Active alert hypnosis improves attentional processing in military pilots (Barabasz, 1985, Journal of Aviation, Space & Environmental Medicine). INAP = Instantaneous Neuronal Activation Procedure. To enhance responsiveness to cockpit cues. Didn”t have way of doing in flight measures of hypnosis. INAP was used clinically with airline pilots (Rhue, Lynn, & Kurtz Handbook on Clinical Hypnosis)
Active alert focused attention hypnosis increases frontal EEG topographic energy and frequency shifts (increased beta) in highly hypnotizable normal and attention deficit disordered children (Barabasz, Crawford & Barabasz, 1993; in press). No significant changes are found with low hypnotizables (Barabasz & Barabasz, 1993). But sample was small.
Can alert focused attention hypnosis alter EEG topography and attentional processing in subjects of average hypnotizability?
MRI type mapping shows that attention deficit kids don”t have normal patterns.
Subjects: all 11 Ss (female) who volunteered for a vitamin B-6 depletion study, with EEG evaluation, also volunteered for hypnosis testing for a $5.00 payment (SHCS score range 2-3).
Used active alert procedure during reading comprehension task, disguised as normal reading procedure. Counterbalanced waking, attentional instructions and alert focused attention hypnosis conditions were imbedded in standard EEG situation.
Nelson Denny H.S. Reading Comprehension Test. “Focus your attention to read faster than normal, paying attention to what you read.”
Used an eye roll induction, and looked for signs of entering hypnosis before they roll their eyes down; were able to cut no. of sessions in neurofeedback training by 50% by using these instructions. To come out next year in Rhue and Lynn.
Reading rate and comprehension increased in alert hypnosis (and words per minute also in attentional instructions). Neurobehavioral feedback for ADD is to decrease theta and increase beta and it ordinarily takes 60 sessions; 40-80 sessions without hypnosis, 15-25 with hypnosis. Eyeroll induction cuts that. (See Barabasz & Barabasz, 1996. Chapter in Lynn, Kirsch, & Rhue, “Casebook of Clinical Hypnosis.” Washington, DC.: APA Press.)
1993
Bertrand, Lorne D.; Stam, Henderikus J.; Radtke, Lorraine (1993). The Carleton Skills Training Package for modifying hypnotic susceptibility–a replication and extension: A brief communication. International Journal of Clinical and Experimental Hypnosis, 41, 6-14.
This study employed the Carleton Skills Training Package (CSTP) to attempt to enhance both objective and subjective components of hypnotic susceptibility. In addition, changes in susceptibility were compared for subjects administered a standard hypnotic induction procedure and for subjects given brief “place yourself in hypnosis” instructions. Results indicated that subjects who were administered the CSTP exhibited significant gains in both objective and subjective susceptibility scores that were maintained at two separate posttests with different scales. No differences were observed between the groups administered the standard induction and those administered the self-induction instructions. NOTES 1:
NOTES
The authors do not make much of the latter finding, but I find it to be the more interesting outcome.
“Two experiments (Barber & Calverley, 1969; Stam & Fraser, 1986) found that subjects who sat quietly for 5 minutes following an instruction to “place yourself in hypnosis” attained similar scores when responding to test suggestions as did subjects who were administered a 5-minute hypnotic induction procedure. The CSTP informs subjects that hypnotic induction procedures do not achieve their effects by inducing a trance state and that such procedures function to produce relaxation rather than to enhance responsiveness to suggestion. In addition, the CSTP emphasizes to subjects that responses to suggestions do not ‘just happen’ but must be actively generated. To the extent that subjects attend to these aspects of the CSTP procedure, they should exhibit equivalent increments on behavioral and subjective indexes of susceptibility regardless of whether they are administered a formal hypnotic induction procedure or simply told to ‘place themselves into hypnosis.'” (p. 7).
“That naive subjects can produce equivalent objective, subjective, and involuntariness scores following such instructions highlights the degree to which hypnotic responses are not dependent on formal induction procedures. The fact that so-called active-alert induction procedures are also equivalent in producing hypnotic responses supports this notion (Banyai & Hilgard, 1976)” (p. 13).
De Pascalis, Vilfredo (1993). EEG spectral analysis during hypnotic induction, hypnotic dream and age regression. International Journal of Psychophysiology, 15, 153-166.
