369.
Retrospective analyses of data from the authors’ program of research on hypnosis and memory are presented, with special emphasis on effects observed among low hypnotizable individuals. In Experiment 1, participants completed seven forced-recall trials in an attempt to remember a series of pictures that had been shown 1 week earlier. For half the participants, the middle five trials were carried out using hypnotic procedures; the remaining participants performed all recall attempts in a motivated waking condition. Hypnosis failed to enhance correct recall for either high or low hypnotizable participants beyond the hypermnesia and reminiscence effects associated with repeated retrieval attempts over time. However, whereas high hypnotizable participants produced substantial numbers of confident recall errors (i.e., intrusions) independent of the use of hypnosis, low hypnotizable participants exposed to hypnotic procedures reported significantly more intrusions than their counterparts in the waking condition. In Experiment 2, participants were asked to identify whether specific recollections, reported during two forced-interrogatory recall tests conducted 1 week earlier, had originated in the first or second of those tests. A general bias to misattribute previously reported recollections to the first of two recall occasions was observed; however, the effect was greatest among low hypnotizables who had undergone the second recall attempt in hypnosis. The findings imply that highly hypnotizable individuals are not unique in their vulnerability to distortions of memory induced by hypnotic techniques. Individuals of lesser hypnotic capacity also manifest memory alterations when exposed to such procedures. — Journal Abstract
American Medical Association Council on Scientific Affairs (1995). Report on memories of childhood abuse. International Journal of Clinical and Experimental Hypnosis, 43 (2), 114-117.
NOTES
The AMA considers the technique of ‘memory enhancement’ in the area of childhood sexual abuse to be fraught with problems of potential misapplication” (p. 114). “Most controversial are those ‘memories’ that surface only in therapy and those from either infancy or late childhood (including adolescence)” (p. 114).
Dywan, Jane (1995). The illusion of familiarity: An alternative to the report-criterion account of hypnotic recall. International Journal of Clinical and Experimental Hypnosis, 43 (2), 194-211.
Hypnosis increases the likelihood that participants will report incorrect material at higher levels of confidence. One interpretation of such data is that hypnosis induces individuals to lower the criterion they use to make memory reports. A lowered report criterion could account for the increase in items that participants are willing to report as memories but not for the increase in confidence that typically accompanies hypnotic retrieval. Although some participants may indeed lower their report criterion, this alone should not result in the highly confident confabulation so often observed. An alternative perspective is that for some participants, hypnosis alters the experience of retrieval such that items generated during retrieval attempts are more likely to have the qualities (e.g., perceptual fluency, vividness) usually associated with remembering. This illusion of familiarity would account for the higher levels of confidence that are so frequently observed in hypnotic recall, and adopting this perspective should lead to even greater caution in the use of hypnosis as an aid to retrieval.
Levitt, Eugene E.; Pinnell, Cornelia Mare (1995). Some additional light on the childhood sexual abuse-psychopathology axis. International Journal of Clinical and Experimental Hypnosis, 43 (2), 145-162.
This exposition is an attempt to unravel the complexities of the relationship between childhood sexual abuse and adult psychopathology. Four facets of the relationship are examined in some detail: (a) the extent of childhood sexual abuse; (b) the probability that sexual abuse in childhood will result in psychopathology in the adult; (c) the reliability of early life memories in later life; and (d) the role of recovered memory of trauma in the healing process. The conclusions of this logico-empirical analysis are that first, government statistics tend to underestimate the extent of childhood sexual abuse, whereas independent surveys tend to overestimate it. Estimating prevalence is further complicated by variations in the definitions of key terms. Possibly the only safe conclusion is that true prevalence cannot be reliably determined. Second, empirical investigations of childhood sexual abuse conclude that not all victims are emotionally injured. A substantial number of these investigations find that a majority of victims suffer no extensive harm. Other variables such as family dynamics are involved; there may be only a few cases in which emotional harm results from sexual abuse as a single factor. Third, memory research suggests that memory in general is a dynamic, reconstructive process and that recall of childhood events is particularly vulnerable to distortion. Memory cannot dependably produce historical truth. Last, there is some clinical evidence that abreaction of a traumatic event in adulthood may have a remediative effect. Similar evidence for childhood trauma is lacking. The belief in the healing effect of recalling and reliving a childhood trauma depends on the therapist’s orientation.
