NOTES 1:
“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).
NOTES 1:
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).
“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).
Fine, C. G. (1989). Treatment errors and iatrogenesis across therapeutic modalities in MPD and allied dissociative disorders. Dissociation, 2, 77-82.
Reviews basic transferences and countertransferences that can be monitored in the treatment of MPD and which can, if unchecked, lead to the creation of new alters. It appears that these phenomena rather than treatment modalities per se provide the major impetus to iatrogenic increases in the complexity of MPD cases. Boundaries violations associated with nurturant transferences, angry transferences, and eroticized transferences are discussed, and boundary violations by the therapist associated with countertransference are elaborated.
[
Johnson, Blair; Eagly, Alice H. (1989). Effects of involvement on persuasion: A meta-analysis. Psychological Bulletin, 106 (2), 290-314.
Defines involvement as a motivational state induced by an association between an activated attitude and the self-concept. Integration of the available research suggests that the effects of involvement on attitude change depended on the aspect of message recipients’ self-concept that was activated to create involvement: (a) their enduring values (value-relevant involvement), (b) their ability to attain desirable outcomes (outcome-relevant involvement), or (c) the impression they make on others (impression- relevant involvement). Findings showed that (a) with value-relevant involvement, high- involvement subjects were less persuaded than low-involvement subjects;
Kihlstrom, John F.; Register, Patricia A.; Hoyt, Irene P.; Albright, Jeanne Sumi; Grigorian, Ellen M.; Heindel, William C.; Morrison, Charles R. (1989). Dispositional correlates of hypnosis: A phenomenological approach. International Journal of Clinical and Experimental Hypnosis, 37, 249-263.
Attempted to construct and validate a questionnaire measure of hypnotic- like experiences based on Shor’s (1979) 8-dimension phenomenological analysis of hypnosis. Separate item pools were developed to measure each disposition: Trance, Nonconscious Involvement, Archaic Involvement, Drowsiness, Relaxation, Vividness of Imagery, Absorption, and Access to the Unconscious. Based on preliminary testing (total Number – 856), a final questionnaire was produced containing 5 items measuring normal, everyday experiences in each domain. Results from a standardization sample (Number – 468) showed that each of the subscales, except for Archaic Involvement, possessed satisfactory levels of internal consistency and test-retest reliability. Factor analysis indicated that 6 subscales loaded highly on a common factor similar to the absorption construct (Tellegen & Atkinson, 1974), while items pertaining to Relaxation and Archaic Involvement formed separate factors. Validation testing on 4 samples receiving the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. Orne (1962) (total Number = 1855) showed that the Absorption and Trance dimensions correlated most strongly with HGSHS:A; the correlations with Drowsiness, Relaxation, and Nonconscious Involvement approached 0. The scales derived form Shor’s analysis, however, did not improve the prediction of hypnotizability over that obtained with the absorption scale (Tellegen & Atkinson, 1974).
Nash, Michael R.; Spinler, Dwayne (1989). Hypnosis and transference: A measure of archaic involvement. International Journal of Clinical and Experimental Hypnosis, 37, 129-144.
20 Likert-type items were derived directly from Shor’s theoretical propositions concerning the occurrence of transference-like experiences among hypnotic Ss. In 3 separate experiments, this 20-item Archaic Involvement Measure (AIM) was administered to 452 Ss following termination of both group and individually administered hypnosis procedures. Results suggest that: (a) AIM is internally consistent, and is significantly correlated with hypnotizability; (b) among high hypnotizable Ss, AIM scores assess an important aspect of hypnotic experience which is relatively unrelated to behavioral response to hypnotic suggestions; (c) there is no change in AIM scores associated with the sex of the hypnotist or S; and (d) there are 3 clusters of AIM items; perceived power of the hypnotist, positive emotional bond to the hypnotist, and fear of negative appraisal. Possible validational and clinical research applications of AIM are presented, along with a plea for further empirical examination of the relational dimensions of hypnosis.
NOTES 1:
Relates these findings to ‘countering’ (Sheehan, P., Countering preconceptions about hypnosis: An objective index of involvement with the hypnotist. Journal of Abnormal Psychology, 1971, 78, 299-322). “Countering is the tendency of some highly hypnotizable Subjects to comply with the intent of the hypnotist, even when there are strong nonhypnotic influences (e.g., social influences, expectations derived from previous lectures, perceptual constraints) to perform otherwise. … Sheehan and Dolby (1979) found that hypnotic Subjects’ dreams about the hypnotist were different than nonhypnotic Subjects’ dreams, by being more positive and more often containing themes of protection, care, and authority. Interestingly, these themes were especially evident in the dreams of hypnotic Subjects who countered” (p. 130).
The several experiments in this study investigate reliability, concurrent validity, and factor structure of the AIM. In their discussion, Nash and Spinler make the following points. As is the case with hypnotizability, AIM scores may have a bi-modal distribution, at least when administered in the same context as a hypnosis measure. It is possible that these two modes define qualitatively different kinds of involvement with the hypnotist. “For high hypnotizable Ss, behavioral response to hypnotic suggestions appeared unrelated to the extent of archaic involvement with the hypnotist across both Experiments 2 and 3. Considering only the overall correlation between AIM and hypnotic responsiveness, one might argue that both scales measure general behavioral compliance and conformity, and that this explains their degree of association. It may indeed be correct to associate AIM scores with an overall conformity to respond, but only among low hypnotizable Subjects. For high hypnotizable Subjects, behavioral compliance (task performance) was not associated with AIM scores. Just as Sheehan’s (1971, 1980) ‘countering’ studies suggest, among high hypnotizable Ss there appears to be no clear-cut relationship between the ability to perform hypnotic tasks and the special, motivated commitment to the hypnotist evidenced in some Ss. The theory of Shor (1979) and the empirical work of Sheehan and Dolby (1979) strongly suggest that an intense involvement with the hypnotist (archaic involvement) is a distinctive feature of the hypnotizable S’s experience. The present work corroborates Sheehan and Dolby’s (1979) finding that, among high hypnotizable Ss, this involvement is not equivalent to overt response to the demands of standard test suggestions.