EEG was recorded monopolarly at frontal (F3, F4), central (C3, C4) and posterior (in the middle of O1-P3-T5 and O2-P4-T6 triangles) derivations during the hypnotic induction of the Stanford Hypnotic Clinical Scale (SHCS) and during performance following suggestions of hypnotic dream and age-regression as expressed in the before-mentioned scale. 10 low-hypnotizable and 9 highly-hypnotizable and right- handed female students participated in one experimental session. Evaluations were Fast- Fourier spectral analyses during the following conditions: waking-rest in eyes-open and eyes-closed condition; early, middle, and late phases of hypnotic induction; rest-hypnosis in eyes closed condition; hypnotic dream and age regression. After spectral analysis of 0 to 44 Hz, the mean spectral amplitude estimates across seven Hz bands (theta 1, 4-6 Hz, theta 2, 6-8 Hz; alpha 1, 8-10 Hz; alpha 2, 10-13 Hz; beta 1, 13-16 Hz; beta 2, 16-20 Hz; beta 3, 20-36 Hz) and the 40-Hz EEG band (36-44 Hz) for each experimental condition were extracted. In eyes-open and -closed conditions in waking and hypnosis highly-hypnotizable subjects produced a greater 40-Hz EEG amplitude than did low hypnotizable subjects at all frontal, central and posterior locations. In the early and middle hypnotic induction highly-hypnotizables displayed a greater amount of beta 3 than did low hypnotizables and this difference was even more pronounced in the left hemisphere. With posterior scalp recordings, during hypnotic dream and age regression, high hypnotizables displayed, as compared with the rest-hypnosis condition, a decrease in alpha 1 and alpha 2 amplitudes. This effect was absent for low hypnotizables. Beta 1, beta 2 and beta 3 amplitudes increased in the left hemisphere during age regression for high hypnotizable; low hypnotizables, in contrast, displayed hemispheric balance across imaginative tasks. High hypnotizables during the hypnotic dream also displayed in the right hemisphere a greater 40-Hz EEG amplitude as compared with the left hemisphere. This difference was even more evident for posterior recording sites. This hemispheric trend was not evidenced for low hypnotizable subjects. Theta power was never a predictor of hypnotic susceptibility, 40-Hz EEG amplitude displayed a very high main effect (p<0.004) for hypnotizability in hypnotic conditions by displaying a greater 40-Hz EEG amplitude in high hypnotizables with respect to lows. NOTES 1: NOTES In the Discussion section, the authors indicate that they have no idea why they didn't replicate results of other theta studies, including their own, except maybe due to complex interaction among personality, subject selection, situation-specific factors, and hypnotizability. They observe that the alpha results conform with previous findings (p. 163). Beta bands were sensitive. Highs showed left-hemisphere prevalence in all beta bands during age regression; they also showed hemispheric balance in the hypnotic dream condition. Beta 3 amplitude was also greater among highs than lows. "among high hypnotizables, beta 3 amplitude in the early hypnotic condition was greater in the left hemisphere as compared to the right and as the hypnotic induction proceeded hemisphere balancing, with reduced beta 3 amplitude, was displayed. This result appears in agreement with the predictions of the neurophysiological model proposed by Gruzelier et al. (1984) and Gruzelier (1988) as well as with other studies in which beta rhythm was found to discriminate performances between high and low hypnotizables (e.g., Meszaros et al., 1986, 1989; Sabourin et al., 1990)" (p. 163-164). 40 Hz amplitude was higher in highs and increased in right hemisphere during the hypnotic dream, especially in posterior areas. "This pattern of hemispheric activation may be interpreted as an expression of the greater right-hemisphere activation and of the release of posterior cortical functions during the hypnotic dream and is compatible with the predictions of the Gruzelier model of hypnosis, however, the results obtained in this study for 40-Hz EEG amplitude failed to reveal an inhibition of the left-hemisphere activity with the progress of the hypnotic induction" (p. 164). (They note that De Pascalis & Penna, 1990, agreed with the Gruzelier 1988 model: highs in early induction had increase of 40-Hz in both hemispheres, but as induction proceeded they had inhibition of left and increase in right hemisphere activity. In this current experiment, only beta 3 showed the hemispheric trend of Gruzelier's model. They cite other details of current study, p. 164, not consonant with Gruzelier.) "The 40-Hz EEG rhythm, which according to Sheer (1976) is the physiological representation of focused arousal, appeared to discriminate between differential patterns of high and low hypnotizables. Both during hypnotic induction and during hypnotic dream and age regression highly hypnotizables exhibit greater 40-Hz EEG amplitude with respect to the lows. These findings support the validity of the assumption that hypnosis is characterized by a state of focused attention (Hilgard, 1965) and that 40-Hz EEG activity reflects differential attentional patterns among subjects high and low in hypnotizability. On the basis of these findings it would appear that 40-Hz EEG and beta 3 spectral amplitudes may prove to be useful measures of individual hypnotizability" (p. 164). 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). 