“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).
Gravitz, Melvin A. (1992, October). Historical and legal issues. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
The 1976 Chowchilla kidnaping case in California stimulated interest in using hypnosis for forensic investigation; in the same year, it was used in a case of airline hijacking in the Mediterranean to Uganda. Hypnosis is used for obtaining “leads” and doesn’t claim to develop “the truth.”
Other uses include: lifting amnesia of witnesses and victims of trauma–including but not limited to crime; obtaining additional information in nonamnesic Ss; evaluation of a subject’s mental condition (e.g. multiple personality disorder vs malingering, as in the Bianchi case). In each use, hypnosis is not infallible, is not complete. But no procedure is. Motivation, resistance, transference are all critical.
Historic questions: 1. whether coercion is entailed 2. impact of hypnosis on memory 3. possible harm to subject, physically and mentally
The coercion issue dates to Mesmer, whose procedures led to accusations of immoral suggestions. In the 1880s Charcot said no one could be forced to do anything while the Nancy school (Liebeault) said they could. Since then we have seen laboratory studies using student volunteers, fake “poison,” rubber daggers, etc., as well as recent “real life” studies where Ss were induced to violate their morals (see Watkins). Review articles include those by Jacob Conn of Baltimore and the 1985 JAMA article written by a panel headed by Martin Orne.
For impact of hypnosis on memory, see the Orne report which did not fully support using hypnosis for memory enhancement.
Regarding possible harm to a hypnotic subject in the 19th century, a young man’s death was attributed to nervousness and exhaustion and diabetes due to repeated hypnosis. Other studies of death (of chickens, of a frog) due to repeated hypnotization were published. Now the consensus is that hypnosis is not dangerous (but incompetence using hypnosis may be dangerous).
LEGAL PRECEDENTS.
In 1897 a California court refused to accept testimony of a Subject who had been hypnotized. People vs Eubanks.
The 1950’s Cornell case established that a person can be hypnotized for their own defense.
In 1963 the California supreme court ruled that a lower court made a mistake in not admitting testimony from someone who had been hypnotized.
In Harding (a Maryland case), the trauma victim, amnestic, was hypnotized one month later. The testimony was accepted. A 1983 Maryland appeals court overturned it, influenced by the California Shirley case.
In 1983 Hurd case, a victim, hypnotized, identified her husband as attacker. Lower court didn’t permit the testimony; then a higher court reversed it. The court issued what are known as the Hurd rules, governing testimony that is acceptable: 1. hypnotist is licensed psychologist or psychiatrist with training in hypnosis 2. hypnotist must be independent of both the prosecution and defense 3. all information given to the hypnotist about the case must be written 4. hypnotist must obtain a nonhypnotic account of the memory before hypnosis is used. 5. must have taped record of the hypnosis sessions (preferably videotaped) 6. only hypnotist and subject should be present in the room
Soon after, California had the Shirley case. The California court ruled hypnosis per se is unreliable because it produces confabulation. This decision had a chilling effect throughout the country for several years.
In 1987 we had Rock vs Arkansas, the first and only case involving hypnosis to come before the U. S. Supreme Court. Vicky Rock shot her husband. Under hypnosis, she remembered she did not have her finger on the trigger, and her husband grabbed her and shook her. Lower court wouldn’t admit the testimony of the gun expert, who testified the trigger was sensitive to jarring. Supreme Court ruled defendants (not necessarily others) could use hypnosis in their own defense.
Historic questions: 1. whether coercion is entailed 2. impact of hypnosis on memory 3. possible harm to subject, physically and mentally
The coercion issue dates to Mesmer, whose procedures led to accusations of immoral suggestions. In the 1880s Charcot said no one could be forced to do anything while the Nancy school (Liebeault) said they could. Since then we have seen laboratory studies using student volunteers, fake “poison,” rubber daggers, etc., as well as recent “real life” studies where Ss were induced to violate their morals (see Watkins). Review articles include those by Jacob Conn of Baltimore and the 1985 JAMA article written by a panel headed by Martin Orne.
For impact of hypnosis on memory, see the Orne report which did not fully support using hypnosis for memory enhancement.
Regarding possible harm to a hypnotic subject in the 19th century, a young man’s death was attributed to nervousness and exhaustion and diabetes due to repeated hypnosis. Other studies of death (of chickens, of a frog) due to repeated hypnotization were published. Now the consensus is that hypnosis is not dangerous (but incompetence using hypnosis may be dangerous).
LEGAL PRECEDENTS.
In 1897 a California court refused to accept testimony of a Subject who had been hypnotized. People vs Eubanks.
The 1950’s Cornell case established that a person can be hypnotized for their own defense.
In 1963 the California supreme court ruled that a lower court made a mistake in not admitting testimony from someone who had been hypnotized.
In Harding (a Maryland case), the trauma victim, amnestic, was hypnotized one month later. The testimony was accepted. A 1983 Maryland appeals court overturned it, influenced by the California Shirley case.
In 1983 Hurd case, a victim, hypnotized, identified her husband as attacker. Lower court didn’t permit the testimony; then a higher court reversed it. The court issued what are known as the Hurd rules, governing testimony that is acceptable: 1. hypnotist is licensed psychologist or psychiatrist with training in hypnosis 2. hypnotist must be independent of both the prosecution and defense 3. all information given to the hypnotist about the case must be written 4. hypnotist must obtain a nonhypnotic account of the memory before hypnosis is used. 5. must have taped record of the hypnosis sessions (preferably videotaped) 6. only hypnotist and subject should be present in the room
Soon after, California had the Shirley case. The California court ruled hypnosis per se is unreliable because it produces confabulation. This decision had a chilling effect throughout the country for several years.
In 1987 we had Rock vs Arkansas, the first and only case involving hypnosis to come before the U. S. Supreme Court. Vicky Rock shot her husband. Under hypnosis, she remembered she did not have her finger on the trigger, and her husband grabbed her and shook her. Lower court wouldn’t admit the testimony of the gun expert, who testified the trigger was sensitive to jarring. Supreme Court ruled defendants (not necessarily others) could use hypnosis in their own defense.
Greenwald, Anthony G. (1992). New Look 3: Unconscious cognition reclaimed. American Psychologist, 47, 766-779.
Recent research has established several empirical results that are widely agreed to merit description in terms of unconscious cognition. These findings come from experiments that use indirect tests for immediate or long- term residues of barely perceptible, perceptible-but-unattended, or attended-but-forgotten events. Importantly, these well-established phenomena–insofar as they occur without initially involving focal attention–are limited to relatively minor cognitive feats. Unconscious cognition is now solidly established in empirical research, but it appears to be intellectually much simpler than the sophisticated agency portrayed in psychoanalytic theory. The strengthened position of unconscious cognitive phenomena can be related to their fit with the developing neural network (connectionist) theoretical framework in psychology.