“Three findings further suggest that AIM scores assess an important aspect of the hypnotic S’s experience which is relatively unrelated to behavioral task performance. First, AIM scores correlated significantly with a measure of subjective depth during hypnosis (Hypnotic Depth Inventory, Field, 1966). Second, the correlation between hypnotic depth and AIM scores was substantial for both low and high hypnotizable Ss. Thus, for high hypnotizable Ss, AIM scores were significantly correlated with hypnotic depth, even though they were unrelated to behavioral task performance. Finally, regression analysis suggested that AIM scores accounted for variance in hypnotic depth which was not explained by task performance scores. These findings, then, conform to Shor’s proposition and Sheehan’s (1971, 1980) later observations that archaic involvement with the hypnotist is a fundamental dimension of hypnotic experience which may not be directly related to the extent of behavioral response to hypnotic suggestions (see Shor, 1979, p. 119).|
“It is of some interest that the mean AIM score for low hypnotizable Ss was roughly equivalent to that of control Ss who had listened to a lecture prior to AIM administration. Only Ss who were exposed to hypnosis and who were behaviorally responsive to hypnotic suggestions evidenced elevated AIM scores” (pp. 140).
1989-1990
Spanos, Nicholas P.; Flynn, Deborah M.; Niles, Judy (1989-90). Rapport and cognitive skill training in the enhancement of hypnotizability. Imagination, Cognition and Personality, 9 (3), 245-262.
The role of interpersonal rapport in facilitating the enhancements in hypnotizability produced by cognitive skill training was examined in two experiments. In Experiment 1 low hypnotizable subjects either received skill training or passively oriented training that was designed to facilitate rapport with the trainer without teaching subjects how to generate the responses called for by test suggestions. Subjects in the two treatments reported equivalently high levels of rapport with their trainer, but only those given skill training attained large gains on two hypnotizability posttests. Subjects given passive training did not differ from untreated controls at posttesting. In Experiment 2 subjects received skill training under conditions designed to either heighten or minimize rapport with the trainer. Those in the high rapport condition showed large hypnotizability gains on both posttests, whereas those in the low rapport condition failed to differ from no treatment controls in the regard. Our findings indicate that high rapport is not sufficient for producing training-induced enhancements in hypnotizability. However, the absence of such rapport may interfere with subjects’ learning and applying skills that can enhance hypnotizability.
1988
Diamond, Michael Jay (1988). Accessing archaic involvement: Toward unraveling the mystery of Erickson’s hypnosis. International Journal of Clinical and Experimental Hypnosis, 36, 141-156.
The “essence” underlying Milton Erickson’s unique style and uncommon technical maneuvers inheres in his uncommon skill at eliciting patients’ archaic involvement. Archaic involvement, as characterized by perspectiveless overevaluation, is explicated and America’s beloved tale, _The Wonderful Wizard of Oz_, is used to evoke further perspectives. The importance of such regressive object-representations are noted. Erickson’s uncanny ability to access archaic involvement and thereby profoundly influence his client is analyzed in terms of his: (a) relationship style; (b) therapeutic “persona”; (c) theoretical orientation; and (d) specific micro-techniques and interventions. Clinical findings derived from a case transcript and videotaped work are employed throughout to substantiate the argument that Erickson fosters regressive interpersonal shifts. Implications of this skill are discussed, and further avenues for investigation are suggested.
NOTES 1:
Shor (1959, 1962, 1979) introduced the concepts of archaic involvement, trance (fading of the generalized reality orientation or altered state of consciousness) and nonconscious involvement (or fulfillment of the role of hypnotic subject, dissociated role taking) to account for experienced hypnotic depth. Shor (1979) defined archaic involvement as “‘the extent to which at any given moment in time there are archaic, primitive modes of relating to the hypnotist that echo back to the love relationships of early life [p. 126]’ (p. 143).”
Archaic involvement develops as a hypnotist actively encourages the subject to regard the hypnotist with the role of parent, teacher, guru. Charismatic authority, protector, etc. Erickson fostered these attitudes in his patients, and his apparent magical expertise can be attributed to his ability to tap into these archaic ties, which are ‘ubiquitous.’ “Freud (1919/1955) long ago noted that human beings’ irresolution and craving for authority should never be underestimated. Fenichel (1945) stressed the universal yearning for ‘omnipotent beings whose help, comfort, and protection he could depend on [ p. 491].’ Kaiser (1965) considered the ‘universal psychopathology’ of attempting to create in real life the fantasy of fusion. Still others (Kohut, 1971, 1977; Kriegman & Solomon, 1985; Newman, 1983) suggested that the motivation to yield to or to create such charismatic leaders stems from the desire to lose all boundaries and become lost within a greater whole–an experience elsewhere termed a fusional or symbiotic alliance (Diamond, 1987). This ‘search for oneness’ (cf. Silverman, Lachman, & Milich,, 1982) is engaged by charismatic leaders as we become enticed by our own archaic wishes to avoid uncertainty, ambivalence, and the complexities of maturation, perhaps even creating such leaders to save us from ourselves” (p. 145). There remains the question of how archaic involvement facilitates or impedes psychotherapy.
