49. The reorganization of unconscious thinking without conscious awareness: Two cases of intellectualized resistance against hypnosis IX. Facilitating New Identity
50. Psychological shocks and creative moments in psychotherapy
51. Facilitating a new cosmetic frame of reference
52. The ugly duckling: Transforming the self-image
53. A shocking breakout of a mother domination
54. Shock and surprise facilitating a new self-image
55. Correcting an inferiority complex
56. The hypnotherapy of two psychosomatic dental problems
57. The identification of a secure reality
58. The hypnotic corrective emotional experience
59. The February man: Facilitating new identity in hypnotherapy
Hart, R. (1980). The influence of a taped hypnotic induction treatment procedure on the recovery of surgery patients. International Journal of Clinical and Experimental
Hypnosis, 28, 324-331.
A study of 40 open heart surgery patients assigned to 1 of 2 equal size treatment groups sought to evaluate the efficacy and utility of a tape-recorded hypnotic induction procedure that preoperatively prepared patients for surgery. The dependent variables included daily blood pressure measurements and postsurgical outcome data pertaining to postoperative units of blood required, state/trait anxiety, and locus of control dimensions. Results of the study tended to provide some support for the tape-recorded hypnotic induction procedure in lessening state anxiety and in promoting a more self- directed attitude toward surgical recovery.
Pajntar, Marjan; Jeglic, Anton; Stefancic, Martin; Vodovnik, Lojze (1980). Improvements of motor response by means of hypnosis in patients with peripheral nerve lesions. International Journal of Clinical and Experimental Hypnosis, 28 (1), 16-26.
In order to accelerate rehabilitation of patients with peripheral nerve lesions, hypnosis was employed to encourage them voluntarily to move those muscles with weak re-innervation and to achieve the best possible activity of the affected muscle groups. By measuring muscle force and endurance and by observing the electrical activity of the affected muscles, it was found that the activity of the affected muscles was much better while patients were in hypnosis than when they were in the waking state. The patients were able to contract even paretic muscles having only weak re-innervation with such strength, that clinically perceptible contraction of the muscles and movement of paretic extremities occurred. Such early and improved activation is very important for prevention of much permanent damage.
1970
Crasilneck, Harold B.; Hall, James A. (1970). The use of hypnosis in the rehabilitation of complicated vascular and post-traumatic neurological patients. International Journal of Clinical and Experimental Hypnosis, 18 (3), 152-158.
Hypnotherapy has been found of value in rehabilitation of many patients experiencing difficulty in the usual procedures which follow cerebrovascular or traumatic brain injury. 3 cases are reported to illustrate the approach taken. Of 25 similar cases seen over a 9-year period, 4 were unresponsive to hypnosis. Although an increase in motivation for recovery seemed to be the major change elicited by hypnotherapy, other theoretical possibilities are mentioned. Hypnosis may be a useful way of approaching motivational problems in rehabilitating patients who manifest negativism toward conventional treatment.
1968
Nuland, William (1968). The use of hypnotherapy in the treatment of the postmyocardial infarction invalid. International Journal of Clinical and Experimental Hypnosis, 16 (3), 139-150.
DEALS WITH THE PSYCHOLOGICAL ASPECTS OF CONVALESCENCE AND REHABILITATION OF PATIENTS FOLLOWING CORONARY INFARCTION. THE FOCUS IS ON THE SITUATIONAL FACTORS WHICH THE PATIENT ENCOUNTERS DURING CONVALESCENCE THAT SERVE TO PROLONG AND REINFORCE THE INVALIDISM. IT IS CONCERNED ESPECIALLY WITH THE VALUE OF HYPNOTHERAPY AS COMPARED WITH OTHER PSYCHOTHERAPEUTIC METHODS IN TREATING THESE CASES. THE ANXIETY AND EMOTIONAL STRESS WHICH CAN BE RELIEVED THROUGH THE USE OF HYPNOSIS IS DIRECTED PRIMARILY TOWARD REDUCING EMOTIONAL TURMOIL WHICH RESULTS FROM THE CORONARY ATTACK WITH THE CONSEQUENT FEAR OF PHYSICAL ACTIVITY AND OF SUDDEN DEATH. SPECIFICALLY, HYPNOSIS IS USED EFFECTIVELY IN REASSURANCE, REEDUCATION, DESENSITIZATION, GUIDANCE, AND OTHER DIRECT SUPPORT TECHNIQUES IN ACCORDANCE WITH THE PATIENT”S SYMPTOMS AND NEEDS. (SPANISH + GERMAN SUMMARIES) (PsycINFO Database Record (c) 2002 APA, all rights reserved)
1953
Kirkner, Frank J.; Dorcus, R. M.; Seacat, Gloria (1953). Hypnotic motivation of vocalization in an organic motor aphasic case. Journal of Clinical and Experimental Hypnosis, 1 (3), 47-49.