Jacoby, Larry L.; Lindsay, D. Stephen; Toth, Jeffrey P. (1992). Unconscious influences revealed: Attention, awareness, and control. American Psychologist, 47, 802-809.
Recent findings of dissociations between direct and indirect tests of memory and perception have renewed enthusiasm for the study of unconscious processing. The authors argue that such findings are heir to the same problems of interpretation as are earlier evidence of unconscious influences–namely, one cannot eliminate the possibility that conscious processes contaminated the measure of unconscious processes. To solve this problem, the authors define unconscious influences in terms of lack of conscious control and then describe a process dissociation procedure that yields separate quantitative estimates of the concurrent contributions of unconscious and consciously controlled processing to task performance. This technique allows one to go beyond demonstrating the existence of unconscious processes to examine factors that determine their magnitude.
Kihlstrom, John F.; Barnhardt, Terrence M.; Tataryn, Douglas J. (1992). The psychological unconscious. American Psychologist, 47, 788-791.
In response to Greenwald’s article on contemporary research on unconscious mental processes, the authors address three issues: (a) the independence of much recent research and theory from psychodynamic formulations; (b) the broad sweep of the psychological unconscious, including implicit perception, memory, thought, learning, and emotion; and (c) the possibility that the analytic power of unconscious processing may depend both on the manner in which mental contents are rendered unconscious and the manner in which they are to be processed.
Lewicki, Pawel; Hill, Thomas; Czyzewska, Maria (1992). Nonconscious acquisition of information. American Psychologist, 47, 796-801.
The authors review and summarize evidence for the process of acquisition of information outside of conscious awareness (covariations, nonconscious indirect and interactive inferences, self-perpetuation of procedural knowledge). Data indicate that as compared with consciously controlled cognition, the nonconscious information – acquisition processes are not only much faster but are also structurally more sophisticated, in that they are capable of efficient sitThmechanisms of non- conscious acquisition of information provide a major channel for the development of procedural knowledge that is indispensable for such important aspects of cognitive functioning as encoding and interpretation of stimuli and the triggering of emotional reactions.
processing of multidimensional and interactive relations between variables. Those mechanisms of non- conscious acquisition of information provide a major channel for the development of procedural knowledge that is indispensable for such important aspects of cognitive functioning as encoding and interpretation of stimuli and the triggering of emotional reactions
1991
Block, Robert I.; Ghoneim, M. M.; Sum Ping, S. T.; Ali, M. A. (1991). Efficacy of therapeutic suggestions for improved postoperative recovery during general anesthesia. Anesthesiology, 75, 746-755.
There have been claims that the postoperative course of patients may be improved by presentation during general anesthesia of therapeutic suggestions which predict a rapid and comfortable postoperative recovery. This study evaluated the effectiveness of such therapeutic suggestions under double-blind and randomized conditions. A tape recording predicting a smooth recovery during a short postoperative stay without pain, nausea, or vomiting was played during anesthesia to about half the patients (N = 109), while the remaining, control patients were played a blank tape instead (N = 100). The patients were primarily undergoing operations on the fallopian tubes, total abdominal hysterectomy, vertical banding gastroplasty, cholecystectomy, and ovarian cystectomy or myomectomy. The anesthesia methods consisted of either isoflurane with 70% nitrous oxide in oxygen to produce end-tidal concentrations of 1.0, 1.3, or 1.5 MAC; or 70% nitrous oxide in oxygen combined with high or low doses of opioids. Assessments of the efficacy of the therapeutic suggestions in the recovery room and throughout the postoperative hospital stay included: the frequency of administration of analgesic and antiemetic drugs; opioid doses; the incidence of fever; nausea, retching, and vomiting; other gastrointestinal and urinary symptoms; ratings of pain; ratings of anxiety; global ratings of the patients’ physical and psychological recoveries by the patients and their nurses; and length of postoperative hospital stay. There were no meaningful, significant differences in postoperative recovery of patients receiving therapeutic suggestions and controls. These negative results were not likely to be due to insensitivity of the assessments of recovery, as they showed meaningful interrelations among themselves and numerous differences in recovery following different types of surgery. Widespread utilization of therapeutic suggestions as a routine operating room procedure seems premature in the absence of adequate replication of previously published positive studies. (Key words: Anesthesia, depth: Awareness, Memory, Recall, Learning.)
Patients ages 19-55 were accepted into the study and they were paid for participation. (Older patients were excluded to guard against memory or hearing problems.) Other criteria for exclusion were: ASA physical status 4 or 5 indicating significant systemic disease, visual or hearing problems, middle ear disease (because it increases probability of nausea and vomiting), if their condition might require heavy sedation, if they were currently taking medication that interferes with memory (e.g. benzodiazepines, if there were intolerance to opioids, or if there were a likelihood of using postoperative pain treatment other than opioids.
The Spielberger State-Trait Anxiety Inventory was administered before surgery. Either suggestions (lasting 6 minutes) or a blank tape were played through headphones, starting 5 minutes after the surgical incision. The tape was played once for the first 59 patients, continuously for the remaining 150 patients. The first 139 patients received additional verbal materials on the tape, for memory tests to test possibility of learning under anesthesia. Operating room sounds were recorded by a tape recorder near the patient’s head, throughout period of unconsciousness (except when tape was being played).
After the first 25% of cases, the team decided that lack of effect on therapeutic suggestions attributable to type of anesthesia did not warrant restriction to a single anesthetic method; also, multiple presentations of the suggestions on tape did not show an effect different from a single presentation.
After the patient regained consciousness and was reoriented, pain, nausea, retching, and vomiting were assessed every 30 minutes. Pain was rated orally on a scale from 1 to 10 in the recovery room, then on visual analogue scales every 2 hours on the day of surgery and the second day, and every 4 hours on subsequent hospital days during waking hours. Variables that were rated by staff every 24 hours included: opioids, other analgesics, antiemetics, nausea, vomiting, retching, presence or absence of nasogastric tube, passage of flatus, bowel movement, fluid intake, solids intake, urination. Temperature was recorded every 4 hours for the first 2 days after surgery, and after that less often. The anxiety measures were repeated on Day 3 postsurgery, as well as self ratings and nurse ratings on physical and psychological recovery. Staff recorded length of postoperative hospital stay and reasons for any delay of discharge. Separate analyses were performed for patients receiving opioids via patient-controlled analgesia (52%) vs traditional administration (48%), but no differences were found for effects of therapeutic suggestions except on postoperative Day 8.
“The inability to detect beneficial effects of therapeutic suggestions probably was not due to insensitivity of the measures of recovery. These measures were sensitive enough to show numerous significant differences in recovery after different types of surgery” (p. 751). The authors supported their contention that the measures were sufficiently sensitive by demonstrating meaningful correlations among the measures themselves; and by demonstrating adequate statistical power for detecting the effects of theoretical interest–at least 1 day in postoperative hospital stay or one half day in fever.