In addition to archaic involvement, Erickson’s behavior as a hypnotherapist during the later years of his career stressed the evocation of nonconscious role-playing, while underplaying the evocation of the trance dimension. He relied on his reputation and interventional skills, stressing ‘naturally occurring trance’ of everyday life. (In his earlier years he spent more time on developing profoundly altered states of consciousness.)
“Erickson’s _therapeutic ‘persona’_ and style of engaging were consistently parental and authoritative, albeit frequently permissive, supportive, flexible, and benevolent. He always remained in control and typically insisted that his orders be carried out strictly and without question (Hilgard, 1984). … Archaic wishes are further gratified by Erickson’s gentle and soothing parental tone and stance, while control is maintained as he invites his patient to ‘enjoy being irritable with me'” (pp. 147-148). To further psychotherapeutic goals, he sometimes assumed the role of surrogate parent, in hypnosis, to supply the patient with needed (childhood) experiences, as in the famous case referred to as the ‘February Man.’
Erickson’s implicit theory of an autonomous and omnipotent unconscious further encouraged “more primitive modes of perceiving and construing consensual and historical reality” (p. 148). “For example, he tells his patient in the Lustig (1975) videotape that: ‘Your unconscious knows all about it; it will inform the conscious mind when it is ready to know'” (p. 149).
Regarding his technical maneuvers (intonation, wording, nonverbal communication, indirect suggestion, metaphor, and anecdote), “contrary to popular belief, he frequently spent long periods of time thinking about and planning his interventions (Hammond, 1986). In addition to using these patterns to evoke both patient resources and archaic alliances, he adopted an exceptionally confident manner, even when prescribing unusual assignments (McCue, 1984). Thus, patient faith and positive expectation in the efficacy of his interventions were maximized” (p. 149).
Erickson’s pacing of his speech was slow, at the same rate as President Reagan’s speeches. He was tone deaf, which may have contributed to the arrhythmia and unusual intonation observed in his speech. He used the patient’s language, typically, which “undoubtedly provides a narcissistically gratifying identification with a hypnotist felt to be inside one’s own psychic system (Diamond, 1987)” (p. 150). When he would say to patients, “My voice will go with you,” he was inviting a “bodily-level incorporation” (p. 150). When he created mental confusion through his maneuvers, he increased the likelihood that the patient would “respond to subsequent direction in order to bind anxiety” (p. 150). “Thus, an archaic object relationship is recapitulated by an invoked regression to earlier, primary phases of cognitive processing, and in turn, Erickson provides a safe, ‘holding environment’ (cf. Winnicott, 1965) for his now regressed patient” (p. 150).
Erickson used what Watzlawick (1978) has called ‘the language of change’–puns, metaphors, indirect communication, analogies. He finessed the defensive functions of secondary processes (Kalt, 1986) by allying himself with the patient’s secondary processes, as when he used anecdotes and teaching tales in the role of a ‘Dutch uncle’ giving advice. The teaching tales usually affirmed basic American values (common sense, pragmatism, self-sufficiency, resiliency, achievement; Diamond, 1983). However, this kindly grandfather approach “recreates an archaic relational situation wherein adult-level defenses and secondary processes are realigned while Erickson the storyteller permits expression and oftentimes symbolic gratification of instinctual drives. This archaic recapitulation occurs as a result of the relaxing of defenses through metaphorical communication (cf. Schafer, 1983), in addition to the revival of opportunities for mastery within this safe and often enchanting context (cf. Bettelheim, 1977)” (p. 151).
The author concludes by addressing clinical issues pertaining to an Ericksonian approach that relies on archaic involvement. “An essential question for clinicians concerns the long-term effects on the patient of the therapist’s fostering such regressive involvement. There are both pluses and minuses of therapeutic relationships which maximize archaic involvement. Consequently, we need to empirically determine the efficacy of Ericksonian interventions both in offering short-term relief from suffering, and in potentiating developmental maturation in the long run. Not only must we ascertain _how much_ archaic involvement is required for lasting change, but _what is done_ with the regressive involvement (i.e., is it merely evoked, managed, utilized, or ultimately worked through?) is critical in assessing the value of Erickson’s contribution” (p. 152).
Greaves, G. B. (1988). Common errors in the treatment of multiple personality disorder. Dissociation, 1, 61-66.
Psychotherapists report widely different experiences in their attempts at treating multiple personality disorder (MPD) patients. Some have deepened their interests and developed full-time specialized practices with this clinical population. Others have declined to have any further contact with them at all, referring possible MPD patients to colleagues when they first suspect that this disorder may be present. Still others have decided against treating more than one or two MPD patients. These diverse decisions are examined with a focus upon the effects of therapists’ uneven attention to the formal properties of the dyadic psychotherapeutic experiences as a possible influence upon their future work with MPD. Problems concerning the framework of psychotherapy and the countertransference conflicts which often move the therapist unconsciously and irrationally to alter the canons of psychotherapy in mutually detrimental ways appear to be crucial determinants.
