Spiegel, David (1983). Hypnosis with medical/surgical patients. General Hospital Psychiatry, 5, 265-277.
The role of hypnosis as a tool in the treatment of problems commonly encountered among medical and surgical patients is examined. Hypnosis is defined as a change in state of mind far more akin to intense concentration than sleep. Diagnostic implications of differences in hypnotic responsivity are explored, and scales suitable for use in the clinic are examined. Uses of hypnosis in treating anxiety, pain, childbirth, psychosomatic symptoms, seizure disorders, neuromuscular dysfunction, and habits are described and evaluated. The phenomenon of hypnosis is presented as a means of exploring the mind-body relationship in a controlled fashion, providing information of diagnostic importance while at the same time allowing hypnotizable patients to intensify their concentration and interpersonal receptivity in the service of a therapeutic goal.

Finkelstein, Selig; Greenleaf Howard, Marcia (1982-83). Cancer prevention: A three year pilot study. American Journal of Clinical Hypnosis, 25 (2-3), 177-183.

A review of the literature in the use of hypnosis for physiological alteration and ego strengthening indicates that the incidence of cancer may be alterable. A pilot study of three years duration for a subject population considered to be at risk for cancer (N = 43) has been completed. The results of this study, as well as the hypnotic model on which the intervention was based, are discussed. Suggestions for further research are noted.

Gardner, G. Gail; Lubner, Alison (1982-83). Hypnotherapy for children with cancer: Some current issues. American Journal of Clinical Hypnosis, 25 (2-3), 135-142.

The authors review some of the problems that now face clinicians and researchers working in the field of hypnotherapy for pediatric cancer patients. These include (1) understanding and dealing with resistance and refusal, (2) developing preventive hypnotherapeutic strategies for children who will survive cancer, and (3) carrying out research that clarifies the value of hypnotherapy with childhood cancer patients and elucidates when and how specific approaches can best be utilized.

Hall, Howard R. (1982-83). Hypnosis and the immune system: A review with implications for cancer and the psychology of healing. American Journal of Clinical Hypnosis, 25 (2-3), 92-103.

Presents a review of the body’s immune system as an introduction to a discussion of the implications of those processes for cancer and the healing mechanisms.

Hall, Marian D. (1982-83). Using relaxation imagery with children with malignancies: A developmental perspective. American Journal of Clinical Hypnosis, 25 (2-3), 143-149.

Developmental theory has been the foundation for this program of relaxation-imagery therapy with its goal of increasing the efficacy of immune mechanisms, thus increasing the survival rate of children with malignancies and/or improving the comfort and quality of their lives. Three basis constructs–the impact of social stress, the positive development of attachment and the negative effects of separation and loss, and the stages of concept formation relating to the functioning of the human body, the processes of disease and death–are basic approaches to the use of imagery-relaxation as an integral part of a comprehensive care plan.

Hoffman, Mark L. (1982/83). Hypnotic desensitization for the management of anticipatory emesis in chemotherapy. American Journal of Clinical Hypnosis, 25 (2-3), 173-176.

A hypnotic treatment employing systematic desensitization was used to alleviate anticipatory nausea and vomiting in a middle-aged man undergoing chemotherapy for Hodgkin’s Disease. After four treatment sessions, all nausea associated with chemotherapy was eliminated. Results of this treatment are compared with those of another hypnotic treatment recently reported by Redd et al (1982), and reasons for differences are discussed. [Redd, W. H., Andersen, G. V. & Minagawa, R. Y. (1982). Hypnotic control of anticipatory emesis in patients receiving cancer chemotherapy. Journal of Consulting and Clinical Psychology, 50, 14-19.]

Margolis, Clorinda G. (1982-83). Hypnotic imagery with cancer patients. American Journal of Clinical Hypnosis, 25 (2-3), 128-134.

This is a clinical report on the use of hypnotic imagery to reduce pain and discomfort in cancer patients. Deep relaxation, ego strengthening, imagery, and suggestions for changes in perception and awareness are the principal techniques used to reduce suffering and to produce a sense of well-being among cancer patients treated at different stages of disease. Hypnotic intervention involving six patients is described, with emphasis on the ease with which positive transference is established and the effectiveness with which it may be used to enhance therapeutic effects.

Meares, Ainslie (1982-83). A form of intensive meditation associated with the regression of cancer. American Journal of Clinical Hypnosis, 25 (2-3), 114-121.

