In factor analyses of the hypnosis scales, the essential result is that the items form a continuous, 2-dimensional fan-shaped pattern. This continuum is referred to as the “spectrum of hypnotic performance.” “Spectral analysis” is introduced as an exploratory procedure which makes use of this notion of continuum or spectrum. Spectral analysis consists of a graphical display of the level of latent correlation between a variable and individual hypnotic performances when the latter are arranged according to their position in the spectrum. The spectral analysis of hypnotic performance with respect to absorption is illustrated using data from a sample of 160 Ss. The results indicate that absorption is more strongly related to difficult hypnotic performances than to easy ones. In particular, illustrative item characteristic curves are presented to show that although easy hypnotic performances do not require the processes tapped by individual differences in absorption, a certain level of absorption is necessary to pass difficult hypnotic items. In addition, a high level of absorption may be sufficient in and of itself for difficult hypnotic performances. These results are discussed in light of some speculations by Shor, M. T. Orne, and O’Connell (1962) and Tellegen (1978/1979) concerning the differential contribution of ability components to performance on difficult hypnotic suggestions. The results are also related to a variety of work in social psychological models of hypnotic performance.
NOTES
Spectral analysis “consists of a graphical display of the level of latent correlation between a variable and individual hypnotic performances when these hypnotic performances are arranged according to their position in the spectrum—which is indexed by item difficulty” (p. 25). Difficulty (the proportion of Ss that pass a given item) is on the X-axis; the degree of latent correlation is on the Y-axis. “It is necessary to differentiate between the manifest and the latent relationship of a variable to a dichotomously scored hypnotic performance. The manifest relationship is given by the point biserial correlation and the latent relationship is given by the biserial correlation. … By inspecting the overall pattern of these biserial correlations as a function of item difficulty, it is possible to overcome the difficulty-content confound, because the biserial correlations are not affected by item difficulty” (p. 25).
“Throughout the easy and middle ranges [of item difficulty], the biserial correlation of hypnotic performance with absorption remains slightly above .2, then it rises sharply in the difficult range–beginning roughly where only one in four Ss can pass the item–to a value slightly above .5 ” (p. 27). “In essence, the proportion of Ss that pass a particular hypnosis suggestion given a particular score on the absorption scale is being plotted” (p. 30).
In their discussion, the authors relate their position to that of other theorists. Shor, Orne, & O’Connell (1962) proposed that both ability and nonability components contributed to hypnosis, with ability being the primary determinant of hypnotic performance at deeper levels. Shor et al. found a correlation between depth ratings and a questionnaire that tapped ‘hypnotic-like experiences’ to be .45; the correlation was .84 when computed for only the Ss who became deeply hypnotized, but only .17 for Ss who were only lightly or medium-level hypnotized. They concluded that their questionnaire predicted hypnotizability only for the “deeper region” of hypnosis.
Tellegen (1978/1979) proposed a two-factor model, one factor being genuine responsiveness and the other being compliance . He suggested that various hypnosis test items draw on the two factors in differing degrees. Tellegen’s genuine responsiveness factor would be similar to Shor et al.’s ability components, and Tellegen’s compliance factor would be similar to Shor et al.’s non-ability components. (The Shor model goes farther than Tellegen in positing a gradual shift in the relative contributions of the two components as one moves form easy to difficult items, and this gradualness is part of the authors’ spectrum model.)
The two-factor model is different from the general factor (plus special factors) model suggested by E. R. Hilgard (1965)); Hilgard’s general factor would probably correspond better to the Tellegen genuine responsiveness factor and the Shor et al. ability component than to the compliance factor or nonability component, which probably would correspond more to the easier items on hypnotizability scales.
Spanos et al. (1980) suggested that cooperativeness and expectation might be more important with ideomotor and challenge suggestions, and ability to treat imaginings as real (i.e. absorption) more important for more difficult cognitive items. Sarbin (1984) developed a typology with two types of individuals–those who respond to the hypnosis context by “joining the game” and knowingly create an illusion that their response is involuntary (the compliance kind of response), and those who convince themselves and others that their response is involuntary (the genuine responsiveness factor kind of response).
[Speaking of the context effects observed but not replicated 100% of the time, on the correlation between absorption and hypnotizability.] “It is possible that context effects may depend on the difficulty of the hypnotic suggestions and the latent abilities of the sample used. For relatively good hypnotic Ss performing relatively difficult suggestions, the correlation of absorption with hypnotizability may be stable across different contexts; however, for less able Ss performing relatively easy suggestions, the correlation, depending more on the ‘non-ability’ component, may be quite responsive to context manipulations. It might also be mentioned parenthetically that details of the instructions used to introduce the particular hypnosis scale employed may differentially pull for one kind of component or the other” (p. 39).
Bindler, Paul R. (1992, October). Biofeedback-assisted hypnosis: Theoretical and clinical perspectives. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES
Relates personality trait of absorption to biofeedback literature. Surprisingly, low absorption ability Ss do better than high absorption Ss on biofeedback (Qualls & Sheehan). All but one study that compared biofeedback and hypnosis found no difference in effectiveness. However recently Miller & Cross found high hypnotizables reduce EMG better with hypnosis and lows did better with biofeedback.
Our findings also supported notion that highs perform better with sensory imagery instructions and lows do better with biofeedback.
Critical in determining the outcome is the way Ss deploy attention. Qualls & Sheehan, and we, find highs don’t like attention drawn away from internal cognitive strategies by the biofeedback signal. However lows find the signal to keep their attention focused.
Author developed model combining biofeedback and hypnosis to capitalize on the attentional characteristics of patients, the specific cognitive and affective characteristics of the pt.
Highs start with using altered state of consciousness to help them to alter their cognition patterns. Some do not relax during hypnosis and biofeedback can be used.
Hypnotic suggestions can be added to biofeedback to emphasize attention to internal discrimination. Attention to stimuli is poor when arousal is too low or too high. Both biofeedback and hypnosis can be used to create a moderate level of attention.
With low hypnotizables, they need to increase awareness of contingencies between cognitions and physiological states; to verbalize and express their feelings. Initially they learn to recognize, label, and express their feelings through biofeedback, which amplifies the physiol. state/body sensations. It provides a means of relaxation. Begin with brief trials of biofeedback to train low arousal states. Duration of training is gradually lengthened to 15 minutes. Patient should be continually questioned about feelings etc. (physical) during exercise, and their response correlated with the feedback signal.
Many lows have difficulty expressing feelings in words. Biofeedback allows the correlation to emerge initially by the instruments. Crystal’s “preparatory” treatment: helping patient with affect tolerance prepares them for next stage of verbalizing emotions. Biofeedback facilitates this by deintensifying the effect of discharged affect.
Bruner, Jerome (1992). Another look at New Look 1. American Psychologist, 47, 780-783.
