Lecture Notes on Hypnosis

Almost everyone has some knowledge of hypnosis--through theatrical demonstrations, in reference to its uses by medical doctors, dentists, and psychotherapists, from university classes in psychology or medicine; or maybe even as a result of actual participation in experiments designed to unravel its mysteries.

Nevertheless, knowledge about hypnosis is very elusive. So what is hypnosis?

1. Hypnoticlike states were described by the ancients, and they can be found within the ceremonies of nonliterate cultures today.

2. Mesmer--a Viennese physician working in France. He believed that hypnotic trances were induced by animal magnetism--a force he believed to be emanating from his own hands. Used to be called Mesmerism. This was thoroughly discredited.

3. For a time, Freud believed that hypnosis would be a good therapeutic technique. But he later abandoned it in favor of his method of psychoanalysis.

4. Today there are a number of scientific societies that publish journals and have international affiliations--the Society for Clinical and Experimental Hypnosis and the American Society of Clinical Hypnosis.

5. But despite this long history, it is hard to specify just what hypnosis is. Many psychological states are difficult to define without pointing to familiar examples of them. It's not easy to provide a precise definition of an alert state, a drowsy state, a sober state, an intoxicated state, an elated state, or a depressed state. Our language is not good for specifying states of awareness.

6. Moreover, there is so much public attention to hypnosis that our descriptions sometimes border on the bizarre. Should try to disentangle our definitions from the pop expectations of what hypnosis can make you do.

1. Lower levels of initiative and planning. The hypnotized subject loses initiative and lacks the desire to make and carry out plans on his or her own. There's a sense of planlessness. Obviously, this is a relative change in state. The hypnotic subject has the ability to initiate action, to deliver a speech, etc. But is more reluctant to make the effort. The planning function is turned over to the hypnotist.

2. Redistribution of attention. Naturally--attention is selective. We do not attend equally to all aspects of the environment. Under hypnosis selective attention and selective inattention go beyond the usual range. For example, the subject may hear only the voice of the hypnotist and neither hear nor respond to other voices.

3. Availability of visual memories from the past, and heightened ability for fantasy production. Age regression. May have vivid memories. But they might not be veridical. Memories in hypnosis are no more special or guided by different principles than are memories out of hypnosis.

Others include reduction in reality testing, increased suggestibility, increased ability to play roles, and in some people amnesia for what happened under hypnosis.

Explanations of hypnosis tend to fall into two categories, so the real explanation probably is a combination of the two (see Myers, pp. 226-228):

1. Divided-consciousness theory: selective attention and selective inattention are heightened and thus there is a split in awareness such that the hypnotized individual is better able to divert his/her attention away from pain, for example.

2. Social influence theory: under hypnosis, the kind of role playing that we do in everyday life is heightened, like actors who are really engrossed in their role. So the hypnotized individual is better able to play the role suggested by the hypnotist.

1. Assessment is conducted by giving subjects instructions that put them in a hypnotic state.

2. Two different scales are used: Harvard, Stanford scales. Each scale has 12 behavioral tasks that you ask the subjects to perform while in the hypnotic state: each task is progressively more dramatic(e.g., amnesia and hallucinations are indicators of greater suggestibility than being unable to lift your arm).

3. Average score is about 4-5 out of 12.

4. Very strong correlations between the different scales: that is, if you score high in hypnotic ability on the Stanford Scale, you are very likely to score high in hypnotic ability on the Harvard Scale.

5. Hypnotic ability is very stable and consistent throughout adulthood: In one study, hypnotic ability was measured over a 25-year period (!). The correlation between hypnotic ability 25-years apart was very high: +.72 (recall that a positive correlation means that as one variable is high, the other one is high, and r = +.72 is very high).

1. It's not very consistent in childhood.

2. Kids are more hypnotically capable than adults. Probably because they engage in more imaginative and play activity, and because they have fewer constraints on reality than adults do.

3. Adult hypnotic ability seems to emerge in late adolescence (and then is stable throughout adulthood--see point #5 above)

4. There are correlations between hypnotic ability and imaginative playfulness: theatre/arts people tend to have higher levels of hypnotic ability.

There are some quite peculiar and convincing clinical case studies on hypnosis. Here are two of them:

A. Allergy patient

1. In the late 50's--a remarkable article was published in Lancet. It was a case study of hypnosis.

2. Woman was a severe asthma sufferer (from a seasonal grass allergy).

3. Hypnosis prior to allergy season--effective in completely eliminating the allergic symptoms. Even on a skin test. (So it wasn't just in the reporting of the symptoms)

4. Researchers then took the blood serum from this woman and injected itinto a physician's bloodstream. The physician showed allergic reaction to it.

