Contemporary theorists struggle less than Freud did with the problem of suggestion and suggestibility (and Freud did not have available the research on those areas!) Emotional upheaval that accompanies “insight” is readily taken to be validating. It may be true that bad memories are repressed, but that doesn’t mean that all bad memories are true.
Treatment groups focus on recalling memories and sharing memories with others in the group, not on current relationships. Hermann states that the group provides powerful stimulus for remembering. The group, of course, is reinforced by others remembering. Repeatedly considering the possibility of abuse can increase the sense of familiarity.
Current views expressed by some clinicians that certain symptoms and syndromes (eating disorders, etc.) indicate early sexual trauma are similar to Freud’s theory of hysteria. In these proposals, the inability to recall abuse becomes evidence that it occurred; and it tallies with the patient not having a sense of remembering.
Because some believe it is necessary to bring memory to light for cure to occur, there is a tendency to believe the reports of early childhood abuse.
Recognizing that some “memories” may have been a product of a therapist’s suggestion helps prevent untoward effects. Modern therapists recapitulate Freud’s “slip” when they do not acknowledge the role of suggestion.
Endorsing repression does not commit us to a belief that recovered memories must be accurate in all particulars. A memory that is repressed does not escape the usual kinds of degradation of memory.
And just because the material comes from unconscious sources, or has emotional accompaniments, it doesn’t mean it is true. (Bowers gave an example of his dream that Israel and Venezuela shared a common border, which was rectified by his waking awareness of the Atlantic Ocean and the Mediterranean. He noted that nothing like the Atlantic can be called upon if the dream is that one’s parent molested oneself at the age of six.)
Ian Hacking, in Rewriting the Soul, labels a more fundamental indeterminacy (for the historical past itself). Bathing rituals in childhood can be redescribed as abuse, which determines the historical past rather than describing it. It is thus easier to justify abuse if the event is something that can be reinterpreted. For example, the conflicts of adolescents with their parents, may be reinterpreted later if personality problems continue. If in adulthood one concludes that abuse occurred, then bathing rituals can be reinterpreted as if it were earlier abuse, as if the abuse has continued for years
Our study looked at suggestibility and resistance to suggestion. During 5-day hospitalization for investigation of child abuse. The first day patient gets physical exam; 2nd day a genital exam, heart arousal, stress arousal; a later day had mental status, emotional functioning, cognitive functioning–and gross screen of IQ for age 5 and up and the digit span for 6 and up, plus rating of global functioning and provisional diagnosis. On Day 5 each child was given structured interview that included questions about the anal- genital exam, with some misleading questions included.
35 minutes after the psychological examination they were given questions about the exam, for brief memory. Next exam was forensic examination of memory for abuse. Gave memory for sentences, perceptual alterations scale (PAS), adolescent version of Dissociative Experiences Scale (A-DES); gave questionnaire to parents.
Hypotheses: suggestibility would be negatively related to age (more errors when younger). Sexually and physically abused children would show more dissociation or psychopathology. Dissociation or psychopathology should be inversely related to memory ability. IQ should be related to memory and resistance to misinformation. Wanted to reconcile two models of post traumatic stress disorder (PTSD): one says they have poorer memory, and the other says they are hypervigilant.
Over 100 children in the 200 received the questionnaire on Day 5. 39% were 3-5 years old, 41% 6-10 years old. 76% were African American. 22% had no documented abuse or neglect; 13% had experienced physical abuse; 30% sex abuse; 12% both types of abuse; 15% neglect; 8% parental addiction.
Measuring dissociation in kids is problematic. The concept is used to describe a huge range of phenomena. Scores on the DES are more highly correlated with the F Scale on the MMPI than with any other measure (Michael Nash’s research). So the DES measures psychopathology. Also, children have healthy kinds of dissociation– daydreaming, etc. Josephine Hilgard noted that young kids are naturally involved in imagination. Early traumas may lead to this dissociative style. How do we sort out the healthy imaginal involvements of children from the psychopathology? There is not sufficient data at this time.
