are over- exerting yourself.’ ‘Tell yourself that you will heal in exchange for something else, not so serious, to replace this disease and to serve the same function'” (pp. 123-124).
They present seven cases involving, respectively, allergies, rectal bleeding, systemic lupus, hyperemesis of pregnancy, adult onset asthma, chronic pain, and cluster headaches. Two cases were particularly interesting because they represented patients who did not respond initially.
Their procedure involves reframing the state or emotion originally associated with the onset of disease using considerations, and then giving a suggestion that it is within the power of the person, rather than factors outside, to heal the body. First they instruct the patient that the body can heal itself; then they give the list of suggestions for the patient to consider, persisting with different considerations until they get an ideomotor response. Incorporation of the patient’s psychodynamic issues appears to be very important.
The authors regard it as unimportant if the patient cannot by hypnotized; “As Cheek (Cheek & LeCron, 1968; Rossi & Cheek, 1988) points out, the patient’s inability to be hypnotized may be synonymous with his disease. It is actually beneficial if the patient cannot achieve ideomotor responses at first because both he and the therapist then trust the validity of the response when it does occur after the appropriate consideration” (p. 127).

Pekala, Ronald J. (1991). Hypnotic types: Evidence from a cluster analysis of phenomenal experience. Contemporary Hypnosis, 8, 95-104.

The phenomenological experiences of very-low and very-high, and low, medium and high susceptible individuals were cluster analyzed, attempting to determine if individuals of differing levels of hypnotic susceptibility report experiencing different types of phenomenological experience during hypnosis. Phenomenological experience was assessed by means of a self-report questionnaire called the Phenomenology of Consciousness Inventory (PCI); it allows for quantification of 12 dimensions of phenomenological experience. K-means cluster analysis yielded two relatively distinct clusters of individuals for both low/very-low and high/very-high susceptible individuals. These results suggest at least two types of very-low/low and very-high/high susceptible individuals as determined by their reported experiences during hypnosis.

The author notes that Sheehan and McConkey (1982) found three types of highs: concentrative, independent, and constructive. Spanos, Lush & Gwynn, 1989, found two groups of lows–one capable of learning hypnotic skills and the other less so.
In this study the author did two cluster analyses: (1) Harvard lows (0-1) and highs (11-12), and (2) all subjects divided into lows, mediums and highs, with cluster analyses performed _separately_ for these three groups.
In the first analysis, there were two groups of very low hypnotizable subjects distinguished on the basis of altered state of awareness and rationality; and two very high groups, distinguished on the basis of imagery and positive affect.
One group of very lows reported “little alteration in altered state and altered experience and almost complete volitional control, self-awareness, rationality and memory” (p. 98)

and were called ‘classic very lows’ because they were like refractory subjects in their self reports. The other group of very lows reported “moderate alterations in altered state and altered experience, and major decrements in volitional control, self- awareness, rationality and memory” (p. 98) and were called ‘pseudo very lows’ because their reports were a little like medium or high hypnotizables.
One group of very high hypnotizables had “great alterations in state of consciousness and moderate altered experiences; a loss of control, self awareness, rationality and memory; and little vivid imagery” (p. 98) and were called ‘classic very highs’ because their reported experience was like that of somnambules. The other type of highs were called ‘fantasy very highs’ because they had “moderate alteration in consciousness and experience, a great deal of vivid imagery, moderate positive affect, and only mild-to-moderate losses in rationality and memory” (p. 100).
When low, medium, and high susceptible subjects’ PCIs had separate cluster analyses, the lows had three clusters: classic, dialoging, and pseudo lows. The dialoging group was between the other two in their experiencing yet reported a great deal of internal dialogue. Among the highs, the same two clusters appeared as for the very highs.
Among the mediums there were two groups: high mediums who reported a significant drop in volitional control, self-awareness, rationality, memory, and internal dialogue, and an alteration in state of awareness; and low mediums who had milder changes.
Comparing results to Sheehan and McConkey (1982), the classic highs may correspond to their concentrative type and the fantasy highs to their independent type, because the latter generated imagery without a request to do so.
Regarding the pseudo-lows, “it is intriguing that there appear to be some individuals who make little response on the behaviorally oriented Harvard Scale, and yet report some phenomenological alterations. Are they individuals for whom hypnosis may be somewhat more effective even though they are not that hypnotizable (as measured by the ‘direct’ Harvard Scale) or could they be Spanos’s (Spanos et al., 1989) ‘trainable’ low susceptibles?” (p. 102).

Wagstaff, Graham F. (1991). Hypnosis and harmful and antisocial acts: Some theoretical and empirical issues. Contemporary Hypnosis, 8, 141-146.

The author analyses paper in same issue of this journal: Gibson, H. B. (1991). Can hypnosis compel people to commit harmful, immoral and criminal acts?: A review of the literature. He presents a critique from the point of view of “state” theorists, and concludes: “Where does this leave us? The area seems to be a potential minefield for any unsuspecting dissociationist. Personally, I think that both parsimony, and what empirical evidence there is, point to a non-state approach to this issue. However, despite the inevitable uncertainties and differences of opinion, there is perhaps a very obvious and important lesson to be gained by all from studies in this area. It has been fashionable to write off experimental studies on this topic on the grounds that subjects in these studies generally perceive the situation as ‘safe’; this is not only the case in hypnosis research but also in general social-psychological work on obedience (see, for example, Orne & Holland, 1968; Mixon, 1974). Some have questioned this assumption that subjects only obey the experimenter when they perceive the situation to be safe (see Barber, 1969; Milgram, 1974), but what often goes unnoticed is the significance of this assumption in itself. If labeling a situation as ‘hypnosis’, or even just an ‘experiment’, can make subjects think that any apparently harmful act they are requested to perform is safe, think of the implications; here, in itself, is a potentially powerful, even lethal, mechanism by which people in hypnotic contexts may be induced to perform harmful and antisocial acts. They perform them because, given the context, they think it is safe to do so! In the study of Orne and Evans the venomous snake the subjects were instructed to grasp was placed behind an ‘invisible’ glass screen, and the acid they were instructed to throw at the experimenter had been, allegedly unknown to them, replaced by a harmless liquid; one wonders, however, if writers would be so dismissive if the liquid that Orne and Evans’ subjects threw at the experimenter had actually burned him, or the snake that they picked up had actually killed them” (pp. 144-45).

induced to perform harmful and antisocial acts. They perform them because, given the context, they think it is safe to do so! In the study of Orne and Evans the venomous snake the subjects were instructed to grasp was placed behind an ‘invisible’ glass screen, and the acid they were instructed to throw at the experimenter had been, allegedly unknown to them, replaced by a harmless liquid; one wonders, however, if writers would be so dismissive if the liquid that Orne and Evans’ subjects threw at the experimenter had actually burned him, or the snake that they picked up had actually killed them” (pp. 144-45).