1992 Kirsch, Irving; Mobayed, C. P.; Council, J. R.; Kenny, D. A. (1992). Expert judgments of hypnosis from subjective state reports. Journal of Abnormal Psychology, 101, 657-662. Suggestibility was assessed in 60 student subjects after a traditional hypnotic induction, an alert induction, progressive relaxation training, or instruction in goal-directed imagery. Responsiveness to suggestion did not differ between groups. Subjects also generated open-ended reports of their states of awareness and of their experience of three hypnotic suggestions. A sample of these reports from 24 moderately to highly suggestible subjects was evaluated by 18 experts in the field of hypnosis. Expert ratings of subjects' open-ended reports indicated that (a) traditional hypnotic inductions produce a state of consciousness that is indistinguishable from nonhypnotic relaxation training, (b) the subjective experience of hypnotic suggestions after imagination training is indistinguishable from that after hypnotic inductions, and (c) suggestibility is unrelated to state of consciousness as assessed by experts. Lewis, D. O. (1992). Hypnoanalgesia for chronic pain: The response to multiple inductions at one session and to separate single inductions. Journal of the Royal Society of Medicine, 85, 620-624. Serial hypnotic inductions conveying the same analgesic message produce a progressively longer response in an increasing number of patients. The resulting analgesia appears to be independent of the spacing of inductions--whether given at a single session or on separate occasions--and to depend upon their number. However, multiple inductions at a single session save time. Elimination of pain can be achieved, by either approach, for a year or more in up to 70% of patients. 1991 Miller, Mary Frances; Barabasz, Arreed F.; Barabasz, Marianne (1991). Effects of active alert and relaxation hypnotic inductions on cold pressor pain. Journal of Abnormal Psychology, 100 (2), 223-226. Contrasted relaxation and active alert hypnotic inductions with or without a specific suggestion for cold pressor pain analgesia. Groups of high (n = 38) and low (n = 27) hypnotizability subjects were tested; hypnotizability had been determined from results of the Stanford Hypnotic Susceptibility Scale, Form C. Cold pressor pain data were obtained after counterbalanced exposure to relaxation and active alert inductions. Highly hypnotizable subjects demonstrated lower pain scores than did low hypnotizability ones. Pain reports did not differ between induction conditions. Highly hypnotizable subjects given an analgesic suggestion showed lower pain scores than did those exposed only to hypnosis. The findings, conceptualized within E. R. Hilgard''s (1977a) neodissociation theory, show that relaxation is not necessary for hypnotic analgesia. NOTES 1: NOTES: The relaxation induction was the SHSS, Form B. The active alert induction used the same instructions except suggestions for alertness, invigoration, and freshness were substituted for drowsiness and relaxation. During the active alert induction, the subjects rode a bicycle ergometer at a constant load of 1-3 kg and a constant rate of 1-2 rotations per s (Banyai & Hilgard, 1976). 1990 Barber, Theodore Xenophon (1990, August). Some things I've learned about hypnosis after 37 years. [Audiotape] Presented at the annual meeting of the American Psychological Association, Boston. NOTES We are a unity of cells. Every cell is a citizen with it's own jobs, communicating all the time; cells send messages; the way we communicate with them is by suggestions. Each _cell_ is a mind-body.... When I do it now [hypnotic inductions], I say, 'We're going to go into hypnosis, we're _both_ going to go into hypnosis. I'm going to close my eyes (etc.)' - modeling hypnosis for them." Cikurel, Katia; Gruzelier, John (1990). The effect of an active-alert hypnotic induction on lateral asymmetry in haptic processing. British Journal of Experimental and Clinical Hypnosis, 7, 17-25. In order to elucidate further left hemispherical inhibitory dynamics in response to instructions of hypnosis, bilateral haptic processing times were compared before and during a traditional hypnotic relaxation procedure and an active-alert procedure in which subjects pedaled a bicycle ergometer and instructions on mental alertness were incorporated with hypnosis. Previous evidence suggesting a slowing of left hemispherical processing and a facilitation of right hemispherical processing in susceptible subjects was replicated, and was shown to characterize high rather than medium susceptibles, the latter showing a bilateral slowing of processing. These effects occurred with both induction procedures whose influence on susceptibility was highly correlated. In fact the lateral shift in processing in the direction of left hemispherical inhibition and right hemispherical facilitation was favoured by the active-alert procedure, indicating that neuropsychological changes which occur with hypnosis cannot be discounted as a by-product of relaxation. 1989 Moss, Barry F.; Magaro, Peter A. (1989). Personality types and hetero- versus auto-hypnosis. Journal of Personality and Social Psychology, 57, 532-538. The Multivariate Personality Inventory (MPI; Magaro & Smith, 1981), the Harvard Group Scale of Hypnotic Susceptibility, and the Inventory of Self-Hypnosis (ISH; Shor, 1970) were used to investigate the relationship between personality style and hypnotic procedure in the determination of hypnotic susceptibility. On the basis of MPI scores, a normal college population was segregated into 5 personality styles: hysteric, manic, depressive, character disorder, and compulsive. The hysteric personality was found significantly more hypnotizable than the other personality types in the HGSHS induction context, whereas the compulsive personality was found significant more hypnotizability in the ISH induction context. Results are discussed in terms of personality and situational factors in relation to previous hypnotic susceptibility research. 