Ambrose, Gordon (1955). Multiple sclerosis and treatment by hypnotherapy. Follow-up and further cases. Journal of Clinical and Experimental Hypnosis, 3 (4), 203-209.

“Summary. Present day treatment of multiple sclerosis appears inadequate from the psychological view point and patients are too often forced to show a negative response to their illness.
“Six patients have been treated by hypnotherapy with marked subjective improvement. Three of these cases are described.
“The aim in these cases is to put the patient more in control of his organism. Patients should be told that their symptoms must never control them, they must control their symptoms.
“The very nature of the illness prevents the medical attendant from feeling scientific in his approach to these cases. Long follow-up is a necessity but much subjective improvement is possible using hypnotherapy.
“In the hypnoanalytical approach the usual exaggeration of the emotions allied with the psychosomatic reaction will often be found. Hypnosis appears to produce a rapid lessening of tension and anxiety in these cases.
“A deep state of hypnosis should be aimed at and auto-hypnosis must always be taught. It is sometimes useful to place a trusted person en rapport with the patient to carry on with positive and direct suggestions.


Gruzelier, John (2000). Unwanted effects of hypnosis: A review of the evidence and its implications. Contemporary Hypnosis, 17 (4), 161-193.

Reviews the growing evidence of unwanted consequences of hypnosis in experimental, clinical, and entertainment settings. Adverse effects are common, may be physiological or psychological, and are mostly short-lived. The more serious consequences almost exclusively occur in clinical and entertainment applications and have included chronic psychopathology, seizure, stupor, spontaneous dissociative episodes, and the resurrection of memories of previous trauma. Associated phenomena may include physiological events and may be unconsciously mediated. Two cases of 1st episode schizophrenia, one following hypnotherapy and one following stage hypnosis, are described. Evidence of affinities between schizophrenia and hypnosis is revisited in the light of contemporary evidence of the neurophysiological mechanisms of hypnosis and schizophrenia, with implications for screening vulnerable individuals. (PsycINFO Database Record (c) 2002 APA, all rights reserved)

MacHovec, Frank J.; Oster, Marc I. (1999). In the best of families: Understanding hypnosis complications in graduate and post-graduate training experiences. American Journal of Clinical Hypnosis, 42 (1), 3-9.

Unexpected, unwanted complications co-incident with the use of hypnosis can occur even to mental health professionals and in advanced hypnosis training. This article reports three such incidents, which occurred in the practice of a trained, licensed mental health professional, and university faculty member. Suggestions are provided for preventive practice, which may have reduced the risk of untoward aftereffects.

In the Discussion section, the authors state, “A common thread throughout these three cases is that most occurred in the formal, controlled setting of a university, in a bona fide course on hypnosis given by a trained, experience [sic], and licensed mental health professional to a sophisticated, fully informed, and receptive class of students. That unwanted side effects occurred in such a setting points to the need for training and skill to avert complications and to properly intervene to correct and neutralize those complications as they arise” (pp. 6-7). They suggest ways of lowering risk of unwanted, unexpected side effects.

Moene, Franny C.; Hoogduin, Kees A. L. (1999). The creative use of unexpected responses in the hypnotherapy of patients with conversion disorders. International Journal of Clinical and Experimental Hypnosis, 47 (3), 209-226.

In a previously completed empirical study examining the use of hypnosis in a comprehensive treatment program with 85 patients who suffered motor conversion symptoms, 16 patients were reported by their therapists to have had unusual and unexpected responses during hypnosis. This article summarizes the literature on the occurrence of unintended phenomena during hypnosis and presents instances encountered in a study of conversion hysterics. The article illustrates these occurrences and their management with 7 clinical vignettes and concludes that surprising or unusual responses to hypnosis with these types of cases can be an opportunity for the patient to enhance understanding and gain control over his or her symptoms.

The authors classify the problems into five groups: problems encountered during induction of hypnosis, problems encountred during treatment proper, untoward affect expression during treatment proper, exaggerated response to suggestions, and problems in terminating hypnosis. They offer a set of guidelines to therapists for managing these kinds of difficulties.

Barber, Joseph (1998). When hypnosis causes trouble. International Journal of Clinical and Experimental Hypnosis, 46 (2), 157-170.

Like any other effective intervention, hypnotic treatment can occasionally cause harmful effects as well as beneficial ones. The first step in avoiding clinical complications is recognizing that they can occur. A review of the literature, however, suggests a long-standing inattention to the potential harmfulness of hypnotic interventions, including patients’ unexpected reactions, leading to clinical complications, including amnesia, catharsis, paralysis, disorientation, literalness of response, accelerated transference, and memory contamination. In addition to these unexpected reactions by patients, complications can also arise from a practitioner’s need for power and by the inappropriately narrow focus on the hypnotic process itself, leading to distraction from the more fundamental clinical process.