Elsewhere I have reported a number of cases of regression of cancer following intensive meditation. This type of meditation is characterized by extreme simplicity and stillness of the mind, and so differs from other forms using a mantra, awareness of breathing or visualization of the healing process. Any logical verbal communication by the therapist stimulates intellectual activity in the patient. So communication is by unverbalized phonation, reassuring words and phrases, and most important, by touch. There follows a profound reduction in the patient’s level of anxiety which flows on into his daily life. The non-verbal nature of the meditative experience initiates a non-verbal philosophical understanding of other areas of life.

Newton, Bernauer W. (1982-83). The use of hypnosis in the treatment of cancer patients. American Journal of Clinical Hypnosis, 25 (2-3), 104-113.

For nearly eight years, cancer patients have been treated at this outpatient facility using hypnosis and psychotherapy. Basic concepts, assumptions and procedures are presented and the issues and problems encountered are discussed. Results are given as they relate to the three goals of treatment.

Oliver, George W. (1982-83). A cancer patient and her family: A case study. American Journal of Clinical Hypnosis, 25 (2-3), 156-160.

In recent years, increasing numbers of mental health workers have been attempting to use techniques of psychotherapy to influence the course of malignant disease. This paper reviews in detail the course of treatment of one female patient with an inoperable malignancy and conveys a sense of the clinical experience of working intensively with a cancer patient and her family. It shows the complex levels of interaction within the patient herself, between the patient and her family, and between the therapist and her family and within the therapist himself during different phases of the therapeutic journey.

Rosenberg, Simon W. (1982-83). Hypnosis in cancer care: Imagery to enhance the control of the physiological and psychological ‘side-effects’ of cancer therapy. American Journal of Clinical Hypnosis, 25 (2-3), 122-127.

The use of surgery, radiation, and chemotherapy has resulted in increased control of malignancy and prolonged survival for cancer patients. These modalities also carry significant morbidity. Normal physiological homeostasis is often altered by both the neoplasm and its treatment. The diagnosis, treatment, and social stigma of cancer exact profound psychological impact. Hypnosis effectively can control the range of both physiological and psychological ‘side-effects’ of cancer and its therapy. This paper will delineate those effects of hypnosis of proven value to the cancer patient. Incorporation of images into each phase of a hypnosis session will be demonstrated with an actual case history and annotated transcript. Imagery as a therapeutic modality will be discussed in general, and specific suggestions and images will be given.

Shapiro, Arnold (1982-83). Psychotherapy as adjunct treatment for cancer patients. American Journal of Clinical Hypnosis, 25 (2-3), 150-155.

During the past ten years psychotherapy as adjunct treatment for cancer patients has become increasingly common. The use of hypnosis as an integral part of that treatment has also burgeoned. This report will follow the progress of two cancer patients in psychotherapy. While each is highly individual, the commonalities which allow treatment to be systematic will be quite apparent. The ability to minimize pain and discomfort, the ability to keep the white cell count high despite ongoing chemotherapy, and augmenting the ability of the body’s immune system to fight the disease are utilized by both of the patients. All of the above are accomplished through the use of visual imagery in the trance state. Visual imagery is also used to reach feelings which patients are often unable to verbalize, and of which they often claim to be unaware. Other aspects of therapy such as the gradual shift from despair to hope and even confidence, and the development of more assertive behavior are discussed.

Black, Stephen (1964). Mind and body. London: Kimber.