NOTES 1:
Discusses countertransference conflicts that often move the therapist unconsciously and irrationally to alter the canons of psychotherapy in mutually detrimental ways.
Lynn, Steven Jay; Weekes, John R.; Matyi, Cindy L.; Neufeld, Victor (1988). Direct versus indirect suggestions, archaic involvement, and hypnotic experience. Journal of Abnormal Psychology, 97 (3), 296-301.
This study examined the effects of direct (Harvard Group Scale of Hypnotic Susceptibility; Shore & Orne, 1962) versus indirect (Alman-Wexler Indirect Hypnotic Susceptibility Scales; Pratt, Wood, & Alman, 1984) suggestions on archaic involvement (Nash & Spinler, in press) with the hypnotists, objective responding, and subjective involvement and involuntariness ratings, when the scales were administered in all possible combinations (direct/indirect, N = 61; indirect/direct, N = 61, direct/direct, N = 57; indirect/direct, N = 95), across two sessions. At the initial testing, subjects who received indirect suggestions reported a greater emotional bond with the hypnotist and increased fear of negative appraisal than subjects who received direct suggestions. Repeated testing resulted in response decrements on measures of objective responding, subjective involvement, and involuntariness that were paralleled by diminished involvement with the hypnotist. The most stable relation between scales was evident when scales were defined as direct hypnosis across both sessions. Although direct and indirect suggestions produced comparable effects in the first session, in the second session, direct suggestions fostered greater subjective involvement and feelings of involuntariness.
Nathanson, Donald L. (1988). Affect, affective resonance and a new theory for hypnosis. Psychopathology, 21, 126-137.
Suggests new theory of hypnosis based on recent experimental and theoretical work on emotion that shows neurological systems (including structural effectors and chemical mediators affecting specific sites of action). Tomkins’ nine innate affects are organizers of the other moieties, genetically determined prewritten subcortical programs that convert quantitative stimuli into qualitative experience. Emotion in the adult involves subtle and complex combinations of innate affect with associations to previous experiences of affect provided by neocortical mechanisms. The infant initially expresses affect in an all-or-none fashion, while the caregiver, usually mother, acts as an external modulator of infantile affect display. All the techniques by which the mother learns to achieve affect mutualization and interaffectivity are analogues of what later may be seen as the techniques of hypnotic induction. Hypnosis may be viewed as the intentional alteration of neocortical cognition made possible by the state of primitive interaffectivity achieved when the hypnotic operator enters the central assembly system of the adult by techniques reminiscent of maternal modulation of infantile affect display.
Wilbur, C. B. (1988). Multiple personality disorder and transference. Dissociation, 1, 73-76.
NOTES 1:
Discusses the importance of appreciating, interpreting, and managing transference in treating patients with multiple personality disorder. The most commonly encountered problematic transferences in work with multiple personality disorder, the hostile, erotic, and dependent, are illustrated and discussed.
1987
Baker, Elgan L. (1987). The state of the art of clinical hypnosis. International Journal of Clinical and Experimental Hypnosis, 35 (4), 203-214.
This paper reviews the contemporary status of clinical hypnosis in light of the current emphasis on briefer, pragmatic forms of therapy and consumer demands to demonstrate effectiveness. Conceptual shifts and an expansion of clinical applications are related to changes in hypnotic strategies and technique. Suggestions for future avenues of clinical research are outlined and the importance of the continued integration of scientific rigor, empirical clarity, and clinical acumen and sensitivity is emphasized.
Diamond, Michael Jay (1987). The interactional basis of hypnotic experience: On the relational dimensions of hypnosis. International Journal of Clinical and Experimental Hypnosis, 35, 95-115.
The ubiquitous interactional basis of hypnosis remains neglected and poorly understood. Vignettes from clinical practice are research are presented to illustrate the significance of hypnotic relational factors and their internal representations. A descriptive theoretical framework is formulated enumerating 4 relational dimensions: (a) transference phenomena in which previous object relationships are enacted; (b) a goal- oriented working alliance comprised of “rational” and “irrational” expectations about the efficacy of hypnotic procedure and its participants; (c) a symbiotic or fusional alliance in which the hypnotist is experienced as a purely internal figure; and (d) a realistic contemporary relationship. Each dimension is considered as it subjectively operates within hypnosis, and a case example is employed to compare the psychotherapeutic operation of these dimensions in waking and hypnotic contexts. Implications of the interactional framework are discussed and further empirical and clinical directions suggested.
Gfeller, Jeffrey (1987, August). The enhancement of hypnotic susceptibility: Interpersonal and rapport factors. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
NOTES
Includes training materials for improving hypnotizability.
Holroyd, Jean (1987). How hypnosis may potentiate psychotherapy. American Journal of Clinical Hypnosis, 29, 194-200.
Hypnotherapy is defined as doing psychotherapy in the hypnotic state. This article reviews cognitive, affective, and motivational changes associated with hypnotic trance, attempting to demonstrate how the hypnotic state might influence ordinary psychotherapy processes. Nine characteristics of trance probably potentiate psychotherapy: (1) changes in attention and awareness, (2) imagery enhancement, (3) increase in dissociation, (4) decrease of reality orientation, (5) increase in suggestibility, (6) increased accessibility of mind-body interactions, (7) diminution of initiative resulting in a sense of nonvoluntariness, (8) increased availability or manipulability of affect, and (9) development of a fusional relationship (rapport). This article touches upon the psychotherapeutic implications of these hypnosis attributes.