Bartis, Scott P.; Zamansky, Harold S. (1990). Cognitive strategies in hypnosis: Toward resolving the hypnotic conflict. International Journal of Clinical and Experimental Hypnosis, 38, 168-182.

Two experiments were carried out to assess the relative contributions of dissociation and absorption as cognitive strategies employed by high and low hypnotizability Ss in responding successfully to hypnotic suggestions. Of special interest was the manner in which Ss deal with conflicting information typically inherent in hypnotic suggestions. In the first experiment, Ss rated their attentional focus and the involuntariness of their experience after responding to a number of hypnotic suggestions administered in the usual manner. In the second experiment, the level of conflict was varied by instructing some Ss to imagine a circumstance that was congruent and other Ss to imagine a circumstance that was incongruent with the suggested behavioral response. The results of the 2 experiments were consistent in suggesting that, depending upon the nature of the hypnotic suggestion, high hypnotizability Ss are able to employ dissociation or absorption in order to respond successfully. Low hypnotizability Ss, on the other hand, seem to be relatively ineffective dissociators. When the structure of the hypnotic suggestion precludes the use of absorption, the performance of low hypnotizables deteriorates.

Coe, William C. (1990). Are the Conclusions Valid? Invited discussion of Levitt, Baker, and Fish: Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 237-239.

The authors confounded variables, e.g. hypnotic susceptibility and monetary incentive (in Study IV), and Study IV was different from the other 3 studies, so that any differences/similarities between these studies can’t be attributed to susceptibility level, degree of incentive, or interaction between them.
A simulator design would clarify why 50% of Ss in Study IV did not resist and lost $100; also, postexperimental interviews focusing on Ss’ reasons for resisting or not resisting would be helpful. Did nonresisters actually believe that they would receive $100 for resisting?
The Subject population was not homogeneous in occupation, and students are financially poorer than others–which would affect incentive strength. Were those who resisted the ones who could use the money the most?
Small sample sizes obviating statistical tests is a problem. Coe nevertheless evaluates 4 variables in terms of the ‘power’ of their effects on hypnosis: 1. Susceptibility level. Studies I, II, and III all show correlations between hypnotizability and compliance with resistance, suggesting that high hypnotizables are not as susceptible to resistance manipulation; however across studies, highs in one study seem to comply at the same rate as lows in another study, and as many as 50% of high hypnotizables in the strong incentive ($100) study were able to resist suggestions. 2. View of the Hypnotist. Coe states that

-gestions. 2. View of the Hypnotist. Coe states that one can’t evaluate the question with the data given. One would need an experimental condition that would also create a negative view of the hypnotist, as all samples tended to view the hypnotist positively. 3. View of Resistance Instructor. Again, one would need a research design that separates the effects of hypnotic susceptibility from effects of Ss’ views of the resistance instructor. “Nevertheless, Study IV suggests that for high susceptibles the view of the resistance instructor has little effect. Three resisters viewed him as positive, whereas the other three viewed him as negative; further, nearly all of the nonresisters viewed him as neutral” (p. 238). 4. Degree of Incentive. This too was confounded with susceptibility level, as “the higher value was only offered to the very high susceptibles in study IV. Half of them took it, half did not” (pp. 238-239).
Coe also remarks that “the expectational effects on subjects of being in an experiment have not been addressed adequately. It is possible that the experimental paradigm as currently presented is incapable of providing an unambiguous answer to the question of coercion. In naturalistic settings subjects may react quite differently than they do when they know they are participating in an experiment” (p. 239).

Dixon, Mike; Brunet, Alain; Laurence, Jean-Roch (1990). Hypnotizability and automaticity: Toward a parallel distributed processing model of hypnotic responding. Journal of Abnormal Psychology, 99, 336-343.

Tested a hypothesis from parallel distributed processing theory that highly hypnotizable Subjects have greater connection strengths along verbal pathways and would show greater Stroop effects than low hypnotizability Subjects. Using the paradigm from J. Cheesman and P. M. Merikle (see PA, Vol 76:3722) which varied cue visibility and probability, automatic and strategic effects on Stroop performance were assessed. Compared with 9 low and 9 moderately hypnotizable Subjects, 9 highly hypnotizable ones showed significantly greater Stroop effects for both visible- and degraded-word trials. No strategic differences emerged for the 3 hypnotizability groups. These findings support the contention that highly hypnotizable persons have stronger verbal connection strengths than their moderately and low susceptible counterparts, and they may account for highly hypnotizable persons’ propensity to disregard personal attributions and label their responses in hypnosis as being involuntary.

Holroyd, Jean (1990). How hypnosis may potentiate psychotherapy. In Fass, Margot L.; Brown, Daniel (Ed.), Creative mastery in hypnosis and hypnoanalysis (pp. 125-130). Hillsdale, NJ: Lawrence Erlbaum Associates

This chapter is a reprint of an article published in the American Journal of Clinical Hypnosis in 1987. It provides a conceptual framework for understanding psychotherapy processes in the context of a hypnotic state. Based on empirical and theoretical considerations, the author identified nine changes occurring with hypnosis: changes in attention and awareness, imagery, dissociation, reality orientation, suggestibility, mind-body interactions, initiative or volition, availability of affect, and relationship. “This chapter proposes that hypnotherapy exploits hypnotic phenomena– takes advantage of them–in the service of standard therapy endeavors” (p. 125).

