Locus of control


Spinhoven, Philip; Baak, Diana; Van Dyck, Richard; Vermeulen, Peter (1988). The effectiveness of an authoritative versus permissive style of hypnotic communication. International Journal of Clinical and Experimental Hypnosis, 36, 182-191.

The differential effectiveness of an authoritative versus permissive style of hypnotic communication was investigated, with locus of control as a moderator variable. 44 Ss received in counterbalanced order both the more authoritatively worded Harvard Group Scale of Hypnotic Susceptibility, Form A and the Wexler-Alman Indirect Hypnotic Susceptibility Scale (WAIHS), which is a more permissive scale with the same item content as HGSHS:A. Permissively worded suggestions did not enhance the level of hypnotic responsiveness. Locus of control did not predict the response level on one of the scales. Unexpectedly, significantly more female Ss preferred the WAIHS, and more male Ss preferred HGSHS:A. It is concluded that Ss’ characteristics (i.e., hypnotizability) are more important for hypnotic responsiveness than variations in style of hypnotic communication or scale preference.

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.

(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.

Saavedra, Ramon Luis; Miller, R.J. (1983). The influence of experimentally induced expectations on responses to the Harvard Group Scale of Hypnotic Susceptibility, Form A. International Journal of Clinical and Experimental Hypnosis, 31, 37-46.

A sample of 75 female and 63 male undergraduates were told that their hypnotizability was predictable through the application of a battery of questionnaires and physiological measures. Three levels of hypnotizability expectations were created, with 3 groups of Ss informed that they were highly hypnotizable, moderately hypnotizable, or low in hypnotizability, respectively. A control group received no such expectations. All Ss were then administered the Harvard. Results indicated a significant main effect due to the assigned hypnotizability expectations. Only Ss in the low expectation group, however, scored significant differently from the other groups on the Harvard. Four other variables were examined as covariates: locus of control, attitude toward hypnosis, absorption, and self-predictions of hypnotizability. All but locus of control correlated significantly with the Harvard. It also was shown that the degree to which assigned expectations influenced Harvard scores was a function of the confidence Ss had in those expectations.

The authors state that research has shown that it is easier to lower hypnotizability scores by providing negative expectancies than to increase hypnotizability scores through provision of positive expectancies. In this study, very little of the variance of hypnotizability scores was accounted for by the expectancy manipulation.

Pickett, Carolyn; Clum, George A. (1982). Comparative treatment strategies and their interaction with locus of control in the reduction of postsurgical pain and anxiety. Journal of Consulting and Clinical Psychology, 50, 439-441.

Relaxation training, relaxation instructions, and an attention-redirection approach were compared with no treatment in terms of their ability to affect postsurgical anxiety and pain in patients undergoing gallbladder surgery. In addition, two hypotheses involving an interaction between treatment and locus of control were investigated. The results indicate that the attention-redirection approach reduced postsurgical anxiety relative to the other interventions. The effectiveness of attention redirection for reducing postoperative pain is more equivocal, whereas neither of the relaxation procedures reduced either anxiety or pain. Support was also found for one of the interaction hypotheses. The results support the effectiveness of brief interventions for reducing state anxiety associated with surgery but indicate that more intensive techniques may be necessary to affect postsurgical pain.

Hurley, John D. (1980). Differential effects of hypnosis, biofeedback training, and trophotropic responses on anxiety, ego strength, and locus of control. Journal of Clinical Psychology, 36 (2), 503-507.

Pretested 60 college students on three scales: the IPAT Anxiety Scale, the Barron Ego-strength scale, and the Rotter I-E scale. The Ss then were assigned randomly to one of four treatment groups designated: hypnotic treatment, biofeedback treatment, trophotropic treatment, and control. Three of these groups met separately for 60 minutes once a week for 8 weeks. The control group did not meet during this time. During the sessions, each group was trained in a different technique for self-regulation. At the end of the 8-week period the scales were readministered to all groups. A series of covariance analyses indicated that hypnosis was a more effective self-regulatory technique for lowering anxiety levels when compared to biofeedback or trophotropic response procedures. With regard to increasing ego strength, both the hypnotic training group and the biofeedback training group proved to be significant. No significant difference was found between the experimental and control groups on the I-E scores.

