Freud's Views and the Contemporary Application of Hypnosis: Enhancing Therapy Within a Psychoanalytic Framework

Freud's theoretical writings on hypnosis are reviewed and reasons for his abandoning of this clinical tool are suggested. Clinical hypnosis is an altered state of consciousness which has its own felt reality and does not bypass the ego. In fact, many of the essential characteristics of hypnosis are ego functions. Functions such as focused or free-floating attention, deep absorption, enhanced memory, imagery, ego-receptivity, ego-activity, defenses, and the capacity for self-observation all remain intact in hypnosis. This view is contrasted with Freud's early uses of hypnosis which were not informed by his later psychoanalytic discoveries. Clinical material is presented which illustrates how the conversion from a psychoanalytic psychotherapy to a hypnoanalysis resolved a therapeutic impasse and allowed for a productive treatment. Fromm's view of hypnosis, as a special form of adaptive regression in the service of the ego is clinically illustrated. It is postulated that the altered state of hypnosis facilitates an increased ego mobility. It is the psychic mobility of hypnosis which facilitates the vacillation between primary and secondary process thinking; the experiencing ego and the observing ego, and conscious and unconscious experience. It is largely the ego-mobility and available memory in hypnosis that account for its advantages as compared to non-hypnotic treatment. Relational and self-psychological components of hypnosis are also proposed.     

催眠定义探新：以恍惚为特色的深度沟通

综述催眠发展史上主要催眠观点,归纳其激活、意境、灵活、具身及整合等基本特征,继而提出催眠是一种以恍惚为特色的深度沟通的新定义,认为催眠本质上是一种沟通,恍惚是其特色,深度与恍惚相结合有助于界定催眠。未来应加强与认知神经科学、精神分析以及中国传统文化等的融合研究。     

Distignuishing the source of memories reported during prior waking and hypnotic recall attempts

Subjects attempted to identify the occasion on which they first reported particular responses to questions that were asked twice during an experiment on hyphosis and memory 1 week earlier. During this earlier experiment, subjects of high and low hypnotizability had been randomly allocatd to one of two recall test sequences: wake-hypnosis ro wake-wake. Recall improved from the first (R1) to the second test (R2) in a comparable manner for both test sequences, indicating a failure of hypnosis to enhance memory. It is noteworthy that, when later queried about the origins of specific recollections, the majority of subjects exhibited a bias to attribute their responses to R1, regardless of whether hypnosis was used during R2. Moreover, low hypnotizables exposed to the hypnotic procedure and, to a lesser extent, high hypnotizables who recalled both times in the waking condition displayed and exaggerated tendency to overattribute recollections to R1. These data indicate that individuals cannot distinguish between memories retrieved prior to hypnosis and those that occured during hypnosis. Implications for implementing judicial standards regarding hypnosis are discussed.     

Hypnosis, the timing of its introduction, and acceptance of misleading information

Allocated independent sets of 16 Ss to a crossed 2 (level of susceptibility: high, low) x 2 (information: misleading, nonmisleading) x 2 (state instruction: hypnosis, walking) design to examine the prediction that hypnosis will facilitate memory distortion when hypnotic instruction precedes the exposure of Ss to incorrect, misleading information. E. F. Loftus's recognition procedures were used to focus on the predicted effect. Free recall was also examined for memory distortion effects. Results indicated the presence of significant memory distortion for both recognition and free-recall memories. The distortion effects accompanying hypnosis, however, were not reliably greater than those accompanying waking instruction. Results are examined in relation to the operation of multiple parameters affecting memory distortion in hypnosis. Pertinent factors include the procedures for testing the effects of distortion and the level of Ss' aptitude for hypnosis.     

Randomized clinical trial of local anesthetic versus a combination of local anesthetic with self-hypnosis in the management of pediatric procedure-related pain.