Levitt, Eugene E.; Baker, Elgan L., Jr.; Fish, Ronald C. (1990). Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 225-236.

Five experimental approaches to the resolution of the century-old Bernheim/Janet dispute and the issue of involuntariness or coercion (the classical suggestion effect) are presented. Four experiments are reported that follow one of the approaches: attempts to induce hypnotic subjects to resist suggestions made in trance. The design is one in which a “resistance instructor” proposes a reward for the resisting subject. Tentative inferences from the results are that the classical suggestion effect is found with a small number of subjects; for a larger number of subjects there is no classical suggestion effect, and for many subjects the outcome is equivocal. Relational factors in the hypnotic dyad influence responsiveness in the subject, the effect being least for those whose susceptibility is high.

Study I. Used a $5 bribe, two suggestions, and Ss resisted average of 1.2 suggestions. 9 Ss resisted both, 5 resisted neither, and 6 (30% of Ss) resisted one test suggestion. Resistance appeared to be related to impression of the resistance instructor, suggesting that “neither the monetary bribe nor hypnotic responsiveness was as important to the resistance/compliance dimension as relational factors” (p. 228).
Study II. Used only one suggestion, obtained quantitative ratings of the two instructors, and offered $10 to resist one suggestion. 19/40 Ss (48%) resisted. The authors wondered whether the difference in impressions of hypnotist and resistance instructor might be due to very limited contact with the latter.
Study III. Ss were greeted by the resistance instructor, who accompanied Ss to the experimental room, discussed the information under ‘Establishing Rapport Prior to the Initial Induction’ in the SHSS:A and a condensed version of the introduction to the Eye Closure item (10 minutes). Then he left, the hypnotist entered and administered the same 9-item SHSS:A that had been employed in Studies I and II. The resistance instructor then entered and offered $10 if the S could successfully resist the hypnotist’s suggestion on the second try [of an item just passed successfully]. The hypnotist re-entered, repeated SHSS:A instructions for the selected item, brought S out of hypnosis, and then a different experimenter did a structured interview–to give impressions of the hypnotist and the resistance instructor on an Adjective Rating Form (ARF), to estimate depth of their trance on 0-8 scale before and after contact by the resistance instructor. Then S was paid if he/she had resisted. The resisters obtained a mean on the SHSS:A of 4.8 compared to 7.9 for the nonresisters, significant t-test for the difference (p<.01). Table 1 A Comparison of Interview Ratings of Hypnotists and Resistance Instructors in Two Studies Hypnotist* Resistance Instructors** Study N Pos Neutral Neg Pos Neutral Neg II 39 69% 31% 0% 5% 72% 23% III 30 63% 20% 17% 43% 27% 30% Chi square (2) = 7.71, p <.05 ** Chi square (2) = 24.3, p <.001 [N.B. Figures were rounded to nearest whole number by JH.] The correlation between hypnotizability on the SHSS and Resistance may be found in Table 2, along with the percentage of nonresisters in each of the four studies. Table 2 Correlation SHSS Percent Study N R-NR/SHSS Mean Nonresisters I 20 -.37* 7.1 40 II 40 -.44 6.2 52 III 30 -.54 5.8 33 IV 12 -- 8.8 50 6.2 52 III 30 -.54 5.8 33 IV 12 -- 8.8 50 * Not significant In Table 1 it may be seen that perceptions of the hypnotist and the resistance instructor changed from Study II to Study III. "In summary, the manipulation of time spent in the second experiment increased the proportion of resisters and dramatically improved the impression of the resistance instructor. Nevertheless, the evidence suggests that the hypnotist continued to be perceived positively and, according to our best measure, was still perceived more positively than the resistance instructor" (p. 232). Because they suspected that the impressions of the experimenters might be confounded by hypnotic susceptibility, and $10 might not be enough reward for behavior shaping, the experimenters designed Study IV. Study IV used 12 high hypnotizables (scoring 11 or 12 on Harvard Scale; with a group mean of 8.8 on a 9-item version of the SHSS:A). The same procedure as in Study II was carried out, except that four experimenters other than the authors were the hypnotists and resistance instructors; each experimenter worked with three subjects. The incentive was $100 to resist. The results of this procedure were that six Subjects resisted and six complied; each group scored 8.8 on the SHSS:A 9-item scale; resisters had 5.7 mean and nonresisters 5.1 mean depth (nonsignificant). Resisters and compliers were exactly alike in their perceptions of the hypnotist, but appeared different in perception of the resistance instructor (and the N was too small to test statistically). Table 3 Rated Impression of Hypnotist (%) Resisters Nonresisters Overall Study Pos Neut Neg Pos Neut Neg Pos Neut Neg II 68 32 0 76 24 0 73 28 0 III 55 25 20 80 10 10 63 20 17 IV 83 17 0 83 17 0 83 17 0 Table 4 Rated Impression of Resistance Instructor (%) Resisters Nonresisters Overall Study Pos Neut Neg Pos Neut Neg Pos Neut Neg II 11 79 11 0 67 33 5 73 23 III 45 30 25 40 20 40 43 27 30 IV 50 0 50 17 83 0 33 42 25 Table 5 Adjective Rating Form Means* Study Resisters Nonresisters Overall Resisters Nonresisters Overall II 46 38 42 65 74 68 III 54 40 50 61 63 62 IV 41 54 48 50 65 57 *Lower score is more favorable. Summary of the Four Studies: The data in Tables 2-5 reflect a critical finding. "There was a sharp drop in the number of Ss who did not resist, or it may be clearer to put it as a sharp increase in the number of resisters. The change is nearly 40%. "However, when only responsive subjects were used as in Study IV, the percentage of nonresisters is much the same as it was in Study II" (p. 233). The authors conclude that "relational factors are more important in hypnotic behavior among less responsive subjects" (p. 233). "The data contrasting resisters and nonresisters are somewhat confusing. There were more positive and negative impressions among subjects who resisted and more neutral impressions and no negative impressions among the nonresisters," (pp. 233-234) though the number of cases involved is quite small. Using the ratings, the nonresisters had a more favorable impression of the hypnotist than did the resisters, which is in accord with the interviewers' ratings. "A striking finding is that nonresister Ss in Study IV had a less favorable impression of both hypnotist and resistance instructor ... a clear reversal from Study III for the hypnotist, not quite so clear for the resistance instructor" (p.234). so clear for the resistance instructor" (p.234). Levitt, Baker, & Fish draw the following inferences: "1. Hypnotic influence is truly coercive for a very small number of what Register & Kihlstrom (1986) have called the 'hypnotic virtuoso,' the most responsive individuals; for them, the