An Introduction to Hypnosis

1. An Introduction to Hypnosis Society of Psychological Hypnosis Division 30 – American Psychological Association

2. An Introduction to Hypnosis I. What is Hypnosis ? II. Common Myths about Hypnosis III. Theories of Hypnotic Responding IV. Key Theoretical Controversies in Hypnosis IV. Hypnotic Suggestibility VI. Hypnosis as a Clinical Tool

3. I. What is Hypnosis ? A. Defining Hypnosis B. Components of a Hypnotic Procedure

4. A. Defining Hypnosis • Hypnosis is a procedure involving cognitive processes (like imagination) in which a subject is guided by a hypnotist to respond to suggestions for changes in sensations, perceptions, thoughts, feelings, and behaviors. • Sometimes, people are trained in self-hypnosis, in which they learn to guide themselves through a hypnotic procedure. • Psychologists hold a wide variety of opinions on how to define hypnosis and on how hypnosis works.

5. B. Two Components of a Hypnotic Procedure • It is useful to think of a hypnotic procedure as consisting of two phases or components: • Hypnotic Induction • Hypnotic Suggestions

6. What is a Hypnotic Induction ? • An introduction to hypnosis in which the subject is guided through suggestion to relax, concentrate, and/or to focus his or her attention on some particular thing. • Some hypnotists believe the purpose of the induction is to induce an altered state of consciousness. • Other hypnotists believe the induction is a social cue that prompts the subject to engage in hypnotic behaviors.

7. What is a Hypnotic Suggestion ? • The subject is guided to undergo changes in experience. • Types of Hypnotic Suggestions: • Ideomotor Suggestions – experience a motor movement. • Challenge Suggestions – subject is told he or she will not be able to do some particular thing and then is asked to perform the prohibited behavior. • Cognitive Suggestions – experience changes in sensations, perceptions, thoughts or feelings.

8. II. Common Myths about Hypnosis • People in hypnosis lose control and can be made to say or do whatever the hypnotist wants. • People may not be able to come out of hypnosis. • Hypnosis only affects weak-willed or gullible people. • Hypnosis reliably enhances the accuracy of memory. • Hypnosis enables people to re-experience a past life. • Hypnosis depends primarily on the skill of the hypnotist. • NONE OF THESE ARE TRUE

9. III. Important Theories of Hypnotic Responding • Psychoanalytic Approach • Neodissociation Approach • Socio-Cognitive Approach • Transpersonal Approach

10. A. Psychoanalytic Approach: Freud’s Model of Hypnosis • Freud initially utilized hypnosis to help remove psychosomatic symptoms from patients who suffered from what we would now call a somatoform disorder. These patients suffered from medical complaints like seizures, muscular spasms, and paralysis of their limbs that was transient and/or was not thought to be the entirely the result of a general medical condition. • Freud learned that he could temporarily or permanently reduce many of these symptoms using direct hypnotic suggestions for the symptoms to be reversed. (e.g.,: “Your arm is calm again and will no longer spasm.”) • Freud also believed that Hypnosis allowed him access to memories within the patient’s unconscious mind which had been previously repressed. • Eventually, Freud began using free association instead of hypnosis as a way of accessing the unconscious.

11. B. The Neodissociation Approach • A more recent psychoanalytically-oriented theory. • Developed by Ernest Hilgard. • Under hypnosis, part of the mind enters an altered state of consciousness. • A second dissociated part of the mind, later designated as the “Hidden Observer”, remains aware of what is going on during a hypnotic session. • The part of the mind in an altered state of consciousness is very open to hypnotic suggestions.

12. B. Neodissociation • The Hidden Observer Experiments • Discovered in highly hypnotizable subjects during dissociative tasks such as hypnotic deafness and hypnotic pain analgesia. • If queried, some subjects could nevertheless give realistic accounts of the dissociated experience as if a hidden observer was present within the person.

13. B. Neodissociation • Hilgard’s Neodissociation theory • These dissociations were evidence of separate cognitive subsystems that were operating during the experiment. • “The concept of a totally unified consciousness is an attractive one, but does not hold up under examination.” • Ernest R. Hilgard (1994)

14. A Sociocognitive take on Neodissociation • The hidden observer is created and enacted by the subject in response to the hypnotic instructions given by the experimenter. (Spanos & Burgess, 1994) • The self or “identity is constructed, role-governed, and performed” (Lynn et al., 1994) as a kind of “narrative process” in which we come to construct our experience as that identity as a “believed-in imagining” (Sarbin, 1998).

15. C. The Sociocognitive Approach • Contends that the principles of social psychology explain behavior during hypnosis. • Not a single theory, but a group of theories. • Examples: • Role Theory – people naturally adopt the role behaviors of a hypnotized person. • Response Expectancy Theory – hypnotic suggestions alter expectations for nonvolitional outcomes (e.g., pain). Such expectations , in turn, then contribute to the experience of those outcomes (Kirsch, 1990).