Discussion: The authors note that a recent investigation that found positive results in a double-blind, randomized design with 39 hysterectomy patients (Evans & Richardson, 1988. Improved recovery and reduced postoperative stay after therapeutic suggestions during general anaesthesia. Lancet, 2:491-493) may not have controlled for variables such as presence of malignancy, physical status of patients before surgery, or ethnicity. Authors note that Evans and Richardson observed shorter periods of pyrexia despite there being no relevant suggestions, but no differences in pain intensity, nausea, vomiting, or urinary difficulties despite there being suggestions relating to those symptoms. There also were no differences in mood and anxiety test scores postoperatively for the experimental and control groups.
The authors note that McLintock, Aitken, Downie, & Kenny (Postoperative analgesic requirements in patients exposed to positive intraoperative suggestions. Br M J 301:788-790. 1990) reported a 23% reduction in opioids by patients receiving suggestions, but no reduction in pain, nausea, or vomiting. They contrast the present study with these earlier studies that had obtained positive results.
“We studied patients who had more than one type of surgery to obtain a large sample size and to assess the possibility that beneficial effects of therapeutic suggestions would be restricted to certain types of operations. Had this been the case, interactions of therapeutic suggestions with type of surgery would have been significant in the overall analyses, and follow-up analyses would have indicated that they were attributable to beneficial effects of therapeutic suggestions for certain surgeries. This did not occur. The two types of surgeries involving the largest numbers of patients seemed particularly promising for demonstrating beneficial effects. It has been reported that therapeutic suggestions presented during anesthesia are likely to be less successful with major and extensive surgery. Certainly, surgery on the fallopian tubes and gastric stapling did not involve a great deal of tissue trauma and blood loss. Patients were motivated to have the surgery and to recover quickly; particularly motivated were those having operations on the fallopian tubes, who were very eager to become pregnant, and those having vertical banding gastroplasties, who wanted desperately to lose weight” (pp. 753-754).
“In practice, we observed no beneficial effects of therapeutic suggestions, and there was no hint that anesthesia methods influenced the efficacy of the therapeutic suggestions. Interestingly, anesthetic methods also did not influence learning under anesthesia in the implicit memory tests we have used previously. Patients anesthetized with nitrous oxide and opioids did not differ from those anesthetized only with inhalational agents. In general, implicit or unconscious memory occurs in patients regardless of anesthesia methods or dosages of drugs” (p. 754).
“The few significant effects of therapeutic suggestions in our study did not point toward a beneficial influence of these suggestions. We found, in fact, an increased frequency of retching (but not nausea or vomiting) in the experimental group. The multiple variables examined in this study increased the likelihood of significant differences arising by chance, such that the null hypothesis was rejected when it should have been accepted. This is the way we interpret the effect on retching—i.e., as a type I error. We used in our therapeutic suggestions one negative or exclusionary sentence, ‘You won’t feel nauseous or have to vomit’, among several positive or affirmative statements, e.g., ‘You will enjoy eating, drinking…You will swallow to clear your throat and everything will go one way, straight down. . . The food will taste good….Your stomach will feel fine.’ We do not think that the negative sentence led to paradoxical results. Evans and Richardson (personal communication) used in their therapeutic suggestions a negative sentence (‘You will not feel sick’), which they repeated, yet the reported incidence of nausea and vomiting did not differ between the experimental and control groups” (p. 754).
when tape was being played). After the first 25% of cases, the team decided that lack of effect on therapeutic suggestions attributable to type of anesthesia did not warrant restriction to a single anesthetic method; also, multiple presentations of the suggestions on tape did not show an effect different from a single presentation.
After the patient regained consciousness and was reoriented, pain, nausea, retching, and vomiting were assessed every 30 minutes. Pain was rated orally on a scale from 1 to 10 in the recovery room, then on visual analogue scales every 2 hours on the day of surgery and the second day, and every 4 hours on subsequent hospital days during waking hours. Variables that were rated by staff every 24 hours included: opioids, other analgesics, antiemetics, nausea, vomiting, retching, presence or absence of nasogastric tube, passage of flatus, bowel movement, fluid intake, solids intake, urination. Temperature was recorded every 4 hours for the first 2 days after surgery, and after that less often. The anxiety measures were repeated on Day 3 postsurgery, as well as self ratings and nurse ratings on physical and psychological recovery. Staff recorded length of postoperative hospital stay and reasons for any delay of discharge. Separate analyses were performed for patients receiving opioids via patient-controlled analgesia (52%) vs traditional administration (48%), but no differences were found for effects of therapeutic suggestions except on postoperative Day 8.
“The inability to detect beneficial effects of therapeutic suggestions probably was not due to insensitivity of the measures of recovery. These measures were sensitive enough to show numerous significant differences in recovery after different types of surgery” (p. 751). The authors supported their contention that the measures were sufficiently sensitive by demonstrating meaningful correlations among the measures themselves; and by demonstrating adequate statistical power for detecting the effects of theoretical interest–at least 1 day in postoperative hospital stay or one half day in fever.
Discussion: The authors note that a recent investigation that found positive results in a double-blind, randomized design with 39 hysterectomy patients (Evans & Richardson, 1988. Improved recovery and reduced postoperative stay after therapeutic suggestions during general anaesthesia. Lancet, 2:491-493) may not have controlled for variables such as presence of malignancy, physical status of patients before surgery, or ethnicity. Authors note that Evans and Richardson observed shorter periods of pyrexia despite there being no relevant suggestions, but no differences in pain intensity, nausea, vomiting, or urinary difficulties despite there being suggestions relating to those symptoms. There also were no differences in mood and anxiety test scores postoperatively for the experimental and control groups.
The authors note that McLintock, Aitken, Downie, & Kenny (Postoperative analgesic requirements in patients exposed to positive intraoperative suggestions. Br M J 301:788-790. 1990) reported a 23% reduction in opioids by patients receiving suggestions, but no reduction in pain, nausea, or vomiting. They contrast the present study with these earlier studies that had obtained positive results.
“We studied patients who had more than one type of surgery to obtain a large sample size and to assess the possibility that beneficial effects of therapeutic suggestions would be restricted to certain types of operations. Had this been the case, interactions of therapeutic suggestions with type of surgery would have been significant in the overall analyses, and follow-up analyses would have indicated that they were attributable to beneficial effects of therapeutic suggestions for certain surgeries. This did not occur. The two types of surgeries involving the largest numbers of patients seemed particularly promising for demonstrating beneficial effects. It has been reported that therapeutic suggestions presented during anesthesia are likely to be less successful with major and extensive surgery. Certainly, surgery on the fallopian tubes and gastric stapling did not involve a great deal of tissue trauma and blood loss. Patients were motivated to have the surgery and to recover quickly; particularly motivated were those having operations on the fallopian tubes, who were very eager to become pregnant, and those having vertical banding gastroplasties, who wanted desperately to lose weight” (pp. 753-754).
