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Sixty-six subjects were tested on a new scale for evaluating "hypnotic-like" experiences (The Creative Imagination Scale), which includes ten standardized test-suggestions (e.g. suggestions for arm heaviness, finger anesthesia, time distortion, and age regression). The subjects were randomly assigned to one of three treatment groups (Think-With Instructions, trance induction, and Control), with 22 subjects to each group. The new Cognitive-Behavioral Theory predicted that subjects exposed to preliminary instructions designed to demonstrate how to think and imagine along with the suggested themes (Think-With Instructions) would be more responsive to test-suggestions for anesthesia, time distortion, age regression, and so on, than subjects exposed to a trance-induction procedure. On the other hand, the traditional Trance State Theory predicted that a trance induction would be more effective than Think-With Instructions in enhancing responses to such suggestions. Subjects exposed to the Think-With Instructions obtained significantly higher scores on the test-suggestions than those exposed either to the traditional trance-induction procedure or to the control treatment. Scores of subjects who received the trance-induction procedure were not significantly different from those of the subjects who received the control treatment. The results thus supported the new Cognitive-Behavioral Theory and contradicted the traditional Trance State Theory of hypnosis. Two recent experiments, by De Stefano and by Katz, confirmed the above experimental results and offered further support for the Cognitive-Behavioral Theory. In both recent experiments, subjects randomly assigned to a "Think-With Instructions" treatment were more responsive to test-suggestions than those randomly assigned to a traditional trance-induction treatment.
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There are numerous reports of untoward effects associated with hypnosis but no reports of hypnosis per se causing a serious untoward effect. The context and manipulations performed are markedly different in the various settings where hypnosis is used. The various settings such as stage hypnosis, amateur hypnosis, clinical hypnosis, and research hypnosis must be considered separately when discussing untoward effects. Although the incidence of untoward effects has been studied in the research setting, the incidence of untoward effects is difficult to assess in some settings (such as stage and amateur hypnosis) and has not been adequately assessed in the clinical setting. After reviewing the literature on untoward effects in these various settings, I conclude that amateur and stage hypnosis should not be done because the risk is not balanced by possible benefits. Research hypnosis and clinical hypnosis by well-trained practitioners are safe procedures if certain guidelines are followed.
Eye movements (with closed lids) were studied in a group of highly hypnotizable experimental subjects experienced in self-hypnosis, and compared with a random sample of control subjects that had never been hypnotized and were low in waking suggestibility. Approximately half the experimental subjects rolled their eyes upwards to a greater extent when hypnosis was induced than during eye closure while awake. In some subjects eye flutter occurred during hypnosis, but not in the awake condition. During passive hypnosis the mean rates of rapid eye movements were lower, but those of slow eye movements were higher than during the resting awake condition of the same subjects or the random control subjects. The mean rates of horizontal eye movements during suggestions about begin in a train and watching passing telephone poles were higher for the experimental subjects in the hypnosis and 'imagination' sessions than that of the random control group in the imagination session. A proportion of the experimental subjects made more lateral eye movements during hypnosis than during the imagination session, but an equal proportion did not differ between the two conditions. The mean rates and durations of horizontal eye movements during dreaming about a tennis match were greater during hypnosis ('hypnotic' dream), than during the awake condition a few minutes later ('natural' dream), or the awake condition in the imagination session ('imagination' dream) of the same subjects or random controls. The performance and subjective involvement of the experimental subjects during the Barber suggestibility scale, 'nystagmus' suggestions and 'dreaming' did not differ significantly between the two hypnosis sessions, but in most cases were significantly greater during hypnosis than during the imagination session of the same group or the random control group.