1988 Hammond, D. Corydon; Haskins-Bartsch, Catherine; Grant, Claude W.; McGhee, Melanie (1988). Comparison of self-directed and tape-assisted self-hypnosis. American Journal of Clinical Hypnosis, 31, 129-137. Previous research on self-hypnosis has concentrated on the relationship between heterohypnosis and either self-directed self-hypnosis or self-initiated self- hypnosis. Despite widespread use of audiotapes to assist the process of self-hypnosis, no previous research has compared tape-assisted and self-directed self-hypnosis. Forty-eight inexperienced volunteers were hypnotized and taught self-hypnosis by posthypnotic suggestion and immediate practice in the office. They were randomly assigned to one of two experimental orders to practice self-directed and tape-assisted self-hypnosis. No differences were found between heterohypnosis or either type of self-hypnosis in response to behavioral suggestions. Experiential ratings, however, consistently favored heterohypnosis over either type of self-hypnosis. Tape-assisted self-hypnosis was consistently evaluated as superior to self-directed practice by newly trained subjects. NOTES 1: NOTES: The tapes were more or less identical with the in-office hypnosis, including voice of the hypnotist, except that those doing self-directed self hypnosis received a posthypnotic suggestion for how to enter hypnosis by themselves. (All Subjects received written instructions to remind them about the procedures for home practice.) When self hypnosis was evaluated, use of a tape produced greater concentration and absorption, less distraction, greater subjective depth, greater perception of nonvoluntary response to suggestion, and more changes in body perception (e.g. loss of awareness of the body, feelings of heaviness or of floating). Therefore, the tape-assisted experience could be viewed as more convincing to the Subjects. People tended to fall asleep more when they did self-directed self hypnosis than when they used a tape. However, people enjoyed heterohypnosis more than either self hypnosis experience, and reported more nonvoluntary experiences. The more positive response to heterohypnosis replicates research by Johnson et al. (1983)., in which preceding self-hypnosis by a heterohypnosis induction may results in less positive experiences with the self-directed self hypnosis. In their Discussion, the authors note that finding no differences between self hypnosis and heterohypnosis in the number of behavioral suggestions successfully passed replicates earlier research (Shor & Easton, 1973; Ruch, 1975; Johnson, 1979; Johnson, Dawson, Clark, & Sikorsky, 1983). "Thus, our present study has replicated previous findings concerning the relationship of heterohypnosis and self-directed self-hypnosis. In clinical practice, it appears that a heterohypnosis experience virtually always precedes training in self- hypnosis. Our findings and those of the Johnson (1983) study suggest, however, that generally patients will experience self-hypnosis as significantly less powerful than their previous office experience. But, by using a tape to assist the patient in initial practice, the discrepancy between the quality of the experiences appears reduced. It should be noted that Johnson et al. (1983) provide the innovative suggestion that there may be something gained by having self-hypnotic instruction and practice precede a hypnotic experience by a therapist. Initial self-hypnotic experience may create a mental set of being more actively involved" (p. 136). "However, we know nothing about how tape-assisted vs self-directed experiences are perceived by Ss with more self-hypnotic and heterohypnotic experience, and particularly if they are utilizing the same tape recording(s) over and over again. Other research (Hammond, 1987) recently followed up premenstrual syndrome patients who were trained in self-hypnosis. In this study, patients showed a clear preference for using tapes to assist them in self-hypnosis shortly after initial training. However, on 6-month follow-up, patients were found to be utilizing self-directed self-hypnosis much more frequently than tapes, with which they may have become somewhat bored. The issue of boredom has thus far not been adequately addressed in the self-hypnosis literature" (p. 136). Immelman, Aubrey (1988, November). The effects of three pain management procedures on the experience of cold pressor. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Asheville, NC. NOTES This research was motivated by Joseph Barber's (1977) claim of 99% success rates with dental patients. This research had 3 conditions or levels of treatment: direct suggested analgesia; indirect suggested analgesia; and self-generated cognitive strategies. 60 male and female psychology students volunteered for the pain experiment; they were divided into Low Medium High hypnotizable Subjects. The Experimenter was blind to hypnotizability scores and there was random assignment to treatment groups. The Ss were tested three times with cold pressor test, with left hand in ice water, and assessed after each immersion. Order of conditions was: Pretest, 5' Rest, Baseline, Experimental Treatment, Post-test using Hilgard's procedures. The Direct suggested analgesia condition used a modified Stanford Scale of Hypnotic Susceptibility Form C induction, with suggested analgesia. The Indirect suggested analgesia condition was Barber's Rapid Induction Analgesia script. For the third condition, Ss listened to a history of the Fast Food Industry and were instructed to 'do whatever you can do to decrease the pain.' The authors hypothesized that direct suggestion analgesia would be more effective for Highs, and indirect suggestion analgesia would be unaffected by level of hypnotizability. RESULTS ANOVA for repeated measures produced sequential main effects for both pain and distress. 