New Look 1 was not initially about the unconscious. It was the new mentalism on its way to becoming the Cognitive Revolution. Its subsequent concern with “unconscious defense mechanisms,” although useful, was not its main theoretical thrust. Its principal questions have always been how and where selective processes operate in perception. Obviously, many such processes are unconscious, for consciously guided attention and search become automatized easily in use. And they are fairly flexible as well. So how smart is “the unconscious”? Not very, but a big help anyway.
Dixon, Michael; Laurence, Jean-Roch (1992). Two hundred years of hypnosis research: Questions resolved? Questions unanswered!. In Fromm, Erika; Nash, Michael R. (Ed.), Contemporary hypnosis research (pp. 34-66). New York: Guilford Press.
NOTES
These notes summarize only that part of the chapter concerning nonvoluntary behavior (pp 38-39; 58-61).
The concept of ‘nonvolition’ has been and continues to be an important issue in hypnosis research. The concept pertains to the “subjective report that the hypnotic suggestion is enacted without the subject’s conscious and willful participation” (p. 38). When hypnosis was attributed to a magnetic fluid, in the days of Mesmer, the issue did not arise (because of course a person would not have control over something that happened to them physically). However, when hypnosis came to be considered a psychological phenomenon, the issue of how a behavior could be the result of motivated action and yet not perceived as being under conscious influence became important. In 1819 Faria wrote that the nonvolition paradox is due to the hypnotized subject’s tendency to misattribute the source or reason for one’s behaviors; he noted that successful suggestions depended upon the subject falsely attributing to the hypnotist the power to influence them. From that point forward, circular reasoning was used to state that one is hypnotized if one experiences their behavior as nonvolitional, and nonvolitional behavior signifies that a person is hypnotized.
“The observation of the seemingly complete automaticity of response in the highly hypnotizable subject led Liebeault in his 1866 book (followed later on by Bernheim and Liegeois) to describe these subjects as ‘puppets’ in the hands of the hypnotist. This was a quite unfortunate statement, since it would lead to one of the fiercest legal debates surrounding the use of hypnosis in the last 20 years of the 19th century (Laurence & Perry, 1988). …
“The most prominent author (if not the only one) who attempted to tackle this difficult question was Pierre Janet, who would make the investigation of automatisms the basis of his theory of hypnosis, rather than suggestion or suggestibility. This theoretical orientation is best exemplified by his concept of desagregation psychologique seen in some psychopathologies, or the carrying out of a posthypnotic suggestion in the normal individual (Janet, 1889; see also Ellenberger, 1970; Perry & Laurence, 1984; Prevost, 1973). Nonetheless, until the end of the 19th century, and for a good part of the 20th century, these reports of nonvolition were thought to be the end result of some neurological changes happening during hypnosis–an idea that has not been substantiated by contemporary research.” (pp 38-39)
Reports of nonvolition are explained as due to dissociation by Hilgard, or as the results of misattributing the origins of behaviors and experiences by Spanos and by Lynn. Neodissociationists like Hilgard regard misattribution to be a cognitive alteration, mainly an internal triggering mechanism, while social psychologists like Spanos and Lynn regard the misattribution to be the results of situational demands and therefore an external triggering mechanism.
“Regardless of one’s preferred metaphor, the issue of nonvolitional reports remains at the core of an integrated view of hypnosis and hypnotizability. The question remains as follows: By which mechanisms does this occur, and how can we predict a priori who will report involuntariness and under what circumstances? Whereas dissociationists have emphasized general cognitive mechanisms and de-emphasized situational factors, social- psychological theorists have emphasized situational variables and de-emphasized individual differences. Given the limitations of both approaches, emphasis will have to be placed not on their continued separation but on their integration, as more and more investigations demonstrate that they clearly interact with each other (see, e.g., Nadon, Laurence, & Perry, 1991).” (p. 60)
“At the height of the confrontation between the two French schools, hypnosis found its way into the legal arena. Following a series of criminal cases in which hypnosis had been allegedly involved, the two schools once again found themselves on opposite sides of the fence. For La Salpetriere, only those who had a propensity toward criminality (and hystericals were prime candidates) could be the victims of hypnosis. For the Nancy school, in highly responsive individuals suggestions could lead to criminal behavior. Unfortunately for the Nancy school, it soon became evident that the concept of suggestion was not sufficient in explaining the questions raised by the courts, and Bernheim was forced to recognize that in cases where suggestions had played a role, other dispositional and situational factors were probably more important in the genesis of the reprehensible behaviors. His espousing a too extreme position meant that the baby was thrown out with the bathwater. History may indicate that the same fate is now awaiting contemporary theoretical positions that adopt an extreme stance vis-a-vis the phenomenon of hypnosis” (p. 61).
Greenwald, Anthony G. (1992). New Look 3: Unconscious cognition reclaimed. American Psychologist, 47, 766-779.
Recent research has established several empirical results that are widely agreed to merit description in terms of unconscious cognition. These findings come from experiments that use indirect tests for immediate or long- term residues of barely perceptible, perceptible-but-unattended, or attended-but-forgotten events. Importantly, these well-established phenomena–insofar as they occur without initially involving focal attention–are limited to relatively minor cognitive feats. Unconscious cognition is now solidly established in empirical research, but it appears to be intellectually much simpler than the sophisticated agency portrayed in psychoanalytic theory. The strengthened position of unconscious cognitive phenomena can be related to their fit with the developing neural network (connectionist) theoretical framework in psychology.
Hilgard, Ernest R. (1992). Dissociation and theories of hypnosis. In Fromm, Erika; Nash, Michael R. (Ed.), Contemporary hypnosis research (pp. 69-101). New York: Guilford Press.
NOTES
[These Notes were made from a prepublication copy and the pagination for quotes added later.] The author reviews the history of dissociation theory, the hidden observer, and the credible-skeptical arguments regarding hypnosis. He briefly summarizes alternative theories about hypnosis, and asserts that we can turn aside from debate by examining the common topic studied, the “domain of hypnosis” or what happens when hypnotist, with consent of subject, attempts to induce hypnosis through conventional procedures: production of hallucinations, contractions, paralyses, age regression, analgesia, posthypnotic amnesia, etc. Even if one disagrees about the nature of these phenomena or the appropriate explanatory concepts, one can agree on the area to be investigated.
The author notes that one never sees these behaviors in the same situation, in any other context. They are distinguishable from other phenomena like meditation, highway hypnosis, responses to a persuasive leader, and even some waking suggestions by several delimiting factors:
1. Hypnosis is not simply a response to suggestion, because that kind of response occurs in other situations. Suggestions can be divided into personal and impersonal (Hull, 1933); and suggestibility can be divided into primary and secondary (Eysenck & Furneaux, 1945). Primary suggestibility includes responses to waking suggestion (e.g. postural sway) that correlate with hypnotizability; secondary suggestibility involves responses to waking suggestion that do not correlate with primary suggestibility. Hypnotizability does not correlate with social suggestibility (i.e. gullibility or conformity) (Burns & Hammer, 1970; Moore, 1964); nor does it correlate with placebo response (McGlashan, Evans, & Orne, 1979).