Available measures are not validated well. The CDC indicates behavior problems in children. The C-PAS conceptualizes dissociation as relating to eating disorders; the A- DES is a self report measure that related to psychopathology.
CDC scores increase, in 3-5 year olds, as the amount of abuse increases. This looks like general psychopathology, and it is a parental rating. The A-DES and C-PAS were not related to abuse or neglect. In the older groups the CDC related to poor performance on memory tests; but only for the 6-10 year olds. (Poorer memories in younger children could have masked the effect in them.)
The main finding for the study was clinician’s estimate of Global Adaptive Functioning was significantly related to Resistance to Misleading Information. The effect did not show for the 3-5 yr old group, perhaps because their memory functioning is poor anyway. Also age was related to memory and suggestibility.
Frischholz, Edward J. (1995, November). A critical evaluation of the 1985 AMA Report on hypnosis and memory. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
JAMA 1985 concluded that hypnotically refreshed memories are less reliable than nonhypnotic recall. There are two problems with their conclusion: 1. No consensually validated definition of ‘hypnosis’ is identified. They talk about administration of induction, and differences in hypnotic susceptibility. 2. Empirical criteria for discriminating the unique and/or moderating effects attributable to hypnosis are not specified.
For example Loftus showed that memory errors can be created without hypnosis. You should not just add hypnosis to that model.
The criticisms have not led to remedial practices. No research has been done to show how to minimize errors or how to facilitate accuracy.
‘What is Hypnosis?’ Something that is done vs. something that happens? A procedure or responsivity? Questions like this are relevant to research on whether hypnotically refreshed memories are less reliable than ordinary recall.
Hypnosis is not a ‘valid therapeutic modality’ (i.e., ‘hypnotherapy’ is a misnomer). Hypnosis can be used adjunctively with many different types of therapeutic modalities: –psychodynamic therapies –behavior modification treatments –cognitive restructuring strategies –systematic desensitization –flooding –direct suggestion
There is a specious communality: hypnosis is used in a different kind of way with each approach.
If hypnosis is defined in terms of whether an hypnotic induction procedure was administered to the subject, then hypnosis is a universal phenomenon (i.e., everyone can be administered an hypnotic induction procedure). This, in the AMA report, permitted the courts to define it this way, which leads to a number of ridiculous results.
We need to highlight ‘What are the variables that are the source of the errors?’ The sources are not hypnosis. We can minimize the sources by the way we ask questions, instruct the subjects, etc.
If hypnosis is defined in terms of the nature of the subjects’ response to the procedures, then hypnosis is not a universal phenomenon (i.e., there are wide individual differences in hypnotic responsivity). I have shown that it is possible to alter memories, using the Loftus model, in people who are both low and high hypnotizable.
We need to take into account induction procedure, hypnotizability, type of memory, and the retrieval/influence procedure. The demand characteristics re forced responding, expectancies about memory (e.g. video recorder model), expectancies about hypnosis (e.g., everyone remembers) must be accounted for.
Dependent variables in this type of research include memory accuracy, memory errors, and subjective confidence.
Laurence, Jean-Roch; Gendron, Marie-Josee (1995, November). Pay attention, it may happen by itself. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
1994
Aronoff, J.; Green, J. P.; Malinoski, P.; Zelikovsky, N.; Lynn, S. J. (1994, October). Hypnosis and autobiographical memories: The impact of contextual factors. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco
We examined the individual differences in recall for early memories, in a college population, using the Autobiographical Memory Scale (AMS) along with other scales and with a hypnotizability scale (measured in same and different contexts). 75 male and 171 females subjects participated.
Presented as two separate experiments, so Ss would not make an explicit link between autobiographical memories and things measured in the second study.
Exper 1. Administered AMS which indicates we are interested in their memories of events, and not what they were later told about the events. First 5 birthdays, first day of school, etc. Rate the detail, vividness, and accuracy.
Exper 2. Administered Fantasy Proneness (Wilson & Barber), Cognition, Imagery Control Scale, Derogotis, SAC (Brier’s symptoms of child abuse), and Dissociative Experiences Scale.