A historical outline is given of the search for an explanation of the still elusive nature of hysteria and hypnosis, their mutual relationship, and that which they bear to psychopathology. Charcot regarded hypnosis as an artificially induced hysterical neurosis, and it was he who first introduced Freud to these two states. Freud was the first to see in hypnosis an experimental instrument for understanding psychopathological mechanisms. His subsequent conceptualization of psychoanalysis derived from these two phenomena at this decisive period. In 1895 Freud attempted to achieve a psychophysiological synthesis of the mental apparatus in his "Project for a Scientific Psychology," but then decided not to publish it. Whether or not recent advance in neurophysiology are sufficiently important bo bring about this synthesis remains an open question. In recent years some psychoanalysts have become interested in hypnosis, which one of them described as a focus for psychophysiological and psychoanalytic investigations. Any theory of the psychical apparatus which does not account for such an obvious psychical phenomenon must necessarily be incomplete. Since Charcot, hysteria presents hardly any new openings for experimental work. It is suggested that the solution of psyche-soma interaction might be sought in the study of hypnosis. It is postulated that hypnosis is a "fourth organismic state," not as yet objectifiable (in contradistinction to the waking state, sleep, and dreaming): a kind of natural or inborn mechanism which acts as one of the regulators of man's relationships with the environment. The author discusses briefly the aims and methodology of future interdisciplinary research on hypnosis, and the study of the transition from one state of consciousness to another, and their potential application to a wide range of subjects, namely, wherever man's relations with the environment are involved.
We predicted the future of hypnosis for the next 10 years using the Delphi method--the best available forecasting tool. A panel of 89 experts in the field of hypnosis completed a 44-item questionnaire that addressed future developments in these areas: (1) training and preparation, (2) general applications of hypnosis, (3) theory, and (4) research. Also predicted was the likelihood of occurrence of certain cogent events in the field. Results indicated probable increases in emphasis in nearly all areas surveyed. We also solicited nominations for major contributors to the field of hypnosis, major books on hypnosis, and journals most likely to publish articles on hypnosis.
Ss were monitored for respiratory rate, pulse rate, blood pressure, skin resistance, EEG activity, and muscle activity. They were monitored during the alert state, meditation (TM or simple word type), hypnosis (relaxation and task types), and relaxation. Ss gave a verbal comparative evaluation of each state. The results showed significantly better relaxation responses for the relaxation states (relaxation, relaxation-hypnosis, meditation) than for the alert state. There were no significant differences between the relaxation states except for the measure "muscle activity" in which meditation was significantly better than the other relaxation states. Overall, there were significant differences between task-hypnosis and relaxation-hypnosis. No significant differences were found between TM and simple word meditation. For the subjective measures, relaxation-hypnosis and meditation were significantly better than relaxation, but no significant differences were found between meditation and relaxation-hypnosis.
Assessment of the physiological effects of physical and emotional stress has been hampered by a lack of suitable laboratory techniques. Since hypnosis can be used safely to induce specific emotional states of considerable intensity, we studied the effect on distal colonic motility of three hypnotically induced emotions (excitement, anger, and happiness) in 18 patients aged 20-48 years with irritable bowel syndrome. Colonic motility index was reduced by hypnosis on its own (mean change 19.1; 95% CI 0.8, 37.3; p less than 0.05) and this change was accompanied by decreases in both pulse (12; 8, 15) and respiration (6; 4, 8) rates (p less than 0.001 for both). Anger and excitement increased the colonic motility index (50.8; 29.4, 72.2; and 30.4; 8.9, 51.9, respectively; p less than 0.01 for both), pulse rate (26; 22, 30; and 28; 24, 32; p less than 0.001 for both), and respiration rate (14; 12, 16; and 12; 10, 14; p less than 0.001 for both). Happiness further reduced colonic motility although not significantly from that observed during hypnosis alone. Changes in motility were mainly due to alterations in rate than in amplitude of contractions. Our results indicate that hypnosis may help in the investigation of the effects of emotion on physiological functions; this approach could be useful outside the gastrointestinal system. Our observation that hypnosis strikingly reduces fasting colonic motility may partly explain the beneficial effects of this form of therapy in functional bowel disorders.