“In practice, we observed no beneficial effects of therapeutic suggestions, and there was no hint that anesthesia methods influenced the efficacy of the therapeutic suggestions. Interestingly, anesthetic methods also did not influence learning under anesthesia in the implicit memory tests we have used previously. Patients anesthetized with nitrous oxide and opioids did not differ from those anesthetized only with inhalational agents. In general, implicit or unconscious memory occurs in patients regardless of anesthesia methods or dosages of drugs” (p. 754).
“The few significant effects of therapeutic suggestions in our study did not point toward a beneficial influence of these suggestions. We found, in fact, an increased frequency of retching (but not nausea or vomiting) in the experimental group. The multiple variables examined in this study increased the likelihood of significant differences arising by chance, such that the null hypothesis was rejected when it should have been accepted. This is the way we interpret the effect on retching—i.e., as a type I error. We used in our therapeutic suggestions one negative or exclusionary sentence, ‘You won’t feel nauseous or have to vomit’, among several positive or affirmative statements, e.g., ‘You will enjoy eating, drinking…You will swallow to clear your throat and everything will go one way, straight down. . . The food will taste good….Your stomach will feel fine.’ We do not think that the negative sentence led to paradoxical results. Evans and Richardson (personal communication) used in their therapeutic suggestions a negative sentence (‘You will not feel sick’), which they repeated, yet the reported incidence of nausea and vomiting did not differ between the experimental and control groups” (p. 754).
reported that therapeutic suggestions presented during anesthesia are likely to be less successful with major and extensive surgery. Certainly, surgery on the fallopian tubes and gastric stapling did not involve a great deal of tissue trauma and blood loss. Patients were motivated to have the surgery and to recover quickly; particularly motivated were those having operations on the fallopian tubes, who were very eager to become pregnant, and those having vertical banding gastroplasties, who wanted desperately to lose weight” (pp. 753-754).
“In practice, we observed no beneficial effects of therapeutic suggestions, and there was no hint that anesthesia methods influenced the efficacy of the therapeutic suggestions. Interestingly, anesthetic methods also did not influence learning under anesthesia in the implicit memory tests we have used previously. Patients anesthetized with nitrous oxide and opioids did not differ from those anesthetized only with inhalational agents. In general, implicit or unconscious memory occurs in patients regardless of anesthesia methods or dosages of drugs” (p. 754).
“The few significant effects of therapeutic suggestions in our study did not point toward a beneficial influence of these suggestions. We found, in fact, an increased frequency of retching (but not nausea or vomiting) in the experimental group. The multiple variables examined in this study increased the likelihood of significant differences arising by chance, such that the null hypothesis was rejected when it should have been accepted. This is the way we interpret the effect on retching—i.e., as a type I error. We used in our therapeutic suggestions one negative or exclusionary sentence, ‘You won’t feel nauseous or have to vomit’, among several positive or affirmative statements, e.g., ‘You will enjoy eating, drinking…You will swallow to clear your throat and everything will go one way, straight down. . . The food will taste good….Your stomach will feel fine.’ We do not think that the negative sentence led to paradoxical results. Evans and Richardson (personal communication) used in their therapeutic suggestions a negative sentence (‘You will not feel sick’), which they repeated, yet the reported incidence of nausea and vomiting did not differ between the experimental and control groups” (p. 754).
Bodden, Jack L. (1991). Accessing state-bound memories in the treatment of phobias: Two case studies. American Journal of Clinical Hypnosis, 34, 24-28.
Two cases of simple phobia demonstrate the inadequacies of both behavioral and psychodynamic theories. These cases and their treatment outcomes provide support for the state-dependent memory and learning theory. Hypnosis and ideomotor signaling proved to be not only effective treatments but also useful means of illuminating the role and nature of symptom function. Issues of symptom removal and substitution are also discussed in relation to these cases
The authors state that Rossi and Cheek (1988) summarize a number of experimental studies on animal memory that demonstrate that different information substances are involved in different learning situations. For example, ACTH and cortisol are involved in avoidance learning while angiotensin is involved in operant conditioning. In hypnosis, state dependent memory seems to be implicated. “Hilgard (1977) interpreted the state-dependent memory studies by Overton and others as entirely consistent with and supportive of his theory of hypnosis. Milton Erickson (1948) has also strongly suggested that it is the altered levels of arousal and affect that are responsible for the encoding and recall of stress-related problems with hypnosis” (p. 26).
“Affective experiences are apparently stored independently from their intellectual counterparts, or the emotional unit form one set may attach itself to a constellation of cues that make up a totally different cognitive set. Hypnosis may facilitate recall by providing relevant cues during an altered state of consciousness” (p. 27).
“In commenting upon [one of Erickson’s cases], Rossi (1986) states that Erickson was effective because he helped the patient access state-bound memories by reviewing the context and sensory-perceptual cues that surrounded their original acquisition” (p. 27).
“When traditional behavior therapy fails it may be because the original fear stimulus is state bound or unconscious. What is conscious to the patient are those stimuli that are similar in some important respect to the original phobic stimulus and are acquired by stimulus generalization. Desensitization may reduce the patient’s reactivity to the associated or acquired stimuli but cannot desensitize the original stimulus until it can be accessed consciously” (p. 27).
“The two main psychological explanations of phobic behavior are psychodynamic and behavioral. The psychodynamic approach is built upon the early writings of Freud (1956) on the traumatic basis of neurosis. Freud speculated that the intense anxiety (psychic pain) associated with the emotional trauma lead to dissociation, repression, and amnesia. Symptoms represented a dissociated or symbolic vestige of the repressed (‘forgotten’) trauma.
“Behavioral explanations (e.g., Rimm & Masters, 1974) are built upon classical and operant conditioning models of learning. Classical conditioning explains how a neutral stimulus (e.g., a bridge) can acquire reactivity and elicit a fear response. Avoidant behavior, which preserves the phobia, is acquired and maintained by operant conditioning. Treatment apparently involves gradual extinction of the fear response.
“These two divergent explanations have spawned quite different therapeutic approaches, with the behavioral approach (systematic desensitization) demonstrating greater empirical support for its effectiveness (Kaplan & Sadock, 1986). The problem is made complex theoretically by the fact that desensitization doesn’t always work, even when applied in a competent fashion” (p. 25).
“Freud’s early work on the traumatic basis of neurosis pointed to but offered an incorrect explanation of phobias whose origins were unconscious or state bound (i.e., not available to recall during the normal conscious state)” (p. 25).
totally different cognitive set. Hypnosis may facilitate recall by providing relevant cues during an altered state of consciousness” (p. 27).
“In commenting upon [one of Erickson’s cases], Rossi (1986) states that Erickson was effective because he helped the patient access state-bound memories by reviewing the context and sensory-perceptual cues that surrounded their original acquisition” (p. 27).
