Rapee, Ronald M. (1991). The conceptual overlap between cognition and conditioning in clinical psychology. Clinical Psychology Review, 11, 193-203.

Given the fact that contemporary theories of conditioning regularly utilize information processing concepts such as memory and expectancies, classifying clinical theories as either cognitive or conditioned appears to be outdated. Yet, this dichotomy is still upheld in many clinical writings. Such a false dichotomy seems to serve more of a political function than a theoretical one and thus is likely to interfere with a complete understanding of psychopathology. While the terms conditioning and cognition are often used to imply unconscious learning on the one hand versus conscious, rational learning on the other, this usage is not consistent. A more empirically useful way to describe pathological behavior may be in terms of the amount of attentional resources utilized.

Van Der Kolk, Bessel; Van Der Hart, O. (1991). The intrusive past: The flexibility of memory and the engraving of trauma. American Imago, 48, 425-454.

Describes the work of Janet concerning narrative versus traumatic memory, dissociation, and subconscious fixed ideas. Janet (1904) believed PTSD patients suffer from a phobia for the traumatic memory. Repression and dissociation are distinguished. Contemporary concepts of memory processing and the concept of schemas are then reviewed. Finally, a model is presented about how the mind freezes some memories. Evidence for the involvement of autonomic hyperarousal, triggering, and state dependent learning in PTSD is reviewed. They conclude that helplessness and the inability of the PTSD victim to take action (psychological and physical immobilization) facilitates dissociation. Includes practical ideas for the working through of trauma.

p. 443 “Traumatic memories are triggered by autonomic arousal … and are thought to be mediated via hyper-potentiated noradrenergic pathways originating in the locus coeruleus of the brain… The locus coeruleus is the ‘alarm bell’ of the central nervous system, which properly goes off only under situations of threat, but which, in traumatized people, is liable to respond to any number of triggering conditions akin to the saliva in Pavlov’s dogs. When the locus coeruleus alarm gets activated, it secretes noradrenaline, and, if rung repeatedly, endogenous opioids. These, in turn, dampen perception of pain, physical as well as psychological (van der Kolk et al. 1989). These neurotransmitters which are activated by alarm affect the hippocampus, the amygdala and the frontal lobes, where stress-induced neurochemical alterations affect the interpretation of incoming stimuli further in the direction of ’emergency’ and fight/flight responses” (p. 443).

Bornstein, Robert F. (1990). Critical importance of stimulus unawareness for the production of subliminal psychodynamic activation effects: A meta-analytic review. Journal of Clinical Psychology, 46, 201-210.

Performed meta-analysis that assessed the magnitude of behavior change produced by subliminal vs supraliminal drive-related stimuli (DRS) on 11 subliminal psychodynamic activation (SPA) studies (published 1966-1989) that employed both types of stimuli. The analysis revealed that subliminal presentation of DRS produced significantly stronger effects on behavior than supraliminal presentation of the same stimuli. Stimulus content, type of outcome measure, and S characteristics influenced the magnitude of subliminal/supraliminal response differences. Results support L. H. Silverman’s (1983) hypothesis that DRS must be presented subliminally to produce SPA effects.

Kihlstrom, John F.; Schacter, Daniel L.; Cork, Randall C.; Hurt, Catherine A.; Behr, Steven E. (1990). Implicit and explicit memory following surgical anesthesia. Psychological Science, 1, 303-306.

Paired associates were presented to 25 surgical patients following the induction of anesthesia by thiopental, vecuronium, and isoflurane. Postoperative testing (immediately or after two weeks) showed no free recall for the list; nor was there significant cued recall or recognition, compared to a matched control list. However, a free-association task showed a significant priming effect on both immediate and delayed trials. At least under some conditions, adequate surgical anesthesia appears to abolish explicit, but not implicit, memory for intraoperative events.

Kunzendorf, Robert G.; Jesses, Michael; Dupille, Leonard; Butler, William (1990-91). Subliminal activation of intrapsychic conflicts: Subconscious realms of mind vs subconscious processes of mentation. Imagination, Cognition and Personality, 10, 117-128.