Lynn, Steven Jay; Martin, Daniel J.; Frauman, David C. (1996). Does hypnosis pose special risks for negative effects? A master class commentary. International Journal of Clinical and Experimental Hypnosis, 44 (1), 7-19.

The authors review evidence in both experimental and clinical hypnosis situations. They conclude that”the available data do not justify the conclusion that hypnotherapy is any more dangerous, or ultimately less effective, than other psychotherapy and relaxation procedures” (p. 13). However, negative effects do sometimes occur in clinic or in laboratory. They indicate that the following situations and factors suggest need for particular care or vigilence:
Increased Psychopathology
Intensified Transference
Misconceptions About Hypnosis
Suggestions May Instigate or Reveal Unexpected Affect
Difficult or Inappropriate Suggestions
Direct Suggestions to Relinquish Symptoms
Countertransference Reactions
Suggestive Procedures and False Memory Creation
Inadeuate Training in Psychology and Psychotherapy

Barber, Joseph (1995, November). When hypnosis causes trouble. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.

Sexual acting out occurs, even with highly trained and responsible clinicians. But other problems occur, and it is the same qualities of hypnosis that make it useful that also make for problems. I found 20 publications that exhibited problems in therapy, and they all discussed only the mental illness of the patients.

Gravitz, Melvin A. (1995). Inability to dehypnotize: Implications for management. International Journal of Clinical and Experimental Hypnosis, 43, 369-374.
One of the possible complications of working with hypnosis, and a concern of some, is difficulty in alerting the patient from the hypnotic condition. Although such adverse reactions are rare and infrequently obserbved, they have been noted for many years. This article presents two cases of inability to dehypnotize and discusses the implications for clinical management of the dynamics that were found to be causally related to such behavior.

The author presents two cases, and writes in conclusion, “It is clear that in both these cases, the individuals were in control of their situations and important personal needs of the moment. Practitioners who may encounter the infrequent problem of inability to dehypnotize their patients should understand that the patient is thereby undertaking to control his or her own behavior for personally significant reasons. Understanding these reasons as defenses, and circumventing and even using such defenses, enable successful resolution of the problem” (p. 374). J. Holroyd

Singh, Asha (1994, August). Positive and negative effects in hypnosis: Some contributing variables. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.

Subjects (N = 155) were randomly assigned to hypnosis with the Harvard hypnotizability scale, hypnosis with neutral imagery instead of the test items in the Harvard scale, and a control condition of a taped chapter read from an Introductory Psychology text. All procedures were taped. Subjects’ attitudes toward hypnosis and psychiatric symptoms were first measured. Using self-report measures, positive and negative effects were assessed at three time periods: (a) retrospective assessment of the experience during the intervention; (b) pre-post testing for assessing state immediately after the intervention; and (c) assessment 2 to 4 days later. Results showed a consistent trend at all three time periods. Hypnosis with imagery was more positive and less negative than the control condition. It was also more positive than the Harvard scale. Hypnosis with the Harvard scale was slightly less negative and slightly more positive than the control condition. Hypnotizability was not correlated with hypnosis effects; however, the intensity of hypnosis, or ‘hypnoidal state’, predicted positive effects (but not negative effects) at every time period in all three groups. Initial attitude was only slightly associated with effect; a positive attitude predicted an overall positive reaction to the experience for all groups, and negative attitude predicted reduced state anxiety 2 to 4 days later. Psychiatric symptomatology predicted a more negative experience during all conditions, but was associated with less negative feelings, more positive feelings, and reduced state anxiety afterward. In conclusion, hypnosis with a self-selected student population in an experimental setting is no more harmful than a control condition; in fact it is more enjoyable and more positive in its effects than the latter. Hypnosis has more positive and less negative effects when the Harvard test items are replaced by neutral imagery. Subject attributes play a more complex role than hypothesized in determining hypnosis effects. The implications of these findings are discussed. (ABSTRACT from Bulletin of Division 30, Psychological Hypnosis, Fall 1994, Vol. 3, No. 3.)

Sivec, Harry; Lynn, Steven Jay (1993, October). Negative posthypnotic effects: The influence of prehypnotic experiences. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.