“When traditional behavior therapy fails it may be because the original fear stimulus is state bound or unconscious. What is conscious to the patient are those stimuli that are similar in some important respect to the original phobic stimulus and are acquired by stimulus generalization. Desensitization may reduce the patient’s reactivity to the associated or acquired stimuli but cannot desensitize the original stimulus until it can be accessed consciously” (p. 27).
“The two main psychological explanations of phobic behavior are psychodynamic and behavioral. The psychodynamic approach is built upon the early writings of Freud (1956) on the traumatic basis of neurosis. Freud speculated that the intense anxiety (psychic pain) associated with the emotional trauma lead to dissociation, repression, and amnesia. Symptoms represented a dissociated or symbolic vestige of the repressed (‘forgotten’) trauma.
“Behavioral explanations (e.g., Rimm & Masters, 1974) are built upon classical and operant conditioning models of learning. Classical conditioning explains how a neutral stimulus (e.g., a bridge) can acquire reactivity and elicit a fear response. Avoidant behavior, which preserves the phobia, is acquired and maintained by operant conditioning. Treatment apparently involves gradual extinction of the fear response.
“These two divergent explanations have spawned quite different therapeutic approaches, with the behavioral approach (systematic desensitization) demonstrating greater empirical support for its effectiveness (Kaplan & Sadock, 1986). The problem is made complex theoretically by the fact that desensitization doesn’t always work, even when applied in a competent fashion” (p. 25).
“Freud’s early work on the traumatic basis of neurosis pointed to but offered an incorrect explanation of phobias whose origins were unconscious or state bound (i.e., not available to recall during the normal conscious state)” (p. 25).
Bowers, Kenneth S. (1991). Dissociation in hypnosis and multiple personality disorder. International Journal of Clinical and Experimental Hypnosis, 39, 155-176.
The first part of this paper examines the concept of dissociation in the context of hypnosis. In particular, the neodissociative and social psychological models of hypnosis are compared. It is argued that the social psychological model, in describing hypnotic enactments as purposeful, does not adequately distinguish between behavior that is enacted “on purpose” and behavior that serves or achieves a purpose. 2 recent dissertations (Hughes, 1988; Miller, 1986) from the University of Waterloo are summarized, each of which supports the neodissociative view that hypnotic behavior can be purposeful (in the sense that the suggested state of affairs is achieved) and nonvolitional (in the sense that the suggested state of affairs is not achieved by high level executive initiative and ongoing effort). The second part of the paper employs a neodissociative view of hypnosis to help understand the current epidemic of multiple personality disorder (MPD). In particular, it is argued that many symptoms of MPD are implicitly suggested effects–particularly prone to occur in persons who have a lifelong tendency to use dissociative type defenses. The present author believes that this account is easier to sustain conceptually and empirically than the current view, which states that a secondary (tertiary, etc.) personality accounts for the striking phenomenological discontinuities experienced by MPD patients.
As an example of the fact that behavior that serves a purpose is not always performed on purpose, the author cites not falling out of bed while sleeping, and waking up in response to signals from the bladder to go to the bathroom. Lower levels of control can be dissociated from executive initiative and/or monitoring. “Since the experience of volition is closely tied to executive initiative and effort, suggested behaviors that bypass such initiative and effort are typically experienced as nonvolitional” (p. 157). Dissociated control occurs under waking conditions also, as when one dials a very familiar phone number rather than the one that they intended to dial. In this case, the behavior that is enacted is not what one consciously intended.
Miller’s dissertation, also published as Miller & Bowers, 1986, is described on p. 158 ff. Without hypnosis, cold pressor pain (cold water immersion) reduced accuracy of performance on a multiple choice vocabulary test 35%. Both hypnotic analgesia and cognitive pain management strategies were equally effective in reducing pain of cold pressor test (and both interventions were more effective for high than for low hypnotizable Ss). However, the cognitive strategy group showed an additional drop of 30% in vocabulary performance from pre- to posttreatment cold water immersion (despite successfully reducing their pain). In the hypnosis condition, lows showed only a slight additional decrease (8%) while highs showed a slight (10%) _increase_ in their vocabulary performance from pre- to posttreatment immersion.
Thus, the effect of hypnosis in pain control “does not depend on S’s utilization of high-level cognitive strategies. Rather, hypnotic analgesia seems to involve the dissociated control of pain–that is, control which is relatively free of the need for high- level, executive initiative and effort. … Because hypnotic analgesia minimizes the degree of executive initiative and ongoing effort required to reduce pain, however, it seems inappropriate to view such reductions as something achieved on purpose” (p. 161).
Hughes’ dissertation is described on p. 162 and ff. Instead of performance decrement on a cognitive task like vocabulary testing, she used increased heart rate as an index of cognitive effort. If heart rate increases when Ss successfully use hypnotic imagery, that would confirm the social psychological view that “suggested effects are achieved by this kind of ongoing allocation of high-level cognitive force or work” (p. 162).
Highs and lows were hypnotized and administered three trials of neutral and three trials of fearful imagery in counterbalanced order. Each imagery trial lasted 1 minute, after which Ss rated vividness of imagery, effort required, and amount of fear experienced.
Average imagery vividness was higher in highs than lows, for both neutral and fear imagery. For lows the correlation between heart rate increases and ratings of cognitive effort were .54 (neutral imagery) and .49 (fear imagery). For highs, the correlations were -.05 (neutral) and -.52 (fear). Thus, “for low but not high hypnotizable Ss, we find the predicted positive relationship between a cardiac indicator of cognitive effort and the ratings of cognitive effort involved in producing neutral imagery” (p. 163).
“First, for low hypnotizables engaged in fear imagery, ratings of effort are correlated .66 with ratings of fear. In other words, the more low hypnotizable Ss work to produce a fearful image, the more frightening the image is. Second, for high hypnotizables engaged in fear imagery, the correlation between ratings of fear and effort is minus 68– indicating that the less effort highs report in producing fear imagery, the more frightened they become. Finally, for high hypnotizables, the correlation between ratings of fear and heart rate increase is .59, indicating that the more fear high hypnotizable Ss experience when engaged in fear imagery, the more their heart rate increases (the comparable figure for low hypnotizables is .16)” (p. 164).
The authors discuss why the pattern of correlations is different for people high and low in measured hypnotizability, and summarize the implications of both Miller’s and Hughes’ research. Both investigations indicate that, at least for high hypnotizable people, less initiative and effort are required to effect a response to hypnotic suggestion than one would expect. The show how behavior can be both purposeful and nonvolitional (in the sense of not exhibiting conscious intention and strategic efforts). By noting that the sense of nonvolition that accompanies a response to suggestion is an actual alteration in executive control, they provide a model for dissociative psychopathology such as MPD. For although executive control is dissociated, these experiments do not suggest that there is a second executive system or ‘personality’ that is responsible for the behavior.