2. Test-retest correlations are approximately +.70 between scores on hypnotizability scales with and without formal inductions. Thus, responses to the type of suggestion on hypnotizability scales–even when in the waking context–belong within the domain of hypnosis. The individual differences in responsivity to items on hypnotizability scales persist over time (Piccione, Hilgard, & Zimbardo, 1989: r = .64 for 10 years test- retest, .82 for 15 years, and .71 for 25 years, on Stanford Form A); and this persistence is observed in twin studies as well (Morgan, 1973; Morgan, Hilgard, & Davert, 1970).
3. Additional evidence of coherence of the domain comes from reports of hypnotized Subjects about their phenomenological experience.
Hilgard’s discussion of the executive and monitoring functions within hypnosis place his theory within the area of cognitive psychology. He presents a theory of a central regulating mechanism, with a hierarchy of subsystems that may be activated (and once activated may continue with some autonomy). When autonomous action occurs, the conscious representation of the control system may recede. Furthermore, the hypnotist’s suggestions may alter the relationships within the hierarchy of subsystems and may also influence the executive functions. He gives as a common example, when a bilingual person talks in one language, the other language is temporarily inhibited.
There are a number of concepts or positions in the history of psychology that relate to Hilgard’s theory of hierarchical control with executive and subsystems:
1. ‘Cognitive structure’ (Edward Tolman, 1932; 1938; Kurt Lewin, 1935). There may be communication problems between cognitive structures.
2. ‘Habit family hierarchy’ (Clark Hull, 1934). Habits are organized in a preferential system, so that if one is blocked the next is activated.
3. ‘Cell assemblies’ (Hebb, 1949; 1975), which are a physiological counterpart of the ‘hidden observer’ phenomenon.
4. ‘Roles’ (Sarbin & Coe, 1972) may be considered cognitive substructures.
5. ‘Cognitive networks’ (Blum, Geiwitz, & Stewart, 1967) serve similar functions.
6. ‘Images’ and ‘plans’ (Miller, Galanter, & Pribram, 1960) provide for control of thought and action and have some kind of hierarchy.
7. ‘Subordinate ego-structures’ (Gill & Brenman, 1959) with a dominant ego; or the ego-apparatuses in a ‘conflict-free ego sphere’ (Hartmann, 1958).
In hypnosis, central executive functions may be shared between hypnotist and Subject. Hilgard gives extensive examples of varying degrees of split in the executive control system.
“It can be argued that, except for relinquishing control over the subsystems that are specifically dissociated from control by suggestion, and the readiness for relinquishing control, the central executive functions have not been much modified in hypnosis. In superficial hypnosis, these mild dissociations can occur through waking suggestions, with little alteration of the general state of consciousness. When varied suggestions to a talented hypnotic subject have cumulative effects, as in suggestions of relaxation and detachment from the environment, the more general features of the hypnotic state begin to appear. A more massive dissociation, so far as the executive is concerned, may be the consequence of the summing up of many specific subsystems for which control has been relinquished. Such an interpretation permits hypnosis as a state to be a relative matter, the specific dissociations being identifiable, but the general state being a matter of how many specific dissociations are operative and how pervasive they are. Only when they are sufficiently pervasive is it appropriate to speak of a change of state” (p. 96).
Hilgard also discusses the monitoring function extensively, relating it to trance logic and contrasting it with the waking state. Less of the usual monitor is retained when the hypnotic involvement is greater, as in deep hypnosis, or when the subject becomes more deeply engrossed in an activated system that has been aroused. He also relates the monitoring function to the Hidden Observer phenomenon.
Isenberg, S. A.; Lehrer, P. M.; Hochran, S. (1992). The effects of suggestions and emotional arousal on pulmonary functions in asthma: A review and a hypothesis regarding verbal mediation. Psychosomatic Medicine, 54, 192-216.
This paper reviews the empirical literature on the relation between asthma, suggestion, and emotion, and proposes the hypothesis that these effects are mediated parasympathetically. The literature indicates that, among asthmatics, suggestion can produce both bronchoconstriction and bronchodilation, and that stress can produce bronchoconstriction. The proportion of asthmatic subjects showing bronchoconstriction to both suggestion and stress averages 35%-40% across studies, but, because of methodological considerations, might be conservatively estimated as closer to 20%. The effect is smaller for suggestion of bronchodilation, and is very short-lived among nonasthmatics. No clear connection has been found between these responses and such subject variables as age, gender, asthma severity, atopy, or method of pulmonary assessment, although some nonsignificant tendencies appear. Most studies in this literature used small n”s and did not systematically examine various somatic, environmental, and demographic factors that could influence results. A hypothesis is presented regarding vagal mediation of psychological effects on the airways, as well as possible alternative mechanisms, and recommendations for future research to evaluate these hypotheses.
1991
The first part of this paper examines the concept of dissociation in the context of hypnosis. In particular, the neodissociative and social psychological models of hypnosis are compared. It is argued that the social psychological model, in describing hypnotic enactments as purposeful, does not adequately distinguish between behavior that is enacted “on purpose” and behavior that serves or achieves a purpose. 2 recent dissertations (Hughes, 1988; Miller, 1986) from the University of Waterloo are summarized, each of which supports the neodissociative view that hypnotic behavior can be purposeful (in the sense that the suggested state of affairs is achieved) and nonvolitional (in the sense that the suggested state of affairs is not achieved by high level executive initiative and ongoing effort). The second part of the paper employs a neodissociative view of hypnosis to help understand the current epidemic of multiple personality disorder (MPD). In particular, it is argued that many symptoms of MPD are implicitly suggested effects–particularly prone to occur in persons who have a lifelong tendency to use dissociative type defenses. The present author believes that this account is easier to sustain conceptually and empirically than the current view, which states that a secondary (tertiary, etc.) personality accounts for the striking phenomenological discontinuities experienced by MPD patients.
NOTES
As an example of the fact that behavior that serves a purpose is not always performed on purpose, the author cites not falling out of bed while sleeping, and waking up in response to signals from the bladder to go to the bathroom. Lower levels of control can be dissociated from executive initiative and/or monitoring. “Since the experience of volition is closely tied to executive initiative and effort, suggested behaviors that bypass such initiative and effort are typically experienced as nonvolitional” (p. 157). Dissociated control occurs under waking conditions also, as when one dials a very familiar phone number rather than the one that they intended to dial. In this case, the behavior that is enacted is not what one consciously intended.