Defines psychosomatic disease as one that responds to psychotherapy. Believes only 5% are highly hypnotizable, that hypnosis is learnable in 1/2 hour, that hypnosis is not a useful treatment for psychosomatic disorders because you can’t use interpretation [of unconscious]. The ‘unconscious’ is “… a complex of informational systems derived from such primaeval mechanisms” (p. 133). “Primaeval mind is involved in these mechanisms of genetics and immunology” (p. 133). “There is thus a ‘somatic mind’ which is unconscious and presumably without any means of verbalization of experience–and a ‘cerebral mind’ which is conscious” (p. 133). The dividing line is not clear.
Rapport is discussed on pp. 160, 169 as one of the spontaneous characteristics of hypnosis, in the absence of suggestion. The same for posthypnotic suggestion (rapport and amnesia). Spontaneous _physiological_ changes in hypnosis relate to mind-body relationships (p. 169)
Conditioned reflex is discussed on p. 161
“…the subjective evidence indicates that a perceptual change involving any sensory modality can be produced by DSUH” [direct suggestion under hypnosis] p. 178. Suggestion can selectively affect different parts of the body p. 197.
Research: “Hypnosis is not only the most important and practical way of _proving_ the existence of the unconscious–which is still in doubt in some circles–but is in fact the only way in which unconscious mechanisms can be manipulated under repeatable experimental conditions for purposes of investigation” (p. 152).
Mind-body is “amenability to control” Catatonia, which characterizes both animal and human hypnosis, seen in hypnosis, is induced by constriction (i.e. disorientation). The Cartesian concept of mind and body tends to confuse the issue p. 157.
Rapport is discussed (p. 157).
Suggestion (p. 159) “It was this concept of ‘suggestion’–which so obviously parallels ‘amenability to control’ in animals–that eventually established hypnosis in the French schools of psychiatry as a state of increased suggestibility. … still the standard definition of hypnosis in most medical psychiatric textbooks and in lay dictionaries” (p. 159).
Black (1969) did some biochemical sleuthing to learn how information transmitted by words becomes information encoded somatically, as when psychosomatic allergies flare and recede or disappear. What accounts for suggestion “curing” an allergic skin reaction in one part of the body while another part not included in the suggestion remains reactive? What accounts for the instantaneous skin allergy cure which sometimes occurs with suggestion (in 24 hours)?
Skin sensitivity tests in highly hypnotizable Ss who were also very allergic were inhibited by direct suggestion under hypnosis under highly controlled experimental conditions–and in one subject the effect (inhibition) was relatively permanent–ruling out (he suggests) a neurological mechanism. He did further experiments to examine whether the result was due to an instant neurological mechanism and a long-term endocrinal mechanism.
p. 212 He ruled out peripheral blood flow as the cause of diminished skin sensitivity (there was no change in blood flow with suggestions of heat or cold). Therefore decrease in blood flow couldn’t explain in neurovascular terms the ‘instant’ inhibition of skin sensitivity (allergy) tests. Was it due to systemic–especially adrenal– changes? He demonstrated increases in plasma cortisol under hypnosis with suggestions of fear. On p. 230 he summarizes the facts he established by skin sensitivity tests, plasma- cortisol studies, and histology – endocrinological.


Groth-Marnat, Gary; Mitchell, Kaye (1998). Responsiveness to direct versus indirect hypnotic procedures: The role of resistance as a predictor variable. International Journal of Clinical and Experimental Hypnosis, 46 (4), 324-333.

Empirical research attempting to demonstrate that indirectly phrased hypnotic suggestions result in greater responsiveness than do direct approaches generally has not shown any differences on formal hypnotizability scales. However, empirical research in related areas along with clinical observation suggests that client resistance might be a crucial moderating variable. specifically, participants with greater resistance would be expected to be more responsive to indirect approaches, whereas those with low levels of resistance would be more responsive to direct hypnotic procedures. To test this hypothesis, participants were given either a standardized test of hypnotic responsiveness that used direct suggestions (Harvard Group Scale of Hypnotizability) or a comparable indirect scale (Alman Wexler Indirect Hypnotic Susceptibility Scale) followed by administration of a measure of resistance (Therapeutic Reactance Scale). The hypothesis was not confirmed, in that those with higher (or lower) reactance/resistance did not score differently than those on either the indirect or direct hypnotizability measures.

Fourie, D. P. (1997). ‘Indirect’ suggestion in hypnosis: Theoretical and experimental issues. Psychological Reports, 80 (3, Pt 2), 1255-1266.

“Indirect” suggestion is conceptualized in two distinct ways in the literature. From an Ericksonian perspective “indirect” suggestions are theoretically approached as suggestions which can circumvent the censorship of consciousness to reach the “unconscious” where they can activate dormant potentials. In contrast, from a research perspective “indirect” suggestion is operationally defined as a technique. Based on Ericksonian theory, it was claimed that “indirect” suggestion was more effective than traditional, “direct” suggestion. However, this claim could not be empirically substantiated. In this paper it is shown that the theoretical claim is based on questionable assumptions about the existence of the “unconscious” as a reified entity and about the direct and lineal influence of certain suggestions on this entity. Also, it is argued that traditional research strategies which emphasize strict controls are unable to verify or unambiguously refute the Ericksonian claim because these strategies are biased toward “direct” suggestion. Finally, the paper provides a different, contextual perspective on “indirect” suggestion, thereby placing the theoretical and experimental issues in a different context of meaning. [PubMed Abstract]

Lynn, Steven Jay; Neufeld, Victor; Mare, Cornelia (1993). Direct versus indirect suggestions: A conceptual and methodological review. International Journal of Clinical and Experimental Hypnosis, 31, 124-152.