Cognitive-state monitoring theory asserts that people perceive subliminal stimulation without self-consciously monitoring its external innervation (as opposed to central innervation). Thus monitoring theory predicts that subconsciously perceived discord, in the absence of any ‘external location’ cues, should be misinterpreted as centrally generated discord and should disrupt self-generated behavior. Consistent with this prediction, mathematical problem-solving in the current experiment was disrupted after mathematically competitive males repeatedly heard the subliminal message IT’S WRONG TO CRUSH DADDY stereophonically localized in the middle of their heads–but not after they repeatedly heard this subliminal ‘Oedipal’ message binaurally localized on one side of their heads. A subliminal message binaurally localized on one side of the self should not interfere with problem-solving behavior _because, even though the message’s external innervation is not self-consciously ‘monitored,’ its external location is inferable from subconscious cues._
Monitoring theory asserts that subliminal [perceptions] of ‘unmonitored’ messages are unaccompanied by any self-consciousness that one is perceiving them (rather than imaging them), and that subliminal or ‘unmonitored’ messages of distress are mistaken for self-generated distress.
Disruption by the ‘internal’ subliminal word WRONG seems to us consistent with the fact that disruption was limited to mathematically competent males.
Indeed, ‘repression’ itself is a mode of processing fearful information: a mode in which subjects suspend their self-awareness that they are perceiving fearful stimulation, as research by Kunzendorf and McLaughlin has demonstrated. This selective suspension of monitoring provides immediate relief from fearful stimuli, Freudian or otherwise, but it does so at the risk of turning self-conscious fear into subconscious anxiety (into consciously lingering fear without a self consciously perceived source). No subconscious realm full of lurking fears is implicated in this ‘unmonitored’ mode of self-protection. All that is implicated is an unconscious storehouse of potentially fearful memories–potentially fearful but sensationless memories, which can be ‘suppressed’ from conscious sensory representation or ‘constructed’ into conscious memory images or ‘subconsciously represented’ as unself-consciously imaged sensations.

Roediger, Henry L. III (1990). Implicit memory: Retention without remembering. American Psychologist, 45 (9), 1043-1056.

Explicit measures of human memory, such as recall or recognition, reflect conscious recollection of the past. Implicit tests of retention measure transfer (or priming) from past experience on tasks that do not require conscious recollection of recent experiences for their performance. The article reviews research on the relation between explicit and implicit memory. The evidence points to substantial differences between standard explicit and implicit tests, because many variables create dissociations between these tests. For example, although pictures are remembered better than words on explicit tests, words produce more priming than do pictures on several implicit tests. These dissociations may implicate different memory systems that subserve distinct memorial functions, but the present argument is that many dissociations can be understood by appealing to general principles that apply to both explicit and implicit tests. Phenomena studied under the rubric of implicit memory may have important implications in many other fields, including social cognition, problem solving, and cognitive development.

Weinberger, Joel; Hardaway, Richard (1990). Separating science from myth in subliminal psychodynamic activation. Clinical Psychology Review, 10, 727-756.

This paper reviews subliminal psychodynamic activation (SPA). Eight common criticisms are described and evaluated: (a) SPA data analysis is too liberal; (b) there are enough nonsignificant unpublished SPA studies to offset those showing effects; (c) SPA studies are difficult to replicate; (d) the claims of SPA proponents rely on unpublished studies; (e) SPA stimuli are not really subliminal; (f) experimenter expectancy effects and/or demand characteristics can account for SPA effects; (g) the mediating events said to underlay SPA effects have never been evinced; and (h) alternative explanations for SPA effects are superior to the psychoanalytic ones typically offered. Theoretical and statistical analyses revealed that only the argument concerning mediating events has serious merit. The SPA stimulus for which the most support was found was Mommy and I Are One. Oedipal sanction stimuli were also found to yield reliable effects whereas Oedipal prohibition stimuli did not. Suggestions for future research are offered. Resistance to SPA findings are considered in Kuhnian terms.

Wood, W. E.; Gibson, W.; Longo, D. (1990). Moderation of morbidity following tonsillectomy and adenoidectomy: A study of awareness under anesthesia. International Journal of Pediatric Otorhinolaryngology, 20, 93-105.

In a double-blind study, 67 children, ages 3-10, were randomly assigned to one of three groups: tape recorded therapeutic suggestions repetitively recited in English or in French, and a control of continuous white noise. The English condition was associated with more favorable outcome on all parameters, although statistical significance could not be demonstrated. Favorable outcomes appeared most significant for those patients at highest risk for poor convalescence (i.e., poor status preoperative patients).

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.

Kihlstrom, John F.; Register, Patricia A.; Hoyt, Irene P.; Albright, Jeanne Sumi; Grigorian, Ellen M.; Heindel, William C.; Morrison, Charles R. (1989). Dispositional correlates of hypnosis: A phenomenological approach. International Journal of Clinical and Experimental Hypnosis, 37, 249-263.

Attempted to construct and validate a questionnaire measure of hypnotic- like experiences based on Shor’s (1979) 8-dimension phenomenological analysis of hypnosis. Separate item pools were developed to measure each disposition: Trance, Nonconscious Involvement, Archaic Involvement, Drowsiness, Relaxation, Vividness of Imagery, Absorption, and Access to the Unconscious. Based on preliminary testing (total Number – 856), a final questionnaire was produced containing 5 items measuring normal, everyday experiences in each domain. Results from a standardization sample (Number – 468) showed that each of the subscales, except for Archaic Involvement, possessed satisfactory levels of internal consistency and test-retest reliability. Factor analysis indicated that 6 subscales loaded highly on a common factor similar to the absorption construct (Tellegen & Atkinson, 1974), while items pertaining to Relaxation and Archaic Involvement formed separate factors. Validation testing on 4 samples receiving the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. Orne (1962) (total Number = 1855) showed that the Absorption and Trance dimensions correlated most strongly with HGSHS:A; the correlations with Drowsiness, Relaxation, and Nonconscious Involvement approached 0. The scales derived form Shor’s analysis, however, did not improve the prediction of hypnotizability over that obtained with the absorption scale (Tellegen & Atkinson, 1974).