classical suggestion effect is a reality; 2. Hypnotic influence, though perhaps not truly coercive, is manifestly strong for a somewhat larger group of highly responsive individuals; the classical suggestion effect may exist for them; 3. For many individuals who behave in accordance with hypnotic suggestions, the classical suggestion effect does not exist; 4. Relational factors in the hypnotic dyad influence hypnotic responsiveness. The influence is strongest among individuals of low-to-moderate hypnotic responsiveness; 5. The more positive the impression of the hypnotist, the greater will be his influence on the hypnotized individual; 6. A subject's impression of a hypnotist will tend to be favorable even though the sole interaction between the two is the induction of the trance; 7. Preliminary efforts to build rapport with the subject will tend to improve the already positive impression created by the hypnotist" (pp. 234-235). Levitt, Eugene E.; Baker, Elgan L., Jr.; Fish, Ronald C. (1990). Some conditions of compliance and resistance among hypnotic subjects: A rejoinder to invited discussion of Levitt, Baker, and Fish: Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 246-249. "We cannot see how Lynn can allege that in three of the studies there was no relationship between resistance-nonresistance and perception of the hypnotist. The appropriate correlation coefficients are reported in Studies II and III. "Coe's point about the confounding of incentive and susceptibility might be valid if we had no prior knowledge of the relationship between resistance and susceptibility. But we already knew that the most susceptible Ss were likely to be the nonresisters. In Study IV, we abandoned susceptibility as an independent variable and made it a sample descriptor. ... [However] we resonate to Coe's suggestion of simulators" (p. 247). "In our first three studies, we reported no relationship between occupation and resistance, an admittedly crude but unobtrusive approach to the question of whether the most financially needy subjects were the resisters. We usually compared the students in the sample with the employed subjects. We did not report this lack of relationship in Study IV in which only three subjects were students. Two resisted, one did not. We must accept responsibility for provoking Coe's question about the credibility of the financial incentive in Study IV, by poor reporting. In a postexperimental inquiry, one subject (a resister) was mildly suspicious of the offer. All other Ss found the resistance instructor credible" (pp. 247-248). "Our own more recent research suggests that offering undergraduate students additional points toward the final class grade can yield more resisters than the money incentive in Study IV (Levitt, Baker, Hacker, Klion, Krause, Lytle, & Vanderwater- Piercy, 1990 in press)" (p. 248). "We have suggested that the hypnotic phenomenon is apparently experienced differently among subjects, and the critical factors are thus also likely to vary from subject to subject. We would be quite willing to accept Bernheim's estimate that 17% are incapable of resisting hypnotic suggestions, as cited by Weitzenhoffer. We agree with Spiegel that the issue of the coercive potential of hypnosis is 'not really settled by mean differences across groups.' Measures of central tendency are apt to obscure the minority of Ss who may experience coercion in experiments with designs different from ours" (p. 248). [The study referred to above is Levitt, E. E., Baker, E. L., Hacker, T., Klion, R., Krause, A. A., Lytle, R., & Vanderwater-Piercy, J. (1990 in press). Compliance and resistance in the hypnotic state: the effect of a social or an academic countermotivation. In R. van Dyck, P. Spinhoven, . J. W. van der Does, Y. R. van Rood, & W. De Moor (Eds.), _Hypnosis: Current theory, research, and practice._ Amsterdam: Free University Press.] Lynn, Steven Jay (1990). Is hypnotic influence coercive? Invited discussion of Levitt, Baker, and Fish: Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 239-241. Unlike Levitt, Baker, & Fish (1990), Lynn, Rhue, & Weekes (Psychological Review, 1990 in press) concluded that nonvoluntary behaviors in hypnosis are similar to other spontaneous social behaviors (like conversational response to social stimuli). "Hypnotized subjects, like nonhypnotized subjects, act in terms of their aims, according to their point of view, and in relation to their interpretation of appropriate behavior and feelings" (p. 239). "Research shows that hypnotizable subjects resist and even oppose suggestions as a function of their expectancies and perceptions about appropriate hypnotic behavior (Lynn, Nash, Rhue, Frauman, & Sweeney, 1984; Lynn, Snodgrass, Rhue, & Hardaway, 1987; Lynn, Weekes, Snodgrass, Abrams, Weiss, & Rhue, 1986; Spanos, Cobb, & Gorassini, 1985). In one study (Spanos et al., 1985), when subjects were informed that deeply hypnotized subjects were capable of becoming involved in suggestions and simultaneously resisting them, subjects resisted 95% of the suggestions. When subjects were told that deeply hypnotized subjects were incapable of resisting suggestions, they passed the majority of suggestions. Thus, knowledge about what constitutes appropriate hypnotic role behavior is a reliable determinant of resistance, apparently more reliable than the monetary lures used by Levitt et al." (P. 240). These studies by Levitt et al. only used behavioral measures of resistance and hypnotizability, and Ss' perceptions of the resistance instructor and hypnotist. "The ratings of global perceptions are, however, no substitute for measures of subjects' perception of the _relationship_. ... The failure to measure important variables relevant to the central dimensions of concern--coercion, compliance, involuntariness, and relational factors--precludes meaningful interpretation of the nonresisters' motivation and behavior" (p. 240). As Orne (1959) has suggested, we should not attribute behavior in the hypnosis context to something unique to hypnosis (such as coercive influence), because other kinds of social context also constrain behavior, e.g. psychotherapy and psychology experiments, with coercive features. Therefore, it seems important in the future to compare the responses of hypnotized subjects with those of subjects in waking-imagination and hypnosis-simulating conditions. In addition to looking at their behavior, it is important to examine their own perceptions of their actions, given the complexity of the social situation entailed in hypnosis. "Finally, there are statistical grounds to be wary of the authors' conclusions. They assert that 'relational factors in the hypnotic dyad influence hypnotic responsiveness,' yet in three of the studies (I, II, and IV), subjects' ratings of the hypnotist failed to discriminate whether they resisted or responded to the suggestion" (p. 241). Even where Study III was compared with Study II, the difference in the percentage of Ss who resisted failed to reach statistical significance. "In fact, across all studies, differences