Miller’s dissertation, also published as Miller & Bowers, 1986, is described on p. 158 ff. Without hypnosis, cold pressor pain (cold water immersion) reduced accuracy of performance on a multiple choice vocabulary test 35%. Both hypnotic analgesia and cognitive pain management strategies were equally effective in reducing pain of cold pressor test (and both interventions were more effective for high than for low hypnotizable Ss). However, the cognitive strategy group showed an additional drop of 30% in vocabulary performance from pre- to posttreatment cold water immersion (despite successfully reducing their pain). In the hypnosis condition, lows showed only a slight additional decrease (8%) while highs showed a slight (10%) _increase_ in their vocabulary performance from pre- to posttreatment immersion.
Thus, the effect of hypnosis in pain control “does not depend on S’s utilization of high-level cognitive strategies. Rather, hypnotic analgesia seems to involve the dissociated control of pain–that is, control which is relatively free of the need for high- level, executive initiative and effort. … Because hypnotic analgesia minimizes the degree of executive initiative and ongoing effort required to reduce pain, however, it seems inappropriate to view such reductions as something achieved on purpose” (p. 161).
Hughes’ dissertation is described on p. 162 and ff. Instead of performance decrement on a cognitive task like vocabulary testing, she used increased heart rate as an index of cognitive effort. If heart rate increases when Ss successfully use hypnotic imagery, that would confirm the social psychological view that “suggested effects are achieved by this kind of ongoing allocation of high-level cognitive force or work” (p. 162).
Highs and lows were hypnotized and administered three trials of neutral and three trials of fearful imagery in counterbalanced order. Each imagery trial lasted 1 minute, after which Ss rated vividness of imagery, effort required, and amount of fear experienced.
Average imagery vividness was higher in highs than lows, for both neutral and fear imagery. For lows the correlation between heart rate increases and ratings of cognitive effort were .54 (neutral imagery) and .49 (fear imagery). For highs, the correlations were -.05 (neutral) and -.52 (fear). Thus, “for low but not high hypnotizable Ss, we find the predicted positive relationship between a cardiac indicator of cognitive effort and the ratings of cognitive effort involved in producing neutral imagery” (p. 163).
“First, for low hypnotizables engaged in fear imagery, ratings of effort are correlated .66 with ratings of fear. In other words, the more low hypnotizable Ss work to produce a fearful image, the more frightening the image is. Second, for high hypnotizables engaged in fear imagery, the correlation between ratings of fear and effort is minus 68– indicating that the less effort highs report in producing fear imagery, the more frightened they become. Finally, for high hypnotizables, the correlation between ratings of fear and heart rate increase is .59, indicating that the more fear high hypnotizable Ss experience when engaged in fear imagery, the more their heart rate increases (the comparable figure for low hypnotizables is .16)” (p. 164).
The authors discuss why the pattern of correlations is different for people high and low in measured hypnotizability, and summarize the implications of both Miller’s and Hughes’ research. Both investigations indicate that, at least for high hypnotizable people, less initiative and effort are required to effect a response to hypnotic suggestion than one would expect. The show how behavior can be both purposeful and nonvolitional (in the sense of not exhibiting conscious intention and strategic efforts). By noting that the sense of nonvolition that accompanies a response to suggestion is an actual alteration in executive control, they provide a model for dissociative psychopathology such as MPD. For although executive control is dissociated, these experiments do not suggest that there is a second executive system or ‘personality’ that is responsible for the behavior.
Patients diagnosed with MPD have very high measured hypnotizability (Bliss, 1984). In fact, they seem to engage in self hypnosis, withdrawing into a trance or a dissociated state (Bliss, 1984). The authors quote Wilson & Barber (1983) as indicating that highly hypnotized, fantasy-prone normal individuals may become so absorbed in a character being imagined that they lose awareness of their own identity.
The authors offer a neodissociative account of MPD: “People prone to MPD are very high in hypnotic ability and are, therefore, vulnerable to the suggestive impact of ideas, imaginings, and fantasies; what is more, they are high in hypnotic ability because they have learned to use dissociative defenses as a way of dealing with inescapable threat– such as physical and sexual abuse (Kluft, 1987). … Fantasied alternatives to reality (including a fantasied alter ego … ) can become increasingly complex and differentiated. Gradually, these fantasied alternatives begin to activate subsystems of control more or less directly–that is, with minimal involvement of executive level initiative and control. Such ‘dissociated control’ of behavior does not necessarily eliminate consciousness of it, though one’s actions are apt to be experienced as increasingly ego-alien. If and when the activating fantasies and resulting behaviors become sufficiently threatening, however, they can also be repressed into an unconscious (i.e., amnesic) status, thus further separating high-level executive and monitoring functions from the dissociated, ego-alien aspects of oneself. The fully realized result of this process is an individual who is subject to profound discontinuities in his or her sense of self. … The experience of behaving in an outwardly uncharacteristic manner requires only that subsystems of control are more or less directly activated by ideas and fantasies in a manner that effectively bypasses executive initiative and control” (pp. 168-169).
923, Bowers, 1992 NOTES: Tart allegedly taught ESP skills based on reinforcement, using a machine that projected display and gave feedback immediately, so the subjects could learn to anticipate the picture better. But the picture presented next was time-linked to the S’s response (so S could learn it).
1987 Behavioral and Brain Sciences review, with 2 target articles, makes one doubt strength of findings. ESP research doesn’t distinguish between description of an observation and it’s proposed cause.
MPD shares with ESP a tendency to predispose toward a certain explanation. Feeling like one has a separate personality leads to finding evidence for one. But an MPD account is wrong-headed because the diagnosis misconstrues a notion of personality, which is a developmental concept (a pattern of thought, feeling, and behavior). Mischel’s (1968) account of human functioning competed with trait theory, so “personality” concept became extraneous.
Defining personality in terms of one’s experiences or beliefs about oneself has lead to further problems, encouraged by the descriptive approach of DSM III (which depends on patient reports). Drew Weston distinguished between the self and self representation. One can’t argue that a computer programmed to describe itself is the same as it’s descriptions.
Personality can’t be reduced to person’s beliefs about themselves. A secondary personality cannot be reduced to bizarre experiences a person believes are due to a second personality. Clinicians do not accept as valid the beliefs of a paranoid schizophrenic; or of an anxious neurotic. With multiple personality disorder (MPD) the patient becomes the expert and the clinician the student.
William Smith’s 1986 SCEH paper: case study of patient who was convinced her problems were due to unresolved problems from a previous life. He didn’t challenge her system but still worked with her successfully, communicating respect without validating her belief.
Advocates of MPDs think the observation that it is associated with high hypnotizability indicates great dissociation; critics think the association indicates great suggestibility. There is a historical parallel: Mesmer probably didn’t suggest seizure-like episodes, but implicit suggestions for seizures were probably partially responsible. Mistaken attribution permitted Mesmer to see this as validation of his theory of animal magnetism.
Clinicians are not the only ones to “suggest” MPD syndrome. High profile cases are in the media. We should also remember Orne’s 1959 research showing that students who received false information a week earlier in lecture on hypnosis showed the behavior when they were hypnotized.