2. By 3 treatment levels: Indirect reduced pain more, though not significantly. (The pretest looks different, with the direct higher, not significantly so however). 3. For High Ss receiving direct suggestion there are similar decreases from baseline to posttest. For Lows receiving indirect suggestion, there were decreased pain ratings, but for those Lows receiving direct suggestion there is no decrease. But these are just trends and not significant. SUMMARY Ratings of pain and distress, irrespective of hypnosis level, decrease from initial to second trial in absence of any intervention. The trends provide limited support for Barber's claims. Nathanson, Donald L. (1988). Affect, affective resonance and a new theory for hypnosis. Psychopathology, 21, 126-137. Suggests new theory of hypnosis based on recent experimental and theoretical work on emotion that shows neurological systems (including structural effectors and chemical mediators affecting specific sites of action). Tomkins' nine innate affects are organizers of the other moieties, genetically determined prewritten subcortical programs that convert quantitative stimuli into qualitative experience. Emotion in the adult involves subtle and complex combinations of innate affect with associations to previous experiences of affect provided by neocortical mechanisms. The infant initially expresses affect in an all-or-none fashion, while the caregiver, usually mother, acts as an external modulator of infantile affect display. All the techniques by which the mother learns to achieve affect mutualization and interaffectivity are analogues of what later may be seen as the techniques of hypnotic induction. Hypnosis may be viewed as the intentional alteration of neocortical cognition made possible by the state of primitive interaffectivity achieved when the hypnotic operator enters the central assembly system of the adult by techniques reminiscent of maternal modulation of infantile affect display. Omer, H.; Darnel, A.; Silberman, N.; Shuval, D.; Palti, T. (1988). The use of hypnotic-relaxation cassettes in a gynecologic-obstetric ward. In Lankton, S. R.; Zeig, J. K. (Ed.), Research, comparisons and medical applications of Ericksonian techniques (pp. 28-36). New York: Brunner-Mazel. NOTES They did three studies in which they gave women having gynecologic procedures tapes with a Rapid Induction Analgesia hypnosis experience. STUDY 1. Women heard tapes before a painful Fallopian tube procedure (salpingography). The patients reported less pain, tension, anxiety, and fear than control patients. (N.B. Physicians' ratings did not show that difference.) STUDY 2. Women practiced with the tapes at home before labor and delivery. One day after delivery, there was no difference in pain report or experience report between treated and control patients. STUDY 3. Women used the tapes during labor. They reported worse pain and labor experiences than the control patients. The authors conclude that their research does not support the hypothesis that Rapid Induction Analgesia is useful for acute pain. 1987 Patterson, David R.; Questad, Kent A.; Boltwood, Michael D. (1987). Hypnotherapy as a treatment for pain in patients with burns: Research and clinical considerations. Journal of Burn Care and Rehabilitation, 8 (3), 263-268. Hypnotherapy has increasingly been included in the management of burn patients, particularly in the area of acute pain. To better understand such issues as (1) overall efficacy of hypnotherapy to alleviate acute burn pain, (2) instances in which hypnotherapy is contraindicated, (3) interaction of hypnotherapy with medication, (4) standard induction techniques to use with various age groups, (5) role of nursing and other staff in facilitating hypnotic effects, and (6) future methodological directions, they examined the clinical and methodological merits of recent studies of hypnoanalgesia. A literature search found 17 studies in which hypnotherapy was applied to the management of burns. The literature generally supports the efficacy of this approach to reduce burn pain; however, little else can be concluded from these studies. Several recent studies have applied hypnotherapy to aspects of burn care other than pain using excellent experimental designs. It is suggested that future studies of acute pain management follow suit. 1986 Mitchell, George P.; Lundy, Richard M. (1986). The effects of relaxation and imagery inductions on responses to suggestions. International Journal of Clinical and Experimental Hypnosis, 34, 98-109. Theoretical attempts to understand the meaning and importance of induction procedures in producing hypnotic phenomena suggest that 2 critical components, relaxation and imagery, should be isolated and their relative effect on hypnotic responding studied. Objectively and subjectively scored responses to 12 hypnotic suggestions, which had followed relaxation, imaginal, or combined inductions, were obtained from 59 Ss, divided into 3 levels of hypnotizability. Regardless of hypnotizability level, the combined induction led to a greater subjective report of hypnotic response than did either the relaxation or the imagery inductions; and the relaxation led to a greater subjective report than the imagery induction. It may follow that the subjective experience of hypnosis is facilitated by inductions which include relaxation. The inductions were equally effective in producing objectively measured behavioral responses. There were no significant interactions found between induction type and hypnotizability level. NOTES 1: NOTES (From the Discussion Section) As suggested by Sacerdote (1970), the combination procedure was the most generally effective in producing hypnotic