Pillemer, D. B.; White, S. H. (1989). Childhood events recalled by children and adults. In Reese, H. W. (Ed.), Advances in child development and behavior. New York: Academic Press.

Authors discuss a dual memory theory. The first memory system is prominent in early childhood, and is a system in which are organized and evoked by persons, locations, and emotions. Such memories are not easily “transportable” outside the original experience. These memories are accessed through images of face and place, actions, or feelings. The second memory system begins to develop in early childhood, is verbally mediated, and stores experiences in narrative form. Such memories are accessible through verbal interaction, and can be reviewed and shared with others verbally. For a small child, to access all of a memory one would need to tap into both memory systems. The authors suggest that the first memory system continues to be available throughout one’s life, especially when strong emotion was associated so that verbal cues are not attached. [This has implications for retrieval of “lost” memories using imagery-based approaches like hypnosis.]

Suler, John R. (1989). Mental imagery in psychoanalytic treatment. Psychoanalytic Psychology, 6, 343-366.

Mental imagery techniques may facilitate the therapeutic process by stimulating patients’ insight into unconscious dynamics, by helping them uncover and master warded-off affect, and by enhancing the clinician’s empathic contact and access to countertransference. The history of imagery techniques in the psychoanalytic movement and the effect of these techniques on the traditional psychoanalytic method are reviewed. A conceptual framework based on the theory of primary and secondary process suggests spontaneity, experiential scope, associative elaboration, and object impact as four dimensions for the clinical evaluation of imagery experience.

Van der Hart, O.; Friedman, B. (1989). A reader’s guide to Pierre Janet on dissociation: A neglected intellectual heritage. Dissociation, 2 (1), 3-16.

A century ago there was a peak of interest in dissociation and dissociative disorders. Janet (1859-1947) was the most important scientific and clinical investigator of this period, whose work is reviewed in this article. The evolution of dissociation theory and its major principles are traced throughout his writings. His introduction of the term ‘subconscious’ and his concept of the existence of consciousness outside of personal awareness are explained. The validity and reliability of dissociation as the underlying phenomenon in a wide range of disorders is presented. It is proposed that Janet’s theory and methodology of psychological analysis and dynamic psychotherapy are cogent and relevant for today.

Borgeat, Francois; Rezanowicz, Thaddeus; Chaloult, Louis (1988). La stimulation preconsciente et consciente de l’imaginaire erotique. Revue Canadienne de Psychiatrie, 33, 394-398.

The stimulation of erotic fantasies through the association of relaxation and erotic conscious or preconscious suggestions has been evaluated. This study was attempted following positive results in the stimulation of fantasmatic activity in alexithymic subjects with a similar procedure. Thirty female subjects, allocated into three groups practiced relaxation daily for two weeks including three sessions with psychological measures. During the second week, erotic suggestions, preconscious for one group and conscious for another one were added. The third group (control) received only relaxation throughout. Results have shown an increase of sexual arousal and erotic imagery during the sessions with erotic suggestions. Sexual activities and desire increased in the two experimental groups. There was no difference between the effects of the preconscious and conscious suggestions. Possible clinical applications of such a procedure are discussed.

Boswell, Louis K. (1987). Abstract imaging: Abstract imaging as a mode of personality analysis and adjustment. Medical Hypnoanalysis Journal, 2, 175-179.

Describes the use of abstract imaging during hypnosis to circumvent defense mechanisms and arrive at the initial sensitizing event behind a patient’s emotional problems. Case examples illustrate how abstract imaging is also used to explore how the patient relates to the world on a conscious level and forms an idealized self-image to work toward.

Goldmann, Les (1987, October). Ways of maximizing patient memory for events during anesthesia. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Los Angeles.

Reported a series of experiments: 1. Under atropine, we did not get an orienting response to things having to do with the operation, but did get an orienting response to jokes, dogs barking, and the name of a polite anesthetist. 2. Replicated the research by Bennett and didn’t get ear pulling response. 3. Studied cardiac patients. Gave subjects a pre-anesthesia speech of importance [of hearing under anesthesia? Notes here are not clear.] and a chin touch suggestion that was successful. 7 of 30 subjects gave reports of recall – usually recalled something of particular interest to them. These 7 subjects appeared more anxious postoperatively than previously. 4. Recognition study: Pre-op “IQ” test. Gave subjects answers to the questions while they were under anesthesia, and postoperatively they had better performance than previously. 5. Recall study, double blind. Interviewer learned something about the patient, and told them something about what was learned about the patient during anesthesia e.g., You have a lovely garden. After surgery they were hypnotized by someone who did not know what information was given, and then recall for information “heard” under anesthesia was tested. 6. 10 female patients who were good hypnotic subjects, all received the same statement under anesthesia, that they would believe for a moment that they had green hair. During the interview, one said she was fascinated by green things, one wanted to go home and wash her hair.