A prospective controlled trial was conducted to compare the efficacy of an analgesic cream (eutectic mixture of local anesthetics, or EMLA) with a combination of EMLA with hypnosis in the relief of lumbar puncture-induced pain and anxiety in 45 pediatric cancer patients (age 6-16 years). The study also explored whether young patients can be taught and can use hypnosis independently as well as whether the therapeutic benefit depends on hypnotizability. Patients were randomized to 1 of 3 groups: local anesthetic, local anesthetic plus hypnosis, and local anesthetic plus attention. Results confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety and less procedure-related pain and anxiety and that they were rated as demonstrating less behavioral distress during the procedure. The level of hypnotizability was significantly associated with the magnitude of treatment benefit, and this benefit was maintained when patients used hypnosis independently.     

Is there a future for investigative hypnosis?

Since its heyday in the 1970s and 1980s, hypnosis as an investigative procedure has declined in popularity such that many experts now consider it to be more a liability than a useful forensic tool. Indeed, in the US, a majority of the states follow a per se exclusion rule, prohibiting any memories retrieved during or after hypnosis from being introduced into evidence. In this paper, factors contributing to the demise of investigative hypnosis are re-examined. It is concluded that a per se exclusion rule is overly inclusive, but it is advisable for investigators to avoid using hypnosis when other, less contentious alternatives, such as the cognitive interview, are available. Nevertheless, it often goes unrecognised that a more positive legacy of investigative hypnosis is very present in modern investigative interviewing best practice; moreover, there may still be procedures employed in hypnotic interviewing that have yet to be exploited. For example, recent research indicates that, when divorced from the context of hypnosis, brief techniques such as focused breathing, and eye closure, can enhance memory. As memory enhancement with these techniques is achieved without the increase in false positive errors familiar to more traditional hypnosis techniques, evidence from such procedures should be acceptable to the courts. The potential role of hypnosis as a tool to reverse the effects of misinformation is also considered. Copyright © 2009 John Wiley & Sons, Ltd.     

Suggestion reduces the stroop effect

We examined the effects of suggestion on Stroop interference in highly suggestible individuals. Participants completed the Stroop task with and without a suggestion to perceive Stroop words as meaningless symbols. Half the participants were given this suggestion in hypnosis, and half were given the suggestion without the induction of hypnosis. Suggestion produced a significant reduction in Stroop inhibition, accounting for about 45% of the variance in Stroop responding, regardless of whether hypnosis had been induced. These findings indicate that suggestion can at least partially overcome the automaticity associated with the Stroop effect.     

Immediate and persisting effects of misleading questions and hypnosis on memory reports

Immediate and persisting effects of misleading questions and hypnosis on memory reports were assessed. After listening to a story, 52 highly suggestible students and 59 low and medium suggestible students were asked misleading or neutral questions in or out of hypnosis. All participants were then asked neutral questions without hypnosis. Both hypnosis and misleading questions significantly increased memory errors, and misleading questions produced significantly more errors than did hypnosis. The 2 effects were additive, so that misleading questions in hypnosis produced the greatest number of errors. There were no significant interactions with level of hypnotic suggestibility. Implications of these findings for the per se exclusion of posthypnotic testimony are discussed.     

The effect of hypnosis therapy on the symptoms and disease activity in Rheumatoid Arthritis

Abstract

The present study aimed to assess the effectiveness of clinical hypnosis on the symptoms and disease activity of Rheumatoid Arthritis (RA). Sixty six RA patients participated in a controlled group design. Twenty six patients learnt the hypnosis intervention, 20 patients were in a relaxation control group and 20 patients were in a waiting-list control group. During hypnosis, patients developed individual visual imagery aimed at reducing the autoimmune activity underlying the RA and at reducing the symptoms of joint pain, swelling and stiffness. Subjective assessments of symptom severity and body and joint function, using standardised questionnaires and visual analogue scales, were obtained. Objective measures of disease activity via multiple blood samples during the therapy period and at the two follow-ups were also taken. These measurements were of erythrocyte sedimentation rate. C-reactive protein, haemoglobin and leukocyte total numbers. Results indicate that the hypnosis therapy produced more significant improvements in both the subjective and objective measurements. above relaxation and medication. Improvements were also found to be of clinical significance and became even more significant when patients practised the hypnosis regularly during the follow-up periods.     