Pereira, M. J.; Austrin, H. R. (1980). Locus of control and status of the experimenter as predictors of suggestibility. International Journal of Clinical and Experimental Hypnosis, 28 (4), 367-374.

The present study investigated locus of control and manipulated status of the experimenter as predictors of suggestibility. Rotter’s (1966) Internal-External Locus of Control Scale was used as the paper-pencil measure of locus of control, and the Barber (1965) Suggestibility Scale was used as the measure of suggestibility. We predicted two main effects on suggestibility; one for high externality, and one for high status. In addition, we predicted an interaction between locus of control and status of experimenter. A main effect for locus of control was not found, but one for status was significant, with externals significantly more suggestible than internals in the high status experimenter condition and significantly less suggestible in the low status condition. This interaction effect was viewed as the most significant finding, and implications for prediction were discussed.

Di Nardo, Peter A.; Raymond, Jayne B. (1979). Locus of control and attention during meditation. Journal of Consulting and Clinical Psychology, 47 (6), 1136-1137.

Undergraduates were assigned to an internal or external group on the basis of their locus of control scores. A meditation task required subjects to focus their attention on an actual stimulus or an imagined stimulus while recording intruding thoughts by pressing a button on a counter. Results showed that an internal locus of control was related to fewer intrusions than was an external locus and that the actual stimulus resulted in fewer intrusions than did the imagined stimulus. These results suggest that performance in meditation, and possibly in other self-control procedures, may be influenced by individual differences in deployment of attention.

Zuroff, David C.; Schwarz, J. Conrad (1978). Effects of transcendental meditation and muscle relaxation on trait anxiety, maladjustment, locus of control, and drug use. Journal of Consulting and Clinical Psychology, 46 (2), 264-271.

Sixty undergraduate volunteers were randomly assigned to receive training in transcendental meditation (Transcendental meditation), training in a muscle relaxation technique, or no treatment. The training in muscle relaxation was designed to be maximally similar in structure and atmosphere to training in Transcendental meditation. Measures of trait anxiety, locus of control, maladjustment, and drug use were collected before and after the 9-week treatment period. On a behavioral measure of trait anxiety, the scores of all three groups decreased equally, but on a self-report measure the Transcendental meditation subjects reported steady decreases in anxiety, whereas the scores of the other two groups remained unchanged. There were no differences in maladjustment, locus of control, or drug use as a function of treatment. Although Transcendental meditation subjects held higher expectancies for benefits, and were slightly more regular in practicing their technique, individual differences in expectancy and frequency of practice were not correlated with degree of reported anxiety reduction. It is concluded that Transcendental meditation may reduce trait anxiety, but it has not been shown to be of value in inducing general personality change.

Miller, Lawrence J. (1976). A comparison of hypnotic susceptibility for internal and external locus of control subjects in hetero- and self-hypnotic treatments (Dissertation). Dissertation Abstracts International, 37, 978-979.

This study investigated the use of self- and hetero-hypnosis with internal and external locus of control subjects. Fifty-eight subjects, matched on hypnotic susceptibility and internal-external locus of control, were randomly assigned to the self- or hetero-hypnotic treatments. Self reports of their hypnotic behavioral scores and hypnotic subjective responses were obtained for each subject. “The statistical analyses showed there were no significant differences between the internal and external locus of control groups or within groups in regard to self- and hetero-hypnosis total behavioral scores, “challenge” or “non-challenge” items, …. their reported subjective experiences. The results supported the similarity of hetero- and self- hypnosis. Various findings from past research in regard to I-E subjects were also challenged in terms of their generalizability to hypnotic settings” (pp. 978-979).

Bean, Bruce W.; Duff, James L. (1975). The effects of video tape, and of situational and generalized locus of control, upon hypnotic susceptibility. American Journal of Clinical Hypnosis, 18 (1), 28-33.