5. So the active ingredients were still there in the woman's blood, but somehow, the symptoms were being inhibited.

6. There were many studies conducted on this woman.

7. This may seem anecdotal. For example, maybe it's a generalized response--a placebo effect.

8. You can do studies that would eliminate possible confounds. For example--they gave her hypnotic suggestions to only show improvement of symptoms on one arm, not the other. That's exactly what happened. This is called a zone-specific effect, because you've demonstrated that it's not the body's reaction; it's specific to the suggestion (increases internal validity, that is, your confidence that the effects were really due to hypnosis rather than to some general change in the body).

B. Icthyosis patient (Fish-skin disease)

1. 1957 Lancet article--16 year old male. Suffering from an extraordinary skin disease--icthyosis. Problem with the sebaceous sweat glands--a congenital problem (was born with it). The sebaceous glands do not produce sweat, and thus, the skin dries up very severely. 80% of the skin turns black and scaly. Very painful and makes the hands almost nonfunctional.

2. Came to a plastic surgeon to get help. The surgeon says that there's no way he will operate. At the very most he's willing to graft skin from the chest onto the hands, which are almost immovable because of the scales.

3. An anesthesiologist named Mason consulted with the surgeon. He thought it was a bad case of warts. And he had just read a case study on wart removal through hypnosis. So Mason says, "why not try hypnosis?" Whereupon the surgeon says, "Why don't you try hypnosis?"

4. So Mason does just that. First he sends off a sample of skin to the lab. Then he gives hypnotic suggestions to the patient for his right arm to be cured. After 11 days, the results are amazing. The right arm is very noticeably better, whereas the left arm remains the same. Zone-specific effects. Very convincing evidence for the effects of the hypnotic suggestions.

5. Then Mason gives hypnotic suggestions to alleviate icthyosis on the entire body. Results in an 80% improvement. It seems that the sebaceous glands are making a partial comeback. How did this happen physiologically? Not at all clear. Maybe due to stimulation of sebaceous glands.

6. Well--if hypnosis works so well, why isn't it the standard treatment?

7. Mason saw 8 more cases of icthyosis. Tried it with all of them. No effects, even though they were just as high as the original patient in hypnotic suggestibility.

8. Points out the annoying aspect of these clinical cases--"now you see it, now you don't." Can work spectacularly well in one patient and not at all in another patient. How do you get around this problem? By doing experiments to demonstrate that it is not a generalized placebo or the patient just happened to get better and that it's all a coincidence. Zone specific effects are very convincing.

1. Pain--especially chronic pain is a staggering problem.

2. Ernest (Jack) Hilgard--in the late 50's was interested in whether hypnosis could be used to alleviate pain. But how do you study pain in an ethical way?

3. Cold pressor test--you put a subject's arm into an ice water bath that is circulating so that there aren't any warm spots in the bath. Very painful, but causes no permanent damage. The dependent measure is how much pain you report experiencing as a function of time your arm is in the bath. Subjects are told to report pain from 1 (low) to 10 (very painful), but "if the pain gets really bad--even higher than 10--you can report higher numbers."

4. Conducted a study in which low, medium, and high hypnotizable individuals were given the cold pressor test either in the waking state or in the hypnotic state

5. Results:

a) In the waking state, all three groups report the same amount of pain as a function of the time in the ice bath.

b) But in the hypnotic state, as hypnotizability increases, the pain reported goes down, although even high hypnotizables report more pain as time in the ice bath increases; they just report less pain than they did in the waking state.

c) Conclusion: hypnosis can relieve pain.

6. How does this happen physiologically?
a) One possibility might be endorphins: perhaps high hypnotizables are producing more endorphins--natural opiates--reduces pain. Let's test this--some subjects were given nalaxone, which is a natural inhibitor of endorphins. If endorphins were being released to a greater extent by high hypnotizables, the nalaxone should wipe out their advantage. Nope--doesn't work. Nalaxone doesn't affect the high hypnotizables at all--doesn't eliminate the pain relief effect. So it's unclear how hypnosis relieves pain.

1. Using hypnosis to enhance memory doesn't work--if anything it just makes people more confident but not more accurate. That's a pretty dangerous combination--people will be more confident in a false memory through hypnosis!

2. How about age regression? It turns out that people aren't remembering real events. They act on their theories about what they would be like at 4 or 6 years of age. For example, if you age regress someone to their 4th birthday and ask them what day of the week it is (was), they will tell you. But the problem is that 4 year olds don't know the day of the week, and so the subject is behaving in accordance to his/her theories of what he/she was like at 4 years of age, and doesn't remember that he/she didn't know the day of the week at that age.