The effect of hypnosis therapy on the symptoms and disease activity in Rheumatoid Arthritis

Abstract The present study aimed to assess the effectiveness of clinical hypnosis on the symptoms and disease activity of Rheumatoid Arthritis (RA). Sixty six RA patients participated in a controlled group design. Twenty six patients learnt the hypnosis intervention, 20 patients were in a relaxation control group and 20 patients were in a waiting-list control group. During hypnosis, patients developed individual visual imagery aimed at reducing the autoimmune activity underlying the RA and at reducing the symptoms of joint pain, swelling and stiffness. Subjective assessments of symptom severity and body and joint function, using standardised questionnaires and visual analogue scales, were obtained. Objective measures of disease activity via multiple blood samples during the therapy period and at the two follow-ups were also taken. These measurements were of erythrocyte sedimentation rate. C-reactive protein, haemoglobin and leukocyte total numbers. Results indicate that the hypnosis therapy produced more significant improvements in both the subjective and objective measurements. above relaxation and medication. Improvements were also found to be of clinical significance and became even more significant when patients practised the hypnosis regularly during the follow-up periods.     

Myths and misconceptions about hypnosis and suggestion: Separating fact and fiction

We present 21 prominent myths and misconceptions about hypnosis in order to promulgate accurate information and to highlight questions for future research. We argue that these myths and misconceptions have (a) fostered a skewed and stereotyped view of hypnosis among the lay public, (b) discouraged participant involvement in potentially helpful hypnotic interventions, and (c) impeded the exploration and application of hypnosis in scientific and practitioner communities. Myths reviewed span the view that hypnosis produces a trance or special state of consciousness and allied myths on topics related to hypnotic interventions; hypnotic responsiveness and the modification of hypnotic suggestibility; inducing hypnosis; and hypnosis and memory, awareness, and the experience of nonvolition. By demarcating myth from mystery and fact from fiction, and by highlighting what is known as well as what remains to be discovered, the science and practice of hypnosis can be advanced and grounded on a firmer empirical footing.     

An evaluation of Woodard's theory of perceptually oriented hypnosis

This article evaluates Woodard's theory of Perceptually Oriented Hypnosis, a welcome addition to theories of hypnosis that emphasize the centrality of subjective experiences in understanding and studying hypnosis. With a focus on subjective experience. Woodard's account of perceptually oriented hypnosis is based on elements of humanistic, client-centered, and perceptual psychology. However, we contend that improvements in the operational clarity and coverage of the theory are necessary to optimize its utility and heuristic value. We also argue that it is important for Perceptually Oriented Hypnosis to address hypnotic phenomena, e.g., individual differences in suggestibility, involuntary responding to suggestions, stability of responding over time, widely recognized as essential to understanding hypnotic experience and responding. With these refinements, we believe that Woodard's theory would have a greater potential to enrich our understanding of both the unique experiences of individuals who undergo hypnosis and of hypnosis in general.     

Memory on the beach: an Australian memory (and hypnosis) laboratory

The memory (and hypnosis) lab at the University of New South Wales investigates a broad range of memory topics. We try to find innovative methods from cognitive and clinical psychology to address theoretical and empirical questions about memory. We aso use hypnosis as one major methodological tool in our investigations of memory (as well as other cognitive processes). In this paper, we review the projects currently underway in our memory (and hypnosis) lab.     

The social nature of hypnosis: An ethogenic analysis of hypnotic pain reduction

This article addresses the central paradox of hypnotic pain reduction: the discrepancy between self-reports and physiological measures of pain, using a constructionist perspective. The analysis is embedded in the ethogenic assumptions about the nature of the social and in realist rather than positivist notions of causality. It reformulates the induction procedure as an entrance ritual, considers the hypnosis experiment proper as a social episode, reveals the causal powers that subjects bring to hypnosis experiments and specifies how the act of hypnotic pain reduction is achieved. The analysis uses, in part, the Olympic athlete and the Olympic competition as analogic models to show that the hypnosis experiment is merely a public occasion for talented hypnotic subjects to display their peculiar powers without risking their standing as rational beings. The paradox is seen to be an artifact of positivist assumptions concerning both the nature of hypnosis and of traditional experimental methods. Two distinct lines of investigation, based on the competence/performance distinction, are recommended as guides for future research.     

