Hypnosis Research and Theory
Hypnosis has been studied scientifically for more than 200 years, most investigations being conducted between 1950 and 1980. A great many experimental and clinical studies have tried to determine what is unique about hypnosis and trance. Findings are far from conclusive but this mysterious and powerful phenomenon continues to fascinate researchers and lay people alike.
Defining Hypnosis.
It is difficult to define hypnosis in a way which is acceptable to everyone. Most agree that there is this thing called "hypnosis," but just exactly what is going on is up for debate. In traditional hypnosis, there is an operator (hypnotist) who induces a change in the subject using some special method. The observable changes include eye-closing, slower respirations, and the increased likelihood that the subject will follow the instructions of the operator (hypersuggestibility). Subjects often report afterward, a feeling of being in a different state of mind which they may call "hypnosis," "trance" or something else. They report feeling disconnected from their immediate environment, a distortion in their perception of time and often amnesia of at least some of the events which occurred during hypnosis.
Two key terms bear some explanation.
Frequent reference is made in discussions of hypnosis to "dissociation." This is defined as a mental detachment from the immediate surroundings or the loss of certain mental contents to conscious awareness. Dissociation has been seen as a way to psychologically escape anxiety. Dr. John Kappas states that hypnosis is an escape from an overload of "message units" (external and internal stimuli) and is a response to the physiological and psychological "fight-or-flight" state. He suggests that the operator can induce this overload to bring about hypnosis in a subject. This is a useful theoretical construct when applying hypnotic techniques to reduce fear and pain, especially in medical patients.
Hypersuggestibility is characterized by a narrow focus of attention and increased likelihood to act upon suggestions given by an operator. There are no consistent electroencephalographic (EEG) patterns correlated to a hypersuggestible state. A recent theory suggests partial control of the hypersuggestible state by the immune system. This, in light of the recent discovery that the immune system and neurological system are more intimately linked that previously thought. It stands to reason that if we can "worry ourselves sick" then we can also use this process in a positive way to "think ourselves well."
Research: So Many Questions...
As with many areas in psychology, it is up to the individual researcher to choose which aspect of the phenomenon to focus on. All of the elements described in the above definition have been emphasized by one theorist or another. The result is a wide variety of theoretical frameworks in the scientific literature. Each seems to make at least some sense but falls short of being a comprehensive description of "what is really going on in hypnosis." Here are the major viewpoints:
- Janet and later Hilgard defined hypnosis in terms of dissociation.
- Sarbin and Coe saw hypnosis as role-playing and fulfilling certain social expectations.
- Barber described hypnosis in terms of non-hypnotic behavior such as task motivation and a subject's own labeling of a particular experience as "hypnotic."
- Weitzenhoffer first described hypnosis as "a state of enhanced suggestibility," but later as a form of "interpersonal influence via suggestion."
- Gill and Brenmand saw hypnosis as regression (to an earlier age) in protection of the Ego.
- Edmonston was influenced by the earlier work of Pavlov when he characterized hypnosis as relaxation and partial cortical inhibition.
- Spiegel and Spiegel saw hypnosis as a distinct biological capacity.
- Milton Erickson described hypnosis as a unique, inner-directed altered state of functioning.
- Later followers of Erickson emphasized that hypnosis should be defined subjectively and phenomenologically as a process between individuals, and as a communications strategy for the achievement of therapeutic goals (with or without mention of "trance").
- Other, non-scientific views frame hypnosis in terms of energy fields, supernatural forces, invisible bodily fluids and alternate planes of existence.
A quick review of these perspectives reveals that many are incomplete or over-simplified. Some speak in physiological terms (such as changes in brain function), others in terms of social behavior (how the subject interacts with the operator).
An Historical Perspective.
Science is, in essence, a conversation over time. One researcher puts forth his or her viewpoint and later another responds by agreeing or disagreeing with the earlier conclusions. As time goes on, more voices join the debate, each influencing the next. Let's take an historical look at hypnosis research and theory.
Franz Anton Mesmer is credited with first creating the concept of "hypnosis." Actually, his early work was done by applying magnets to the body to produce cures. He later came to believe that it was not the magnets, but he himself who was producing these results. He believed that the role of human imagination was actually more important that any magnetic or other physical force in producing the changes. Even today, hypnotherapy can be seen as the therapeutic use of a person's imagination.
A split arose between those interested in hypnosis as a tool for personal or spiritual fulfillment and those who sought to focus on hypnosis' apparent spiritual, religious or magical nature. In fact, faith-healing, mind cure and Christian Science were all heavily influenced by hypnosis. Even today, we are left with the legacy of hypnosis as simultaneously a form of entertainment, a spiritual practice, a therapeutic modality and a psychological phenomenon.