Jana, Hrishikesh (1987). History and present state of hypnosis in India. [Lecture] Presented at the Department of Psychiatry, UCLA.
NOTES 1:
Hypnosis is discussed in relationship to traditional Indian medical and psychological treatments. The following Table illustrates some of the relationships among Asian approaches, which also include philosophical and religious elements.
1986
Chertok, Leon (1986). Psychotherapeutic transference, suggestibility. Psychotherapy, 23 (4), 563-569.
Discusses suggestion in psychotherapy and defines it as a body-affective process, an indissociable psychosociobiological entity that acts at an archaic unconscious level far beyond that of transference, mediates the influence of one individual on another, and is capable of producing manifest psychological and physiological changes. Present in all types of therapy, indirect (nondeliberate, nonintentional) suggestion is the element that plays an important role in change and can be observed in hypnotic experimentation. It is further argued that transference and suggestion are phenomena that do not altogether overlap. Suggestion is the condition of transference without which transference could not be established.
Diamond, Michael Jay (1986). Hypnotically augmented psychotherapy: The unique contributions of the hypnotically trained clinician. American Journal of Clinical Hypnosis, 28 (4), 238-247.
In the last century, psychotherapists trained in clinical hypnosis have made a number of unique contributions to the psychotherapeutic endeavor, particularly in the areas of psychotherapeutic theory, technique, and practice. Nine factors indexing the contribution of hypnotherapists are discussed. They are: 1) communication focus; 2) maximizing expectation and belief; 3) mind-body emphasis; 4) handling of resistance; 5) employing trance phenomena; 6) using archaic levels of relationship; 7) stressing healthy, adaptive ego functions; 8) using therapist trance; and 9) permitting responsible creativity. Each factor is considered as it pertains to hypnotic technique and phenomena as well as how it is manifested in clinical treatment.
Diamond, Michael Jay (1986). When the knight regains his armor: An indirect, psychodynamically based brief hypnotherapy of an ego-dystonic sexual impulse disorder. In Dowd, E. Thomas; Healy, James M. (Ed.), Case studies in hypnotherapy.
NOTES 1:
This is a case study demonstrating successful treatment of an ego-dystonic sexual disorder, using brief hypnotherapeutic treatment.
Holroyd, Jean (1986). Hypnosis applications in psychological research. Imagination, Cognition and Personality, 5, 103-115.
It is proposed that hypnosis leads to altered cognition, affect, or motivation as reflected by changes in 1) reality orientation, 2) attention and awareness, 3) imagery, 4) dissociation, 5) suggestibility, and 6) mind-body interaction. Hypnosis may be used as an experimental method to effect such cognitive, affective and motivational changes in order to pursue research in learning, personality, physiological, and social psychology. Examples of possible applications of hypnosis are provided. The influence of individual differences in hypnotic responsivity on research also is discussed.
NOTES 1:
The author concludes, “Contributions of hypnosis to research in psychology may have been diminished by the confusion inherent in searching for main effects while giving insufficient attention to interaction effects between personality variables and experimental manipulations. As psychology becomes more cognitive in orientation, the phenomena of hypnosis may seem less bizarre and more amenable to inclusion in psychological research. However great care must be taken not to confuse the contributions of hypnosis with the contributions of the hypnotically responsive personality” (p. 109).
1985
Kelly, Paul James (1985, November). The relationship between hypnotic ability and hypnotic experience (Dissertation). Dissertation Abstracts International, 46 (5), 1690-B.
“This study investigated the relationship between four types of hypnotic experience and hypnotic ability. The types of experiences were: dissociation, the experience of involuntariness, altered state effects, such as perceptual alterations and diminished reality sense rapport, transference-like involvement with the hypnotist, and relaxation. A 47-item scale, the Hypnotic Experience Questionnaire was developed to measure types of hypnotic experience. It was given to 484 subjects and then to a subsample of 272 students. When the scale was factored, four stable factors emerged: Nonconscious/Trance, Rapport, Relaxation, and Cognitive Rumination. A Group Profile Scale was also developed to measure students and when it was factor analyzed four factors were extracted: Hallucinations and Fantasies, Amnesias and Post-Hypnotic Compulsions, Motor Inhibition, and Direct Motor Suggestion. “Two statistical approaches were used to investigate the connections between hypnotic ability and hypnotic experience . Canonical analysis was used to identify the main relationships between hypnotic ability and hypnotic experience and factor analysis was used to explore the relationship among measures of hypnotizability and hypnotic experience. Two canonical variates from the canonical analysis were significant. The first variate was characterized by a dissociative-imaginative involvement process, and the second variate tapped a rapport-social compliance process. “When 25 variables, representing components of hypnotic ability and hypnotic experience, were factored, five factors were extracted. Imaginative Involvement, Ideomotor Response, Rapport, Cognitive Inhibition, and Relaxation. The results of the factor analysis suggested that dissociative experience and altered state experience are related to hypnotic ability but rapport and relaxation are not. “The results of study, taken as a whole, suggest that relaxation and rapport may happen in the hypnotic situation, but neither experience is related to the condition of being hypnotized in any essential way. The results suggest that the hypnotic condition is characterized by dissociative experience, altered state experience, and by successful performance on hypnotic ability tasks. From a theoretical point of view, the results strongly supported Hilgard’s theory, partially supported Shor’s theory, and failed to support Edmonston’s theory” (p. 1690).