Ss and Experimenters may mis-attribute negative experiential effects to hypnosis because of temporal contiguity. This study required Ss to complete the experiences scale before and after hypnosis and before and after a non-hypnotic control procedure. The PES is a 65 item scale and has a stable factor structure assessing pleasant, perceptual/kinesthetic, anger, and anxiety experiences.
49 Ss completed the test before and after the Harvard Group Scale, minus the word “hypnosis” in the induction, though it was presented as a study of hypnosis; 33 had the study presented as study of body awareness, and were to focus on body parts corresponding to the parts mentioned on the Harvard.

Ss in both groups reported more perceptual/kinesthetic effects after than before the experience. Research failed to find hypnosis was associated with unique effects that were negative. The single increase might be due to focusing on the body. The only difference between groups was that hypnosis Ss reported fewer anger experiences than those in the other group.
This data disconfirms the belief that hypnosis is associated with negative effects.

Brentar, John P.; Lynn, Steven J. (1992, August). The Post-Hypnotic Experience Scale: Validity and reliability. [Paper] Presented at the annual meeting of the American Psychological Association, Washington, DC.

This paper describes the development of the Posthypnotic Experiences Scale (PES), a 57-item scale comprised of four subscales labeled Pleasant, Somatic- Kinesthetic, Irritability/Anger, and Anxiety. It was derived by way of an initial factor analysis using 444 subjects and refined by a second factor analysis using 288 subjects. In three data collection phases, the subscales were found to be internally consistent and to exhibit low to moderate test-retest reliabilities. The PES was also found to evidence excellent content, convergent, and discriminant validity, as measured by indices of hypnotizability, positive affect, depression, anxiety, hostility, sensation seeking, dysphoria, social desirability, perceptual aberration, absorption, and physical symptomatology. Behavioral validity was demonstrated in so far as subjects who were willing to volunteer for a second experiment, without reimbursement, scored higher on the Pleasant subscale than did nonvolunteers. (ABSTRACT from the Bulletin of Division 30, Psychological Hypnosis, Fall, 1992, Vol. 1, No. 3.)

Crawford, Helen J.; Kitner-Triolo, Melissa; Clarke, Steven W.; Olesko, Brian (1992). Transient positive and negative experiences accompanying stage hypnosis. Journal of Abnormal Psychology, 101 (4), 663-667.