Goldmann, Les; Shah, M. V.; Hebden, M. W. (1987). Memory of cardiac anesthesia: Psychological sequelae in cardiac patients of intra-operative suggestion and operating room conversation. Anesthesia, 42 (6), 596-603.

Thirty elective cardiopulmonary by-pass surgery patients were interviewed pre- and postoperatively. A random selection of patients heard a prerecorded audio tape toward the end of surgery after they were rewarmed to 37 degrees C. The tape contained suggestions for patients to touch their chin during the postoperative interview, to remember three sentences, and to recover quickly. The interviewers were blind to the experimental conditions. The experimental group touched their chins significantly more often than the control group (p = .015). Sentence recognition did not reach significance, perhaps due to the small numbers and low salience of the stimuli. Seven patients (23%) recalled intraoperative events, five with the aid of hypnosis. Three reports (10%) were corroborated. Preoperative medication (p < .01) and postoperative anxiety (p < .05) were significant predictors of those patients who reported recall. Kihlstrom, John F. (1987). The cognitive unconscious. Science, 237, 1445-1452. Contemporary research in cognitive psychology reveals the impact of nonconscious mental structures and processes on the individual's conscious experience, thought, and action. Research on perceptual-cognitive and motoric skills indicates that they are automatized through experience, and thus rendered unconscious. In addition, research on subliminal perception, implicit memory, and hypnosis indicates that events can affect mental functions even though they cannot be consciously perceived or remembered. These findings suggest a tripartite division of the cognitive unconscious into truly unconscious mental processes operating on knowledge structures that may themselves be preconscious or subconscious. Stolzy, Sandra L.; Couture, Lawrence J.; Edmonds, Harvey L., Jr. (1987, October). Partial recall of events occurring during general anesthesia. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Los Angeles. The incidence and causes of awareness during anesthesia are subjects of controversy. It is often assumed that the degree of recall of events occurring during general anesthesia is directly related to the depth of anesthesia. However, patients who are apparently adequately anesthetized have experienced such recall. A randomized double-blind study using a standardized anesthetic protocol was conducted to determine if recall of intraoperative events occurs following deep anesthesia. Fifteen-minute tape recordings consisting of repetitions of either six nonsense words (control) or six uncommon words (target words) were presented to patients under deep surgical anesthesia. Within 48 hours after anesthesia, they were asked to choose the six words that were most familiar from a list of thirty-six uncommon words. When compared with the control group, the patients who heard the six target words selected those words from the list at a rate significantly greater than chance (P<0.04). None of the patients had any conscious recall of an intraoperative event. 1986 Chertok, Leon (1986). Psychotherapeutic transference, suggestibility. Psychotherapy, 23 (4), 563-569. Discusses suggestion in psychotherapy and defines it as a body-affective process, an indissociable psychosociobiological entity that acts at an archaic unconscious level far beyond that of transference, mediates the influence of one individual on another, and is capable of producing manifest psychological and physiological changes. Present in all types of therapy, indirect (nondeliberate, nonintentional) suggestion is the element that plays an important role in change and can be observed in hypnotic experimentation. It is further argued that transference and suggestion are phenomena that do not altogether overlap. Suggestion is the condition of transference without which transference could not be established. Kissin, Benjamin (1986). Conscious and unconscious programs in the brain. (1 ). New York: Plenum Press. NOTES Hypnosis is discussed in terms of inhibition/excitation mechanisms in the central nervous system, with both feedback and feedforward controls and lateralizing controls. The author employs a concept of engrams (neural representations of an idea, represented throughout the neocortex) to discuss sensation and perception as well as conscious and unconscious processes. Sensory information is processed serially with encoding of information mostly on the conscious level (but sometimes, less efficiently, on the unconscious level); and it also is processed in parallel. Parallel processing operates almost entirely at the unconscious level and is basic to perception. Associative phenomena are explained in terms of overlapping engrams, so that two 'related hypercomplex engrams' could be assumed to have at least one simple engram in common. With Premack, he describes three types of engrams: veridical (primary sensory data perceived), abstract (formalized representations of concepts like line drawings of dog or house; Premack's iconic representations), and symbolic (more complex entities that encompass an entire class of objects, actions, or ideas and may have artificial symbols such as words). With Neiser he suggests that thinking (verbal and nonverbal) involves logical sequential processing of cognitive engrams of external (environmental), internal (visceral),and intracerebral (ideational) origin. Evoked response investigations shed light on the nature of such engrams, their distribution in brain tissue. John, Bartlett, Slumokochi, & Kleiman (1973) found that an error in choice discrimination learning (cats learning colors) is accompanied by the cortical evoked potential of the stimulus associated with that (erroneous) behavior, not the evoked potential of the true stimulus. In other