The article reviews the literature on the effects of direct versus indirect hypnotic suggestions. A conceptual and methodological analysis of direct versus indirect suggestions is also provided. Three conclusions follow from the review: (a) Contrary to views of Ericksonian hypnotists, suggestion style has little effect on objective responding to hypnotic test items; (b) studies of clinical- and laboratory-induced pain and other measures of subjective experience have yielded contradictory results–however, the best controlled studies have not indicated that indirect suggestions are superior to direct suggestions; and (c) there is insufficient evidence to conclude that hypnotizability level and suggestion wording interact, such that low hypnotizable subjects are particularly responsive to indirect suggestions. Methodological and conceptual problems in defining and studying hypnotic communications, the lack of rigorous experimental controls, and research issues and directions are highlighted. NOTES 1:
NOTES: Although this article is primarily concerned with the nature of suggestion, the review also mentions several studies comparing hypnosis with other interventions for pain, in passing:
Crowley (1980)
Snow (1979)
Omer, Darnel, Silberman, Shuval, & Palti (1988)
Stern (1982)
Bassman (1983)
“Like the clinical studies using the RIA [Rapid Induction Analgesia], pain studies that did not use the RIA lack appropriate control groups: Neither Bassman’s (1983) nor Stern’s (1982) research explicitly compared direct and indirect suggestions. What our review does suggest is that studies (e.g., Crowley, 1980; Snow, 1979; Van Gorp et al., 1985) that imposed the greatest degree of methodological control yielded the outcomes least favorable to the hypothesis that indirect suggestions are effective and account for the pain relief achieved, above and beyond factors common to placebo treatments” (p. 132).
“Lynn and his colleagues’ studies indicate that whereas indirect suggestions enhance archaic representations of the hypnotist, direct suggestions facilitate involvement in the events of hypnosis, as measured by subjective involvement and involuntariness” (p. 136).

Maurer, Candida; Santangelo, Michael; Claiborn, Charles D. (1993). The effects of direct versus indirect hypnotic suggestion on pain in a cold pressor task. International Journal of Clinical and Experimental Hypnosis, 41, 305-316.

Past studies have investigated the usefulness of hypnosis in pain reduction. Although hypnotic analgesia has been found to be effective, it is generally only those subjects who are highly susceptible to hypnosis who benefit. Some experimenters have found that even low-susceptible subjects can use hypnotic analgesia, if the hypnotic induction uses indirect rather than direct hypnotic suggestions. In the present study, high- and low-susceptible subjects were tested for analgesia using either direct or indirect hypnotic suggestion on pain in a cold pressor task. Findings suggest that high susceptibles experience greater pain reduction than do low susceptibles. However, no significant differences were found between the pain reduction in the direct versus the indirect hypnotic suggestion groups. Possible explanations for this lack of differences are discussed. NOTES 1:
NOTES: They noted that this study differed from Joseph Barber’s (1979) in that the latter used continuous suggestion whereas in the current study only posthypnotic suggestion was employed. Also, they used the Harvard Scale to classify Ss, and Register and Kihlstrom (1986) found that only one third of their HGSHS:A tested high-susceptible subjects were able to be so classified on a subsequent administration of the Stanford Hypnotic Susceptibility Scale, Form C, perhaps due to social demands inherent in group hypnosis. Also, perhaps 1 minute was not sufficient time to challenge the effectiveness of alternative coping strategies that some “low” Ss could have used to endure the procedure.

Szabo, Csaba (1993). The phenomenology of the experiences and the depth of hypnosis: Comparison of direct and indirect induction techniques. International Journal of Clinical and Experimental Hypnosis, 41, 225-233.

The effect of two hypnotic induction styles on subjective experience was measured in an experiment in which 44 subjects participated in both traditional direct hypnosis, induced by the Stanford Hypnotic susceptibility Scale, Form A, and indirect hypnosis (presented in counterbalanced order), followed by 4 minutes of rest before dehypnosis. The depth of hypnosis was measured retrospectively by a subjective scale, and the structure of experiences was measured by the Phenomenology of Consciousness Inventory. Subjects were subsequently administered the Stanford Hypnotic Susceptibility Scale, Form B, so that awareness of their hypnotizability would not affect their subjective depth reports. No differences were found in a comparison of subjects’ structure of experiences in direct and indirect hypnosis. In addition, low and medium hypnotizable subjects reported indirect hypnosis as deeper. This may reflect the possibility that while hypnotized different mechanisms come into play for subjects high in hypnotizability compared to those who are less hypnotizable.

Zeig, Jeffrey K.; Geary, Brent B. (1990). Seeds of strategic and interactional psychotherapies: Seminal contributions of Milton H. Erickson. American Journal of Clinical Hypnosis, 33 (2), 105-112.

Describes history of Erickson’s relationship to the Palo Alto group and family therapy practice (both strategic and interactional), and identifies seven philosophical and methodological realms which represent the incorporation of Ericksonian principles into strategic and interactional family therapy models.