The "operator-assisted altered state induction" model was one of the first. This states that hypnosis is a sleep-like state induced by the special behaviors of an operator which result in extreme responsiveness to suggestion and anomalies of the experience of volition and memory. However, hypnosis is not sleep per se. Modern research shows that hypnosis and trance look physiologically much like the awake state and that they both differ from the sleep state. The dream-like quality of hypnosis has been found to more closely resemble daydreaming (fantasizing) than night time dreaming.
James Braid, a British surgeon is credited with coining the term "hypnosis" in 1843, although it was already in use by French researchers. His view was that hypnosis was a unique condition of the nervous system. However, he later rejected this and emphasized the "mental" (read: psychological) factors almost exclusively. This view, called "monoideism," stated that unconflicted ideas automatically lead to actions. "Ideomotor Action Theory" states that ideas suggested by the hypnotist lead automatically to actions which are experienced by the subject as unwilled.
The end of the nineteenth century saw the emergence of the "Paris School" which stated that a single, distinctive neurological and physiological state underlies all hypnotic phenomena. The beginning of the twentieth century saw the birth of the "Nancy School" which held that suggestions somehow mechanically produce responses without the participation of the subject. This perspective was notable for deemphasizing the hypnotic ritual (induction) emphasizing rather the suggestion as a key element in hypnosis.
The well known psychologist Clark Hull conducted research on hypnosis. His student, Milton Erickson would come to disagree with Hull's emphasis on measurable correlates and standardized procedures in favor of stressing the complex subjective inner processes operating in hypnosis. (This mirrors the modern disagreement over the usefulness of quantitative vs. qualitative research methods in psychology.)
Countering the previous mechanistic theories, Theodore Sarbin pioneered the "skeptical" conception of hypnosis in 1950, seeing it as a social encounter in which the hypnotist and subject act out predetermined roles. This was the first time hypnotic behavior was seen as creative and goal-directed, rather than automatic and mechanical. Skeptical research often points to observations that hypnotic subjects do not display behavioral capabilities beyond those of the waking state. On this point Erickson agreed. He stated that it is not so much that the abilities are special (in fact, they are indeed accessible in a waking state), but the access through hypnotic trance which is unique.
Trance Logic.
Underlying many hypnosis theories is the concept of "trance logic," a state where language processing is altered, words are taken more literally and there is a decrease in critical judgment and an increase in tolerance for incongruity. From this, a number of theories about trance arose:
- That trance is a form of psychological age regression.
- That cognitive dissociation is a key element.
- Trance can be seen as "contact with the unconscious [subconscious].
- Trance involves selective use of one hemisphere (specifically, the non-language side) of the brain.
The differences among the theorists fall into a few general categories. One theoretical division is that between the emphasis on a mental state and situation-related expectations (or Social Role Theory). Is there some actual change in the state of the brain under hypnosis or is the subject acting the way he or she thinks is expected? There is also a difference of emphasis on the hypnotic induction process (whether any special preparation must be performed to create a hypnotic state) and the condition of hypersuggestibility which apparently results. Many prefer to see hypersuggestibility as an end-point to which hypnosis is only one route.
Cortical Inhibition Theory focuses on the apparent decrease in activity in the cerebral cortex (specifically in the left hemisphere), perhaps the cause of the reduced critical thinking abilities of hypnotized subjects. However, this Pavlovian view has been criticized as overly simplistic. Any "left-brain / right-brain" dominance shift does not seem to be the primary mechanism of enhanced suggestibility.
Hypnotized Monkeys?
Despite this, there seems to be a "trance reflex" in humans and also in primates. Experimentation with Rhesus monkeys has induced a hypnosis-like response in these non-human subjects. Of the 45 monkeys in one study, six went quickly into a motionless state when sat in front of a gently oscillating shining ball. Twelve others who initially tried to turn away or push away the ball also became motionless after being secured to their chair. This is notable because it contradicts the "freedom reflex" normally found in this situation. In the end, all of the monkey subjects ended up displaying "hypnotized" behavior in response to the ball. EEG monitoring showed some changes in the hemispheric dominance of the monkeys. Certain factors seemed to influence this "animal hypnosis" including: emotional stress, the novelty of the hypnotic condition, restricting motor freedom, and others.
Some of these can be generalized to human subjects as well. The Kappasinian model of hypnosis advises hypnotists to take advantage of the first hypnotic experience as this is when the subject is likely to go very deep. The monkey research conclusions about the role of novelty and anxiety seem to support this. As for physical restraints, it is not ethical to tie down hypnosis subjects, but humans have the ability to be restrained in a chair by social pressure, whereas monkeys do not. Our subjects are tied down in a sense, not by straps, but by an unspoken expectation that they stay put.
Hypnosis and Mind Control.
What do we know about the degree to which a hypnotist can control a subject. Most hypnotists and hypnotherapists will tell you that hypnosis is not mind-control. They often state the subject is free to follow or not follow any suggestions given in hypnosis. Is this true? No less than Milton Erickson himself ran an experiment where the hypnotist attempted to force his will on subjects. Not only did subjects discriminate which suggestions they did and did not respond to, but also came up with ways to hurt or humiliate the hypnotist in retaliation for the attempt to control them!