words, ERPs represented the idea, not the actual visual stimulus provided to the cat. Emotional/motivational influences are part of every cognition (R. S. Lazarus's position). Interaction of motivational-emotional and cognitive engrams seems to occur primarily in the inferior temporal lobe and the entorhinal cortex. The interaction involves the upper rhinencephalon, the amygdaloid-hippocampal complex, the septal region, the cingulate gyrus, and the inferior and medial aspects of temporal lobe of the cortex. He also explains classical and operant conditioning (on pp. 75-76) in terms of the association of engrams. The author's position is that consciousness is the subjective equivalent of brain activity in the 'alerting' and 'awareness' systems. Awareness of the environment ('general, vague') appears to involve the limbic area (thalamus and basal ganglia), while more specific awareness of the self entails a system stretching from the basal ganglia through the parietal lobe (posterior aspect). Normal alert consciousness involves the noradrenergic reticular activating system, as well as associated excitation of the general awareness system in the involved thalamic- basal gangliar nuclei and the self-awareness system in the posterior inferior parietal lobe system. Altered states of consciousness characterized by a relaxed hazy sense of the world involves thalamic activation of the self-awareness system. Dreaming involves activation from cholinergic cells in the pons. "Impaired general awareness occurs with lesions of the thalamic-basal gangliar centers while impaired self-awareness occurs with lesions in the posterior inferior parietal lobes. Finally, in certain physiological states such as sleep, hypnosis, and so on, the entire awareness system--the thalamic-basal gangliar and posterior inferior parietal nuclei--may be activated by different activation systems, such as the cholinergic in the pons or the dopaminergic in the thalamus, to produce different states of consciousness" (p. 82). Consciousness is described as having seven dimensions: alertness, attention, arousal (heart rate, GSR), activation (EEG, evoked potential), affect, and the two awarenesses. The seven are related, so that changes in any one usually are correlated with changes in others (though dissociation among the seven also can be demonstrated). Motivational-emotional arousal produces electrophysiological activation of the brain, which is translated epiphenomenally into alertness and awareness; awareness is focused through attention onto the cognitively and motivationally significant events in the internal and external environments to determine the final sequence of drive-oriented behavioral responses. The EEG is useful for diagnosing different states of consciousness: beta and gamma waves alertness, stemming from locus coeruleus and reticular activating system delta (2-4/sec) waves coma alpha synchronized relaxing influences stemming from thalamus; low level of awareness as in twilight sleep or hypnagogic states theta, delta inactivity due to less stimulus from locus coeruleus reticular activating system influences; associated with increased inhibitory thalamic and septal- hippocampal impulses radiating upward to the cortex. In some altered states of consciousness there is theta-wave activity, indicating influences from the inhibitory septal-hippocampal circuit. The reticular activating system (RAS) and thalamus interact in complex ways. The RAS is essential to maintain consciousness, but if destroyed stepwise (in animal research) a low-grade type of consciousness can be maintained by thalamus and basal ganglia. The thalamus has two kinds of influence: it inhibits the cortex, as in sleep; and stimulates the cortex in the form of activating alpha waves. "The median thalamus is also related in a feedforward-feedback circuit with the inhibitory septal-hippocampal complex which generates theta-wave activity, thus accounting for the close association between alpha and theta wave activity in sleep and in other altered states of consciousness" (p. 86). Thus there are two different activating systems originating in the lower brain stem: the norepinephrine locus coeruleus system that is associated with normal behavior, and the cholinergic FTG neurone system of REM sleep. The relationship of the latter to consciousness, awareness, self awareness, etc. is unknown, since the only time that it is readily observed is during REM sleep. The author reports that altered states of consciousness (e.g. hypnosis, fugue, alpha state) resemble Stage 1 sleep, rather than REM sleep, physiologically, with the central locus of activation in the medial thalamus rather than the RAS and locus coeruleus. "It appears then that consciousness may be driven by one or another of three different activation centers: the norepinephrine RAS (emanating from the locus coeruleus), the cholinergic FTG cell system in the pons, and the dopaminergic alpha rhythm system radiating upward from the thalamus (Fig. 6-2). Brain activation by each of these centers is associated with a different state of awareness" (p. 91). The relative contribution from each center determines qualitative aspects of awareness. The author refers to Mesulam and Geschwind (1978) who traced the self- awareness system from amygdala/hippocampus/midbrain to the inferior parietal lobe where they converge with the body's proprioceptive neural tracts. What results is "a sense of self that was not necessarily present in the sense of general awareness stemming from the median thalamic-basal gangliar complex" (p. 97). The thalamic-basal gangliar complex is both a center for emotional reception and a relay station for somatosensory events. Both somatic sensory reception and somatosensory elements of emotion are also represented in the parietal lobe. "Affective and somatosensory stimuli, which are constant and persistent even though we are unaware of them most of the time, produce the sense of one's body which is the most basic element in the 'sense of self.'