The Journal of article Does Clinical Hypnosis Have Anything to Do with Experimental Hypnosis? Michael Heap, PhD* Hypnosis originated as a healing practice and its historical roots can be traced back to the ideas and methods of the physician Franz Anton Mesmer in 18th century Europe. As we now understand it hypnosis is a normal psychological phenomenon that can be in- vestigated in the laboratory and understood in terms of mainstream psychology and the neurosciences. Normally one would expect there to be continuity between experimental research and theory on the one hand and the practical application of hypnosis on the other. In this paper it is suggested that there is reason to question how much the clini- cal application of hypnosis is informed by the non-clinical scientific evidence and even whether clinicians can be said to be using hypnosis as it is now defined and understood in the academic literature. These matters are also briefly addressed by reference to certain other contexts in which hypnosis is applied. The historical antecedents of Introduction modern hypnosis Implicit or explicit in most descriptions of hyp- A good starting point for this enquiry is to remind nosis are two key components, namely the ‘hyp- ourselves of the historical development of modern notic trance’ (or ‘altered state of consciousness’) hypnosis, the true origins of which can be traced and the use of suggestion. The two are presumed directly back to 18th century Europe and the ideas to be linked in that the subject is more responsive and practices of the Austrian physician Franz mbr.synergiesprairies.ca to suggestions when he or she is ‘in a hypnotic Anton Mesmer (1734–1815). Recall that Mesmer state’. A third component, namely the ‘induction proposed the existence of a universal force that he of hypnosis’, also links the two; the induction it- eventually called ‘animal magnetism’. Illness was self is a series of suggestions that directs or guides associated with disturbances in the natural tidal the subject into the hypnotic state. Finally one flow of animal magnetism in the body and Mes- can distinguish a fourth component, suggestibil- mer claimed the ability to restore this and thus ity or hypnotic susceptibility, which is the inher- heal the patient. His preferred technique was to ent responsiveness of the subject to suggestion. make slow passes with his hands over the patient’s In this paper I examine the relationship body from the head to the toe. In response to between the two key components of hypnosis this, patients would experience ‘crises’ (swooning, identified above — trance and suggestion — and convulsing, shaking, crying, laughing hysterically, explore the significance afforded to each in the etc). Finally they would appear to enter some kind historical development of hypnosis and in the of stupor with a glazed look in their eyes. Most * Honorary Lec- various contexts in which hypnosis is said to famously he devised group treatment methods at turer, Department of be taking place, notably the laboratory and the his salons in Paris in the 1770s and 80s. Psychology, University clinic. On this basis I shall raise the question How the theory and practice of hypnosis to- of Sheffield, Sheffield, whether the disparity in the way hypnosis is rep- day evolved from the methodology and ideas of United Kingdom. resented and applied in these different contexts mesmerism is a fascinating and instructive story e-mail: is often so wide that we may doubt whether the (see Gauld, 1992, for a comprehensive history). m.heap@sheffield. theoreticians and the practitioners are describing In summary (Heap, 2008a) first there was the ac- ac.uk the same phenomenon. knowledgement that central aspects of mesmeric practice, such as the bacquet, the mesmerist’s 17 || MBR || Volume : 1 || Issue : 1 article The Journal of Mind-Body Regulation passes, and the patients’ crises, were unneces- nosis (or its forerunner, mesmerism) with a key sary for the purposes of treatment. Mental and individual continued throughout much of this physical relaxation became the more characteris- period. However, unlike earlier formulations, the tic response of the patient from the start of the theories and models proposed by these writers procedure. Secondly we see the development of were based on well-controlled laboratory experi- theories based on biological accounts of the hu- ments on normal participants. I refer the reader man nervous system at the time. Later, psycho- to Lynne and Rhue (1991) and Nash and Barnier logical explanations were advanced and verbal (2008) for comprehensive accounts. suggestion became the core feature of hypnosis, Before proceeding, it is important to briefly both procedurally and theoretically. Finally it acquaint the reader unfamiliar with this work was established quite early on that people varied with what a laboratory session of hypnosis may in their responsiveness to hypnosis, only a minor- consist of. Firstly the