Edgette, John H. (1988). ‘Dangerous to self and others’: The management of acute psychosis using Ericksonian techniques of hypnosis and hypnotherapy. In Lankton, Stephen R.; Zeig, Jeffrey K. (Ed.), Ericksonian Monographs: No. 3. Treatment of special populations with Ericksonian approaches (pp. 96-103). New York: Brunner/Mazel.

Edgette shows how several agitated psychotics were hypnotized using an Ericksonian approach. His inductions were bold attempts to introduce hypnosis in a setting where drugs and restraints are often the only available tools. He offers some ideas concerning the myth that hypnosis will not work with such a population.

Lynn, Steven Jay; Weekes, John R.; Matyi, Cindy L.; Neufeld, Victor (1988). Direct versus indirect suggestions, archaic involvement, and hypnotic experience. Journal of Abnormal Psychology, 97 (3), 296-301.

This study examined the effects of direct (Harvard Group Scale of Hypnotic Susceptibility; Shore & Orne, 1962) versus indirect (Alman-Wexler Indirect Hypnotic Susceptibility Scales; Pratt, Wood, & Alman, 1984) suggestions on archaic involvement (Nash & Spinler, in press) with the hypnotists, objective responding, and subjective involvement and involuntariness ratings, when the scales were administered in all possible combinations (direct/indirect, N = 61; indirect/direct, N = 61, direct/direct, N = 57; indirect/direct, N = 95), across two sessions. At the initial testing, subjects who received indirect suggestions reported a greater emotional bond with the hypnotist and increased fear of negative appraisal than subjects who received direct suggestions. Repeated testing resulted in response decrements on measures of objective responding, subjective involvement, and involuntariness that were paralleled by diminished involvement with the hypnotist. The most stable relation between scales was evident when scales were defined as direct hypnosis across both sessions. Although direct and indirect suggestions produced comparable effects in the first session, in the second session, direct suggestions fostered greater subjective involvement and feelings of involuntariness.

Lynn, Steven Jay; Neufeld, Victor; Matyi, Cindy L. (1987). Inductions versus suggestions: Effects of direct and indirect wording on hypnotic responding and experience. Journal of Abnormal Psychology, 96 (1), 76-79.

This study examined the effects of direct wording (authoritative language, specific responses) versus indirect wording (permissive language, choice of responses) of hypnotic inductions and suggestions in measures of behavioral and subjective responding. Subjects experienced suggestion-related involuntariness and suggested effects to a greater degree in response to direct-word suggestions (Harvard Group Scale of Hypnotic Susceptibility; Form A; Shor & Orne, 1962) than in response to indirect-worded suggestions (Alman-Wexler Indirect Hypnotic Susceptibility Scale; Pratt, Wood, & Alman, 1984). No difference in behavioral responding was observed. Furthermore, induction wording did not have an effect on these measures, nor did the wording of the induction and the wording of the suggestion types interact with each other. Female subjects attributed less of their responsiveness to their own efforts when they received direct suggestions, and male subjects were less likely to attribute their responsivity to the hypnotist’s ability when they received indirect suggestions. Rapport with the hypnotist did not vary as a function of induction or suggestion wording.

Price, Donald D.; Barber, Joseph (1987). An analysis of factors that contribute to the efficacy of hypnotic analgesia. Journal of Abnormal Psychology, 96, 46-51.

An analysis was made of factors that contribute to the magnitude of hypnotic analgesia produced by indirect hypnotic suggestions. Two groups of human volunteers made _sensory_ and _affective_ visual analogue scale (VAS) responses to nociceptive temperatures (44.5-51.5C) before and after hypnotic suggestions were given for analgesia. Group 1 was given suggestions for developing a hypnotic state only once just before analgesic testing and did not have significantly reduced VAS responses to experimental pain after hypnosis. Group 2 was continuously given cues for maintaining a hypnotic state during their analgesia testing session and had large reductions in both VAS- sensory and, especially, VAS-affective responses to pain. A small but statistically reliable correlation was found between hypnotic susceptibility and overall magnitude of reduction in VAS-sensory responses (R = .4). The correlations were much larger for intense stimuli compared to those near threshold. Reductions in VAS-affective pain responses were not correlated with hypnotic susceptibility.

Woolson, Donald A. (1986). An experimental comparison of direct and Ericksonian hypnotic induction procedures and the relationship to secondary suggestibility. American Journal of Clinical Hypnosis, 29 (1), 23-28.