Patients diagnosed with MPD have very high measured hypnotizability (Bliss, 1984). In fact, they seem to engage in self hypnosis, withdrawing into a trance or a dissociated state (Bliss, 1984). The authors quote Wilson & Barber (1983) as indicating that highly hypnotized, fantasy-prone normal individuals may become so absorbed in a character being imagined that they lose awareness of their own identity.
The authors offer a neodissociative account of MPD: “People prone to MPD are very high in hypnotic ability and are, therefore, vulnerable to the suggestive impact of ideas, imaginings, and fantasies; what is more, they are high in hypnotic ability because they have learned to use dissociative defenses as a way of dealing with inescapable threat– such as physical and sexual abuse (Kluft, 1987). … Fantasied alternatives to reality (including a fantasied alter ego … ) can become increasingly complex and differentiated. Gradually, these fantasied alternatives begin to activate subsystems of control more or less directly–that is, with minimal involvement of executive level initiative and control. Such ‘dissociated control’ of behavior does not necessarily eliminate consciousness of it, though one’s actions are apt to be experienced as increasingly ego-alien. If and when the activating fantasies and resulting behaviors become sufficiently threatening, however, they can also be repressed into an unconscious (i.e., amnesic) status, thus further separating high-level executive and monitoring functions from the dissociated, ego-alien aspects of oneself. The fully realized result of this process is an individual who is subject to profound discontinuities in his or her sense of self. … The experience of behaving in an outwardly uncharacteristic manner requires only that subsystems of control are more or less directly activated by ideas and fantasies in a manner that effectively bypasses executive initiative and control” (pp. 168-169).
923, Bowers, 1992 NOTES: Tart allegedly taught ESP skills based on reinforcement, using a machine that projected display and gave feedback immediately, so the subjects could learn to anticipate the picture better. But the picture presented next was time-linked to the S’s response (so S could learn it).
1987 Behavioral and Brain Sciences review, with 2 target articles, makes one doubt strength of findings. ESP research doesn’t distinguish between description of an observation and it’s proposed cause.
MPD shares with ESP a tendency to predispose toward a certain explanation. Feeling like one has a separate personality leads to finding evidence for one. But an MPD account is wrong-headed because the diagnosis misconstrues a notion of personality, which is a developmental concept (a pattern of thought, feeling, and behavior). Mischel’s (1968) account of human functioning competed with trait theory, so “personality” concept became extraneous.
Defining personality in terms of one’s experiences or beliefs about oneself has lead to further problems, encouraged by the descriptive approach of DSM III (which depends on patient reports). Drew Weston distinguished between the self and self representation. One can’t argue that a computer programmed to describe itself is the same as it’s descriptions.
Personality can’t be reduced to person’s beliefs about themselves. A secondary personality cannot be reduced to bizarre experiences a person believes are due to a second personality. Clinicians do not accept as valid the beliefs of a paranoid schizophrenic; or of an anxious neurotic. With multiple personality disorder (MPD) the patient becomes the expert and the clinician the student.
William Smith’s 1986 SCEH paper: case study of patient who was convinced her problems were due to unresolved problems from a previous life. He didn’t challenge her system but still worked with her successfully, communicating respect without validating her belief.
Advocates of MPDs think the observation that it is associated with high hypnotizability indicates great dissociation; critics think the association indicates great suggestibility. There is a historical parallel: Mesmer probably didn’t suggest seizure-like episodes, but implicit suggestions for seizures were probably partially responsible. Mistaken attribution permitted Mesmer to see this as validation of his theory of animal magnetism.
Clinicians are not the only ones to “suggest” MPD syndrome. High profile cases are in the media. We should also remember Orne’s 1959 research showing that students who received false information a week earlier in lecture on hypnosis showed the behavior when they were hypnotized.
problems, encouraged by the descriptive approach of DSM III (which depends on patient reports). Drew Weston distinguished between the self and self representation. One can’t argue that a computer programmed to describe itself is the same as it’s descriptions.
Personality can’t be reduced to person’s beliefs about themselves. A secondary personality cannot be reduced to bizarre experiences a person believes are due to a second personality. Clinicians do not accept as valid the beliefs of a paranoid schizophrenic; or of an anxious neurotic. With multiple personality disorder (MPD) the patient becomes the expert and the clinician the student.
William Smith’s 1986 SCEH paper: case study of patient who was convinced her problems were due to unresolved problems from a previous life. He didn’t challenge her system but still worked with her successfully, communicating respect without validating her belief.
Advocates of MPDs think the observation that it is associated with high hypnotizability indicates great dissociation; critics think the association indicates great suggestibility. There is a historical parallel: Mesmer probably didn’t suggest seizure-like episodes, but implicit suggestions for seizures were probably partially responsible. Mistaken attribution permitted Mesmer to see this as validation of his theory of animal magnetism.
Clinicians are not the only ones to “suggest” MPD syndrome. High profile cases are in the media. We should also remember Orne’s 1959 research showing that students who received false information a week earlier in lecture on hypnosis showed the behavior when they were hypnotized.
Janet’s disaggregation (dissociation) theory said hysterics and hypnotized people responded to ideas dissociated from the main stream of consciousness. So his contemporaries thought that spontaneous amnesia was a defining feature of hypnosis; yet it is not thought to be so in our era. The idea may have circulated in Janet’s time, by popular culture.
MPDs are always highly suggestible so can respond to circulating accounts in the media, and every account that reaches the media can influence these people.
We could abandon the diagnosis of MPD in favor of Spiegel’s “disorder of self integration.” It is less provocative, does not imply any clinical benefit in the benefits of seeking out more personalities. This might reduce the incidence of this disorder, or likelihood that a suggestible person would develop the disorder iatrogenically.
Davidson, T. M.; Bowers, K. S. (1991). Selective hypnotic amnesia: Is it a successful attempt to forget or an unsuccessful attempt to remember. Journal of Abnormal Psychology, 100, 133-143.
Subjects in two experiments learned a 16-item, 4-category word list and were then administered hypnotic suggestions to be amnesic for all the words in one of the categories. Even when selective amnesia was completely successful, subjects in both experiments revealed a high level of recall for words not targeted for amnesia; moreover, these words were recalled in a highly organized, category-by-category fashion. Evidently, attention to relevant retrieval (i.e., organizational) cues does not oblige recall of words targeted for amnesia. Forgetting in the presence of such powerful mnemonic cues seems to characterize hypnotic amnesia and some spontaneous forms of forgetting as well.
Grabowski, Karen L.; Roese, Neal J.; Thomas, Michael R. (1991). The role of expectancy in hypnotic hypermnesia: A brief communication. International Journal of Clinical and Experimental Hypnosis, 39, 193-197.