Final sample of 247 Ss.
Earliest memory was 3.8 years.
Ss ratings of details, vividness, and accuracy were highly correlated. These were negatively correlated with age of first memory.
Bloom, Peter B. (1994). Clinical guidelines in using hypnosis in uncovering memories of sexual abuse: A master class commentary. International Journal of Clinical and Experimental Hypnosis, 42 (3), 173-178.
“Joan,” a clinical psychologist, requested a psychiatric consultation to determine whether hypnosis could recover accurate memories of suspected child abuse by her still living father. Are there clinical guidelines in using hypnosis in uncovering such possible memories of sexual abuse? We asked Dr. Peter B. Bloom to share his views with us.
NOTES
Gives case example and clinical guidelines for using hypnosis in uncovering memories of sexual abuse. 1. In medical practice, “Primum non nocere,” i.e. “First do no harm.” 2. “No therapist should ever, either directly or indirectly, suggest abuse outside of a specific therapeutic context–certainly not to a client who is on the phone making a first appointment!” 3. “A therapist must not jump quickly to the conclusion that abuse occurred simply because it is plausible.” 4. “A therapist should never simply assume that a client who cannot remember much from childhood is repressing traumatic memories or is in denial.” 5. “Remember ‘a client is most vulnerable to suggestion and the untoward influence of leading questions when therapy begins to delve into painful life situations from the past, particularly from childhood.'” 6. “Therapists … should be cautious about suggesting that clients cut off communication with their families.” 7. “Therapists should reconsider the ‘no pain, no gain’ philosophy of treatment.” 8. “The context of therapy is as important as the content.” 9. “Tolerate ambiguity.” (Sincerity and conviction on the part of the patient reporting abuse are not in and of themselves reason to believe the material.) 10. “Respect the current science of memory.” 11. “Maintain responsibility for making the diagnosis and choosing the treatment.” 12. “Pursue alternative diagnoses to account for the symptoms.” 13. “Historical and narrative truth: Understand the difference.”
COMMENT: The tenet that insight is necessary for change and growth is not true. Change can occur without insight, although insight may be helpful in maintaining change once it has occurred.
SUMMARY: These guidelines are presented to enhance safe practice, however, clinicians should use their own judgement to determine the best path to follow with each patient.
NOTE: Guidelines 1, 8, 9, 10, 11, 12, and 13 are those of Peter B. Bloom. Those labeled as Guidelines 2, 3, 4, 5, 6, and 7 were taken with permission from Yapko, M. (1993 September/October). “The seductions of memory. The false memory debate.” Family Therapy Networker, 17, pp. 30-37. All discussions, however, are those of Peter B. Bloom.
COMMENT
The tenet that insight is necessary for change and growth is not true. Change can occur without insight, although insight may be helpful in maintaining change once it has occurred.
SUMMARY
These guidelines are presented to enhance safe practice, however, clinicians should use their own judgement to determine the best path to follow with each patient.
NOTE
Guidelines 1, 8, 9, 10, 11, 12, and 13 are those of Peter B. Bloom. Those labeled as Guidelines 2, 3, 4, 5, 6, and 7 were taken with permission from Yapko, M. (1993 September/October). “The seductions of memory. The false memory debate.” Family Therapy Networker, 17, pp. 30-37. All discussions, however, are those of Peter B. Bloom
Bowers, Kenneth S. (1994, October). Bringing balance to controversy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
Skeptics argue that concept of “repression” has no scientific merit, though even if a valid concept, it wouldn’t validate all memories recovered. Skeptics regard laboratory evidence as essential, while clinicians are impressed by case reports. See Polonyi, _Personal Knowledge_.
It is not reasonable to say there is no evidence for fugue states, when seeing one, if it has not been demonstrated in the laboratory. But you can investigate some of the phenomena in the laboratory.
Most of the time it is an affectively loaded idea that is repressed; in contrast, trauma usually lead to intrusions into consciousness. So repression of a traumatic event may be a rare way to deal with the event.