Frequency of positive and negative experiences accompanying stage hypnosis was assessed in follow-up interviews with 22 participants of university-sponsored performances. Most subjects described their experience positively (relaxing, interesting, exciting, satisfying, illuminating, and pleasurable), but some described it negatively (confusing, silly, annoying, and frightening). Five subjects (22.7%) reported partial or complete amnesia; all were highly responsive to the stage hypnosis suggestions. One subject was completely unable to breach amnesia and felt annoyed and frightened. Five subjects (22.7%) believed the hypnotist had control over their behavior. Participants (n=15) tested subsequently on the Stanford Hypnotic Susceptibility Scale, Form C (Weitzenhoffer & Hilgard, 1962) were mostly moderately to highly hypnotizable (M = 7.07), and the scores correlated significantly (r = .68) with the percentage of passed stage hypnosis suggestions.
NOTES: Echterling and Emmerling (1987, American Journal of Clinical Hypnosis) conducted a follow-up of 18 people who participated in stage hypnosis at a university, within a month after the experience. Referring back to the hypnosis itself, 39% reported positive experiences, 39% reported both positive and negative experiences, and 22% (four people) reported ‘strongly negative’ experiences. The present study contacted subjects immediately after the stage hypnosis experience, either in person or by telephone. They completed both objective questions and open-ended questions referring to three time periods: after the hypnotic induction, during the hypnotic suggestions, and after the stage hypnosis had been terminated. Subjects were invited to come to the laboratory to be tested for hypnotizability, and 15 of the 22 did return for testing.
Of the 22 Ss, 4 had previously participated in stage hypnosis, one in laboratory hypnosis, and one had been hypnotized by her father. Of the 15 tested with the Stanford Hypnotic Susceptibility Scale, Form C: 7 were high hypnotizables (scoring 9-12), 7 were medium hypnotizables (scoring 4-8), and one was a low hypnotizable (scoring 0-3). Several people reported that they ‘went along with’ the hypnotist’s suggestions, role playing rather than actually experiencing the suggestions.
“Most of the subjects found the experience positive: 86.4%, relaxing; 86.4%, interesting; 77.3%, exciting; 59.0%, satisfying; 54.6% illuminating; and 54.6%, pleasurable. Negative experiences were also reported: 36.4%, confusing; 36.4%, silly; 9.1%, annoying; and 9.1%, frightening. Only 1 subject reported the stage hypnosis experience as entirely negative.
“The stage hypnotists told the participants about the suggestions at the end of the stage hypnosis performance and supposedly lifted amnesia. Despite this, some participants continued to experience partial or full amnesia for the suggestions. …
“One participant reported complete amnesia even after the interview and was distraught, permitting only a telephone interview and not accepting an offer to be hypnotized at a later time to help recall what had been forgotten. …
“… The interviewer told her what had been observed and attempted to breach the amnesia. The subject continued to report complete amnesia.
“Two other participants continued not to remember many of the suggestions but showed no major concern. Waking suggestions to breach amnesia were given, but no further information was obtained.
“Five participants reported feeling that the hypnotist had complete control over their behavior and that they could not resist the hypnotist’s suggestions” (p. 664).
In their Discussion, the authors note that in general, when negative experiences occur, they tend to be mild and transient. None of the subjects in this investigation reported some of the negative sequelae reported in earlier literature (headaches, nausea, drowsiness). The few subjects who had strong cognitive distortions following hypnosis were highly hypnotizable, which also was observed in an earlier study published by the first author and her colleagues (Crawford, Hilgard, & Macdonald, 1982, International Journal of Clinical and Experimental Hypnosis).
Spontaneous post hypnotic amnesia is one example of cognitive distortion. The authors remarked on the rather high incidence of spontaneous amnesia for some specific suggestions (22.7%) , which was discovered when friends of the subjects described to them what they had done on stage. In an experimental study by Hilgard and Cooper (1965), only 7% of student subjects had spontaneous amnesia (though 35% had amnesia following suggestions for posthypnotic amnesia). Furthermore, in the Hilgard and Cooper study, hypnotizability correlated with suggested amnesia but not with spontaneous amnesia. Cooper (1972) reviewed the literature on posthypnotic amnesia and observed that spontaneous occurrence is less frequent than suggested amnesia.
Explanations of spontaneous amnesia include ideas that high hypnotizables who experience it are significantly different from those who do not (Chertok, 1981; Weitzenhoffer, 1989); or that it is due to expectancy (Kirsch, 1985); or that it is found in people with a tendency for dissociation in and out of hypnosis, or people who may be prone to repression or dissociative and post-traumatic stress disorders. For reviews of these issues, see Kihlstrom, 1987; Kihlstrom & Hoyt, 1990; Frankel, 1990; Nemiah, 1985; Spiegel, 1990; Spiegel & Cardena, 1991).
The authors note that stage hypnotists, while they may otherwise be ethical, do not provide information to subjects to correct misperceptions about hypnosis. For example, in this study 22.7% of the subjects believed, after the stage hypnosis experience, that the hypnotist had control over their behavior and they couldn’t resist the suggestions. “Appropriate guidelines for stage hypnosis (see also Crawford et al., 1982) include screening out participants who are in therapy or counseling, correcting misperceptions about hypnosis among the participants before the hypnosis begins, screening subjects prior to hypnosis, avoiding embarrassing or upsetting suggestions, providing dehypnosis instructions to those who do not remain in hypnosis (or are asked to leave the performance), terminating fully the hypnotic experience, removing all amnesia suggestions and reviewing the events at the end of hypnotic experience, and remaining available afterward for further questions” (p. 666).

Peterson, Patricia; Coe, William C. (1991, April). Negative sequelae to hypnosis: A function of expectations?. [Paper] Presented at the annual meeting of the Western Psychological Association.

Researchers have theorized that the ways in which hypnotic subjects respond may result from their expectancies of the experience. If so, it seems likely that warning subjects of possible negative aftereffects before they are hypnotized could elicit subsequent reports of such effects.
Three groups of subjects were given varied expectancies prior to a hypnotic induction and scale: (A) a specific warning of a 50% chance of negative aftereffects, (B) a vague warning of negative aftereffects, and (C) no mention of aftereffects. Subjects later reported positive, negative, sleep related, and bodily change sequelae.
The findings were in the expected direction in that Group A reported more negative sequelae than Groups B or C. However, Group C (the controls) also reported more negative sequelae and bodily changes than Group B. The inadvertent addition of a positive expectancy administered in the Group B scenario may have acted as a confound and caused that group’s lower level of negative sequelae.

Gravitz, Melvin A. (1990). Adverse behavior associated with the eye-roll test of hypnotizability: Clinical and theoretical considerations. Psychotherapy: Theory, Research and Practice, 27, 267-270.