This study examined the effects of mode of induction (video tape vs. live), general locus of control, and situational locus of control upon hypnotic susceptibility. A total of 62 student volunteers was hypnotized in eight small groups using the Harvard Group Scale of Hypnotic Susceptibility. Results confirmed that video taped inductions were as effective as live inductions. None of the other variables, singly or in interaction, significantly affected susceptibility scores. An analysis of variance was also performed upon subjects’ subjective ratings of having experienced hypnosis. Results revealed that subjects with an external general locus of control (Rotter’s I-E scale) rated themselves as having experienced hypnosis more fully. This was interpreted as a greater response to the demand characteristics of the hypnosis situation by externally controlled subjects. Discussion explores the potential flexibility provided by video tape hypnosis.



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

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

Attias, J.; Shemesh, Z.; Sohmer, H.; Gold, S.; Shoham, C.; Faraggi, D. (1993). Comparison between self-hypnosis, masking and attentiveness for alleviation of chronic tinnitus. Audiology, 32, 205-212.

A total of 45 male patients close in age with chronic tinnitus related to acoustic trauma were assigned to three matched subgroups: self-hypnosis (SH), masking (MA), and attentiveness to the patients’ complaints (AT). The therapeutic stimuli in the SH and MA sessions, recorded on audio cassettes, were given to the patients for use when needed. SH significantly reduced the severity of tinnitus, AT partially relieved the tinnitus, and MA had no significant effect.

Bejenke, Christel J. (1993, October). A clinician’s perspective. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.

Presents point of view of a private practice anesthesiologist in Santa Barbara, California. Used hypnosis for 20 years.
Use of hypnosis as hypnoanesthesia is rare since Esdaile, with brief resurgence in 50’s, because surgery techniques advanced before anesthesias did in areas that were very risky. Now it is a matter of choice, and may be undertaken because of a patient’s extreme fear of anesthesia, previous bad experience with anesthesia, fervent belief in holistic method, allergy, or previous experience with hypnosis. Still advised to use hypnosis for MRIs, radiation procedures, former drug addicts (who may have problems with drugs), burn patients, release of neck contractions, and medical procedures–especially with children–like lumbar puncture.
She disagrees with Kroger’s estimate of only 10% of patients being able to use hypnoanesthesia; she does not believe it requires a lot of training, or profound muscle relaxation.
There is no indication of how many cases are actually done with hypnosis. Also, published cases are not representative of the quantity or complexity of cases; most published cases have a few extraordinary characteristics. The Irish surgeon Jack Gibson has done more than 4000 cases, some very complicated.
I have used it for D & Cs, and complex cases that were not published. Most of my patients elected to be alert during the hypnosis and conversed with their surgeons. The most common benefit is that recovery from anesthesia is not necessary; but these days with newer anesthesias recovery from anesthesia is rapid anyway. However, if as we suspect anesthesia affects immune function, that would be another reason to use hypnosis.

I have used it for D & Cs, and complex cases that were not published. Most of my patients elected to be alert during the hypnosis and conversed with their surgeons. The most common benefit is that recovery from anesthesia is not necessary; but these days with newer anesthesias recovery from anesthesia is rapid anyway. However, if as we suspect anesthesia affects immune function, that would be another reason to use hypnosis.
Preparation for surgery may be of three types: 1. formal hypnosis techniques 2. “hypnoidal” techniques that aren’t formal 3. unprepared patients in whom hypnosis is used at last moment.
Examples. 1. Formal hypnosis: This symposium deals with this type of approach. Three groups derive particular benefit — those requiring prolonged artificial ventilation postoperatively (because otherwise sedation must be used, which leads to complications), where prepared patients tolerate interventions calmly and comfortably — cancer patients, for whom this can be first experience of patient to see self as active participant in care rather than a victim of the illness and of complicated technology — pediatric patients. 2. Hypnoidal (hypnosis like) techniques: This is the most important application. Time doesn’t permit much discussion here. Patients are in an altered state when they come for surgery, highly suggestible, and suggestions appear to be as effective as during formal trance state. The doctor can elicit positive responses during “casual conversation” while seemingly giving information to the patient. (The reverse is true also, with inadvertent negative suggestions, to the detriment of the patient.) Scrupulous adherence to medical facts is important during this type of conversation.
Operating room fixtures are useful for focus of attention, and I have published this information in an article.
Recovery room also is place where case specific information and appropriate suggestions can be given. Patient can experience his ability to alter sensations, for the first time, following suggestions.
Remainder of the hospitalization offers opportunity for reinforcing case specific positive suggestions.