Recent studies reporting the disparate effects of direct and indirect suggestion upon hypnotized subjects have indicated that standardized, direct hypnotic susceptibility tests may not accurately predict the suggestibility of subjects exposed to an indirectly worded, albeit similar, test. Historically, primary suggestibility correlates highly with hypnotizability, while secondary suggestibility does not and has been reported to be a subject’s response to indirect suggestion. In this study 56 volunteers for self-hypnosis training were first tested for secondary/indirect suggestibility, then each singly received either a direct standardardized [sic] induction or an Ericksonian (indirect) version. While susceptibility scores between groups were close, a greater number of the Ericksonian group subjects were rated as medium or highly susceptible. This occurred regardless of their type of suggestibility. Also, the Ericksonian group subjects appeared to be less aware of their depth of trance, as judged by a comparison of their susceptibility scores and their self-report depth scores. – Journal Abstract

Coe, William C.; Scharcoff, J. A. (1985). An empirical evaluation of the neurolinguistic programming model. International Journal of Clinical and Experimental Hypnosis, 33 (4), 310-318.

The neurolinguistic programming hypothesis that most people have a preferred way of dealing with the world — a primary representational system — was tested. 50 Ss were evaluated for sensory modality preference in 3 ways: (a) they chose among written descriptions using either visual, auditory, or kinesthetic wording (preference); (b) their eye movements were recorded during an interview; and (c) their verbal responses were scored for sensory predicates. The results did not support neurolinguistic programming theory in that preference of 1 modality on 1 measure did not relate to the same modality on the other measures as would be expected if primary representational systems were characteristic of the sample. Other studies have shown mixed results. The conclusion seems warranted that a good deal more empirical support is needed before the positive therapeutic claims of neurolinguistic programming proponents can be taken seriously.

Matthews, W. J.; Bennett, H.; Bean, W.; Gallagher, M. (1985). Indirect versus direct hypnotic suggestions – an initial investigation: A brief communication. International Journal of Clinical and Experimental Hypnosis, 33 (3), 219-223. Keywords: indirect suggestion, suggestion

The clinical use of indirect hypnotic suggestion is purported to be an effective method of trance induction because it allows S a wider latitude of responsiveness than does a traditional hypnotic induction. In the present study, 15 male and 15 female Ss each received a traditional hypnotic induction followed by the Stanford Hypnotic Clinical Scale (SHCS) of Morgan and Hilgard (1978) and an Ericksonian hand levitation induction (Erickson, E. L. Rossi, & S. Rossi, 1976) followed by a rewritten SHCS, utilizing indirect suggestions for each scale item (Indirect Suggestion Scale — ISS). The results revealed no significant main effect differences between hypnotic methods on the behavioral response measure. Ss did report feeling more deeply hypnotized during the indirect hypnotic procedure. High hypnotizable male Ss felt more aware of the hypnotic suggestions and more in charge of their experience when they experienced ISS than they did on SHCS. This difference in self-reported experience may possibly be due to the time differential between SHCS and ISS, with the latter taking approximately one-third longer. Implication and limitations of the study are discussed.

Stone, Jennifer A.; Lundy, Richard M. (1985). Behavioral compliance with direct and indirect body movement suggestions. Journal of Abnormal Psychology, 94 (3), 256-263.

Investigated the effectiveness of 2 types of suggestions in eliciting body movement by presenting 96 high-, medium-, and low-susceptible undergraduates, in hypnotic or nonhypnotic conditions, with either of 2 series of body movement suggestions. The indirect suggestions were designed to represent the approach of M. H. Erickson (see PA, vol 60:11116 and 12262) and resulted in greater compliance in the hypnotic condition. Direct suggestions resulted in greater compliance in the nonhypnotic condition. Susceptibility to hypnosis was related to compliance in the hypnosis condition, but no interactions were found between susceptibility and type of suggestion. Sense of volition in responding was unrelated to the major findings. Discussion of the results includes a call for the accurate reporting of the wording of hypnotic suggestions in future research.

Van Gorp, Wilfred G.; Meyer, Robert G.; Dunbar, Karen D. (1985). The efficacy of direct versus indirect hypnotic induction techniques on reduction of experimental pain. International Journal of Clinical and Experimental Hypnosis, 33, 319-328.

The cold pressor test was used to investigate the efficacy of Rapid Induction Analgesia, a new, indirect hypnotic technique introduced by J. Barber (1977). Rapid Induction Analgesia was compared with traditional hypnosis, relaxation, suggestion without an induction, and a no-treatment control in Subject of high and low hypnotizability. Only traditional hypnosis was found to significantly reduce Subject”s reported pain when compared to the control group Subject, and Rapid Induction Analgesia was not found to be an effective treatment in this study, in contrast to J. Barber”s earlier findings

105 subjects were randomly assigned to conditions, based on high (8-12) or low (0-4) scores on the Harvard Group Scale of Hypnotic Susceptibility. There were 9-13 Subjects per cell in the treatment conditions.