For 15 years, subjects’ response to the eye-roll test has been used to measure susceptibility without adverse effects. A case is described of a hospitalized young man who displayed dissociative behavior when asked to do the eye-roll as part of a diagnostic evaluation. Etiological and theoretical considerations, and implications for therapeutic strategy are discussed.
Lazarus, A. A.; Mayne, T. J. (1990). Relaxation: Some limitations, side effects, and proposed solutions. Psychotherapy, 27, 261-266.
Deep-muscle relaxation has been widely regarded as anxiety inhibiting, and the relaxation response an antidote to tension and stress. However, some relaxation techniques have been shown to have negative effects. These include relaxation-induced anxiety and panic, paradoxical increases in tension, and parasympathetic rebound. Specific indications and contraindications are discussed

The following unpleasant side effects have been observed: “unpleasant sensations of heaviness, warmth, perspiration, tingling, numbness, dizziness, floating, coolness; paradoxical increases in tension; rapid heart rate; feelings of physical and psychological vulnerability; depression; fear of losing control; depersonalization; dissociation; myoclonic jerks; spasms; headache; akathesia; negative auditory, gustatory, and olfactory reactions; intrusive images and thoughts; anxiety; irritability; guilt; regressive urges; hallucinations; and panic” (p. 261).
People have been observed to have “negative or untoward reactions to meditation ([Lazarus, 1976]; French, Schmid & Ingalls, 1975; Kennedy, 1976), relaxation (Borkovec & Grayson, 1980; Carrington, 1977; Edinger & Jacobsen, 1982), and biofeedback (Miller & Dworkin, 1977). In his doctoral dissertation Heide (1981) found that more than half of his subjects under focused relaxation reported increased tension due to the relaxation session. Recently, the concept of RIA–relaxation-induced anxiety–has appeared in the literature (Heide & Borkovec, 1983; 1984). Clients suffering from generalized anxiety appear to be especially prone to RIA” (pp. 261-262).
Others have suggested that relaxation may be counterindicated for asthmatics, because the small airways dilate with sympathetic nervous system arousal. The specific instructions of autogenic training may be counterindicated for patients with gastrointestinal disease because focusing on a sense of warmth in the abdomen tends to produce more peristalsis, increased blood flow in the gastric mucosa, and acidity in the gastric juice (Luthe & Schultz, 1979). Even the standard relaxation therapy for tension headache (as well as other pain problems) is being replaced with cognitive behavioral therapy, which may have relaxation as only one component. “The point again is that relaxation is not a panacea, and that an informed selection and administration of treatments is mandated, even in disorders where relaxation has traditionally been held second only to medication” (p. 264).
Interviews suggest people with relaxation induced anxiety (RIA) fear losing control. “Some are afraid of heightened arousal; others refer to helplessness, depression, some unidentified internal or external danger, a fear of going crazy, a negative association with anesthetics, a fear of falling from heights, plus any number of catastrophic expectations (Chambless & Goldstein, 1980)” (p. 264). Lazarus recommends that if someone displays RIA, the therapist may try alternative techniques, which might include for example tensing-relaxing muscles, passive receptivity, positive or pleasant imagery, focus on breathing, subvocal monotonous chant or mantra, or the Vipassana meditation practice of achieving awareness of spontaneous sensations and thoughts. The relationship with the therapist, differences in room illumination, amount of time per session, and sitting or reclining may be important.
“If a therapist deduces that a client is likely to derive benefit from relaxation training, three obvious questions arise: (1) Which of the many types of relaxation training programs is this particular client likely to respond to? (2) How frequently, and for what length of time, should the client practice the selected relaxation sequence? (3) Will treatment adherence be augmented or attenuated by the supplementary use of cassettes for home use?” (P. 262).
The authors describe their Structural Profile Inventory (SPI; Lazarus, 1989), a 35- item questionnaire, which may be used to predict the preferred sequences and forms of relaxation to employ with individual clients. “A predominantly imagery/sensory reactor, for example, may do well with visualization and autogenic training, whereas a highly active/cognitive client might be better advised first to engage in strenuous exercise followed by calming self-statements (Zilbergeld & Lazarus, 1988)” (p. 265). They suggest that for those patients who are perfectionistic and simply can’t “just let go,” they might simply fill a bathtub with warm water and sit in it for 10-20 minutes and rest with a magazine (rather than “relax”) once or twice a day.

Page, Roger A.; Handley, George W. (1990). Psychogenic and physiological sequelae to hypnosis: Two case reports. American Journal of Clinical Hypnosis, 32 (4), 250-256.

