UC Berkeley UC Berkeley Previously Published Works

Title Unconscious Mental Life

Permalink https://escholarship.org/uc/item/13r1q6qd

ISBN 9780123977533

Author Kihlstrom, JF

Publication Date 2016

DOI 10.1016/B978-0-12-397045-9.00269-X

Peer reviewed

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Hypnosis Mesmer’s theory of animal magnetism was discredited by a commission led by Benjamin John F. Kihlstrom Franklin in 1784 (Kihlstrom 2002), but mesmer- University of California, Berkeley, Berkeley, CA, ism was revived in the 1840s when James USA Elliotson and James Esdaile used it successfully to relieve pain in surgical patients. Scientific inter- est was further stimulated by William James, who Synonyms believed that hypnosis was relevant to the prob- lem of the will (Kihlstrom and McConkey 1990), Animal magnetism, Artificial somnambulism, and by Jean-Martin Charcot and Pierre Janet, who Hypnotic suggestion, Mesmerism, Suggestion, viewed hypnosis as an analog of hysteria (now Trance known as the dissociative and conversion disor- ders; see Kihlstrom 1994). In the 1920s, research on hypnosis was carried out by P.C. Young and Definition others at Harvard; and in the 1930s, before he ventured into learning theory, C.L. Hull carried Hypnosis is an altered state of consciousness in out an extensive program of hypnosis research at which the subject responds to suggestions by the Wisconsin in the 1930s. Beginning in the late hypnotist for alterations in perception, memory, 1950s, hypnosis entered a sort of Golden Age, and the voluntary control of action. In the classic with research by E.R. Hilgard, M.T. Orne, case, these responses entail a degree of subjective T.R. Sarbin, T.X. Barber, K.S. Bowers, their stu- conviction bordering on delusion and an experi- dents and colleagues, and many others, and ence of involuntariness bordering on compulsion increasing interest in clinical applications in med- (Kihlstrom 2008; for comprehensive coverage, icine, dentistry, and psychotherapy stimulated by see Jamieson 2007; Nash and Barnier 2008). Milton Erickson and others (Gauld 1992). Common phenomena of hypnosis include: ideomotor suggestions, including direct sugges- Introduction tions for the facilitation of motor activity (e.g., hand levitation) and challenge suggestions for Hypnosis had its origins in the practices of Franz the inhibition of motor activity (e.g., arm rigidity); Anton Mesmer in eighteenth-century Vienna and sensory anesthesias in all modalities, and positive Paris and got its modern name from James Braid, and negative hallucinations; age regression; post- based on an analogy with sleep (Kihlstrom 1992). hypnotic suggestion; and posthypnotic amnesia.

# Springer International Publishing AG 2016 V. Zeigler-Hill, T.K. Shackelford (eds.), Encyclopedia of Personality and Individual Differences, DOI 10.1007/978-3-319-28099-8_1384-1 2 Hypnosis