responses. The difference between combined and imagery inductions reached statistical significance on four dependent variables, and the difference between combined and relaxation reached significance on three. It may also be of interest that Ss receiving the combined procedure scored consistently higher on all nine dependent variables. A somewhat unexpected finding was that the relaxation induction produced scores on four of the dependent variables that were statistically higher than the imagery induction scores. Considering the difficulty of isolating relaxation and imagery components, it is quite noteworthy that these differences between inductions were found. The four variables in which the combination and relaxation conditions produced significantly higher scores than the imagery condition were subjective reports--subjective score, degree hypnotized, response volition, and Field Inventory. In contrast to Ss in the imagery induction, Ss in the other two induction conditions believed that they were responding more, felt that their responses were more nonvolitional, and felt that they were more deeply hypnotized. The fact that relaxation instructions were present in both conditions that were superior to the imagery condition would appear to support Edmonston's (1981) position which posits relaxation as essential for the production of the state of neutral hypnosis. For Edmonston the condition of neutral hypnosis is defined as the relaxed state and precedes other phenomena, such as dissociation and increased suggestibility, which other theoreticians may include in the definition of hypnosis. However, the statistically significant superior effect of the combined over the relaxation induction on three measures casts doubt on Edmonston's position. The S believes that he or she is more deeply hypnotized and is responding less volitionally when an imagery component is combined with relaxation. The Ss also responded more to the Field Inventory when the combined induction was used. Another explanation for imagery's relatively poor showing may lie in Ss' differential expectations. The Ss, especially those with previous experience with a traditional hypnotic induction, as was the case in the present study, may not expect to be hypnotized when presented with an imagery alone induction. Such expectations, of course, might reduce responses. On the other hand, there is no reason to believe that the reduced expectation in the imagery condition would not affect the behavioral responses as well, and such was not the case. Thus, we may be left with the explanation that relaxation adds to the subjective experience of hypnosis. This is in keeping with Edmonston's (1981) position as well as with previous research, such as that by Hilgard and Tart (1966), which finds traditional inductions, with their relaxation components, superior to nontraditional inductions, such as fantasy or task-motivational. If future research should find that bodily involvements such as the physical exertion or repetitive motor behavior (Banyai and Hilgard, 1976) lead to the same level of subjective experience as relaxation did, then we may need to broaden the concept of the somatic component beyond relaxation alone. In terms of the behavioral compliance of Ss, the results of the present study are in accord with some previous studies in finding all procedures equally effective. Neither imagery, relaxation, nor the combined procedure was superior for the behavioral measure. Personality factors (social desirability, internality/externality, and absorption) did not affect the basic findings. To the degree that the Tellegen scales measure the ability to engage in imagery there seems to be little basis for believing that imagery ability is related to the general findings. Sarbin (1983) would call the inductions studied here 'entrance rituals,' and he has recently asked in his review of Edmonston's book, "Which ritual is more suitable... [p. 58]' for preparing S to respond in various hypnotic ways? One answer from the present results is that an entrance ritual should include muscular relaxation if one wants a better subjective response from S. From Sarbin's point of view, the relaxation component may be more ego-involving, producing more subjective experience and meaning for S. If one wants to produce only a behavioral response, either a relaxation or imagery ritual will serve. 1985 Matthews, William J.; Kirsch, Irving; Mosher, Donald (1985). Double hypnotic induction: An initial empirical test. Journal of Abnormal Psychology, 94 (1), 92-95. NOTES In separate experimental sessions, 34 undergraduate students experienced audiotapes of a standard hypnotic induction and a double induction similar to that described by Bandler and Grinder (1975). In the double induction, subjects heard a hand- levitation induction through the ear that is contralateral to the dominant cerebral hemisphere and, simultaneously, heard grammatically childlike messages through the other ear. Half of the subjects experienced the double induction first. There were no significant within-subject differences between the two inductions. However, subjects who experienced the double induction prior to the standard induction were significantly less responsive to suggestions following both inductions, which suggests that the double induction as a first experience of hypnosis may have a negative impact on subsequent experiences of hypnosis. 