Nagy, Thomas F. (1995). Incest memories recalled in hypnosis — a case study: A brief communication. International Journal of Clinical and Experimental Hypnosis, 43 (2), 118-126.
Accuracy of repressed memories recovered in hypnosis cannot be reliably determined with any greater certainty than non-hypnotically recalled events. Therefore, the practice of therapists’ accepting hypnotically enhanced memories as veridical, absent corroborating evidence, is not advocated. A 52-year-old woman with a 27-year history of panic attacks and sleep disorder inadvertently recovered incest memories in hypnosis. Photographs and remembered events by other family members were thought by the patient to provide general support although they did not constitute actual proof of abuse. Implications are discussed.
Sarbin, Theodore R. (1995). On the belief that one body may be host to two or more personalities. International Journal of Clinical and Experimental Hypnosis, 43 (2), 163-183.
The belief in the validity of the multiple personality concept is discussed in this article. Two scaffolding constructions are analyzed: dissociation and repression. As generally employed, these constructions grant no agency to the multiple personality patient. The claim is made that the conduct of interest arises in discourse, usually with the therapist as the discourse partner. In reviewing the history of multiple personality and the writings of current advocates, it becomes clear that contemporary users of the multiple personality disorder diagnosis participate in a subculture with its own set of myths, one of which is the autonomous actions of mental faculties. Of special significance is the readiness to transfigure imaginings into rememberings of child abuse, leading ultimately to the manufacture of persons. The implications for both therapy and theory of regarding the patient as agent in place of the belief that the contranormative conduct is under the control of mentalistic faculties are discussed.
1994
Ceci, Stephen J.; Loftus, Elizabeth F.; Leichtman, Michelle D.; Bruck, Maggie (1994). The possible role of source misattributions in creation of false beliefs among preschoolers. International Journal of Clinical and Experimental Hypnosis, 42 (4), 304-320.
In this article the authors examine one possible factor in the creation of false beliefs among preschool-aged children, namely, source misattributions. The authors present the results from an ongoing program of research which suggest that source misattributions could be a mechanism underlying children’s false beliefs about having experienced fictitious events. Findings from this program of research indicate that, although all children are susceptible to making source misattributions, very young children may be disproportionately vulnerable to these kinds of errors. This vulnerability leads younger preschoolers, on occasion, to claim that they remember actually experiencing events that they only thought about or were suggested by others. These results are discussed in the context of the ongoing debate over the veracity and durability of delayed reports of early memories, repressed memories, dissociative states, and the validity risks posed by therapeutic techniques that entail repeated visually guided imagery inductions.
Frankel, Fred H. (1994, October). On patients remembering abuse when it in fact may not have occurred. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES
The concept of hidden memories has supported the profession of psychotherapy for a century. This process can only occur if there is a mechanism to support it. Bowers says, if memory is not reliably accurate, it is not reliably inaccurate either.
“Ideas passing as descriptions lead us to equate the tentative with [the factual.]” – Gould.
Three studies purporting to establish repression: 1. Briere & Comte sampled 450 adults who reported abuse. They asked, “Was there ever a time when you couldn’t remember the forced experience?” How does respondent understand the question? Clients were all in therapy. 2. Herman and Schatzow (1989) “verification of abuse” study. 53 Ss in a survivor’s group. Reports percentages who had no or little recall. Authors don’t acknowledge that the group discussion and the attitude of therapist may have shaped the response. It is also not clear how many Ss who claimed to have “verified” their accounts were among those who had severe amnesia for the event. They could be Ss who had never lost the memory in the first place. 3. Williams interviewed women who earlier were in Emergency Rooms because of abuse being suspected. 38% did not report childhood abuse when questioned, and author concluded it was due to repression. Significant numbers of adults cannot remember things even past the age of 5.
Problem with wording of questions. Some of the women interviewed might have preferred not to report the event. This was not investigated in the study.
Frankel, Fred H. (1994). The concept of flashbacks in historical perspective. International Journal of Clinical and Experimental Hypnosis, 42, 321-336.
A computer search of the literature for papers indexed under “flashbacks” produced a list of 70 references, many found in publications on the topics of substance abuse and trauma. Several of these were letters or papers written in languages other than English. In all, the author reviewed 55 papers. Although most of these papers contained comments that addressed the subject matter to some extent as recurrences or reminiscences of past happenings, the variability in the use of the term leaves many unresolved questions regarding the veridicality of the imagery. Nothing in the presentations reviewed by the author clearly demonstrates the unidimensional nature of flashbacks nor any recognizable neurophysiological correlate. The content of a flashback appears to be at least as likely to be the product of imagination as it is of memory.