Claims for repression and ESP differ in that there are probably observable mechanisms in the former (e.g. thought avoidance). If a person ejects thoughts about a topic frequently enough, the ejections become automatic. Freud’s original description of repression used the word “intentional” and it was a footnote that took out that idea. (See Erdelyi’s publications).
Recent research we conducted on intuition and on problem solving is relevant to this problem.
[The remainder of Bowers’ presentation is not summarized here.]
1994
Farvolden, Peter; Bowers, Kenneth. S.; Woody, Erik Z. (1994, October). Hypnotic amnesia: Avoiding the intentional loop. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
Social-cognitive position is that suggestions for amnesia lead to motivated attempts to forget, and the sense of nonvolition is due to attributional error. Neo- dissociation position is that post-hypnotic amnesia is activated by suggestions, and material is not available to consciousness. Ss may mistakenly attribute their amnesia to their own efforts, or to their imaginings. (See their analgesia studies.)
Used a recall organization paradigm. Ss learn 16 item categorized word list, then are given suggestion to forget one category. After suggestion is canceled, Ss are told to report again. In their heart rate study, highs were amnestic and recalled words not targeted for amnesia. Highs weren’t trying to forget, even though they were experiencing things happening cognitively during the waiting period.
Study II. One group of highs engaged in a distraction task, which would prevent their participating in task relevant practice. Ss in the distraction condition recalled fewer words, just as in the standard hypnosis condition. However, their subjective report indicated they had even a stronger feeling that something had happened beyond their volition or control than did Ss in the standard hypnotic condition.
It appears that task relevant thoughts and imagery reported by Highs are not necessary. They are co-suggestion effects. See Hargedon, Bowers, & Woody in similar work, on analgesia. However, during the recall period Highs did not work as hard as the Lows in trying to remember according to both their self-reports and the heart rate measure.
standard hypnosis condition. However, their subjective report indicated they had even a stronger feeling that something had happened beyond their volition or control than did Ss in the standard hypnotic condition.
It appears that task relevant thoughts and imagery reported by Highs are not necessary. They are co-suggestion effects. See Hargedon, Bowers, & Woody in similar work, on analgesia. However, during the recall period Highs did not work as hard as the Lows in trying to remember according to both their self-reports and the heart rate measure
Frankel, Fred H. (1994, October). On patients remembering abuse when it in fact may not have occurred. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
The concept of hidden memories has supported the profession of psychotherapy for a century. This process can only occur if there is a mechanism to support it. Bowers says, if memory is not reliably accurate, it is not reliably inaccurate either.
“Ideas passing as descriptions lead us to equate the tentative with [the factual.]” – Gould.
Three studies purporting to establish repression: 1. Briere & Comte sampled 450 adults who reported abuse. They asked, “Was there ever a time when you couldn’t remember the forced experience?” How does respondent understand the question? Clients were all in therapy. 2. Herman and Schatzow (1989) “verification of abuse” study. 53 Ss in a survivor’s group. Reports percentages who had no or little recall. Authors don’t acknowledge that the group discussion and the attitude of therapist may have shaped the response. It is also not clear how many Ss who claimed to have “verified” their accounts were among those who had severe amnesia for the event. They could be Ss who had never lost the memory in the first place. 3. Williams interviewed women who earlier were in Emergency Rooms because of abuse being suspected. 38% did not report childhood abuse when questioned, and author concluded it was due to repression. Significant numbers of adults cannot remember things even past the age of 5.
Problem with wording of questions. Some of the women interviewed might have preferred not to report the event. This was not investigated in the study.
Freyd, Jennifer J. (1994). Betrayal-trauma: Traumatic amnesia as an adaptive response to childhood abuse. Ethics and Behavior, 4.