Janet’s disaggregation (dissociation) theory said hysterics and hypnotized people responded to ideas dissociated from the main stream of consciousness. So his contemporaries thought that spontaneous amnesia was a defining feature of hypnosis; yet it is not thought to be so in our era. The idea may have circulated in Janet’s time, by popular culture.
MPDs are always highly suggestible so can respond to circulating accounts in the media, and every account that reaches the media can influence these people.
We could abandon the diagnosis of MPD in favor of Spiegel’s “disorder of self integration.” It is less provocative, does not imply any clinical benefit in the benefits of seeking out more personalities. This might reduce the incidence of this disorder, or likelihood that a suggestible person would develop the disorder iatrogenically.
Brown, Jason W. (1991). Self and process: Brain states and the conscious present. New York: Springer-Verlag.
NOTES
Author, from the Department of Neurology at New York University Medical School, presents a theory about the genetic unfolding of mental content (mind) through stages, from mental state into consciousness or into behavior. He relates the genesis of mind to brain development but avoids assuming that there is a straightforward correlation between brain development (e.g. myelination) and cognitive development or perception. To some degree, the theory is based on subjective report data and psychological symptoms. The author discusses issues that bear on the phenomena of nonvoluntary responding and dissociation that are reported or described by hypnotized persons.
“The nature of the mental state will determine the relation between self and world, and thus the interpretation given to agency and choice. … The crossing of the boundary from self to world is a shift from one level in mind to another” (pp. 10-11).
“… if we begin with mind as primary and seek to explain objects from inner states and private experience, the discontinuity between inner and outer evaporates: mind is everywhere, a universe. … Whereas before we thought to perceive objects, now we understand that we think them” (p. 19).
“The concept of a stratified cognition is central to the notion of a mental state …. This entails an unfolding from depth to surface, not from one surface to the next, a direction crucial to agency and the causal or decisional properties of consciousness” (p. 52). By unfolding from depth to surface, he means from Core, through Subconscious, then Conscious Private Events, and finally Extra-Personal Space.
He goes on to provide a definition of mental states. “A mental state is the minimal state of a mind, an absolute unit from the standpoint of its spatial and temporal structure. … The state also has to include the prehistory of the organism. … The concept of a mental state implies a fundamental unit that has gestalt-like properties, in that specific contents– words, thoughts, percepts–appear in the context of mind as a whole (p. 53).
“The entire multitiered system arborizes like a tree, with levels in each component linked to corresponding levels in other components. For example, an early (e.g., limbic) state in language (e.g., word meaning) is linked to an early stage in action (e.g., drive, proximal motility) and perception (e.g., hallucination, personal memory) …. In sum, a description of the spatial and temporal features of a _single_ unfolding series amounts to a description of the minimal unit of mind, the _absolute_ mental state” (p. 54).
The author’s discussion of an individual’s physical movement relates to the concept of nonvoluntary movement (or movement without awareness of volition) in hypnosis. “More precisely, levels in the brain state constitute the action structure. As it unfolds, this structure generates the conviction that a self-initiated act has occurred. This structure–the action representation–does not elaborate content in consciousness. … As with the sensory-perceptual interface, the transition to movement occurs across an abrupt boundary. In some manner, perhaps through a translation of cognitive rhythms in the action to kinetic patterns in the movement, levels in the emerging act discharge into motor (physical) events” (p. 57).
“The self has the nature of a global image or early representation within which objects-to-be are embedded. … The self is the accumulation of all the momentary cognitions developing in a brain configured by heredity and experience in a particular way (p. 70).
“The deposition of a holistic representation … creates the deception of a self that stands behind and propagates events. The feeling of the self as an agent is reinforced by the forward thrust of the process and the deeper locus of the self in relation to surface objects. The self appears to be an instigator of acts and images when in fact it is given up in their formation. The self does not cause or initiate, it only anticipates (p. 70).
The foregoing notes cover only the first five chapters, less than half the book. Other chapters relevant to hypnosis would be those titled ‘The Nature of Voluntary
Action,’ ‘Psychology of Time Awareness,’ ‘From Will to Compassion,’ and ‘Mind and Brain.’
Brown, Peter (1991). The hypnotic brain: Hypnotherapy and social communication. New Haven, CT: Yale University Press.
NOTES
Notes are taken from a review of this book: Diamond, Michael (1993). Book review. Bulletin of the Menninger Clinic, 57 (Winter), 120-121.
Brown “posits that because the fundamental matrix of the human brain is metaphoric, hypnosis results from skillful matching of metaphorical communication with the brain’s biological, rhythmic alterations. The most significant feature of trance experience is thereby located in the hypnotist-subject interaction” (p. 120).
“The middle section [of the book is comprised largely of] literature reviews in support of Rossi’s (1986) ultradian rhythm theory of hypnosis and Lakoff and Johnson’s (Johnson, 1987; Lakoff & Johnson, 1980) experientialist theory of conceptual thought” (p. 120). The final section includes “research evidence on medical uses of hypnosis, a theory of dissociation and multiple personality disorders, and an uncritical discussion of Milton Erickson’s naturalistic hypnotherapeutic approach … [and also] a brief discussion of the social-cultural functions of possession states among the Mayotte culture” (p. 120).
Erxleben, Jan; Cates, Jim A. (1991). Systemic treatment of multiple personality: Response to a chronic disorder. American Journal of Psychotherapy, 45 (2), 269-278.
Proposes a treatment approach for multiple personality disorder (MPD) in which the personality fragments are viewed from a systemic perspective. MPD is considered the result of a dissociative defense in response to severe trauma during the formative period of personality. As the child dissociates to defend against the trauma, the fragments of personality develop as separate entities. The traditional focus of therapy is integration, or fusion of the various fragments of the personality. The alternative treatment process attempts to maintain balance within the system as a short-term goal, and strives for integration as a long-term goal.
Proposes a treatment approach for multiple personality disorder (MPD) in which the personality fragments are viewed from a systemic perspective. MPD is considered the result of a dissociative defense in response to severe trauma during the formative period of personality. As the child dissociates to defend against the trauma, the fragments of personality develop as separate entities. The traditional focus of therapy is integration, or fusion of the various fragments of the personality. The alternative treatment process attempts to maintain balance within the system as a short-term goal, and strives for integration as a long-term goal.
1990
Barber, Theodore Xenophon (1990, August). Some things I’ve learned about hypnosis after 37 years. [Audiotape] Presented at the annual meeting of the American Psychological Association, Boston.
NOTES
“We are a unity of cells. Every cell is a citizen with it’s own jobs, communicating all the time; cells send messages; the way we communicate with them is by suggestions. Each _cell_ is a mind-body…. When I do it now [hypnotic inductions], I say, ‘We’re going to go into hypnosis, we’re _both_ going to go into hypnosis. I’m going to close my eyes (etc.)’ – modeling hypnosis for them.”