Ganaway, George K. (1994, October). The thin line: Reality and fantasy in hypnotically facilitated memory retrieval during psychotherapy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES
Historical review: Every hundred years there has been a peak in interest in altered states–a fin de ciecle zeitgeist. It is the Brigadoon effect, i.e. something materializing for one day every 100 years. The theories developed then suffer from “paradigm grandiosity.” In hypnosis, we can refer back to:
1694 Salem witch trials
1790s Gaussner’s exorcism (see Ellenberger); in a 1775 showdown between him and Mesmer, there occurred the turning point between exorcism and psychotherapy.
1880s Charcot at Salpetrier ‘demonstrated’ that hypnosis was an organic, pathological condition. Ultimately this contributed information about the plasticity of hypnotized people. (In the 1880s Bernheim thought it wasn’t pathological and thought that suggestion was the important element in hypnosis.)
Recent historical contributions have influenced our views of MPD. Spiegel and Kardiner published book about hypnosis and war neuroses. Cheek & LeCron developed ideomotor questioning, which ignores the contribution of unconscious fantasy. Jacob Arlow’s metaphor for MPD is two movie projectors aiming at a screen from two different sides. The subjectively known experiential world thereby combines external reality and the person’s internal, motivated perceptions. The author presented a case study of female therapist, who had been previously diagnosed as MPD, who presented with dissociative symptoms that she thought were due to abuse by her grandmother. She fabricated the memories in order to get the holding and physical nurturing from her therapist for being courageous and remembering the abuse.
Maintenance of professional boundaries is very important in treatment.
Garry, Maryanne; Loftus, Elizabeth F. (1994). Pseudomemories without hypnosis. International Journal of Clinical and Experimental Hypnosis, 42 (4), 363-378.
Hypnosis is often colloquially associated with “the power of suggestion”; however, some cognitive memory researchers believe that suggestions have power even without hypnosis. A well-known phenomenon in cognitive psychology is the “misinformation effect,” in which subjects who are misled about previously witnessed events often integrate that inaccurate postevent information into their accounts of the event. In the present article, we review the misinformation literature in four major rounds according to the nature of the memory distortion. The first three rounds are studies of memory suggestibility for observed events; by contrast, the fourth (and newest) one deals with personal or autobiographical memory. Considered collectively, these four rounds of research provide compelling evidence that it is not hard at all to make people truly believe they have seen or experienced something they have not — without any hypnosis at all. Finally, we discuss the tragic implications for the unquestioned acceptance of all recovered memories.
Kihlstrom, John F. (1994). Hypnosis, delayed recall, and the principles of memory. International Journal of Clinical and Experimental Hypnosis, 42 (4), 337-345.
This article reviews the seven principles of memory function that set limits on the degree to which any attempt to recover a long-forgotten memory can succeed: encoding, organization, time dependency, cue dependency, encoding specificity, schematic processing, and reconstruction. In the absence of independent corroboration, there is no ‘litmus test’ that can reliably distinguish true from false memories, or memories that are based on perception from those that are based on imagination. Practicing clinicians should exercise great caution when using hypnosis or any other technique to facilitate delayed recall.
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.
Lynn, Steven. Jay; Rhue, Judith W.; Myers, Bryan P.; Weekes, John R. (1994). Pseudmemory in hypnotized and simulating subjects. International Journal of Clinical and Experimental Hypnosis, 42 (2), 118-129.
High hypnotizable (n = 23) and low hypnotizable simulating (n = 13) subjects received pseudomemory suggestions. High hypnotizable and low hypnotizable simulating subjects were equally likely to pass the target noise suggestion during hypnosis and were also equally likely (high hypnotizables, 47.83%; low hypnotizable simulators, 64.29%) to report pseudomemories when tested for pseudomemory after instructions to awaken. As in previous research with task-motivated subjects, pseudomemory rate (high hypnotizables, 47.48%; low hypnotizable simulators, 46.25%) was not reduced by informing subjects that they could distinguish fantasy and reality in a nonhypnotic state of deep concentration. At final inquiry, after deep concentration, high hypnotizable and low hypnotizable simulating subjects’ pseudomemories remained comparable (43.48% and 38.46%, respectively). Unlike previous research, high hypnotizable subjects did not report more unsuggested noises and more pseudomemories of novel sounds than did awake low hypnotizable simulating subjects. Pseudo-memory reports were generally consistent with subjects’ ratings of whether the hypnotist expected them to believe the sounds were real or imagined.