... It is most probable that a major component of the sense of self is produced by the constant barrage of affective and somatosensory stimuli converging from all parts of the body; the majority of these stimuli may not reach consciousness most of the time but they must register a sense of feeling in the thalamus and parietal cortex even though the individual may be unconscious of it" (p. 100). The author presumes that most of the incoming stimuli that define self are unconscious. "Whether sense-of-self stimuli are unconscious because of constant habituation ... or whether they are unconscious because they are transmitted predominantly to the right hemisphere ..., it appears that the major components of the self- concept are unconscious rather than conscious" (p. 102). "Even the acutely self-aware component of the self-concept, by definition conscious, varies markedly in different altered states of consciousness. The conscious awareness of oneself in the alert condition is different from (1) that in the twilight state, (2) that in dreams, (3) that in hypnosis, (4) that under the influence of alcohol, (5) that under the influence of other sedatives, (6) that under the influence of stimulants, and (7) that under the influence of hallucinogens. In that sense the acute sense of self is a function of the momentary chemical and physiological state of the brain" (p. 102). " ... the decision-making apparatus of the brain is lodged largely in a consortium of neocortical centers including the prefrontal lobes (integration), the posterior inferior lobes (motivation and emotion), the anterior and posterior associational areas (cognition), the posterior inferior parietal lobes (self-awareness), the left-hemispheric language centers (language), and the precentral frontal lobe motor area (motor). Within the context of this integrated cortical complex, self-awareness functions are somewhat stronger on the right hemisphere while language and decisional activities are somewhat stronger on the left" (pp. 102-103). The Chapter titled "Attention as directed consciousness" is relevant for investigations of hypnosis but is not included in these notes. Miller, Mary E.; Bowers, Kennneth S. (1986). Hypnotic analgesia and stress inoculation in the reduction of pain. Journal of Abnormal Psychology, 95, 6-14. Investigated the influence of hypnotic ability on 3 methods of reducing cold-pressor pain. Following a baseline immersion, 30 high- and 30 low-hypnotizable undergraduates were randomly assigned to 1 of 3 treatment groups: stress inoculation training, stress inoculation training defined as hypnosis, or hypnotic analgesia. Analysis of pain reports indicated a significant hypnotic ability x treatment interaction. Among Ss receiving hypnotic analgesia, high-hypnotizables reported significantly less intense pain than lows. There was no differential response for high- and low-hypnotizable Ss receiving stress inoculation training, whether or not it was defined as hypnotic. Moreover, Ss in the stress inoculation condition (whether or not defined as hypnosis) reported using cognitive strategies to reduce pain, whereas this was not the case for Ss in the hypnotic analgesia condition. The present findings seem inconsistent with the social psychological account of hypnosis and are discussed from a dissociation perspective, which views hypnosis as involving changes in the way information is processed. 1985 Balaam, M. (1985-86). On Crowley's and Mills "The nature and construction of therapeutic metaphors for children". [Comment/Discussion] . The Milton H. Erickson Foundation, Inc. 3606 North 24th Street Phoenix, Arizona 85016 602-956-6196 The Milton H. Erickson Foundation, Inc. is dedicated to promoting and advancing the contributions made to the health sciences by the late Milton H. Erickson, M.D. through training mental health professionals and health professions world wide Revised: 3/21/02 MILTON H. ERICKSON INSTITUTES AND SOCIETIES For information on how to become a Milton H. Erickson Institute, Click here Milton H. Erickson Institutes CERTIFICATION GUIDELINES (Requires Adobe Acrobat Reader) RUSSIA THE MILTON H. ERICKSON INSTITUTE OF WEST SIBERIA Bogatkova, 262, #42 Novosibirsk, 630089 Inga Topeshko, M.A. RUSSIA Anatoly Tkachey, M.A. +7/383 2/26 43 64 Vladislav Chemych, M.M. email: tkachev_av@mail.ru (87) Established: 1995 Eich, Eric; Reeves, John L.; Katz, Ronald L. (1985). Anesthesia, amnesia, and the memory/awareness distinction. Anesthesia and Analgesia, 64, 1143-1148. Several studies have shown that surgical patients cannot consciously recall or recognize events to which they had been exposed during general anesthesia. Might evidence of memory for intraoperative events be revealed through the performance of a postoperative test that does not require remembering to be deliberate or intentional? Results of the present study, involving the recognition and spelling of semantically biased homophones, suggest a negative answer to this question and imply that intraoperative events cannot be remembered postoperatively, either with or without awareness. NOTES In this experiment, we attempted to apply the distinction between memory and awareness of memory to the question of whether adequately anesthetized and apparently unconscious patients can register and retain what is said in their presence during surgery. Prior research relating to this question has focused, for the most part, on the ability of postoperative patients to recall or recognize a specific item....The inference need not be drawn, however, that 'patients in so-called surgical planes of anesthesia cannot hear' (15, p. 89) or that anesthetized patients cannot encode and store in memory events that transpire during their surgery. The possibility remains that even though the effects of memory for