Counts, R. M. (1990). The concepts of dissociation. Journal of American Academy of Psychoanalysis, 18, 460-479.
Reviews conceptualizations of dissociation. Dissociation is the underlying mechanism in a number of defensive mechanisms. Repression, intellectualization, splitting, and other defense mechanisms rely upon dissociation to accomplish their specific tasks. Dissociation is thus believed to be the underlying and basic mechanism of many aspects of mental functioning.
Fellows, Brian J. (1990). Current theories of hypnosis: A critical overview. British Journal of Experimental and Clinical Hypnosis, 7, 81-92.
The present state of theory in hypnosis is reviewed and observations are made concerning future prospects. The state- non-state issue continues to dominate theoretical debate, although no satisfactory reply has yet been made to T. X. Barber’s criticisms of the ‘hypnotic trance’ concept. The impact of social-psychological theory has been considerable and the results of Spanos’s hypnotic training programme could have significant implications for our understanding of hypnosis. Future theorizing should see a move towards a more integrated sociocognitive approach. Neodissociation theory has generally not fulfilled its early promise and is encumbered with the ‘hidden observer’ concept. The role of imaginative processes continues to be a dominant theme in hypnosis theory, although the relatively small correlation between imaginative and hypnotic abilities remains a problem. The links between hypnosis, sleep and relaxation deserve further research, although, as theories of hypnosis, their scope seems limited. Suggestibility and role enactment theories have shown few signs of development in recent years. Theoretical problems over the interpretation of hypnosis need to be more widely recognized and the use of question-begging terminology curtailed. One advantage of the imagination hypothesis is that it provides a bridge, or a point of convergence, between state and non-state approaches (Spanos & Barber, 1974). It also handles certain hypnotic phenomena very well. For example, the known facts of age regression can be readily interpreted, together with the oddities of age progression and past life regression, as imaginative reconstructions (Barber, 1979). However, other phenomena, such as amnesia and analgesia, are less easily explained.
Gauld, Alan (1990). Mesmeric analgesia and surgery: A reply to Spanos and Chaves. British Journal of Experimental and Clinical Hypnosis, 7, 171-174.
NOTES
Spanos and Chaves’ criticisms of the author’s paper in this journal (vol. 5, 1988, pp 17-24) on mesmeric analgesia are considered. Spanos and Chaves are unnecessarily dismissive of nineteenth century reports of mesmeric analgesia and, in order to bring these cases within the compass of their theory, they make assumptions about them that are not supported by the facts.
Heyneman, Nicholas E. (1990). The role of imagery in hypnosis: An information processing approach. International Journal of Clinical and Experimental Hypnosis, 38 (1), 39-59.
Imagery is widely agreed to be an important component of hypnosis. The theoretical framework from which to conceptualize the role of imagery in hypnosis, however, has remained controversial. A model is presented which attempts to reconceptualize hypnotic imaginal processing in terms of current theory and research in cognitive psychology and psychophysiology. This model draws from a propositional approach to imagery (e.g. Pylyshyn, 1973), particularly as adapted by Lang’s (1979) bioinformational theory. It is argued that the hypnotic image is fundamentally more complex than simple iconic mental representation, containing instead both stimulus and response components. It is proposed that the critical properties of the hypnotic image are not the stimulus components or propositions which give rise to the experience of the image but instead are response propositions which are associated with overt behavior. Processing of these response propositions is conceptualized as a negative feedback system between the brain and effector site. Some preliminary sources of support as well as implications and research suggested by this model are discussed.
NOTES
The author notes that the brain does not store a kind of “photograph,” but rather stores “meanings” (Anderson, 1978); and that images actually represent response processes, as observable in physiological concomitants (Lang, 1977).
The hypnotic suggestion that a Subject’s arm is being pulled up into the air by a large helium balloon is represented by two separate propositions: “There is a helium balloon tied to your arm” (a stimulus proposition) and “Your arm is moving up into the air” (a response proposition). According to Peter Lang (1979), an image is not a mental stimulus to which a response is made, but is in itself an active response process, accompanied by physiological activity. Verbal instructions to a Subject determine whether they will access stimulus propositions or response propositions. “Lang et al. (1980) found that only those Ss given response training coupled with response proposition scripts showed significant physiological arousal. These Ss were presumably better able to access and process that portion of the propositional network which controls visceral and motoric responding” (p. 46).
This author proposes that cognitive processing of a hypnotic image involves (internal) responding, and that ‘responsive propositions’ provide the basis for understanding the function of imagery in hypnosis, and are more important to hypnotic imagery than stimulus propositions. “In other words, the experience of a visual image and thus the vividness or controllability of that image is not critical for hypnosis. What is important to note is that the hypnotic behavior is not a response to a visual image but is instead a function of the processing of the image itself (cf. Lang, 1979)” (pp. 47-48).
In explaining how an image might facilitate amplification of a subtle response (such as in arm levitation), the author suggests that physiological and external feedback systems are involved–principally a neural feedback loop between brain and target organ (in this case, arm muscles). “Efferent signals, which are activated by processing response propositions, initiate the overt behavior while afferent signals feed back to the brain and modulate further input tot he effector system. The process progressively reduces the mismatch between the image instructions and behavior until the hypnotic task is completed” (p. 48). The feedback loop “provides information on the discrepancy between desired behavior and actual behavior: e = Bd-Ba, where e = error, Bd = desired behavior, and Ba= actual behavior (Arbib, 1972). The error signal generated by this discrepancy modifies the efferent output so as to eventually approximate e = 0” (p. 49). The author notes that this complex process of physiological feedback may be “augmented by external feedback such as modified verbal instructions or vocal intonations of the hypnotist and self-observation by S” (p. 49).
The author’s model is summarized as: “1. The context, setting, and expectations implied by being hypnotized as well as the wording of the hypnotic suggestions provides S with: (a) explicit or implicit instructions to use imagery, (b) repetitious wording which may increase the probability of fully accessing the relevant propositions, and (c) instructions that task completion is expected. This may function to increase the probability that the deep structure of the response propositions will be processed. 2. The hypnotic suggestion proper is composed of stimulus and response propositions embedded within a propositional network. 3. Stimulus propositions give rise to the phenomenological characteristics or the percept- like experience of the image but may be unimportant in determining hypnotic behavior. 4. Processing of the response propositions includes an active response. This response process is facilitated by S’s expectation to become actively involved in the imagined scene. Response propositions are the critical features of hypnotic imagery. 5. During hypnosis, the propositional network may be systematically modified by physiological or external feedback regarding the relative progress of the behavior toward task completion. This processing of response propositions is conceptualized as a negative feedback system. Efferent signals are delivered to the appropriate effector site while afferent signals feed back to the brain in order to modify further neural input, functioning to reduce the error between image and behavior. While the initial feedback is probably physiological, additional feedback may be obtained from the hypnotist’s instructions and S’s self-observations. 6. If stimulus propositions are simultaneously accessed, S experiences an image” (p. 51).