1984 Kirsch, Irving; Council, James R.; Vickery, Anne R. (1984). The role of expectancy in eliciting hypnotic responses as a function of type of induction. Journal of Consulting and Clinical Psychology, 52 (4), 708-709. NOTES Combined data from a study by J. R. Council et al (see PA, vol 7:4975) and from a study by the present 3rd author (1983) on cognitive skill hypnotic induction to test the hypothesis that the relationship between expectancy and suggestibility varies as a function of type of induction. Analysis of data on 100 Ss shows significant Expectancy x Type of Induction interactions on the Stanford Hypnotic Susceptibility Scale, the Creative Imagination Scale, and an inventory of hypnotic depth. Within-cells correlations revealed a significant relationship between expectancy and responses to skill induction. Correlations between expectancy and responses to a traditional trance induction were nonsignificant Malott, James M. (1984). Active-alert hypnosis: Replication and extension of previous research. Journal of Abnormal Psychology, 93 (2), 246-249. NOTES Compared levels of hypnotic responsiveness resulting from 4 induction procedures: (a) verbal active-alert induction alone, (b) bicycle pedaling alone, (c) verbal active-alert induction plus bicycle pedaling and (d) traditional relaxation induction. Ss were 48 undergraduates. Stanford Hypnotic Susceptibility Scale scores indicated that the verbal induction plus pedaling procedure was significantly more effective than either the verbal- or pedaling-alone procedures. There were no significant differences in scores produced by the verbal plus pedaling and traditional relaxation inductions. Findings are consistent with A. M. Ludwig''s (1966) proposal that there exists a range of stimulation necessary for the maintenance of normal waking consciousness and that levels of stimulation above or below that range are conducive to the production of altered states of consciousness. This study adds experimental controls to the research design used by Banyai for active alert induction. 1983 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. NOTES 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. Council, James R.; Kirsch, Irving; Vickery, Anne R.; Carlson, Dawn (1983). 'Trance' versus 'skill' hypnotic inductions: The effects of credibility, expectancy, and experimenter modeling. Journal of Consulting and Clinical Psychology, 31 (3), 432-440. A hypnotic induction procedure based on social learning principles (skill induction) was compared with a traditional eye-fixation/relaxation trance induction, a highly credible placebo induction, and a no-induction base-rate control. The trance induction surpassed the skill induction only on the Field Inventory, a measure of hypnotic depth that contains items corresponding to suggestions contained in the trance induction. Experimenter modeling was not found to enhance the effectiveness of the skill induction. Skill and trance inductions elicited slightly higher behavioral scores on the Stanford Hypnotic Susceptibility Scale: Form C than did the placebo induction. However, this difference was not obtained on other measures of hypnotic responsibility and depth. Significant correlations were found between expectancy, absorption, and responsiveness on all dependent measures. Multiple regression analyses indicated that the relationship between absorption and responsivity was mediated by expectancy. The results are interpreted as supporting the hypotheses that hypnotic responses are elicited by the expectancy for their occurrence and that induction procedures are a means of increasing subjects' expectancies for hypnotic responses. NOTES Trance induction resulted in a higher score on subjective experiences (cognitive & perceptual distortions) but not higher suggestibility scores than cognitive- behavioral skill induction. 2) Trance and cognitive-behavioral inductions got slightly higher scores in suggestibility than placebo biofeedback induction. 3) All inductions did better than a "no induction" control group on subjective and behavioral indices of hypnosis. One of the goals of this research was to examine the contribution of experimenter modeling to the behavioral skill induction that "trains the subject in hypnosis skills and requires the subject's conscious cooperation in learning cognitive strategies that will enhance hypnotic responsivity" (p. 432). Another goal was to assess the contribution of "a subject's expectancies for the occurrence of behaviors perceived as being involuntary" (p. 433). A third goal was to determine whether congruence between a subject's beliefs about hypnosis and the rationale for a particular induction would increase expectancy. Two different skill inductions were employed (one with, one without a model). Subjects were asked to predict their performance, based on a description of the induction that they would receive. The contributions of credibility and expectancy were assessed using a highly credible placebo (pseudo biofeedback of EEG theta rhythm). The investigation used only subjects who had never experienced hypnosis. Independent variables included Rotter's (1966) Internal-External Locus of Control Scale, Rotter's (1967) Interpersonal Trust Scale, and Tellegen's Absorption Scale (Tellegen & Atkinson, 1974). Mediating variables included a measure of induction credibility based on Borkovec and Nau (1972), and a 20-item inventory measuring expectancies for hypnotic performance. Dependent variables included 20 standard hypnotic suggestions taken from the Stanford Hypnotic Susceptibility Scale, Form C; the Creative Imagination Scale; ratings of the 'realness' or experienced intensity of each suggestion; and the Field Inventory of Hypnotic Depth (Field, 1965). The authors conclusion reads as follows: "The results of this study may be summarized as follows: (a) Traditional trance hypnotic inductions and cognitive- behavioral skill inductions were shown to be equally effective in eliciting experiential and behavioral responses to hypnotic suggestions, although trance subjects reported a somewhat greater