Blankfield, Robert; Scheurman, Kathleen; Bittel, Sue; Alemagno, Sonia; Flocke, Sue; Zyzanski, Stephen (1992, October). Taped therapeutic suggestions and taped music as adjuncts in the care of coronary artery bypass graft patients. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.

18 studies have explored the issue with an experimental design; half used tapes, half didn’t; majority of studies found benefits; 2 were of heart surgery patients.
This study used taped suggestions with coronary bypass patients. Used tape recorder rather than person delivering suggestions because it was more convenient; used tape intra-surgery and post-operatively for more impact.
We hypothesized: shorter length of stay, less narcotic analgesia, less anxiety, faster recovery, more positive mental outlook, resume activities sooner, have less symptoms postoperatively, etc.
Used a prospective, randomized, single-blind trial in 2 community hospitals in Cleveland with coronary artery bypass graft surgery patients. Study was done between Dec 1989 – Feb 1992.
3 groups were involved: (1) Suggestion, (2) music, and (3) tape. Control subjects had a blank tape. Tapes were played continuously and repeatedly with headphones. Postoperatively, a different tape was played.
Excluded: Patients with emergent surgery, hearing impairment, poor comprehension of English, patients who died in hospital, patients whose hospital stay lasted longer than 14 days (3 of them). 5% of sample were eliminated for last 2 reasons.
Music: Herb Ernst, Dreamflight II. Suggestions: Music background, permissive, based on Evans & Richardson’s study.
Outcome Measures: Nurse assessment of anxiety and progress post operatively, Symptom scale, Depression scale.
Mean age 62, 3/4 men, 92% white, 75% married. The groups were same on a variety of preoperative variables (status of heart and arteries). Length of stay was 6.5 in all 3 groups. No difference in narcotics use, in nurse assessment of anxiety or of progress; of depression scale, or activities of daily living.
Recategorized data into patients who said the tapes were helpful (both music and suggestion) N = 33 vs the other patients N = 62. No difference in the variables evaluated.

Excluded: Patients with emergent surgery, hearing impairment, poor comprehension of English, patients who died in hospital, patients whose hospital stay lasted longer than 14 days (3 of them). 5% of sample were eliminated for last 2 reasons.
Music: Herb Ernst, Dreamflight II. Suggestions: Music background, permissive, based on Evans & Richardson’s study.
Outcome Measures: Nurse assessment of anxiety and progress post operatively, Symptom scale, Depression scale.
Mean age 62, 3/4 men, 92% white, 75% married. The groups were same on a variety of preoperative variables (status of heart and arteries). Length of stay was 6.5 in all 3 groups. No difference in narcotics use, in nurse assessment of anxiety or of progress; of depression scale, or activities of daily living.
Recategorized data into patients who said the tapes were helpful (both music and suggestion) N = 33 vs the other patients N = 62. No difference in the variables evaluated.

Bierman, Steven F. (1989). Hypnosis in the emergency department. American Journal of Emergency Medicine, 7, 238-242.

Five cases are presented wherein hypnosis was used by the emergency physician either as the primary mode of treatment or as an adjuvant to standard medical care. Common hypnotic phenomena (e.g. anesthesia, analgesia), as well as novel effects, are reported. The technique used for trance induction and utilization is briefly outlined, and criteria are set forth for the bedside recognition of hypnotic trance.

Brown, Erick L.; Kinsman, Robert A. (1984). Resolving intractable medical problems through psychological intervention: A clinical report. Psychotherapy, 21, 452-455.

Treatment of chronic physical illness is often complicated by psychological factors that maintain and exacerbate the illness. Hypnotic techniques, coupled with insight-oriented psychotherapy comprised an effective strategy for favorably influencing medical outcome. A clinical report illustrates how psychological intervention initiated the resolution of severe medical problems in an asthmatic patient.