in overall resistance rates were not documented by statistical tests--despite procedural variations and differing monetary incentives. So contrary to authors' assertion, relational factors _in the hypnotic dyad_ generally had little bearing on resistance behavior. If anything, ratings of the resistance instructor had greater weight" (p. 241). Pekala, Ronald J.; Forbes, Elizabeth J. (1990, Spring). Subjective effects of several stress management strategies: With reference to attention. Behavioural Medicine, 39-43. This study assessed variations in reported attentional experience associated with several stress management techniques (hypnosis, progressive relaxation, deep abdominal breathing) and baseline (eyes closed) as a function of hypnotic susceptibility. Three hundred nursing students experienced the stress management conditions and afterward completed a self-report inventory, the Dimensions of Attention Questionnaire (DAQ), in reference to each condition. The DAQ quantifies 12 aspects of attentional experience in a reliable and valid manner. The results demonstrated that progressive relaxation, hypnosis, and deep abdominal breathing are characterized by differences in reported attentional experience that are further moderated by an individual's hypnotic susceptibility. The clinical implications of these results are discussed. "Significant main effects were found for conditions for perspicacity, absorption, and control, with progressive relaxation associated with increased perspicacity and absorption, but with decreased control vis-a-vis hypnosis. "Significant main effects for groups were found for perspicacity, locus, direction of attention, absorption, control, and vigilance. ... [Post-hoc comparisons] revealed that high susceptibles (vis-a-vis low susceptibles) reported increased perspicacity, absorption, a more inward-focused attention, more feelings of being out of their bodies, and decreased control and vigilance. High-mediums were also different from lows (in the same direction) for all of the above comparisons except for direction of attention. Low-mediums, along with lows, were different from highs for absorption and control. "Significant interactions between conditions and groups were found for absorption, control, and vigilance. Whereas low susceptibles reported significantly increased absorption but significantly decreased control and vigilance during progressive relaxation than during hypnosis, high susceptibles reported no significant differences between relaxation and hypnosis for absorption, control, or vigilance" (p. 41). The authors describe the differences found for deep abdominal breathing on p. 41. "The interaction effects suggest that the experience of hypnosis and progressive relaxation are moderated by a person's hypnotic susceptibility--low susceptibles experience significantly greater absorption, but decreased control and vigilance during progressive relaxation than during hypnosis, although there are no such differences for high susceptibles. This suggests that progressive relaxation may be a 'better' procedure than hypnosis to use with low susceptibles, at least if one wants to increase absorption and decrease vigilance and control" (p. 42). The authors also note that "deep abdominal breathing is associated with increased 'calmness of mind,' in reference to a baseline condition, as demonstrated by increased attentional detachment and equanimity, and decreased vigilance and density (the 'amount' of thoughts going through one's mind)" (p. 42). Perry, Campbell (1990). Coercion by hypnosis? Invited discussion of Levitt, Baker, and Fish: Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 242-243. "A postexperimental inquiry (following Orne, 1959) might have informed the reader of the degree to which operationalization of the coercion in terms of disobedience was successful. Without this additional step, it is difficult to determine whether what was found in the laboratory by these investigators applies to what has been reported in clinical and field settings for almost 200 years" (p. 242). "In particular, elsewhere, the authors equate coercion with involuntariness and appear to view involition as a euphemism for coercion. While I agree that perceiving involition of one's own behavior may contribute to the commission of unconsenting acts in hypnosis, the two are easily distinguished at the conceptual level. Laboratory subjects ordinarily report much behavior in hypnosis that is experienced involuntarily, without the issue of it being coerced ever being broached" (p. 242). Author describes cases in which patients claimed they participated in sex with hypnotist against their wills because they were hypnotized. "What may be happening in both of these reports is that the hypnotized subjects found themselves responding involuntarily; from this, they appear to have adduced that they could not resist the hypnotist's suggestion. That is, they were coerced not by hypnosis but by their belief, which was a direct function of the experience of involuntariness, that they could not resist" (p. 243). "In short, if a hypnotized person equates involuntary behavior with powerlessness, "coercion" may occur in this limited sense. Conceptually, this appears to be a far cry from equating involition with coercion" (p. 243). Spiegel, David (1990). Theoretical and empirical resistance to hypnotic compliance. Invited discussion of Levitt, Baker, and Fish: Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 243-245. Does hypnosis bypass the will, facilitate coercion? The hardest thing for trauma victims to do is to admit helplessness. Furthermore, it is interesting that these same dissociative phenomena seem to be elicited by traumatic experience, the stark imposition of involuntariness (Stutman & Bliss, 1985; Spiegel, Hunt, & Dondershine, 1988). What, then, are we to make of experiments that purport to show that hypnotizable and hypnotized individuals comply with hypnotic instructions irrationally? At some level this challenges our comfortable belief that we always act in our enlightened self-interest, unaffected by unwanted influence. If that can happen even once, our pride of self- ownership is reduced. Taken as a whole, the studies show that high hypnotizables comply with hypnotic instructions, even in the face of resistance instructions, whereas low hypnotizables are less likely to, especially when conditions foster a relatively less negative view of the resistance instructor. As the authors note, subjects always viewed the hypnotist more positively than the resistance instructor, which in itself suggests the nonrational influence intrinsic to hypnosis. Free will is not abrogated, it is simply not exercised. The Ss are fundamentally choosing whether or not to comply. Half of the highs in Study IV resisted the hypnotic instruction. However, hypnotized individuals tend to narrow the focus of attention, thereby reducing their ability to consider alternatives such as the resistance instruction. William James (1890) believed that all ideas were invitations to action. Why, then, do