McConkey, Kevin M. (1984). The impact of an indirect suggestion. International Journal of Clinical and Experimental Hypnosis, 32 (3), 307-314.

The impact of an indirect suggestion was investigated in 2 different test contexts; real and simulating Ss were tested. The Experiential Analysis Technique was employed with real Ss in order to explore their perceptions and processing of the indirect suggestion. Real Ss were seen to be more heterogeneous in their response to the indirect suggestion than were simulating Ss, and the pattern of response was similar in the 2 test contexts. Some real Ss perceived the indirect suggestion as an illegitimate basis for a change in their phenomenal awareness. Findings point to the ways in which real Ss differ in the detail of their hypnotic response, and comment is made on the relevance of cognitive style for understanding the response patterns of hypnotic Ss.

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

Compared the effects of indirect hypnosis (e.g., metaphors, stories, vague suggestions, and implied directives) on muscle contraction headaches with a relaxation and a no-treatment control condition. Both hypnosis and relaxation conditions reduced symptoms more than did the no-treatment condition. Unlike relaxation, indirect hypnosis did not reduce the intensity and duration of headaches, although it did reduce the amount of medication and also benefitted sleep.

Stern, T. E. (1982). The effects of Ericksonian hypnosis and biofeedback on self-reported measures of pain (Dissertation). Dissertation Abstracts International, 43, 3744-B.

Conducted a 6-subject case study comparing the effectiveness of so-called Ericksonian hypnosis and biofeedback on chronic pain. Two subjects improved more on subjective and behavioral pain measures using biofeedback, three improved more using hypnosis, and one did not improve in either condition.

Crowley, R. (1980). Effects of indirect hypnosis (Rapid Induction Analgesia) for relief of acute pain associated with minor podiatric surgery (Dissertation). Dissertation Abstracts International, 40, 45-49.

Lynn et al. (1993) cited this dissertation. They noted that all 30 volunteer subjects responded painfully when stimulated by a needle administered by a podiatrist and that the Rapid Induction Analgesia of Joseph Barber (RIA) was not as effective as local chemical analgesia. Furthermore, according to Lynn et al., RIA patients did not report a reduction in their anxiety following podiatric surgery comparable to that reported by patients who received chemical analgesia. The author also found that hypnotizability was related to multiple chronic pain indices.

Edwards, William Henry (1980). Direct versus indirect hypnosis for the relief of chronic pain in spinal cord injured patients (Dissertation, United States International University). Dissertation Abstracts International, 40 (10-B), 4996.

This study compared effectiveness of direct hypnosis and indirect hypnosis (Rapid Induction Analgesia, developed by Joseph Barber) in reducing experimental and clinical pain in spinal cord injured patients. The 30 male paraplegic patients who had chronic benign pain volunteered for the study. They were administered three tests: the Pain Estimate Scale (Sternbach, 1974), Ischemic Muscle Pain Test (IMPT), and the Stanford Profile Hypnotic Susceptibility Scale, Form II — SPHSS — (Weitzenhoffer and Hilgard, 1967). Each patient experienced three sessions: (1) Baseline Control, (2) Direct Hypnosis, and (3) Indirect Hypnosis. Patients were randomly assigned to Sessions (2) and (3). The results indicated no significant statistical difference in the effectiveness of direct versus indirect hypnotic analgesia in these chronic pain patients. Direct and indirect hypnosis were equally effective; hypnotizability was not associated with outcome. Furthermore, there was no interaction between treatment effects and pretreatment pain level. The results were similar for both clinical and experimental pain.

McConkey, Kevin M.; Sheehan, Peter W. (1980). Inconsistency in hypnotic age regression and cue structure as supplied by the hypnotist. International Journal of Clinical and Experimental Hypnosis, 28 (4), 394-408.

Inconsistency in hypnotic age regression was elicited by asking Ss to write a complex sentence, in contexts that varied appreciably in the extent to which they cued Ss that illogical response was appropriate. Hypnotically responsive and unresponsive Ss were assigned to a real or simulating group in application of the real-simulating model of hypnosis and tested in 1 of 3 distinct cue conditions. Cue conditions either followed those of previous studies and communicated that no particular response was appropriate, or communicated that an illogical response was appropriate, or inappropriate. It was hypothesized that cue structure would have a significant impact. Data indicated that cues for logical response had a greater influence on the behavior of Ss than did cues for illogical response when compared with the base response condition; at times, real Ss behaved appreciably more illogically than simulating Ss. Also, detailed analysis of the reports of both groups of Ss indicated distinctive properties of experience that point to the importance of recognizing the complexities of consciousness underlying the experiences of highly susceptible Ss.