intraoperative events may not--and probably cannot--be revealed in postoperative tests of retention that require remembering to be deliberate or intentional, such effects might be evident in the performance of tests that do not demand awareness of remembering. "To explore the possible dissociation between memory and awareness of memory for intraoperative events, we modeled our experiment after a recent neuropsychological study by Jacoby and Witherspoon (5)" (p. 1143). "...it appears that the prior presentation of a word has a substantial impact on its subsequent interpretation and spelling, regardless of whether or not the word is correctly classified as 'old' in a later test of recognition memory" (p. 1144). "Approached from the standpoint of anesthesia theory and practice, the idea that recognition and spelling tap different memory processes or systems raises an interesting question for research. Specifically, suppose that during surgery, an anesthetized patient listens to a series of short, descriptive phrases, each consisting of a homophone and one or two words that bias the homophone's less common interpretation (e.g., war and PEACE, deep SEA). Suppose further that several days after surgery, the patient is read a list composed chiefly of old and new homophones (i.e., ones that either had or had not been presented intraoperatively) on two successive occasions. On one occasion, the patient is simply asked to spell each list item aloud; on the other occasion, the patient is asked to state aloud which list items he or she recognizes as having been presented during surgery. Given the situation sketched above, might the patient spell significantly more old than new homophones in line with their less common interpretations, and yet fail to reliably discriminate between the two types of items in the test of recognition memory" (p. 1144). Kaplan, Rosalind (1985). Further data on the effects of subliminal symbiotic stimulation on schizophrenics. Journal of Nervous and Mental Disease, 173 (11), 658-666. Examined the effects of activating unconscious symbiotic fantasies in 128 hospitalized schizophrenic men (aged 18-65 years) who qualified as relatively differentiated on an adjective rating scale and were randomly assigned to 4 groups. Each group was assessed for pathological thinking, pathological nonverbal behavior, and self- esteem before and after the subliminal exposure of an experimental and control stimulus. The control stimulus for all groups were the messages "Mommy and I are one," "Mommy is always with me," "Mommy feeds me well," and "I cannot hurt Mommy""(one for each group). One-half of each group was subliminally exposed to verbal messages only and one-half to verbal messages accompanied by congruent pictures. The 1st stimulus ("Mommy and I are one") was intended to activate unconscious symbiotic fantasies that in a number of prior studies reduced pathology in groups of relatively differentiated schizophrenics. The other stimuli were intended to activate reassuring unconscious fantasies about "Mommy" that were not specifically symbiosis-related. Only the "Mommy and I are one" stimulus led to more adaptive behavior and did so on all 3 dependent variables. This supported the supposition that it is specifically symbiosis-related gratifications that are ameliorative for schizophrenics. (23 ref.) Oliver, J. M.; Burkham, Robert (1985). 'Comments on three recent subliminal psychodynamic activation investigations': Reply to Silverman. Journal of Abnormal Psychology, 94 (4), 644. Contends that the present authors' (see PA, vol 69:1571) failure to replicate L. H. Silverman's (1976) description of subliminal psychodynamic activation, which was disputed by Silverman (see PA, vol 73:12007), can be traced in part to Silverman's (1978) description of the "symbiotic" stimulus (MOMMY AND I ARE ONE"), 1 of the 2 experimental stimuli used, as a "ubiquitous therapeutic agent". It is suggested that, although Silverman's willingness to modify his theory in light of empirical findings is commendable, modifications that are too frequent and numerous will pose problems for both theory and research. (5 ref) Porterfield, Albert L.; Golding, Stephen L. (1985). Failure to find an effect of subliminal psychodynamic activation upon cognitive measures of pathology in schizophrenia. Journal of Abnormal Psychology, 94 (4), 630-639. Replicated the work of L. H. Silverman and colleagues (see PA, vols. 43:14557 and 46:1566) using 30 21-59 year old schizophrenics. Ss were exposed to an aggressive, a merging, and a meaningless lexical stimulus in a within-S design. Dependent variables were inkblot through pathology and form quality, as measured on Rorschach and Holtzman Inkblot Techniques, and performance on the interference task of the Stroop Color-Word Test. Analyses of variance conducted on simple poststimulation scores, rather than on unreliable change scores, revealed no effect of stimulus content. Predicted interactions between stimulus content, Ss self-object differentiation, and temporal position of the assessment tasks did not emerge. Findings do not support Silverman's hypothesis that subliminal tachistoscopic presentations of stimuli with aggressive content temporarily increase thinking disorder in schizophrenics. (44 ref.) Porterfield, Albert L. (1985). 'Comments on three recent subliminal psychodynamic activation investigations': Reply to Silverman. Journal of Abnormal Psychology, 94 (4), 645-646. NOTES Contends that in defending his nonverbal pathology measure against the claim that it lacks demonstrated validity, L. H. Silverman (see PA, vol 73:12007) painted a misleading picture of its face validity. A correction to that picture is presented, and the impact of the present author and S. L. Golding's (see PA, vol 73:11992) findings on subliminal psychodynamic activation explanations of schizophrenic thought disorder is defended, despite the absence of a nonverbal pathology measure. (5 ref) Silverman, Lloyd H. (1985). 