we not act on every idea we have, he pondered on a snowy morning while lying in bed. He observed that he would try to get himself to arise by picturing himself doing so. "Why, then, am I still in bed?" He realized that he was editing the primary idea, reflecting on how cold it was, how long it would take to light a fire, and how much time he had until his classes. In a state characterized by a narrowing of the focus of attention, we are less likely to edit the primary idea, and therefore more likely to act. In the experiments presented, the resistance instructor attempts to act as an external editor on the primary hypnotic instruction. Those capable of focusing attention sufficiently disattend to the editing and comply. These studies show that, thankfully, hypnosis is less than automatic submission to instruction but, interestingly, more than simple conscious response to new information. Weekes, John R.; Lynn, Steven Jay (1990). Hypnotic suggestion type, and subjective experience - the order-effects hypothesis revisited: A brief communication. International Journal of Clinical and Experimental Hypnosis, 38, 95-100 In a replication and extension of Field, Evans, and Orne's (1965) research, no support was found for the hypothesis that suggestion order is related to hypnotic responding. Confirming earlier findings, subjects were no more responsive to suggestions ordered from easy-to-difficult than they were to suggestions ordered from difficult-to- easy. Measures of subjective involvement in suggestions, involuntariness, and archaic involvement with the hypnotist were no more sensitive to order effects, nor were order effects more apparent with subjects who received direct versus indirect suggestions. Confirming earlier research, direct suggestions did facilitate suggestion-related involuntariness and response to the hypnotic amnesia item after cancellation, whereas indirect suggestions enhanced fears of negative appraisal by the hypnotist. Thus, authoritative suggestions enhance responding to a cognitive-delusional item relative to more permissive suggestions. Finally, female subjects were more involved in suggestions than were males, particularly in response to more difficult tests items. Weitzenhoffer, Andre M. (1990). Are induced automatisms necessarily coercive? Invited discussion of Levitt, Baker, and Fish: Some conditions of compliance and resistance among hypnotic subjects. American Journal of Clinical Hypnosis, 32 (4), 245-246. "For the sake of maintaining historical accuracy, I would like first to remark that the ability of hypnotized Ss to resist suggestions was probably never a central issue in the Nancy-Salpetriere controversy. The main quarrel was about other fundamental matters (Crocq, 1900; Barrucand, 1967). It also needs to be said that Pierre Janet should not be seen as representing the Salpetriere in the above controversy. Very little of his extensive writings reflect the ideas of Charcot with whom he was associated for only 4 years (1889- 1893) (Barrucand, 1967; Ellenberger, 1970). Lastly, let it be noted that the association of automatism with hypnotic behavior antedates Bernheim. Despine wrote about it at length as early as 1868, and Charcot (1882) clearly stated before Bernheim that automatic responses to suggestions were characteristic of induced somnambulism. This was at least one view they shared. Referring to the material quoted from my 1978 paper, the authors assert Bernheim's definition of automatism implies a subject responding to a suggestion qua suggestion is "unable to resist" it. But all the definition says is that the will does not directly enter into the production of automatisms. It does not say the will cannot effectively intrude at some point or other. This definition, quoted out of context, was part of a more extensive discussion of _what the nature_ of an automatism was for Bernheim. The discussion also went into details regarding _the conditions_ under which Bernheim understood automatisms can occur and hold sway. In this greater context, Bernheim (1888a, 1888b) viewed the occurrence of automatisms as normally subject to control by the ego processes responsible for volitional activities. He saw the degree to which a person's behavior can be controlled by automatisms initiated by suggestions to be a function of the extent to which certain ego processes become inactive, ineffective, or cooperatively permit the automatisms to occur. Bernheim recognized that both cognitive and relational factors played an important part in the latter case. Bernheim (1888a, 1888b) also stated that data he had collected showed subjects _could_ resist suggestions to varying degrees, with only 17%, who made up the class of somnambules, being _totally incapable_ of resisting" (pp. 245-246). "Stating the matter more concretely, I doubt many people would speak of an individual having been 'coerced' into producing a knee-jerk reflex under appropriate stimulation. Should the situation be any different in the case of other reflexes and, more particularly, the reflex ideodynamic action presumed to underlay suggested acts (Weitzenhoffer 1978, 1989)? I do not think so. It seems to me that what the authors have really and directly examined in their article is the extent to which the classical suggestion effect can be countered by conscious, voluntary control" (p. 246). 1989 Baker, Elgan L.; Levitt, Eugene E. (1989). The hypnotic relationship: An investigation of compliance and resistance. International Journal of Clinical and Experimental Hypnosis, 37, 145-153. The purpose of this investigation was to assess the ability of hypnotic Ss to voluntarily resist a neutral suggestion when a monetary reward was offered for resistance. 19 of 40 Ss (47.5%) successfully resisted after money was offered by the "resistance instructor." The correlation between resistance/compliance and hypnotizability was -.44 (high hypnotizables were more likely to comply). Ss' impressions of the hypnotist tended to be positive; impressions of the resistance instructor tended to be neutral. There was a tendency for nonresistors to have a more positive view of the hypnotist but it is not as marked as was found in an earlier study (Levitt & Baker, 1983). Twelve (75%) of the high hypnotizables did not resist; two (16.7%) of the low hypnotizable Ss did not resist. In their discussion, they state that "these data support the conclusion that hypnotizability or talent accounts for a significant portion of the variance in determining compliance with suggestions during trance. ... [Further], this research may be conceptualized as examining the contributions of a trait variable (hypnotizability) as compared with a variety of situational or state variables (motivation, social perception, environmental contingencies) in determining compliance and suggestibility. Inherent in this model of research is the assumption that many observed hypnotic phenomena (such as suggestibility) are interactive in nature, representing the outcome of the interplay between trait and state variables and between historically determined and