Spear, J. E. (1975). The utilization of non-drug induced altered states of consciousness in borderline recidivists. American Journal of Clinical Hypnosis, 18, 111-126.

Utilizing non-drug induced altered states of consciousness, various modes of interior reflection, behavior modification and reprogramming of conscious attitudes and values were utilized with 49 borderline recidivists. Such offenders were so determined by the Department of Corrections, Probation and Parole Office, District II. No coercion was used to induce such individuals to enter the program and there was no reprisal for stopping therapy at any time. Over a two and one-half year period the recidivist rate among this group was less than 5%. It is suggested that non-drug induced altered states of consciousness combined with indirect as well as symbolic techniques may prove to be the most effective means of criminal rehabilitation.

Berderline recidivists were “individuals, who, in the opinion of the P.O. [probation officer] were, in all probability, to be returned to prison within a few months, or less, if there wasn’t a major change in attitude and actions” (p. 111). Therapy employed closed circuit TV with bi-directional audio and induction of altered state of consciousness using an ophthalmology-type rotary prism. Therapy involved (s) recall of relaxed state when under stress, (2) exploration of early conditioning events, (3) self evaluation during the ASC, (4) use of symbolic mental exercises and mental practice for similar circumstances in normal waking state, (5) suggestions for setting goals and ideals, (7) a type of logotherapy, (7) ‘nudging’ the person to examine their relationship with their concept of God. The author noted in the parolees: (1) low levels of self esteem, (2) depression, (3) going into deep levels of altered states once trust was established with the therapist.

Beahrs, John O. (1974). Dynamics of experiential therapy. American Journal of Clinical Hypnosis, 17, 1-4.

Modern experiential therapies have significant features in common with hypnotherapy. The essence of hypnotically oriented psychotherapy is described by Milton H. Erickson (1971) as ‘meet the patient at the patient’s level, thereby gaining rapport. As trust is developed, modify the patient’s productions by covert suggestions, thereby gaining control. This control is then utilized in order to get the patient to institute therapeutic growth from within.’ He further emphasizes the necessity of an indirect approach, of subtle manipulations leading the patient to circumvent his resistances. The modern experiential therapist follow Erickson’s maxim and display many features in common with hypnotic therapies. It is our observation that successful experiential work almost always leads to a hypnotic trance, in even very resistant subjects, and that this greatly augments its therapeutic effectiveness. It differs from Erickson’s therapy in not requiring the indirect, round-about approach. In essence, it is highly suited to the therapist who admires the ingenuity of Erickson but who is more suited, personality-wise, to a direct approach, of zeroing right in on a problem where the energy is. Instead of circumventing a patient’s resistances, the therapist helps the patient fully experience them. The two styles, however, are seen as both similar and compatible with one another. [Emphasis removed.]

Evans, Frederick J. (1967). An experimental indirect technique for the induction of hypnosis without awareness. International Journal of Clinical and Experimental Hypnosis, 15, 72-85.

A procedure is described which has been used in an experimental setting as a method of indirectly inducing hypnosis without S’s awareness. Ss are not told that hypnosis is involved in the procedure, but are told they will be taught how to relax. The aim of the indirect procedure is to create different expectations and preconceptions from those normally occurring in the special hypnotic relationship. Evidence from 3 studies (samples of 63, 63, 120) indicates that the procedure successfully induces hypnosis comparable in depth to other standard hypnotic procedures. About half of the Ss tested apparently do not recognize the procedure involves hypnosis. Approximately 30% of the Ss who receive the procedure, as well as 30% of the Ss in the control group who did not receive the procedure, but were tested with the same test suggestions, recognized that an attempt had been made to induce hypnosis. The perceptions about whether hypnosis was involved were unrelated to scores on typical hypnotic phenomena. It was concluded that the indirect induction technique successfully induces hypnosis and is a useful technique for manipulating S-expectations in an experimental context.

[The Subject] is told, ‘A series of experiments are being conducted investigating the effects of relaxation on behavior. Because of confusing results in the literature, this study is designed to examine the relationship between relaxation and several other psychological phenomena, some of which might remind you of a variety of other phenomena which you may have heard or read about.’ The S was told that a technique had been devised that would assist him to relax completely. His main task was to relax as completely as possible. This would be facilitated by lying comfortably on a couch, and by allowing his mind to become completely blank. To prevent himself from falling asleep, he should concentrate his attention on some object or idea. To help exclude other thoughts from his mind, E would continue to talk in a monotonous voice saying little of importance, while the S stared at a spot on the wall. This shaping of the situation was continued with a considerable degree of apparent permissiveness.