Two cases of hypnotic sequelae occurring in a research context (with a non-clinical college population) are reported. Case 1 was a male who experienced retroactive amnesia following hypnosis: He was unable to recall familiar telephone numbers later that day. This was not a continuation of an earlier confusion or drowsiness (as is often found) since he indicated he was wide awake following hypnosis. Two parallels exist with previous reports: unpleasant childhood experiences with chemical anesthesia and a conflict involving a wish to experience hypnosis but a reluctance to relinquish control. Case 2 was a female who, while in hypnosis, experienced an apparent epileptic seizure that had characteristics of both petit mal and grand mal seizures. Although having a history of epilepsy, she had not had a seizure in 7 years. We suspect that the seizure was psychogenic and may have been triggered by wording used in the hypnotic scale or other similarities. Possible mechanisms are discussed and preventative recommendations are made.

Brentar, J.; Lynn, Steven J. (1989). ‘Negative’ effects and hypnosis: A critical examination. British Journal of Experimental and Clinical Hypnosis, 6, 75-84.

Reviews evidence concerning if hypnosis is responsible for unwanted or negative posthypnotic effects, concluding that support for this hypothesis is lacking. Many such investigations are either anecdotal reports or are marred by methodological flaws that render the interpretation of posthypnotic experiences problematical. Controlled research has not provided support for the hypothesis that hypnosis per se is responsible for certain subjective changes which accompany it, or that hypnosis is more stressful or anxiety provoking than other common experiences encountered by subjects. Although a small percentage of subjects appear to experience posthypnotic reactions, they are typically fleeting, and the link between hypnotic procedures and negative effects has not been adequately substantiated. Indeed, routine hypnosis is typically harmless and is perceived by many subjects as a pleasant, positive experience.

Rickard, Henry C.; McCoy, Anthony D.; Collier, James B.; Weinberger, Martha B. (1989). Relaxation training side effects reported by seriously disturbed inpatients. Journal of Clinical Psychology, 45, 446-450.

Examined the extent to which 50 seriously disturbed inpatients (aged 24-74 years) reported side effects related to passive and progressive relaxation training. Questionnaire results show that most Subjects reported few side effects. When side effects were reported, intrusive thoughts were most frequent. There was no significant difference in side effects reported in response to the 2 training procedures.

MacHovec, Frank J. (1988). Hypnosis complications, risk factors, and prevention. American Journal of Clinical Hypnosis, 31, 40-49.

There is a substantial body of clinical and experimental research data documenting the incidence of mild to severe after effects coincident with the use of hypnosis in persons with no prior history of similar medical or mental problems. This article provides an overview of relevant clinical and experimental research and a review of pertinent literature since 1887. Subject, hypnotist, and environmental risk factors are listed, a definition and classification system for hypnosis complications is suggested, and recommended preventive practices are described.

Echterling, Lennis G.; Emmerling, David A. (1986, August). Contrasting response expectancies of stage and clinical hypnosis. [Paper] Presented at the annual meeting of the American Psychological Association, Washington, DC.

Although both are labeled hypnosis, the experience, behaviors, and effects of hypnosis in stage and clinical settings differ dramatically. We explore these differences between stage and clinical hypnosis and conceptualize them within the framework of nonvolitional response expectancy. Two methods were used to gather information for this study. First, we observed the contrasting styles, strategies and situations in both stage and clinical hypnosis. Second, we identified and interviewed individuals who had experienced trance in both clinical and stage settings. We found significant differences in hypnotist style, subject attribution of causality, trance depth, trance behavior, and outcome. Our discussion contrasts the differing response expectancies of stage and clinical hypnosis in terms of situation, subject’s role, and subject’s perception of hypnotizability.

Hendler, Cobie S.; Redd, William H. (1986). Fear of hypnosis: The role of labeling in patients’ acceptance of behavioral interventions. Behavior Therapy, 17, 2-13.

One hundred and five outpatient cancer chemotherapy patients were interviewed to assess their attitudes toward hypnosis and relaxation as well as to determine their beliefs in and willingness to try a behavioral procedure. Patients were randomly assigned to groups receiving identical descriptions labeled “hypnosis,” “relaxation,” or “passive relaxation with guided imagery.” The description stressed the behavioral components of hypnosis and relaxation rather than the nonbehavioral techniques often associated with hypnosis such as age regression and posthypnotic suggestion. Patients believed hypnosis to be a powerful process that involved loss of control and altered states of consciousness. When compared with a group of college students, patients held significantly more fearful, conservative views about hypnosis. Patients who received a description of an intervention labeled “hypnosis” were significantly less likely to believe the procedure would effectively control their nausea and vomiting and were significantly less likely to state they would try the procedure than patients in the other two label conditions. This reaction to the label occurred independently of patients’ degree of nausea, vomiting, and pain due to their chemotherapy treatments.

Judd, Fiona K.; Burrows, Graham D.; Dennerstein, Lorraine (1986). Clinicians’ perceptions of the adverse effects of hypnosis: A preliminary study. Australian Journal of Clinical and Experimental Hypnosis, 14, 49-60.