Betrayal-trauma theory suggests that psychogenic amnesia is an adaptive response to childhood abuse. When a parent or other powerful figure violates a fundamental ethic of human relationships, victims may need to remain unaware of the trauma not to reduce suffering but rather to promote survival. Amnesia enables the child to maintain an attachment with a figure vital to survival, development, and thriving. Analysis of evolutionary pressures, mental modules, social cognitions, and developmental needs suggests that the degree to which the most fundamental human ethics are violated can influence the nature, form, processes, and responses to trauma.
A logical extension of this research direction, based on a strategy that has been very effective in cognitive neuroscience, would be to look for neuroanatomical underpinnings of the cognitive mechanisms implicated in dissociation. … For instance, the ability to dissociate current experience may depend partly on representational structures that support spontaneous perceptual transformations of incoming events. One possible perceptual transformation that is amenable to scientific investigation, would be the creation of spatial representations in which the mental ‘observer’ is spatially distinct from the real body of that observer. Such a representation would fit patient descriptions of ‘leaving their body’ during a traumatic episode and viewing the scene as if from afar. Additionally one could investigate the role of mental recoding and restructuring during memory ‘recovery’ and psychotherapy” (pp. 19-20).
to scientific investigation, would be the creation of spatial representations in which the mental ‘observer’ is spatially distinct from the real body of that observer. Such a representation would fit patient descriptions of ‘leaving their body’ during a traumatic episode and viewing the scene as if from afar. Additionally one could investigate the role of mental recoding and restructuring during memory ‘recovery’ and psychotherapy” (pp. 19-20).
Ganaway, George K. (1994, October). The thin line: Reality and fantasy in hypnotically facilitated memory retrieval during psychotherapy. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
Historical review: Every hundred years there has been a peak in interest in altered states–a fin de ciecle zeitgeist. It is the Brigadoon effect, i.e. something materializing for one day every 100 years. The theories developed then suffer from “paradigm grandiosity.” In hypnosis, we can refer back to:
1694 Salem witch trials
1790s Gaussner’s exorcism (see Ellenberger); in a 1775 showdown between him and Mesmer, there occurred the turning point between exorcism and psychotherapy.
1880s Charcot at Salpetrier ‘demonstrated’ that hypnosis was an organic, pathological condition. Ultimately this contributed information about the plasticity of hypnotized people. (In the 1880s Bernheim thought it wasn’t pathological and thought that suggestion was the important element in hypnosis.)
Recent historical contributions have influenced our views of MPD. Spiegel and Kardiner published book about hypnosis and war neuroses. Cheek & LeCron developed ideomotor questioning, which ignores the contribution of unconscious fantasy. Jacob Arlow’s metaphor for MPD is two movie projectors aiming at a screen from two different sides. The subjectively known experiential world thereby combines external reality and the person’s internal, motivated perceptions. The author presented a case study of female therapist, who had been previously diagnosed as MPD, who presented with dissociative symptoms that she thought were due to abuse by her grandmother. She fabricated the memories in order to get the holding and physical nurturing from her therapist for being courageous and remembering the abuse.
Maintenance of professional boundaries is very important in treatment.
Krippner, Stanley (1994, August). Improvement of academic skills for children and adolescents with hypnosis. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
Literature and research in this area are sparse, though there is clinical evidence that hypnosis is useful. My definition of hypnosis is a procedure facilitating a variety of structured goals or procedures in which a suggestion or motivation is enhanced by a mechanical device, another person, or oneself.
There are 3 areas of application in academics:
study habits
test taking
strengthening academic motivation
The hypnotist should know the specifics of academic achievement, because specific suggestions (e.g. “Imagine you are at desk focusing well for 20 minutes,”) are better. Emphasis on the positive is better than negative. Use the words “imagination,” “concentration,” or “imagining pictures,” rather than “hypnosis.” I try to determine what they expect, based in part on what words they use.
In elementary school I focus on attitude and self esteem. I have them imagine reading a story, then how well they feel; that when they notice mistakes they won’t be bothered because everyone makes mistakes.
For high school, I help them develop good habits for time motivation (e.g. suggestions to “make an outline to follow while you study”). At college level, I introduce self hypnosis. I make frequent use of mental imagery, at all levels–especially imagery rehearsal, in which the person is engaged in a particular activity.