Authors’ Summary – A 41 year old male patient with a history of mutism on an organic basis for a year and a half failed to respond to speech retraining efforts. Comprehension was good and motivation poor. With the aid of hypnosis, he was induced to vocalize. Following vocalization, oral speech retraining progress was steady. Retraining efforts in writing met with repeated failure.
The patient had suffered a cerebral vascular accident, attributed at the time to an embolism.
RELATIONSHIPS
1994
Adrian, Cheri (1994, August). Sexual feelings in hypnosis: Managing therapeutic boundaries in hypnotic work. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
Therapist countertransference has been little addressed in discussions of hypnosis, particularly the sexual feelings that may be evoked in therapists in the hypnotic context. These are some of the most disturbing and problematic feelings therapists can experience toward patients, and they are little addressed in training. This issue is important both because of our increasing efforts to prevent sexual boundary violations in therapy and because therapist sexual feelings, like other countertransference feelings, can have important clinical meanings that are often avoided or ignored. This discussion defines the nature and purposes of patient-therapist boundaries. It describes the various dynamics which have been identified in therapists who become confused about sexual boundaries and proceed to mismanage them. It then elaborates the ways that using hypnosis may create special vulnerability for the therapist, not only to experiencing sexual feelings toward patients, but to becoming confused about their meaning and relevance to treatment. The discussion focuses attention on the origins and clinical significance of therapist sexual feelings, and acknowledges that such feelings may serve both awareness enhancing and defensive functions in the therapeutic process. A clinical case example illustrates various kinds of sexual feelings therapists may experience, the many meanings therapist sexual feelings may have, the various discomforts they typically generate, and the impulses to avoidance or acting out they may provoke. Further discussion addresses both clinically appropriate and inappropriate ways of managing boundaries in the presence of sexual arousal, and of utilizing sexual feelings as a means of deepening clinical understanding and of directing treatment. (ABSTRACT from Bulletin of Division 30, Psychological Hypnosis, Fall 1994, Vol. 3, No. 3.)
Grant, Carolyn (1994). The Computer-Assisted Hypnosis Scale: Standardization and norming of a computer-administered measure of hypnotic ability (Dissertation). Dissertation Abstracts International, 54 (10/B), 5387.
“In a counterbalanced, within-subjects, repeated measures design, 130 subjects were administered both the Computerized Assisted Hypnosis Scale (CAHS) and the Stanford Hypnotic Susceptibility Scale, Form C (Stanford Hypnotic Susceptibility Scale: C). For each hypnotic procedure responsiveness was assessed along three dimensions: behavioral (CAHS, Stanford Hypnotic Susceptibility Scale: C), subjective depth (Field Depth Inventory), and relational involvement (Archaic Involvement Measure). Subjects also completed a Stanford Hypnotic Susceptibility Scale: C self scoring measure and the Tellegen Absorption Scale. The CAHS was shown to be a psychometrically sound instrument for measuring hypnotic ability. The various dimensions of CAHS hypnotic responsiveness were highly positively related, and the CAHS compared favorably with the Stanford Hypnotic Susceptibility Scale: C across the three dimensions assessed. Results are discussed in terms of the theory and practice of clinical assessment, noting directions for future research” (p. 5387).