Hypnosis as a counselling tool

The history of hypnosis is outlined, with particular reference to recent developments. The main current theories are expounded briefly, and applications in short-term therapy and counselling are discussed As therapists from a wide range of systems of psychotherapy and analysis are increasingly incorporating hypnosis into their practice, the hope is expressed that counsellors will take more advantage of training opportunities and extend the use of hypnosis in their own work.     

Changes in the sense of agency during hypnosis: The Hungarian version of the Sense of Agency Rating Scale (SOARS-HU) and its relationship with phenomenological aspects of consciousness

Changes in the sense of agency are defining feature of hypnosis. The Sense of Agency Rating Scale (SOARS) is a 10-item questionnaire, administered after a hypnosis session to assess alteration in the sense of agency. In the present study, a Hungarian version of the measure (SOARS-HU) is presented. The SOARS-HU and the Phenomenology of Consciousness Inventory (PCI) were administered to 197 subjects following hypnotizability screening with the Harvard Group Scale of Hypnotic Susceptibility Scale, Form A (HGSHS:A). Confirmatory factor analysis and correlations with hypnotizability demonstrate the reliability and validity of the SOARS-HU. Changes in the Involuntariness and Effortlessness subscales of the SOARS-HU were associated with alterations in subjective conscious experience, as measured by the PCI. These changes in subjective experience remained significant after controlling for HGSHS:A scores. These results indicate that changes in the sense of agency during hypnosis are associated with alterations of consciousness that are independent of hypnotizability.     

WILLIAM JAMES AND HYPNOSIS: A Centennial Reflection

Like many other early psychologists, William James was fascinated by hypnosis and related phenomena. For James, hypnosis was both an experimental technique for creating divisions of consciousness, and a laboratory model of naturally occurring disorders of awareness. James' treatment of consciousness in hypnosis presages contemporary interests in dissociation and implicit cognition, and underscores the role of the self in conscious mental life. At the same time. James recognized the complexity of hypnosis as an interpersonal process. In the end. James' views suggest how a rapprochement between the cognitive and social approaches to hypnosis might be achieved.     

Hypnotic interviewing: the best way to interview eyewitnesses?

It has been suggested that hypnosis techniques may have the potential to enhance eyewitness memory in forensic investigations. However, laboratory research shows that increases in recall with hypnosis techniques are often associated with decreases in accuracy, false confidence in incorrect information, and increased suggestibility to leading questions and misleading post-event information. These problems limit the usefulness of hypnosis as an interviewing procedure. However, in practical investigations, many factors associated with hypnosis, apart from the hypnotic induction itself, might lead to memory enhancement compared with standard police interviews. For example, hypnotic interviewers, because of their psychological, clinical, and interpersonal skills, may be better interviewers than police officers. They may use effective interviewing strategies such as those associated with the “cognitive interview”; a procedure which has the potential to enhance recall by approximately 35% without the problems of memory distortion associated with hypnosis. It is concluded, therefore, that a cognitive interview procedure should be used in preference to hypnosis. © 1998 John Wiley & Sons, Ltd.     

Artifact in the hypnosis-creativity relationship

Subjects who pretested high or low in hypnotic suggestibility took a creativity test either under hypnosis or in a waking state. All subjects made a global estimate of their general degree of creativity. Greater figural-spatial creativity was exhibited in the hypnosis condition than in the waking condition by both high and low suggestibles. Creativity self-reports were not corroborated by actual creative performance.     

Hypnosis and pseudomemories: the effects of prehypnotic expectancies

Contrary to predictions, the pseudomemory rate of subjects who received prehypnotic information that hypnosis increased recall was indistinguishable from the pseudomemory rates of subjects who received information that hypnosis did not increase recall and of subjects who received no specific prehypnotic information. Indeed, by the last recall trial, none of the 47 subjects exhibited pseudomemory. Subjects exhibited faulty memory of events that actually occurred (i.e., pencils spilling), and were as uncertain of events that actually occurred, as they were of suggested events that did not occur during the session (telephone ringing). Subjects were generally consistent in their certainty, or lack of it, across events. Finally, subjects led to believe that hypnosis is an altered state of consciousness were less aware of external events, and had the lowest rate of recall of target suggestions compared with subjects in the comparison groups.