Nash, Michael R. (1994). Memory distortion and sexual trauma: The problem of false negatives and false positives. International Journal of Clinical and Experimental Hypnosis, 42 (4), 346-362.
Logically, two broad types of mnemonic errors are possible when adult psychotherapy or hypnosis patients reflect on whether they were sexually abused or not as a child. They may believe that they were not abused when in fact they were (false negative error), or they may believe they were abused when in fact they were not (false positive error). The author briefly reviews the empirical evidence for the occurrence of each of these types of errors, and illustrates each with a clinical case. Further, in considering the incidence, importance, and clinical implications of these errors, the author contends that clinical efficacy in no way assures that a false negative or a false positive has been avoided. A plea is made for theorists and researchers to acknowledge that both categories of errors can occur and to conduct future clinical and laboratory research accordingly.
Nash, Michael R. (1994, October). Reports of early sexual trauma: The problem of false negatives and false positives. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES
The problem of false positives and problem of false negatives are distinct and should be treated differently. The question involves pseudomemories vs repression.
Evidence for false positives: 1. Memory research 2. Developmental psychopathology 3. Contemporary psychoanalytic theory 4. Clinical field studies
No laboratory researcher has produced false memories that are as gravid, or as emotionally loaded as early abuse.
Evidence for repression: 1. “Repressor Personality” research (Weinberger & Schwartz, who view it as a trait rather than a state). 2. Implicit memory research 3. Hypnosis research on memory (see Nash chapter in Fromm & Nash book on research in hypnosis) 4. Clinical field studies
Ofshe, Richard; Singer, Margaret T. (1994). Recovered memory and robust repression: Influence and pseudomemory. International Journal of Clinical and Experimental Hypnosis, 42, 391-410.
A subset of the psychotherapists practicing trauma-focused therapy predicate their treatment on the existence of a newly claimed, powerful form of repression that differs from repression as used in the psychoanalytic tradition and from amnesia in any of its recognized forms. Recovered-memory specialists assist patients to supposedly retrieve vast quantities of information (e.g., utterly new dramatic life histories) that were allegedly unavailable to consciousness for years of decades. We refer to the hypothesized mental mechanism as ‘robust repression’ and call attention to the absence of evidence documenting its validity and to the differences between it and other mental mechanisms and memory features. No recovered-memory practitioner has ever published a full specification of the attributes of this mechanism. That is, the properties it would have to have for the narratives developed during therapy to be historically accurate to any significant degree. This article reports a specification of the properties of the robust repression mechanism based on interviews with current and former patients, practitioners’ writings, and reports to researchers and clinicians. The spread of reliance on the robust repression mechanism over the past 20 years through portions of the clinical community is traced. While involved in therapy, patients of recovered-memory practitioners come to believe that they have either instantly repressed large numbers of discrete events or simultaneously repressed all information about abuse they may have endured for as long as a decade. Patients’ therapy-derived accounts are thought by some social influence, memory, and clinical specialists to be inadvertently created iatrogenic effects: inaccurate pseudomemories and confabulations produced due to patient-therapist interaction, the use of leading, (sic) suggestions, hypnosis, and the mismanagement of the dependent relation of the patient on the therapist. Three cases are reported which illustrate how new life accounts predicated by robust repression can develop during therapy with a recovered- memory practitioner.
Scheflin, Alan W. (1994). Forensic hypnosis: Unanswered questions. Australian Journal of Clinical and Experimental Hypnosis, 22, 25-37.
Many courts have mistakenly identified hypnosis as more suggestive than eyewitness testimony or leading questions, and therefore these courts have applied unnecessarily restrictive rulings on hypnosis. The dangers of suggestion in eyewitness and interrogation cases pose reliability problems that are equally as great. In all situations, pre- trial evidentiary hearings on admissibility of ‘suggestive’ testimony is essential. Expert testimony should be available to assist the judge. The forensic rules to date have failed to clarify some hard cases. In resolving these cases, courts are encouraged to adopt a case- by-case analysis rather than a total prohibition on hypnotically refreshed recollection. Courts have assumed conclusions about hypnosis that the laboratory experiments suggest are incorrect – juries are not overly persuaded by hypnosis testimony, there is no inevitable concreting effect and witnesses do not become impervious to cross-examination. Thus, the restrictive per se disqualification rules for hypnotically refreshed recollection are too severe.