In the NSF report on accelerated learning techniques (a project sponsored by the Army), Lozonov’s “suggestopedia” techniques were studied. This review indicated it might enhance training effectiveness and reduce training time.
I have observed the suggestopedia classes in Bulgaria and Hungary. Classes had a relaxed comfortable learning environment. Rather than individual learning, it was group learning. It included preliminary exercises, new material, and a review of what was learned. The first stage used 2/3 of the time. Then suggestions were given by the teacher to promote learning. The presentation phase took one third of the time. The method encourages students to make mental images of the material. In foreign language classes, people take on new roles.
positive is better than negative. Use the words “imagination,” “concentration,” or “imagining pictures,” rather than “hypnosis.” I try to determine what they expect, based in part on what words they use.
In elementary school I focus on attitude and self esteem. I have them imagine reading a story, then how well they feel; that when they notice mistakes they won’t be bothered because everyone makes mistakes.
For high school, I help them develop good habits for time motivation (e.g. suggestions to “make an outline to follow while you study”). At college level, I introduce self hypnosis. I make frequent use of mental imagery, at all levels–especially imagery rehearsal, in which the person is engaged in a particular activity.
In the NSF report on accelerated learning techniques (a project sponsored by the Army), Lozonov’s “suggestopedia” techniques were studied. This review indicated it might enhance training effectiveness and reduce training time.
I have observed the suggestopedia classes in Bulgaria and Hungary. Classes had a relaxed comfortable learning environment. Rather than individual learning, it was group learning. It included preliminary exercises, new material, and a review of what was learned. The first stage used 2/3 of the time. Then suggestions were given by the teacher to promote learning. The presentation phase took one third of the time. The method encourages students to make mental images of the material. In foreign language classes, people take on new roles.
1993
Bennett, Henry L. (1993, October). Hypnosis and suggestion in anesthesiology and surgery. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
He began by saying that he is opposed to using hypnosis for surgery, though he favors a theory of how hypnosis effects physiological change, and cites T. X. Barber’s classic “Changing Unchanging Bodily Processes.”
Relaxation puts patient in a “psychological strait jacket” because surgery is so highly stressful. He gives information “about how to go through the surgery more comfortably,” gets across the idea about coping style, tells them surgery is exertional and that they are tired afterward, that he can help them “using things you already know how to do,” and specifies exactly what they can do–using model of himself as a trainer.
In some recent research he used pairs of pictures, some of which lead to pupillary constriction (blood pressure goes down) or dilation (blood pressure goes up). Instructing them to look, patients looked twice as long at the pictures than they did during free gaze. When not instructed to look, heart rate went down; when told to look, heart rate went up. So the researchers went back to free gaze. He uses this as a metaphor for many of the pre- surgery preparation activities that encourage relaxation “inappropriately.”
He cites Cohen & Lazarus re vigilant copers, Price et al (1957), and some other studies on epinephrine effects. He uses examples of work patients may have done (e.g. planting a garden) when talking with patients prior to surgery, that gives them a sense of accomplishment later.
You have to give specific instructions or suggestion, not general relaxation suggestions.
Question from the audience: Can preoperative instructions (not hypnosis) diminish blood loss.
In Bennett’s answer he seems to be reporting the earlier study: they found 150- 4000 cc blood loss, high variability. Extent of blood loss was determined by extent of surgery, by instructions to patients vs no instructions.
This study was replicated by Enqvist, Bystedt, & von Konow in the Anesthesia conference at Emory University in 1992.
May 1993 Western Journal of Medicine article, Disbrow, Bennett, & Owinos, with 40 lower abdominal surgery patients who got specific instructions or not. The SHCS was used to measure hypnotizability: highs resolved quicker than low hypnotizable patients. They also found that instructed patients did better than those who did not get specific instructions.
There are now 3 replications of McClintock’s study: people use less medications after surgery, when tapes about rapid recovery are played *during* surgery.
Bennett is now using tapes with suggestions for recovery during surgery.