experimenter will perform ity being very susceptible. a hypnotic induction procedure that usually One way of characterising this evolutionary consists of suggestions of mental and physical process is to say that gradually the role of a spe- relaxation and an inner focus of attention (say cial state or trance assumed less significance and on pleasant imagery). Then he or she will ad- the role of suggestion became more pivotal, along minister various suggestions that certain things with suggestibility. This process in fact occurred are happening to the subjects or that they are in very early on with the investigation by the 1784 certain situations that would, if they were real, Royal Commission of animal magnetism and significantly affect the way they are perceiving, its conclusion that mesmeric phenomena were thinking, feeling and behaving. Examples of sug- attributable to the subject’s imagination (Salas gestions are as follows: that one arm is becoming & Salas, 1996). A later illustration is the resolu- light and will float in the air; that an arm is too tion of the dispute that continued for around 20 heavy for the subjects to lift; that one hand is im- years, again in France, during the latter part of the mersed in ice and is feeling numb and insensitive; 19th century between Jean-Martin Charcot and that subjects can smell their favourite perfume; Hippolyte Bernheim and their associates (Gauld, that they see their best friend in front of them; 1992). Charcot drew comparisons between hyp- that they cannot see an object in front of them or notic phenomena and neurotic symptoms in his hear a particular sound; and that they are reliving Post-hypnotic suggestion hysterical patients. He proposed a three-stage an event from childhood. Some suggestions are model of hypnosis, namely lethargy, then cata- intended to take effect after the subject has been A suggestion that is admin- istered during hypnosis but lepsy, then somnambulism. However, Bernheim alerted and are termed ‘post-hypnotic’. The ex- is intended to take effect demonstrated that the entire range of hypnotic tent to which the subjects respond to these sug- following termination of the phenomena could be elicited in 15% of the normal gestions and experience the effects as realistic and mbr.synergiesprairies.ca hypnotic experience. population. He was also very critical of Charcot’s automatic varies from person to person; some are three-stage model and demonstrated that these highly responsive, some do not respond at all, stages were not representative of the usual re- and most lie somewhere in between. sponse of subjects to hypnosis. According to The main issue of contention amongst mod- Bernheim (1888/1973) hypnosis is ‘the induction ern theorists has been whether, in order to explain of a peculiar psychical condition which increases hypnotic phenomena such as enhanced suggest- susceptibility to suggestion’ (p. 15). This emphasis ibility, it is necessary to posit an altered state of on suggestion can be seen in the titles of several consciousness or whether all can be accounted of his writings including his book whose title in for by reference to concepts and processes from the English translation is Hypnosis and sugges- mainstream social and cognitive psychology such tion in psychotherapy: A treatise on the nature and as imagination, expectancy and role enactment. uses of hypnotism (Bernheim, 1988/1973). One The assault on state theories of hypnosis has been of his students, Émile Coué, became famous for quite intense, to the extent that sceptics have felt establishing a system of psychotherapy based on entitled to say that ‘hypnosis is a myth’ or ‘there is repeated autosuggestion without the induction of no such thing as hypnosis’ (see Baker, 1990, for a hypnosis. highly sceptical exposition of hypnosis). Despite the ferocity of the debate between the Modern theoretical ‘state’ or ‘special process’ supporters and those approaches to hypnosis who adopt the socio-cognitive position, there is good evidence that over the last 10 years or so I shall now fast-forward this brief account of the a greater consensus on the fundamental nature evolution of hypnosis to developments during the of hypnosis has emerged in the academic litera- second half of the 20th century. The identifica- ture. (A comparison between the chapters in, tion of a particular theoretical position on hyp- say, Lynne and Rhue, 1991, and the theoretical 18 || MBR || Volume : 1 || Issue : 1 article The Journal of Mind-Body Regulation accounts in Nash and Barnier, 2008, bears this 1991; Spanos, Cross, Menary & Smith, 1988). out.) It is my belief that the modern state-versus- According to this approach, unlike low respond- non-state controversy parallels the earlier conflict ers, highly responsive subjects have a positive between the relative significance of the induction attitude to hypnosis and willingly become ‘stra- of ‘trance’ on the one hand and the process of sug- tegically involved’.