Spiegel, David; Scheflin, Alan W. (1994). Dissociated or fabricated? Psychiatric aspects of repressed memory in criminal and civil cases. International Journal of Clinical and Experimental Hypnosis, 42 (4), 411-432.
During the last decade, clinicians, courts, and researchers have been faced with exceedingly difficult questions involving the crossroads where memory, traumatic memory, dissociation, repression, childhood sexual abuse, and suggestion all meet. In one criminal case, repressed memories served as the basis for a conviction of murder. In approximately 50 civil cases, courts have ruled on the issue of whether repressed memory for childhood sexual abuse may form the basis of a suit against the alleged perpetrators. Rulings that have upheld such use underscore the importance of the reliability of memory retrieval techniques. Hypnosis and other methodologies employed in psychotherapy may be beneficial in working through memories of trauma, but they may also distort memories or alter a subject’s evaluation of their veracity. Because of the reconstructive nature of memory, caution must be taken to treat each case on its own merits and avoid global statements essentially proclaiming either that repressed memory is always right or that it is always wrong.
Spiegel, David (1994, October). On patients not remembering abuse when it in fact may have occurred. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES
False memories and false non-memories may be two sides of the same coin. What is the evidence for repression?
If people are abducted by extraterrestrials, why don’t they just keep them? [Joke!] It seems counter-intuitive that people would forget important, arousing things that happen.
The three main components of hypnosis (suggestibility, absorption, and dissociation) are also aspects of memory: 1. Absorption relates to encoding (narrowing attention); also happens during traumatic events (Loftus’ “gun memory” which is so clear, while they don’t encode what gunman’s face looks like). 2. Dissociation relates to memory storage (compartmentalization of information). Traumatized people have symptoms of dissociation, depersonalization. If you are in an unusual mental state, you may watch the event; the memory is stored without the usual network of associations. 3. Suggestibility relates to retrieval. The way questions are asked influences one’s response. But hypnosis is not an infinite influencer; the main damage to memory contributed by hypnosis is “confident errors” (McConkey).
We did research one week after the Loma Prieta earthquake, and found significant cognitive alterations, memory alterations, etc. In our sample, 1/4 of the people felt detached from their body or from the ground right after the earthquake.
Memory alterations were compared with data from other studies after other traumas. Difficulties with memory occurred in 29% of our sample.
The disorganization of memory can follow even just witnessing trauma (e.g. the recent slaying of 8 people in the law office in San Francisco) And people who witnessed the execution of Harris. They were in no danger themselves, yet the level of dissociative symptoms were as high in the former.
The Briere & Cone and Herman & Shatzow studies are based on self report of earlier trauma, and that is a problem in research. But Williams’ study does have the age of people when they were abused as children; see her article in Journal of Consulting and Clinical Psychology.
COMMENTS FROM THE AUDIENCE
Dabney Ewin: Sex abuse trauma differs from earthquakes because the abuser says, “If you tell anybody I’ll kill you.” This is like a post hypnotic suggestion, which is carried out compulsively when given to the victim during fear.
Dale: How to we account for the vigor in the attempts of each side to convince the other. The people who have been real victims of sexual abuse need to be able to talk with the people who are victims of False Memory Syndrome. The impact on a family is just as traumatic as the sexual abuse itself.
Response by D. Spiegel: I wouldn’t recommend that combination, but the point you make about damage to the falsely accused is relevant. Their lives are shattered but remember the damage done throughout life by sexual abuse.
Yapko, Michael D. (1994). Suggestions of abuse: True and false memories of childhood sexual trauma. New York, NY: Simon & Schuster.
NOTES
From the section titled “A Note to Therapists:”
“I would encourage you _not_ to (1) preclude open communication at all times among family members; (2) act as your client’s ‘hired gun’; (3) act as if corroboration of allegations of abuse were unnecessary; (4) jump quickly to the conclusion abuse occurred simply because it is plausible; (5) suggest a history of abuse to someone who is not your client; (6) refer a client out for hypnotic confirmation or disconfirmation on the false premise that hypnosis is some kind of lie detector; (7) ask leading or suggestive questions; (8) assume repression is in force when someone does not have much memory from childhood; (9) rely on your memory of the interaction. Tape your investigative sessions and review them later for any evidence of possible unintentional contamination of your client’s recollections” (p. 217).