'Comments on three recent subliminal psychodynamic activation investigations': Rejoinder to Oliver and Burkham and to Porterfield. Journal of Abnormal Psychology, 94 (4), 647-8. Considers the replies of A. L. Porterfield (see PA, vol 73:11991) and J. M. Oliver and R. Burkham (see PA, vol 73:11985) to the critique of the present author (see PA, vol 73:12007). The original criticisms are seen as valid. A critical deficiency in the design of Porterfield and S. L. Golding's (see PA, vol 73:11992) study is viewed as disqualifying it as a fair attempt at replication. It is suggested that although Oliver and Burkham's (see PA, vol 69:1571) study was well-designed, statements made in their write- up are unwarranted. (12 ref) Silverman, Lloyd H. (1985). Comments on three recent subliminal psychodynamic activation investigations. Journal of Abnormal Psychology, 94 (4), 640-643. Contends that unwarranted statements about subliminal psychodynamic activation research by the present author (1976, 1983, 1984) were made in the work of J. M. Oliver and R. Burkham (see PA, vol. 69:1571); K. C. Haspel and R. S. Harris (see PA, vol 69:4952) and A. L. Porterfield and S. L. Golding )see PA, vol 73:11992). Issues considered include the choice of subliminal stimuli, the present author's statistical analyses, and the necessity of a nonverbal measure of psychopathology in this research (17 ref). Silverman, Lloyd H. (1985). Research on psychoanalytic psychodynamic propositions. Clinical Psychology Review, 5 (3), 247-257. Discusses a research program in which the present author has been involved that deals with the subliminal psychodynamic activation method. In this method, verbal and/or pictorial stimuli, some of which contain content related to unconscious wishes, fears, and fantasies and other of which are (relatively) neutral, are presented to Ss at 4-msec exposures. A variety of psychoanalytically based hypotheses have been tested on various clinical and nonclinical populations. Two major findings have emerged: (a) a number of clinical groups (e.g., schizophrenics, depressives, stutterers) have shown intensifications of their symptoms after the subliminal exposure of stimuli designed to stir up particular unconscious conflicts; and (b) various clinical and nonclinical groups have manifested enhanced adaptive behavior after the subliminal exposure of the message "Mommy and I are one," conceived as activating unconscious symbiotic fantasies. Tranel, Daniel; Damasio, Antonio R. (1985, June). Knowledge without awareness: An autonomic index of facial recognition by prosopagnosics. Science, 208 (4706), 1453-1454. Prosopagnosia, the inability to recognize visually the faces of familiar persons who continue to be normally recognized through other sensory channels, is caused by bilateral cerebral lesions involving the visual system. Two patients with prosopagnosia generated frequent and large electrodermal skin conductance responses to faces of persons they had previously known but were now unable to recognize. They did not generate such responses to unfamiliar faces. The results suggest that an early step of the physiological process of recognition is still taking place in these patients, without their awareness but with an autonomic index. 1984 Bowers, Kenneth S. (1984). On being unconsciously influenced and informed. In Bowers, Kenneth S.; Meichenbaum, D. (Ed.), The unconscious reconsidered (pp. 227-273). New York: John Wiley & Sons. NOTES Research on confirmatory bias has uncovered additional cognitive processes that are frequently automatic in function and significant in modifying behavior, affect, and cognition. Snyder and Swann (1976, 1978) provided subjects with set inducing hypotheses about the personalities of certain target individuals. Subjects were then asked to test these hypotheses by interviewing the target individuals. It was found that subjects regularly looked for and found evidence that was consistent with their initial hypotheses rather than for evidence which could show these hypotheses to be incorrect. This biased search strategy of the subjects had more profound effects as well, for it also influenced the behaviors of the target individuals in a manner leading them to produce behaviors that seemed to confirm the original mental set of the subjects. Subjects were unaware that their manner of interviewing was producing a biased sample of behavior from the targets. Here too an automatic cognitive process was affecting perception and thinking without conscious awareness" (p. 280). Bryant-Tuckett, Rose; Silverman, Lloyd H. (1984). Effects of the subliminal stimulation of symbiotic fantasies on the academic performance of emotionally handicapped students. Journal of Counseling Psychology, 31 (3), 295-305. Divided 64 10.8 - 19.3 yr old emotionally disturbed residents of a treatment school into an experimental and control group matched for age, IQ, and reading ability. Both groups were seen 5 times/week for 6 weeks for tachistoscopic exposures of a subliminal stimulus. The stimulus for the experimental group was the phrase, "Mommy and I are one," conceived of as activating symbiotic fantasies that in a number of previous studies with varying groups of Ss had led to greater adaptive behavior. The control group was exposed to the phrase, "People are walking." Results show that experimental Ss manifested significantly greater improvement on the California Achievement Tests-- Reading than did the controls. On 5 of 6 secondary variables--arithmetic achievement, self-concept, the handing in of homework assignments, independent classroom functioning, and self-imposed limits on TV viewing--the experimental Ss showed better adaptive functioning. It is suggested that activation of unconscious symbiotic fantasies can increase the effectiveness of counseling and teaching. (42 ref)