Unnecessary Hand-Waving?
So what about those elaborate induction rituals? Are they necessary? If not necessary, do they enhance the results of the hypnosis in some way? The respected Theodore Barber promoted the view that induction was not necessary. He says the secret of hypnosis involved the ability to fantasize in a hallucinatory way and provide drama and excitement.
Consider this. A public figure makes a public address. From a simple podium with no ceremony, the listeners will hear the message. But when the speech is accompanied by colorful banners, stirring music and the attendance of respected dignitaries, the excitement we feel changes the way we take in the information. Suddenly it becomes much more important and the information becomes more reliable. Think of any situation that involves such pageantry (religious services, political campaign rallies). In most cases, the goal is to communicate something to the audience, to sway their opinions or change their beliefs. The inclusion of drama and emotion ensures that more people will "hear" what is being said. It is the same in hypnosis. The induction may not be necessary, but the anxious anticipation that "something" is about to happen makes the suggestions even more powerful.
In addition to research on the nature of hypnosis, there is quite a bit of literature examining the therapeutic applications of hypnosis or "hypnotherapy." There is evidence which supports the use of hypnotherapy for pain control, anesthesia, analgesia, certain skin conditions, control of bleeding, healing after surgery, enhanced cognition and learning, improved physical performance, strengthened immune response and others.
Other research areas which are not reviewed here include: the occurrence of psychic and extraordinary experiences while under hypnosis, memory retrieval under hypnosis, "false memory syndrome" and hypnotizability.
Many important questions remain in the scientific study of hypnosis. Is an induction procedure necessary for the elicitation of a hypersuggestible state in a person? In what specific ways are cognitive functions altered in hypnosis? What is the nature of dissociation in hypnosis? This also brings to bear some central questions in psychology such as the very nature of belief, imagination, motivation, volition and compliance. We also need to know how a placebo works, how suggestions can affect dermatological responses, how imagination can produce the experience of a dry mouth, nausea, or an itch, and how coping strategies can affect the experience of pain.
While it is up to each of us to make our own conclusions about the hypnosis phenomenon, scientific research suggests there is something going on which changes individuals. This may be caused by some physiologic change, a person simply doing what he or she feels is expected or some other undefined process. For some, scientific evidence is not essential. If something seems to work, it works. And to an extent this is true. In the case of smoking cessation, it does not matter whether a person quits "cold-turkey," by taking Wellbutrin®, with hypnosis or any other method. When smoke no longer fills the lungs, the damage it causes stops. The ex-smoker is healthier and can expect a longer life expectancy. The research continues, as does the use of hypnosis for helping people live happier, healthier lives.
References.Primary reference for the preparation of this article:
Stark, T.I. (1993). Frequently asked questions regarding the scientific study of hypnosis. Retrieved August 6, 2003, from PsychWeb Website: http://www.psywww.com/asc/hyp.html.
Barber, T. X., Spanos, N. P., & Chaves, J. F. (1974). Hypnosis, imagination, and human potentialities. Pergamon.
Barber, T.X., (1969). Hypnosis: A scientific approach. New York: Van Nostrand Reinhold.
Barber, T.X., (1961). Physiological effects of "hypnosis." Psychological Bulletin, 58. 390-419.
Barber, T.X., 1965, "Physiological effects of 'hypnotic suggestions': a critical review of recent research (1960-1964)," Psychological Bulletin, 63: 201-222.
Johnson, R. F. Q. & Barber, T. X. (1976). Hypnotic suggestions for blister formation: Subjective and physiological effects." American Journal of Clinical Hypnosis, 18: 172-181.
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Hilgard, E. R. (1991). A neodissociation interpretation of hypnosis," in Lynn & Rhue (Eds.) Theories of Hypnosis, New York: Guilford Press.
Hull, C. L. (1933). Hypnosis and suggestibility: An experimental approach." Appleton-Century-Crofts.
Kappas, J. G. (2001). Professional Hypnotism Manual: Introducing Physical and Emotional Suggestibility and Sexuality. Panorama Publishing Co.
Petrova E.V., Shlyk G.G., Kuznetsova G.D., Shirvinska M.A., Pirozhenko A.V. (????). Hypnosis In macaca rhesus is characterized by different phases and interhemispheric EEG asymmetry. Russian email journal article.
Sarbin, T.& Coe, W. (1972). Hypnosis. New York: Holt.
Weitzenhoffer, Andre, 1953, "Hypnotism: An Objective Study in Suggestibility," N.Y.: Wiley.
© Copyright 2003
Scott G. Shelp
All rights reserved.
Scott G. Shelp, RN BA CCHt is a registered nurse, personal coach and certified clinical hypnotherapist in Los Angeles. More information can be found at www.HypnoRN.com.
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