Previous research has yielded equivocal evidence of hypnotic memory enhancement. This study assessed effects of expectancy and hypnotizability on recall for videotaped material under waking and hypnotic conditions. Ss (n – 138) were informed of hypnotic induction either before (expectancy condition) or after (no expectancy condition) watching a videotaped enactment of a crime and completing an initial waking recall test (R1). Both groups then underwent hypnotic induction, and completed the test again (R2). Ss’ raw recall scores were significantly greater under hypnotic than waking conditions, but this hypermnesia was not evident when scores were corrected for mere increase in rate of responding. Ss expecting later hypnosis scored significantly higher than Ss with no such expectations, but again, this different was not evident in corrected scores. Hypnotizability of Ss was, however, related to corrected recall, with high hypnotizability Ss displaying the greatest increase in rate of responding from R1 to R2. No evidence for the hypothesized “suppression effect” underlying hypnotic hypermnesia was found.
Thus Ss tended to answer more questions on R2 but most of this increase was error. Moreover, high hypnotizability Ss displayed this pattern to a far greater extent than other Ss, indicating that they were more likely than others to increase the no. of responses made between tests.
The finding of an interaction effect between hypnotizability and corrected recall suggests that hypnosis does play some role in the hypnotic hypermnesia described in the literature, possibly refuting the findings of several recent studies (e.g., Nogrady, McConkey, & Perry, 1986; Register & Kihlstrom, 1987). High hypnotizability Ss increased the number of responses made from R1 to R2 to a greater extent than other Ss. The lack of an interaction between hypnotizability and expectancy, however, fails to support the suggestion by Salzberg and DePiano (1980) that people of differing hypnotizabilities differ also in their susceptibility to demand biases.
As both Klazky and Erdelyi (1985) and Whitehouse et al. (1988) have noted, however, the use of hypnosis with witnesses of crimes may be useful if it can stimulate individuals to share uncertain recollections, perhaps providing otherwise unconsidered clues. The present data suggest that such guessing may also be increased by mere expectation of hypnosis. The value of forensic hypnosis may, therefore, be in part one similar to placebo: the simple notion of hypnosis placed in witnesses’ minds may be sufficient to inspire useful leads.
Hasher, L.; Stoltzfus, E. R.; Zacks, R. T.; Rypma, B. (1991). Age and inhibition. Journal of Experimental Psychology: Learning, Memory, and Cognition, 17 (1), 163-169.
Two experiments assess adult age differences in the extent of inhibition or negative priming generated in a selective-attention task. Younger adults consistently demonstrated negative priming effects; they were slower to name a letter on a current trial that had served as a distractor on the previous trial relative to one that had not occurred on the previous trial. Whether or not inhibition dissipated when the response to stimulus interval was lengthened from 500 ms in Experiment 1 to 1,200 ms in Experiment 2 depended upon whether young subjects were aware of the patterns across trial types. Older adults did not show inhibition at either interval. The age effects are interpreted within the Hasher-Zacks (1988) framework, which proposes inhibition as a central mechanism determining the contents of working memory and consequently influencing a wide array of cognitive functions.
Jansen, C. K.; Bonke, B.; Klein, J.; van Dasselaar, N.; Hop, W. C. J. (1991). Failure to demonstrate unconscious perception during balanced anaesthesia by postoperative motor response. Acta Anaesthesiologica Scandinavica, 35, 407-410.
Eighty patients undergoing a standardized balanced anaesthesia were randomly assigned to either a suggestion group (N = 38) or a control group (N = 42), in a double-blind design. Anaesthesia was maintained with nitrous oxide, enflurane and fentanyl. Patients in the suggestion group were played seaside sounds, interrupted by statements of the importance of touching the ear during a postoperative visit, by means of a prerecorded audiotape and headphones. Tapes containing these suggestions were played from 30 min after the first incision, for a duration of 15 min. Patients in the control group were only played seaside sounds. There were no significant differences between the groups in either the number of patients touching their ears postoperatively or the number and duration of ear touches.
This research follows upon other studies in which patients carried out postoperative motor responses while still being amnesia for the source of the suggestions for the action (e.g. Bennett, Davis, & Giannini, 1985; Goldmann, Shah, & Hebden, 1987). The earlier studies used widely varied anesthesia techniques, small sample sizes, and did not measure baselines for those responses or clearly delimit the amount of time for recording the responses postoperatively. This investigation was an attempt to improve on the research design of earlier investigations that had obtained positive results.
Patient assignment to groups was stratified over three levels of estimated intensity of pain stimulation during surgery (based on the type of surgery).
The outcome measure, number of ear touches and their duration, was made by the anesthetist and an observer during the first 10 minutes of the pre- and postoperative interviews. (The observer was blind for the patient group assignment.) 75 of the patients were interviewed on the first postoperative day, and the remainder on the second postoperative day. The interview included questions regarding recall of the intravenous administration of drugs and of events during surgery. The outcome data may be seen in the Table below.
Distribution of ear touches during the first 10 min of the preoperative interview and, after the intraoperative suggestion, during the first 10 min of the postoperative interview. ——————————————————————————————————-
No. of patients with Total no. of ear touches for Duration of ear touches
ear touches for all responders
——————————————————————————————- Grp N Pre Post Pre Post Pre Post —————————————————————————————————— S 38 2 3 2 9 62 155 C 42 5 3 8 4 38 23 ——————————————————————————————————
S = suggestion group C = control group
In discussing their results, the authors offer several reasons why they might not have obtained the same results as those of previous investigators. “First, our anaesthetic techniques were different from those used in the studies of Bennett et al., 1985, and Goldmann et al., 1987” (p. 408).
“A second reason for the discrepancy between our results and those of the other two studies could be that our suggestion was perhaps less meaningful to the patients undergoing surgery than the one used by our fellow researchers. It has been argued that recollection of perioperative events is influenced by the salience of the stimuli [Dubovsky & Trustman, 1976, Anesth Analg; Goldmann & Levey, 1986 (letter) Anaesthesia]. This salience depends largely on the content of the message. It may be that the requested response, i.e., to touch the ear, is one that in our culture, or environment, has insufficient emotional impact and is thus ignored. It is interesting to note in this context that the percentage of patients touching the ear postoperatively was significantly lower (Fisher’s exact test: P<0.01) in our study than in the study by Bennett et al., both for the suggestion group and the control group. On the other hand, recent findings showed robust effects with emotionally neutral stimuli [Jelicic, Bonke, & Appelboom, 1990, Lancet; Roorda- Hrdlickova, Wolters, Bonke, & Phaf, 1990, in Bonke, Fitch, Millar, Eds. Memory and awareness in anesthesia. Amsterdam: Swets & Zeitlinger]. Salience also depends on the timbre and strength of the requesting person's voice, the manner in which the response is requested and, possibly, many other subtle factors. We tried to increase the emotional impact of the message by adding reassuring phrases, as had been done in the previous studies. Furthermore, we had the message recorded by the anaesthetist who also conducted the pre- and post-operative interviews, assuming this would make the voice more familiar to the patient. During all interviews, as well as on the tape, the anaesthetist clearly introduced himself to the patient, mentioning his name a number of times. This was done to increase the possibility that the voice was 'recognized'" (p. 409).