Nash, Michael R.; Lynn, Steven Jay; Stanley, Scott; Frauman, David; Rhue, Judith (1985). Hypnotic age regression and the importance of assessing interpersonally relevant affect. International Journal of Clinical and Experimental Hypnosis, 33, 224-235.
The present study was undertaken to replicate an earlier experiment and to clarify which factors in this previous experiment (Nash, Johnson, & Tipton, 1979) were responsible for the obtained child-like behaviors of hypnotically regressed Ss. As in the previous study, 3 characteristics of the transitional object relationship (spontaneity, specificity, and intensity) were used as the primary criteria to investigate the effects of hypnotic age regression when Ss were regressed to age 3 and placed in 3 home situations. While in the previous study E suggested separation anxiety and isolation during the 3 home situations (mother-absent condition), the present study deleted all references to anxiety and isolation, and replaced them with suggestions of security and maternal proximity (mother-present condition). As expected, the mother-present versus mother-absent conditions led to similar hypnotized- simulating differences. In further accord with predictions, hypnotized Ss and simulating Ss requested a transitional object infrequently in the presence of mother. The importance of using dependent measures which index affective processes germane to interpersonal affect-laden experience is discussed.
1984
Diamond, Michael Jay (1984). It takes two to tango: Some thoughts on the neglected importance of the hypnotist in an interactive hypnotherapeutic relationship. American Journal of Clinical Hypnosis, 27, 3-13.
Hypnotists can vary in their ability to produce meaningful trance experiences. Certain hypnotists produce more meaningful trance experiences than do others. Therapeutic hypnosis is regarded as a “dual phenomenon” occurring within an intense interpersonal relationship. This interactive dimension is important as is the unique contribution made by the hypnotist. A brief historical survey demonstrates the causal attribution of hypnotic effects. The theoretical literature on the reciprocal nature of hypnotic experience emphasizes the importance of the interpersonal functions of hypnosis, the hypnotic relationship per se, and the impact of the hypnotist. Recent research investigating interactional parameters supports these conclusions and suggests future empirical directions. Finally, an emergent interactional theoretical framework is presented which views hypnotherapeutic skill primarily as a function of the hypnotherapeutic ability to create a facilitating “holding” environment for the patient’s internal experience.
Frauman, David C.; Lynn, Steven Jay; Hardaway, Richard; Molteni, Andrew (1984). Effect of subliminal symbiotic activation on hypnotic rapport and susceptibility. Journal of Abnormal Psychology, 93 (4), 481-483.
L. H. Silverman’s subliminal symbiotic activation paradigm (Silverman, 1982) was used to manipulate unconscious affective factors in hypnosis to determine whether gratification of symbiotic fantasy would enhance hypnotic susceptibility and rapport with the hypnotist. Seventy-two male undergraduates were divided into two groups matched for susceptibility (high, medium, low). The experimental group received symbiotic, MOMMY AND I ARE ONE, subliminal stimulation via tachistoscope in a double-blind design. The comparison group received a psychodynamically neutral stimulus, PEOPLE ARE WALKING. Following subliminal stimulation, subjects were hypnotized individually. Projective tasks that indexed rapport with the hypnotist and the mother were administered during hypnosis. Rapport was also measured by rated intimacy of self-disclosure topics and by valence of topics selected to disclose to the hypnotist. A significant multivariate group selected more positively valenced topics to disclose on. The effect for symbiotic activation on hypnotic susceptibility was not quite significant (p<.056, two-tailed). 2350, Frauman, Lynn, Mare, & Kvaal, 1992 NOTES: [Paper presented by Lynn.] A number of observations and conclusions are based on literature reviews done with Brentar (British Journal of Experimental and Clinical Hypnosis; Chapter in Rhue, Lynn, & Kirsch [Eds.] Handbook of Clinical Hypnosis) and 15 years of training students in hypnotherapy. Some of this may seem elementary to some of you. For half a century there have been reports of negative effects after hypnosis: minor, serious, transient, and chronic. Clinicians need be as wary (but no more wary) of negative effects in hypnosis as in other therapies. There are more negative effects in clinical situations than non clinical situations. Therapists must be prepared to recognize negative effects and intervene. Too often hypnosis is seen as a technique divorced from psychotherapy. The hypnotist must be a competent psychotherapist. What makes you a good therapist will make you a good hypnotherapist. There should be careful assessment of the client for: 1. those with history of unusual experiences following anesthesia or drugs 2. those with a history of dissociation People may recapitulate a previous bad experience with anesthesia, based on the unusual physiological feelings. The dissociative client must be stabilized before using hypnosis. Depressed clients may also have problems, with the imagery becoming dysphoric. Those vulnerable to psychotic decompensation, with paranoid or borderline character structures, must be evaluated carefully. A lot depends on your comfort zone in therapy. Life experiences with parents and authority figures may also play into the reaction. Many clients, and experimental Ss, are ambivalent about hypnosis. This ambivalence must be acknowledged and one must work with the ambivalence before proceeding. One may: - explain hypnosis - reframe in terms of self hypnosis or relaxation - explain as a state of awareness with full consciousness - offer active induction which is just as effective as the passive induction - do induction with eyes open Research clearly shows that Subjects can monitor events outside the framework of a suggestion--especially if you suggest they can do so with ease. We do not use ideomotor suggestions because they aren't necessary. We tell them to open their eyes and communicate with us during hypnosis. We always assess their feelings about hypnosis, have