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.
NOTES
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.]
1993
Nadon, Robert (1993, October). Nomothetic and idiographic approaches to hypnosis. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
NOTES
Scientists and practitioners are not benefitting from each other’s contributions. The central contribution to hypnosis, both basic and applied, is the logic and validity of study designs. The false memory issue is an example. Clinicians supply an answer the public likes, but scientist provide data based on nomothetic (group average) models that are not useful here.
Most of my own work is nomothetic, but it can work together with case study approach. We use a synergistic model: the combined effects of traits, cognitive, social, and affective factors are investigated. Interactions are tricky to detect, but we need a spirit of enquiry that encourages designs sensitive to interactions.
One example is Radke & Spanos’ study that used a scale rating whether subject was hypnotized and another indicating degree of absorption-and-hypnotized vs absorption-and-not-hypnotized. Nadon’s reanalysis showed a scale by Ss interaction: mediums were different on the 7 point scale but highs were not. (Highs were less manipulated by the scale manipulation).
Jean-Roche Laurence and Nadon replicated the interaction. Then Nadon did a study to test the idea that highs were less affected by scale manipulation because they relied more on subjective experience. They measured Absorption in a different context and hypothesized that the highs here would be less affected on the 7 point scale in the other context; it was validated. There seemed to be a linear absorption by a quadratic hypnotizability interaction.
Another simple example of interaction at work: there are different lines predicting hypnotic ability based on the Absorption scale, representing need for control on the scale. Those low in need for control have a stronger prediction of hypnotizability from Absorption scale. With high need for control, Absorption doesn’t predict hypnotizability. This may explain why the correlation isn’t stronger between Absorption and hypnotizability.
Nadon investigated how level of relaxation could be affected by an interaction. Measured muscle tension of masseter (?) while listening to music (half of Ss) or focusing on relaxing (50%). In an experiential condition there was a negative correlation between Absorption and muscle tension (highs relaxed more); in an Instrumental condition it was the opposite. So both high and low Absorption people were capable of relaxation, but to get the best relaxation you would have to know their Absorption score.
A second study hypothesized that predispositions for certain kinds of affect (Tellegen’s positive affect, like extroversion) and negative effect (like neuroticism). High Absorption extraverts low in neuroticism worked best with music; and [missed words]. This supports Tellegen’s hypothesis re the effects of positive and negative affect and Absorption.
Now we can discuss individual characteristics that suggest which relaxation strategy will benefit. The practical implications can be validated by case studies.
Sheehan, Peter W.; Garnett, Michelle; Robertson, Rosemary (1993). The effects of cue level, hypnotizability, and state instruction on responses to leading questions. International Journal of Clinical and Experimental Hypnosis, 41, 287-304.
Two sessions were conducted in which independent groups of 86 high- and 85 low-susceptible subjects, responding individually under waking or hypnotic instruction, answered high- and low-cued leading questions about a video event that depicted shooting at an airport. The two sessions were separated by 1 week, and the same questions were asked in both sessions. It was predicted that highly susceptible subjects responding under hypnotic instruction would show the most evidence of accepting false information via strongly cued leading questions. Results showed general effects for leading questions and level of susceptibility but no firm support for the involvement of hypnosis. Data are discussed in terms of both the linguistic and social factors that appear to have operated on subjects in the study, results overall highlight the strong influence of level of susceptibility on subjects’ acceptance of false information.
1992
Faller, Kathleen Couborn (1992, Summer). Can therapy induce false allegations of sexual abuse?. The Advisor (Published by American Professional Society on the Abuse of Children), 5 (3), 3-6.
NOTES
Concern about the impact of therapy on children’s accounts of sexual abuse should be understood in the context of two phenomena: (1) the adult need to deny that children are sexually abused, and (2) adult identification with the alleged abuser. These phenomena operate at both individual and societal levels” (p. 3).
“Research related to impact of stressful situations on children’s ability to recall provides mixed results, some studies finding children are less accurate if the event is traumatic (Peters, 1991) and others finding they are not (Goodman, Reed, & Hepps, 1985).
“Research reveals that it is rare for children to falsely allege that they have been touched in their private parts. In one study, a substantial proportion of children who experienced genital and anal touch during a physical examination by a doctor did not volunteer this information when asked general questions about the examination. The majority of children in the study revealed genital and anal touch only when they were asked specific questions like, “Did the doctor touch you there?” (Saywitz, Goodman, Nicholas, & Moan, 1991)” (pp. 3-4).