Question from the audience: Can preoperative instructions (not hypnosis) diminish blood loss.
In Bennett’s answer he seems to be reporting the earlier study: they found 150- 4000 cc blood loss, high variability. Extent of blood loss was determined by extent of surgery, by instructions to patients vs no instructions.
This study was replicated by Enqvist, Bystedt, & von Konow in the Anesthesia conference at Emory University in 1992.
May 1993 Western Journal of Medicine article, Disbrow, Bennett, & Owinos, with 40 lower abdominal surgery patients who got specific instructions or not. The SHCS was used to measure hypnotizability: highs resolved quicker than low hypnotizable patients. They also found that instructed patients did better than those who did not get specific instructions.
There are now 3 replications of McClintock’s study: people use less medications after surgery, when tapes about rapid recovery are played *during* surgery.
Bennett is now using tapes with suggestions for recovery during surgery.
1992
Barrett, Deidre (1992). Fantasizers and dissociaters: Data on two distinct subgroups of deep trance subjects. Psychological Reports, 71, 1011-1014.
The study delineated two subgroups of highly hypnotizable subjects. The first subgroup (fantasizers) entered trance rapidly, scored high on absorption (mean of 34 on the 37-item Absorption Scale), and described hypnosis as much like their rich, vivid, and very realistic waking fantasy life. None of the fantasizers experienced unsuggested amnesia, and 5/19 failed to produce suggested amnesia. Only 2/19 fantasizers described hypnosis as very different from their other experiences. The earliest memories of fantasizers were all identified as occurring before age 3, and before age 2 for 11 of 19. The second subgroup (dissociaters) took time to achieve a deep trance (unlike Wilson and Barber’s fantasy-prone subjects, but they did achieve as deep a trance as fantasizers), experienced hypnosis as different from any prior experiences, and were more likely to exhibit amnesia for both hypnotic experience and waking fantasies. None of the dissociaters described their waking imagery as entirely realistic, and the earliest memories in this group were all over the age of 3 (mean age – 5). Of the 15 dissociaters, 7 scored below the norm on the Absorption Scale (Mean – 26).
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.
1992
Christianson, S-A (1992). Emotional stress and eyewitness memory: A critical review. Psychological Bulletin, 112, 284-309.
Although not addressing hypnosis specifically, this is a comprehensive review of literature on memory for negative emotional events relevant to issues of hypnosis and memory. The final conclusion is that emotional events are indeed remembered differently than neutral or ordinary events and are well retained with respect to the event itself and concerning central, critical detail (not peripheral detail). Such memories seem less susceptible to forgetting. There is evidence for dissociation between memory for emotional information and memory for specific event information. There is also evidence of amnesia or memory impairment effects after high-arousal events, with memory increasing as more time passes after the event. The functional amnesia effects are probably due to an interaction between altered encoding operations and the specific retrieval circumstances aiding consciously and unconsciously controlled reconstructive processes. There is little evidence to support Loftus’ contentions that emotional stress is bad for memory.
Claridge, Karen (1992). Reconstructing memories of abuse: A theory-based approach. Psychotherapy, 29, 243-252.
The recovery of traumatic memories is an important part of therapy with survivors of abuse. This article describes a conceptual framework for memory reconstruction based on Horowitz’ (1986) theory of stress response syndromes. The client’s history of intrusive symptoms provides a way to anticipate the nature of the trauma, even when no memory of it exists. Ongoing intrusive symptoms are used to retrieve memory fragments, and their emotional impact is used to build the client’s emotional tolerance. Emphasis is placed on preparing for memories by identifying what the client will need when the memories return, building coping skills, and beginning to restructure cognitions at the “what if” stage of remembering. Case material is used to illustrate.
Darken, Rachel (1992). Hypnosis in the treatment of survivors of sexual abuse. Australian Journal of Clinical and Experimental Hypnosis, 20, 105-110.
This paper outlines the problems of child sexual abuse and its long-term sequelae, often reaching down generations. In psychotherapy with survivors of childhood sexual abuse, hypnosis offers a flexible treatment modality and the paper focuses particularly on the use of hypnosis and self-hypnosis for the “reparenting” element of psychotherapy.
