CuFwentEamments” EUGENE GARFIELD INSTITUTE FOR SCIENTIFIC INFORMATION* 3501 MARK ET ST, PHILADELPHIA, PA 191C4 Taking the Hype Out of Hypnosis and a Look at Its Entrancing Use in Pain Control Number 3 Januarv ,, 19, 1987 In the most hackneyed depictions of hyp- Chinese, Egyptians, and Gre&s.2 There nosis on television and in the movies, the are even rdlusions in the Bible to activities hypnotic subject is invariably shown star- that are hypnotic in character. Historical ac- ing at a swinging pocket watch or pendu- counts of hypnotism in the modem era gen- lum while repeating the instructions of the erally begin with Franz Anton Mesmer hypnotist in a halting monotone. Once the (1734-18 15), an Austrian physician whose “trance” is broken through a snap of the name survives in the word “mesmerize. ” fingers or some other hypnotically suggested Mesmer is most often associated with the signal, the subject awakens, fully if uncon- theory of “animal magnetism. ” As dis- sciously prepared to perform whatever deed cussed by Henri F. Ellenberger, Universi- the hypnotist has directed. Other popular no- ty of Montreal, Canada, in 7?seDiscovery tions surrounding hypnotism no doubt de- of the Unconscious, the theory involved the rive from entertainers known as stage hyp- existence of a subtle physical fluid that sup- notists, who induce volunteers from their au- posedly filled the universe and connected hu- diences to engage in comic or ribald behav- mans, the earth, and the heavenly bodies. ior for the amusement of the others. Believing that disease originated from an These distorted, inaccurate views do not imbalance of this magnetic fluid in the do justice to the serious discipline of clini- human body, Mesmer maintained that cal hypnosis. Although not entirely free of restoring the fluid’s equilibrium would have controversy and criticism, clinical hypno- a curative effect. 3 His methods included sis has been recognized for more than a cen- rather theatrical sessions in which he would tury as a legitimate tool in the treatment of pass his hands over his patients in an attempt a variety of disorders. In rezent years, hyp- to influence these fluids. The patients would nosis has been associated with behavior often go into seizures and awaken apparently modification in the treatment of cigarette cured. Although Mesmer’s procedures and smoking, overeating, and assorted phobic the theory of animal magnetism were even- disorders. Hypnosis has even been used in tually discredited, this era did mark the be- successfully treating dermatological disor- ginning of serious scientific investigation in- ders, such as warts, according to Harold B. to hypnosis and its applications. Crasilneck and James A. Hall, southwestern Most historians credit James Braid, a Me&al School, University of Texas Health Scottish surgeon, with coining the word Science Center, Dallas. 1 @. 369-82) In this “hypnotism” in the 1840s, although there essay, however, I’ll concentrate on research is evidence that the term was used earlier.4 concerning hypnosis and pain control. The word comes from the Greek hyprsos, In his review of the historical antecedents meaning “to sleep. ” Braid’s theories, of modem hypnotism, William E. Edrnon- though not entirely accurate, did much to ston, Jr., Colgate University, Hamilton, bring hypnosis research into the realm of sci- New York, notes that techniques resembling entific respectability. He recognized, for ex- hypnotic induction can be traced back to ample, the importance of verbal suggestion healing praetiees among the ancient Hindus, in the hypnotic process. s Throughout the 14 latter half of the nineteenth century, theo- ject while listening to the instructions of the ries of hypnosis underwent further refine- therapist. Another technique is to have the ment. Crasilneck and f-fallnote tiat resmrch patient hold a coin at arm’s length on the on hypnosis declined in the early part of the fingertips, while, in response to the twentieth century but stepped up consider- therapist’s suggestions of deeper and deeper ably in the years after World War IL In the relaxation, the arm is allowed to drop slowly US, the stature of hypnosis research was aid- until it rests in the patient’s lap. Another ed by a 1958 policy statement from the technique is to encourage the patient to American Medical Association recognizing imagine that one arm is growing pro- hypnosis as a legitimate treatment tool in gressively lighter as if pulled by a balloon, medicine and dentistry. 