1989
Alexieva, A.; Nicolov, N.A. (1989). Brain mechanisms in classical conditioning. Behavioral and Brain Sciences, 12, 137.
NOTES
This is a Commentary on article by J. S. Turkkan (1989), Classical Conditioning: The new hegemony. In Behavioral and Brain Sciences.
Commentators note that the objective of the target article is to show how current thinking about Pavlovian conditioning differs substantially from the historical view; also that this has been recently emphasized by Rescorla (1988). Commentators note that the neural pathways and neural mechanisms involved in Pavlovian conditioning are of great interest and are investigated by many neuroscientists all over the world (Grigoryan & Tchilingaryan 1988; Kositsyn N.S. & Dorochov 1986; Onifer & Durkovic 1988; Storzhuk 1986: Vartanyan & Pirrgov 1986). Commentators also note the work of Ramachandran & Pearce (1987) and Uryvaev Yu.V. et al. (1988).
They express the opinion that Turkkan’s review affords a thorough description and interpretation not only of basic data and new conceptual views, but also of certain key notions in the modern theories of Pavlovian associative learning.
Blum, Gerald S. (1989). A computer model for unconscious spread of anxiety-linked inhibition in cognitive networks. Behavioral Science, 34, 16-45.
Unconscious inhibitory processes, triggered by a potential anxiety reaction, are reviewed in the context of an emerging rapprochement between psychodynamic and cognitive approaches in experimental psychology. Conditions underlying spread of inhibitory action to other cognitive networks are first explored in three tachistoscopic experiments utilizing words posthypnotically tied to a potential anxiety, pleasure, or neutral reaction. Response times of subjects, instructed to ignore those words while naming pictures or solving anagrams as quickly as possible, reveal a highly differentiated pattern of circumstances governing likelihood of inhibitory spread from anxiety-linked words to target stimuli. Next a computer model is constructed to simulate cognitive processes from onset of display to eventual response, and the model is then tested for its fit to the empirical data. Finally, an illustrative study shows that a subset of computer- generated predictions for spread of inhibitory action is verifiable experimentally.
Buss, A. H. (1989). Personality as traits. American Psychologist, 44, 1378-1388.
Personality traits have been challenged as unimportant determinants of behavior, but evidence suggests that traits may carry as much variance as experimental manipulations. Asking whether traits or manipulations control more variance is useless because researchers can plan paradigms that favor one or the other. When traits and manipulations complement each other there are several major kinds of interaction. The trait-manipulation dichotomy is analogous to the person-environment dichotomy, and both are related to active versus passive models of behavior. Trait variance is increased by aggregating across responses, situations, and time. Underlying aggregation are the issues of units and classes of behavior. Individual responses are on a continuum of breadth that extends successively upward to response classes, personality traits, and higher order traits. Broad and narrow traits each have advantages and disadvantages. Recent research has led to novel personality traits and to knowledge about the origin and maintenance of traits. If there is to be a specialty called personality, its unique and therefore defining characteristic is traits.
Gardner, Beatrix T.; Gardner, Allen R. (1989). Beyond Pavlovian classical conditioning. Behavioral and Brain Sciences, 12, 143-144.
NOTES
This is a commentary on the article by Turkkan (1989) entitled “Classical conditioning: The new hegemony” in Behavioral and Brain Sciences, 12, 121-179. (Pavlov’s theory of hypnosis was based on a conditioning model, which is why this material may be relevant.)
“Traditionally, the mechanism of stimulus association proposed by Pavlov early in this century is invoked to account for conditioning that is independent of the positive and negative consequences of responding. … Pavlov attributed this result to stimulus substitution (i.e., the subject responds to the Sa as if it were the S*) and this has been the dominant view throughout this century” (p. 143).
‘In Pavlov’s classical procedure, only increases and decreases in the original consummatory or defensive response are counted as conditioned responses. … Pavlov’s classical procedure is only a special case of a much broader case of a phenomena” (p. 143).
“Key-pecking by pigeons and lever-pressing by rats are responses that were long held up as prototypes of arbitrary behaviors that could only be shaped by response- contingent reinforcement. In the autoshaping procedure, however, these same responses have been easily conditioned to an arbitrarily selected stimulus (Sa) when the delivery of food was entirely independent of the response of the subjects. Not only that, but robust rates of responding have been maintained when food was withheld if the pigeons pecked the key or the rats pressed the lever, that is, when the contingency was negative (Williams & Williams 1969)” (p. 143).
“Turkkan follows a grand tradition when she discusses the similarities between associative conditioning and fundamental aspects of human verbal behavior. Yet an essential characteristic of verbal behavior is the difference between the response to an object and the response to a word for the object. The response to the spoken or written word ‘apple’ must be distinctly different from the response to an actual apple. Whatever we learn when we acquire vocabulary, it cannot be the simple stimulus-stimulus connection advocated in Pavlov’s classical theory. Even the popular Rescorla (1967) design for separating stimulus-stimulus contiguity from stimulus-stimulus contingency only succeeds in comparing two sources of stimulus-stimulus association. Meanwhile, the recently discovered autoshaping experiment does offer us a laboratory model in which associative conditioning can result in a response to the Sa that is different from the consummatory response to the S*” (p. 144).
“The theory of stimulus-stimulus association that Pavlov built upon the results of his special procedure is inadequate to deal with the wide range of phenomena of associative conditioning that have been discovered since his time.
“We wholeheartedly agree with Turkkan regarding the enormous theoretical and practical significance of the new discoveries but we are convinced that the terms ‘Pavlovian conditioning’ and ‘classical conditioning’ serve us best in their historical usage. … The new discoveries seem to us to show that a wide range of significant phenomena fall outside the boundary conditions of traditional Pavlovian and Skinnerian theories” (p. 144).
1988
Baker, Elgan L. (1988). The contributions of Milton Erickson: Reflections on the forest and the trees. International Journal of Clinical and Experimental Hypnosis, 36, 125-127.
NOTES
This is the introduction to a special issue of International Journal of Clinical and Experimental Hypnosis, which is devoted to the contributions of Milton Erickson. “The conclusions of these analyses are sometimes surprising. The usual understanding of Erickson’s work and the hallmarks of the Ericksonian tradition emphasize such parameters as indirect suggestion; naturalistic or permissive trance induction; confusional strategies; ‘unconscious learning’; and the focal use of metaphor, analogy, anecdote, and storytelling. These authors suggest, however, that Erickson’s work frequently did not entail the use of hypnotic trance in any conventional sense and attribute many of the crucial variables in his therapeutic work to a variety of nonhypnotic phenomena” (p. 126).