them have a fantasy about what hypnosis would be like, do an informal semantic analysis of the descriptors clients use (and then reframe them), inquire about previous experiences with counseling and psychotherapy, and do a mental status. Don't make assumptions. We want to know about early life experiences to know about transference and form an alliance. Hypnosis procedures employed must have explicit informed consent (cf MacHovic book), which also provides opportunity to demystify the experience. Our research shows the great majority of Ss find it relaxing, invigorating. Even perceptual distortions can be created without hypnosis. Can create confidence by sharing the research information on hypnosis. Elicit cooperation with easier suggestions, then use graded suggestions. We want to titrate the demands on clients, move at a pace that keeps anxiety low, promote self efficacy and mastery through ... [missed a few words] and graduated tasks. Carefully monitor clients for frowns, lack of attention, etc. It is important to ask them what they are experiencing. Rarely, a client appears unable to talk, in which case the therapist can offer hypotheses to the hypnotized client. Don't terminate hypnosis if there is a problem (Orne also says this); instead, offer reassurance to explore/release the feelings. It is beneficial to work through what is being experienced. There is a somewhat higher risk of emotional reactions with age regression or induced dreams. We simply tell people they can tell us at any time about what they are experiencing, without going through any ritual. When we give suggestions about amnesia, we ask what they would like to remember and suggest that they forget what they would like to forget. The usual permissive suggestion doesn't work; find out what it is, exactly, that they want to forget and then devise strategies for it. Follow for 2 weeks after any abreactive experience that may have occurred. Let them know they can contact you. Forceful suggestions to abandon symptoms can promote resistance and the therapist may generate negative transference. (See their chapter in book edited by Rhue, Lynn, and Kirsch, Handbook of Clinical Hypnosis, published by the Amer Psychological Association.) Kelly, Paul James (1984, December). The relationship between hypnotic ability and hypnotic experience. Newsletter of Division 30, Psychological Hypnosis, of the American Psychological Association, 5. This study investigated the relationship between four types of hypnotic experience and hypnotic ability. The types of experience were: dissociation, the experience of involuntariness; altered state effects, such as perceptual alterations and diminished reality sense; rapport, transference-like involvement with the hypnotist; and relaxation. A sample of 230 students was given the HGSHS:A, a group version of the SHSS:C, and the Hypnotic Experience Questionnaire (Kelly, 1984), a 47-item multidimensional scale of hypnotic experience. Items were taken from these tests to form 11 hypnotic ability variables (Positive Hallucinations, Dreams and Regressions, Post- Hypnotic Compulsions, Amnesia (HGSHS:A), Amnesia (SHSS:C), Arm Rigidity, Arm Immobilization, Other Motor Inhibitions, Head Falling, Moving Hands Together, and Hand Lowering). Fourteen hypnotic experience variables were also formed (Generalized Dissociative Effects, Dissociative Inhibition, Trance, Unawareness, Transference-like Involvement, Trust, Friendliness, Physical Relaxation, Mental Relaxation, Imagery Presence, Imagery Vividness, Imagery Detail, Self Consciousness, and Analytic Thoughts). The 25 variables were intercorrelated and factored with principal axis factoring. Five factors with eigenvalues greater than 1 were extracted and rotated to varimax criteria. These factors, which accounted for 54.4 percent of the variance, were called: Imaginative Involvement, Ideomotor Response, Rapport, Cognitive Inhibition, and Relaxation. Hypnotic ability variables loaded significantly on three of the factors (Imaginative Involvement, Ideomotor Response, and Cognitive Inhibition) and these three factors also tapped some aspect of altered state experience and/or dissociative experience. It was concluded therefore that dissociative experience and altered state experience are related to hypnotic ability. The remaining two factors, Rapport and Relaxation, showed significant loadings only for rapport variables and relaxation variables, respectively. Neither of these two factors were related to any of the traditional measures of hypnotic ability or to the experience of dissociative effects or altered state effects. The results of this study suggest that rapport and relaxation may happen in the hypnotic situation but neither experience is related to the condition of being hypnotized in any essential way. The hypnotic condition is characterized by dissociative experience, altered state experience, and by successful performance on hypnotic ability tasks. The results also raise questions about Edmonston's (1981) theory that relaxation is the essence of hypnotic responsiveness. The finding that the experience of relaxation is unrelated to hypnotic ability is more congruent with Hilgard's (1977) view that relaxation is a nonhypnotic process. NOTES 1: This is an abstract of an unpublished Ph.D. dissertation, University of Waterloo, 1984. It won the American Psychological Association Division 30 award for Best Student Paper at the 1984 APA Convention. Lindner, H. (1984). Therapist and patient reactions to life-threatening crises in the therapist's life. International Journal of Clinical and Experimental Hypnosis, 32 (1), 12-27. This paper presents an analysis of the transference and the counter-transference factors in both the patient and the therapist arising from the occurrence of a life-threatening crisis in the life of the therapist. Evaluation of these factors includes a description of the role of hypnosis in the elicitation of repressed feelings of denial and hostility in both members of the therapeutic dyad. 1983 Diamond, Michael Jay (1983). Therapeutic indications in applying an innovative hypnotherapeutic technique: The client-as-hypnotist. American Journal of Clinical Hypnosis, 25 (4), 242-247. A novel hypnotic induction technique is described wherein the client reverses roles and serves as hypnotist for the therapist willing to enter trance. Indications and