contemporary forces. Such a perspective is consistent with the emerging view of trance behavior and experience and validly parallels the phenomenology of experimental and clinical hypnosis which describe both consistency and variability in hypnotic responsiveness for a specific subject or patient across varying conditions and time" (p. 151). -temporary forces. Such a perspective is consistent with the emerging view of trance behavior and experience and validly parallels the phenomenology of experimental and clinical hypnosis which describe both consistency and variability in hypnotic responsiveness for a specific subject or patient across varying conditions and time" (p. 151). "This study also serves to clarify the important role of positive social perception and a positive sense of alliance with the hypnotist as a correlate of compliance with suggestion. It is clear that Ss who complied despite inducements to resist reported a more positive perception of the hypnotist and a more gratifying sense of relatedness with him than did their counterparts who resisted in response to financial inducement. These data do not indicate whether the positive perceptions contributed to compliance, as transference theories of trance involvement would predict, or whether they were consolidated after the fact due to other variables such as management of potential cognitive dissonance. It does seem reasonable to conclude, however, that the relationship is influential in the process of suggestibility and compliance" (p. 151). Lynn, Steven J.; Rhue, Judith W.; Weekes, John R. (1989). Hypnosis and experienced nonvolition: A social-cognitive integrative model. In Spanos, N.P.; Chaves, J.F. (Ed.), Hypnosis: The cognitive-behavioral perspective (pp. 78-109). Buffalo, NY: Prometheus. The authors present a model to account for the subjective experience of nonvolition. The model rests on four observations: (1) nonvoluntary responses "have all of the properties of behavior that is typically defined as voluntary" (p. 108); (2) "hypnotizable subjects can resist suggestions when resistance is defined as consistent with the role of a 'good' hypnotized subject" (p. 108); (3) "Hypnotic behaviors are neither reflexive/automatic ... nor manifestations of innate stimulus-response connections" (p. 108); (4) "Hypnotic performances consume attentional resources ... in a manner comparable to nonhypnotic performances" (p. 108). They continue, "At the same time, many of the cognitive operations and affective reactions that accompany hypnotic responding are not readily accessible to consciousness" (pp. 108-109). Meyer, H. K.; Diehl, B. J.; Ulrich, P. T.; Meinig, G. (1989). Changes in regional cortical blood flow in hypnosis. Zeitschrift fur Psychosomatische Medizin und Psychoanalyse, 35, 48-58. Regional cerebral blood flow (rCBF) was measured by means of the 133-Xenon inhalation method in 12 healthy male volunteers who had several months of experience in doing self-hypnosis (autogenic training). During hypnotically suggested right arm levitation, as compared to resting conditions, they found an increase in cortical blood flow and an activation of temporal areas; the latter finding was considered to reflect acoustical attention. In addition, a so-far-unexplained deactivation of inferior temporal areas was observed during successful self hypnosis and hypnosis. While there was a global absolute increase of cortical blood flow bilaterally, they could not observe a relative increase of the right as compared to the left hemisphere during hypnosis. Several subjects successfully performed the levitation of the right arm, despite a relative left hemispheric activation, provided the absolute right hemispheric activation remained dominant. Pekala, Ronald J.; Bieber, Stephen L. (1989-90). Operationalizing pattern approaches to consciousness: An analysis of phenomenological patterns of consciousness among individuals of differing susceptibility. Imagination, Cognition and Personality, 9 (4), 303-320. Pattern differences in subjective experience, as assessed by a self-report inventory, the Phenomenology of Consciousness Inventory (PCI), were compared across low, low-medium, high-medium, and high hypnotically susceptible individuals during hypnosis and eyes-closed. A hierarchical factor analytic approach was utilized that allowed for the determination of pattern differences among PCI dimensions as a function of hypnotic susceptibility. The factor analyses found that the four suspectibility (sic) groups were 'pattern equivalent' during eyes-closed, partially pattern dissimilar during hypnosis, and partially pattern dissimilar when comparing hypnosis against eyes-closed. The nature of these results support previous analyses (1) which compared pattern structure differences as a function of correlational matrices. The results suggest the complementarity of Bieber's (2) and Pekala's (3) approaches for assessing pattern differences in consciousness and are congruent with the theorizing of Tart (4), Izard (5), and the PDP researchers on the importance of pattern structure changes in understanding states of consciousness. Pekala, Ronald J.; Kumar, V. K. (1989). Phenomenological patterns of consciousness during hypnosis: Relevance to cognition and individual differences. Australian Journal of Clinical and Experimental Hypnosis, 17 (1), 1-20. Relationships among phenomenological subsystems of consciousness associated with a baseline condition and an hypnotic induction condition were compared across individuals of differing hypnotic susceptibility. Phenomenological experience on 12 subsystems of consciousness was quantified by means of the Phenomenology of Consciousness Inventory (PCI) and the relationships between dimensions were statistically assessed. The results replicated previous findings and suggested that hypnosis has differential effects upon the reported organization of phenomenological structures of consciousness across subjects of differing susceptibility. The data from the previous and present studies were pooled and the combined data were reanalyzed. The results provided further support for the differential pattern structure across low and high susceptibles during hypnosis. Furthermore, differences in pattern structure were augmented when comparing very low versus very high susceptible individuals. Ronnestad, Michael Helge (1989). Hypnosis and autonomy: A moderator analysis. International Journal of Clinical and Experimental Hypnosis, 37, 154-168. The study focused on autonomy as a moderator variable in the prediction of subjectively reported hypnotic depth. Ss in the experimental part of the study were 56 undergraduate psychology and education majors classified as either high or low in autonomy. Ss who were equated on capacity for absorption were individually administered 1 of 3 hypnotic inductions: an authoritarian induction, a permissive hetero- induction, or a self-hypnosis induction. The study had a double-blind design. The data suggest that situational manipulation has greater impact on low than on high autonomy Ss. Individual-difference