Erdelyi, Matthew, Hugh (1992). Psychodynamics and the unconscious. American Psychologist, 47, 784-787.
The original New Look integrated the constructivist-psychodynamic traditions of Bartlett and Freud. The unconscious (Greenwald’s “New Look 3”) is a logically different idea, although in practice it is often intertwined with constructivist – psychodynamic approaches. The unconscious is a pretheoretic term with a variety of problems: It has multiple and unsettled meanings; null reports need not signify null awareness; the conscious-unconscious dichotomy implied by the limen may not exist; even “absolute subliminality” (chance-level accessibility) is relative to the time interval of testing, as accessibility can increase to above-chance levels over time (hypermnesia). Yet, the phenomena that the unconscious sloppily subsumes are not simple or dumb. The capacity of subliminal perception should not be confused with the capacity of subliminal (unconscious) memory and cognition.
Faller, Kathleen Couborn (1992, Summer). Can therapy induce false allegations of sexual abuse?. The Advisor (Published by American Professional Society on the Abuse of Children), 5 (3), 3-6.
“Concern about the impact of therapy on children’s accounts of sexual abuse should be understood in the context of two phenomena: (1) the adult need to deny that children are sexually abused, and (2) adult identification with the alleged abuser. These phenomena operate at both individual and societal levels” (p. 3).
“Research related to impact of stressful situations on children’s ability to recall provides mixed results, some studies finding children are less accurate if the event is traumatic (Peters, 1991) and others finding they are not (Goodman, Reed, & Hepps, 1985).
“Research reveals that it is rare for children to falsely allege that they have been touched in their private parts. In one study, a substantial proportion of children who experienced genital and anal touch during a physical examination by a doctor did not volunteer this information when asked general questions about the examination. The majority of children in the study revealed genital and anal touch only when they were asked specific questions like, “Did the doctor touch you there?” (Saywitz, Goodman, Nicholas, & Moan, 1991)” (pp. 3-4).
“Clarke-Stewart and her colleagues (1989) have demonstrated that children’s interpretation of ambiguous events can be manipulated and altered by an authority figure who insists upon a particular interpretation (see also Lindberg, 1991)” (p.4).
“In sum, the research suggests that older children are likely to provide more complete unassisted disclosure than younger children. Younger children may need more memory cues in the form of specific questions than older children. Therapists are much more likely to find false negatives than false positives. Finally, therapists should be aware of the possibility the child may identify the wrong person. … Generally, however, the research indicates that concern about the contaminating effects of therapy on children’s recollections of sexual abuse is exaggerated” (pp. 4-5).
“Research indicates that the proportion of fabricated reports may be higher in the divorce scenario than in other contexts (Faller, 1990; Jones & Seig, 1988). Studies suggest most false reports are made by adults, not children (Jones & McGraw, 1987; Jones & Seig, 1988)” (p. 5).
“Clinical research (Sorenson & Snow, 1991) and experience (Faller, 1988) indicate that for most children, revealing sexual abuse is a process which occurs over time. A typical pattern is one in which children begin with the least overwhelming experience and gradually disclose more and more as their accounts are accepted and believed” (p. 5).
“[In conclusion]… therapists should be aware of the findings from research on children’s memory and suggestibility. This research indicates that there are vulnerabilities which should be taken into account during therapy” (p. 6).
results, some studies finding children are less accurate if the event is traumatic (Peters, 1991) and others finding they are not (Goodman, Reed, & Hepps, 1985).
“Research reveals that it is rare for children to falsely allege that they have been touched in their private parts. In one study, a substantial proportion of children who experienced genital and anal touch during a physical examination by a doctor did not volunteer this information when asked general questions about the examination. The majority of children in the study revealed genital and anal touch only when they were asked specific questions like, “Did the doctor touch you there?” (Saywitz, Goodman, Nicholas, & Moan, 1991)” (pp. 3-4).