Hypnosis has often been described as a useful adjunctive treatment for excess weight. However, the literature shows that very few controlled studies have been conducted in this realm, and none have incorporated the key variables of either the hypnosis components or the weight-reduction components. In this paper I offer a brief review of the literature on hypnosis for weight reduction, present weight-reduction outcome data, outline variables common to people with chronic weight problems, and I offer suggestions for future uses of hypnosis within a comprehensive approach to weight reduction rather than as the primary treatment. Suggestions are also made concerning the multiple opportunities for future research using hypnosis in the substance-abuse field.
The present paper addresses 3 issues raised by Coe (1992). First, it maintains that the "altered state" issue of the 1960s remains buried in current dichotomous classifications of hypnosis theories as involving either "special processes" or the social-psychological position. Given the current diversity of the field, it appears imprudent to classify theorizing in either/or terms; additionally, despite a history of using the term "altered state" in a circular way, it is not an inherently circular formulation. It can be used descriptively simply to point to the observation that some individuals in hypnosis report subjective alterations. A second issue broached concerns the metaphorical status of the term "hypnosis"; it is accepted as a misleading metaphor inherited from 19th century investigators such as Braid, Faria, Puységur, and Liébeault. Provided that is is recognized that this metaphor refers to a "domain" (E.R. Hilgard, 1973) of characteristically elicited behaviors, no problem ensues in retaining this metaphor derived from nocturnal sleep. A subsequent discussion of current conceptualizations of hypnosis indicates considerable agreement among investigators; there is much consensus that hypnosis is an individual differences phenomenon, in which imagination may, in some individuals, become so intense and so vivid, as to take on "reality value," to the extent that a hypnotized person may have difficulty in distinguishing fantasy from reality. The S abilities of imagery/imagination, absorption, dissociation, and automaticity (which may be proved to be an index of dissociation) are proposed as being the main ingredients of the hypnotic experience. Finally, a synergistic approach is proposed as a means of progressing beyond the current impasse of either/or theorizing.
Both clinical and experimental views of hypnosis are social constructions that reflect the biases and interests of practitioners and scientists. Each perspective offers useful metaphors for hypnosis. Underlying clinical uses of the term hypnosis are states of mind associated with imaginative reverie and automatic behavior based on procedural knowledge. Social discourse and narratives shape hypnotic experience, but they are themselves influenced by mechanisms of attention and automaticity. Study of hypnosis must proceed on both social and psychological fronts to account for the experience and clinical efficacy of hypnosis.
Hypnosis has been used successfully in treating cancer patients at all stages of disease and for degrees of pain. The experience of pain is influenced not only by physiological factors stemming from disease progression and oncological treatment, but also from psychosocial factors including social support and mood. Each of these influences must be considered in the successful treatment of pain. The successful use of hypnosis also depends upon the hypnotizability of patients, their particular cognitive style, their specific motivation, and level of cognitive functioning. While most patients can benefit from the use of hypnosis, less hypnotizable patients or patients with low cognitive functioning need to receive special consideration. The exercises described in this chapter can be successfully used in groups, individual sessions, and for hospice patients confined to bed. Both self-hypnosis and therapist guided hypnosis exercises are offered.
Two patients underwent outpatient percutaneous liver biopsy under hypnosis without complications. One patient had severe anxiety about the procedure because of a previous adverse experience with liver biopsy and the other had a history of severe allergy to local anesthesia. Both patients had undergone a session of hypnosis at least once prior to the biopsy. One received no local anesthetic and the other received 1% lidocaine as a local anesthetic. Both patients were completely cooperative during the procedure with the required respiratory maneuvers. Both patients stated that they were aware of the procedure under hypnosis but described no pain and would be most willing to have the procedure done under hypnosis in the future. Hypnosis can be a useful method of preparing carefully selected patients for percutaneous liver biopsy.