Albornoz-Ruiz, Jose M. (1977). Suggestibility as a factor in medical treatment. Maryland State Medical Journal, 26, 66-68.

This paper presents the view that a physician must be aware of the great influence, direct and indirect, s/he has with the patient as a result of their relationship. “Here it should be remembered that the power of a suggestion, without the benefit of formalized hypnosis, is directly related to the intensity and nature of the emotional bond between the patient and the doctor, often colored by a marked transferential unconscious component, where the doctor stands ‘in loco parentis’ vis-a-vis the patient, regardless of the age, education or intellectual sophistication of the latter. Whatever the nature of the perception that is eventually presented by the patient as a symptom or identified by the doctor as a sign of illness, such perception will be elaborated upon by the patient’s fancy, in lonely reveries where he defines for himself causes, nature and possible course of his disorder, not always in keeping with those established by the doctor as he exposes the same set of phenomena to his learned medical judgment” (p. 68).

by the patient’s fancy, in lonely reveries where he defines for himself causes, nature and possible course of his disorder, not always in keeping with those established by the doctor as he exposes the same set of phenomena to his learned medical judgment” (p. 68).

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.

Carli, G. (1975). Some evidence of analgesia during animal hypnosis [Abstract]. Experimental Brain Research, 23, 35.

The purpose of this study was to investigate the response to painful stimuli during animal hypnosis. The experiments were performed on unanesthetized, free-moving rabbits carrying implanted electrodes for recording the EEG and EMG activity and nerve stimulation. Injection of formaline into the dorsal region of the foot produced long lasting EEG desynchronization and motor pain reactions. In some rabbits a procedure of habituation was used to reduce hypnosis duration below 45 sec. Hypnosis was induced by inversion. The following results were obtained: 1) Polysynaptic reflexes eliced [sic] by electrical stimulation of cutaneous and muscle afferents were depressed during hypnosis. 2) Hypnosis transitorily suppressed all the painful manifestations due to formaline injection and was characterized by hygh [sic] voltage slow wave activity in the EEG, 3) In habituated rabbits, a significant increase in hypnotic duration and EEG synchronization was observed when hypnosis was preceded by formaline injection. Hypnosis duration was not potentiated by painful stimuli when Naloxone (5mg/Kg i.v.) was injected before hypnosis induction. 4) In habituated rabbits a recovery in hypnotic duration coupled to EEG synchronization was obtained, in absence of painful stimuli, following subanalgesic injection of Morphine (1mg/Kg). It has been previously shown that in the rabbit administration of 5-20 mg/Kg of Morphine produces EEG synchronization and strong reduction of pain reactions. It is suggested that, during animal hypnosis in a condition of continuous nociceptive stimulation, the pain response is blocked by a mechanism which exibit [sic] similar effects of Morphine both at spinal cord (polysynaptic reflexes) and at cortical levels (EEG synchronization).

Bowers, Kenneth S.; Kelly, P. (1970). Stress, disease, psychotherapy, and hypnosis. Journal of Abnormal Psychology, 490-505.

Presents evidence for the importance of suggestion and hypnotic ability in the healing or amelioration of various somatic disorders. It is argued that even in some treatment interventions that are not explicitly hypnotic, suggestion and hypnotic ability may be hidden factors that help to promote successful healing. Consequently, hypnotic ability may be an individual difference variable that influences treatment outcome in a manner not heretofore recognized by many investigators and clinicians involved in helping the psychologically and physically ill.

promote successful healing. Consequently, hypnotic ability may be an individual difference variable that influences treatment outcome in a manner not heretofore recognized by many investigators and clinicians involved in helping the psychologically and physically ill.

Bartlett, K. A. (1968). A rationale of the nature of hypnosis. American Journal of Clinical Hypnosis, 11, 112-118.

A rationale of the nature of hypnosis without formal trance induction is presented. Central to this viewpoint is meeting the needs of the patient in accord with his perception of them and in a manner based on patient-oriented treatment. Case material illustrates practical applications.

British Tuberculosis Association (1968). Hypnosis for asthma: A controlled trial: A report to the research committee of the British Tuberculosis Association. British Medical Journal, 71-76.