1993
Diamond, Michael J. (1993). A question of filling in the gaps: A master class commentary. [Comment/Discussion] .
This is a response to a clinical vignette described as follows: “‘Judy,’ a professional writer, asked me to use hypnosis to help her ‘fill in the gaps’ in her knowledge of certain periods in her youth. As she was so keen, getting her into trance was relatively easy. I asked a few questions and she answered in a slurred voice. Then, after a few minutes, she said that she wasn’t hypnotized. ‘Not to worry, Judy, I’ll bring you out’ was my reply. With that, a flood of memories, absolutely unstoppable for approximately 4 minutes, came pouring forth. Thereafter, I asked questions relating to an earlier period in her life. Again came the statement that she wasn’t hypnotized, and I replied as before. With that, a second flood of unstoppable experiences poured forth. later, on coming out of trance, she was able to recall all she’d spoken about while in trance and often punctuated her recollections with ‘I didn’t know that they punished me at y by locking me in the cupboard under the stairs!'” (p. 261).
1992
Diamond, Michael Jay (1992). The interactive nature of hypnotic experience. [Lecture] UCLA Hypnosis Seminar.
NOTES 1:
Relationship is the area where healing occurs. The basis of the relationship in hypnosis is poorly understood scientifically.
1983 – Freud’s hypnosis of a conversion hysteric led him to postulate a “mysterious element” (i.e. sexualized transference) which occurred when the patient threw her arms around his neck. He, and many other analysts, abandoned hypnosis – which was nevertheless continued by some doctors who were working with war neurosis or PTSD.
Freud equated hypnosis to direct suggestion and saw it as a definitive therapy. Today clinicians think it is the context of using hypnosis (not just the hypnotic state) that makes hypnosis useful for psychotherapy.
Example: A borderline patient may become more comfortable, not just because of an altered state (which they may be experiencing all the time anyway) but because of the [containing, comforting] context.
Shor’s paper on the “Three dimensions of hypnotic depth” is a useful way to begin a conceptualization of the relationship between hypnotist and patient. See also Michael Diamond (1984), It takes two to tango. AJCH, 27, 3-13. The most capable hypnotherapists are able to enter empathic bonds with patients, comforting the patient. This represents the “courage to not understand” (Reik). The therapist should be comfortable with the disintegrated material that is evoked, helping the patient to metabolize the material.
Orne’s (1962) concept of “folie a deux” is a precursor to the concept of projective identification: the patient projects onto the therapist an idea that the therapist is all- powerful, and the therapist must buy into that (while at the same time realizing it is a fantasy – using it for the purposes of therapy, but not believing it.)
Spinhoven, Philip; van Wijk, Jorrit (1992). Hypnotic age regression in an experimental and clinical context. American Journal of Clinical Hypnosis, 35, 40-46.
Investigated role of a clinical context in the experience of hypnotic age regression. 25 patients experienced hypnotic age regression in an experimental and clinical context in counterbalanced order. Patients obtained significantly lower scores for experimental age regression than for clinical age regression, in particular when the experimental assessment preceded the clinical assessment of age regression. Moreover, scores for clinical and experimental age regression were only significantly and positively correlated when the clinical assessment of age regression preceded the experience assessment. These findings give a tentative indication that more patients are able to experience clinical age regression than can be predicted from their responses to an experimental suggestion for hypnotic age regression where almost no opportunities for patient contact or maximizing of hypnotic responsiveness are provided.
1991
Lynn, Steven Jay; Weekes, J. R.; Neufeld, U.; Ziuney, O.; Brentar, J.; Weiss, F. (1991). Interpersonal climate and hypnotizability level: Effects of hypnotic performance, rapport, and archaic involvement. Journal of Personality and Social Psychology, 60, 737-743.