However, not every subject will have these expe- Hypnosis involves suggestions, but not all sug- riences. Hypnotic “virtuosos” are relatively rare, gestions are alike. Hypnosis seems most closely comprising less than 10% of the population. related to “primary” suggestibility, involving direct, explicit suggestions for some effect (e.g., the body sway test), but even this connection is relatively weak. But there are other forms of sug- Measuring Hypnotizability gestibility to which hypnosis does not seem to be closely related: including “secondary” suggest- Hypnotizability is measured by performance- ibility, involving implied suggestions (e.g., the based work samples such as the individually progressive weights illusion), and “tertiary” sug- administered Stanford Hypnotic Susceptibility gestibility (e.g., conformity, persuasion, and other Scales (Forms A, B, and C) and the Harvard forms of social influence); “interrogative” sug- Group Scale of Hypnotic Susceptibility, Form A. gestibility, which can bias eyewitness testimony; Because it samples a wider swath of the domain of and the placebo effect – not to mention the kinds hypnosis, the Stanford Form C is generally con- of suggestions that people make to each other in sidered to be the gold standard for measuring the ordinary course of everyday living. hypnotizability. All of these scales begin with a standardized hypnotic induction procedure consisting of suggestions for relaxation and focused attention, followed by suggestions for a Personality Correlates of Hypnotizability representative series of hypnotic suggestions; response to each suggestion is scored objectively The search for personality correlates of hypnotiz- in terms of some observable behavioral response. ability was long a study in frustration, as scores on Hypnotizability, so measured, follows a quasi- the standardized scales did not correlate with normal distribution in the population, with some scores on such inventories as the MMPI and skew to the right and a hint of bimodality. CPI. However, hypnotizability does correlate There is a lingering question as to whether with the tendency to have “hypnotic-like” experi- hypnotizability is best characterized as a single ences in the ordinary course of everyday living, dimension, much like Spearman’s g, or is multi- such as becoming deeply involved in reading (the dimensional, like Thurstone’s primary mental “book-reading fantasy”), music, or nature. Mea- abilities. Factor analyses of the standardized surement of these experiences culminated in scales generally yield three or four factors, Tellegen’s development of a scale to measure representing two types of ideomotor suggestions “absorption,” a disposition to experience states (direct suggestions for the facilitation of some of narrowed or focused attention, resulting in a motor response and challenge suggestions for blurring of ego boundaries. However, the actual the inhibition of voluntary motor activity); correlation between absorption and hypnotizabil- perceptual-cognitive alterations, such as positive ity is relatively weak, so that hypnotizability can- and negative hallucinations; and posthypnotic not be confidently predicted in advance by means amnesia. These factors are not an artifact of dif- of the Absorption scale or any of the usual sorts of ferential item difficulty, suggesting that their con- paper-and-pencil questionnaires. stituent items tap different component abilities. Absorption, in turn, is a component of open- This factor structure, in turn, suggests that there ness to experience, one of the “Big Five” dimen- may be different “types” of hypnotizable individ- sions of personality. But openness as currently uals, who are good at some kinds of items but not measured is a sort of hodgepodge of absorption, at others (Kihlstrom 2015). Still, the factors them- intellectance, and sociopolitical liberalism: hyp- selves are strongly intercorrelated, justifying the notizability correlates only with the first of these measurement of hypnotizability as a single facets (Glisky and Kihlstrom 1993). In this way, dimension. studying a relatively narrow problem in Hypnosis 3 hypnotizability has contributed to a better under- suggestions can produce significant pain relief in standing of the structure of personality in general. up to 50% of unselected patients. Hypnosis has been shown to be cost-effective in outpatient sur- gery, for example, reducing both medication Theories of Hypnosis usage in controlled sedation and procedural com- plications; it is also cost-effective, even though it Skepticism about hypnosis goes back to Mesmer adds another staff member (the hypnotist) to the and Esdaile. Most modern theorists agree that operating room. The effects of hypnosis are not hypnosis is “genuine,” in the sense that hypnotic attributable to the placebo effect, or the effects of subjects really do experience what is suggested to relaxation and distraction, and affect both the them, but differ about the mechanisms involved. sensory and suffering components. As another One group of theories emphasizes alterations of benefit, there is also evidence that hypnotic sug- consciousness occurring during hypnosis. gestions can accelerate the healing of surgical According to one view, hypnotic phenomena are wounds. characterized by a division in consciousness, such Hypnosis has long been used in psychotherapy that the subject is unaware of percepts and mem- (Lynn and Kirsch 2006; Lynn et al. 2011). Charcot ories that continue to influence experience, and Janet employed hypnosis in the diagnosis and thought, and action outside of conscious aware- treatment of hysteria. Although Freud, who stud- ness. In another version, the dissociative process ied with Charcot (and competed with Janet), ulti- alters the hierarchy of executive control systems, mately rejected hypnosis, hypnoanalysis so that hypnotic phenomena occur automatically, developed later under the theory that the state not as a result of deliberate effort. represented an adaptive regression that would Other approaches focus on underlying social- facilitate potentiate psych. A form of hypnother- cognitive processes. In one view, hypnotic sug- apy popularized by Milton Erickson, employing gestions are mediated by positive response expec- indirect suggestion, metaphors, and paradoxical tations which, somewhat like placebo