“Clarke-Stewart and her colleagues (1989) have demonstrated that children’s interpretation of ambiguous events can be manipulated and altered by an authority figure who insists upon a particular interpretation (see also Lindberg, 1991)” (p.4).
“In sum, the research suggests that older children are likely to provide more complete unassisted disclosure than younger children. Younger children may need more memory cues in the form of specific questions than older children. Therapists are much more likely to find false negatives than false positives. Finally, therapists should be aware of the possibility the child may identify the wrong person. … Generally, however, the research indicates that concern about the contaminating effects of therapy on children’s recollections of sexual abuse is exaggerated” (pp. 4-5).
“Research indicates that the proportion of fabricated reports may be higher in the divorce scenario than in other contexts (Faller, 1990; Jones & Seig, 1988). Studies suggest most false reports are made by adults, not children (Jones & McGraw, 1987; Jones & Seig, 1988)” (p. 5).
“Clinical research (Sorenson & Snow, 1991) and experience (Faller, 1988) indicate that for most children, revealing sexual abuse is a process which occurs over time. A typical pattern is one in which children begin with the least overwhelming experience and gradually disclose more and more as their accounts are accepted and believed” (p. 5).
“[In conclusion]… therapists should be aware of the findings from research on children’s memory and suggestibility. This research indicates that there are vulnerabilities which should be taken into account during therapy” (p. 6).
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
Joseph 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.
Murrey, Gregory J.; Cross, Herb J.; Whipple, Jim (1992). Hypnotically created pseudomemories: Further investigation into the ‘memory distortion or response bias’ question. Journal of Abnormal Psychology, 101 (1), 75-77.
In order to study whether pseudomemories represent actual memory distortions or are a result of response bias, 60 highly hypnotizable subjects and subjects from the general population were divided into 4 experimental groups and were tested for pseudomemory manifestation after receiving a false suggestion. Of the 4 groups of subjects, 3 were offered a monetary reward as a motivation to distinguish false suggestion from the actual occurrence. Pseudomemory manifestation was found to be significantly higher among subjects not offered a reward than among subjects who were offered such a reward. The implications of these findings are discussed.
NOTES
The article contains a review of the literature through 1989. The study tested the hypothesis that when it is important to distinguish fantasy from reality in a hypnosis experiment, subjects can do so–a position presented by Spanos and McLean (1986). They used a verifiable event to test for pseudomemory production, as in research published by McCann and Sheehan (1988). Subjects were 30 high hypnotizable and 30 unselected students.
Subjects were shown a videotape of a mock robbery scene. The next week, Groups A, B, and C heard audiotapes “to enhance memory,” but in addition to motivating statements about “trying to remember” certain details, the tapes included misleading information (e.g. “Remember the color of the hat the robber was wearing” when in fact there was no hat on the robber). Subjects in these groups were ‘influenced.’
“Both highly hypnotizable subject groups (Groups A and B) listened to the audiotape after being administered a 10-min hypnotic induction procedure (modified from that of Barber, 1969). Subject Group C listened to the audiotape without hypnosis. The control group, Group D, did not listen to the audiotape and was, therefore, classified as ‘uninfluenced.'”
A week later subjects responded to multiple-choice and yes-no or true-false questions about the robbery scene. The yes-no question about whether the robber was wearing a hat served as the dependent variable, a measure of pseudomemory. “To motivate subjects to report the truth rather than to follow any perceived expectations of the experimental of social context, we offered subjects in Groups B, C, and D a monetary reward if they achieved the most correct answers on the quiz (according to the videotape). The reward was offered just before administration of the quiz to ensure that no collusion between the subjects could occur. Group A was not offered any such reward” (p. 76).
“The number of subjects in Group A (hypnotized, influenced, no reward) who reported the false information at posttest (12) was significantly greater then that of Group B (hypnotized, influenced, offered reward…. However, the difference in incidence of pseudomemory between Group B and the control group, Group D (not hypnotized, uninfluenced, offered reward), was nonsignificant” (p. 76).
Table 1 Incidence of Pseudomemory Per Group ——————————————————————————————- False suggestion Group A Group B Group C Group D
result (n=15) (n=15) (n=15) (n=15) ——————————————————————————————-
Accepted 12 6 7 3