contraindications in employing innovative hypnotherapeutic interventions are considered in terms of the therapeutic goals and context, patient-therapist interaction, and patient as well as therapist characteristics. Benefits provided by the technique to the client, client-therapist interaction, and therapist respectively are briefly discussed. The specific methodology of this technique is described according to seven steps: (1) permission request: (2) client observation: (3) session structure: (4) client confidence: (5) therapist trance: (6) feedback: and (7) subsequent utilization. Relevant clinical examples are provided. Fourie, David P. (1983). Width of the hypnotic relationship: An interactional view of hypnotic susceptibility and hypnotic depth. Australian Journal of Clinical and Experimental Hypnosis, 11 (1), 1-14. Efforts have been reported in the hypnosis literature to correlate measurements of hypnotic susceptibility with measurements of hypnotic depth. Not only have the findings not been consistent, but recently the whole issue of hypnotic susceptibility and depth and their measurement has become controversial, as evidenced by Weitzenhoffer's (1980) and Hilgard's (1981) statements. This paper offers a different perspective on the issue and introduces the concept of the width of the hypnotic relationship as a useful indication of the degree of hypnotic involvement. The width of the hypnotic (paradoxical) relationship refers to the scope of the relationship within which certain involuntary behaviors can occur. The larger the number of such behaviors that are possible within the bounds of the paradoxical relationship, the wider that relationship shall be considered to be. This is an investigation of the relationship between the width of the relationship and the depth of hypnosis experienced. The SHSS: A, as a measurement of the width of the relationship, was applied to 18 volunteer female subjects. A 10-point self-report scale was applied before and after a procedure to widen the relationship. The correlations between the SHSS: A scores and both sets of self-report scores were positive and significant, as expected. The widening procedure had a definite deepening effect, but it seemed possible that this effect was not uniform. Levitt, Eugene E.; Baker, Elgan L. (1983). The hypnotic relationship--another look at coercion, compliance and resistance: A brief communication. International Journal of Clinical and Experimental Hypnosis, 31, 125-131. The purpose of the present investigation was to assess the ability of hypnotic Ss to voluntarily resist neutral suggestions on a monetary reward incentive. The results were ambiguous; Ss resisted with a mean of 1.2 of 2 suggestions each. Postexperimental interviews disclosed that all Ss felt that the instructions to resist were asking them to be disloyal to the hypnotist or to betray him. Ability to resist was positively correlated with Ss' impressions of the "resistance instructor" and tended to be negatively correlated with the impression of the hypnotist. These findings are interpreted to suggest support for an interactional conception of the hypnotic state. 1982 Chertok, Leon (1982). The unconscious and hypnosis. International Journal of Clinical and Experimental Hypnosis, 30 (2), 95-107. This paper reviews Soviet approaches to the unconscious and to hypnotic phenomena, before examining psychoanalytic theories of hypnosis which are generally based on transference. The author believes the existing theories are inadequate, arguing that there is a psychophysiological dimension to hypnosis; but what unconscious processes does this conceal? Psychoanalysis opened one road to the unconscious, but affect, nonverbal communication, and psychophysiological process are still uncharted territories towards which hypnosis may yet prove to be another royal road. NOTES 1: The author concludes, "hypnosis and the unconscious ... are closely linked. Historically, experiments on posthypnotic suggestion were in fact the starting point for the discovery of the unconscious. Posthypnotic suggestion is in effect one of the most irrefutable proofs that psychical contents can influence behavior, albeit eluding the subject's consciousness. "In this paper, the present author provides a description of Soviet researchers' conceptions of the unconscious, and of the point of view from which they approach hypnotic phenomena. Psychoanalytic theories of hypnosis are then presented, which are essentially based on transference. It is shown why this notion seems to the present author powerless to account for the specific nature of the hypnotic relationship. There is, in effect, a psychophysiological dimension to hypnosis. It lies at the crossroads between the instrumental and the relational dimension. But nothing is known about what unconscious processes hide at the psychophysiological level. Psychoanalysis has brought to light the laws governing the functioning of unconscious representations. But the realm of the affect, the nonverbal communication, and bodily processes still remain beyond our knowledge. This is a hidden side of the unconscious, in relation to which hypnosis may serve as another 'royal road'" (pp. 104-105). Hong, G. K.; Skiba, A. H.; Yepes, E.; O'Brien, R. M. (1982). Effects of ethnicity of hypnotist and subject on hypnotic susceptibility. International Journal of Clinical and Experimental Hypnosis, 30 (1), 23-31. The effect of ethnic similarity of hypnotist and hypnotic S on hypnotic susceptibility was examined in a 2-part study. The first part of the study compared the performance of Anglo versus Chinese hypnotists on Anglo versus Chinese Ss. In the second half of the study, Anglo and Hispanic Ss and hypnotists were compared using the same Anglo hypnotist-S control group. In total, 112 volunteers were administered the Stanford Hypnotic Susceptibility Scale, Form A, of A. M. Weitzenhoffer and Hilgard (1959), with 16 Ss (8 males and 8 females) in each condition. A 2 x 2 ANOVA was performed on the data for each part of the study. Ethnic similarity of hypnotist and S was found not to enhance hypnotic susceptibility. The implications of these results are discussed in relation to the assumed superiority of homoethnicity in psychotherapy. Silverman, Lloyd H.; Lachmann, Frank M.; Milich, Robert H. (1982). The search for oneness. New York: International Universities Press.