Questionnaires were sent to all members of the Australian Society of Hypnosis and responses obtained from 202 members and associate members who used hypnosis clinically. Respondents’ experience in the use of hypnosis and the frequency of use of hypnosis as a treatment modality varied. Overall 43.5% of respondents reported adverse effects with one or more patients over the preceding year. Most adverse effects attributed to hypnosis were transient and included development of panic or extreme anxiety, development of excessive dependence and difficulty in terminating hypnosis. Exacerbation or precipitation of significant depression was an infrequent but serious adverse effect attributed to hypnosis. Other infrequent adverse effects included symptom substitution, acting out behaviour, fantasied sexual seduction, precipitation or worsening of psychotic illness or difficulties in the management of organic conditions The difficulties were acknowledged of differentiating between the effects of hypnosis itself and other components of the therapeutic transaction, but the results of this survey suggested both that hypnosis be employed clinically by properly trained professionals and that further sensitive clinical research is needed in the area.

LeBoeuf, Alan (1986). Relaxation-induced anxiety in an agoraphobic population. Perceptual and Motor Skills, 62, 910.

Two groups of 14 agoraphobic patients with anxiety attacks were randomly assigned to suggestion-imagery (like hypnosis) and progressive relaxation (with muscle tensing and release). The progressive relaxation group showed greater drop in subjective anxiety, but there was no different between groups with regard to heart rate. Following the experience, the suggestion-imagery group had more negative responses to : Did you experience anxiety? Did you ever fear losing control? Did you experience any strange sensations during the session? Was the session aversive?

Milne, Gordon (1986). Hypnotic compliance and other hazards. Australian Journal of Clinical and Experimental Hypnosis, 14, 15-29.

Hypnosis is not an external ‘force’ or ‘power but a special kind of interaction between two persons. The outcome depends on the skill and intentions of the hypnotist and the responsiveness and compliance of the subject. Skill may be marred by procedural errors, ‘sins of omission’; intentions by a self-centred rather than a patient- centred approach, ‘sins of commission’. A hazard peculiar to the use of hypnosis is a fallacious belief in the power it enables the operator to wield over the subject.

Fellows, Brian J. (1985). Hypnosis teaching and research in British psychology departments: Current practice attitudes and concerns. British Journal of Experimental and Clinical Hypnosis, 2 (3), 151-156.

The author mailed a questionnaire to 58 departments of psychology to determine the extent/nature of hypnosis teaching and research, and attitudes toward teaching and research on hypnosis. The author noted a general anxiety about teaching students how to do hypnosis (as contrasted with learning about hypnosis). “Some of the anxieties which departments have about the teaching of hypnosis seem to stem from some rather ancient and invalid conceptions about the nature of hypnosis and what it can do” (p. 153). The author also relates his personal experience teaching undergraduates “something about the procedures and phenomena which have been traditionally associated with hypnosis” (p. 153). They may use one of the standard hypnotizability scales, study a particular hypnotic phenomenon such as ideomotor action or age regression, or study an empirical issue such as facilitation of recall. He reports not meeting with “any particular difficulties,” but also that he has seen two problems: the student who is anxious about doing the procedure, and an occasional subject who reports the experience was unpleasant or disturbing–e.g. during age regression. He reports teaching students to handle these events in a normalizing manner. J. Holroyd

Fewtrell, W. E. (1984). Relaxation and depersonalization. British Journal of Psychiatry, 145, 217.

In 40 anxious patients treated with Jacobson’s progressive relaxation, 7 reported distress (something like Heide’s Relaxation Induced Anxiety). Looking retrospectively at the clinical notes, these seven usually reported symptoms of a depersonalization syndrome prior to treatment. The author administered Dixon’s (1963) Self Alienation Questionnaire, which purports to measure depersonalization. The patients who had distress scored significantly higher on Self-Alienation than ten randomly selected control subjects who had responded to the relaxation procedures without problems (adverse effects patients’ mean = 32; controls’ mean = 22; P = .05).
This article presents evidence that the presence of relaxation may distress depersonalized patients, presumably exacerbating feelings of unreality.

Heide, F. J.; Borkovec, T. D. (1984). Relaxation-induced anxiety: Mechanisms and theoretical implications. Behaviour Research and Therapy, 22, 1-12.

Literature evidence documenting the occurrence of relaxation-induced anxiety is reviewed, and several hypothesized mechanisms to explain the phenomenon are discussed. Possible avenues for circumventing the problem in therapy are offered. Finally, a theoretical model is presented wherein the phenomenon is viewed with a broader framework designed to explain the development and maintenance of the more generalized anxiety disorders. That framework emphasizes the emergence of fear of somatic anxiety cues and fear of loss of control from more fundamental interpersonal anxieties.