408).
"A second reason for the discrepancy between our results and those of the other two studies could be that our suggestion was perhaps less meaningful to the patients undergoing surgery than the one used by our fellow researchers. It has been argued that recollection of perioperative events is influenced by the salience of the stimuli [Dubovsky & Trustman, 1976, Anesth Analg; Goldmann & Levey, 1986 (letter) Anaesthesia]. This salience depends largely on the content of the message. It may be that the requested response, i.e., to touch the ear, is one that in our culture, or environment, has insufficient emotional impact and is thus ignored. It is interesting to note in this context that the percentage of patients touching the ear postoperatively was significantly lower (Fisher's exact test: P<0.01) in our study than in the study by Bennett et al., both for the suggestion group and the control group. On the other hand, recent findings showed robust effects with emotionally neutral stimuli [Jelicic, Bonke, & Appelboom, 1990, Lancet; Roorda- Hrdlickova, Wolters, Bonke, & Phaf, 1990, in Bonke, Fitch, Millar, Eds. Memory and awareness in anesthesia. Amsterdam: Swets & Zeitlinger]. Salience also depends on the timbre and strength of the requesting person's voice, the manner in which the response is requested and, possibly, many other subtle factors. We tried to increase the emotional impact of the message by adding reassuring phrases, as had been done in the previous studies. Furthermore, we had the message recorded by the anaesthetist who also conducted the pre- and post-operative interviews, assuming this would make the voice more familiar to the patient. During all interviews, as well as on the tape, the anaesthetist clearly introduced himself to the patient, mentioning his name a number of times. This was done to increase the possibility that the voice was 'recognized'" (p. 409).
1990
Bonnano, George A. (1990). Remembering and psychotherapy. Psychotherapy, 27, 175-186.
Reviews some of the empirical literature demonstrating the reconstructive nature of memory. The notion that the memory trace can consist of different forms of information is integrated with J. S. Bruner's (see PA, Vol 38:6801) tripartite model of representation, using the concepts of narrative and memory schemata. A case illustration demonstrates the pervasive organizing quality of the nuclear script and how, through such a structure, childhood events can hold a lasting impact on adult behavior. It is concluded that conceptual understanding can be translated into schematic terminology provided it is adequately modified to account for the reconstructive nature of memory.
Evans, Frederick J. (1990). Behavioral responses during sleep. In Bootzin, Richard R.; Kihlstrom, John F.; Schacter, Daniel L. (Ed.), Sleep and Cognition (pp. 77-87). Washington, DC: American Psychological Association.
Subjects were 19 male student nurses who met a criterion of having EEG alpha density of at least 40% during an eyes closed, waking condition. They slept in the laboratory for two nights in succession, while being monitored by an EEG, and were told only that sleep cycles were being studied. Suggestions were presented while they were sleeping, e.g. "Whenever I say the word itch, your nose will feel itchy until you scratch it" "Whenever I say the word pillow, your pillow will feel uncomfortable until you move it." Then they were tested by Experimenter saying the cue word ("itch" or "pillow") during
the word pillow, your pillow will feel uncomfortable until you move it." Then they were tested by Experimenter saying the cue word ("itch" or "pillow") during subsequent REM periods later that night and again on the next night. (The suggestions were not repeated on the second night; but two new suggestions were given on the second night when possible.)
After the Subjects awakened in the morning, they were interviewed to test their memory for the events that had occurred, and also cue words were presented in the context of a word association test to assess memory indirectly by observing behavioral and physiological responses. A more detailed inquiry was made after the second night.
The results were as follows. Ss responded to a mean of 21% of cue words administered. Ss continued to demonstrate REM sleep for at least 30 seconds for 71% of all cues administered, indicating that they were not aroused by the cue. When a suggestion was successfully completed (i.e., without eliciting alpha activity) it was not repeated. However, the cue words were tested in several subsequent REM periods. Cue word testing occurred immediately (during the same REM period as the suggestion) on the same night, as well as in a later REM period, and during REM on Night 2 (after the suggestion had been given during Night 1).
Correct responses were given for 20% of immediate, 23% of delayed, and 23% of carry-over conditions. Ss did not remember the suggestion, verbal cues, or their responses when they awoke. Since Ss often responded to the cue the next night without repetition of the suggestion itself, the authors inferred amnesia rather than forgetting had occurred. Responses were not elicited by repeating the cue word in the waking state, but appeared to be specific to the sleep condition.
Six Ss returned five months later for a third night of testing. Four had shown carryover response on Night 2 to a Night 1 suggestion. When verbal cues were presented (without re-administering the suggestion) those 4 Ss responded, even though there was no intervening waking memory about the procedure or the suggestions. Some Ss responded even more frequently than during the original two nights; hypnotic depth did not seem to account for the increased responsivity. Experimenters attempted to reverse the amnesia observed during the waking condition by using hypnosis, age regression, and other hypnotic techniques, with some positive effect. The author speculates that perhaps the techniques originally used to probe morning recall were not sufficiently sensitive. He also raises the question of whether this waking state amnesia is related to the amnesia for night dreams when people awaken in the morning.
The relationship between hypnotizability and sleep suggestibility was analyzed. Hypnotizability was measured with the Harvard Group Scale, several weeks later, by Experimenters who were blind to the Ss' rate of responding to suggestions given during sleep. More hypnotizable Ss slept through the verbal stimuli more than low hypnotizable Ss; so they slept longer and more cues could be tested. Ss who responded most frequently to sleep-induced suggestions were more responsive to hypnosis. Analysis of response rate percentage (which controls for higher number of cues administered when Ss slept longer) showed that correlations between sleep suggestibility and hypnotizability were higher for percentage of delayed responses than for percentage of immediate responses.
Analysis by type of item on the hypnotizability scales suggested that the correlation with sleep suggestibility was due to the hallucinatory-reverie and the posthypnotic- dissociative clusters of hypnotic behavior, which are more difficult kinds of items. Correlations were significant for carry-over responses but not for immediate responses. These items represent phenomena experienced by Subjects who can be deeply hypnotized. The author reports that this relationship observed between hypnotizability and response to sleep-induced suggestions was not significant in a later study by Perry et al. (1978).
This author raises a question about why high hypnotizable subjects sleep better than low hypnotizables. The 6 Ss who were least susceptible accounted for 48% of all awakenings that occurred during the 2 experimental nights; the 6 Ss who were most hypnotizable accounted for only 26% of the awakenings (p<.01).
in a later study by Perry et al. (1978).
This author raises a question about why high hypnotizable subjects sleep better than low hypnotizables. The 6 Ss who were least susceptible accounted for 48% of all awakenings that occurred during the 2 experimental nights; the 6 Ss who were most hypnotizable accounted for only 26% of the awakenings (p<.01).