Summary: An investigation of hypnosis in asthma was made among patients aged 10 to 60 years with paroxysmal attacks of wheezing or tight chest capable of relief by bronchodilators. One group of patients was given hypnosis monthly and used autohypnosis daily for one year. Comparisons were made with a control group prescribed a specially devised set of breathing exercises aimed at progressive relaxation. Treatment was randomly allocated and patients were treated by physicians in nine centres. Results were assessed by daily diary recordings of wheezing and the use of bronchodilators, and by monthly recordings of F.E.V. and vital capacity. At the end of the year independent clinical assessments were made by physicians unaware of the patients” treatment.
There were 252 patients (127 hypnosis and 125 controls) accepted for analysis, but a number of them did not continue the prescribed treatment for the whole year: 28 hypnosis and 22 control patients failed to cooperate, left the district, or had family problems; one hypnosis and one control patient died. Seven hypnosis and 17 control patients were withdrawn as treatment failures, the difference between the two groups being statistically significant.
As judged by analyses based on the daily ” score ” of wheezing recorded in patients” diaries, by the number of times bronchodilators were used, and by independent clinical assessors, both treatment groups showed some improvement. Among men the as-sessments of wheezing score and use of bronchodilators showed similar improvement in the two treatment groups; among women, however, those treated by hypnosis showed improvement similar to that observed in the men, but those given breathing exercises made much less progress, the difference between the two treatment groups reaching statistical significance. Changes in F E.V. and V.C. between the control and hypnosis groups were closely similar.

Independent clinical assessors considered the asthma to be ” much better ” in 59% of the hypnosis group and in 43% of the control group, the difference being significant. There was little difference between the sexes. Physicians with previous experience of hypnosis obtained significantly better results than did those without such experience.

Bernstein, Norman R. (1965). Observations on the use of hypnosis with burned children on a pediatric ward. International Journal of Clinical and Experimental Hypnosis, 13 (1), 1-10.

Several cases are described and observations made about the interplay of forces between staff, patient, and therapist, as well as the expectations of the patients to assess how these factors influenced the use of hypnosis. Hypnosis appears to be a particularly useful means for reaching isolated and depressed children with burns and for improving the morale of the staff team working with these children. The results may be along specific lines in terms of pain tolerance and improved eating, or in general improvement of cooperativeness and mood on the part of the child. (PsycINFO Database Record (c) 2002 APA, all rights reserved)

Attar, A.; Muftic, M. (1964). Narcohypnosis in abdominal surgery. British Journal of Medical Hypnotism, 16 (1), 29-32.

Effectiveness of a relaxation technique to increase the comfort level of patients in their first postoperative attempt at getting out of bed was tested on 42 patients, aged 18 to 65, who were hospitalized for elective surgery. Study group patients were taught the relaxing technique; control group patients were not taught the technique. Each group had an equal distribution of cholecystectomy, herniorrhaphy, and hemorrhoidectomy patients. Blood pressure, pulse, and respiratory rates of subjects in both groups were compared prior to surgery and after the postoperative attempt to get out of bed. Subjects’ reports of incisional pain and bodily distress were measured via a pain and distress scale after their attempt at getting out of bed. Amount of analgesics used in the first 24 hrs following surgery was examined. Mean differences in report of incisional pain and body distress, analgesic consumption, and respiratory rate changes were statistically significant, supporting the hypothesis that use of a relaxation technique to reduce muscular tension will lead to an increased comfort level of postoperative patients.

Cedercreutz, Claes (1961). Hypnosis in surgery. International Journal of Clinical and Experimental Hypnosis, 9, 93-95.

(Author”s Summary) “It is possible to treat painful conditions and spasms in the alimentary canal by hypnosis. In the rehabilitation of patients with limb injuries and fractures, hypnosis has also proved useful. There is seldom reason to resort to this method of inducing anaesthesia in surgery” (p. 95).


Holroyd, Jean (2003). The science of meditation and the state of hypnosis. American Journal of Clinical Hypnosis, 46 (2), 109-128.