Designed to extend research by McConkey and Sheehan, they tested 24 hypnotizable and 21 unhypnotizable Ss in high interpersonal/high rapport (including education about misconceptions about hypnosis, eye contact, and friendly self-disclosure) and low interpersonal/low rapport testing contexts. Overall, hypnotizable Ss were more responsive to hypnosis, rated the hypnotist more positively, and experienced greater involuntariness and archaic involvement than unhypnotizable subjects. However, results provide support for the hypothesis that low hypnotizable Ss are particularly sensitive to variations of the hypnotist’s interpersonal behavior. Only low hypnotizable Ss’ objective and subjective hypnotic performance on the SHSS, Form C, was enhanced by hypnotist behavior designed to optimize rapport. Hypnotizable Ss’ behavior was stable across testing contexts.
Sheehan, Peter W. (1991). Hypnosis, context, and commitment. In Lynn, S. J.; Rhue, J. W. (Ed.), Theories of hypnosis: Current models and perspectives (pp. 520-541). New York: Guilford Press.
NOTES 1:
“There are several different ways to classify the model that is expounded in this chapter. One may view it … as an individual-differences model of hypnosis, because it emphasizes the significance of intragroup differences in the pattern of hypnotic performance. Alternatively, one may view it as a phenomenologically based model…. Invariably, however, single categories fail to do justice to the nature of theories, and hence it is perhaps wisest to view this theory as a means of exploring particular hypotheses about hypnotic phenomena that focus primarily on the meaning of suggestion as perceived by susceptible subjects. This model focuses, in a way that most other theories do not, on the motivational implications of the cognitive involvement of the susceptible subject in the events of the hypnotic setting. It offers a variant of contextual theories of psychological functioning, but is experiential in its emphasis rather than simply behavioral” (p. 537).
1990
Barber, Theodore Xenophon (1990, August). Some things I’ve learned about hypnosis after 37 years. [Audiotape] Presented at the annual meeting of the American Psychological Association, Boston.
NOTES 1:
“We are a unity of cells. Every cell is a citizen with it’s own jobs, communicating all the time; cells send messages; the way we communicate with them is by suggestions. Each _cell_ is a mind-body…. When I do it now [hypnotic inductions], I say, ‘We’re going to go into hypnosis, we’re _both_ going to go into hypnosis. I’m going to close my eyes (etc.)’ – modeling hypnosis for them.”
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.
NOTES 1:
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 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).
Hoencamp, Erik (1990). Sexual abuse and the abuse of hypnosis in the therapeutic relationship. International Journal of Clinical and Experimental Hypnosis, 38, 283-297.
In the Netherlands, individuals charged with rape may be prosecuted only in instances in which the suspect could have known that the victim was unconscious or in a state of powerlessness. Hypnosis might be looked upon as a method by which an unscrupulous person could sustain such a state of powerlessness in a victim. As an expert witness, the present author participated in a court case against a lay hypnotist who was accused of abusing 9 women. The methods and strategy used by the lay hypnotist are presented as well as are the diverse reactions of the women involved in the case. Feelings of nonvolition appear to have been a relevant factor in the coercion, especially in women who demonstrated hypnotic phenomena such as arm levitation, catalepsy, etc. The basis for sexual coercion was established only after the interpersonal relationship had been redefined as a therapeutic relationship. Introduction within the pseudotherapeutic relationship of a sexual rationale for the presented complaints helped to provide a framework for actual sexual acts to occur. With certain individual patients, the introduction of hypnosis enhanced the subjective experience of nonvolition and with it the vulnerability for abuse. It may be hypothesized that patients with a tendency for external attribution and high hypnotizability are specifically at risk for this kind of abuse when hypnosis is used in the context of a therapeutic relationship.
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.
NOTES 1:
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.
NOTES 1:
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
* 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).
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.
NOTES 1:
"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.
NOTES 1:
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).
Mason, Albert A. (1990, January). A psychoanalyst looks at a hypnotist; or, where the elephant skinned boy took me. [Paper] Presented at the Psychoanalytic Center of California Scientific Meeting.