1 (p. 13) so that the arm levitates of its own accord. Or the therapist may simply have the patient visualize a scene, such as a beach, or the Hypnotic Technique patient’s favorite place. Once the patient is According to Andr6 M. Weitzenhoffer, relaxed, the therapist may try a “deepen- Stanford University, California, the induc- ing” technique, such as suggesting that the tion of hypnosis consists of three phases: patient is descending on an elevator or preparation, induction proper, and deepen- escalator toward deeper levels of relax- ing.6 One step in preparation, he notes, is ation.g allaying any fears or uncertainties that the There is some disagreement among re- patient may have about the process or ef- searchers concerning the exact nature of the fects of hypnosis. Another step, according hypnotic trance. Reviewing current theoret- to William C. Wester II, Behavioral Science ical approaches to hypnosis, Brian J. Center, Cincinnati, Ohio, involves a careful Fellows, Department of Psychology, Ports- assessment of the symptom or symptoms for mouth Polytechnic, UK, mentions the de- which the patient is seeking help. T Since bate between’ ‘state” and’ ‘non-state” the- some people are more susceptible than orists. The state theorists tend to argue that others to hypnosis. the therapist may choose hypnosis involves a special, or unique, state to administer one of the rating sales devel- of consciousness. Non-state themists, on the oped by researchers to gauge “hypnotic other hand, prefer to view hypnotic response talent. ” As reviewed by Barbara DeBetz, in terms of other psychosocird, cognitive, Columbia University College of Physicians or behavioral factors. 10 For example, aild Surgeons, New York, in A Primer of Theodore X. Barber, director, Mediield Clinical Hypnosis, the scales record such Foundation, Massachusetts, in his book items as eye closure, motor inhibition, age Hypnosis: A Scientific Approach, criticizes regression, time distortion, and other char- the entire construct of’ ‘hypnosis” (includ- acteristics of subjects undergoing hypnosis. ing’ ‘hypnotic state” and’ ‘trance”) as mis- Subjects who score high on such measures leading and unnecessary. The effects of hyp are judged to have heightened responsive- nosis, he notes, may be due to such factors ness to hypnosis. Hypnotizability seems to as the subject’s expectations, or the desire be related to a subject’s ability to become to comply with the therapist, rather than to imaginatively involved in an activity-read- any unique state of consciousness achieved ing a book, or watching a play or fiim, for through hypnotic induction. 11 (p. 7-10) example. Standard tests for hypnotic respon- In A Primer of Clinical Hypnosis, G&ard siveness include such scales as the Stanford Sumen, New York University Medical Cen- Hypnotic Susceptibility Scales, the Spiegel ter, New York, writes that although there Eye-Roll Technique, the Harvard Group is fairly good agreement concerning hypnot- Scale of Hypnotic Susceptibility, and the ic phenomena, there is a lot of disagreement Barber Suggestibility SCaie.g about explaining them. 12This disagreement Actual techniques of induction, as dis- applies to hypnosis and pain relief as well. cussed by Wester and psychologist Alex- Despite considerable research and a good ander H. Smith, Jr., may include having the deal of theorizing, some of which 1’11ex- patient gaze fixedly at a certain spot or ob- amine later, the exact mechanisms at work 15 in hypnosis and analgesia remain unclear. out, involves more than the reduction of anx- As Crasilneck and Hall point out, perhaps iety. It involves reductions in the other as- the one conclusion on which all authorities pects of pain, which they term the senso~ would agree is that we do not know how or and the suflen”ng components. “fiey also why hypnosis controls organic pain. I (p. note that hypnotic procedures are equally ap- 97) plicable to many painfid conditions. 15 (p. 190) Hypnosis and Pain Control One of Ernest Hilgard’s theories in ex- From early in the nineteenth century there plaining hypnotic phenomena involves the have been accounts of hypnotic techniques concept of dissociation. This theory states being used in the control of pain. James Es- that particular cognitive systems may be split daile, for example, a British surgeon work- off from the major (i.e., conscious) cogni- ing in India in the 1840s, reportedly per- tive system and that these systems are sub- formed over 300 major operations using ject to different cognitive controls. In regard mesmerism as the sole anesthetic, according to pain control, hypnotic dissociation seems to Graham F. WagstafY,University of Liver- to involve an amnesia-like process whereby pool, UK.13 (p. 153) pain is diverted from reaching the conscious One of the best-known modem research- level. lb ers on hypnosis and pain control is Ernest Psychiatrist Milton H. Erickson, former R. Hilgard, Department of Psychology, editor of the American Journal of Clinical Stanford. We reviewed his work recently, Hyrmosis, was very influential in his clinical when he received the 1984 National Acade- uses of hypnosis. In his beak Hjptwtherapy, my of Sciences Award for Excellence in coauthored with psychologist Ernest L, Scientific Reviewing for his reviews on con- Rossi, Erickson explains his view of hyp- ditioning and learning theory. 14 Much of nosis as a process of what he calls utilizat- Hilgard’s work on hypnosis and analgesia, ion.