Two aspects of Buddhist meditation — concentration and mindfulness — are discussed in relationship to hypnosis. Mindfulness training facilitates the investigation of subjective responses to hypnosis. Concentration practice leads to altered states similar to those in hypnosis, both phenomenologically and neurologically. The similarities and differences between hypnosis and meditation are used to shed light on perennial questions: (1) Does hypnosis involve an altered state of consciousness? (2) Does a hypnotic induction increase suggestibility? It is concluded that a model for hypnosis should include altered states as well as capacity for imaginative involvement and expectations.

1999 Wickramasekera, Ian (1999). How does biofeedback reduce clinical symptoms and do memories and beliefs have biological consequences? Toward a model of mind-body healing. Applied Psychophysiology and Biofeedback, 24 (2), 91-105.

Changes in the magnitude and direction of physiological measures (EMG, EEG, temperature, etc.) are not strongly related to the reduction of clinical symptoms in biofeedback therapy. Previously, nonspecified perceptual, cognitive, and emotional factors related to threat perception (Wickramasekera, 1979, 1988, 1998) may account for the bulk of the variance in the reduction of clinical symptoms. The mean magnitude of these previously nonspecified or placebo factors is closer to 70% when both the therapist and patient believe in the efficacy of the therapy. This powerful placebo effect is hypothesized to be an elicited conditioned response (Wickramasekera, 1977a, 1977c, 1980, 1985) based on the memory of prior healing. These memories of healing are more resistant to extinction if originally acquired on a partial rather than continuous reinforcement schedule. High and low hypnotic ability in interaction with threat perception (negative affect) is hypothesized to contribute to both the production and reduction of clinical symptoms. High and low hypnotic ability respectively are hypothesized to be related to dysregulation of the sympathetic and parasympathetic arms of the autonomic nervous system. Biofeedback is hypothesized to the most effective for reducing clinical symptoms in people of low to moderate hypnotic ability. For people high in trait hypnotic ability, training in self-hypnosis or other instructional procedures (e.g., autogenic training, progressive muscle relaxation, meditation, CBT, etc.) will produce the most rapid reduction in clinical symptoms.

Easterlin, Barbara L.; Cardena, Etzel (1998-99). Cognitive and emotional differences between short- and long-term Vipassana meditators. Imagination, Cognition and Personality, 18 (1), 69-81.

This study compared perceived stress and cognitive and emotional differences between two groups of Buddhist mindfulness [Vipassana] meditators. Nineteen beginning and twenty-four advanced meditators carried electronic pagers for five days and responded to daily random signals by completing an Experience Sampling form (ESF) containing items related to the dependent variables. As compared with beginners, advanced practitioners reported greater self-awareness, positive mood, and acceptance. Greater stress lowered mood and self-acceptance in both groups, but the deleterious effect of stress on acceptance was more marked for the beginners. These findings validate in a naturalistic setting some of the effects described in traditional Buddhist texts on mindfulness.

so precise that what was “I” is deconstructed into evanescent flux, into thoughts, images, emotions (like a movie with solitary frames); the yogi dissolves the self sense, but because of fixed concentration the separate self disappears and yogis feel like merging with larger Self.
So now for first time in history we can compare and map both similarities and differences. Now we have new possibilities for understanding and contrasting different practices. We can now differentiate the many states of consciousness that are available. But there are an awful lot of states. Can we find an over-arching framework? For the first time, we can say yes–due to the work of Ken Wilber. This is Developmental Structuralism (looking for common deep structures).
For example, you can identify millions of different faces, and they are surface structures; but they all have a common deep structure. Likewise, if we see that a Hindu creates images of [devas] and a Christian sees saints, they are seeing archetypal images. Likewise, Buddhists experience nirvana in which all phenomena disappear, and so does another group. This [sense of all phenomena disappearing] is common to both, but different from those who see archetypal images. We may be able to come up with a typology of altered states.
Wilber also says that these deep structures and corresponding states may develop in a developmental sequence, with common stages. Three transpersonal stages are subtle, causal, and non-dual. In meditation, first you learn how out of control the mind is, then gradually it quiets and you discover subtle experiences that you usually overlooked. Going further, all thoughts cease to arise, and there is only pure consciousness. Beyond that, images re-arise but are now recognized as projections of consciousness.