Kleinhauz, Moris; Beran, Barbara (1984). Misuse of hypnosis: A factor in psychopathology. American Journal of Clinical Hypnosis, 26, 283-290.

Six cases of posthypnotic trauma are presented to illustrate possible psychopathologic symptoms that may be exhibited in Ss following the misuse of hypnosis, particularly for a stage performance. Medical professionals must be made aware of the possibility of immediate as well as long-term deleterious effects that may follow misuse of hypnosis so that those cases which come to the attention of the physician will be properly diagnosed and treated.

Nash, Michael R.; Lynn, Steven Jay; Stanley, Scott (1984). The direct hypnotic suggestion of altered mind/body perception. American Journal of Clinical Hypnosis, 27, 95-102.

Attentional and emotional shifts are examined following a hypnotically suggested out-of-body experience (OBE). Two hypotheses were testes: 1) that the OBE is maintained by blocking the perception of body-relevant stimulation at a sensory level; 2) that a hypnotically produced OBE is an emotionally neutral or even pleasant experience. Fourteen hypnotic subjects and 15 simulating Ss were administered a standardized induction followed by suggestions for an OBE. Geometric figures were then presented to the body but not to the “awareness.” Although hypnotic Ss reported that they could not see the information, they still correctly “guess” the identity of the figures beyond chance levels. Thus, body-relevant information was obviously not blocked at a sensory level, but was kept out of awareness by some other mechanism. In addition, a significantly greater number of hypnotized than simulating Ss reported the OBE to be troubling and unpleasant, despite explicit suggestions for a positive experience. The potentially disturbing nature of OBEs and ways to minimize risk of negative affect are discussed.

Smith, Mark Scott; Kamitsuka, Michael (1984). Self-hypnosis misinterpreted as CNS deterioration in an adolescent with leukemia and Vincristine toxicity. American Journal of Clinical Hypnosis, 26 (4), 280-282.

A thirteen year-old girl with leukemia was taught self-hypnosis techniques for symptom control. She was hospitalized with probable vincristine toxicity and a superimposed hyperventilation syndrome. Her spontaneous use of the self- hypnosis technique was misinterpreted as central nervous system deterioration until her apparently comatose state resolved with suggestions from the therapist.

Heide, F. J.; Borkovec, T. D. (1983). Relaxation-induced anxiety: Paradoxical anxiety enhancement due to relaxation training. Journal of Consulting and Clinical Psychology, 51, 171-182.

The present study was designed to document the occurrence of relaxation- induced anxiety. Fourteen subjects (7 male, 7 female) suffering from general tension and significant levels of anxiety were given one session of training in each of two relaxation methods, progressive relaxation and mantra meditation; order of presentation was counterbalanced. Four of the subjects plus one other who terminated prematurely displayed clinical evidence of an anxiety reaction during a preliminary practice period, while 30.8% of the total group under progressive relaxation and 53.8% under focused relaxation reported increased tension due to the relaxation session. Progressive relaxation produced greater reductions in subjective and physiological outcome measures and less evidence of relaxation-induced anxiety, and the phenomenon was not clearly evident from physiological measures and from subjective ratings even in this clinical population.

Crawford, Helen J.; Hilgard, Josephine R.; MacDonald, Hugh (1982). Transient experiences following hypnotic testing and special termination procedures. International Journal of Clinical and Experimental Hypnosis, 30, 117-126.

For those who are responsive to hypnosis, the experiences can be unusual and involving. It is not surprising, therefore, that such experiences in response to tests of susceptibility may not be fully terminated when the hypnotic sessions end. In order to study the initial persistence of the effects, following administration of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. Orne (1962) and the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) of Weitzenhoffer and E. R. Hilgard (1962), 107 college Ss were interviewed about their hypnotic experiences and subsequent experiences related to hypnosis. 72% of Ss reported feelings of relaxation and being rested following SHSS:C. Only 5% reported minor transient posthypnotic experiences following HGSHS:A, while 29% of Ss reported these feelings following SHSS:C. Except in 1 case, cognitive distortions or confusion were reported only following the more cognitively oriented SHSS:C by Ss who scored significantly higher on cognitive items than those Ss who reported feeling drowsy. A special termination procedure involving exercise and conversation had no significant effect on the number of transient experiences. Such minor transient experiences are not a risk to Ss and any slight discomfort or uneasiness they cause can easily be dealt with by a well-trained hypnotist.