NOTES 1:
"The results of working with hypnotism experimentally in the production of anaesthesia for surgery, dentistry and obstetrics; in controlled series of treatments of asthmatics, skin disorders, and allergic manifestations; as well as its clinical use, have convinced me that it is a delusional state akin to mania which depends on the omnipotent denial of mental pain. The mania is stimulated by the hypnotized subject having phantasies of an omnipotent object that it fuses with and shares in the omnipotence. The hypnotist has similar unconscious phantasies about himself. Both subject and hypnotist projectively identify with each others' phantasies, and together produce phenomena like anaesthesia which can be likened to delusional states. In fact, true hallucinations can also be deliberately produced.
"I believe that similar psychotic mechanisms can also occur in life between parents and children and in other relationships, and produce delusional states. These form a continuum from intractable narcissism on the one side, through Christian Science and the denial of evolution in the center, to frank folie a deux and transexualism on the other side. The therapeutic course of these states seems quite dissimilar from that of psychosis arising without the encouragement of external objects."
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.
NOTES 1:
"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).
Smith, Alexander (1990). The hypnotic relationship and the holographic paradigm. American Journal of Clinical Hypnosis, 32 (3), 183-193.
The holographic paradigm is a recently constructed model of consciousness derived from neuropsychology and quantum physics. It views the processing of mental forms as occurring within the context of a part/whole relationship, where the identified part exists within the code of the whole. In this paper I have applied this paradigm to the hypnotic relationships, viewing the hypnotic process as an undulation of form and transitional states and proposing the holographic paradigm as a cutting edge to understand the curative processes in hypnosis.
NOTES 1:
The proposed model represents a synthesis of neuropsychology and quantum physics.
"Based on precise neuroanatomical and neurophysiological processes, Pribram was able to account for a distribution of memory across the brain in its entirety. This occurs not within each neuron, but between them. Graded waves of neural potentials, rather than neural impulses, accounted for the structure of interference patterns (Pribram, 1982, p. 32)" (p. 185).
"Pribram then set out to answer these implied questions: What if there is no world of objects 'out there?' What if the world as we know it is a hologram itself? This search led him to David Bohm's work on the quantum theory.
"Bohm's (1980) world view, based upon study of light waves, consists of a primary reality that remains enfolded (within the frequency domain) and unfolded reality (the world of 'objects' and images). Appearances or objects and images are abstractions reconstructed from the frequency domain" (p. 185).
"A holographic interpretation resets the therapy relationship as a shared partnership: 'The sharing emphasizes the whole of which a partner holds a part, but the holographic paradigm makes it clear that each partner holds not just a part, but the whole because each part contains the whole' (Zinkin, 1987, p. 18)" (p. 186).
"Pribram (1983) seems to suggest, in a similar vein, that the unconscious and consciousness are 'opponent processes' of implicate and explicit orderings. Citing Matte Blanco's (1975) concept of unconscious processes as infinite sets (of opponent emotional states, for example), he considers the process relationship between conscious and unconscious: 'Conscious intelligence is manifest when circumscribed sets can be appropriately partitioned into reasonably unambiguous categories. When behavior is guided by sets of variables which cannot be readily partitioned--variables which show opponent characteristics--we are apt to conclude that behavior is based on intention or that unconscious processes are at work' (Pribram, 1983, p. 10)" (p. 187).
"Tart's (1967) procedure of mutual hypnosis resulted in such an overlapping of experiential detail between participants that the startling, consensually derived reality became too much to tolerate" (p. 187).
"It is possible that during hypnosis, at some point the therapist and patient's organizations of consciousness in some way literally and not metaphorically cross into a wave length or plane in which there is neither reality nor fantasy but the enfolded- implicate-primary reality that is mutually shared? If so, how would these wave length resonances be determined? What would this mean for various psychopathological states?
"To answer these questions we may be catapulted into a whole rethinking of just what hypnosis is in connection to repression, to developmental capacities to form self and object images, and to the shifts to more advanced levels of adaptation. In particular, the hologram will become perhaps a means of exploring this challenging advance, if it can bring the hypnotic relationship more squarely into focus.
"The expansion and contraction of conscious awareness, as a holistic process between therapist and patient within the context of the trance, may provide us with more precise clues to understand altered states of consciousness, rather than the other way around" (p. 191).
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.
NOTES 1:
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.