16. D. A Transpersonal Approach • Many of humanity’s earliest views of hypnotic phenomena are described by various religious and spiritual traditions in the world. (Krippner, 2005). • Shamanistic Healing Rituals • Exorcism and Demonology • Advanced meditative practices to achieve Mind/Body Unity within Mystical Christianity, Tibetan Buddhism, Native American, Islamic Sufism, Jewish Kabbalah, and Hindu Tantra. • This is an important diversity issue since many people around the world hold these beliefs.

17. Class Demonstration • Chevreul Pendulum

18. IV. Two Key Theoretical Controversies in Hypnosis • The State Controversy • The Trait Controversy

19. A. The State Controversy • Do people enter an altered state of consciousness during hypnosis ? • The essence of the dispute between the Neodissociation and Sociocognitive approaches. • This remains a hotly debated issue.

20. B. The Trait Controversy • Is there a trait that accounts for how much or how little people respond to hypnosis ? • One’s position on the Trait Controversy is unrelated to one’s position on the State Controversy. They are NOT opposite poles of a single dimension or question. • The research evidence strongly suggests that there is a trait that explains how much people respond to hypnosis.

21. V. Hypnotic Suggestibility – The Individual Difference Variable • Hypnotic suggestibility is the general tendency to respond to hypnotic suggestions. • It can be measured with scales typically consisting of a hypnotic induction and a series of behavioral test suggestions. • The number of test suggestions that an individual responds to or passes indicates the person’s level of suggestibility. • It is a trait-like, individual difference variable – people differ in terms of how high or low they fall on suggestibility. Scores in the population are arrayed in a bell-shaped curve. • Suggestibility tends to be very stable over time – some researchers found that scores taken 25 years apart were correlated at r = .71.

22. VII. Hypnosis as a Clinical Tool • Hypnosis is generally used in two ways as a clinical tool: • Making Direct Suggestions for Symptom Reduction • Using hypnosis as an adjunct to other forms of psychotherapy (e.g., CBT).

23. A. Making Direct Suggestions for Symptom Reduction • Example – A hypnotist suggests to a patient undergoing a painful medical procedure (e.g., surgery, a lumbar puncture, spinal tap) that the affected body part (i.e., the back) is numb and insensitive to pain. • This is a classic use of hypnosis.

24. Example: Hypnotic Analgesia • Hypnosis can alter and eliminate the psychological experience of pain and also the brain’s neurophysiological processing of pain. • Data indicates that the sensory aspect of pain is diminished at the somatosensory cortex. • The meaning or suffering component of pain is diminished at the anterior cingulate cortex.

25. B. Presenting Cognitive-Behavioral Therapy plus Hypnosis • Research suggests that using a combination of hypnosis and CBT improves outcomes for about 70% of patients relative to using CBT alone (Kirsch et al., 1995). • Additionally, standard CBT techniques can be presented in a hypnotic context by preceding the CBT technique with a hypnotic induction, delivered with the unique tone and cadence of hypnosis, and described as being hypnotic in nature. • Examples: • Progressive Muscle Relaxation becomes hypnotic relaxation. • Guided Imagery becomes hypnotic imagery. • Systematic Desensitization becomes hypnotic desensitization. • Coping self-statements become coping self-suggestions.

26. Some Clinical Problems Thought to Be Responsive to Hypnosis • Acute and Chronic Pain • Phobias • Post Traumatic Stress Disorder and Acute Stress Disorder • Performance Anxiety • Depression • Eating Disorders • Dissociative Identity Disorder • Smoking • Obesity

27. Conclusion • Once associated with fringe psychology and the supernatural, hypnosis is now accepted as the valid subject of scientific research and as a useful clinical tool. • Psychologists hold a wide variety of opinions on how to define hypnosis and on how hypnosis works. • Research strongly suggests that hypnotic suggestibility is a trait that accounts for a portion of how much or how little people respond to hypnosis. However, research strongly indicates that the vast majority of people can benefit from hypnosis interventions. • Research indicates that hypnosis is very effective for treating a wide range of clinical problems and symptoms, including pain, anxiety, depression, obesity, and smoking.

28. Instructions for Chevreul Pendulum Demonstration • Obtain scissors, string, and ½ inch washers at a hardware store. • At the beginning of the presentation, distribute these materials to the class. Have students cut a 6-inch length of string and tie it to the washer. • Explain that you will be doing a demonstration in which students will have an opportunity to experience an imaginative suggestion. • Have students place their right elbow on their right thigh and hold the string between their right thumb and index finger so the washer is suspended beneath. • Have students hold their hand as still as possible. • Ask students to imagine that the washer is beginning to move from left to right. Continue repeating the suggestion until some washers begin to move. There will be a range of responses. Some students will show no response at all. Others will find that their washer moves quite a bit. • Cancel the suggestion by telling students their hands are back to normal. • Ask students what this has to do with what you were just discussing. • This should lead naturally to the next topic – hypnotic suggestibility.