variables such as absorption, have greater impact on hypnotic depth for high than for low autonomy Ss. The data indicate that the hypnotic behavior of high autonomy Ss is more likely to be self-congruent and less likely to be demand-congruent. A factor-analytic inquiry of absorption confirmed the importance of affective/regressive capacity for hypnotic functioning for high autonomy Ss. The study supported the alternate-path perspective of hypnosis. There is very little research on autonomy and hypnosis. The authors cite studies showing only a modest relationship between hypnotizability and locus of control. In this study, 176 students were assigned to the high autonomy group if they were in the upper 1/3 of two of 3 autonomy scales (Rotter's Locus of Control Scale, the Inner- Directedness Subscale of the Shostrom Personal Orientation Inventory, and the Autonomy subscale of Jackson's Personality Research Form) and not in the lower 1/3 of the third scale. Ss were designated as low autonomy if the obverse obtained. This procedure yielded 27 high and 29 low autonomy Ss. Ss were hypnotized with one of three inductions: authoritarian with many motor items (Barber Suggestibility Scale), permissive with mostly imagery (Barber & Wilson's Creative Imagination Scale), or guided self-hypnosis with mostly imagery (taken from Fromm et al, 1981). After hypnosis, Ss rated their own hypnotic depth on a 1-10 scale, and their perception of E or the procedure as authoritarian and directive. Ss' attitude, expectations, motivation, and experienced effortlessness were measured. E rated Ss for pre-hypnosis rapport and post-hypnosis rapport. The results indicated that there was no difference in hypnotizability level between high and low autonomy Ss. The correlation between effortlessness of experience and hypnotic depth was high for low autonomy Ss (.51) but not significant for high autonomy Ss (.12). In general the two groups were very similar in terms of mean scores on most variables. The differences appeared in the correlations between self-reported hypnotic depth and the other variables. For low autonomy Ss correlations were not significant between depth and pre-hypnotic variables (rapport-pre, absorption, expectation) but for highs the same correlations were significant (rapport-pre .47, absorption .54, expectation .48). But for post-hypnosis variables, low autonomy Ss had significant correlations between depth and the two variables measured from post-hypnosis interviews (perceived authoritarian/directiveness .40, effortlessness .51) and the highs did not have significant correlations. The multiple correlation between these variables and depth was R = .28 for low autonomy Ss (with no contribution from rapport-pre) and R = .72 for high autonomy Ss, with absorption contributing most. The more they perceived the induction as authoritarian or directive, the greater depth reported by low autonomy Ss. Although low and high absorption Ss did not differ on the Absorption Scale, absorption predicted hypnotic depth better for the highs. The author divided the Absorption Scale into four rational factors: Affective/Regressive, Perceptual/Cognitive, Dissociative, and Mystical. Low and high autonomy Ss scored at approximately the same level on these categories, but correlations between these categories and depth for low and high autonomy Ss were somewhat different. (See Table.) Correlations between Categories of Absorption and Hypnotic Depth for Low and High Autonomy Ss Absorption Low Autonomy High Autonomy All Ss Category r r r Affective/Regressive .14 .56** .33** Perceptual/Cognitive .25 .33* .29* Dissociative .32* .57** .47** "Mystical" .07 .16 .11 In their discussion, the authors note that one might assume that high autonomy Ss would be less affected by variations in hypnosis procedures than low autonomy Ss. The differences found in depth scores for these two groups were supportive of this expectation. "Fluctuations in subjectively reported depth scores for low autonomy Ss only, clearly suggest autonomy to be a moderator variable" (p. 163). Moreover, the results indicate "that high autonomy Ss in comparison to low autonomy Ss are more likely to express their inner dispositions, such as absorption and expectation, in the hypnotic setting. High autonomy Ss may be more reflective of and attuned to individual predisposing characteristics and less influenced by situational demands. ... the hypnotic behavior of high autonomy Ss is more likely to be self- congruent and less likely to be demand-congruent. Low autonomy Ss, however, are more likely to be demand congruent and less likely to be self-congruent. The latter finding was suggested both by the significant F ratio for low autonomy Ss across treatments, and also by the stronger relationship found for this group between depth and how authoritarian/directive they perceived the procedure to be" (p. 163). [Paradoxically, among low autonomy Ss an authoritarian approach yields less depth but greater suggestibility (higher hypnotizability scores).] "The tendency for low autonomy Ss to have a higher behavioral score on the authoritarian procedure is consistent with Tellegen's (1979) assumption that there are two pervasive dimensions in current hypnotizability measures--a compliance dimension and a true hypnotic responsiveness dimension. According to Tellegen, motor items may be more saturated with compliance, while cognitive items may be more saturated with true hypnotic responsiveness. The BSS has a motor emphasis, and the higher behavioral scores for the low autonomy group of Ss may be interpreted as an expression of compliance. "In addition to the inner-directedness and self-congruence hypothesis of why autonomy may be a moderator variable, another possible explanation is related to accuracy of self-perception. The intercorrelational and multiple regression data showed repeatedly that a stronger relationship existed between prehypnotic variables and hypnotic depth for high autonomy than for low autonomy Ss. The relational capacity, as tapped by the rapport-pre variable, absorption, which may be conceptualized as a personality trait; and expectation, a cognitive variable, were all related to depth for high autonomy Ss. For low autonomy Ss, none of these variables were individually related to depth. Differences in Ss' accuracy of self-reporting may explain this. According to ego-psychology theory, highly individuated Ss, with clear self-other differentiation and congruence in self-perception, are better able to make accurate statements about themselves. The self-assessments of Ss with low differentiation capability may be less accurate and possibly more affected by demand characteristics and response set. In other words, their self-assessments have more error. The generally lower correlations for the low autonomy Ss may reflect this" (p. 164). "A report of subjectively reported hypnotic depth following CIS and the self- hypnosis scales may reflect clarity of imagery, while a report of depth following BSS may reflect experiences of kinesthetic/bodily changes" (p. 165).