alteration in conscious experience. (b) Experimenter modeling was not found to be an effective component of the skill induction package. (c) Subjects' expectancies for hypnotic responses, reported prior to hypnotic induction, bore a very strong relationship to hypnotic responsivity. (d) A highly credible placebo induction resulted in levels of expectancy and hypnotic responsivity generally comparable to those produced by trance and skill hypnotic inductions. (e) Absorption was significantly correlated with expectancy, but was not found to be significantly related to responsiveness once variance due to expectancy was taken into account. Thus the relationship between absorption and hypnotic responsiveness appears to be mediated by expectancies. "In sum, these results suggest that various hypnotic inductions elicit expectancies for responding to hypnotic suggestions and that these expectancies are sufficient to elicit hypnotic responses. Further studies are needed to determine the nature of the relationship between absorption and hypnotic response expectancies" (p. 439). 1980 Diamond, Michael Jay (1980). The client-as-hypnotist: Furthering hypnotherapeutic change. International Journal of Clinical and Experimental Hypnosis, 28, 197-207. A novel hypnotic induction technique is described wherein the client reverses roles and serves as hypnotist for the therapist. Relevant theoretical processes are discussed as are mutual hypnosis, modeling, and the uncommon techniques of Erickson (1964). 3 case illustrations are presented and implications discussed. It is hypothesized that the 'client-as-hypnotist' may in certain special situations further hypnotherapy by: (a) increasing client motivation; (b) enhancing therapeutic rapport; (c) increasing both client trust and skills in utilizing unconscious processes; (d) overcoming resistance and increasing hypnotizability; (e) providing a useful psychodiagnostic and behavior assessment index; (f) presenting a role 'model' for dealing with feelings, alterations in consciousness, and self-control; (g) providing a client-centered framework for subsequent therapeutic interventions; (h) increasing client self-esteem, mastery, and ego strength; and (i) increasing client self-control skills. Potential risks and contraindications for use of the technique are also discussed. 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. NOTES 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. Hart, R. (1980). The influence of a taped hypnotic induction treatment procedure on the recovery of surgery patients. International Journal of Clinical and Experimental Hypnosis, 28, 324-331. A study of 40 open heart surgery patients assigned to 1 of 2 equal size treatment groups sought to evaluate the efficacy and utility of a tape-recorded hypnotic induction procedure that preoperatively prepared patients for surgery. The dependent variables included daily blood pressure measurements and postsurgical outcome data pertaining to postoperative units of blood required, state/trait anxiety, and locus of control dimensions. Results of the study tended to provide some support for the tape-recorded hypnotic induction procedure in lessening state anxiety and in promoting a more self- directed attitude toward surgical recovery. 1977 Barber, Joseph (1977). Rapid induction analgesia: A clinical report. American Journal of Clinical Hypnosis, 19, 138-149. This is a report of clinical dental experience using a newly developed, hypnotic pain control procedure. Characteristics of the procedure are outlined, an explanation for its success is suggested, and the broader implications of this success are discussed. The unusually high incidence of clinical analgesia rapidly obtained with this procedure leads the author to question the meaning and relevance of the concept of 'hypnotic susceptibility' for the practical clinical application of hypnosis. Buckner, Linda G.; Coe, William C. (1977). Imaginative skill, wording of suggestions and 3 groups of 20 s based on preselected imaginative capacity were administered either a hypnotic susceptibility scale containing item wording that suggested a goal-directed fantasy or one that did not. Preselected imaginative ability did not predict hypnotic susceptibility or the production of goal-directed fantasies during hypnosis. However, Ss who received the hypnotic scale containing item wording that suggested goal-directed fantasies reported more goal-directed fantasies than Ss who received the other scale. Limitations of the study are discussed and the causal role of goal-directed fantasy in hypnotic responsiveness is questioned. 1976 Erickson, Milton H.; Rossi, Ernest L. (1976). Two level communication and microdynamics of trance and suggestion. American Journal of Clinical Hypnosis, 18, 153-171. The authors provide the transcript and commentaries of an hypnotic induction and an effort to achieve automatic writing. An unusual blend of Erickson's approaches to two level communication, dissociation, voice dynamics and indirect suggestion are made explicit in the commentaries. The junior author offers a 'context theory of two level communication' that conceptualizes Erickson's clinical approaches in terms consonant with Jenkins' (1974) recent contextual approach to verbal associations and memory. A summary of the microdynamics of Erickson's approach to trance induction and suggestion is outlined togetehr with a utilization theory of hypnotic suggestion. Jenkins, J. J. (1974). Remember that old theory of memory? Well, forget it! American Psychologist, 29, 785-795. Jackson, T. L.; Barkley, R. A.; Pashko, S. M. (1976). The effects of hypnotic induction versus high motivation on oral temperature. International Journal of Clinical and Experimental Hypnosis, 24, 22-28.