Several consistent themes emerge, which Baker refers to as perhaps the “essence” of Erickson’s contributions: “(a) the charismatic power of Erickson’s personal presentation and style; (b) the marked influence of social variables; (c) consideration of primitive, unconscious relationship variables; (d) the evocative use of language, symbolism, and nuances of communication; (e) the ingenious tailoring of therapeutic interventions to the perceived uniqueness of each patient; and (f) the central influence of nonhypnotic variables rooted in social learning and cognitive-behavioral paradigms” (p. 126).
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
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).
Gorassini, Donald R.; Hooper, Cynthia L.; Kitching, Kathleen J. (1988). The active participation of highly susceptible hypnotic subjects in generating their hypnotic experiences. Imagination, Cognition and Personality, 7 (3), 215-226.
Hypnotized individuals have traditionally been considered to be detached from the control of their own suggested behavior. We tested this and the alternative notion that hypnotized subjects attempt to self-generate the experiences (i.e., mainly of involuntariness) as well as produce the behaviors thought to be prototypical of high hypnotic ability. In an experimental investigation, highly susceptible hypnotic subjects were found to engage in the kind of imaginative activity that would be expected of individuals who were attempting deliberately to generate their experiences of involuntariness; they engaged as actively in imagery-generation as did subjects who were specifically instructed to imagine during suggested responding, and they experienced as much involuntariness as subjects in whom suggested movements were produced by an external physical force. The implications of these findings for the neodissociation and social psychological theories of hypnotic responding are discussed.
Hawkins, Russell; Le Page, Keith (1988). Hypnotic analgesia and reflex inhibition. Australian Journal of Clinical and Experimental Hypnosis, 16, 133-139.
The major change in thinking about models of analgesia over the last decade or so may be seen as a shift away from the earlier emphasis on a one-way afferent transmission sequence. Analgesia was effected, according to the older models, by a simple blocking of afferent impulses at some level (as achieved by local anaesthesia). Recent models suggest that there are at least two CNS analgesia control systems, each operating via an active mechanism for the inhibition of nociception which includes reciprocal _efferent_ impulses able to respond to input from lower centres by sending control signals which modify their output. One CNS analgesia system has now been quite well described. This “opiate” analgesia system has proved to be naloxone reversible and seems to be mediated by reciprocal pathways between brain stem structures and the dorsal horn and trigeminal caudalis. This is not likely to be the system responsible for all cases of hypnotic analgesia, since the common experience of continued awareness of some elements of a normally painful stimulus, in spite of a freedom from pain, implicates a higher level involvement such as input from the prefrontal cortex.
NOTES
The authors present a surgery case (of a cystoscopy and urethrotomy performed under hypnotic analgesia, with a highly hypnotizable patient) as an illustration of their position. The patient grimaced when the urethrotome was inserted into the urethra and dilated, but she denied discomfort and did not exhibit a reflex adduction of the thighs that is often observed even under standard general anaesthesia. She had spontaneous amnesia for the entire surgery. Later, under hypnosis, the patient could remember “discomfort and a sharp pain” which lasted for “seconds, if that” (p. 134).
The authors refer to Melzack and Wall’s (1965) gate control theory as well as Hilgard’s (1973) neodissociation interpretation of pain reduction in hypnosis. They review research by Hardy and Leichnetz (1981) with monkeys, in which they “traced the projections of the periaqueductal gray (PAG) to determine the extent of any possible cortical involvement in the endogenous analgesic system. Their work showed that the prefrontal cortex was the principal source of projections to the PAG” (p. 136). They quote the latter as writing that, “Patients who have had prefrontal lobotomies for relief of chronic pain report that while they still feel the pain they are no longer bothered by it … the prefrontal cortex by virtue of its projections to the PAG may play a role in modulating nociception at the spinal level” (Hardy & Leichnetz, 1981, p. 99).
“Hardy and Leichnetz have also suggested that there may be more than one analgesic system within the CNS. The first system is a naloxone-reversible mechanism which can be activated by opiates (presumably both endogenous and exogenous) and by acupuncture. Since hypnotic analgesia has shown itself not to be naloxone-reversible (Goldstein & Hilgard, 1975) it may have little to do with the opiate reception analgesia system. Instead the mechanism of hypnotic analgesia may lie in Hardy and Leichnetz’s second system which is sensitive to affective and cognitive influences” (pp. 136-137).
The authors include a review of the work by Mayer and Price (1976) which established the importance of brain stem structures in analgesia, especially for eliciting stimulation-produced analgesia. They cite Mayer and Price as drawing a distinction between “analgesia achieved by incapacitating a component in a pain transmission system or by activating a pain inhibition system” (p. 137). They also report that Mayer and Price conclude that stimulation-produced analgesia does not result from a “functional lesion” in the brain stem, but results from stimulation of a pain-inhibiting mechanism, suggesting the dorsal horn and trigeminal nucleus caudalis may be involved. This would be consistent with the inhibition of spinal reflexes (the adductor reflex) observed in their urethrotomy case, and the spinal reflex to nociception has also been reported by Finer (1974).
“The concomitant inhibition of reflexes in humans during hypnotic analgesia can be interpreted as evidence that nociception is probably not ascending to the cerebral cortex and that therefore the source of analgesia can be localized to the brain stem areas. It may be the case, however, that the locus of effect of hypnotic analgesia is not uniform across cases and may be identified by the overall pattern of subjective reports and physiological responses. Hypnotic analgesia may be experienced in more than one way subjectively and these differences may be attributable to differing underlying physiological mechanisms. On some occasions the relevant body part may be experienced as totally anaesthetised and all sensation (not only painful sensation) may be lost. This experience matches well with a brain stem involvement, which presumably inhibits any further afferent action. On other occasions, however, and more commonly, patients are still aware of a variety of sensations, which might include pressure in the case of childbirth or even cutting in the case of surgery, but these sensations are not described as painful. This is reminiscent of the effect of frontal lobotomy and it is tempting to focus on the frontal lobe as the locus of hypnotic analgesia effects in such instances” (p. 138).
Hilgard, Ernest R. (1988). Milton Erickson as playwright and director. International Journal of Clinical and Experimental Hypnosis, 36, 128-140.
Milton Erickson in his therapeutic practice can be characterized as a playwright who plans a little play for each patient and then leads that patient to accept and enact the assigned role. This arrangement permits him to be authoritarian as playwright and director by providing the staging and the strategy, while the patient then provides the tactics by carrying out the assignment in his or her own way. Several examples are given from published cases. The first is a case of enuresis in both husband and wife, selected because in this instance no mention is made of hypnosis as Erickson sets the circumstances and gives direct orders for carrying out the instructions. 3 pairs of cases are described to indicate how differently Erickson has treated cases with similar symptoms. Finally, 1 case is discussed more extensively because the treatment extended over a 6-year period. Its interpretation shows how difficult it is to distinguish what belongs to the strategic drama and what to hypnosis. All cases had successful outcomes.