effects, intention, among other “utilization techniques,” generate nonvolitional experiences through ideo- inspired Gregory Bateson’s concept of the double motor action. According to another, features of the bind and Jay Haley’s “strategic” approach to fam- hypnotic context encourage both positive ily therapy. Although tempting, it is not usually responses to hypnotic suggestions and a mis- advisable to employ direct hypnotic suggestions appraisal of these responses as involuntary expe- for symptom control. The admonition that hypno- riences rather than voluntary actions. At the sis cannot make subjects do anything they other- neuroscientific level of analysis, much specula- wise would not want to do applies to therapy as tion focuses on the dorsolateral prefrontal cortex well as to antisocial behavior. Along the same and the “default mode network” (Halligan and lines, clinicians should be careful not to treat Oakley 2013; Kihlstrom 2013). with hypnosis any condition that they are not qualified to treat without hypnosis. Hypnosis has also found a place in modern Applications cognitive behavioral therapy (CBT), often as an adjunct to other techniques (Green et al. 2014). Theoretical disputes aside, hypnosis has found a Early on, for example, Joseph Wolpe used hypno- number of applications in medicine, dentistry, sis to enhance relaxation during systematic desen- psychotherapy, and sports psychology. Certainly sitization. More recently, an emerging literature the most popular (and effective) application strongly suggests that adjunctive hypnosis can involves suggestions for analgesia to control potentiate outcome in a number of different pain (Hilgard and Hilgard 1975; Jensen and domains, including anxiety disorders, depression, Patterson 2014). Of course, hypnotizability mat- eating disorders, and post-traumatic stress disor- ters, but clinical studies indicate that hypnotic der (PTSD). In some cases, such as PTSD and 4 Hypnosis depression, the evidence favoring hypnosis meets References the strictest criteria for an “empirically supported treatment” (Chambless and Hollon 1998). In other Chambless, D. L., & Hollon, S. D. (1998). Defining empir- cases, hypnosis is promising, but the research ically supported therapies. Journal of Consulting & Clinical Psychology, 66,7–18. design lacks one or another feature that would Gauld, A. (1992). A history of hypnotism. Cambridge, UK: meet this standard. Of course, the success of Cambridge University Press. adjunctive hypnosis may depend on the hypnotiz- Glisky, M. L., & Kihlstrom, J. F. (1993). Hypnotizability ability of the patient. Precisely how hypnosis and facets of openness. International Journal of Clin- ical & Experimental Hypnosis, 41(2), 112–123. potentiates CBT is not well understood, and it Green, J. P., Laurence, J.-R., & Lynn, S. J. (2014). Hypno- has been argued that the hypnotic context has a sis and psychotherapy: From Mesmer to mindfulness. sort of placebo effect, capitalizing on patients’ Psychology of Consciousness: Theory, Research, & – beliefs about hypnosis and enhancing their expec- Practice, 1(2), 199 212. Halligan, P. W., & Oakley, D. A. (2013). Hypnosis and tations concerning the outcome of treatment. cognitive neuroscience: Bridging the gap. Cortex, Unfortunately, the use of hypnosis in psychother- 49(2), 359–364. apy is hampered by the relative lack of training in Hilgard, E. R., & Hilgard, J. R. (1975). Hypnosis in the hypnosis in medical and graduate schools. In the relief of pain. Los Altos: Kaufman. Jamieson, G. A. (Ed.). (2007). Hypnosis and conscous United States, excellent training is offered by the states: The cognitive neuroscience perspective. Oxford: Society for Clinical and Experimental Hypnosis Oxford University Press. and the American Society of Clinical Hypnosis, Jensen, M. P., & Patterson, D. R. (2014). Hypnotic professional organizations which also publish approaches for chronic pain management: Clinical implications of recent research findings. American Psy- journals devoted to clinical and experimental chologist, 69(2), 167–177. research. Kihlstrom, J. F. (1992). Hypnosis: A sesquicentennial essay. International Journal of Clinical & Experimen- tal Hypnosis, 40(4), 301–314. Kihlstrom, J. F. (1994). One hundred years of hysteria. In Conclusion S. J. Lynn & J. W. Rhue (Eds.), Dissociation: Clinical and theoretical perspectives (pp. 365–394). New York: The Guilford Press. Hypnosis offers much to interest a personality Kihlstrom, J. F. (2002). Mesmer, the Franklin Commission, psychologist. It exemplifies the challenge of and hypnosis: A counterfactual essay. International objectively studying subjective mental states. Journal of Clinical & Experimental Hypnosis, 50, 408–419. Hypnosis underscores the interaction of aptitude Kihlstrom, J. F. (2008). The domain of hypnosis, revisited. and attitude in human performance; it brings into In M. Nash & A. Barnier (Eds.), Oxford handbook of bold relief the question of how ideas translate into hypnosis (pp. 21–52). Oxford: Oxford University actions; and the relationship between hypnotist Press. Kihlstrom, J. F. (2013). Neuro-hypnotism: Hypnosis and and subject provides a laboratory model for the neuroscience. Cortex, 49(2), 365–374. study of dyadic interactions in general. And the Kihlstrom, J. F. (2015). Patterns of hypnotic response, search for the correlates of individual differences revisited. Consciousness & Cognition, 38,99–106. in hypnotizability revealed a heretofore Kihlstrom, J. F., & McConkey, K. M. (1990). William James and hypnosis: A centennial reflection. Psycho- unappreciated dimension of personality, openness logical Science, 1(3), 174–178. to experience, whose various facets deserve fur- Lynn, S. J., & Kirsch, I. (Eds.). (2006). Essentials of ther exploration in the future. Research on the clinical hypnosis: An evidence-based approach. Wash- development of hypnotizability may offer a new ington, DC: American Psychological Association. ’ Lynn, S. J., Rhue, J. W., & Kirsch, I. (Eds.). (2011). view of the child s distinction between imagina- Handbook of clinical hypnosis (2nd ed.). Washington, tion and reality and the development of the theory DC: American Psychological Association. of mind in general. Nash, M. R., & Barnier, A. J. (Eds.). (2008). Oxford hand- book of hypnosis: Theory, research and practice. Oxford, UK: Oxford University Press.